No abstract available.
Aged* ; Femur* ; Humans

A 39-year-old male patient presented with chronic abdominal pain and intermittent diarrhea for 8 months. Colon study showed an annular stricture at the ileocecal value. He underwent ileocecectomy with clinica impression of intestinal tuberculosis. The resected intestinal wall along the lieocecal junction demonstrated a localized, annular constriction and intramural nodular inflammatory growth in which were clusters of multiple microabscesses as well as acute and chronic inflammatory cell infiltration including eosinophils and fibrosis. Encountered were a few resolving phase of parasitic granulomatous tunnels in which fragments of degenerated sparganum with foreign body reaction were found in one focus. He had history of ingesting uncooked frogs 2 years ago. The above case suggests that differential diagnosis of inflammatory tumorous lesions in the intestine should include sparganosis in Korea.
Male ; Humans ; Diagnosis, Differential

Elevations of serum PSA concentrations have been widely reported due to prostatic cancer, but other causes haute not been formally characterized or quantified. So that, we evaluated the causes of elevated serum PSA concentrations in men whose prostate biopsy showed no cancer. The effects of prostate volume, inflammation, echogenecity on ultrasound and calculi were examined in 43 men that serum PSA concentrations greater than 4.0 ng/ml with negative biopsy. These men were compared with 16 men who had suspicious rectal examinations, negative biopsy and serum PSA concentrations of 4.0 ng/ml. or less. Prostate volume (22.5%, p<0.005) and inflammation (3%, p<.05) were significantly associated with elevated serum PSA concentrations (>4.0 ng/ml) than control group (< or = 4.0 ng/ml) and age echogenecity on ultrasound and calculi were statistically less significant (p> or =0.05). In summary, prostate volume and inflammation were the most important factors contributing to increase serum PSA concentration in men that clinically undetectable prostatic cancer.
Biopsy ; Calculi ; Humans ; Inflammation ; Male ; Prostate ; Prostatic Neoplasms ; Ultrasonography

PURPOSE: The hemostasis and closure of the collecting system are still problems to be overcome during a partial nephrectomy. Herein, our initial experience of a parenchymal compression technique, without clamping of the renal pedicle during an open partial nephrectomy, is reported. MATERIALS AND METHODS: Between May 2000 and August 2005, 10 patients underwent an open partial nephrectomy, without pedicle clamping, for a renal mass. The open partial nephrectomy was performed under regional ischemia, which was achieved by parenchymal compression using a long curved vascular clamp. Several parameters were retrospectively assessed, including the tumor size, location, pathology, estimated blood loss, preoperative and postoperative serum creatinine, complications, and tumor recurrence. RESULTS: The mean mass size was 23.8mm, ranging between 12 and 55mm, and the tumors were located in the upper, mid and lower poles in 2, 3 and 4 cases, respectively. Pathological examinations revealed renal cell carcinomas in 6, an angiomyolipoma in 1, and complicated renal cysts in 3 patients. In all the patients with renal cell carcinoma, the frozen and permanent sections analyses confirmed negative margins. There were no differences between the preoperative and postoperative creatinine levels, with no significant complications observed, including urinary leak and bleeding, during the recovery period. No patient developed a local recurrence or distant metastasis during the mean follow-up period of 17.2 months. CONCLUSIONS: This technique is simple, and can be easily practiced by any urological surgeon, without concerns relating to the ischemic time and complications. It is suggested that the regional parenchymal compression is an efficient technique for hemostasis and repair of the collecting system during an open partial nephrectomy.
Angiomyolipoma ; Carcinoma, Renal Cell ; Constriction* ; Creatinine ; Follow-Up Studies ; Hemorrhage ; Hemostasis ; Humans ; Ischemia ; Kidney Neoplasms ; Neoplasm Metastasis ; Nephrectomy* ; Pathology ; Recurrence ; Retrospective Studies

Wilms' tumor is a rare malignant renal tumor in adults and it usually presents as a parenchymal mass that resembles renal cell carcinoma. The authors observed one case of adults Wilms' tumor developing in the renal pelvis and the initial diagnosis was renal pelvis tumor. The patient underwent radical nephroureterectomy with bladder cuff excision and adjuvant chemotherapy with the combination of vincristine and actinomycin. The patient has remained healthy and was without evidence of tumor recurrence on a follow-up CT scan at 18 months postoperatively.
Adult ; Carcinoma, Renal Cell ; Chemotherapy, Adjuvant ; Dactinomycin ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney Pelvis* ; Recurrence ; Tomography, X-Ray Computed ; Urinary Bladder ; Vincristine ; Wilms Tumor*

BACKGROUND/AIMS: Balloon dilatation is a useful alternative to surgery in patients with benign pyloric stenosis. However, little data are available on the long-term outcome of the procedure. This report was attempted to determine the safety and efficacy of endoscopic balloon dilatation for 14 patients with gastric outlet obstruction caused by duodenal ulcer. METHODS: Review of medical records or telephone interview was performed retrospectively. RESULTS: Follow-up was conducted for median 18.5 months (3-48 months). Gastric outlet strictures had a median diameter 6 mm (range, 2-9 mm). Five (35.7%) patients had active ulcer. 12 mm to 18 mm balloons were inflated a median of 1 times (range, 1-4 times) for a median of 4 minutes (range, 1-11 minutes). Thirty-two procedure (1.5/patient) were performed; 9 patients (64.3%) had one treatment and 5 patients (35.7%) had multiple treatment. Immediate symptomatic relief was achieved in 13 patients (92.8%) and 7 patients (50%) achieved sustained symptomatic relief. Dilatation failed only in 2 patients (14.3%) ultimately and both recovered by palliative bypass surgery. No complication was noted during treatment. CONCLUSIONS: Endoscopic balloon dilatation is safe and effective for most patients with gastric outlet obstruction induced by duodenal ulcer. And due to limitation of retrospective aspect of this report, further prospective, randomized studies must be performed.
Constriction, Pathologic* ; Dilatation* ; Duodenal Ulcer ; Follow-Up Studies ; Gastric Outlet Obstruction ; Humans ; Interviews as Topic ; Medical Records ; Pyloric Stenosis ; Retrospective Studies ; Ulcer

BACKGROUND: The purpose of this study is to compare the difference of the symptom, sign and laboratory findings among chronic inflammatory bowel diseases such as ulcerative colitis, Crohn's disease and tuberculous colitis in Korea. METHODS: We studied in Chungnam National University Hospital from March, 1990 to December, 1998. Seventy-eight cases of ulcerative colitis, fifteen cases of Crohn's disease, and thirty-nine cases of tuberculous colitis were analyzed in terms of age, sex, symptomatology, laboratory findings, radiologic findings and consequence of treatment. RESULTS: The sex ratio of ulcerative colitis, Crohn's disease and tuberculous colitis were 1.17:1, 1.14:1, and 1.29:1, respectively, and the mean age were 39.3, 26.5 and 36.0 years, respectively. The most common symptoms of ulcerative colitis, Crohn's disease and tuberculous colitis were bloody stool, diarrhea, and abdominal pain, respectively. In terms of symptoms and signs, we found that significant differences were bloody stool, diarrhea, and weight loss. Patients with tuberculosis colitis revealed significantly high rate of tuberculous lesion on chest X-ray. Among them, 14(35.9%) of the cases showed active tuberculous lesions. In terms of anatomical distribution of the lesion, the most frequently involved sites of ulcerative colitis, Crohn's disease and tuberculous colitis were rectosigmoid colon. descending colon, and ileocecal valve, respectively. CONCLUSION: In differential diagnosis of ulcerative colitis, Crohn's disease and tuberculous colitis, we should consider clinical findings, laboratory findings, colonoscopic appearance, histologic assessment, anatomical distribution of the lesions, and treatment course.
Abdominal Pain ; Chungcheongnam-do ; Colitis ; Colitis, Ulcerative ; Colon ; Colon, Descending ; Crohn Disease ; Diagnosis, Differential ; Diarrhea ; Humans ; Ileocecal Valve ; Inflammatory Bowel Diseases* ; Korea ; Sex Ratio ; Thorax ; Tuberculosis ; Weight Loss

Salmonella infection is an acute systemic disease that can lead to diffuse organ involvement with septicemia and cause clinically a variety of complications. But acute acalculous cholecystitis and acute hepatitis with jaundice due to Salmonella typhi occurred rarely. A 42 years old female was admitted with fever, chilling sensation and abdominal pain. On admission, the blood, stool, bile acid and bone marrow cultures were positive for Salmonella typhi. The patient had subsequently developed acute acalculous cholecystitis and acute hepatitis with jaundice. Her symptoms and signs resolved after cholecystostomy, parenteral antibiotic (ciprofloxacin) and supportive treatment. We report a case of acute acalculous cholecystitis and acute hepatitis with jaundice in a 42-ear-ld female, whose conditions were recovered completely after cholecystostomy and administration of ciprofloxacin, with reviewing the literatures.
Abdominal Pain ; Acalculous Cholecystitis* ; Adult ; Bile ; Bone Marrow ; Cholecystostomy ; Ciprofloxacin ; Female ; Fever ; Hepatitis* ; Humans ; Jaundice ; Salmonella Infections ; Salmonella typhi* ; Salmonella* ; Sensation ; Sepsis

BACKGROUND/AIMS: After colorectal cancer surgery, colonoscopic surveillance should be done for prevention and early detection of secondary cancer. This study aimed to identify the group with high risk of developing colorectal adenoma after curative surgery of colorectal cancer. METHODS: We retrospectively investigated the medical records of the subjects of 130 patients who had been examined using colonoscopy before and after the curative surgery. RESULTS: The average age was 59.4 years. Synchronous adenomas were in 42 patients (32.3%). The occurrence rate was significantly high in men (38.8%) than women (22.0%). After the operation, the mean interval of examining colonoscopy was 11.6 months (3-24 months) and metachronous adenomas were detected in 26 patients (20.0%). The patients who have both metachronous and synchronous adenomas were observed in 13/42 (30.9%) and the patients of metachronous adenomas without synchronous adenomas were observed in 13/88 (14.8%). The occurrence rate of metachronous adenomas with synchronous adenomas was significantly high. The frequency of synchronous adenomas didn't increase with age. However, the frequency of metachronous adenomas increased with age: 0/9 (0%) under 40 years, 7/49 (14.3%) in 41-61 years and 19/72 (26.4%) over 61 years. The occurrence rate was higher in men (26.3%) than women (10.0%). CONCLUSIONS: The occurrence rate of metachronous adenomas after colorectal cancer surgery was higher in the patients with synchronous adenomas, male gender and old aged patients.
Adenoma/*diagnosis ; Adult ; Aged ; Colonoscopy ; Colorectal Neoplasms/*surgery ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis ; Neoplasms, Second Primary/*diagnosis ; Risk Factors

Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.
Administration, Intravenous ; Administration, Oral ; Cerebrospinal Fluid ; Drug Therapy ; Early Diagnosis ; Humans ; Intracranial Pressure ; Meningeal Carcinomatosis* ; Methotrexate ; Molecular Biology ; Molecular Weight ; Perfusion