BACKGROUND/AIMS: Guidelines for current postoperative colonoscopic surveillance are not specified in colorectal cancer (CRC) patients with synchronous adenoma (SA). We performed this retrospective study to determine the postoperative colonoscopic surveillance interval for the CRC patients with SA. METHODS: One hundred and twenty-four CRC patients with SA (SA-group) and the same number of patients without SA (NSA-group) were selected from our database. Two groups were matched by the stage of CRC. Median colonoscopic surveillance period was 55 (12-99) months. The colonoscopic surveillance frequency and interval were similar between the two groups. RESULTS: Mean age was higher and male was more frequent in SA-group than NSA-group (p= 0.0001). The incidence of missed adenoma, advanced missed adenoma and metachronous adenoma (MA) were higher in SA-group (30.8% vs. 5.8% at 1st yr., p=0.0001; 4.4% vs. 0%, p=0.0001; 31.1% vs. 9.1% at 2nd yr., p=0.016) during the first consecutive two years of surveillance. The MA- and advanced-MA-free survival rate were lower in SA-group (24.6% vs. 6.6%, p=0.0001; 4.1% vs. 0%, p=0.02) during three years after surgery. Dysplasia of the SA (p=0.04; OR, 110.3; 95% CI, 1.13-10742.6) and presence of missed adenoma (p=0.036; OR, 43.6; 95% CI, 1.28-1490.1) were risk factors for the advanced MA on a multivariate analysis in SA-group. CONCLUSIONS: Postoperative colonoscopic surveillance at first year after surgery is warranted in CRC patients with SA.
Adenoma/diagnosis/*surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma/diagnosis/*surgery ; Colonic Neoplasms/diagnosis/*surgery ; *Colonoscopy ; Colorectal Neoplasms/diagnosis/*surgery ; Disease-Free Survival ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis/*surgery

No abstract available.
Atrioventricular Block

We experienced a case of diastasis of the symphysis pubis accompanying severe pubic pain and serious gait disturbance, which was developed at 34 weeks gestation before labor pain in 36-year-old primiparous woman, who has experienced previous cesarean section at her first pregnancy due to pelvic pain before onset of labor, so we report a case with a review of the literature.
Adult ; Cesarean Section ; Female ; Gait* ; Humans ; Labor Pain* ; Pelvic Pain ; Pregnancy

Epithelioid hemangioendothelioma (EHE) is a well-differentiated and rare vascular tumor. Systemic metastases are uncommon. Herein, we present a patient with skin metastasis of pulmonary EHE (PEH) that was treated by wide excision. A 76-year-old male was evaluated due to pulmonary thromboembolism and a solitary pulmonary nodule. A biopsy was performed and pathological examination of the mass confirmed EHE. No metastasis was observed. The patient returned to care approximately two years later due to a painful nodule in the right lower leg. A skin biopsy showed metastatic EHE from the lung. We used a safety margin of 1 cm based on clinical experience, because no prior case had been reported regarding the resection margin appropriate for primary cutaneous EHE and skin metastases of PEH. At four months after surgery, the patient recovered without complications or recurrence. Skin metastasis of PEH is extremely rare, and only two cases have been reported in the literature. In this case, we report a rare case of PEH with histologically diagnosed skin metastasis that was successfully treated by curative resection. It is expected that this case report will provide a helpful contribution to the extant data regarding PEH metastases.
Aged ; Biopsy ; Dermatologic Surgical Procedures ; Hemangioendothelioma, Epithelioid* ; Humans ; Leg ; Lung ; Male ; Neoplasm Metastasis* ; Pulmonary Embolism ; Recurrence ; Skin* ; Solitary Pulmonary Nodule

OBJECTIVE: The purpose of this study was to evaluate the risk of cesarean section in nulliparous women who undergone induction at postterm pregnancy. METHODS: The retrospective study was conducted from March, 1997 to March, 2005 by reviewing 331 nulliparous patients more than 41 weeks' gestation delivered after induction at our Hospital. The evaluated variables to assess the risk of cesarean section were maternal age, body mass index (BMI), gestational age (GA), Bishop scores (BS), fetal body weight (FBW), fetal head circumference (FHC) and fetal sex. t-test and x2-test were used to compare these categorical variables. RESULTS: The study included 331 nulliparous singleton pregnant women undergoing elective induction for postterm pregnancy: 127 (38.4%) delivered babies by cesarean section due to induction failure, progression failure and fetal distress, whereas 204 (61.6%) delivered vaginally. The mean maternal ages were 27.59+/-2.57 in cesarean delivery group and 26.99+/-2.61 in vaginal delivery group. The average values of BMI at postterm in cesarean and vaginal delivery groups were 26.70+/-2.82 and 25.75+/-2.67 kg/m2. GA was 41.36+/-0.27 weeks in cesarean delivery group, whereas 41.20+/-0.19 weeks in vaginal delivery group. The average FBW and FHC were 3460.31+/-358.22 g and 34.59+/-1.18 cm in cesarean delivery group, compared to 3363.95+/-361.22 g and 34.03+/-1.34 cm in vaginal delivery group. CONCLUSION: The BMI, FBW and FHC have linked to the risk of cesarean delivery in nulliparous women who underwent elective induction. Thus, these information would provide the useful tools to assess the risk of cesarean section in postterm nulliparous patients for planning an induction.
Body Mass Index ; Cesarean Section* ; Female ; Fetal Distress ; Fetal Weight ; Gestational Age ; Head ; Humans ; Maternal Age ; Pregnancy ; Pregnancy* ; Pregnant Women ; Retrospective Studies

The mechanism of apoptosis was first discovered at the end of the 19th century, but it was only recently that its importance was recognized. Not only in a pathologic environment but also in a normal environment, apoptosis has an important role in homeostasis. The number of cells is restricted by apoptosis which is controlled by several SlgBS lll VlVO. In pregnancy, the placenta regulates the maternal-fetal exchange of molecules and functions as a barrier for the protection of the fetus. As the pregnancy proceeds, changes occur in the number and components of placental cells. Observing the placental tissues, apoptosis was found in the syncytiotrophoblasts of early and late pregnancy. In particular, the fact that apoptosis observed in the placenta of late pregnancy supports the hypothesis that pmgrammed cell death is a normal sequence. Pregnancy-induced hypertension is usually accompanied by abnormal placenta and intrauterine growth restriction. In this study, using the TdT-FragEL DNA fragmentation detection kit, the changes in the nucleus by apoptosis in the placental tissues of 23 to 40 gestational weeks in preeclampsia and eclampsia were compared with normal placenta. Apoptosis was observed in the normal term placenta and in pregnancy-induced hypertension patients, regardless of whether vasculopathy was observed in Doppler ultrasound or confirmed by pathology, more apoptoses were observed aside from the number of gestational weeks.
Apoptosis ; Cell Death ; DNA Fragmentation ; Eclampsia ; Female ; Fetus ; Homeostasis ; Humans ; Hypertension, Pregnancy-Induced* ; Maternal-Fetal Exchange ; Pathology ; Placenta* ; Pre-Eclampsia ; Pregnancy ; Trophoblasts ; Ultrasonography

We experienced 3 cases of early stage tubal cancer incidentally recognized during the operation and diagnosed pathologically after surgery of the tubo-ovarian abscess, the symptomatic adenomyosis, the myoma with adnexal cyst patients, so we report our cases with a review of the literature.
Abscess ; Adenomyosis ; Humans ; Myoma

Intrauterine contraceptive device (IUD) is the most common contraceptive method in the world, but it exists a little risk of uterine perforation and even more severe risk such as a perforation of intra-abdominal organs. In this case, the patient recognized that the previously inserted IUD was translocated but she was asymptomatic without any management. After insertion of the second IUD, she visited our hospital for lower abdominal pain. The abdominal X-ray finding and transvaginal sonography revealed one translocated IUD in peritoneal cavity and another IUD in intrauterine cavity. Thus, we report a case with the laparoscopic diagnosis of small bowel perforation by a previously inserted IUD and its removal by segmental resection of small bowel after mini-laparotomy, along with the brief review.
Abdominal Pain ; Contraception ; Diagnosis ; Humans ; Intrauterine Devices* ; Peritoneal Cavity ; Uterine Perforation

BACKGROUND: The facial bone has a complex structure compared to other bones, and various types of fractures can occur due to its characteristics. Among them, in comminuted fractures of anterior maxillary wall, multiple depressed and impacted bony segments cannot be reduced easily when performing internal fixation using plates and screws or wires, and inadequate restoration leads to a range of complications. This paper introduces an alternative technique using a resorbable mesh with fibrin glue to restore comminuted fractures of anterior maxillary wall. METHODS: Thirteen patients were diagnosed with comminuted fractures of anterior maxillary wall between March 2017 and February 2018 in the authors’ hospital. All patients with comminuted fractures of anterior maxillary wall underwent restoration using resorbable mesh with fibrin glue. The patients’ demographics, causes of facial trauma, mean operation time, length of hospital stay, follow-up period, and complications were recorded. RESULTS: No major complications and only one hypoesthesia of the skin area was noted. Three months after surgery, the hypoesthesia recovered completely. After surgery (mean, 3.9 months; range, 2–12 months), computed tomography showed that the bone fragments in all patients were fixed successfully in their anatomical places. CONCLUSION: In comminuted fractures of anterior maxillary wall, the use of a resorbable mesh with fibrin glue can be an advantageous and effective method for a successful restoration without complications.
Demography ; Facial Bones ; Fibrin Tissue Adhesive* ; Fibrin* ; Follow-Up Studies ; Fractures, Comminuted* ; Humans ; Hypesthesia ; Length of Stay ; Methods ; Skin

OBJECTIVE: To assess the efficacy of spinal manipulation for the patients with acute low back pain. METHOD: Twenty patients with acute low back pain have been received spinal manipulation 3 times per week. The 10-point scale and the distance of the fingertips from the floor on maximum forward flexion (fingertip-flexion test) were checked pretreatment, immediately posttreatment, 2 days posttreatment, 1 week posttreatment, and 2 weeks posttreatment. RESULTS: The results were as follows: 1) The 10-point scale at pretreatment, immediately posttreatment, 2 days posttreatment, 1 week posttreatment, and 2 weeks post-treatment were 10.0+/-0.0, 5.8+/-1.4, 2.2+/-1.0, 1.1+/-0.2, and 1.0+/-0.0, respectively (P<0.01). 2) The fingertip-flexion test at pretreatment, immediately posttreatment, 2 days posttreatment, 1 week posttreatment, 2 weeks posttreatment were 35.4+/-8.4 cm, 22.4+/-7.0 cm, 14.1+/-4.9 cm, 7.4+/-3.6 cm, and 5.4+/-4.6 cm, respectively (P<0.01). CONCLUSION: In our study, the spinal manipulation for the patients with acute low back pain offered significant efficacy and appeared to be a reasonable therapeutic option. But the effectiveness of this method leaves a critical aspect that should be dealt with in future studies.
Humans ; Low Back Pain* ; Manipulation, Spinal*