This study was designed to evaluate the worth of preoperative chemoradiation therapy in the management of locally advanced rectal cancer. Between march 1993 and January 1997, 64 patients with adenocarcinoma of the rectum were treated with preoperative irradiation followed by operation by one surgeon at department of surgery, Chungnam national university hospital. Cancers were treated with high-dose radiation (45 to 54 Gy) with (group 2) or without (group 1) chemotherapy Preoperatively 64 Patients were analysed prospectively, of these, 15 cases were preoperative radiotherapy alone arm and 49 cases were preoperative radiotherapy plus chemotherapy arm. The average age of the patients were 56 years (range 38~67) in group 1 and 57 years (range 27~80) in group 2. Male to female ratio was 8 : 7 in group 1 and 30 : 19 in group 2. Most clinical stage of the primary tumor mass were 73 (80% in Group 1,96% in group 2), being palpated slightly fixed (40% in group 1, 43% in group 2) or fixed (13.3% in group 1, 24.5% in group 2). As to distance of tumor from anal verge, most patients ranged from 4 to 8 cm (53% in group 1, 63.3% in Group 2). Chemotherapy consisted of 2 cycles of 5-fluorouracil (500 mg/m2/day for S days) delivered as a continuous infusion or bolus therapy and low-dose leukovorin (20 mg/m2/day for 5 days). After six weeks resting period of radiation, definitive surgical approach was performed. Overall treatment related toxicity rate was similar in both group except erythema on perineal skin, which was more frequent in group 2 than in group 1. Most frequent postoperative complication was intestinal obstruction (7.8%) followed by wound infection (6.3%), but there was no significant difference between two groups. There was one case of postoperative mortality in group 2 patients at 44 days after operation due to pneumonia and sepsis combined with liver cirrhosis. Tumor depth was downstaged in 38.5% of group 1 and 70% of group 2 patients on preoperative CT staging, and nodal downstaging was more effective on the respect of postoperative pathological report. Overall recurrence rate was 38.5% in group 1 and 20.5% in group 2. Of these, failure occured first as a distant metastasis more frequently than as a local recurrence in both group. These data do suggest that the preoperative chemotherapy and radiotherapy used are as safe as preoperative radiotherapy alone. Futhermore, tumor and lymph node downstaging are more effective in combined arm. Preoperative chemotherapy will more promising in prevention of distant metastasis when treated in the period of least metastatic tumor burden. Whether combined arm will have greater or lesser survival awaits the completion of this relevant study.
Adenocarcinoma ; Arm ; Chungcheongnam-do ; Drug Therapy ; Erythema ; Female ; Fluorouracil ; Humans ; Intestinal Obstruction ; Leucovorin ; Liver Cirrhosis ; Lymph Nodes ; Male ; Mortality ; Neoplasm Metastasis ; Pneumonia ; Postoperative Complications ; Prospective Studies ; Radiotherapy ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sepsis ; Skin ; Tumor Burden ; Wound Infection

A clinical observation on the vesicovaginal repair was done on24 cases admitted to the Dep. of Urology, Keimyung University Hospital, during the period from 1971 through 1981. Vesicovaginal fistula can be surgically repaired via vaginal route or transvesical extraperitoneal or transperitoneal technique and the following results were obtained. 1. Overall success rate of vesicovaginal fistula repair was 71% and that of simplified transperitoneal transvesical approach was higher than conventional method (88%). 2. Excision of the fistulas were facilitated by continuing traction on the Foley catheter, vaginal insertion of assistant`s finger and sand bag application below hip. 3. Preoperative infection with scar tissue, short duration, large sized fistula, inadequate exposure and dissection of bladder from vagina turned out to be main factors of the operative failure. 4. Wide exposure with tension free closure of well-vascularized peritoneal flaps and the judicious interposition of pedicled omentum have produced the most encouraging results and supravesical diversion by ileal or colonic conduit can be avoided. 5. Previous attempts for surgical repair seemed to have relation with success rate.
Catheters ; Cicatrix ; Colon ; Fingers ; Fistula ; Hip ; Omentum ; Silicon Dioxide ; Traction ; Urinary Bladder ; Urology ; Vagina ; Vesicovaginal Fistula*

Eosinophilic gastroenteritis is a rare disorder of unknown etiology characterized by protein losing enteropathy, peripheral eosinophilia and iron deficiency anemia secondary to gastrointestinal blood loss. It is often accompanied by signs of systemic allergy. This case of a 26-month-old male patient who developed scrotal edema and diarrhea for a month had peripheral eosinophilia ranged from 24 to 32% of total leukocyte, iron deficiency anemia and hypoalbuminemia with slightly increased level of serum lgE. Biopsies of the stomach and duodenum demonstrated marked eosinophilic infiltration of the mucosa and lymphatic dilatation, which was consistent with eosinophilic gastroenteritis. We report a case of eosinophilic gastroenteritis with a brief review who was treated with corticosteroid alone and had marked symptomatic improvement.
Anemia, Iron-Deficiency ; Biopsy ; Child, Preschool ; Diarrhea ; Dilatation ; Duodenum ; Edema ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Humans ; Hypersensitivity ; Hypoalbuminemia ; Leukocytes ; Male ; Mucous Membrane ; Protein-Losing Enteropathies ; Stomach

A case of infantile digital fibromatosis which developed on the right fifth toe of 2 year-old girl is reported. Microscopically, the eosinophilic cytoplasmic inclusions were frequently seen in the cytoplasm and outside of the fibroblasts.
Child, Preschool ; Cytoplasm ; Eosinophils ; Female ; Fibroblasts ; Fibroma ; Humans ; Inclusion Bodies ; Toes

Granuloma, annulare is a chronic dermatosis characterized by skin colored, firm intradermal papules or subutaneous nodules, which may be discrete or arranged in an annular configuration. Histologically the dermis shows well define8 areas of necrobiosis of collagen tissue surrounded. by palisading histiocytes and lymphocytes. There may be lobules of epithelioid cells ani multinucleated giant ce.1s surrounding the necrobiotic areas. Many factors have been implicated in the genesis of this reaction. Recent studies have indicated that delayed hypersensitivity reactions rnay be involved in the pathogenesis of granuloma annulare. We present a typical granulorna annulare on a 16 year-old boy who had flesh colored, hyperkeratotic small nodules arranged in ring fashion on the dorsum of hands and right ear auricle.
Adolescent ; Collagen ; Dermis ; Ear Auricle ; Epithelioid Cells ; Granuloma Annulare* ; Granuloma* ; Hand ; Histiocytes ; Humans ; Hypersensitivity, Delayed ; Lymphocytes ; Male ; Necrobiotic Disorders ; Skin ; Skin Diseases

No abstract available
Constriction, Pathologic* ; Stents*

Acute Febrile Neetrophilic Dermatosis(AFND, Sweet's syndrome) ia characterixed by painful erythematous plaquea aaaociatcd with arthralgia, fever and leukocytoeis, We preagented a case of acute febrice neutrophilie denmatoeis in acutemyelogenous leukemia which occurred in a 55-year-old man. After 10 days of treatment with prednisolone, the skin lesion disapceared, but he die of pneumonia in spite of anticancer therapy.
Arthralgia ; Fever ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Middle Aged ; Pneumonia ; Prednisolone ; Skin ; Sweet Syndrome*

Anthracnose symptoms severely occurred up to 50% on leaves of English ivy growing in greenhouses in Cheongwon area of Korea during disease survey in April, 2000. The symptoms developed as concentric spots with dot-like acervuli on leaves of the plant. A total of 24 isolates of Colletotrichum sp. were obtained from the spotted lesions and identified as Colletotrichum trichellum based on the morphological and cultural characteristics. Leaf spots similar to the original anthracnose symptoms were induced on the host leaves by artificial inoculation with the isolates of the fungus. This is the first record of C. trichellum causing anthracnose of English ivy in Korea.
Colletotrichum* ; Cultural Characteristics ; Fungi ; Hedera* ; Korea* ; Plants

About 20 or more cases of seminal vesicle cyst were reported up to nowadays, but CT findings are not yetdescribed. Seminal visicle cyst is often associated with ipsilateral renal agenesis, and the mechanism ofdevelopment is based on embryogenesis. A 26 year old male was confirmed as seminal vesicle cyst in S.N.U.H. inNov. 1981. CT of the seminal vesicle cyst revealed huge, globular and homogeneous mass with well-circumscribedsmooth margin between urinary bladder and rectum. Adilated tubular structure was also found lateral to the hugecystic mass. The ipsilateral kidney was not found in any level of abdomen from the diaphragmetic dome to thesymphisis pubis.
Abdomen ; Embryonic Development ; Female ; Humans ; Kidney ; Male ; Pregnancy ; Pubic Bone ; Rectum ; Seminal Vesicles ; Urinary Bladder

Osteoid Osteoma occurs anywhere in skeleton. They are most common in lower extremity, particularly femur about 40%. Two-thirds of femoral lesions is in the intertrochanter or intracapsular regions of the hip. The lesion is usually cortical and may extend into the periosteal or endosteal surface of the bone. It is rare in the cancellous bone. We experienced a case of osteoid osteoma in intertrochanteric cancellous portion of the femur in 50 year old man. Many complained right hip pain worsend three weeks before his visit. Radiograph shows sclerosis around a lucent nidus in cancellous portion. The lesion did not extend to the endosteal surface. We have removed nidus and surrounding reactive portion completely with curettage. Follow up radiographic results after 20 weeks, showed no evidence of recurrence.
Adult* ; Curettage ; Femur* ; Follow-Up Studies ; Hip ; Humans ; Lower Extremity ; Middle Aged ; Osteoma, Osteoid* ; Recurrence ; Sclerosis ; Skeleton