Retroperitoneum is often the site of occurrence of schwannoma, but reports on schwanoma of the adrenal gland is exceptional and only 4 cases have been documented in the literature. This report is to add one such case occurred in a 53 year-old male who had anorexia, nausea and indigestion for one month. Whole body bone scan and abdominal CT scan revealed a 10 cm sized solid mass at upper pole of the left kidney. Under the impression of renal cell carcinoma, an operation was performed. The tumor was well encapsulated and appeared not to involve the kidney. The cut surfaces were light yellow and seemed to be composed of several hard lobules with areas of mucoid, cystic and calcific changes. No adrenal gland was identified grossly. But microscopically, the tumor was found to be partly surrounded by a small portion of adrenal cortical tissue. Histologically the tumor was a typical schwannoma with Verocay bodies, although modified in some extents by mucoid degeneration, cystic change, hyaline change and focal calcification. It is worthwhile to remember that the retroperitoneal schwannoma commonly had a huge size, sometimes involving the adjacent structures.
Male ; Humans

A case of Maffucci's syndrome is reported in a 6-year-old girl. She had multiple enchondromas of the long bones and the phalangeal bones with hemangiomatous skin lesions. The hemangiomas were the capillary type and were not anatomically related to the bone lesions.
Capillaries ; Child ; Chondroma ; Enchondromatosis ; Female ; Hemangioma ; Hemangioma, Capillary ; Humans ; Skin

Gastric lipomas are rare benign submucosal tumors which can present the diagnostic and therapeutic problems. The preferred treattment is observation or local excision. Since preoperative diagnosis and differentation from malignant tumors can be difficult by use of the conventional diagnostic modalities such as X-ray or endoscopic examination, patients are sometimes subjected to more extensive surgical procedures than warranted. As to the diagnosis of submucosal tumors of the upper digestive tract, a newly developed diagnostic modality of endoscopic ultrasonography(EUS) allows us to visuialize the structures underlying the gastrointestinal wall in a noninvasive maneuver, and can contribute to make differential diagnosis and decision of management. Strip biopsy is an endascopic tissue resection technique which permits resection of both mucosal and submucosal tissue regardless of the morphological type of the lesion, because the submucosal saline injections during the procedures make the flat or depressed lesions to be elevated. Now, we report a 56-yr-old female which had a Yamada type I polypoid gastric submucosal lipoma in the antrum, which could be performed the different diagnosis and successful endoscopic removal by endoscopic ultrasonography and strip biopsy.
Biopsy* ; Diagnosis ; Diagnosis, Differential ; Endosonography ; Female ; Gastrointestinal Tract ; Humans ; Lipoma*

A new method for combining ultrasonography snd endoscopy, endoscopic ultrasonography (EUS), was developed to improve the diagnostic accuracy of ultrasound by direct image of the target lesion via the gastrointestinal lumen. EUS has the unique ability to provide clear sonographic images of the wall structure of the stomach. This capability can be ultilized in assessing the depth of cancer invasion of the stomach by identifying which layer the ultrasonographic change extends to. However, the depressed types of early gastric cancer(EGC) are often accompanied by ulcerative change in the tumor foci. And the ultrasonographic picture is also influenced by the ulcerative change. (continue...)
Endoscopy ; Endosonography* ; Stomach ; Stomach Neoplasms* ; Ulcer ; Ultrasonography

To determine the most effective and tolerable method of preparation with Golytely for colonoscopy, 141 consecutive cases were randomly allocated to drink either 2,000cc(74 cases, Group I) or 4,000cc(67 cases, Group 2), with infusion rate of 1,000cc/h. The reaults were as follows. 1) The rates of effective colonic clearance in group 1 and group 2 was 94.6% and 94.0%, respectively. There is no significance difference between two groups. 2) There was no significant difference in the ingested volume until the first bowel movement and the time required for rectal efflunt to be clear between two groups. 3) Patient acceptance was higher in group 1 than in group 2. 4) Side effects were less noticed in group 1 than group 2, and incraased in body weight (average 0.8 kg) after ingestion of Golytely was observed only in group 2.
Body Weight ; Colon ; Colonoscopy* ; Eating ; Humans ; Therapeutic Irrigation*

Non-operative palliative treatment for malignant colonic obstruction can sometimes be accomplished by the insertion of anorectal tube, endoscopic balloon dilation or endoscopic laser therapy. But these methods have some disadvantages, such as limitaation of activity, need of repetitive treatment and high-risk of perforation. Endoscopic prosthesis is generally accepted as a safe, effective palliative treatment for malignant esophageal stricture, because this method has no above disadvantages. Neverthless, there is only a few experence with endoecopic prosthesis in malignant colorectal stricture over the world. We report two cases which were safely, effectively performed endoscopic prosthesis in palliative treatment for their malignant rectal strictures.
Colon ; Constriction, Pathologic* ; Esophageal Stenosis ; Laser Therapy ; Palliative Care ; Prostheses and Implants*

Gastric glomus tumor is an uncommon benign, submucosal neoplasm and does not require radical surgical procedure. Because there are no specific clinical or radiologic features associated with the glomus tumor, it can be recognized only by its histologic characteristics. We report a 30-year-old woman who had 10 years history of epigastric hunger pain. Radiologically, a gastric submucosal tumor was discovered, which was suggestive of leiomyoma. Gastric antrectomy was performed. The tumor cells showed immunohistochemical and ultrastructural evidence of smooth muscle differentiation.
Female ; Humans

One hundred seven consecutive patients aged 3 years to 34 years with simple ventricular septal defect were prospectively investigated with 2-dimensional Doppler echocardiography to assess the echocardiographic criteriae in defining the anatomic site of the VSD. The anatomy was confirmed in all patients at operation. Two-dimensional Doppler echocardiography correctly categorized the site and extension of VSDs in 104 of 107(97%). All doubly committed subarterial VSDs were correctly diagnosed as an area of discontinuity beneath the pulmonary valve in the parasternal short-axis plane taken at the aortic root level. Forty eight of 49 perimembranous VSDs with infundibular extension showed an area of discontinuity beneath the right aortic cusp in the parasternal long axis plane of the left ventricle. Of 17 perimembranous VSDs with trabecular extension, 16 had an area of discontinuity around the medial papillary muscle in the short axis plane taken at the level of high left ventricular outflow tract(LVOT). All 5 perimembranous VSDs with inlet extension showed an area of discontinuity adjacent to the septal leaflet attachment in the short axis plane taken at the level of high LVOT. One muscular trabecular VSD was categorized correctly by the short axis view and the apical 4-chamber view. Thus, these 2-dimensional Doppler echocardiographic criteriae are a simple and reliable in identifying the anatomic site of VSDs.
Axis, Cervical Vertebra ; Bays ; Classification* ; Echocardiography ; Echocardiography, Doppler* ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Papillary Muscles ; Prospective Studies ; Pulmonary Valve

Scleroderma is an incidious and chronic disease of unknown cause. The clinical picute of scleroderma is characterized by the apperance of circumscribed of diffuse, hard, smooth, ivory colored areas that are immobile upon upon the underlying tissues. It may be classified to as a localized form (morphea) and a systemic scleroderma or progressive systemic sclerosis (PSS) which is characterized by diffuse involvment of the connective tissue of the skin and certain intemal organs. The authors observed 3 cases of PSS and 6 cases of morphea. They have complained of marked sclerosis or thickening of skin or slowly developing dyspneadue to interstitial pulmonary fibrosis which were confirmed by chest X-ray. Recently, penicillamine-D has been advocated as a beneficial agent in scleroderma by Asboe-Hansen. therefore, penicillamine-D was administered to the above patients. Two of PSS were markedly improved with normal skin softness. Two of morphea were also moderately improved. Other patients remained stationary or no effect.
Chronic Disease ; Connective Tissue ; Humans ; Pulmonary Fibrosis ; Scleroderma, Diffuse ; Scleroderma, Localized ; Scleroderma, Systemic ; Sclerosis ; Skin ; Thorax

The lower ureter is not so frequent site of the urinary tract obstruction. In lower ureteral obstruction, the obstruction should be relieved by any method for maintaining renal parenchyme. A clinical studies were made on the 24 ureters of the lower ureteral obstruction. This studies were mainly focused on the method of management by internal stent indwelling. The following results were obtained. 1. In etiology, acquired lower ureteral strictures were most common ; tuberculosis in 10 ureters, radiation in 6 ureters, pelvic lymphadenopathy in 4 ureters, and iatrogenic stricture in 3 ureters. Congenital UVJ stricture was only one ureter. 2. In the method of management, open surgeries were done in 10 ureters and endourologic methods in 14 ureters. 3. In 5 failures of the first management, open surgeries were done in 3 ureters and endourologic methods in 2ureters. The tuberculosis was the most of their etiology. 4. Complications in internal stent indwelled cases were flank pain, severe vesical irritation, migration into the bladder and the obstruction of the lumen of stent.
Constriction, Pathologic ; Flank Pain ; Lymphatic Diseases ; Stents* ; Tuberculosis ; Ureter* ; Ureteral Obstruction* ; Urinary Bladder ; Urinary Tract