A case of mucous gland adenoma arising from the main bronchus of the middle lobe of the right lung is reported, with review of related literatures. The patient, a 12 year-old Korean male, was admitted to Pusan National University Hospital with complaints of progressive coughing and dyspnea. Roentgenographic studies revealed a well defined mass involving the right middle lobe of the lung. With the impression of benign tumor, right middle lobectomy was performed. The gross specimen revealed a polypoid mass involving the main bronchus, measuring 4.5x 3.7 x 2.5cm. The cut surface of the mass revealed yellow-gray myxoid tissue. Histologically, the mass consisted of glandular structures filled with mucus, which proved to be acid one on histochemical study. The glandular lining was made up of a single layer of berign mucous cells, many of them being flattened.
Adenoma

No abstract available.
Mediastinum* ; Neuroblastoma*

Obesity is a serious worldwide health problem causing numerous obesity-related comorbidities such as hyperlipidemia, hypertension, diabetes, and cardiovascular dysfunctions. Recently, many studies indicate that obesity is strongly related with high rate of renal lesions and reducing weight with surgical intervention can improve renal parameters in obese patients, but the effect of bariatric surgery on obesity-induced chronic kidney disease (CKD) is hardly documented. This review study shows that bariatric surgery demonstrates beneficial reduction in proteinuria and albuminuria leading to improve both glomerular hyperfiltration and chronic kidney disease in obese population. Yet, bariatric surgery is not a definite treatment of choice for the obese patients with CKD because of lack of evidence explaining the risk of complications following bariatric surgery and clarification on estimating glomerular filtration rate (eGFR) in obese patients. Future, high quality studies with a long term follow up are required to determine the effective durability of bariatric surgery on obese-related CKD patients.
Albuminuria ; Bariatric Surgery* ; Comorbidity ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Hyperlipidemias ; Hypertension ; Obesity ; Proteinuria ; Renal Insufficiency, Chronic*

Bariatric surgery is considered the most effective treatment for reducing and maintaining weight for morbid obesity. Moreover, this surgery not only reduces weight but also improves comorbidity. However, concern about the safety of the surgery has grown with the favorable effects and has been heightened by high-profile reports in the death of a famous singer after bariatric surgery in Korea. In the beginning of the era of bariatric surgery, animal experiments had been conducted to improve surgical techniques in bariatric surgery. Among animals, a large animal such as pig and rabbit was used to develop and assess surgical skill. Recently, many researchers have been trying to investigate the mechanism of bariatric surgery for the resolution of morbid obesity and related comorbidities. An experimental model employing small animal has been developed to study underlying mechanism. We expect that this experiment will pave the way for developing a novel morbid obesity treatment.
Animal Experimentation* ; Animals* ; Bariatric Surgery* ; Comorbidity ; Korea ; Models, Theoretical ; Obesity, Morbid ; Singing

Hyponatremia is a dangerous electrolyte disturbance in patients on chemotherapy and may cause sudden death if not detected early. SIADH (syndrome of inappropriate antidiuretic hormone) is one of the known causes of hyponatremia in patients undergoing chemotherapy. Few chemotherapeutic agents, however, are reported to cause SIADH. The current study reports that SIADH developed in a 55 year old woman on S-1 (80 mg/m2) and cisplatin (60 mg/m2) chemotherapy for the peritoneal metastasis of gastric cancer. The patient underwent a total gastrectomy, a splenectomy, and a segmental resection of the transverse colon for gastric cancer. She had used thiazide and betablocker to treat hypertension for 12 years. She admitted to our hospital with complaining of general weakness, dysarthria, loss of appetite, and urinary discomfort. The serum level of sodium and potassium were 94 mEq/L and 2.2 mEq/L respectively. The hyponatremia completely resolved uneventfully after 3% saline infusion, which led to normalized electrolyte balance. The patient was discharged on the 13th hospital day.
Appetite ; Cisplatin ; Colon, Transverse ; Death, Sudden ; Drug Therapy ; Dysarthria ; Female ; Gastrectomy ; Humans ; Hypertension ; Hyponatremia ; Inappropriate ADH Syndrome* ; Middle Aged ; Neoplasm Metastasis ; Potassium ; Sodium ; Splenectomy ; Stomach Neoplasms ; Water-Electrolyte Balance

PURPOSE: The TNM staging system showed limitation in stratifying patients into different prognostic groups with gastric cancer. Since the treatment for stage IV gastric cancer with distant metastasis (M1) is defined as non-curative one, we hypothesized that the survival rate of stage IV gastric cancer with M1 is different to that of stage IV gastric cancer with no distant metastasis (M0), which will provide a rationale to subdivide stage IV into IVa and IVb. MATERIALS AND METHODS: From June 1992 to December 2005, of 1,630 gastric cancer patients who underwent surgery, 308 patients with stage IV gastric cancer were selected and analyzed. The clinicopathologic characteristics and survival of the patients, according to distant metastasis, were determined retrospectively. Median follow-up period was 13 months (range: 1~154 month). RESULTS: 5 year survival rate of M0 and M1 group was 35% and 16% respectively with statistic significance (P=0.0000). When the survival rate of M0 group was analyzed according to the difference of T and M factor, T1-3N3M0 and T4N1-2M0 group showed no significant statistical difference (P=0.1898). CONCLUSION: Given the result in this study, we suggest that the stage IV gastric cancer be subclassified into stage IVa and IVb according to M factor.
Follow-Up Studies ; Humans ; Neoplasm Metastasis* ; Neoplasm Staging ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

PURPOSE: Evaluating the clinicopathologic characteristics of recurred gastric cancer is essential for early detection of the recurrence and for better clinical outcome. The aim of this study was to establish the patterns of the recurrence, the timing of the recurrence, and the clinical result after recurrence according to the clinicopathologic characteristics of gastric cancer. MATERIALS AND METHODS: From June 1992 to December 2005, of the 1338 gastric cancer patients who underwent a curative gastric resection, 241 patients who recurred during the follow-up period were selected and their cases were analyzed. The clinicopathologic characteristics of the patients, the time to recurrence after operation and survival were determined retrospectively according to the type of recurrence. RESULTS: For the recurrent group, the numbers of total gastrectomies, advanced stages, lymphatic and/or venous infiltrations, whole stomach cancer cases, large tumors, undifferentiated tumors, and Borrmann type 4 tumors were higher than they were for the non-recurrent group, and the differences were statistically significant. When the recurrence types were classified as peritoneal seeding, hematogenous recurrence, and locoregional recurrence, independent risk factors were female gender, stage III, upper third, and whlole stomach cancer, and undifferentiated-type, diffuse-type, and Borrmann type 4 tumors for peritoneal seeding; early gastric cancer, stage I for hematogenous recurrence; and Borrmann type 1, 2, and 3 tumors for locoregional recurrence. Survival duration after detection of the recurrence was shorter for peritoneal seeding than for hematogenous or locoregional recurrence (7.0 months vs. 9.5 months and 12.5 months). CONCLUSION: For early detection of the recurrence after curative surgery for gastric cancer, it is important to recognize that the high risk factors for recurrence vary with the clinicopathologic data for the patients.
Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*

We report a rare case of primary glomerular disease with both features of IgA nephropathy and membranous glomerulonephritis in a 27 year-old woman with nephrotic syndrome. Histologically, glomeruli showed slight mesangial expansion, proliferation of mesangial cells, and short subepithelial spikes on capillary wall. Direct immunofluorescence demonstrated granular IgG and C3 deposits along the capillary walls, and IgA with C3 deposits in mesangium. Granular subepithelial and rnesangial deposits were observed by electron microscopy. The patient showed complete remission after 6 months therapy with steroid and ACE inhibitor.
Adult ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerulonephritis, IGA* ; Glomerulonephritis, Membranous* ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Mesangial Cells ; Microscopy, Electron ; Nephrotic Syndrome

PURPOSE: The purpose of this study was to determine the role of CT and MR imagings in the diagnosis aortic dissection and differentiation between the true and false lumen. MATERIALS AND METHODS: We retrospectively studied forty patients with aortic dissection(AD) diagnosed imagings or surgery. Of the forty patients, 19 were examined with only CT, 14 with CT and MR, and 7 with MI~: Our points of view were(1) the classification of AD according to configuration of intimal flap by cross-sectional imaging, (2) differentiation between the true and false lumens, (3) the course of the false lumen, and (4)! detectability of the origin of major branch vessels of the abdominal aorta. RESULTS: The classification by corss-sectional imaging were crescentic(65%), circumferential(15%), flat(12%), and irregular(8%) type, in which false negative diagnosis was made in 1 case of crescentic and circumferential type, respectively. In 2 case of flat type and 1 case of irregular type, the differentiation between the true and false lumen was impossible with CT. The course of the false lumen in descending thoracic aorta revealed countrclock wise rotation(66%), clockwise rotation(5%) or fixed(29%) apperance. MR imaging was superior to CT in the detection of the origin of major branch vessels of the abdominal aorta. The determination of the origin of major branches of abdominal aorta arising from the true and false lumen were impossible in 2 cases in which only CT was done. CONCLUSION: Diagnosis of crescentic and circumferential types of AD with narrow and thrombosed false lumen was problematic in both CT and MR with no difference of diagnostic accuracy between the two modalities. The differentiation between the true and false lumen was difficult in flat and irregular types with only CT. Therefore, when surgical treatment is considered as in type B aortic dissection, MR imaging is recommended in order to determine the origin of major branch vessels.
Aorta, Abdominal ; Aorta, Thoracic ; Classification ; Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

PURPOSE: The role of prophylactic antibiotics in totally extraperitoneal (TEP) laparoscopic repair of inguinal hernia is unclear. This study was conducted to evaluate the effects of antibiotic therapy for surgical site infection (SSI) in post TEP laparoscopic repair of inguinal hernia. METHODS: We prospectively reviewed data collected from 280 patients with inguinal hernias who were treated by TEP laparoscopic repair between August 2008 and July 2012. None of the patients received prophylactic antibiotics. Patients with a history of recurrent hernias, immune suppressive disease or diabetes mellitus were excluded from the study. RESULTS: There were 265 male patients and 15 female patients aged 19 to 82 years. There were 240 indirect, 38 direct, and 2 pantaloon hernias. The mean operating time was 49 minutes, and the mean length of hospital stay was 1.4 days. The most frequent complications of TEP laparoscopic repair of inguinal hernia were ecchymosis (32.85%), followed by wound pain (16.42%). Surgery related complications occurred in two cases (0.71%) of SSI and 13 cases (8.65%) of wound hematoma. No additional surgical treatment for complications were required. No mesh infection occurred in patients during the follow up period. CONCLUSION: Non-prophylactic antibiotics for elective TEP laparoscopic repair of inguinal hernia appear to be acceptable. Randomized controlled trials of the efficiency of antibiotic therapy in SSI in patients with inguinal hernia should be conducted.
Aged ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Diabetes Mellitus ; Ecchymosis ; Female ; Follow-Up Studies ; Hematoma ; Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Laparoscopy ; Length of Stay ; Male ; Prospective Studies ; Pyrazines