No abstract available.
Antiemetics* ; Cisplatin* ; Dexamethasone* ; Humans ; Lorazepam* ; Metoclopramide* ; Ondansetron*

From the young neurosurgeon's standpoint, the authors analyzed eighty patients of spontaneous subarachnoid hemorrhage who were admitted to the department of neurosurgery in Taejeon Eulji General hospital from May 1989 to Jan. 1992. The results of analysis were as follow: 1) Of 80 total cases, sixty six were managed from beginning to end, and forty two were operated on for neck clipping. The most common cause of SAH was aneurismal rupture(70%), and the idiopathic comprised 30%. The male versus female ratio was 1:1.7, and the most frequently involved decade was the 7th. 2) Fifty six of total aneurismal cases turned out to be ruptured prior to admission. Common locations of aneurysms were A-com., P-com., and M.C.A. in order of descending frequency. Mirror aneurysms were 4%, and the multiple, 21%. The smallest size of aneurysm that had already ruptured was 3mm in its largest diameter of sac. The giant cases were 2(4%). 3) The most common chief complaint was headache(62.5%), and the most common symptom and/or sign was vomiting(90%). The hypertension accompanied in 29% and the most common neurological sign was nuchal rigidity(71%). 4) The brain CT was performed with the frequency of 1.44 per patient, and it detected SAH in 86%, The most frequently obliterated cistern was basal cistern. In 11 cases(14%), there were no evidence of SAH at all. Contrastingly in 12 cases(15%), aneurismal sacs were directly visualized in post-contrast films. 5) The angiographic study was performed in 59 cases(74%) to detect abnormality in 54 cases all of which turned out to be aneurysms. The mean size of detected 69 sacs was 7.7mm in diameter, and of 26 cases(44%) of normal variation, hypoplasia was the most frequent type. It occurred most frequently at right A1 portion. 6) Of 66 patients who were managed from start to finish, the mortality was 43%, and that of 46 operated cases, 21%. The best operative results were harvested in delayed operation group, the next in intermediate one, and the worst in early one.
Aneurysm ; Brain ; Daejeon ; Female ; Hospitals, General ; Humans ; Hypertension ; Male ; Mortality ; Neck ; Neurosurgery ; Subarachnoid Hemorrhage

A case of lipomatous meningioma is described. On pre-enhanced CT study the lesion was radioluscent but after enhancement almost half of the lesion was strongly enhanced and the other half was still radioluscent. A review of the literatures showed few similar reported cases.
Meningioma*

BACKGROUND: Macrophages are a component of a tumor's microenvironment and have various roles in tumor progression and metastasis. This study evaluated the relationships between tumor-associated macrophage (TAM) density and clinical outcomes in 14 different types of human cancers. METHODS: We investigated TAM density in human tissue microarray sections from 14 different types of human cancers (n = 266) and normal thyroid, lung, and breast tissues (n = 22). The five-year survival rates of each cancer were obtained from the 2011 Korea Central Cancer Registry. RESULTS: Among 13 human cancers, excluding thyroid cancer, pancreas, lung, and gallbladder cancers had the highest density of CD163-positive macrophages (7.0+/-3.5%, 6.9+/-7.4%, and 6.9 +/- 5.5%, respectively). The five-year relative survival rates of these cancers (pancreas, 8.7%; lung, 20.7%; gallbladder, 27.5%) were lower than those of other cancers. The histological subtypes in thyroid cancer exhibited significantly different CD163-positive macrophages densities (papillary, 1.8 +/- 1.6% vs anaplastic, 22.9 +/- 17.1%; p < .001), but no significant difference between histological subtypes was detected in lung and breast cancers. Moreover, there was no significant difference in CD163-positive macrophages densities among the TNM stages in lung, breast, and thyroid cancers. CONCLUSIONS: Cancers with higher TAM densities (pancreas, lung, anaplastic thyroid, and gallbladder) were associated with poor survival rate.
Breast ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Korea ; Lung ; Macrophages* ; Neoplasm Metastasis ; Pancreas ; Prognosis ; Survival Rate* ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: Infantile constipation is one of the most common problems in pediatric gastrointestinal outpatient clinic. We planed to show the clinical feature of infantile constipation and explore the possible relationship between diets and symptoms of constipation. METHODS: We analyzed the medical records and telephone questionnaire about infants under 2 years of age with constipation, who visited outpatient clinic of Department of Pediatrics, Ilsan Paik Hospital during the time from March 2002 to February 2005. Data including the symptoms and signs of constipation, diet history, and past-medical history were analyzed. RESULTS: Total 96 infants, 40 male and 56 female, were enrolled in this study. The mean age was 9 months. Twenty-three infants were exclusively breast milk fed (BMF), 20 infants were cow's milk fed (CMF) and 53 infants had a history of mixed feeding with cow's milk and breast milk (MMF). Patients showed painful defecation (95.8%), abdominal distension (53.1%), palpable rectal stool (35.1%), hard stool (30.2%), blood-tinged stool (29.2%) and anal fissure (16.7%). Patients with exclusive cow milk feeding had prominent clinical features, such as anal fissure (p=0.03), hematochezia (p=0.04) and palpable rectal stool (p=0.025). Patients who had a history of larger intake of liquid food had a tendency to get anal skin tag (p<0.05). CONCLUSION: Exclusive breast milk feeding seemed important to avoid constipation with clinical significance. To educate caregivers in appropriate way of the weaning food may help the infants with constipation.
Ambulatory Care Facilities ; Breast Feeding ; Caregivers ; Constipation* ; Defecation ; Diet ; Female ; Fissure in Ano ; Gastrointestinal Hemorrhage ; Humans ; Infant ; Male ; Medical Records ; Milk ; Milk, Human ; Pediatrics ; Surveys and Questionnaires ; Skin ; Telephone ; Weaning

Ingestion of strong acids or strong alkalies may produces severe inflammation on the mucosa of the esophagus and this may also causes esophageal stricture. Several forms of non-operative dilatations have been utilized for the treatment of esophageal stricture and they have shown good results. Yet some patients do not achieve acceptable symptom relief despite of intensive dilatation. Temporary placement of esophageal stent has recently been used in some of these patients. Furthermore, mitomycin C has been used as a conservative treatment for refractive esophageal stricture in children, yet its efficacy has not been well established. We experienced a case of a 64-year old man with severe, recurrent esophageal stricture, and this was successfully managed by temporary placement of an esophageal stent, together with a spray of mitomycin C. We report on this case along with the review of the literature.
Alkalies ; Child ; Dilatation ; Eating* ; Esophageal Stenosis* ; Esophagus ; Humans ; Inflammation ; Lye* ; Middle Aged ; Mitomycin* ; Mucous Membrane ; Stents*

PURPOSE: Most burn scar contractures are curable with skin grafts, but free flaps may be needed in some cases. Due to the adjacent tissue scarring, local flap is rarely used, and thus we may consider free flap which gives us more options than local flap. However, inappropriate performance of free flap may lead to unsatisfactory results despite technical complexity and enormous amount of effort. The author will discuss the points we should consider when using free flaps in treating burn scar contractures METHODS: We surveyed patients who underwent free flaps to correct burn scar contractures from 2000 to 2007. We divided patients into two groups. The first group was those in which free flaps were inevitable due to exposure of deep structures such as bones and tendons. The second group was those in which free flap was used to minimize scar contracture and to achieve aesthetic result. RESULTS: We performed 44 free flap on 42 patients. All of the flaps were taken well except one case of partial necrosis and wound dehiscence. Forearm free flap was the most common with 21 cases. Most of the cases(28 cases) in which free flaps were inevitable were on the wrist and lower limbs. These were cases of soft tissue defect due to wide and extensive burns. Free flaps were done in 16 cases to minimize scar contracture and to obtain aesthetic outcome, recipient sites were mostly face and upper extremities. CONCLUSION: When using free flaps for correction of burn scar contractures, proper release and full resurfacing of the contracture should be carried out in advance. If inadequate free flap is performed, secondary correction is more challenging than in skin grafts. In order to optimize the result of reconstruction, flap thickness, size and scar of the recipient site should be considered, then we can achieve natural shape, and minimize additional correction.
Burns ; Cicatrix ; Contracture ; Forearm ; Free Tissue Flaps ; Humans ; Lower Extremity ; Necrosis ; Skin ; Tendons ; Transplants ; Wrist

Flexible fiberoptic colonoscopy is extensively used for the diagnosis and management of colorectal disease. Many possible complications can occur. The most common and most serious complications are hemorrhage, perforation and respiratory problems. Colonic perforation usually results in a fatal and emergent condition. However, management of iatrogenic colonic perforation has been controversial. The choice between the medical versus the surgical approach has been dependent on the mechanism of the perforation, bowel preparation, location, size of the defect and severity of symptoms. We report here a case where colonic perforation emerged during endoscopic submucosal resection of a rectal tumor. The rectal perforation was accompanied with pneumoperitoneum, subcutaneous emphysema, pneumoretroperitoneum and pneumomediastinum. As the bowel preparation was excellent, intravenous antibiotics and total parenteral nutirition were administered. The patient was treated successfully without any complications.
Anti-Bacterial Agents ; Colon ; Colonoscopy ; Diagnosis ; Hemorrhage ; Humans ; Mediastinal Emphysema* ; Pneumoperitoneum* ; Rectal Neoplasms ; Retropneumoperitoneum* ; Subcutaneous Emphysema*

Flexible fiberoptic colonoscopy is extensively used for the diagnosis and management of colorectal disease. Many possible complications can occur. The most common and most serious complications are hemorrhage, perforation and respiratory problems. Colonic perforation usually results in a fatal and emergent condition. However, management of iatrogenic colonic perforation has been controversial. The choice between the medical versus the surgical approach has been dependent on the mechanism of the perforation, bowel preparation, location, size of the defect and severity of symptoms. We report here a case where colonic perforation emerged during endoscopic submucosal resection of a rectal tumor. The rectal perforation was accompanied with pneumoperitoneum, subcutaneous emphysema, pneumoretroperitoneum and pneumomediastinum. As the bowel preparation was excellent, intravenous antibiotics and total parenteral nutirition were administered. The patient was treated successfully without any complications.
Anti-Bacterial Agents ; Colon ; Colonoscopy ; Diagnosis ; Hemorrhage ; Humans ; Mediastinal Emphysema* ; Pneumoperitoneum* ; Rectal Neoplasms ; Retropneumoperitoneum* ; Subcutaneous Emphysema*

Schwannomas of the gastrointestinal (GI) tract are rare subepithelial tumors comprising approximately 3.3% to 12.8% of all mesenchymal tumors of the GI tract. On endoscopic ultrasound (EUS) they are seen as hypoechoic tumors arising most commonly from the 4th proper muscle layer. Although EUS helps to distinguish tumor characteristics, tissue sampling is required for differentiation with other more common tumors such as GI stromal tumors. Both EUS-guided fine needle aspiration and EUS-guided trucut biopsy (EUS-TCB) can be used for tissue sampling. However, only EUS-TCB allows core biopsy and a high yield of immunohistochemical staining. We report a case of a gastric schwannoma diagnosed by EUS-TCB.
Biopsy ; Biopsy, Fine-Needle ; Gastrointestinal Tract ; Muscles ; Neurilemmoma