The present experimental study was undertaken to observe the chronological change of the worm structure of Clonorchis sinensis and the pathological findings of the liver when this fluke was inoculated to the mouse intraperitoneally. The recovery rate, survival rate, location and size of the inoculated worms as well as the pathological changes of the liver were investigated for the comparison among the groups of mice, classified by number of worms and the duration of experiment. The results obtained were summarized as follows: The recovery and survival rates of the worms decreased especially 28 days after the inoculation. Most of worms (90.l percent) were collected from the peritoneal cavity and some of worms were found tightly adherent to the capsules of the liver, spleen, stomach, intestine and diaphragm. There were no worms recovered penetrated in the parenchymes of these organs. The mean worm size after inoculation was smaller than that before inoculation. At the 10th day after the inoculation, the shrinkage of posterior portion of the worm body was observed. Remarkable atrophy in the reproductive organs of the worm, such as spermatheca, testes, vitelline glands and ovary was frequently observed at the 10th day of inoculation. Histopathologically the liver failed to show any parasitic worm inside the intrahepatic biliary system. However, multiple well formed egg-containing granulomas were present along the liver capsule. These necrotic granulomas were occasionally found under the fibrotic liver capsule. Focal necrosis and focal phlebitis together with vascular dilatation were prominent features seen in the liver. The bile duct in the liver showed mild dilation of the lumen, flattening of epithelial cells and periductal small round cell infiltration. Neither adenomatous hyperplasia nor portal fibrosis was seen in the whole experimental groups. Foci of intralobular micro-granulomas were found in some experimental animals. The worms recovered in the capsule of the liver were degenerated and necrotized. Usually, there were remarkable capsulitis and granuloma formation around the eggs.
parasitology-helminth-trematoda ; Clonorchis sinensis ; pathology ; liver ; spleen ; stomach ; intestine ; diaphragm ; granuoma ; peritoneal cavity

No abstract available.

No abstract available.
Femur* ; Osteosarcoma*

To fill the large bone defect after bone and soft tissue tumor resection, there are several options such as tumor prosthesis, bone cement with intramedullary nail, autogenous bone graft and allograft. We had used isotrophic autogenous bone graft by using the heat-treated bone removed from tumor site. We analyzed the periods for junctional union and regeneration of autoclaved or low-heat treated groups, and compared these two methods to know which method is better for reconstruction of the bone defect after tumor resection. From Jan. 1987 to Sept. 1993, twelve patients took heat-treated autogenous bone graft: 6 auto- claved, and 6 low heat-treated. Each group had 10 places of junction sites between host and grafted bone. The tumors were 2 cases of osteosarcoma, 3 parosteal osteosarcoma, 2 Ewing's sarcoma, 2 malignant soft tissue tumors, 1 giant cell tumor, and 2 metastases from thyroid cancer and synovial sarcoma. The graft sites were 4 in humerus, 4 pelvis and 4 femur. Two cases showed marginal surgical margin and others wide surgical margin. Here we compare4 the difference between autoclaved group(120℃, 2 atm., 20 min) and low heat-treated group(65℃, 30 min. in water) on the aspect of complications and period to achieve junctional union to host bone. Average follow-up period was 25.3(11 to 88) months. Graft related complications in autoclaved group were bone resorption(2 sites), fracture of grafted bone(2). For low heat-treated group there was no such complication. Nonunion occurred in 3 sites for autoclaved group and 1 for low heat-treated group. Average period for junctional union was 7.3 months(5 to 10 months) for autoclaved group and 6.1 months(5 to 9 months) for low heat-treated group. With these results, heat treated bone autograft may have several advantages such as easy accessi- bility, low cost and anatomical reconstruction of the bone defect. The low heat-treated autogenous bone graft may have more advantages than that of the autoclaved one, and this method may be ratio- nalized to fill the large bone defect made by tumor resection.
Allografts ; Autografts ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Hot Temperature ; Humans ; Humerus ; Methods ; Neoplasm Metastasis ; Osteosarcoma ; Pelvis ; Prostheses and Implants ; Regeneration ; Sarcoma, Ewing ; Sarcoma, Synovial ; Thyroid Neoplasms ; Transplants

No abstract available.
Hernia, Umbilical* ; Ultrasonography*

No abstract available.
Calcinosis*

Chondrosarocoma is a malignant, relatively slow-growing cartilaginous tumor that generally has a long natural history. From Feb. 1986 to Jan. 1993, 29 cases of chondrosarcoma were registered in the Department of Orthopedic Suergery of Korea Cancer Center Hospital. We reviewed 23 cases of chondrosarcoma which were treated surgically, aimed at curative procedure. Fourteen patients were male and 9 female. The average age at the time of diagnosis was 31.9(17-59) years. The pelvis was the most frequent site(7 patients) followed by femur(6), scapula(4), tibia(2), and each one case of spine, rib, humerus, and finger. The Enneking s surgical stage was II B (18 cases), II A (1), I B (3) or I A (1). The histological grades were as follows : 4 cases of grade 1; 3 grade 2 and 16 grade 3. Local resection with or without reconstruction were done for 20 cases and amputation or disarticulation 3. Chemotherapy was done in four cases and was not effective. The average follow-up period was 34.2(9-81) months. As complications, local recurrence occurred in 4(17.3%) cases, infection 2(8.7%), fracture 1(4.3%), lymphedema 1 and rediation necrosis of soft tissue 1, Distant metastasis occurred in 7(30.0%) cases: 6 cases to lung and 1 to brain. At final follow up 15 cases were continuous disease free, 3 alive with disease, 4 died of disease and 1 no evidence of disease. The Kaplan-Meier's estimated 5-year actuarial survival rate of total 23 cases was 66. 9%. Seven cases with histopathologic grade less than 2 showed 100% of 5 year actuarial survival rate, even one case is alive with disease at final follow up of 62 months. Fifteen cases of surgical stage II B with histopathologic grade 3 had 55.4% of 5 year actuarial survival rate: ten cases with wide surgical margin 87.5%o five cases with intralesional or marginal surgical margin 25%. Early surgical excision of chondrosarcoma with enough wide surgical margin can prevent local recurrence and metastasis.
Amputation ; Brain ; Chondrosarcoma ; Diagnosis ; Disarticulation ; Drug Therapy ; Female ; Fingers ; Follow-Up Studies ; Humans ; Humerus ; Korea ; Lung ; Lymphedema ; Male ; Natural History ; Necrosis ; Neoplasm Metastasis ; Orthopedics ; Pelvis ; Recurrence ; Ribs ; Spine ; Survival Rate

From Mar. 1985 to Dec. 1992, 170 cases of osteosarcoma, which were proved histologically were admitted in our department at least one time. Among them we analysed 89 cases of Ennekings stage IIB who took limb-salvage(54) or amputation(35) and followed our protocol, with non-randomized retrospective study. The average age of the 89 patiens was 17.0 years(7 to 57). Fifty-four cases of salvage group took neoadjuvant chemotherapy, 35 cases of amputation group took neoadjuvant or adjuvant chemotherapy. The result revealed prevalences of 2/54, 0/35 as to local recurrence; 15 of 54, 17 of 35 as to metastasis; 14 of 54, 15 of 35 as to death. Of the 2 patients who had a local recurrence, one died of metastasis and the other was lost follow up. According to Kaplan-Meier's plot 5-year continuously disease free survival rate for whole 89 cases of stage IIB was 43.1%, for salvage group 56.4%, for amputation group 34.0%. There were no signifcant difference in survival rate between salvage and amputation groups(p>0.05, by log-rank test). This result means the limb-salvage operation for Enneking's stage IIB osteosarcoma does not hinder patients survival.
Amputation ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteosarcoma ; Prevalence ; Recurrence ; Retrospective Studies ; Survival Rate

So far with the advancement in treatment modalities for malignant bone and soft tissue sarcomas the survival rate become higher. Till now there are some questions who can survive. Temporary procedure not affecting the treatment schedule would have more advantages than primary permanent one. When there is higher possibility of survival, this can be switched to permanent one. From Dec. 1986 to Jan. 1994, we had performed 40 cases of temporary arthrodesis after segmental resection of malignant bone and soft tissure tumors around the knee by using intramedullary nail andbone cement. Thirty eight cases of bone tumors[osteosarcoma(33), malignant fibrous histiocytoma(MFH)(3), chondrosarcoma(1), Ewing's sarcoma(1)] and 2 cases of soft tissue sarcomas[MFH(1), squamous cell carcinoma(1)] were analysed. Types of intramedullary nail used were rigid(Huckstep, 23 cases) or flexible(Ender, 17 cases). Six cases(15%) showed mechanical implant failure due to fracture (Huckstep;5, Ender;1) between 2 to 20 months after operation. Rearthrodesis using Ender nail and bone cement(5) or arthroplasty using Kotz prosthesis(1) were done for fractured cases. The other complicaitons were deep infection(2), peroneal nerve palsy(2), or transfixing screw fracture(2). Second reconstruction procedure was carried out in 2 cases with arthroplasty using Kotz prothesis. For IM nail, multiple Ender nailing seems to be superior to the Huckstep in mechanical strength. Contrary to the primary permanent reconsturction of the bone defect, this procedure has several advantages: 1) simple and does not hinder postoperative chemotherapy, 2) even in the extensively involved cases, can save the limb if the neurovascular structures are spared, 3) in Stage III, can save the salvagable limb, 4) economic and immediate stability can be helpful in the patient's quality of life, 5) two years later, when the survival approaches plateau, we can switch to another kinds of salvage operation, 6) Ender nail was superior to Huckstep in mechanical stability, 7) can be used for children expecting leg lengthening near puberty. It is useful for sarcoma patients around knee who require prolonged chemotherapy anbd whose life expectancy is relatively unexpectable.
Adolescent ; Appointments and Schedules ; Arthrodesis ; Arthroplasty ; Child ; Drug Therapy ; Epithelial Cells ; Extremities ; Humans ; Knee ; Leg ; Life Expectancy ; Peroneal Nerve ; Puberty ; Quality of Life ; Sarcoma ; Survival Rate

BACKGROUND/AIMS: Pancreaticoduodenectomy( PD ) is a complicated procedure that carried a very high postoperative mortality and mobidity until 1970s. Since early 1980, motality has been decreased but morbidity is still high now. So this study was conducted to analyze the motality and morbidity as well as survival rates after PD for valiable disease. METHODS: From January 1988 to January 2000, 164 patients underwent PD in the Korea Cancer Center Hospital. Standard pancreaticoduodenectomy was performed in terms of lymph node dissection and main method of pancreaticoenterostomy was end-to-side pancreaticojejunostomy, among which ductto- mucosa anastomosis comprised of about half of cases. Survival rates and the differences were estimated by Kaplan-Meier method and Log-Lank test respectively, and multivariate analysis was done with Cox Regression hazard model using SPSS program for Windows. RESULTS: Median age of all patients was 57 years with slight male predominance(54.8%). Classical Whipple's operation was performed in 113 cases(68.9%), and PPPD in 40 cases(24.3%), hepatopancreaticoduodenectomy in 10 cases(6.1%). Operative mortality was 1.8%( 3/164 ), however no additional in-hospital death occurred. Nine patients underwent reoperation. Postoperative complication occurred in 56 cases(34.2%). The most common complication was pneumonia(11.5%), and delayed gastric emptying( 7.3%), pancreatic fistula(4.8%), intra-abdominal bleeding(4.8%) in orders. No pancreatic leakage occured in duct-to-mucosa anastomosis group. Median survival of 123 periampullary carcinoma was 25 months and better survival was shown in ampulla of Vater cancer. Factors influencing on survival for periampullary carcinoma were origin of tumor, cellular differentiation, lymph node invasion. CONCLUSION: Pancreaticoduodenectomy can be performed safely in the terms of mortality. Bleeding is the most common cause of reoperation and motality, so meticulous bleeding control is very important. And duct-to-mucosa anastomosis is very safe method of pancreaticoenterostomy.
Ampulla of Vater ; Hemorrhage ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes ; Male ; Mortality ; Mucous Membrane ; Multivariate Analysis ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy ; Postoperative Complications ; Proportional Hazards Models ; Reoperation ; Survival Rate