This is a retrospective clinical analysis of 156 patient with colorectal cancer who were surgically treated from January 1988 to June 1996 at the Department of Surgery, Seoul Adventist Hospital. The results are as follows: 1) The peak age incidence was in the 7th decade (31.4% of the cases), and the sex ratio of males to females was 1.03 : 1. 2) The most common location of the tumor was the rectum in 77 cases (49.4%); next were the sigmoid colon in 25 cases (16.0%) and the ascending colon in 25 cases (16.0%). 3) In the right colon, the most frequent symptoms and signs were abdominal pain, a palpable mass, weight loss; in the left colon and rectum, bloody tarry stool and bowel- habit change were the most common symptoms and signs. 4) The duration of the symptoms and signs prior to admission was most commonly less than 3 month (46.8% of the cases). 5) The diagnostic methods were digital rectal examination, sigmoidoscopy, colonofiberoscopy, barium enema, and abdominal CT. In two cases,an exploratory laparotomy was done. Also, 2.8 studies were done per patient. 6) The operations performed included an abdominoperineal resection in 36 cases (24.0%) and a right hemicolectomy (18.7%). The operability was 96.2%, and the total resectability was 79.5%. 7) The staging of the tumor was performed during the initial operation according to the Aster Coller classification and the TNM classification. Stages C2 (33.8%) and B2 (29.1%) and T3N0M0 were the most frequent stages in both classification. 8) The most common histologic type was an adenocarcinoma (96.8%). 9) The most common macroscopic finding was of the annular type (59.6%) 10) The most common distant metastasis sites were the pelvic organs and the liver. 11) The most frequent postoperative complication was wound infection (14.7%). The complication rate and perioperative mortality were 32.7% and 2%, respectively.
Abdominal Pain ; Adenocarcinoma ; Barium ; Classification ; Colon ; Colon, Ascending ; Colon, Sigmoid ; Colonic Neoplasms ; Colorectal Neoplasms* ; Digital Rectal Examination ; Enema ; Female ; Humans ; Incidence ; Laparotomy ; Liver ; Male ; Mortality ; Neoplasm Metastasis ; Postoperative Complications ; Rectal Neoplasms ; Rectum ; Retrospective Studies ; Seoul ; Sex Ratio ; Sigmoidoscopy ; Tomography, X-Ray Computed ; Weight Loss ; Wound Infection

Coronary arteriovenous fistulas (CAVF) are rare malformations of the coronary circulation. They are seen in approximately 0.1% to 0.2% of all patients undergoing selective coronary angiography. We experienced a 58-years old male patient with bilateral coronary AV fistulas whoes diagnosis was confirmed by selective coronary angiography.
Arteriovenous Fistula* ; Coronary Angiography ; Coronary Circulation ; Diagnosis ; Fistula ; Humans ; Male ; Middle Aged

Henoch-Schonlein purpura (HSP) is the most common form of systemic vasculitis in children. Palpable purpura, arthralgia, arthritis, abdominal pain and renal involvement are the major clinical manifestations. Gastrointestinal involvement is related with abdominal pain and bleeding. We described a 71 year-old female experienced acute exacerbation of HSP presented with gastrointestinal bleeding. She was hospitalized for hematemesis and diagnosed duodenitis by esophagogastroduonenoscopy (EGD). Duodenitis was improved at EGD checked in 7 days. She still complained of melena and abdominal pain. There were no abnormal findings at sigmoidoscopy. Jejunal ulcer and purpura were diagnosed by capsule endoscopy. Symptoms were relieved after administration of systemic steroid. But she needed renal replacement therapy for 3 months. Small bowel ulcer diagnosed by capsule endoscopy in patients with HSP was rarely described in Korean literature. This case suggests that capsule endoscopy have a role in diagnosis of small bowel ulcer and its severity in HSP with gastrointestinal symptom.
Abdominal Pain ; Arthralgia ; Arthritis ; Capsule Endoscopy ; Child ; Duodenitis ; Female ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage ; Humans ; Melena ; Purpura ; Purpura, Schoenlein-Henoch ; Renal Replacement Therapy ; Sigmoidoscopy ; Systemic Vasculitis ; Ulcer

BACKGROUND: The treatment of facial telangiectasia include microsclerotherapy, laser, and electrosurgery. It is important that the treatment for telangiectasia be relatively risk-free, especially avoiding unsightly scarring. OBJECTIVE: We evaluated the effectiveness, complications, and recurrence rate of patients with facial telangiectasia treated with microsclerotherapy using osmotic sclerosing agent. In addition, we also evaluated the associated factors, the sites of predilection, and types of facial telangiectasia. PATIENTS AND METHODS: Fifteen patients with facial telangiectasia were treated with microsclerotherapy using osmotic sclerosant(Sclerodex(R)). The procedure was performed at 4 week intervals and on average 2 times. The effectiveness was evaluated by the comparison of photographs monthly during mean 6 months follow-up period. RESULTS: Mean improvement rate was 70% and partial recurrence was observed in 3 cases(20%). Transient bruising(33%), transient pigmentation(7%) and telangiectatic matting(7%) were observed as complications. CONCLUSION: Sclerotherapy with osmotic sclerosant(Sclerodex(R)) is safe and moderately effective; because it usually has more than a good response and minimal complications.
Cicatrix ; Electrosurgery ; Follow-Up Studies ; Humans ; Recurrence ; Sclerotherapy ; Telangiectasis*

Cryptococcosis is the infection caused by the encapsulated yeast Cryptococcosis neoformans. Cutaneous manifestation can develop as a result of the dissemination from pulmonary lesion or, rarely, through inoculation. They have variable morphologies, including papules or pustules, nodules, eczematoid plaques, ulcers, cellulitis, purpura and cold abscess. The authors experienced one case of disseminated cryptacoccosis by multiple papules and two cases of primary cutaneous cryptococcosis manifested by ulcerative lesions. We present 3 cases of cryptococcosis with cutaneous manifestations with review of literatures, especially in point of clinical manifestations.
Abscess ; Cellulitis ; Cryptococcosis* ; Purpura ; Ulcer ; Yeasts

Kaposi's sarcoma(KS) is a multicentric vascular neoplasm involving the skin or internal organs. Cutaneous manifestations are usually present with multiple papules or plagues, either diffusly or bilaterally. The cases showing multiple cutaneous lesions on unilateral portion of body are unusual. We report a case of KS occurring in an allogeneic renal recipient, whose multiple discrete papulonodular lesions localized on the left lower leg. Because of unusual distribution of cutaneous lesions, we observed the clinical progression of present case on the basis of long term follow-up.
Follow-Up Studies ; Kidney Transplantation* ; Leg ; Sarcoma, Kaposi* ; Skin ; Vascular Neoplasms

Glomangioma is a kind of glomus tumor showing components of glomus cells and blood vessels. A 12-year-old female visited our department due to a tender 8 X 7 cm sized plaque formed by multiple conglobated nodules that had been growing on the left thigh since her birth. Histopathological findings showed dilated, thin walled vascular spaces surrounded by several layers of glomus cells, compatible with glomangioma. Glomangioma has been treated with surgical excision, laser, and sclerotherapy. We treated her by sclerotherapy in considering size and depth of the lesion. After second sclerotherapy with 1% sodium tetradecyl sulfate, the tender lesion almost disappeared. Sclerotherapy was effective to treat large glomangioma with good cosmetic outcome.
Blood Vessels ; Child ; Female ; Glomus Tumor* ; Humans ; Parturition ; Sclerotherapy* ; Sodium Tetradecyl Sulfate ; Thigh

BACKGROUND:Accurate and timely diagnosis of acute surgical disease in pregnant patient is chal enging. Although magnetic resonance imaging (MRI) is the most accurate modality to diagnose acute appendicitis in pregnant patients, it is often used as a last resort because of high cost and long scan time. We performed this study to analyze differential diagnoses of appendix MRI and to investigate if there are any blood tests that can predict surgical condition in pregnant patients. METHODS:A retrospective, cross-sectional study was conducted on 46 pregnant patients who underwent non-enhanced appendix MRI in suspicion of acute appendicitis from 2010 to 2016. Differential diagnoses of appendix MRI were analyzed and blood tests were compared between those who had surgical and non-surgical disease. RESULTS:Appendix MRI differentiated two surgical disease; acute appendicitis and ovarian torsion; and various non-surgical conditions such as uterine myoma, hydronephrosis, ureterolithiasis and diverticulitis among clinically suspected acute appendicitis in pregnancy. The diagnostic accuracy of MRI for acute appendicitis in this study was 93.5％. Patients who had surgical disease showed significantly higher WBC count (≥11,000/mm3), proportion of neutrophils in the WBC (≥79.9％), neutrophil-to-lymphocyte ratio (NLR≥6.4), levels of C-reactive protein (CRP≥1.82 mg/dL) and bilirubin (≥0.66 mg/dL ) than those who had non-surgical disease. CONCLUSION:MRI can reliably differentiate surgical conditions and several blood tests (WBC, proportion of neutrophils in the WBC, NLR, CRP, bilirubin) can help anticipate acute surgical condition among pregnant patients suspected to have acute appendicitis.

Hepatoid adenocarcinoma is a rare variant of adenocarcinoma of the stomach. The tumor has been found to be an alpha-fetoprotein (AFP) producing carcinoma arising in extrahepatic organs, and it mimics hepatocellular carcinoma in terms of morphology and function. Vascular invasion, usually prominent, is often complicated by extensive liver metastases, and vascular permeation, especially in the veins, has been described as a characteristic finding of this tumor. A patient with hepatoid adenocarcinoma of the stomach with a huge mass is described. Gastrofiberscopy revealed an elevated lesion with a central depression on the greater curvature of the antrum and with extrinsic compression on the lesser curvature and the duodenum. Computed tomography revealed a large lobulated mass in the lesser curvature of the stomach, attached from the liver, gall bladder and porta hepatitis to the pancreas. The AFP serum level was markedly elevated. After a diagnosis was made of AFP-producing stomach carcinoma with huge lymph node metastasis, subtotal gastectomy with wedge resection of the liver, and cholecystectomy including the huge mass ware performed. Microscopically, the tumor and intraabdominal huge mass showed mainly hepatoid differentiation. The tumor showed immunohistochemical positivity for AFP and huge lesser omental metastasis with adhesion to the liver and extensive venous invasion. Lymph node metastasis was not found. According to these histopathological findings, the tumor was diagnosed as hepatoid adenocarcinoma of the stomach with venous invasion. We report this rare variant of adenocarcinoma of the stomach, which mimics hepatocellular carcinoma in its propensity for venous permeation.
Adenocarcinoma* ; alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Cholecystectomy ; Depression ; Diagnosis ; Duodenum ; Hepatitis ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Pancreas ; Stomach* ; Urinary Bladder ; Veins

BACKGROUND/AIMS: HBeAg-negative chronic hepatitis B (CHB) has a poor long-term prognosis. Since no precise clinically relevant HBV thresholds are known in HBeAg-negative CHB, the decision to treat is difficult. The aim of this study was to evaluate the levels of serum HBV DNA and transaminase and to investigate the correlation of these values in patients with HBeAg-negative CHB. METHODS: The study analyzed the sera from 82 patients with HBeAg-negative CHB, 61 men and 21 women. The mean age was 45 years. The patients were divided into two groups according to serum ALT levels: the patients with lower ALT level (n=52, UNL < ALT < 2 X UNL) and higher level (n=30, ALT >or= 2 X UNL). The level of serum HBV DNA was determined by the Cobas Amplicor HBV Monitor(TM) (Roche). RESULTS: The median serum HBV DNA level was 2.7 X 10(5) copies/mL in patients with HBeAg-negative CHB. The median serum HBV DNA level of patients with a higher ALT level (1.0 X 10(6) copies/mL) was significantly higher than that of patients with a lower ALT level (5.6 X 10(4) copies/mL)(p<0.001). The serum ALT level was correlated with serum HBV DNA levels in patients with HBeAg-negative CHB (r=0.416, p<0.001). The serum level of HBV DNA in patients with cirrhosis (median 2.0 X 10(5) copies/mL) did not differ from patients without cirrhosis (median 4.7 X 10(5) copies/mL). CONCLUSIONS: The level of serum HBV DNA was higher in patients with higher serum ALT level than it was in patients with lower serum ALT, and it was closely correlated with serum ALT levels in HBeAg-negative CHB.
Alanine Transaminase/*blood ; DNA, Viral/*blood ; English Abstract ; Female ; Hepatitis B e Antigens/*blood ; Hepatitis B virus/*genetics/isolation & purification ; Hepatitis B, Chronic/blood/diagnosis/*virology ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged