Fetal teratomas rarely complicate pregnancy,having an incidance of only 20,000:1 to 40,000:1 of live births. Overthere, cervical teratomas are rare and accounts for only 5.5% of all neonatal teratomas. We have experienced a large cervical immature teratoma and present this case with a brief review of literatures.
Live Birth ; Teratoma*

BACKGROUND: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis. MATERIAL AND METHODS: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome. RESULTS: Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis. CONCLUSION: On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.
Appendicitis* ; Diagnosis ; Humans ; Incidence ; Multivariate Analysis ; Postoperative Complications

PURPOSE: This study was conducted to determine whether low intensity regular exercise following dexamethasone treatment could attenuate steroid-induced muscle atrophy. METHOD: 36 Wistar-rats(90-110g) were divided into six groups: control group(C), dexamethasone treatment group(D), sedentary group after normal sedentary period(C+S), sedentary group after dexamethasone treatment period(D+S), exercise group after normal sedentary period(C+E), and excercise group after dexamethasone treatment period(D+E). D, D+S, and D+E groups received dexamethasone injection(5mg/Kg) for seven days whereas C, C+S, and C+E groups received normal saline injection. Both C+E and D+E groups ran on a treadmill for 60 minutes/day(20minutes/4hours) at 15m/min and a 10degreegrade for seven recovery days. RESULT: Post-weight(body weight before muscle dissection) of D group significantly decreased by 16.03%, and that of D+E group significantly increased by 15.51% compared with pre-weight(body weight before steroid treatment). Type II muscle(plantaris and gastrocnemius) weights of D group were significantly lower than those of C group. Myofibrillar protein contents of type II muscles of D group tended to decrease comparing with C group. In D+E groups, body weights and relative weights of typeII muscles(muscle weight(mg)/post-weight(g)) tended to increase comparing with D+S group. CONCLUSION: It is suggested that steroid- induced muscle atrophy can be ameliorated through low intensity regular exercise after dexamethasone treatment.
Animals ; Body Weight ; Dexamethasone ; Muscle Fibers, Fast-Twitch ; Muscles* ; Muscular Atrophy ; Rats* ; Weights and Measures

In this retrospective study, 49 patients who were treated by surgical resection of colorectal cancer, confuted to proper muscle and confirmed histologically from 1979 to 1996 were included. To examine the significance of growth pattern in terms of polypoid growth(PG)(n=26; m,sm 5, pm 21) and non-polypoid growth(NPG)(n=23; m,sm 3, pm 20), we analyzed several clinocopathologic variables by x2 test and unpaired t-test, 5-year survival rate by Kaplan-Meier method and Log-Rank statistics according to growth type comparatively: 1) In the PG tumor, muscle elevation(P<0.0117) and association with adenoma(P<0.0001) were more frequent than in the NPG. 2) The NPG type showed smaller size(P<0.0172) and higher rate of lymph node metastasis(P=0.025) and higher tendency of lymphatic invasion(P=0.07) and poor differentiation(P=0.0693) and deeper invasion(P=0.0972) and worse 5-year survival(P=0.0607). 3) Otherwise there was no difference in inflammation, fibrosis, and angioinvasion. 4) The mean thickness of Outer Longitudinal Muscle(OLM) was thicker in rectum than colon(rectum 1.62 mm, colon 0.74 mm, p<0.0059) and pm cancer was more in rectum than in colon(rectum 10.3%, colon 4.0% , p=0.0057). In the view of results, NPG in early colorectal cancer may suggest the possibility of de novo cancer. NPG type was smaller in the size but more aggressive in lymph node metastasis, lymphatic invasion, invasion depth, tumor differentiation, 5-year survival rate. So it needs more thorough follow up. The higher incidence of pm cancer in rectum than in colon, is probably due to thicker OLM of rectum than that of colon.
Colon ; Colorectal Neoplasms* ; Fibrosis ; Follow-Up Studies ; Humans ; Incidence ; Inflammation ; Lymph Nodes ; Lymphatic Metastasis ; Rectum ; Retrospective Studies ; Survival Rate

Despite major diagnostic advances, 10-30% of hepatic metastases of colorectal carcinoma remain undetected. In this study, CEA levels of peripheral (p-CEA), drainage venous blood(d-CEA) and gallbladder bile(b-CEA) in patients with colorectal cancer were determined to examine the significance of their CEA levels in predicting hepatic metastases. From January 1993 through May 1996, p-CEA, d-CEA and b-CEA were obtained in 50 colorectal carcinoma patients without gallbladder pathology. Synchronous hepatic metastases were found in 5 patients(Hm group) and 45 cases had no hepatic metastasis. Among the 27 cases who followed up over 2 years, metachronous hepatic metastases(Hr group) were found in 6 cases and remaining 21 cases had no metastases(Ho group). Elevation of p-CEA, d-CEA, and b-CEA was significantly correlated with lymph node metastases and hepatic metastasis. The b-CEA levels were significantly correlated with p-CEA(r=0.533926, p<0.0001) while d-CEA levels were not(r=0.276437, p=0.0520). Although all the levels of p-CEA, d-CEA, and b-CEA in Hr & Hm group were significantly higher than those in Ho group, d-CEA level was considered as most sensitive index in predicting hepatic metastases(mean 12.7 ng/ml in Ho, 88.6 in Hr, and 137.3 in Hm group. p<0.0001). The possible cut-off level of d-CEA was 40 ng/ml because all of the cases with d-CEA < 40 ng/ml had no hepatic metastasis nor hepatic recurrance, whereas 11 out of 12 patients with d-CEA > 40 ng/ml had hepatic metastases(5 synchronous, 6 metachronous). However it is impossible to establish the possible of b-CEA because of high false positive and negative rate in predicting metachronous hepatic metastases. In conclusion, it is suggested that d-CEA could be highly sensitive indicator for selecting high-risk patients of metachronous hepatic metastases of colorectal cancer.
Bile* ; Colorectal Neoplasms* ; Drainage* ; Gallbladder* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Pathology

PURPOSE: This study was designed to evaluate the effect of growth hormones on children with growth hormone deficiency(GHD) or idiopathic short stature(ISS). METHODS: Between January 1988 to July 2003, 45 patients(M26, F19) with GHD and 24 patients (M13, F11) with ISS were enrolled in this study. Height standard deviation score(Ht SDS) for chronological age(CA) and Ht SDS for bone age(BA) were obtained for each patient upon diagnosis and after growth hormone(0.1-0.15 IU/kg) was injected subcutaneously daily. RESULTS: Ht SDS for CA was -2.06+/-0.23 before treatment, -1.60+/-0.21 at one year, -1.52+/-0.23 at two years, -1.61+/-0.28 at three years, -1.60+/-0.31 at four years, and -1.54+/-0.32 at five years, showing a statistically significant increase for five years(P<0.05). Meanwhile, the values were -2.03+/-0.55 before treatment, -1.44+/-0.66 at one year, -0.14+/-1.06 at two years, -0.68+/-1.27 at three years, -1.16+/-0.96 at four years, and -1.37+/-0.94 at five years, in ISS, showing a statistically significant increase for the first three years(P<0.05) only. Ht SDS for BA in GHD was -0.53+/-0.19 before treatment, -0.39+/-0.18 at one year, -0.32+/-0.20 at two years, -0.43+/-0.22 at three years, -0.39+/-0.19 at four years, and -0.32+/-0.22 at five years, not showing a decrease, and the decrease in ISS was statistically not significant(P> or =0.05). CONCLUSION: Both groups exhibited significant increase in Ht SDS through growth hormone treatment, proving its efficacy. As for the evaluation of growth-related factors, the 1st year increase of Ht SDS was the most important factor in evaluation of growth effect in both groups. However, further study is required to investigate the effect of GH therapy on ISS.
Body Height ; Child ; Diagnosis ; Growth Hormone* ; Hormone Replacement Therapy ; Humans

Ovarian Pregnacy is a rare form of ectopic pregnacy. Its estimated overall incidence is highly variable, but improved diagnosis of acute hemoperitoneum of ovarian pregnancy may reveal a high incidence than reported earlier. Ovarian pregnancy occurs in the corpus luteum, and is usually accompanied with the rupture of the ovary and massive hemoperitoneum. It presents as a hemorragic ovary and frequently misdiagnosed as a ruptured corpus luteum. Risk facters to ovarian pregnacy include a history of pelvic inflammatory disease(PID), prior pelvic surgery, and use of an intrauterine contraceptive device(IUD). We have experienced two cases of ovarian pregnancy and reviewed it briefly.
Corpus Luteum ; Diagnosis ; Female ; Hemoperitoneum ; Incidence ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

Despite the recognized desirability of spenic salvage,forced splenectomy remains the rule in many operative situations,including trauma and pancreatic cancer. The aim of this study was to evaluate the phagocytic function,histologic finding and anatomic change when the perfusion of preserved spleen was done only through short gastric vessels after splenic vessel ligation. In this situation, we evaluate the necessity of mass reduction to improve the perfusion into the residual spleen by 2/3 patial splenectomy. We studied 41 Sprague-Dawley rats by subdiving them into 3 main groups.In HL(;Hilar ligation)group, splenic vessel ligation was done(n=18). In HLS(Hilar ligation + 2/3partial splenectomy), splenic vessel ligation and partial splenectomy were done(n=18), and the others(n=5) were used as a control group. The changes of anatomy,histologic findings, and phagocytic functions in the preserved splenic tissue were observed at 1hour,2weeks, and 5months postoperatively,based on results of the India ink technique for demonstrating phagocytic function and on results of regular histologic examination. In all rats,at least 1 upper short gastric vessel was noted without direct connection to splenic vessel.In HL group,at 2weeks postoperatively,the size and weight of the preserved spleens were severely decreased to 1/3 of those of control group(p=0.0002). But,after 5months,the size and weight recovered to about 70-80% of those of initial spleen parameters.In HLS group,the size and weight changes were not found.At 1hour postoperatively phagocytic activity decreased to 35% in the control group,10% at 2weeks and not improved at 5months in both groups.The white pulps didn't show any specific change. We concluded that in spite of splenic mass reduction,the white pulp did not change, and phagocytic function was not improved.Therefore,the splenic mass reduction is not essential for the recovery of phagocytic function at the preserved spleen.
Animals ; India ; Ink ; Ligation ; Pancreatic Neoplasms ; Perfusion ; Rats* ; Rats, Sprague-Dawley ; Spleen ; Splenectomy

The gastric polyps may be premalignant lesions and they should be removed as possible. The gastric polyps can be remoued by various endoscopic methods. The safety and therapeutic effectiveness of snare polypectomy, neodymium YAG laser therapy and electrocutery were compared in a total number of 106 patients who were diagnosed as benign polyps by means of endoscopic biopsy.Safety was evaluated by the rate of complications such as perforation and bleeding, and therapeutic effectiveness was evaluated by the average numbers of treatment session of each modality. Average numbers of treatment session of snare polypectomy, laser therapy and electrocautery were 1.04, 1.38 and l.44, respectively. Average numbers of treatment session of snare polypectomy were significantly (p<0.05) lower than those of other two methods. Perforation was not occurred in any group. Bleeding rates after snare polypectomy, laser therapy and electrocautery were 17.4%, 1.0% and 3.8%, respectively. Bleeding was significantly (p<0,05) more frequent after snare polypectomy than after other two methods. In conclusion therapeutic effectiveness was best in snare polypectomy but complication was most frequent after snare polypectomy. There was no difference between laser therapy and electrocautery for therapeutic effectiveness and safety. Therfore, laser therapy and electrocautery caa be used for the removal of flat adenoma, alternatively.
Adenoma ; Electrocoagulation ; Hemorrhage ; Humans ; Laser Therapy ; Lasers, Solid-State ; Neodymium ; Polyps ; SNARE Proteins

The gastric polyps may be premalignant lesions and they should be removed as possible. The gastric polyps can be remoued by various endoscopic methods. The safety and therapeutic effectiveness of snare polypectomy, neodymium YAG laser therapy and electrocutery were compared in a total number of 106 patients who were diagnosed as benign polyps by means of endoscopic biopsy.Safety was evaluated by the rate of complications such as perforation and bleeding, and therapeutic effectiveness was evaluated by the average numbers of treatment session of each modality. Average numbers of treatment session of snare polypectomy, laser therapy and electrocautery were 1.04, 1.38 and l.44, respectively. Average numbers of treatment session of snare polypectomy were significantly (p<0.05) lower than those of other two methods. Perforation was not occurred in any group. Bleeding rates after snare polypectomy, laser therapy and electrocautery were 17.4%, 1.0% and 3.8%, respectively. Bleeding was significantly (p<0,05) more frequent after snare polypectomy than after other two methods. In conclusion therapeutic effectiveness was best in snare polypectomy but complication was most frequent after snare polypectomy. There was no difference between laser therapy and electrocautery for therapeutic effectiveness and safety. Therfore, laser therapy and electrocautery caa be used for the removal of flat adenoma, alternatively.
Adenoma ; Electrocoagulation ; Hemorrhage ; Humans ; Laser Therapy ; Lasers, Solid-State ; Neodymium ; Polyps ; SNARE Proteins