No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.

No abstract available.
Cholesteatoma* ; Facial Paralysis*

The description of the carotid artery and venous structure in the cavernous sinus, because of their size and location, was very short or even absent in the most anatomical textbooks. But, since the report of a direct surgical approach to the cavernous sinus by Parkinson in 1965, there has been an increasing number of reports of successful direct surgical approaches to the cavernous sinus. With the introduction of microsurgery and the developement of new techinques and surgical approach, a more accurate knowledge of vascular anatomy of the cavernous sinus is not only of theoretical academic interest, but may also have implications. To better study this vascular anatomy, eighty cavernous sinuses from fresh cadavers of adult subjects were dissected under the operating surgical microscope. A red solution of resin was injected to facilitate the dissection, and twenty cavernous sinuses were studied, based on serial sections in the coronal planes for the study of the venous structure of the cavernous sinus. The results of this study were summarized as follows. 1) The most common branch of internal carotid artery in the cavernous sinus was the meningohypophyseal trunk, the largest intracavernous branch, which was presented in 100% of our specimens, the inferior cavernous artery, in 96.3%, and capsular artery, in 13.8%. 2) The ophthalmic artery arised within the paraclinoid portion of the internal carotid artery in 33.8%. In 3.8%, it entered the floor of the optic canal through a foramen in the bone. But there was no intracavernous origin of the ophthalmic artery. 3) The cavernous sinus seemed to be a venous pathway, an irregualr network of venous channel, not a trabeculated sinus.
Adult ; Arteries ; Cadaver ; Carotid Arteries* ; Carotid Artery, Internal ; Cavernous Sinus ; Humans ; Microsurgery ; Ophthalmic Artery

The cavernous sinus is a extradural venous pathway enclosed by leaves of dura and periosteum located on either side of the sella turcica, and has connections with cerebrum, cerebellum, brain stem and orbit. It contains the internal carotid artery, the abducens nerve, and the sympathetic nerves, and its lateral wall contains the third and fourth cranial nerves as well as the first and sometimes the second division of the fifth cranial nerve. These connections and the relationships make the sinus of special interest to neurosurgeons. However, the descriptions of the cavernous sinus and its contents show great variation in books and journals. To better define this anatomy, in this report, eighty cavernous sinuses from fresh cadavers were studied in detail using surgical microscope with special attention to the relationships imprortant in surgical approaches on the intracavernous structures, and twenty cavernous sinuses were studied, based on serial sections in the coronal planes for the study of the microanatomical structures. The results of this study were summarized as follows : 1) The average distance between the posterior clinoid process and the entrance of the 3rd, 4th, 5th, 6th cranial nerve into the cavernous sinus were 5.99+/-1.69, 12.00+/-2.83, 15.44+/-2.38, 17.85+/-3.12mm. 2) The lateral wall of the sinus was composed of two layers : a deep layer is formed by the sheathes of nerve III, IV, and VI with a reticular membrane and some dural fold, and the deep layer was less defined and more irregular and imcomplete. 3) The average length of the Parkinson's striangle was 14.76+/-3.40mm(superior), 18.54+/-3.96mm(inferior), 6.33+/-2.14mm(posterior). 4) There were many variations in the origin and course of the sixth nerve. Among these, calssic pattern which originated and run all its course to the orbit as a single trunk is 67.5%.
Abducens Nerve ; Brain Stem ; Cadaver ; Carotid Artery, Internal ; Cavernous Sinus* ; Cerebellum ; Cerebrum ; Cranial Nerves* ; Membranes ; Orbit ; Periosteum ; Sella Turcica ; Trigeminal Nerve ; Trochlear Nerve

We experienced a case of Plasmodium falciparum gametocytemia successfully treated with primaquine in a twenty seven-years old woman. The patient had been admitted due to general malaise after diagosis and treatment of P. falciparum at Tanzania one month ago. On microscopic examination, P. falciparum gametocytemia was seen and treated with mefloquine for one week but gametocytemia was not disappeared. After primaquine treatment for two weeks, she was successfully treated.
Female ; Humans ; Mefloquine ; Plasmodium falciparum* ; Plasmodium* ; Primaquine* ; Tanzania

PURPOSE: We performed a comparative analysis of the clinicopathologic features and oncologic outcomes of colorectal cancer patients with metachronous versus synchronous metastasis, according to the prognostic factors. METHODS: Ninety-three patients who underwent curative resection for distant metastatic colorectal cancer were included in the study between December 2001 and December 2011. We assessed recurrence-free survival and overall survival in patients with distant metastasis who underwent curative surgery. RESULTS: The most common site of distant metastasis was lung alone (n = 19, 51.4%) in patients with metachronous metastasis, while liver alone was most common in those with synchronous metastasis (n = 40, 71.4%). Overall survival rate was significantly different between patients with synchronous metastasis and metachronous metastasis (34.0% vs. 53.7%; P = 0.013). Incomplete resection of the metastatic lesion was significantly related to poor overall survival in both, patients with synchronous metastasis, and metachronous metastasis. CONCLUSION: Our study indicates that patients developing distant metastasis after initial treatment show a different metastatic pattern and better oncologic outcomes, as compared to those presenting with distant metastasis. Resection with tumor free margins significantly improves survival in patients with metachronous as well as synchronous metastasis.
Colorectal Neoplasms* ; Humans ; Liver ; Lung ; Metastasectomy* ; Neoplasm Metastasis* ; Survival Rate

Hyperreactio luteinalis(HL)referes to moderate to marked cystic bilateral enlargement of ovaries due to benign theca lutein cysts, usually related to hydatidiform mole or choriocarcinoma. After its first description by Berger in 1938, almost 53 cases of HL unassociated with trophoblastic disease have been reported in the literature. We encountered one such case in a 34 years old female which was incidentally diagnosed during cesarean section at term.
Adult ; Cesarean Section ; Choriocarcinoma ; Female ; Humans ; Hydatidiform Mole ; Lutein ; Ovary ; Pregnancy ; Trophoblasts

PURPOSE: Clinical usefulness of sentinel lymph node (SLN) mapping in colorectal cancer remains controversial. The aim of this study is to evaluate the accuracy of the SLN mapping technique using serial sectioning, and to compare the results between ex vivo and in vivo techniques. METHODS: From February 2011 to October 2012, 34 colon cancer patients underwent SLN mapping during surgical resection. Eleven patients were analyzed with the in vivo method, and 23 patients with the ex vivo method. Patient characteristics and results of SLN mapping were evaluated. RESULTS: The SLN mapping was performed in 34 patients. Mean age was 67.3 years (range, 44-81 years). Primary tumors were located in the following sites: 13 in the right colon (38.2%) and 21 in the left colon (61.8%). SLN mapping was performed successfully in 88.2% of the patients. There was no significant difference in the identification rate between the two methods (90.9% vs. 87.0%, P = 1.000). Both the mapping methods showed a low sensitivity and high rate of skip metastasis. CONCLUSION: This study showed that SLN evaluation using serial sectioning could not predict the nodal status with clinically acceptable accuracy despite the high detection rate.
Colon ; Colonic Neoplasms* ; Colorectal Neoplasms ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy

PURPOSE: Preoperative localization is the most important preparation for laparoscopic surgery. Preoperative marking with India ink has widely been used and is considered to be safe and effective. However, India ink can cause significant inflammation, adhesions and bowel obstruction. Therefore, we have used the patient's blood instead of the ink since 2011. In this retrospective study, we wanted to examine the feasibility of preoperative localization by using the patient's blood. METHODS: Twenty-five patients who underwent preoperative localization in which 10 mL of their own venous blood was used as a tattooing agent were included in this study. The characteristics of the patients, the anatomy of the colon cancer, and the efficacy and the side effects of using this procedure were analyzed. RESULTS: In 23 cases (92%), through the laparoscope, we found perfectly localized bloody smudges in the serosa. However, in 2 cases (8%), we could not find the exact location of the lesion. No patients showed any complications. CONCLUSION: Preoperative localization of early colon cancer or a malignant polyp by using patient's blood is feasible, safe and simple. We think that using the patient's blood for localization of a lesion is better than using some other foreign material such as India ink.
Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; India ; Inflammation ; Ink ; Laparoscopes ; Laparoscopy ; Polyps* ; Preoperative Care ; Retrospective Studies ; Serous Membrane ; Tattooing