No abstract available.

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

No abstract available.
Cholesteatoma* ; Facial Paralysis*

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

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

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

PURPOSE: This study reviews the feasibility of a total colectomy with ileo-rectal anastomosis (TCIRA) and the functional outcome following the operation. METHODS: The cases of a total of 50 patients (31 men and 19 women) with a median age of 61 who underwent a TCIRA were reviewed retrospectively. The median follow-up time was 28 months (4~72). The clinical records were reviewed to analyze the postoperative complications and bowel function. The clinical outcomes were examined directly from patients' scoring. RESULTS: The indications of TCIRA were metachronous or synchronous colorectal cancer (34 percent), multiple polypoid lesions (22 percent), malignant colon obstruction (24 percent), ischemic colitis (2 percent), Crohn's disease (6 percent), and tuberculosis colitis (2 percent). The overall mortality and morbidity rates were 0 and 31 percent, respectively. The morbidity included postoperative bleeding, obstruction, intra-abdominal abscess formation, pneumonia, and wound complications. We used the CCIS index to evaluate postoperative functional bowel habit change. The CCIS index evaluation revealed perfect continence in 57 percent of the patients with short-term follow up (<6 months) and in 83 percent of the patients who had undergone a TCIRA more than 2 years ago. CONCLUSIONS: Most patients were satisfied with their bowel function on long-term follow up, and we think the TCIRA is a safe operation, and the clinical outcomes are relatively satisfactory.
Abdominal Abscess ; Colectomy* ; Colitis ; Colitis, Ischemic ; Colon ; Colorectal Neoplasms ; Crohn Disease ; Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Mortality* ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Tuberculosis ; Wounds and Injuries

PURPOSE: The aim of this study was to investigate the clinical and radiological incidence of parastomal hernia and to analyze the risk factors for parastomal hernia. METHODS: We reviewed retrospectively 108 patients with end colostomy from January 2003 to June 2010. Age, sex, surgical procedure type, body mass index (kg/m2), stoma size, and respiratory comorbidity were documented. RESULTS: There were 61 males (56.5%) and 47 females (43.5%). During an overall median follow-up of 25 months (range, 6 to 73 months), 36 patients (33.3%) developed a radiological parastomal hernia postoperatively and 29 patients (26.9%) presented with a clinical parastomal hernia. In multivariate analysis, gender (odds ratio [OR], 6.087; P = 0.008), age (OR, 1.109; P = 0.009) and aperture size (OR, 6.907; P < 0.001) proved to be significant and independent risk factors after logistic regression analysis. CONCLUSION: This study showed that the incidence of radiological parastomal hernia is higher than clinical parastomal hernia. Risk factors for parastomal hernia proved to be female, age, and aperture size.
Colostomy ; Comorbidity ; Female ; Follow-Up Studies ; Hernia ; Humans ; Incidence ; Logistic Models ; Male ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Somatotypes

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