Sparganosis is a rare tissue-parasitic infestation caused by a plerocercoid tapeworm larva(sparganum), genus Spirometra. The most common clinical presentation of sparganosis is a palpable subcutaneous mass or masses. Fifteen simple radiographs and 10 ultrasonograms of 17 patients with operatively verified subcutaneous sparganosis were retrospectively analyzed to find its radiologic characteristics for preoperative diagnosis of sparganosis. The locations of the subcutaneous sparganosis were lower extremity, abdominal wall, breast, inguinal region and scrotum in order of frequency. The simple radiographs showed linear or elongated calcification with or without nodular elongated shaped soft tissue mass shadows in 8 patients, soft tissue mass shadow only in 2 patients and lateral abdominal wall thickening in 1 patient. But no specific findings was noted in 4 patients with small abdominal and inguinal masses. We could classify the subcutaneous sparganosis by ultrasound into 2 types: one is long band-like hypoechoic structures, corresponding to the subcutaneous tunnel-like tracks formed by migration of sparganum larva and the other is elongated or ovoid hypoechoic nodules, representing granulomas. Long band-like hypoechoic structures within or associated with mixed echoic granulomatous masses were noted in 6 patients and elongated or ovoid hypoechoic mass or masses were noted in 4 patients. In conclusion, sparganosis should be considered when these radiologic findings-irregular linear calcifications on simple radiograph and long ban-like hypoechoic structures on ultrasonography, corresponding to the subcutaneous tunnel-like tracks formed by migration of sparganum larva-are noted in the patients who have subcutaneous palpable mass or masses. And radiologic examination especially ultrasonography is very helpful to diagnose sparganosis.
Abdominal Wall ; Breast ; Cestoda ; Diagnosis ; Granuloma ; Humans ; Larva ; Lower Extremity ; Retrospective Studies ; Scrotum ; Sparganosis* ; Sparganum ; Spirometra ; Ultrasonography

PURPOSE: The incidence of upper gastric cancer and especially the diffuse type have increased in western countries. The aim this study was to investigate the chronologic changes of the clinicopathological features and survival rates of Korean upper gastric cancer patients. MATERIALS AND METHODS: 1,638 gastric cancer patients who underwent gastrectomy were included in this study and they were divided into two groups; the 1990's (1991~1999, n=987) and the early 2000's (2000~2003, n=651). We evaluated the differences of the clinicopathologic features and the factors that affected the survival rates by univariative and multivariative analysis. RESULTS: The older age (>60) patients increased from 42.7% to 50.7% respectively. Being overweight (body mass index> or =23) also increased from 31.5% to 43.2%. For the pathology, the incidence of stage Ia gastric cancer increased (29.8% to 44.5%) and the incidence of stage IV gastric cancer decreased (23.5% to 11.8%). Yet there was no difference according to the WHO classification, Lauren's classification and the location of tumor between the groups. The 5 year survival rates increased 67.7% to 83.7%, according to the group. Multivariative analysis showed that the odd ratios of the early 2000s was 0.715 (95% CI; 0.555~0.921) as compared to that of the 1990s. CONCLUSION: There were no changes of the clinicopathologic features, like the pattern in western countries, although the incidence early gastric cancer, old age patients and overweight patients increased. The survival rate of early 2000s was better that that of the 1990s.
Gastrectomy ; Humans ; Incidence ; Overweight ; Stomach Neoplasms ; Survival Rate

A recurrent myoepithelioma of the lung in a 36-year-old man is reported. The neoplasm showed histologic features identical to those described in myoepitheliomas of major and minor salivary glands on the basis of Dardick's morphological classification of Myoepitheliomas. He was treated totally with surgical en-bloc resection including the chest wall. The tumor was found to be well encapsulated, and it appeared to be mainly composed of plasmacytoid cells and clear cells with occasional microcystic spaces in a solid growth form by light microscopy. Immunocytochemical, ultrastructural and flow-cytometrical studies supported myoepithelioma differentiation.
Adult ; Classification ; Humans ; Lung Neoplasms ; Lung* ; Microscopy ; Myoepithelioma* ; Salivary Glands, Minor ; Thoracic Wall

Endometriosis represents extrauterine nonneoplastic endometrial tissue. It is most commonly diagnosed in women of childbearing age, with a peak age of 40 to 44 years. The incidence of genitourinary involvement ranges from 1% to 2%. Ureteral endometriosis is a rare entity, and its diagnosis requires a high index of suspicion. We report a case of ureteral endometriosis in a 44-year-old multiparous woman with a brief review of literature.
Adult ; Diagnosis ; Endometriosis* ; Female ; Humans ; Hydronephrosis ; Incidence ; Ureter*

BACKGROUND: It is not easy to surgically correct caustic pharyngeal strictures and a lot of effort is required to restore normal swallowing after the surgery. The authors reviewed the course in patients who underwent pharyngocolostomy. MATERIAL AND METHOD: From August 1995 to March 1998, 6 patients with caustic stricture underwent esophageal reconstruction surgery. The time of injury to the replacement of the esophagus was from 3 months to 2 years and 4 months. The left colon was used in all patients. The surgical route was used under the sternum in 5 patients and through the esophageal hiatus in 1 patient. In the cervical anastomoses, the cervical pharyngocolic anastomosis was performed on the left pyriform sinus after a partial resection of the thyroid cartilage in 3 patients and on the posterolateral aspect of the inferior pharyngeal constrictor in 3 patients. RESULT: Postoperative complications consisted of a dysphagia in 3 patients and left vocal cord palsy in 1 patient. There was no cervical anastomotic stricture. Revisional procedures consisted of an esophageal dilation and free jejunal graft in 1 patient, supraglottic scar band resection in 1 patient, and colonic mucosal resection in 1 patient. Swallowing training was required in the 3 patients with dysphagia. Restoration of normal swallowing was obtained in all patients between the 9th and the 303rd day. CONCLUSION: Pharyngocolostomy is a satisfactory method of treatment for patients with intractable caustic stricture. Pharyngocolojejunostomy is an effective alternative for esophagocologastrostomy in cases where gastric outlets are involved.
Cicatrix ; Colon ; Constriction, Pathologic* ; Deglutition ; Deglutition Disorders ; Esophageal Stenosis ; Esophagus ; Humans ; Postoperative Complications ; Pyriform Sinus ; Sternum ; Thyroid Cartilage ; Transplants ; Vocal Cord Paralysis

PURPOSE: The purpose of this study is to investigate pathologic changes of blood vessels and perivascular tissue in subsynovial connective tissue (SSCT) of idiopathic carpal tunnel syndrome (CTS) by examining elastin distribution and vascular morphology and by observing ultrasturctural changes of extracellular matrix using transmission electron microscope (TEM). MATERIALS AND METHODS: The Verhoeff-van Gieson stain was used to identify histopathology and to localize elastin in the SSCT of the middle finger flexor digitorum superficialis (FDS) within the carpal tunnel in ten CTS patients and ten cadaver specimens as control group. In each specimen, the elastin density within and around vessels was calculated with image analyzing software including Adobe photoshop 6.0 and Scion image analysis. The vessel number per unit area and the mean thickness of vessel walls were also calculated. The ultrastructural changes of SSCT were compared between the specimens of both groups by TEM. RESULTS: The mean elastin density within vessels was 0.10 +/- 0.03 (p=0.001) in the CTS group and 0.18 +/- 0.04 in the control group. The mean elastin density around vessels was 0.15 +/- 0.04 in the CTS group and 0.23 +/- 0.04 in the control group (p=0.002). The mean number of vessels per unit area (0.00155 mm2) was 0.36 +/- 0.12 in the CTS group and 0.15 +/- 0.10 in the control group (p=0.002). The mean thickness of blood vessels was 38.10 +/- 20.60 micrometer in the CTS group and 18.90 +/- 3.68 micrometer in the control group (p=0.023). In general, the severer the vascular hypertrophy and obstruction, the less elastin noted within and around blood vessels. The TEM showed some important ultrastructural changes in SSCT of CTS. Generally, SSCT contained two kinds of cells, fibroblast-like cells and macrophage-like cells. And these cells and elastin were dispersed among collagen fibrils. In SSCT of control group, the collagen fibrils showed round margin and uniform diameter in transverse section, and showed similar thickness in longitudinal section. However, in SSCT of CTS, the collagen fibrils had irregular margin called "spiraled collagen"and variable diameter in transverse section, and uneven thickness in longitudinal section. In addition, the elastolysis and the phagocytosis of the changed collagen fibrils were observed. CONCLUSION: SSCT of CTS showed significant decrease of elastin density within and around vessels along with degenerative histopathological vascular changes. In addition TEM revealed ultrastructural abnormalities like metamorphosis of collagen fibrils, phagocytosis of spiraled collagen fibrils and elastolysis. Therefore, it is suggested that pathology of CTS may involve active cellular processing related to ischemic cellular environmental changes in carpal tunnel as well as well known pathology of nerve.
Blood Vessels* ; Cadaver ; Carpal Tunnel Syndrome* ; Collagen ; Connective Tissue* ; Elastin ; Extracellular Matrix* ; Fingers ; Humans ; Hypertrophy ; Pathology ; Phagocytosis

A 58-year-old male patient visited our hospital for epigastric discomfort and dysphagia which had developed 5 months earlier. He was diagnosed with esophageal cancer at the mid-thoracic level based on radiologic, endoscopic, and histologic examinations. An esophagectomy(Ivor Lewis technique) was done to treat the esophageal cancer. He was doing well until the 20th postoperative day when he began to complain of cough, sputum, fever and chills, Subsequently, thereafter, abdominal pain and generalized abdominal tenderness developed on the 22nd postoperative day. Upon gastrofiberscopy and esophagographic examinations, he was diagnosed with gastrobronchial fistula and an emergency operation was performed. On operative findings, the gastric fundus was perforated and directly connected to the abscessed cavity of the right upper lobe due to a gastric ulcer. We, herewith, report this case after review of the literature.
Abdominal Pain ; Abscess ; Chills ; Cough ; Deglutition Disorders ; Emergencies ; Esophageal Neoplasms* ; Esophagectomy* ; Fever ; Fistula* ; Gastric Fundus ; Humans ; Male ; Middle Aged ; Sputum ; Stomach Ulcer* ; Ulcer

BACKGROUND: Early detection and surgical resection offer the most advantage out of all cures for lung cancer. Elderly patients may fail to benefit maximally from these interventions because of their general condition and residual lung function. To study the impact of age on stages, histology, symptoms, and treatments of the patients with non-small cell lung cancer, we undertook a retrospective review. MATERIAL AND METHOD: Two hundred eleven patients with non-small cell lung cancer were operated on at Samsung Seoul hospital between October 1994 and June 1997. Patients were arbitrarily arbitrarily by age less than 70 years(176 patients) and 70 years or more(35 patients), and their medical records were reviewed. RESULT: There were no differences in pathologic staging and diagnosis. But there were differences in surgical methods, complications, and mortality rates between the two groups. There were much more complications in the 70 years or more group(p=0.02). We chose less invasive surgical methods in the 70 years or more group. CONCLUSION: More complications were experienced in the 70 years or more group. Although thoracic operation imparts the greatest survival advantage, this benefit is diminished in elderly patients because of their high complications and mortality rate. We recommend serious consideration of surgical indications and operative methods.
Aged* ; Carcinoma, Non-Small-Cell Lung ; Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Medical Records ; Mortality ; Neoplasm Metastasis ; Retrospective Studies ; Risk Factors* ; Seoul

Hydrogen peroxide has been used for various medical purposes and also recommended in the disinfection process for endoscopes. However, hydrogen peroxide as a cause of chemical colitis or disinfectant colitis has been infrequently reported. The endoscopic findings of hydrogen peroxide induced colitis revealed pseudomembranous-like enteritis such as white plaques, erythema, foamy liquid, patchy, granularity, and ulcerations, resulting from effervescence caused by the release of oxygen from the breakdown of hydrogen peroxide. A 36 year-old single male, who had 30 ml of 3% hydrogen peroxide inserted into his anus the day before due to sexual reasons, was hospitalized as a result of suffering from hematochezia, tenesmus, and lower abdominal pain. Colonoscopy revealed discrete or confluent white plaques adherent to the colonic mucosa, severe erythema on the surrounding mucosa, patchy granularity, and scattered ulcerations up to 28 cm from the anal verge. Pathologic finding revealed inflammatory cells infiltration, variable sized vacuoles, vascular congestion, hemorrhage, fibrin deposition and ulcerations with regenerating epithelium in the lamina propria, consistent with acute mucosal injury caused by hydrogen peroxide. A case of hydrogen peroxide induced colitis is herein reported.
Abdominal Pain ; Adult ; Anal Canal ; Colitis* ; Colon ; Colonoscopy ; Disinfection ; Endoscopes ; Enteritis ; Epithelium ; Erythema ; Estrogens, Conjugated (USP) ; Fibrin ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Male ; Mucous Membrane ; Oxygen ; Ulcer ; Vacuoles

The term enterolith refers to concretions formed within the gastrointestinal tract. Enteroliths are thought to result from stasis and are usually found proximal to an area of stricture or within diverticulum. Meckel's diverticulum occurs in 1% to 3% of the population at autopsy and is the most common congenital anomaly of the gastrointestinal tract. Common complications of Meckel's diverticulum include hemorrhage, infection, inflammation, and intussusception. However, enterolith formation in a Meckel's diverticulum, which referred to as Meckel's enterolith, is rare. A 58-year-old female who experienced constipation and low abdominal pain for 20 years, was admitted due to severe low abdominal pain for 3 days. A 3 2 cm sized, lozenge-shaped radiopaque stone with peripheral dense calcification and radiolucent center, located between two areas of stricture in the distal ileum, was observed in abdominal radiograph, abdominal sonogram, small bowel study, and CT scan. Pathologic findings after surgery reveal an enterolith in Meckel's diverticulum without ectopic gastric mucosa. The case of Meckel's enterolith is herein reported.
Abdominal Pain ; Autopsy ; Constipation ; Constriction, Pathologic ; Diverticulum ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Inflammation ; Intussusception ; Meckel Diverticulum ; Middle Aged ; Tomography, X-Ray Computed