Leiomyosarcoma (LMS) within the scrotum is a rare malignant genitourinary tumor in adults. Due to its rarity, a consensus on a clear approach to diagnosis and treatment guidelines has not yet been reached. We present a case of a paratesticular LMS in a 64-yearold man with a painless swelling of the right scrotum. Scrotal ultrasound and pelvic MRI were performed and revealed an extratesticular mass with a heterogeneous appearance.The patient underwent a right radical orchiectomy, and the mass was confirmed to be LMS, originating from the right spermatic cord. Preoperative diagnosis of LMS is challenging since it has overlapping clinical and imaging features with other sarcomas. MRI is a valuable imaging modality for the definitive characterization of the tumor. To provide timely and appropriate treatment, the correlation of the patient’s clinical information and imaging findings is necessary.

PURPOSE: Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. MATERIALS AND METHODS: We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. RESULTS: A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19:6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. CONCLUSIONS The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.

BACKGROUND/AIMS: The purpose of this study was to evaluate the clinicopathologic characteristics of colon cancers detected at the SOK Sokpeynhan Internal Medical Network, a nationwide system of primary health care institutions. METHODS: We analyzed 579 colon cancer patients diagnosed using colonoscopy at the SOK network from January 2011 through December 2012. Cancers from the rectum to the splenic flexure were classified as left colon cancer. Patients over 65 were classified as senior. RESULTS: The mean age (+/-SD) of subjects was 60.9+/-10.5 years and 61.1% were men. More than one quarter (28.2%) of patients were asymptomatic. The prevalence of left colon cancer was higher (77.9%) than that for right colon cancer. The most frequent macroscopic and histologic types were depressed (58.9%) and moderately differentiated adenocarcinoma (52.2%), respectively. Asymptomatic subjects displayed protruding or well differentiated adenocarcinoma, while symptomatic patients were more likely to display depressed or moderately differentiated adenocarcinoma (P<0.05). The mean age of the right colon cancer group was higher than that for the left colon cancer group (P<0.05). Among symptomatic patients, the most frequent symptoms were bloody stool for patients with left colon cancer and abdominal discomfort for patients with right colon cancer (P<0.05). The prevalence of depressed cancer was higher in older subjects as compared to younger subjects (P<0.05). The prevalence of right colon cancer tended to increase with age, although this difference did not achieve statistical significance (P>0.05). CONCLUSIONS: Study results indicated an increase of colon cancer amongst younger demographics in recent years. The effectiveness of colonoscopy screening was also evident, as asymptomatic patients demonstrated frequent findings of well differentiated adenocarcinomas. Study results also suggested a need for closer examination of older patients, as right colon cancer tended to increase with age.
Adenocarcinoma ; Colon, Transverse ; Colonic Neoplasms* ; Colonoscopy ; Demography ; Humans ; Male ; Mass Screening ; Population Characteristics ; Prevalence ; Primary Health Care* ; Rectum

BACKGROUND/AIMS: Stomach cancer is prevalent in Korea. The purpose of this study was to evaluate the characteristics of superficial gastric cancers detected at SOK Sokpeynhan Internal Medical Network, the nationwide primary health care institutions. METHODS: We prospectively analysed the clinicopathologic and endoscopic characteristics of 218 superficial gastric cancer patients diagnosed using gastric endoscopy at SOK network from January 2011 through December 2011. RESULTS: The mean age was 58.5 years old and male to female ratio was 1.7 : 1. Asymptomatic patients were most common (45.0%). The macroscopic classification revealed that simple types (63.8%) were more common than complex types (36.2%). The most common type was IIc (28.4%) and other types were as follows; IIb (16.1%), IIb+IIc (13.3%), IIa (10.6%), III (9.2%), IIa+IIc (7.3%), IIc+IIa (6.0%), IIc+IIb (5.0%). The most commonly involved sites were the body (53.1%) and greater curvature (32.6%) of the stomach. The size of lesion was less than 1 cm (69.3%) and less than 5 mm (33.5%) in diameter. The most common pathologic type was tubular adenocarcinoma (75.7%). Helicobacter pylori infection rate was 50.2%. Fifty five percent of the cases were diagnosed via endoscopy of National Health Insurance Corporation screenings. CONCLUSIONS: Superficial gastric cancers in 2011 at primary health care SOK network were different from those of previous reports. Type IIc was most common but type IIb was more prevalent and the body and greater curvature of the stomach were the most commonly involved sites. Therefore, careful observation of the proximal gastric mucosa and mucosal color change is needed.
Adenocarcinoma/pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Gastroscopy ; Helicobacter Infections/diagnosis ; Humans ; Male ; Middle Aged ; National Health Programs ; Primary Health Care ; Prospective Studies ; Stomach Neoplasms/*pathology

A pathologic splenic rupture is rare, occurring primarily in a spleen affected by infective, hematological, and neoplastic disease. To the best of our knowledge, no prior reports of a pathologic splenic rupture due to scrub typhus exist. Intrasplenic pseudoaneurysms and focal infarctions are visible on an initial CT scan. Moreover, the spontaneous splenic rupture occurred a week later. We report a case of nontraumatic-splenic rupture in a patient with scrub typhus.
Aneurysm, False ; Humans ; Infarction ; Rupture ; Scrub Typhus ; Spleen ; Splenic Rupture ; Typhus, Endemic Flea-Borne

BACKGROUND/AIMS: Polyethyleneglycol (PEG) is safe but its large volume and bad taste reduces patients' compliance. Sodium phosphate (NaP) is a hyperosmotic agent and its small volume can increase patients' compliance but electrolyte imbalance is a problem. Therefore, we conducted a study to determine whether patients' compliance can be enhanced and electrolyte imbalance reduced by combining these two agents. METHODS: Forty-one admitted patients receiving colonoscopy at Korea University Hospital from June 28, 2004 to August 14, 2004 were randomly divided into two groups for colon cleansing with either PEG 4 L (n=21) or PEG 2 L plus NaP 45 mL (n=20). Patients were assessed for patient tolerance, quality of preparation, and changes of biochemical parameters. RESULTS: Overall discomfort was statistically lower in the combination group, PEG 2 L plus NaP 45 mL (p=0.035). Although patients in the combination group reported less fullness (p=0.076) and nausea (p=0.087), the findings were not statistically significant. The quality of the preparation was comparable between the two groups (p=0.872). The phosphorus level in the combination group showed a statistically significant increase (0.58+/-0.46) after colon cleansing (p=0.020) but was not clinically significant. CONCLUSIONS: The combination of NaP 45 mL and PEG 2 L showed less overall discomfort with comparable quality of preparation and without serious electrolyte abnormality compared to 4 L of PEG. Therefore, the combination of NaP 45 mL and PEG 2 L could be used as an alternative colonoscopic colon cleansing agent when patients have trouble taking 4 L of PEG alone.
Colon* ; Colonoscopy* ; Compliance ; Detergents ; Humans ; Korea ; Nausea ; Phosphorus ; Prospective Studies* ; Sodium*

BACKGROUND/AIMS: Recently, treatment using an endoscopic device is actively being developed. Techniques for incision and bleeding control have been developed, but endoscopic suturing remains to be perfected. Using an endoscopic suturing technique, a variety of diseases could be managed noninvasively. We have attempted to use a new endoscopic suturing device which enables a continuous suture using a flexible upper endoscope. METHODS: A suturing device was designed where a semicircular needle could sew through tissue by rotation making a continuous suture possible. RESULTS: We successfully sutured the stomach tissue of a dog using an optimized suturing device model. CONCLUSIONS: The initial model was found to have some problems. However, we hope to develop a continuous suturing device for flexible upper endoscope procedures in Korea.
Animals ; Dogs ; Endoscopes ; Endoscopes, Gastrointestinal* ; Endoscopy ; Hemorrhage ; Hope ; Korea ; Needles ; Stomach ; Sutures*

Cap polyposis is a rare disorder characterized by bloody, mucoid diarrhea with rectosigmoid polyps covered by a cap of fibrinopurulent exudate. The etiology and pathogenesis of cap polyposis is unknown, and no specific treatment has been established. Drug therapies are usually unsuccessful. Patients with a solitary cap polyp respond well to endoscopic polypectomy, while patients with multiple polyps and concurrent anorectal pathology require surgical resection. However, rapid recurrence has been described after a limited surgical resection, and this necessitates panproctocolectomy. We report a case of a 58-year-old female diagnosed as cap polyposis on rectum with similar clinical and endoscopic features of pseudomenbranous colitis successfully treated with infliximab (murine chimeric monoclonal antibody to TNF-alpha).
Colitis ; Diarrhea ; Drug Therapy ; Enterocolitis, Pseudomembranous ; Exudates and Transudates ; Female ; Humans ; Middle Aged ; Pathology ; Polyps ; Rectum ; Recurrence ; Infliximab

Duodenal intramural hematoma is mostly caused by blunt abdominal trauma. Spontaneous duodenal intramural hematoma has been reported in the literature in patients with over-anticoagulation and coagulation disorders. The presentation of patients can vary from mild and vague abdominal pain to intestinal tract obstruction and an acute abdomen. The diagnosis is evident by gastroduodenal endoscopy, EUS and abdominal CT scan. We report a case of spontaneous duodenal intramural hematoma without the history of abdominal trauma and coagulation disorders in 54-year-old male patient. After conservative treatment, the patient was discharged without any complications.
Abdomen, Acute ; Abdominal Pain ; Diagnosis ; Duodenum ; Endoscopy ; Hematoma* ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Crohn's disease is a chronic inflammatory bowel disease which affects mainly children and young adults, and its cause remains unknown so far. Infliximab, a monoclonal antibody to the pivotal cytokine tumor necrosis factor-alpha, has been approved as a drug for both induction and maintenance therapy for moderately to severely active, or fistula-complicated Crohn's disease. The authors report a 12-year-old male patient diagnosed as Crohn's disease complicated with a perianal fistula, which was refractory to the conventional therapy. After the 0, 2, and 6 week scheduled intravenous infusion of infliximab, the patient reached to clinical remission in both subjective symptoms and objective manifestations. For children or young adults who develop Crohn's disease in a refractory course, infliximab may serve as a drug which leads to a clinical improvement or even to an extent of remission.
Antibodies, Monoclonal/*administration & dosage ; Child ; Crohn Disease/*drug therapy ; Drug Administration Schedule ; English Abstract ; Gastrointestinal Agents/*administration & dosage ; Humans ; Infusions, Intravenous ; Male