ABSTRACT
Biliary Papillomatosis is an extremely rare pathologic entity. Only about 40 cases of intrahepatic or diffuse intra- and extrahepatic papillomatosis have been described since the first report in 1959 by Caroli. Although this is a histologically benign lesion, its course is unfavaurable because of its tendency to extend to the entire biliary tract, high recurrence rate following local excision and the probability of progression to malignancy. We described herein a case of biliary papillomatosis associated with diffuse bile duct dilatation. The patient, a 59-year-old male, was admitted to our hospital because of right upper abdominal pain and weight loss. Cholangiogram revealed multiple round filling defects in common hepatic duct with intrahepatic bile duct dilatation. The patient underwent Whipple's operation with right lobectomy. Grossly, multiple small pin-head sized polypoid masses were seen in common bile duct, common hepatic duct and right intrahepatic duct. Microscapically, papillary epithelial hyperplasia with moderate cellular atypia was seen and there was no evidence of stromal invasion. He is healthy with a follow-up for 7 months.
Subject(s)
Humans , Male , Middle Aged , Abdominal Pain , Bile Ducts , Bile Ducts, Intrahepatic , Biliary Tract , Common Bile Duct , Dilatation , Follow-Up Studies , Hepatic Duct, Common , Hyperplasia , Papilloma , Recurrence , Weight LossABSTRACT
BACKGROUND: Gastric carcinoma is the leading cause of cancer death in Korea. Although the incidence of gastric carcinoma has the tendency to increase in recent years with the increase in the elderly in Korea, clinicopathological characteristics of gastric carcinoma in the elderly has not been studied in detail yet. This study was undertaken to investigate the clinicopathological features of gastric carcinoma in the Korean elderly. METHODS: The clinicopathological data, such as age, gender, cancer location, macroscopic appearance, histopathology, depth of invasion, lymph node metastasis, distant metastasis, stage, and type of operation, were retropectively reviewed from the hospital records of 682 patients with gastric adenocarcinoma admitted to the Asan Medical Center from Jan. 1996 to Dec. 1996. In 581 patients treated with gastrectomy, the postoperative findings were used in analysis, while in 101 patients receiving no operation due to mestastasis, clinical and laboratory findings were used. All patients were divided into three groups: the young; 39 years of age or younger, the middle-aged; between 40 and 64 years old, and the elderly; 65 years old or over. RESULTS: A total of 183(26.8%) of 682 patients were in the elderly, while 91(13.3%) and 408(59.8%) were in the young and middle-aged, respectively. The gender ratio for male to female was 2.3: 1 in the elderly, which was not different from that the young or middle-aged. In the elderly patients, as compared with the young or middle-aged, the antral involvement, well and moderately differentiated adenocarcinoma, Borrmann type I and II, and stage IV were more frequent, and the rate of early gastric cancer was less common. There was no significant difference in the depth of invasion, lymph node metastasis, distant metastasis and type of operation between three groups. CONCLUSION: Some of the clinicopathological features of gastric adenocarcinoma in the elderly are different from those of the young or middle-aged, and in consequence these differences should be considered in the management and study of the elderly patients with gastric carcinoma.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma , Gastrectomy , Hospital Records , Incidence , Korea , Lymph Nodes , Neoplasm Metastasis , Stomach NeoplasmsABSTRACT
BACKGROUND: Limited exercise capacity is common in the elderly. Kinetics of recovery oxygen consumption plays an important role in determining exercise capacity. This study was performed to evaluate the kinetics of recovery oxygen consumption as well as peak oxygen consumption during exercise and recovery in the elderly. METHODS: Thirty healthy volunteers were included for this study. They were divided into three groups according to their ages(20 to 39; 40 to 59; and over 60). All subjects performed symptomlimited maximal treadmill exercise. RESULTS: Peak oxygen consumption(pVO2, ml/min/kg) was gradually decreased with the age. Half-recovery time of peak oxygen consumption(T1/2VO2) was maintained from third to sixth decades without significant changes, and then rapidly delayed in the elderly. CONCLUSION: Kinetics of recovery oxygen consumption was rapidly and markedly delayed in the elderly and this may result in the exercise intolerance.
Subject(s)
Aged , Humans , Healthy Volunteers , Kinetics , Oxygen Consumption , OxygenABSTRACT
Pyoderma gangrenosum is a painful, chronic, ulcerating skin disease of unknown cause. It commences as an erythematous papulopustule and rapidly evolves to form an area of frank ulceration with undermined, violaceous edges and a bright outer halo of erythema. Diagnosis is clinical, there being no accepted histological diagnostic criteria. An underlying systemic illness is present in more than 50 percent of patients. Pyoderma gangrenosum develops in 0.8~5.0 percent of patients with inflammatory bowel disease, which is the most frequent underlying disease of pyoderma gangrenosum. There is no report of pyoderma gangrenosum associated with Crohn's disease in Korea. We recently experienced two cases of pyoderma gangrenosum, a 52-year old man with Crohn's disease and a 30-year old man with ulcerative colitis. The cases are presented with the review of literature.