A Case of Cecal Volvulus Diagnosed with Abdominal Computed Tomography

Cecal volvulus is a rare disease of the colon, which occurs in less than 2% of adult intestinal obstruction cases. Precipitating factors can be identified in some patients, including adhesions, a recent abdominal operation, congenital bands, pregnancy, violent exercise, malrotation, obstructing lesions of the left colon and colonoscopy, etc. A right colectomy is a definitive treatment for the best long term control of symptoms, and is the treatment of choice when gangrenous changes are present in the bowel. However, in the presence of viable bowel, the preferred treatment is a controversial matter, with options including; detorsion, cecopexy and cecostomy, etc. We experienced a case of cecal vovulus, which had been treated for COPD at ICU. A diagnosis was made with abdominal computed tomography, and a right hemicolectomy was performed.

Osteogenic Sarcoma of the Breast

Osteogenic sarcoma is a rare breast tumor. The first report of a malignant mammary neoplasm composed of bone and cartilage was that of Bonet in 1700. Meanwhile in Korea, Kim et al reported one case of osteosarcoma of the breast in 1999. A 44 year old woman visited our hospital because of a mass on her right breast. The mass was fixed on the skin and 5 5 cm in size. Following a frozen biopsy result of malignancy. A modified radical mastectomy was performed. The tumor was confirmed histologically and immunohistochemically as an osteogenic sarcoma. This study presents one case of an osteogenic sarcoma of the breast, and the report of this rare breast tumor is accompanied by a review of the literature.

Surgical Treatment of Graves' Disease

PURPOSE: Graves' disease can be treated with antithyroid medication, radioiodine, or a thyroidectomy. Antithyroid medication is less likely to achieve a permanent remission than radioiodine or thyroidectomy. Radioiodine is preferred in the United States and antithyroid medication is used more often in Europe. However a thyroidectomy is less preferred as a primary therapy and is used only in the cases of recurrence or no response to medication. METHODS: We studied 152 patients with Graves' disease who had been treated at Samsung Medical Center. Fifty seven patients of them were surgically managed after antithyroid medication, and the rest of them were managed medically. Patient's age, sex, symptoms, thyroid fuction, autoantibody, treatment method and recurrence were retrospectively analyzed. RESULTS: Women had Graves' disease more frequently than men a thyroidectomy was performed more often in women and relatively young patients. The symptoms of Graves' disease were neck mass, palpitation, eye symptoms, weight loss and etc. The response to treatment was much higher in the thyroidectomy group than in the medically treated group. And more patients in surgically treatmented group had their thyroid function normalized. A subtotal thyroidectomy was performed in all patient and a mean of 7.4 g of thyroid tissue was remained. Hypothyroidism was noted in 7 patients (12.3%), permanent hypocalcemia in 1 (1.8%), vocal cord paralysis in 1 (1.8%) and transient hoarseness, transient hypocalcemia in the others. Recurrences were noted in 4 patients. There was no correlation between recurrence and remnant thyroid mass. However, preoperative TBII (thyrotropine binding inhibiting immunoglobulin) values were higher in recurrence group and immediate and late postoperative values were also higher than in the recovered group. CONCLUSION: A thyroidectomy is the treatment of choice in Graves' disease. However, further investigation will be needed to predict thyroid the function after a thyroidectomy for Graves' disease

Surgical Treatment of Graves' Disease

PURPOSE: Graves' disease can be treated with antithyroid medication, radioiodine, or a thyroidectomy. Antithyroid medication is less likely to achieve a permanent remission than radioiodine or thyroidectomy. Radioiodine is preferred in the United States and antithyroid medication is used more often in Europe. However a thyroidectomy is less preferred as a primary therapy and is used only in the cases of recurrence or no response to medication. METHODS: We studied 152 patients with Graves' disease who had been treated at Samsung Medical Center. Fifty seven patients of them were surgically managed after antithyroid medication, and the rest of them were managed medically. Patient's age, sex, symptoms, thyroid fuction, autoantibody, treatment method and recurrence were retrospectively analyzed. RESULTS: Women had Graves' disease more frequently than men a thyroidectomy was performed more often in women and relatively young patients. The symptoms of Graves' disease were neck mass, palpitation, eye symptoms, weight loss and etc. The response to treatment was much higher in the thyroidectomy group than in the medically treated group. And more patients in surgically treatmented group had their thyroid function normalized. A subtotal thyroidectomy was performed in all patient and a mean of 7.4 g of thyroid tissue was remained. Hypothyroidism was noted in 7 patients (12.3%), permanent hypocalcemia in 1 (1.8%), vocal cord paralysis in 1 (1.8%) and transient hoarseness, transient hypocalcemia in the others. Recurrences were noted in 4 patients. There was no correlation between recurrence and remnant thyroid mass. However, preoperative TBII (thyrotropine binding inhibiting immunoglobulin) values were higher in recurrence group and immediate and late postoperative values were also higher than in the recovered group. CONCLUSION: A thyroidectomy is the treatment of choice in Graves' disease. However, further investigation will be needed to predict thyroid the function after a thyroidectomy for Graves' disease