RESUMO
PURPOSE: With recent advances of diagnostic methods and precise histopathologic examination, the incidence of synchronous multiple gastric cancer has increased. The purpose of this study was to evaluate the clinicopathologic features of patients with synchronous multiple gastric cancer. MATERIALS AND METHODS: We reviewed the clinicopathologic features of 189 patients with synchronous multiple gastric cancer out of 8,101 patients who underwent gastric resections for gastric cancers during 20 years from January 1977 to December 1996 at the Department of Surgery, Seoul National University Hospital, and compared them with single gastric cancer patients. The clinicopathologic features evaluated were age, sex, diagnostic method and accuracy, location of lesions, tumor size, histologic differentiation, Lauren classification, macroscopic classification, depth of invasion, lymph node metastasis, TNM stage, and type of operation and prognosis. RESULTS: The overall incidence of multiple synchronous gastric cancer was 2.33%. The mean age was 57.2 years old (27~84) and peak incidence was sixth decade. Male was predominant, that the sex ratio was 3.9: 1. Multiple gastric cancer was more frequent in old age, male and early gastric cancer patients. The number of lesions ranged from 2 to 5. In most cases, the lesions were located in lower two-thirds of the stomach. However, in 13 cases, lesions were located in both upper one-third and lower one-third. Only 33.3% of multiple cancer was diagnosed preoperatively, with the diagnostic accuracy of GFS was 30.0% and that of UGIS 26.1%. The most frequently missed lesions at preoperative examination were located in upper third of stomach, posterior wall of middle third and anterior wall of lower third of stomach. The most common macroscopic type was Borrmann type III (54.5%) in advanced lesions and type IIc (47.0%) in early lesions. Regarding the histologic differentiation, 58.7% of the cases were of the same differentiation and the cases composed of well differentiated adenocarcinomas were most common. According to the Laurens classification, 66.7% of lesions were intestinal type. As to the progression of the lesions, all lesions were early cancers in 75 cases, advanced cancers in 39 cases and advanced cancers were coexist with early cancers in 75 cases. Lymph node metastasis was less frequent than in single gastric cancer. Total gastrectomy was performed more frequently in multiple cancer patients than in single gastric cancer patients. The 5-year survival rate of patients with multiple gastric cancer was 70.2%, which was not significantly different from that of patients with single gastric cancer. CONCLUSIONS: Surgeons must keep in mind the possibility of multiple gastric lesions. More careful preoperative and intraoperative examination is mandatory to detect the possible accessory lesions, and postoperative periodic follow-up is necessary to detect any missed lesions, especially in the old age, male and early gastric cancer patients.
Assuntos
Humanos , Masculino , Adenocarcinoma , Classificação , Seguimentos , Gastrectomia , Incidência , Linfonodos , Metástase Neoplásica , Período Pós-Operatório , Prognóstico , Seul , Razão de Masculinidade , Estômago , Neoplasias Gástricas , Taxa de SobrevidaRESUMO
BACKGROUND: The incidence of skin diseases in the university hospital cannot be a true indication of their prevalence in the population, but it offers the only available source of information on the their ecology. OBJECTIVE AND METHODS: To study the prevalence of common dermatoses and compare these to previous reports, we reviewed 67,924 new outpatients who visited the dermatology clinic at Hanyang University Hospital in Seoul from Jan. 1st, 1981 to Dec. 31st, 1990. RESULTS: The results of the study are summarized as follows : 1. Among the 67,924 outpatients, the number of male patients was 32,812(48.4%) and female patients 35,112(51.6%). 2. Age distribution of patients were 17,883(26.3%) in the 3rd decade, 13,319(19.6%) in the 1st decade, 11,678(17.2%) in the 4th decade, 9,884(14.6%) in the 2nd decade in order. 3. The distribution of dermatoses as disease groups were eczema(23.9%), urticaria-drug erup-tion(13.2%), skin appendage disorder(12.9%), dermatophytosis(11.1%), viral infection(7.7%), disease due to animal parasi es(5.7%), and bacterial infection(3.8% ). 4. The 15 most common dermatoses were dermatophytosis(10.1%), contact dermatitis(8.8%), urticaria(7.8%), acne vulgaris(6.6%), other eczemas(65%), atopic dermatitis(5.0%), bacterial infections(3.8%), scabies(3.7%), seborrheic dermatitis(3.6%), drug eruptions(2.9%), verruca(2.1%), herpes zoster(1.9%), psoriasis(1.7%), syphilis(1.5%), and vitiligo(1.4%), 5. Those dermatoses which showed an annually increasing tendency were acne vulgaris, urticaria, contact dermatitis, seborrheic dermatitis, and those of decreasing tendency were scabies, bacterial infections, syphilis, and vitiligo. 6. Dermatophytosis, urt caria, bacterial infection, seborrheic dermatitis, verruca, and vitiligo occurred frequently during the summer. The incidence of other eczemas, scabies, atopic dermatitis, and her pes zoster increased during the winter, 7. In sexual distribution, dermatophytosis, scabies, seborrheic dermatitis were more frequent in the males, whereas contact dermatitis, urticaria, other eczemas, acne vulgaris, and herpes zoster were more frequent in the females. 8. In age distribution, atopic dermatitis and bacterial infections were the most frequent in the 1st decade. Acne vulgans, syphilis, psoriasis, verruca, and dermatophytosis were the most frequent in the 3rd decade, with scabies and vitiligo in the 2nd decade, and herpes zoster in the 7th decade. CONCLUSION: The distribution of skin diseases in our hospital showed similar with reported studies in other areas. Comparing these results with an Bang's report 10 year ago in Seoul, there was relative high incidence of viral infections compared to the low incidence of bacterial infections.
Assuntos
Animais , Feminino , Humanos , Masculino , Acne Vulgar , Distribuição por Idade , Infecções Bacterianas , Dermatite Atópica , Dermatite de Contato , Dermatite Seborreica , Dermatologia , Ecologia , Eczema , Herpes Zoster , Incidência , Pacientes Ambulatoriais , Prevalência , Psoríase , Escabiose , Seul , Pele , Dermatopatias , Estatística como Assunto , Sífilis , Tinha , Urticária , Vitiligo , VerrugasRESUMO
BACKGROUND: In recent years gonorrhea has been panendemic and remains one of the most common STDs in the world, especially in developing countries. OBJECTIVE & METHOD: For the detection of a more effective teripeutic regimen and assessing the prevalence of PPNG, will have been trying to study the paieits who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. RESULTS: In 1993, 187 strains of N. gonorrhoeae were isolated, ar, ong which 139(74.3%) were PPNG. CONCLUSION: Our results suggests that the prevalence of PPNG in Seoul is still increasing.
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Países em Desenvolvimento , Gonorreia , Prevalência , Saúde Pública , Seul , Infecções Sexualmente TransmissíveisRESUMO
BACKGROUND: Tinea versicolor may be treated by topical oroal antifungal drugs. OBJECTIVE: Ihe objertive of this study was to evaluate the their, peutic effect and safety of oral itraconazole(100-200mg/day), cloconazole cream, 20% sodium chiosulfate solution, sulconazole cream and 2% ketoconazole shampoo in Tinea versicolor. METHODS: Forty patients with Tinea versicolor were studys clinically and treated in five groups, with oral itraconazxale(100-200mg/day), cloconazole crean 20% sodium thiosulfate solution, sulconazole cream and 2% ketoconazole shampoo, from JuIIy 1991 to June, 1994. The writers also compared the results with the writers previous similar studies in 1986, 1990. RESULTS: The average age was 29.9 years, the oldest patient were 52 year-old and the youngest patient was a 14 year-old. The ratio of male to female a 1.2: 1. The distributions of lesions was most common in the axilla(26.9%), and the other sitsuere the anterior chest(19.2%), the back(17.3%), the neck(15.4%), the upper extremites(9.6%) the abdomen(7.7%) and the lower extremites(3.9%), in order. The incidence of hyperpigrietted lesions was 76.8% and of hypopigmented lesions was 23.2%. The average duration of treatment until cure was 3.00+0.55 weeks in the oral itraconaxile treated group, 3.31+1.18 weeks in the cloconazole cream group, 3. 25+1.03 weeks in the 20%, sodium thiosulfate solution group 3.45+0.52 weeks in the sulconazole cream group and 3.40+0.33 weeks in the 2% ketoconazole shapen group. Mere were no statistically significant differences of therapeutic efficacy in each the five groups(p>0.05). Compared with the study in 1990, the average age was higher from 5.7 to 29.9 years, and the male to female ratio was slightly less, showing a relative increase in male incidence. But, there was no statistical difference in therapeutic efficacy(p>0.05). CONCLUSION: This study was shown that the above five theraieric regimens can be used safely and simply, according to patients preferences.
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Adolescente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Incidência , Cetoconazol , Sódio , Tinha Versicolor , TinhaRESUMO
We report the clinical evolution of two elderly male patients with extramammary Paget's disease who were treated with radiotherapy. Both cases primarily involved the scrotum and penile root, and were not associated with any underlying or visceral malignancy. The total doses administered were 6000 cGy and 3000 cGy, respectively. A good clinical response was achieved in both cases. No major side effects were observed. The patients are being followed for any signs of recurrence and have been completely asymptomatic to date
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Idoso , Humanos , Masculino , Doença de Paget Extramamária , Radioterapia , Recidiva , EscrotoRESUMO
Backgraund : Most of the inflammatory bullous lesions in bullous pamphigoid(BP) and epidermolysis bullosa acquisite(EBA) demonstrate similar clinical and histological features. However, the specificities of the autoantibodiea reactive to the dermo-epidermal junction antigeins are different. In these two bullouk dermat loses, there are no remarkable differences in symptomaiology, there are no unique predilection sites for the lesions and they do not usually leave scars after nvolution. Considering these similarities, dermatologists could encounter some clinical confuiion in maling a provisional diagnosis. OBJECTIVE: Authors examined three patients of BP with classic inflammatory bullous eruptions and threa patients of EBA with inflammatory bullous lesions to see if here were any differences in the morphology of the immuno-fluorescence(IF) pattern. METHODS: For direct IF of vertical or semi-vertical sections, perilasional skin was obtained in each patient for indirect IF of horizontal or semi-horizonta1 sections, Ig(bound substrates were prepared from all these autoantibody-positive individuals. All specimens veri; observed at 200/400-magnification fields through an ordinary fluorescence microscopy. RESULTS: Patterns of fluorescence observed by direct IF were characterized as thin-linear in BP and thick/coarse-linear in EBA along the basement membrane zone. On the horizontal section preparations in indirect IF, the patterns of fluorescence were clean-linear in E3P hnd more fluffy-linear in EBA at the dermoepidermal junction, These patterns could be recognized aim/larly in the fields of both 200 and 400-magnification, however each minor differences were not easy to distinguish each other. CONCLUSION: The above findings of subtle differences in the pattern of IF may provide some suggestions to the examiners for the need of differential diagnosis in theae riseases.
Assuntos
Humanos , Masculino , Membrana Basal , Vesícula , Cicatriz , Diagnóstico , Diagnóstico Diferencial , Epidermólise Bolhosa Adquirida , Epidermólise Bolhosa , Fluorescência , Microscopia de Fluorescência , Penfigoide Bolhoso , PeleRESUMO
Backgraund : Most of the inflammatory bullous lesions in bullous pamphigoid(BP) and epidermolysis bullosa acquisite(EBA) demonstrate similar clinical and histological features. However, the specificities of the autoantibodiea reactive to the dermo-epidermal junction antigeins are different. In these two bullouk dermat loses, there are no remarkable differences in symptomaiology, there are no unique predilection sites for the lesions and they do not usually leave scars after nvolution. Considering these similarities, dermatologists could encounter some clinical confuiion in maling a provisional diagnosis. OBJECTIVE: Authors examined three patients of BP with classic inflammatory bullous eruptions and threa patients of EBA with inflammatory bullous lesions to see if here were any differences in the morphology of the immuno-fluorescence(IF) pattern. METHODS: For direct IF of vertical or semi-vertical sections, perilasional skin was obtained in each patient for indirect IF of horizontal or semi-horizonta1 sections, Ig(bound substrates were prepared from all these autoantibody-positive individuals. All specimens veri; observed at 200/400-magnification fields through an ordinary fluorescence microscopy. RESULTS: Patterns of fluorescence observed by direct IF were characterized as thin-linear in BP and thick/coarse-linear in EBA along the basement membrane zone. On the horizontal section preparations in indirect IF, the patterns of fluorescence were clean-linear in E3P hnd more fluffy-linear in EBA at the dermoepidermal junction, These patterns could be recognized aim/larly in the fields of both 200 and 400-magnification, however each minor differences were not easy to distinguish each other. CONCLUSION: The above findings of subtle differences in the pattern of IF may provide some suggestions to the examiners for the need of differential diagnosis in theae riseases.
Assuntos
Humanos , Masculino , Membrana Basal , Vesícula , Cicatriz , Diagnóstico , Diagnóstico Diferencial , Epidermólise Bolhosa Adquirida , Epidermólise Bolhosa , Fluorescência , Microscopia de Fluorescência , Penfigoide Bolhoso , PeleRESUMO
No abstract available.