The Palmaris longus tendon is important not because of its function but because of its usefulness as a donor tendon. Variations in the palmaris longus muscle ar elfrequent and the most common variation of the muscle is its absence. The incidence of absence of this muscle varies in different racial groups. Reinmann and his coworkers found the palmaris longus muscle absent in 12.9% of in their 1,600 limbs surgery. We have experiened 307 cases of palmaris longus graft surgery and found that there were 4 cases of absence of the palmaris longus tendon. We examined 2,000 limbs of Korean to see the presence of the palmaris longus muscle. Among 1,000 persons, the muscle was absent bilaterally in 11 persons(1.1%). It was absent unilaterally in 32 persons(3.2%). The probability that the muscle is absent in any single limb is 2.7%. There was no significant differences in the incidence of absence by sex or right and left side.
Extremities ; Humans ; Incidence ; Tendons ; Tissue Donors ; Transplants

During the period from January 1980 to September 1988, 59 patients suffering from brachial plexus injury, have admitted to Seoul National University Hospital. Fifty-four patients were male and 5 patients were female, and age ranged from 6 to 58 years (mean:26.8 years). The most common cause of injury was traffic accident accounting for 66% (39patient), and among them 24 patients(62%) had the motor cycle accident. Birth injury, stab or gun shot wound, fall down and industrial hazard were following causes. Fracture and dislocation of involved limb accompanied in 19 patients(32%) and 2 patients of arterial injury were also found. EMG and cervicsl myelography with or without CT were performed in almost all the patients and MRI was performed in selected patients. Forty-five patients(76%) had supra-clavicular lesion and 14 patients (24%) had infra-clavicular lesion. In supra-clavicular lesion, upper roots or whole roots were involved in most of cases. Forty-nine cases were treated with conservative treatment for more than 8 months and operative procedures were performed in 36 cases. In operative cases, 30 patients were followed up for more than 1 year (average 24.3 months). Signs of root avulsion were found in 25 out of 31 cases of cervical myelography. MRI was performed in 7 cases, but it was inconclusive in diagnosis of root involvement. Infra-clavicular lesion showed better prognosis than supra-clavicular lesion. In supra-clavicular lesion, upper root involvement had the best prognosis. A pseudocyst detected by myelography usually precluded recovery in the root at the level of pseudocyst. Result of reparative treatment was better than that of conservative treatment. Overall satisfactory result in reparative treatment was 36%. However, if we include neurological improvement, positive result was 53%. Complete recovery was gained in half cases of neurolysis and other half showed no recovery, but all the cases of neurotization showed poor result. Reconstructive surgery including arthrodesis or muscle transfer can be effective treatment method, if it is performed properly on a selective patient.
Accidents, Traffic ; Arthrodesis ; Birth Injuries ; Brachial Plexus ; Diagnosis ; Dislocations ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Methods ; Myelography ; Nerve Transfer ; Prognosis ; Seoul ; Surgical Procedures, Operative ; Wounds and Injuries

Forty one cases of Hodgkin's disease and non-Hodgkin's lymphomas were immunohisto-chemi-cally studied for the presence of CD30 antigen on the paraffin embedded formaldehyde fixed tissue by using Ber H2(CD30) monoclonal antibody (Dakopatts, diluted l : 20) and avidin biotin peroxidase complex technique seventy five %(6/8) of Hodgkin's lymphoma and 27% (9/33) of non-Hodgkin's lymphomas were CD30 positive. Five of l7 diffuse large cell and immunoblastic lymphoma and one large cell anaplastic lymphoma showed large numbers of CD30 positive cells. Occasional CD30 positive cells were found in one of 2 angiommunoblastic lymphadenopathy-like T cell lymphoma, one of 4 small lymphocytic lymphoma and one unclassified lymphoma. Immunophenotypically l6% of B cell lymphoma and 42% of T cell lymphoma showed CD30 positivity. six cases of Hodgkin's disease except lymphocyte predominance showed positive tumor cells. Our results show that CD30 is more widespread in histologic subtypes of lymphomas and is not specific for the diagnosis of Hodgkin's disease.

This experimental studies was to investigate the location of PNS and CNS labeled neurons following injection of 2% WGA-HRP and pseudorabies virus (PRV), beta-galactosidase inserted Bartha strain, into the epididymis of rats. After survival times 4~5 days following injection of 2% WGA-HRP and PRV-Ba-Gal, the rats were perfused, and their brain, spinal cord, sympathetic ganglia and spinal ganglia were frozen sectioned (30 mm). These sections were stained by HRP histochemical and beta-galactosidase histochemical staining methods, and observed with light microscope. The results were as follows : 1. The WGA-HRP labeled sympathetic ganglia projecting to the epididymis were observed in pelvic ganglion and L1-6 lumbar sympathetic ganglia. 2. The WGA-HRP labeled spinal ganglia projecting to the epididymis were observed in L1-6 spinal ganglia. 3. The beta-galactosidase labeled neurons projecting to the epididymis were observed in lamina VII of cervical segments. In thoracic segments, beta-galactosidase labeled neurons were observed in dorsomedial part of lamina I, II and III. Dense labeled neurons were observed in intermediolateral n. and dorsal commissural n.. In lumbar segment, labeled neurons were observed in lamina III, IV, V, dorsal commisural n. and superficial dorsal horn. 4. In the medulla oblongata, beta-galactosidase labeled neurons projecting to the epididymis were observed in the trigeminal spinal n., A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular n., rostroventrolateral reticular n., area postrema, n. tractus solitarius, raphe obscurus n., raphe pallidus n., raphe magnus n., parapyra-midal n., lateral reticular n. and lateral paragigantocellular reticular n.. 5. In the pons, labeled neurons were observed in Kolliker-Fuse n., locus coeruleus, subcoeruleus n. and A5 noradrenalin cells. 6. In midbrain, labeled neurons were observed in periaqueductal gray substance, retrorubral n., substantia nigra and dorsal raphe n.. 7. In the diencephalon, labeled neurons were observed in paraventricular hypothalamic n., lateral hypothalamic nucleus., medial preoptic n. and retrochiasmatic n.. These results suggest that WGA-HRP labeled neurons of the spinal cord projecting to the rat epididymis might be the first-order neurons related to the viscero-somatic sensory and sympathetic postganglionic neurons, and beta-galactosidase labeled neurons of the brain and spinal cord may be the second and third-order neurons response to the movement of vascular smooth muscle in epididymis. These beta-galactosidase labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory and motor system monitoring the internal environment. These observations provide evidence for previously unknown projections from epididymis to spinal cord and brain which may be play an important neuroanatomical basic evidence in the regulation of epididymal function.
Animals ; Area Postrema ; beta-Galactosidase ; Brain ; Diencephalon ; Epididymis* ; Ganglia, Spinal ; Ganglia, Sympathetic ; Ganglion Cysts ; Herpesvirus 1, Suid* ; Horns ; Hypothalamic Area, Lateral ; Locus Coeruleus ; Male ; Medulla Oblongata ; Mesencephalon ; Muscle, Smooth, Vascular ; Neural Pathways* ; Neurons ; Periaqueductal Gray ; Pons ; Pseudorabies* ; Rats* ; Reflex ; Spinal Cord ; Substantia Nigra ; Wheat Germ Agglutinin-Horseradish Peroxidase Conjugate*

PURPOSE: It is important to know for transurethral resection of prostate (TURP) affecting the serum prostate specific antigen (PSA) value how long one should wait before being able to ~ obtain an accurate and meaningful serum PSA level. We evaluated the change of serum PSA concentration in patients with benign prostate hypertrophy(BPH) before and after TURP in association with time course and resected prostatic weight. MATERIALS AND METHOD: The effect of TURP was examined in 27 patients with BPH (mean age: 64 years; range: 55-79 years). The serum PSA levels were measured serially (before and 1, 3, 5, 7, 14, 30, 60, 90 days after TURP) by Abott IMX assay. RESULTS: The level of serum PSA appeared to be consistent with prostatic volume by transrectal ultrasonography(TRUS) and was elevated by about 0.16 ng/mL for each gram of hyperplastic tissue present (p=0.375, p=0.058). TURP caused an immediate elevation in the serum PSA concentration, with a median increase of 19 ng/mL (p=0.0001). The larger resected group showed a dramatic and statistically significant PSA rise immediately after TURP than the smaller resected group (p=0.023). From the 15 post-operative day, the PSA concentrations continued slightly lower than that of pre-operative day (p=0.0001), and was still decreased on 30 days (p=0.0001). The median time to return to a baseline level of PSA was 30 days (range: 1460 days) after TURP. CONCLUSION: These findings indicate that TURP caused an immediate increase in the serum PSA level, which generally return to stable, baseline level within 30 days. However, because in some patients the serum PSA still remained elevated than upper normal limit after 30 days, it is recommended that a serum PSA determination should be obtained for at least 60 days after TURP.
Humans ; Hypertrophy* ; Prostate* ; Prostate-Specific Antigen* ; Transurethral Resection of Prostate*

PURPOSE: It is important to know for transurethral resection of prostate (TURP) affecting the serum prostate specific antigen (PSA) value how long one should wait before being able to ~ obtain an accurate and meaningful serum PSA level. We evaluated the change of serum PSA concentration in patients with benign prostate hypertrophy(BPH) before and after TURP in association with time course and resected prostatic weight. MATERIALS AND METHOD: The effect of TURP was examined in 27 patients with BPH (mean age: 64 years; range: 55-79 years). The serum PSA levels were measured serially (before and 1, 3, 5, 7, 14, 30, 60, 90 days after TURP) by Abott IMX assay. RESULTS: The level of serum PSA appeared to be consistent with prostatic volume by transrectal ultrasonography(TRUS) and was elevated by about 0.16 ng/mL for each gram of hyperplastic tissue present (p=0.375, p=0.058). TURP caused an immediate elevation in the serum PSA concentration, with a median increase of 19 ng/mL (p=0.0001). The larger resected group showed a dramatic and statistically significant PSA rise immediately after TURP than the smaller resected group (p=0.023). From the 15 post-operative day, the PSA concentrations continued slightly lower than that of pre-operative day (p=0.0001), and was still decreased on 30 days (p=0.0001). The median time to return to a baseline level of PSA was 30 days (range: 1460 days) after TURP. CONCLUSION: These findings indicate that TURP caused an immediate increase in the serum PSA level, which generally return to stable, baseline level within 30 days. However, because in some patients the serum PSA still remained elevated than upper normal limit after 30 days, it is recommended that a serum PSA determination should be obtained for at least 60 days after TURP.
Humans ; Hypertrophy* ; Prostate* ; Prostate-Specific Antigen* ; Transurethral Resection of Prostate*

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants

Nerve compression syndromes can be caused by compression of the peripheral nerve from interior or exterior of the nerve. In the upper extremities, brachial plexus, ulnar nerve and median nerve can be compressed in thoracic outlet syndrome, cubital tunnel syndrome and carpal tunnel syndrome respectively. Because these syndromes are caused by compression, decompressive management can be expected to be the principle of treatment. From Jan. 1980 to Dec. 1988, 94 patients were admitted and treated for nerve compression syndromes of the upper extremities in Seoul National University Hospital. Among these, 52 patients suffered from carpal tunnel syndrome and operation was performed to 86 hands. Twelve patients suffered from thoracic outlet syndrome and 25 from cubital tunnel syndrome. Ten patients were treated with conservative method and 84 with decompressive surgery. Satisfactory results were obtained in 92.3% of carpal tunnel syndrome and 84% of cubital tunnel syndrome. Of 4 operated cases of thoracic outlet syndrome, 3 cases were satisfactory.
Brachial Plexus ; Carpal Tunnel Syndrome ; Cubital Tunnel Syndrome ; Hand ; Humans ; Median Nerve ; Methods ; Nerve Compression Syndromes ; Peripheral Nerves ; Seoul ; Thoracic Outlet Syndrome ; Ulnar Nerve ; Upper Extremity

The author treated 3 class I malocclusion patients with the lingual appliance followed by the extraction of the 4 bicuspids. One of them was finished with the labial appliance at the final stage. The treatment results were acceptable and the patients had good tolerance to the lingual appliance without complaints in these cases. There were some problems in treatment on the lingual side both the patient and the practioner, but I think we can overcome them with the development of the orthodontic materials, the treatment technics & the increased clinical experience. Of course, we cannot treat all the patients with the lingual braces, but patients are carefully selected, lingual braces will be a valuable orthodontic appliance. In conclusion, the lingual braces have very good esthetic advantages, so the patients, especially in adults, who hesitate or refuse the orthodontic treatment due to the esthetic problem of the labial braces will get the motivation & the chance for the orthodontic treatment.
Adult ; Bicuspid ; Braces ; Humans ; Malocclusion* ; Motivation ; Orthodontic Appliances