A case of the neurovascalar island pedicle graft for restoration of sensation after amputation of both thumb fingertip pulp in 17 years old male patient is presented at Department of Orthopedic Surgery, College of Medicine, Korea University. Tho island pedicle graft is suggested by Esser firstly and it is very difficult and excitement. At postoperative follow up check within one month, we obtained very good result without other complications.
Amputation ; Follow-Up Studies ; Humans ; Korea ; Male ; Orthopedics ; Sensation ; Thumb ; Transplants

Subtrochanteric fracture of the femur are difficult to treat successfully. Although performing operative treatment, the incidence of mechanical complications is higher than other sites of long bones. Among many factors influenced management of subtrochanteric fracture, there are three more important factors which subtrochanteric area composed mainly of cortical bone, high concentration of stress, and influenced to surrounding large and powerful muscles. During the period of Nov. 1979 to Sep. 1981, 10 cases of subtrochanteric fracture of femur were treated by Zickel I-M nail at the Department of Orthopedic Surgery, College of Medicine, Korea University, and results were obtained as follows: l. Of 10 cases of subtrochanteric fracture, 8 cases occured in man, and 2 cases in woman. 2. Causes of 10 cases of subtrochanteric fracture were fall down or slip in 6 cases, and T-A in 4 cases. 3. Of 10 cases of subtrochanteric fracture, 2 cases were type I, 6 case were type II, and 2 cases were type lll by Zickel's classification. 4. There are no significant complieatioris except 1-2 cm shortening in the 2 cases of unstable comminuted intertrochanteric fracture. 5. Zickel nail is the good implant for rigid fixation of subtrochanteric fracture or subtrochanteric fracture extend to intertrochanteric area of the femur, if suitable indication.
Classification ; Female ; Femur ; Humans ; Incidence ; Korea ; Muscles ; Orthopedics

Hepatie hilar ductal carcinoma is relatively rare, but the prognosis is known to be poor because an early diagnosis is difficult. Because the majority of patients are already infiltrated into adjacent organ by itself at the diagnosis, the rate of resectability is low. The best method of treatment is curative resection, and the range of tumor invasion is very important. The preoperative diagnosis is difficult because the cholangiography may be normal in cases of superficial invasion. Multifocal lesions within the biliary tract may be identified in as many as 10 percent of patients, Especially, the papillary type has the best prognosis and is associated with multiple tumors within the bile duct. We report a case that percutaneous transhepatic cholangiogram showed normal distal common bile duct, but the hepatic hilar confluence and ampulla of Vater lesion was confirmed as adenocarcinoma.
Adenocarcinoma ; Ampulla of Vater* ; Bile Ducts ; Biliary Tract* ; Carcinoma, Ductal ; Cholangiocarcinoma* ; Cholangiography ; Common Bile Duct ; Diagnosis ; Early Diagnosis ; Humans ; Pancreas* ; Prognosis

Respiratory distress syndrome (RDS) is a major cause of death in premature neonates, and it is caused by the failure of morphological and biochemical lung maturation (synthesis and secretion of lung surfactant). It is known that cortisol, thyroxine, prolactin, epidermal growth factor (EGF), and estrogen accelerate the lung maturation. Cortisol and thyroxine are currently used in the antenatal treatment for the prevention of RDS in premature neonates. In order to evaluate the effect of EGF on the levels of cortsol, thyroxine, and prolactin, this study was undertaken. Phosphate buffered saline (PBS) with and without EGF was directly injected into the 25 days gestational fetus in uterus. Blood was collected for the measurement of cortisol, thyroxine, and prolactin one day or two days after the injection. Body weights and lung weights were also measured. The results were as follows: 1. There was no significant difference in body weights and lung weights between PBS-treated group(control group) and EGF-treated poup(experimental group), 24 hours and 48 hours after the injection. 2. 24 hours after the injection, the levels of cortisol were significantly inaeased in the EGF-treated group compared with those in the PBS-treated group. However 48 hours after the injection, there was no significant difference in the levels of cortisol between the two groups. The levels of thyroxine and prolactin in the EGF-treated group did not significantly differ from those in the PBS-treated group 24 hours and 48 hours after the injection. In conclusion, in vivo, the synthesis of cortisol may be affected by EGF treatment, which suggests that the action of EGF for lung maturation may be partially mediated by the increased endogenous levels of cortisol.
Body Weight ; Cause of Death ; Epidermal Growth Factor* ; Estrogens ; Fetus ; Humans ; Hydrocortisone ; Infant, Newborn ; Lung ; Prolactin* ; Rabbits* ; Thyroxine* ; Uterus ; Weights and Measures

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign proliferation of intravascular endothelial cells. However, IPEH can be easily mistaken for an angiosarcoma, thus differential diagnosis is very important to avoid over-treatment. We report the case of a 22-year-old man who presented with small lobulating mass in nasopharynx. Computed tomography showed about 4 cm homogenous mass in the nasopharynx without extension into soft tissues. Complete surgical excision was done and biopsy during operation showed distended vessels and numerous papillae consist of endothelial cells lining a hyaline core. At follow up, no other complications were observed. Thus we present the case and a review of the literature.
Biopsy ; Diagnosis, Differential ; Endothelial Cells ; Follow-Up Studies ; Hemangiosarcoma ; Humans ; Hyalin ; Hyperplasia* ; Nasopharynx* ; Young Adult

A 71-year-old man was admitted due to abdominal distension and periumbilical pain. He was diagnosed as having mucinous ductal ectasia (MDE) of the pancreas three months prior, but refused an operation. Three months later, an abdominal computed tomography revealed more dilated pancreatic duct, newly developed liver metastasis and ascites in comparison with previous findings. Fine-needle aspiration cytology of the cystic lesion in the pancreatic head was conducted and yielded adenocarcinoma. Also, an ascitic fluid cytology determined adenocarcinoma. This patient was diagnosed to be inoperable and received palliative chemotherapy and pain control. The patient expired 5 months after the initial diagnosis.
Adenocarcinoma ; Aged ; Ascites* ; Ascitic Fluid ; Biopsy, Fine-Needle ; Diagnosis ; Dilatation, Pathologic* ; Drug Therapy ; Head ; Humans ; Liver* ; Mucins* ; Neoplasm Metastasis* ; Pancreas* ; Pancreatic Ducts

No abstract available.
Bicuspid* ; Echocardiography*

Primary adrenal lymphoma is extremely uncommon. The tumor is accidentally discovered by abdominal ultrasonography(USG), computed tomography(CT) or magnetic resonance imaging (MRI) in patients with nonspecific symptoms and diagnosed at operation or autopsy. In this case, a 60-year-old man was admitted for the evaluation of mild left frank discomfort for two months before admission. The abdominal USG was performed and showed the dense masses in both adrenal glands. The laboratory tests including blood count, chemistry and hormonal tests showed the normal levels except for the basal ACTH level of 108 pg/ml(normal range: 9~52 pg/ml). The 123I MIBG scan was normal. The bilateral adrenalectomy was done. The tumor was diagnosed as diffuse large B-cell non-Hodgkin's lymphoma(NHL) according to the Revised European-American lymphoma(REAL) classification. He was treated with the adjuvant combination chemotherapy of CHOP(cyclophosphamide, adriamycin, vincristine and prednisolone) but expired due to sepsis after the second chemotherapy. We describe the first case of primary bilateral adrenal NHL in Korea. Primary adrenal lymphoma should be included in the differential diagnosis of suprarenal mass.
3-Iodobenzylguanidine ; Adrenal Glands ; Adrenalectomy ; Adrenocorticotropic Hormone ; Autopsy ; B-Lymphocytes ; Chemistry ; Classification ; Diagnosis, Differential ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Korea ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Magnetic Resonance Imaging ; Middle Aged ; Sepsis ; Vincristine

BACKGROUND: Although a significant number of studies were done on focal segmental glomerulosclerosis(FSGS), its pathogenesis has not been sufficiently established yet. Recent studies suggested certain types of circulating factor(s) played an important role in development and recurrence after renal transplantation of FSGS by modifying the glomerular permeability of albumin. The purpose of this study performed on animals and through molecular-biological experiments is to certify the role of circulating factor (s), which cause proteinuria, by manipulating plasma of a FSGS patient who showed massive of proteinuria and wide effacement of glomerular epithelial foot processes in histologic examination after renal transplantation. also, whose massive proteinuria decreased significantly after plasma exchange. METHODS: The patient's plasma prior to(plasma A) or post to(plasma B) plasma exchange were injected into tail veins of two groups of male Sprague-Dawley rats, six in each. The ratio of 24 hour urine protein and urine creatinine(Uprt/Ucr) was calculated for each case. The 2D gel electrophoresis was performed in plasma A and plasma B. The pattern of 2D gel electrophoresis of plasma A was compared to those of plasma B and healthy human serum. RESULTS: Compared to control group, there was no significant differences in 24-hour Uprt/Ucr afer injecting 1, 2, 3, 5 mL of plasma A(p>0.05). There was no significant difference in 24-hour Uprt/Ucr between the injecting groups of plasma A and plasma B(p>0.05). We were not able to observe any new protein which did not appear in plasma B or healthy human serum in 2D gel electrophoresis. CONCLUSION: These results suggest that the proteinuria developed in a few hours after renal transplantation and is related to wide effacement of glomerular epithelial foot processes, and that it may be induced by a certain factor which is eliminated by the plasma exchange or restrained by the immunosuppressive agents. However, we were not able to find certain circulating factor(s) which rapidly changes albumin permeability in the patient's plasma with FSGS.
Animals ; Electrophoresis, Gel, Two-Dimensional ; Foot ; Glomerulosclerosis, Focal Segmental* ; Humans ; Immunosuppressive Agents ; Kidney Transplantation ; Male ; Permeability ; Plasma ; Plasma Exchange ; Proteinuria ; Rats, Sprague-Dawley ; Recurrence ; Veins

PURPOSE: To evaluate and compare the efficacy and safety of cyclosporine 0.05% (Cyporin N eye drops 0.05%) to an active comparator (Restasis®) in moderate to severe dry eye patients. METHODS: This is a multicenter, randomized, double-blind, parallel, active control, non-inferiority, phase III study. Patients had a 2-week run-in period (during the run-in period, patients used artificial tears, if applicable), and afterward 158 patients were randomly assigned treatment for 12 weeks with cyclosporine 0.05% (with artificial tears, if applicable), in which the efficacy and safety were evaluated every four weeks. RESULTS: Corneal staining tests showed that in the per protocol set group, the study group was not inferior to the control group; the results for the full analysis set analytic group were the same. The number of adverse events reported from the 158 patients was not significantly different between groups (p = 0.1107). Additionally, other evaluations, including tolerability evaluations, clinical pathology examinations, and vital signs, show that there is no difference in terms of safety between the groups. CONCLUSIONS: Cyclosporine A 0.05% (Cyporin N eye drops 0.05%) is considered to have the same efficacy and safety compared to the active comparator.
Cyclosporine* ; Dry Eye Syndromes ; Humans ; Lubricant Eye Drops ; Ophthalmic Solutions ; Pathology, Clinical ; Vital Signs