1.Upper Extremity Replantation for Patients with Major Amputation Injury: Follow-up Results of 11 Patients.
Hyung Kee KIM ; Jayun CHO ; Seung HUH ; Chang Wuk OH ; Ho Yun CHUNG ; Young Nam ROH ; Young Wook KIM
Journal of the Korean Society for Vascular Surgery 2013;29(1):10-16
PURPOSE: To report follow-up data on upper extremity (UE) macroreplantation in patients with traumatic amputation injuries. METHODS: Between 1996 and 2003, 11 patients underwent UE macroreplantation at a single institution. All patients had an open fracture (n=9; upper arm, 5; forearm, 4) or an open dislocation of the elbow (n=2), combined with neurovascular and soft tissue transection injuries. The replantation procedures were performed on an emergency basis by a multi-departmental team. The mean warm ischemic time was 328 minutes (range, 165 to 480 minutes). Functional recovery of the replanted UE was evaluated with Chen's classification system, and patient satisfaction was determined using Russell's questionnaire; periodic examinations were conducted over a minimum follow-up period of 2 years. RESULTS: Early complications consisted of 2 arterial thromboses, 1 soft tissue infection resulting in sepsis, and 1 episode of acute renal failure; UE reamputation was required in 2 patients. As a result, limb salvage was achieved in 82% of patients (9/11). A functional extremity, defined as grades I and II using Chen's criteria, was preserved in 33.3% of patients with successfully replanted limbs. Despite the objectively poor rate of function preservation, 89% of patients who had successful replantation procedures were satisfied with the results. CONCLUSION: Even though the functional recovery rate was low, UE macroreplantation resulted in acceptable limb salvage rates and good patient satisfaction.
Amputation
;
Amputation, Traumatic
;
Arm
;
Dislocations
;
Elbow
;
Emergencies
;
Extremities
;
Follow-Up Studies
;
Forearm
;
Fractures, Open
;
Humans
;
Limb Salvage
;
Patient Satisfaction
;
Replantation
;
Sepsis
;
Soft Tissue Infections
;
Thrombosis
;
Upper Extremity
;
Warm Ischemia
2.Two Cases of Endoscopically Diagnosed Gastric Metastatic Malignant Melanoma of Unknown Origin.
Jae Seong RYU ; Hyae Ju OH ; Jin Wuk HU ; Jee Yeon KIM ; Jee Young LEE ; Byung Cheol YUN ; Moo In PARK ; Seun Ja PARK ; Hee Kyung CHANG ; Ja Young KOO
Korean Journal of Gastrointestinal Endoscopy 2004;28(2):71-75
Although malignant melanoma involving the stomach is commonly mentioned in association with autopsies, endoscopic experience in this gastric malignancy is still limited, and few cases have been illustrated in the literature. This clinical condition is even rarer in Asians who are much less vulnerable to malignant melanoma than Caucasians. We experienced two cases of gastric metastases of malignant melanoma which presented as indigestion and epigastric pain. In the first case, a 75-year-old man visited because of indigestion persisting for 2 months. He had a history of multiple gastric ulcer and was treated at a local medical center, but symptoms did not improved. Endoscopic finding revealed multiple and elevated lesions with central black pigmented bases. In the second case, a 47-year-old man visited because of epigastric soreness and intermittent pain for 1 month. Metastatic melanoma in the stomach was noticed by endoscopic examination. Both patients had multiple metastatic lesions in the liver, thyroid, and brain. These two cases were diagnosed as having metastatic malignant melanoma in the stomach of unknown origin. Therefore, we report these cases with a brief review of the related literature.
Aged
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Asian Continental Ancestry Group
;
Autopsy
;
Brain
;
Dyspepsia
;
Humans
;
Liver
;
Melanoma*
;
Middle Aged
;
Neoplasm Metastasis
;
Stomach
;
Stomach Ulcer
;
Thyroid Gland
3.A Case of Gastric Submucosal Tumor Suspected to be Caused by Anisakis.
Paul CHOI ; Jin Wuk HUR ; Hyun Jung LIM ; Jee Young LEE ; Dong Wan KIM ; Moo In PARK ; Seun Ja PARK ; Hee Kyung CHANG ; Kyung Seung OH ; Ja Young KOO
Korean Journal of Gastrointestinal Endoscopy 2003;27(1):26-30
Anisakiasis is a parasitic disease following eating raw fishes infected with Anisakis larvae. The endoscopic features of the gastric mucosa are edema, erosion, ulceration and hemorrhage. Gastric anisakiasis forming submucosal tumor is rare. Twenty six-year-old man who complained of severe epigastric pain was admitted. The pain began approximately three hours after eating slices of raw Astroconger myriaster. Gastric endoscopy revealed a submucosal tumor with central erosion on the gastric fundus. Endoscopic ultrasonography detected a thickening of the gastric wall made of mainly thickened submucosal layer. Abdominal CT scan showed a gastric mass lesion with hypodensity in the gastric fundus and subsequently wedge resection was performed. The pathologic finding of the resected mass was eosinophilic abscess in the submucosal layer. We report a case of gastric submucosal tumor which seems to be caused by Anisakis, with a review of relevant literature.
Abscess
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Anisakiasis
;
Anisakis*
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Eating
;
Edema
;
Endoscopy
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Endosonography
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Eosinophils
;
Fishes
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Gastric Fundus
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Gastric Mucosa
;
Hemorrhage
;
Larva
;
Parasitic Diseases
;
Tomography, X-Ray Computed
;
Ulcer
4.A Case of Needle Tract Seeding of Hepatocellular Carcinoma after Percutaneous Ethanol Injection Therapy; Needle Tract Seeding after Percutaneous Ethanol Injection Therapy.
Sung Wuk SONG ; So Young KWON ; Yang Wook KANG ; Jin Neyn KIM ; Tae Hoon KIM ; Myoung OH ; Bong Ki CHUNG ; Hye Seung YU ; Hee Jin CHANG
The Korean Journal of Hepatology 2001;7(3):325-329
The tumor seeding after percutaneous ethanol injection (PEI) therapy has been considered to be a rare complication in hepatocellular carcinoma. We report a case of needle tract implantation of hepatocellular carcinoma following PEI manifested as subcutaneous nodule. A 57-years old male patient had been treated with PEI for hepatocellular carcinoma. Thirteen months after completion of the PEI session, a subcutaneous nodule was palpated at the site of the needle puncture. A CT scan showed that the subcutaneous nodule was 1.7 cm in size and enhanced in the early phase. The nodule was surgically removed. Microscopic examination showed hepatocellular carcinoma.
Carcinoma, Hepatocellular*
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Ethanol*
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Humans
;
Male
;
Middle Aged
;
Needles*
;
Punctures
;
Tomography, X-Ray Computed
5.Fixation Failure of LCP during the Treatment of Proximal Humerus Fractures.
Woo Kie MIN ; Sang Jin SIN ; In Ho JEON ; Ki Bong CHA ; Chang Wuk OH ; Poong Taek KIM ; Sang Ho CHEON
Journal of the Korean Fracture Society 2006;19(2):188-192
PURPOSE: To evaluate the causative factors in the catastrophic failure of LCP in the proximal humerus fracture. MATERIALS AND METHODS: Six patients (6 cases) were collected between October 2003 and July 2005. The mean age was 55.6 years (range: 38~70). The cause of injury was road traffic accident in four, fall down in one and slip down in one. According to the Neer classification, four were 2 part fractures, each one in 3 part fracture and 4 part fracture. RESULTS: Fixation failure occurred due to back-out of the plate and screw in five and plate breakage in one. Analysis of the preoperative radiographs revealed medial cortical defect in all and no bone graft and tension band wiring in the greater tuberosity fragment were carried out. Postoperative radiographs showed the anatomical reduction in three and non-anatomical in three. CONCLUSION: Non-anatomical reduction, insufficient medial bony buttress, inadequate screw length to the head and the neglect for the greater tuberosity fragment were the contributing factors to the failure of LCP. Knowledge of these factors will enable the surgeon to avoid failure of the LCP. Augmentation fixation and bone graft procedures with careful preoperative planning are necessary for successful fixation of LCP.
Accidents, Traffic
;
Classification
;
Head
;
Humans
;
Humerus*
;
Transplants