The normal vascularization of peripheral nervesand the vascular factor in peripheral nerve les ons have regained increasing interest among surgeons. So, several attempts have been made to assess the relative importance of the vasa nervorum and intrinsic longitudinal vascular plexuses of nerve in maintaining the blood supply.of a segment of nerve trunk. The purpose of our experiment was to determine in laboratory animals the maximum extent to which a nerve can be mobilized without impairing its vascular supply so much that nerve function is jeopardized. All our studies were carried out on both sides of the sciatic-tibial nerve of thirty-two rabbit which were anesthetized intraperitoneally with urethane. The experimental procedure differed in three groups, Group I in which the sciatic nerve was mobilized 3 cm in length, Group II was mob lized 7 cm length and Group III was mobilized 10cm long. The tibialis post. muscles of each group were analyzed at intervals ot 1,2,4,6 and 8 weeks after neurolysis. Each muscles were examined grossly and histologically after hematoxylin and eosin staining. Experimental studies showed that a peripheral nerve is a well vascularized structure with a considerable reserve capacity in its microirculation. The intrinsic collateral system is well developeed and experimental deta supported the view that peripheral nerves may be mobilized over a cons derable length with or the only minium interference with their microvascular flow. The results were as follows: 1. The first evidence of histologic change in the muscle fibers was in the sarcolemmal neclei. 2. Localized atrophy of muscle fibers were observed at the six weeks after neurolysis. 3. With increasing length of neurolysis, abnormal finding were developed in early stage. 4. Massive atrophy of muscle fibers were noted in the muscle fibers which neurolysed more 7cm.
Animals, Laboratory ; Atrophy ; DEET ; Eosine Yellowish-(YS) ; Hematoxylin ; Muscles ; Peripheral Nerves ; Sciatic Nerve ; Surgeons ; Urethane ; Vasa Nervorum

The patient was a 52-year-old female with swelling in both lower legs and peripheral blood eosinophilia. Biopsy specimen revealed the heavy infiltration of eosinophils with sparse small lymphocytes showing mild atypia. The diagnosis was Kimura disease. The symptoms including eosinophilia were relieved by steroid treatment. At 17 months from initial biopsy, the patient developed swelling of the buttock. At 25 months, fever and dyspnea with multiple lung nodules developed. Wedge resection revealed multiple aggregates of CD3(+), CD56(+), Epstein-Barr virus(+) large atypical lymphocytes with necrosis. The patient was finally diagnosed with extranodal NK/T cell lymphoma (NKTL). Epstein-Barr virus in situ hybridization retrospectively performed on the previous biopsies demonstrated Epstein-Barr virus infection in small CD3(+) lymphocytes. The patient expired after 26 months despite chemotherapy. Blood eosinophilia correlated well with disease activity during the clinical course. This case shows not only unusual histologic features, which hampered the correct diagnosis, but also a unique clinical manifestation of NKTL.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Buttocks ; Dyspnea ; Eosinophilia ; Eosinophils ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leg ; Lung ; Lymphocytes ; Lymphoma ; Middle Aged ; Morphinans ; Muscle, Skeletal ; Necrosis ; Retrospective Studies

The patient was a 52-year-old female with swelling in both lower legs and peripheral blood eosinophilia. Biopsy specimen revealed the heavy infiltration of eosinophils with sparse small lymphocytes showing mild atypia. The diagnosis was Kimura disease. The symptoms including eosinophilia were relieved by steroid treatment. At 17 months from initial biopsy, the patient developed swelling of the buttock. At 25 months, fever and dyspnea with multiple lung nodules developed. Wedge resection revealed multiple aggregates of CD3(+), CD56(+), Epstein-Barr virus(+) large atypical lymphocytes with necrosis. The patient was finally diagnosed with extranodal NK/T cell lymphoma (NKTL). Epstein-Barr virus in situ hybridization retrospectively performed on the previous biopsies demonstrated Epstein-Barr virus infection in small CD3(+) lymphocytes. The patient expired after 26 months despite chemotherapy. Blood eosinophilia correlated well with disease activity during the clinical course. This case shows not only unusual histologic features, which hampered the correct diagnosis, but also a unique clinical manifestation of NKTL.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Buttocks ; Dyspnea ; Eosinophilia ; Eosinophils ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leg ; Lung ; Lymphocytes ; Lymphoma ; Middle Aged ; Morphinans ; Muscle, Skeletal ; Necrosis ; Retrospective Studies

Leiomyosarcoma of the rectum is a extremely rare disease without well documented report on its management and prognosis. The most complicated problem lies on the correct diagnosis. Many pathologic and histologic criteria have been proposed to make it clear. The treatment of rectal leiomyosarcoma is controversial. Some authors recommand wide local excison for low-grade tumors as much as 2 cm in diameter. However, radical abdominoperineal resection is the procedure of choice. Leiomyosarcoma of the rectum is resistant to radiotherapy, and no single effective chemotherapeutic drug has been found yet, although adriamycin is effective in one third of all cases. The local recurrence rate was much higher in patients receiving wide local excision and the overall 5-year or 10-year survival rate is similar. We report a case of rectal leiomyosarcoma and review the literature.
Diagnosis ; Doxorubicin ; Humans ; Leiomyosarcoma* ; Prognosis ; Radiotherapy ; Rare Diseases ; Rectum* ; Recurrence ; Survival Rate

A rare case of traumatic bilateral anterior and posterior dislocstions of the hip wss occured by autamobile accident as a passenger injury. The right hip was dislocated anteroinferior to the righ scetabulum(neer the right obturator froamen), and the left hip was dislocated posterosuperior to the left acetsbulum with a ipsilateral femur head fracture caudsd to the fovea centralis(Fig. 1).
Dislocations ; Femur Head ; Femur ; Hip

PURPOSE: This study was designed to explore quality of life (QOL) in patients with stomach cancer by using the World Health Organization Quality of Life (WHOQOL) Instrument-Korean version. MATERIALS AND METHODS: Thirty-one (31) patients with stomach cancer after curative resection were recruited with informed consent. Age- and gender-matched hospital staff served as controls. The 100-item WHOQOL Instrument, including physical domain, psychological domain, social domain, independence domain, environment domain, and spiritual domain, was employed for the all subjects. RESULTS: In patients with stomach cancer after operation, only two domains, physical and independence, were associated with worse quality of life. In those domains, patients with advanced stage, with total gastrectomy, with adjuvant chemotherapy, and early or late postoperative period (< or =2 years or >5 years after operation), could be perceived of having a worse quality of life. CONCLUSION: Not only scientific objective success but also individual subjective perception of condition could be important for managing patients with stomach carcinomas after curative resection. In this context, the WHOQOL reflecting multi-dimensional state of well being could be a useful tool across a variety of cultural and value systems in the world.
Chemotherapy, Adjuvant ; Drug Therapy ; Gastrectomy ; Humans ; Informed Consent ; Postoperative Period ; Quality of Life* ; Stomach Neoplasms* ; Stomach* ; World Health Organization

A 52-year-old women, suffering from generalized pruritus due to intrahepatic and common hepatic duct stones, was treated with astemizole, 30mg daily. Sixty one days later, convulsions and syncope developed suddenly during hospitalization. She had no history of arrhythmia, heart disease, electrolytes imbalance, or CNS disorders. As another case, a 44-year-old man suffering from pruritus due to liver cirrhosis, was treated with astemizole, 30mg daily. Thirty two days later, palpitations and syncope also developed suddenly during hospitalization. He was diagnosed liver cirrhosis, 3 years ago and there was no history of arrhythmia, heart disease, electrolytes imbalance, or CNS disorders. Administration of astemizole was stopped immediately. The laboratory investigations revealed the normal range of serum potassium, calcium and magnesium in both cases. The ECG finding showed the prolongation of QTc interval, frequent VPCs and intermittent polymorphic drugs. On 1st and 3rd day, after discontinue of astemisole, the ECG abnormalities disappeard. It is suggested that astemizole overdose can induce prolongation of QTc interval and torsade de pointes, especially in the patient with liver disease.
Adult ; Arrhythmias, Cardiac ; Astemizole* ; Calcium ; Electrocardiography ; Electrolytes ; Female ; Heart Diseases ; Hepatic Duct, Common ; Hospitalization ; Humans ; Liver Cirrhosis ; Liver Diseases ; Magnesium ; Middle Aged ; Potassium ; Pruritus ; Reference Values ; Seizures ; Syncope ; Torsades de Pointes*

BACKGROUND: The effectiveness of some therapeutic modalities for cutaneous sporotrichosis may be changed depending on the individual and geographic characteristics, and the clinical type. Itraconazole has been known to be effective for it, however, there have been no standard and ideal guideline on the oral dosage and duration yet. OBJECTIVE & METHODS: In this study, we evaluated the effectiveness of oral itraconazole in patients with cutaneous sporotrichosis in relation to dosage and clinical status. The observation of 17 patients with sporotrichosis were made retrospectively Oral itraconazole was administered at the dose of 200 mg daily in 15 adults over 18 years old and 100 mg in the other 2 children. RESULTS: The duration for healing was within 30 days in 4 cases, within 60 days in 4 cases, within 90 days in 2 cases, within 120 days in 3 cases, and within 150 days of therapy in 2 cases. The average duration in all cases was 12.1+/-8.6 weeks. Comparison our results to the previous reported one revealed that more shorter treatment time was needed in cases treated with 200 mg daily than that with 100 mg. There was no treatment failure by drug intolerance or resistance. The duration for healing was significantly shorter in the patient groups with prevalence duration more than 5 months, however there was not any significant difference in sex of patients, and the clinical types. The cases with the lesion on the face and cases with fixed type tended to be healed more rapidly than the others. CONCLUSION: Oral itraconazole may be a safe and e(fictive antifungal agent for the treatment of cutaneous sporotrichosis in a daily dose of 200 mg for 3 months on the average. However, duration for healing could be influenced by the clinical status.
Adolescent ; Adult ; Child ; Humans ; Itraconazole* ; Prevalence ; Retrospective Studies ; Sporotrichosis* ; Treatment Failure

Papular mucinosis, or lichen myxedematosus, is a rare cutaneous disease characterized by papular-lichenoid eruptions, mucin deposition, paraproteinemia, no abnormalities of thyroid function and IgG or IgM deposition in the reticular dermis or just below the epidermis in about 35% cases on direct immunofluorescence study. We report a case of papular mucinosis in a 48-year-old male, who noticed the skin colored or yellowish waxy papules on his upper arm 1 year ago. Since then, similar lesions developed on his upper extremities, upper trunk, and neck during last year. Histopathological findings of the lichenoid papules showed that the collagen fibers in the upper dermis are loosly arranged and separated by amorphous materials. These amorphous materials were positve with colloidal iron stain. Serum protein electrophoresis showed no abnormal bands and an abnormal paraprotein was not detected. Direct immunofluorescenc study of a skin biopsy specimen showed a granular IgM deposit in the papillary dermis. This is the sixth case of papular mucinosis reported in Korea, but is the first case showing IgM deposit in the skin by immunofluorescence study.
Arm ; Biopsy ; Collagen ; Colloids ; Dermis ; Electrophoresis ; Epidermis ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Iron ; Korea ; Male ; Middle Aged ; Mucins ; Neck ; Paraproteinemias ; Scleromyxedema* ; Skin ; Thyroid Gland ; Upper Extremity

OBJECTIVE: Endovascular treatment (EVT) outcomes for acute M2 segment of middle cerebral artery occlusion remains unclear because most results are obtained from patients with large artery occlusion in the anterior circulation. The objective of this study was to assess procedural outcomes for acute M2 occlusion and compare outcomes according to thrombus location (M1 vs. M2).METHODS: A systematic review was performed for online literature published from January 2004 to December 2016. Primary outcome was successful recanalization rate and symptomatic intracranial hemorrhage (S-ICH) after the procedure. A fixed effect model was used if heterogeneity was less than 50%.RESULTS: Eight articles were included. EVT showed successful recanalization rate of 69.1% (95% confidence interval [CI], 54.9–80.4%) and S-ICH rate of 6.1% (95% CI, 4.5–8.3%). The rates of good clinical outcome at 3 months and mortality were 59.4% (95% CI, 49.9–68.2%) and 14.9% (95% CI, 11.4–19.3%), respectively. According to thrombus location (M1 vs. M2), successful recanalization (odds ratio [OR], 1.539; 95% CI, 0.293–8.092; p=0.610) and S-ICH (OR, 1.313; 95% CI, 0.603–2.861; p=0.493) did not differ significantly. Good clinical outcome was more evident in M2 occlusion after EVT than that in M1 occlusion (OR, 1.639; 95% CI, 1.135–2.368; p=0.008). However, mortality did not differ significantly according to thrombus location (OR, 0.788; 95% CI, 0.486–1.276; p=0.332).CONCLUSION: EVT seems to be technically feasible for acute M2 occlusion. Direct comparative studies between EVT and medical treatment are needed further to find specific beneficiary group after EVT in patient with M2 occlusion.
Arteries ; Humans ; Infarction ; Infarction, Middle Cerebral Artery ; Intracranial Hemorrhages ; Middle Cerebral Artery ; Mortality ; Population Characteristics ; Stroke ; Thrombectomy ; Thrombosis