The musculocutaneous nerve has a short course and is deeply placed before piercing the coracobrachialis muscle at the point where it is relatively fixed by branches along its course between biceps brachii and brachialis muscles. Therefore, an isolated palsy of the musculocutaneous nerve is extremely rare and usually caused by stab, cut or bullet injuries. An isolated musculocutaneous nerve palsy, sparing the coracobrachialis muscle, can occur after heavy exercise of the arm musculature and has a good prognosis. We report a patient with an isolated musculocutaneous nerve palsy caused by motorcycle accident.
Arm ; Humans ; Motorcycles ; Muscles ; Musculocutaneous Nerve* ; Paralysis* ; Prognosis

A statistical observation was made on 448 in-patients in the Department of Urology Catholic Medical College, during the period from the January 1, 1976 to December 31, 1977.
Urology

Renal tubular dysfunctions have been observed in hydronephrosis, resulting in metabolic acidosis, hyperkalemia and excessive free water diuresis. These findings are occasionally found in infant and children. Batle et al. first reported distal tubular acidosis associated with low potassium excretion resulting from aldosterone resistance in adults with obstructive uropathy. We have experienced a case of transient hyperkalemia and hyperaldosteronism secondary to hydronephrosis in 63-year-old female patient. The causes of hyperkalemia were examined under the impression of secondary adrenal insufficiency due to corticosteroid abuse or hyporeninemic hypoaldosteronism due to diabetic nephropathy. But it proved to be resulted from hyperaldosteronism due to hydronephrosis. The hyperkalemia resulting from hyperaldosteronism is rare in adults. It may result from aldosterone resistance at distal nephron due to obstructive uropathy or the defect of distal nephron in hydrogen and potassium secretion in the distal nephron rather than from aldosterone deficiency. After she underwent percutaneous nephrostomy, serum potassium was maintained within normal range. She performed total cystectomy with ureterocutaneostomy in purpose for treatment of bladder cancer. So we report this case with a review of literature.
Acidosis ; Adrenal Insufficiency ; Adult ; Aldosterone ; Child ; Cystectomy ; Diabetic Nephropathies ; Diuresis ; Female ; Humans ; Hydrogen ; Hydronephrosis* ; Hyperaldosteronism* ; Hyperkalemia* ; Hypoaldosteronism ; Infant ; Middle Aged ; Nephrons ; Nephrostomy, Percutaneous ; Potassium ; Reference Values ; Urinary Bladder Neoplasms ; Water

PURPOSE: The reported incidence of early gastric cancer located in the upper portion of the stomach has been increasing with the recent advances in its diagnosis and screening. Recently, we have successfully performed laparoscopic assisted proximal gastrectomy and gastric tube reconstruction, without pyloroplasty, on six patients with an early gastric carcinoma located in the upper third of the stomach. Herein, we describe our modification of this procedure. METHODS: After creating a surgical pneumoperitoneum, the stomach was mobilized using laparoscopic coagulating shears. The upper half of the greater curvature and three- quarters of the lesser curvature were then dissected in conjunction with a regional D2 lymphadenectomy. This was followed by a 5 cm, longitudinal mini-laparotomy in the upper abdomen, with the construction of the exterior stomach using a 20 cm long and 4 cm wide gastric tube. Reconstruction, with an esophagogastrostomy, was performed using a circular stapler. RESULTS: No post-operative morbidity or mortality was observed in this small series of patients. The average operative time and blood loss were 230 minutes, ranging from 190~290 minutes, and 150 ml, ranging from 90-180 ml, respectively. The mean number of lymph nodes harvested during these laparoscopic proximal gastrectomies was 22.8 nodes, ranging from 19~30 lymph nodes. The average postoperative hospital stays was 8.3 days, ranging from 7~10 days. CONCLUSION: Our technique of laparoscopic assisted proximal gastrectomy and gastric tube reconstruction, without pyloroplasty, offers a minimally invasive technique, with the potential of improving the post-operative quality of life of patients with early-stage proximal gastric cancer.
Abdomen ; Diagnosis ; Gastrectomy* ; Humans ; Incidence ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mass Screening ; Mortality ; Operative Time ; Pneumoperitoneum ; Quality of Life ; Stomach ; Stomach Neoplasms*

Psoriasis, whose symptom is shown in around 1~3% American people, is a chronic and inflammatory skin disease. There are many treatments for pustular and erythrodermic psoriasis and oral retinoid which is a synthetic derivative of vitamin A is the most popular drug of them. Acitretin called as the second generation retinoid is a kind of active retinoid metabolite, which shows some drug toxicities in hepatic, skeletal and cardiovascular systems including atherosclerosis after a long term use. Even though that, we have just one case which has ever reported on acitretin-associated thrombotic stroke so far. We report a case on a patient who has multiorgan thrombotic occlusions resulted from longstanding psoriatic treatments by using acitretin for five years. This patient suffers from lots of complications such as superior mesenteric artery thrombosis, small cerebellar infarctions, cerebral infarction, acute renal failure concomitant with both small renal infarctions and atherosclerosis obliterans in his two legs.
Acitretin* ; Acute Kidney Injury ; Atherosclerosis ; Cardiovascular System ; Cerebral Infarction ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Infarction ; Leg ; Mesenteric Artery, Superior ; Psoriasis* ; Skin Diseases ; Stroke ; Thrombosis ; Vitamin A

We carried out coronary artery bypass grafting using saphenous vein on 8 patients from May, 1987 through January, 1988 at Hanyang University Hospital in Seoul. There were 4 men and 4 women and the mean age was 58.3 years. Except for 1 patient, they were all diagnosed as unstable angina not responding to medical therapy. The average ejection fraction was 66.9%, and no operative death was found. Two sequential anastomoses were performed in one patient. There was no significant event to influence adversely on postoperative prognosis. During the mean follow up period of 6.3 months, none of the patients experienced new symptoms and all of them remain relatively well off the medications used pre and perioperatively execpt for aspirin and persantin.
Angina, Unstable ; Aspirin ; Coronary Artery Bypass* ; Coronary Vessels* ; Dipyridamole ; Female ; Follow-Up Studies ; Humans ; Male ; Prognosis ; Saphenous Vein ; Seoul

PURPOSE: The technique of laparoscopic gastrectomy has developed for early gastric cancer, but a few reports have studied the objective advantages of laparoscopic techniques in a prospective manner. The purpose of this study is to compare laparoscopy-assisted gastrectomy (LG) with conventional open gastrectomy (OG) by the operative outcomes, the recovery of bowel function, and the complications in a prospective nonrandomized manner. METHODS: We studied 73 patients with gastric cancer who were diagnosed as stage I (IA, IB) preoperatively between July 2003 and September 2004. 38 patients underwent LG and 35 patients underwent OG. All patients underwent radical lymphadenectomy (D2), and were treated by a single surgeon. RESULTS: Patients of the two groups were comparable by age, sex, BMI (Body mass index), preoperative stages and mean number of retrived lymph nodes. The mean operative time was shorter in the OG group (P=0.012), and the mean amount of blood loss was significantly less in the LG group than in the OG group (P=0.002). The patients in the LG group recovered bowel function significantly earlier than those in the OG group (P=0.01), thus, the mean hospital stay was significantly shorter in the LG group (P=0.007). The postoperative pain was significantly lower in the LG group (P<0.001). The postoperative complications were 4 cases in the LG group and 6 cases in the OG group, and there were no conversions and no mortalities. CONCLUSION: LG, when compared with OG, has several advantages, including less blood loss, rapid return of gastrointestinal function, less pain, and shorter hospital stay with compromising the cure rate. In addition, for evaluation of the validity of laparoscopic surgery in gastric cancer, a large scaled randomized prospective multicenter study is required.
Gastrectomy* ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Prospective Studies* ; Stomach Neoplasms*