PURPOSE: Laparoscopy-assisted gastrectomy (LAG) is gaining wider acceptance as a minimally invasive treatment for early gastric cancer, but the safety, efficacy and clinical benefits of this type of surgery are still unclear. The purpose of this study is to compare laparoscopy-assisted gastrectomy (LADG) and conventional open distal gastrectomy (CODG) for early gastric cancer (EGC) according to the changes of the postoperative nutritional status and acute inflammatory reaction. MATERIALS AND METHODS: Eighty seven patients with EGC and who underwent a LADG between March 2006 and May 2009 at Daegu Catholic University Hospital, was enrolled. Over the same period, we enrolled 30 patients who underwent CODG and they were confirmed to have EGC from their pathology. The clinico-pathological features and serologic parameters were evaluated from the medical records and then retrospectively analyzed. RESULTS: There were no differences in the preoperative white blood cell (WBC), C-reactive protein (CRP) level, albumin level, the T4/T8 ratio and the other clinical data between the two groups. The total WBC counts gradually increased and they were significant lower at the 1st and 3rd postoperative days in the LADG group than that in the CODG group (P=0.001 and 0.008, respectively). The postoperative CRP levels were significantly lower at postoperative 5th day in the LADG group (P<0.001). The postoperative albumin and T4/T8 ratio gradually decreased, and the T4/T8 ratio was significantly higher at the 3rd postoperative day in the LADG group compared to that in the CODG group (P=0.003). CONCLUSION: This study demonstrates that the LADG has less of an influence on an acute inflammatory reaction than does CODG. Therefore, it is one of the safe and feasible procedures for the treatment of early gastric cancer.
C-Reactive Protein ; Gastrectomy ; Humans ; Leukocytes ; Medical Records ; Nutritional Status ; Retrospective Studies ; Stomach Neoplasms

BACKGROUND: Common and effective treatments for calcific tendinitis involve needling procedures. However, it has been widespread practice to refer patients with calcific tendinitis, which is a predominantly orthopedic condition, to radiology department. The purpose of this study was to compare clinical and radiological outcomes after ultrasound-guided needling for calcific tendinitis between the orthopedics and radiology department. METHODS: Seventy-seven shoulders (Group 1) and 38 shoulders (Group 2) treated in the radiology and orthopedic department, respectively. A fellowship-trained orthopedic surgeon and a musculoskeletal radiologist each performed the procedure of ultrasound-guided needle decompression with subacromial steroid injection. Clinical outcomes was evaluated using the visual analogue scale for pain (pVAS) and the American Shoulder and Elbow Surgeons (ASES) shoulder score before treatment and at each follow-up. The pre- and post-needling size and shape of the calcific deposits were compared between the two groups. RESULTS: We analyzed a total of 56 shoulders for Group 1 and 32 shoulders for Group 2. The mean age and sex ratio of the patients no significantly different. We found that the mean decrease in the diameter of calcification between pre- and post-needling was 9.0 mm for Group 1 and 13.1 mm for Group 2; the difference was significantly larger in Group 2 than in Group 1. Both groups showed improved pVAS and ASES scores after needling but the extent of these improvements did not differ with the type of operator. CONCLUSIONS: Needling decompression performed by orthopedic surgeons could a viable option for the treatment of calcific tendinitis.

Perforation of Meckel's diverticulum by foreign bodies is an extremely rare cause of acute abdomen in adults. We report a case of perforated Meckel's diverticulum by a chicken bone with localized abdominal abscess in a 46-year old man. The patient had been brought to the hospital with fever, abdominal pain and abdominal distention. On computed tomography, the mass-like lesion was considered to be an abdominal abscess caused by perforated bowel due to a suspicious foreign body. Resection of a segment of ileum including the perforated diverticulum was performed; the patient had an uncomplicated postoperative course and was discharged. We report this rare case of perforation of Meckel's diverticulum by a chicken bone with a review of the literature.
Abdomen, Acute ; Abdominal Abscess ; Abdominal Pain ; Adult ; Chickens* ; Diverticulum ; Fever ; Foreign Bodies ; Humans ; Ileum ; Meckel Diverticulum*

No abstract available.
Aged* ; Femur Neck* ; Femur* ; Humans

Intrsneural ganglion cysts of the peroneal nerve are rare. The precise etiology and pathological changes remain obscure. We have experienced recently a case of intraneural ganglion cyst developed in the sheath of the peroneal nerve. A 28 year old male had suffered from lump producing pain over the posterolateral aspect of the upper portion of the fibula, weakness of dorsiflexion of the ankle and of extension of the toes and diminution of sensation on the dorsum of the foot. He underwent excision of the ganglion and the prognosis for recovery of function is good.
Ankle ; Fibula ; Foot ; Ganglion Cysts ; Humans ; Male ; Peroneal Nerve ; Prognosis ; Recovery of Function ; Sensation ; Toes

OBJECTIVE: Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a progressive cardiac muscle disease characterized as progressive fibrofatty replacement of the right ventricle, severe ventricular arrhythmia, and sudden death. However, there is no report of ARVC as a cause of sudden death in Korea. METHODS and RESULTS: Postmortem studies were done to 115 cases of sudden unexplained death at department of legal medicine, school of medicine, Kyungpook national university in year 1999. We identified 7 cases(6%) of typical ARVC with no other identifiable cause of sudden death. The subjects included 5 males and 2 females, ranging in age from 19 to 41 years (mean 29.7 years). All were found dead at bed (5 cases) or workshop (2 cases). Five cases were fibrofatty types and two cases were fatty types. Right ventricular aneurysm, inflammatory infiltrates and left ventricular involvement were found in 4, 2 and 1 cases, repectively. Two cases had family history of sudden death before age 40. No one was suspected of having cardiovascular disease or ARVC before death. CONCLUSION: These findings indicate that ARVC in Taegu-Kyungpook area may be more frequent than previously thought. ARVC may be a major cause of sudden unexplained death.
Aneurysm ; Arrhythmias, Cardiac ; Arrhythmogenic Right Ventricular Dysplasia* ; Cardiovascular Diseases ; Death, Sudden ; Education ; Female ; Forensic Medicine ; Gyeongsangbuk-do ; Heart Ventricles ; Humans ; Korea ; Male ; Myocardium

Although a popliteal cyst is most commonly identified as an asymptomatic mass occurring just below the popliteal fossa, the fluid may further extravasate into a deep compartment, causing compression with symptoms of local pain and tenderness. When the popliteal vein is compressed by a popliteal cyst, it may develop the symptom simulating the deep vein thrombosis, when the popliteal artery is compressed, it may develop the symptom simulating the ischemic pain and intermittent claudication. It is unusual for popliteal cysts to involve a nerve. When such does occur, it usually involves the tibial nerve, very rarely the peroneal nerve. It is important to diagnose a popliteal cyst early and to differentiate it from a ganglionic cyst, thrombophlebitis or a popliteal aneurysm, to effect optimal therapy and to obviate a potential neuropathy. We are now reporting a case of a thirty four-year-old male who had a popliteal cyst causing tibial nerve compression.
Aneurysm ; Ganglion Cysts ; Humans ; Intermittent Claudication ; Male ; Peroneal Nerve ; Popliteal Artery ; Popliteal Cyst* ; Popliteal Vein ; Thrombophlebitis ; Tibial Nerve* ; Venous Thrombosis

Most hepatocellular carcinomas arise in orthotopic liver tissue as a result of chronic hepatitis B or C infection or cirrhosis secondary to other chronic liver disease. There have been reports of ectopic liver tissue located in an extrahepatic organ such as the gallbladder, spleen, hepatoduodenal ligament and subdiaphragm. However, the incidence of hepatocellular carcinoma originating from ectopic liver is very low. There have been 22 cases of ectopic HCCs (hepatocellular carcinoma) reported in the literature, and ruptured HCC has not yet been reported in the literature. As for the pathogenesis, the development of an ectopic HCC may be result of a compromised vascular supply or biliary drainage. We report here on a case of ruptured ectopic hepatocellular carcinoma arising in the left subdiaphragm in a 76-year-old man who was treated with surgical resection. The patient was followed up for 1 year after surgery and he remained free of recurrence. Therefore, the unique localization and growth pattern of ruptured ectopic HCC may give the physician and patient the chance to achieve a curative resection.
Aged ; Carcinoma, Hepatocellular ; Drainage ; Fibrosis ; Gallbladder ; Hepatitis B, Chronic ; Humans ; Incidence ; Ligaments ; Liver ; Liver Diseases ; Recurrence ; Spleen

No abstract available.
Neurofibromatoses*

BACKGROUND: The goal of successful resuscitation is not only to stop the process of ischemia as soon as possible but also to overcome the secondary injury process after resuscitation, which involves a complex interplay of mechanisms. Brain damage accompanying cardiac arrest and resuscitation is frequent and devastating. Cells die by one of two mechanisms: necrosis or delayed neuronal death. Delayed neuronal death may require protein synthesis. Neurons in the CA1 subfield of the hippocampus are selectively vulnerable to death after injury by ischemia and reperfusion. Death of these neurons occurs after an interval of 1 or 2 days. We assessed the effects of a protein synthesis inhibitor, cycloheximide(CHX), on hippocampal neuronal death of rats by using the ventricular fibrillation cardiac arrest(VFCA) model. METHODS: The effect of CHX(3mg/kg, s.c.) on hippocampal neuronal death was studied in two groups of 18 rats each, one group being subjected to a 2-min VFCA and the other to a 3-min VFCA. Each group was divided into three subgroups: control(group I,II) without subcutaneous injection of CHX, 'exp-12' of group I/II treated with CHX 12 hours after return of spontaneous circulation (ROSC), and 'exp-24' of group I/II treated with CHX 24 hours after ROSC. The coronal sections of the hippocampus levels were stained with hematoxylin-eosin after 72 hours of survival. The histologic damage score(HDS) was used to assign a score to the total number of damaged neurons counted in each of the hippocampal CA1 subfields. RESULTS: 1. There were not significan differences in heart rates, blood pressures, blood sugar, and blood gas in group I & II during the pre-arrest steady state or at 5 min and 30 min after ROSC. 2. In group I & II, the HDS, were significantly reduced in rats(I exp-12, 1.1+/-0.6; I exp-24, 1.3+/-0.5; II exp-12, 1.4+/-0.7; and II exp-24, 1.8+/-0.8) treated with CHX 12 hours or 24 hours after ROSC than control rats(I, 2.5+/-0.9, II, 2.9+/-0.8)(p<0.05). CONCLUSION: These results suggest that delayed hippocampal neuronal death from ischemic insult after ventricular fibrillation cardiac arrest followed by resuscitation can be prevented by a protein synthesis inhibitor, CHX. Further experimental studies of the action mechanism of protein synthesis inhibitors to delayed neuronal death and clinical applications are required.
Animals ; Blood Glucose ; Brain ; Heart Arrest* ; Heart Rate ; Hippocampus ; Injections, Subcutaneous ; Ischemia ; Necrosis ; Neurons* ; Protein Synthesis Inhibitors ; Rats* ; Reperfusion ; Resuscitation ; Ventricular Fibrillation*