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

The association of gastric tubular adenoma and adenocarcinoma is already well known. Then, are those two pathologic lesions merely incidentally coexisting or does the one evolve to the other? That is a longstanding controversy. Nowadays, as is the case with the colonic tubular adenoma, the hypothesis that gastric tubular adenoma may be a precancerous lesion is generally accepted. However the direct evidences are rare. We report a clear case proving the potential of direct malignant transformation of gastric tubular adenorna through the 9-year close endoscopic follow-up. The developed cancer is well differentiated, surrounded with background tubular adenoma and limited to the submucosal layer.
Adenocarcinoma ; Adenoma* ; Colon ; Follow-Up Studies*

BACKGROUND: To investigate the role of alpha-adrenergic receptors in the development of delayed afterdepolarization, the effect of alpha-adrenoceptor stimulation and blockade on ouabain induced delayed afterdepolarization(DDAD) was examined in rabbit heart Purkinje fibers. METHODS: Purkinje fibers, taken from adult rabbit(1.8 - 2.0kg) heart anesthetized with penobarbital, were mounted in a Luicite chamber and superfused with Tyrode's solution. The transmembrane potentials were measured by the conventional microelectrode technique while the fibers were being stimulated with rectangular pulses of 50% above threshold voltage. The delayed afterdepolarizations were induced by overdrive excitation in the presence of ouabain. RESULTS: Delayed afterdepolarizations were not observed during superfusion of the control Tyrode's solution containing propranolol(5x10(-7)M). However, the addition of ouabain in the presence of propranolol elicited DADs which were dose-, time- and drive cycle length- dependent. Phenylephrine(PE ; 10(-7)M), and alpha-adrenoceptor agonist, potentiated the ouabain-induced DAD during the initial superfusion(for 10 or 20 min) of the test Tyrode's solution. However, it was followed by attenuating-effects after a superfusion time of 50 to 60 min. Both effects showed ouabain dose-dependence. Ouabain(2x10(-7)M), in the presence of propranolol, depolarized the maximum diastolic potential and shortened the action potential duration, and the addition of PE(10(-7)M) did not affect the characteristics of action potential except a decrease in velocity of phase 0 depolarization. Prazosin, an alpha1-adrenoceptor antagonist, inhibited the PE's enhancing effects of ouabaininduced DDAD at 20 min superfusion, but did not affect the attenuating-effects of PE at 60 min superfusion. On the other hand, yohimbine, an alpha2-adrenoceptor antagonist, did not affect the PE's DAD potentiating-effects at 20 min superfusion, but inhibited the attenunating-effects of PE at 60 min superfusion. CONCLUSION: It is inferred that alpha-adrenergic stimulation induce delayed afterdepolarization and triggered activity in the rabbits, being responsible for the arrhythmia development, and the effects are mainly due to the action of alpha1-subtpe adrenoceptor stimulation.
Action Potentials ; Adult ; Arrhythmias, Cardiac ; Hand ; Heart ; Humans ; Membrane Potentials ; Microelectrodes ; Ouabain ; Prazosin ; Propranolol ; Purkinje Fibers ; Rabbits ; Receptors, Adrenergic, alpha* ; Yohimbine

Lymphangioma is a benign form of neoplasm arising from the lymphatic system. It occurs as a result of congenital malformations of the lymphatics leading to the obstruction of local lymph flow and the development of lymphangiectasia. Lymphangiomas are common in pediatric patients, in the soft tissues of the neck and the axillae, but lymphangioma of the pancreas is extremely rare, accounting for less than 1% of these tumors. It occurs more frequently in females and is often located in the distal pancreas. Although extremely rare, cystic lymphangioma of the pancreas should be taken into consideration as a differential diagnosis of pancreatic cystic or retroperitoneal lesions, especially in women. Herein, we report on a case of cystic lymphangioma of the distal pancreas in a 37-year-old woman who was treated with complete surgical resection with a review of the literature.
Accounting ; Adult ; Axilla ; Diagnosis, Differential ; Female ; Humans ; Lymphangioma ; Lymphangioma, Cystic ; Lymphatic System ; Neck ; Pancreas ; Pancreatic Cyst ; Retroperitoneal Space