Despite significant advances in the diagnosis and treatment of various malignancies, the management of esophageal cancer remains one of the least responsive malignancies, Unfortunately complete excision of the tumor is impossible, because expandable anatomic structures are involved early when the diagnosis is made. (continue...)
Diagnosis ; Esophageal Neoplasms* ; Esophagus

Polydactyly is one of the most common congenital anomalies of the limb, however its surgical treatment varies from simple excision to reconstruction. The purpose of this study is to present out classification of polydactyly in which the type of surgery was concerned primarily. Two hundred and thirty five digits(134 fingers and 101 toes) in 188 patients were operated from 1980 to 1992. We divided the polydactyly into two types-the simple type, in which the extradigit arises from only one digit, and the complex type in which the extradigit connects more than two adjacent main digits. The simple type was subdivided into joint type(type I), in that the extradigit has its own joint in its origine; epiphyseal type(type II), the extradigit share common epiphysis with main digit; and hypoplastic type(type III), the extradigit is connected only by soft tissue to the main digit. The epiphyseal type(type II) was further divided into subtype A(type IIA), in that the origin seems to be directly derived from the epiphysis; and subtype B(type IIB), which resemble an osteochondroma. Type III and type IIB can be treated by simple excision, however the type I and type IIB can be treated by arthroplasty with or without osteotomy as well as excision of extradigit. Result of surgical treatment in 1 digit of the simple form, which siginifies the extradigit arising from only one digit, are good in 193 digits(91%), fair 14(6.6%), and poor 5(2.4%) after an average follow-up period of 20 months. Our principles in the surgical treatment of polydactyly was treatment according to the type, and early treatment.
Arthroplasty ; Classification ; Epiphyses ; Extremities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Osteochondroma ; Osteotomy ; Polydactyly

The lacrimal fossa can be invovled by a wide specturm of orbital pathology. The correct diagnosis is importantto avoid unnecessary procedure and to do appropriate management. 14 patients with mass lesions in the lacrimalfossa were evaluated with CT and clinical findings. The results were as follows: 1. Final diagnosis of 14 caseswith lacrimal fossa tumors was pleomorphic adenoma in 3 cases, adenoid cystic carcinoma in 1 case, pseudotumor incases, lymphoma in 2 cases, neurofibroma in 1 case, chloroma in 1 case and metastatic adenocarcinoma in 1 case. 2.The duration of symptoms of pleumorphic adenoma was more than 1 year and characteristic CT findings were globularmasses with pressure erosion of the adjacent bone. Patient wih adenoid cystic carcinoma had a short history ofsymptoms. CT showed a fusiform mass but intracranial extension with frank destruction of sphenoid bone. 3.Patients wtih pseudotumor and lymphoma had symptoms for less than 1 year. The CT findings were ill-definedinfiltrative patterns with scleral thickening and the differential diagnosis of them was difficult. 4. The marginsof neurofibroma and chloroma were well defined while that of the metastatic adenocarcinoma was ill-defined. 5. Thedegree and the extent of the contrast enhancement gave no benefit in the differential diagnosis of each diseaseentities and even of the benign and malignant lesions.
Adenocarcinoma ; Adenoma ; Adenoma, Pleomorphic ; Carcinoma, Adenoid Cystic ; Diagnosis ; Diagnosis, Differential ; Humans ; Lymphoma ; Neurofibroma ; Orbit ; Pathology ; Sarcoma, Myeloid ; Sphenoid Bone ; Unnecessary Procedures

No abstract available.
Congenital Abnormalities*

Collagen is the major structural protein in the human body, especially in connective tissues. There are more than 13 types of collagen. Among them, type II collagen is a main component of articular cartilage structure. Altered immunological conditions against type II collagen may be closely related to the pathologic conditions of joint, especially arthritis. Since 1977, animal model for collageninduced arthritis(CIA) has been developed and used in the investigation of arthritis. In those animals, high titers of anti-type II collagen antibody were noticed. Pathologic findings were similar to rheumatoid arthritis of human, which suggested that rheumatoid arthritis might be one of the autoimmune diseases. There had been many reports about elevation of serum and synovial level of anti-type II collagen antibody in rheumatoid arthritis patients. But majority of them did not discriminate the antibody titers according to the type of immunoglobulin(i.e. IgG, IgM). And the question whether the elevated antibody titers are cause or effect of the arthritis is still in controversy. In this study, the serum levels of anti-type II collagen antibody were determined in 82 persons(35 degenerative arthritis patients, 24 rheumatoid arthritis patients and 22 normal controls without any joint problem) via ELISA method. In each person the serum IgG, IgM and IgG+M+A antibody levels against bovine type IIcollagen and chicken typeII collagen were determined individually. Statistical evaluation of these data among degenerative arthritis group, rheumatoid arthritis group and normal control group was performed. The results were as follows; 1. Degenerative arthritis group revealed significant elevation of anti-type II collagen antibody(IgG, IgG+M+A) compared to normal control(p < 0.05). 2. Rheumatoid arthritis group showed significant elvation of IgM and IgG+M+A compared to normal control. 3. Between degenerative arthritis and rheumatoid arthritis group, no sigificant difference was noticed. 4. Rheumatoid arthritis group showed significant increase of IgM antibody level compared to normal control. 5. Female rheumatoid arthritis group showed significant increase of IgM level compared to female degenerative arthritis group. These findings suggested that the elevation of anti-type II collagen antibody titer is not specific for rheumatoid arthritis and related with general pathologies destroying articular cartilage. And it is suggested that anti-type II collagen antibody associated with rheumatoid arthritis is mainly IgM proportion, especially in female patients. So further investigation of anti-type II collagen antibody associated with rheumatoid arthritis is needed to target IgM antibody.
Animals ; Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Cartilage, Articular ; Chickens ; Collagen ; Collagen Type II ; Connective Tissue ; Enzyme-Linked Immunosorbent Assay ; Female ; Human Body ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Methods ; Models, Animal ; Osteoarthritis ; Pathology

In 1958, Jackson first reported on the use of proximal tibial osteotomy in the treatment of pain due to osteoarthritis of the knee joint. Subsequently, various osteotomy techniques have been reported. The varus deformity of the knee associated with osteoarthritis can be corrected by realigning the joint and thereby shifting the line of weight bearing to the compartment with preserved articular cartilage. This procedure has been found to relieve pain, improve function and arrest the progress of the condition. Twenty five cases of genu varum associated with osteoarthritis were treated by high tibial osteotomy at Dept. of O.S., Seoul National University Hospital, from July 1976 to June 1983. And the following results were obtained. 1. In a review of 25 high tibial osteotomies, excellent and good results were noted in 80% of the knees after average follow-up 2.9 years. 2. Postoperative valgus angles, ranging from 5° to 20°, were averaged to be 10.8°. 3. Though some authors indicate the obesity as one of risk factors, we obtained satisfactory results in 25 knees of obese patients.
Cartilage, Articular ; Congenital Abnormalities ; Follow-Up Studies ; Genu Varum ; Humans ; Joints ; Knee ; Knee Joint ; Obesity ; Osteoarthritis ; Osteotomy ; Risk Factors ; Seoul ; Weight-Bearing

No abstract available.
Humans ; Infant* ; Infant, Newborn* ; Radial Artery*

PURPOSE: To evaluate the prevalence and the patterns of sterile gas shown at computed tomography(CT) after transarterial embolization(TAE) for primary hepatic tumor. MATERIALS AND METHODS: Among 102 patients who performed TAE for hepatoma, thirty-four in whom follow-up CTwas underwent constituted the basis of our study. At CT, we evaluated the patterns and locations of intratumoral gas. We also reviewed the clinical data to exclude an infectious origin of intratumoral gas. RESULTS: Of 34 patients, intratumoral gas was detected in 11 patients(32%), in all of whom Gelfoam was used as an embolic material. The initial tumor size measured at pre-TAE CT was larger in patients with intratumoral gas than in patients without it(p < 0.005). No specific patterns or locations of intratumoral gas were noted on CT scans. No patients had clinical signs and symptoms that suggested infection. CONCLUSION: Intratumoral gas formation without clinical evidence of infection is not an infrequent finding after TAE for hepatoma, especially when Gelfoam is used and when the tumor is large in size. This finding may be a part of postinfarction syndrome and should not be misinterpreted as an postprocedural abscess formation.
Abscess ; Carcinoma, Hepatocellular ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Prevalence ; Tomography, X-Ray Computed

No abstract available.
Histiocytoma, Malignant Fibrous* ; Maxillary Sinus* ; Nasal Cavity*

From January 1982 to December 1991, we experienced 96 hands of 66 patients with Dupuytren's disease in Seoul National University Hospital. We performed retrospective analysis of these 96 hands of 66 patients and the results were as follows. Among 66 patients, 60 patients (91%) were male and 51 patients (77%) were in sixth or seventh decade, the average age 58.1 years. Occupations of 66 patients were manual laborer(18 patients, 28%), farmer(15 patients, 22%), sportsman(4 patients, 6%) and deskworker(29 patients, 44%). Among the diseases such as diabetes mellitus, alcoholics, epilepsy known as associated with Dupuytren's disease, diabetes mellitus was more common in our cases, whereas alcoholics and epilepsy were relatively rare. There was no case in which family history was present. Both hands were involved in 30 patients, right hand only in 30 patients, and left hand only in 6 patients. Right hand was involved in 60 patients(91%), whereas left hand was involved in 36 patients(55%). The case in which only the 4th finger was involved was most common(42 hands, 44%). The 4th finger was affected most frequently(81 hands, 84%). In diabetic patients, the middle finger was involved more frequently than in non-diabetic patients(p < 0.05). Most of patients(83 hands, 86%) had symptoms of flexion contracture, nodule or contracted cord simultaneously. Surgical treatment was per- formed in 32 hands of 22 patients, with the results of excellent in 24 hands(75%), good in 6 hands(19%) and no recurrence, in average follow-up 3.6 years(2.6 years to 5.0 years). In conclusion, it might be thought that Dupuytren's disease in which surgical treatment was required was relatively rare in Korean and even if necessary, partial fasciectomy resulted in rather good result.
Alcoholics ; Contracture ; Diabetes Mellitus ; Dupuytren Contracture ; Epilepsy ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Male ; Occupations ; Recurrence ; Retrospective Studies ; Seoul