Two cases of tendon transfer for paralysis of the radial nerve due to trauma in the humerus have been operated by transferation of foream flexors such as flexor carpi radialis, pronator teres and palmaris longus at the Department of Orthopedic Surgery, Chosun University Hospiatl. The one case was a open fracture at midshaft of the humerus with cut down the radial nerve in the distal third of the humerus and with contaminated severe muscle injuries. The other case was radial nerve injury at the level of supracondylar area of humerus by the wound of deep laceration. The operative procedure carried out two month later after neurorrhpy of the radial nerve. However, the result of these cases were exhibited very good motor and sensory function of the radial nerve during two year follow up study. A review of literatures is included.
Follow-Up Studies ; Fractures, Open ; Hand ; Humerus ; Lacerations ; Orthopedics ; Paralysis ; Radial Nerve ; Sensation ; Surgical Procedures, Operative ; Tendon Transfer ; Tendons ; Wounds and Injuries

Infantile hypertrophic pyloric stenosis (IHPS) a common childhood disorders characterized by nonbilious projectile vomiting, an olive shaped mass in the right upper quadrant of the abdomen and visible gastric peristaltic wave in the upper abdomen. Its etiology and pathogenesis are not clear but abnormal nerve distribution of the pylorus has been postulated2-6. We performed immunocytochemical staning to the pyloric muscle from 10 IHPS and 3 controls patients, utilizing specific monoclonal antibody to NCAM(neural cell adhesion molecule). In IHPS patients, the number of NCAM protein immunoreactive nerve fibers were less than that in normal subjects. Auerbach myenteric plexuse was well developed and interbundle nerve plexuse was present but nerve fibers supplying individual muscle cells in smooth muscle bundles were poorly developed. These results indicate reduction of innervation in smooth muscles in IHPS patients that possibly contributes to the pathogenesis of IHPS.
Abdomen ; Cell Adhesion ; Humans ; Muscle Cells ; Muscle, Smooth ; Myenteric Plexus ; Nerve Fibers ; Neural Cell Adhesion Molecules ; Olea ; Pyloric Stenosis, Hypertrophic* ; Pylorus* ; Vomiting

A case of a small cell carcinoma of the stomach is reported. A small cell carcinoma of the stomach is a very rare disease. Preoperative diagnosis is very difficut. The prognosis of this disease is very poor compared with the common type of gastric carcinoma. Considering the poor prognosis of this particular disease, adjuvant chemotherapy might be mandatory in all cases even when a surgically curative resection is perfomed. A 63-year-old male was referred to our hospital for elective surgery for gastric cancer, which is located in the cardia. A total gastrectomy and splenectomy with D4 systematic lymph node dissection were perfomed. The serosal layer was invaded. The metastases were found in the number 1, 7, 8, and 12 lymph node. Thirteen of the 62 dissected nodes were positive. Other organs were grossly intact. The tumor cells were show small-sized cells with hyperchromatic nuclei and scanty cytoplasms, and were arranged in solid nests. No glandular differentiation was observed in the tumor itself. Postoperative adjuvant chemotherapy was perfomed with etoposide and carboplatin. The patient has been followed up for 10 months he appears to be relatively healthy and is doing well, but the prognosis is expected to be poor.
Carboplatin ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell* ; Cardia ; Chemotherapy, Adjuvant ; Cytoplasm ; Diagnosis ; Etoposide ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Rare Diseases ; Splenectomy ; Stomach Neoplasms ; Stomach*

A patient with mucin hypersecreting papillary adenocarcinoma of intrahepatic bile duct had jaundice and symptoms of cholangitis. Radiologic evaluations-ultrasonography and computerized tomographyrevealed passage disturbance of bile at the level of the distal common bile duct or ampulla of Vater. But, primary lesion was located at left intrahepatic duct proximal to the ductal dilatation. This peculiar phenomenon confused clinicians. A 59-year-old man was referred to our hospital for evaluation of recurrent cholangitis. Ultrasonogram, computerized tomogram and endoscopic retrograde cholangiography disclosed dilatation and amorphous filling defect extending from left intrahepatic bile duct to common bile duct suggesting choledochal cyst(type IVa). Preoperative endoscopic examination showed spillage of mucin through duodenal papilla. Abdominal exploration revealed mucin hypersecreting papillary adenocarcinoma of left intrahepatic duct and dilated distal common bile duct filled with tenacious mucin. Left hepatic lobectomy and Roux-en-Y hepaticojejunostomy were performed.
Adenocarcinoma ; Adenocarcinoma, Papillary* ; Ampulla of Vater ; Bile ; Bile Ducts, Intrahepatic ; Cholangiography ; Cholangitis ; Common Bile Duct ; Dilatation ; Humans ; Jaundice ; Middle Aged ; Mucins* ; Ultrasonography

We report various causes of acute abdominal aortic occlusion, a condition which is infrequent but usually ends catastrophically. The three cases are embolic occlusion by myxoma, thrombotic occlusion of aortic aneurysm, and thrombosis of an atherosclerotic aorta; the first two causes are very rare clinical presentations. All patients showed leg paralysis, pain, and severe ischemic symptoms. Diagnosis was done by emergent-CT (computed tomography) scan and surgery was performed urgently. Nevertheless, all patients died in the early postoperative period. As acute aortic occlusion is infrequent, its diagnosis may be delayed. The mortality rates remains high even with urgent surgical care.
Aorta ; Aorta, Abdominal* ; Aortic Aneurysm ; Diagnosis ; Humans ; Leg ; Mortality ; Myxoma ; Paralysis ; Postoperative Period ; Thrombosis

BACKGROUND/AIMS: Despite of increasing numbers of reports on intraductal papillary mucinous tumor (IPMT), there is still difficulty in its' diagnosis, treatment and prediction of prognosis. The purpose of this multicenter study was to evaluate the clinico-pathological features of IPMT in Korea and suggest the prediction criteria of malignancy in IPMT. METHODS: We retrospectively reviewed the clinico-pathological data of 208 patients who underwent operations with IPMT between 1993 and 2002 at 28 institutes in Korea. RESULTS: Of the 208 patients with a mean age of 60.5+/-9.7 years, 147 were men and 61 were women. 124 patients underwent pancreatoduodenectomy, 42 distal pancreatectomy, 17 total pancreatectomy, 25 limited pancreas resection. Benign cases were 128 (adenoma (n=62), borderline (n=66)) and malignant cases were 80 (non-invasive (n=29), invasive (n=51)). A significant difference in 5-year survival was observed between benign and malignant group (92.6% vs. 65.3%; p=0.006). Of the 6 factors (age, location, duct dilatation, tumor appearance, main duct type, and tumor size) that showed the statistical difference in univariate analysis between benign and malignant group, we found three significant factors (tumor appearance (p=0.009), tumor size (p=0.023), and dilated duct size (p=0.010)) by multivariate analysis. CONCLUSION: Although overall prognosis of IPMT is superior to ordinary pancreatic cancer, more curative surgery is recommended in malignant IPMT. Tumor appearance (papillary), tumor size (> or =30 mm) and dilated duct size (> or = 12 mm) can be used as preoperative indicators of malig-nancy in IPMT.
Academies and Institutes ; Diagnosis ; Dilatation ; Female ; Humans ; Korea* ; Male ; Mucins* ; Multivariate Analysis ; Pancreas* ; Pancreatectomy ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Prognosis ; Retrospective Studies