During the period from January 1980 to September 1988, 59 patients suffering from brachial plexus injury, have admitted to Seoul National University Hospital. Fifty-four patients were male and 5 patients were female, and age ranged from 6 to 58 years (mean:26.8 years). The most common cause of injury was traffic accident accounting for 66% (39patient), and among them 24 patients(62%) had the motor cycle accident. Birth injury, stab or gun shot wound, fall down and industrial hazard were following causes. Fracture and dislocation of involved limb accompanied in 19 patients(32%) and 2 patients of arterial injury were also found. EMG and cervicsl myelography with or without CT were performed in almost all the patients and MRI was performed in selected patients. Forty-five patients(76%) had supra-clavicular lesion and 14 patients (24%) had infra-clavicular lesion. In supra-clavicular lesion, upper roots or whole roots were involved in most of cases. Forty-nine cases were treated with conservative treatment for more than 8 months and operative procedures were performed in 36 cases. In operative cases, 30 patients were followed up for more than 1 year (average 24.3 months). Signs of root avulsion were found in 25 out of 31 cases of cervical myelography. MRI was performed in 7 cases, but it was inconclusive in diagnosis of root involvement. Infra-clavicular lesion showed better prognosis than supra-clavicular lesion. In supra-clavicular lesion, upper root involvement had the best prognosis. A pseudocyst detected by myelography usually precluded recovery in the root at the level of pseudocyst. Result of reparative treatment was better than that of conservative treatment. Overall satisfactory result in reparative treatment was 36%. However, if we include neurological improvement, positive result was 53%. Complete recovery was gained in half cases of neurolysis and other half showed no recovery, but all the cases of neurotization showed poor result. Reconstructive surgery including arthrodesis or muscle transfer can be effective treatment method, if it is performed properly on a selective patient.
Accidents, Traffic ; Arthrodesis ; Birth Injuries ; Brachial Plexus ; Diagnosis ; Dislocations ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Methods ; Myelography ; Nerve Transfer ; Prognosis ; Seoul ; Surgical Procedures, Operative ; Wounds and Injuries

Portal vein thrombosis (PVT) is a rare but serious complication of splenectomy that is more common in patients with hematologic disorders (hemolytic anemia, myeloproliferative disease, etc.), but relatively rare when splenectomy is conducted because of trauma. We present the case of a 42-year-old woman, admitted for abdominal trauma, who produced a computed tomography (CT) scan showing a grade IV splenic laceration with perisplenic hematoma and subsequently underwent splenectomy. Preoperatively, a hematologic workup revealed no underlying platelet or coagulation disorder. The patient developed PVT in her anterosuperior branch of the right portal vein and anticoagulation treatment was immediately started. After the event was resolved, no symptoms of PVT were observed, which was confirmed by laboratory and radiologic findings. In summary, we report a case of spontaneous PVT after splenectomy for trauma and its successful resolution with anticoagulation treatment.
Anemia ; Blood Platelets ; Female ; Hematoma ; Humans ; Lacerations ; Portal Vein ; Splenectomy ; Thrombosis

Spontaneous bleeding from a short gastric artery in the absence of pre-disposing trauma is reported very rarely. To the best of our knowledge, the published literature includes only 14 cases. Young men comprise almost all of the patients, and were induced by vomiting or gagging. The patients usually required emergent surgery. Our patient, a 32-year-old man, was diagnosed with spontaneous hemoperitoneum due to short gastric artery tearing after a few instances of vomiting. We managed him conservatively including fluid, vitamin K and antifibrinolytic agent without surgery.
Adult ; Arteries* ; Gagging ; Hemoperitoneum ; Hemorrhage* ; Humans ; Male ; Splenic Artery ; Tears ; Vitamin K ; Vomiting*

PURPOSE: Papillary thyroid carcinomas are hypervascular tumors. The tumor growth and their metastases are dependent on factors that stimulate vessel formation (angiogenesis). Vascular endothelial growth factor (VEGF) has been reported to play an important role in the angiogenesis in papillary thyroid carcinomas in terms of the clinicopathological prognostic factors. METHODS: The expression of VEGF in specimens surgically removed from 23 papillary thyroid cancer patients were examined by immunohistochemical methods. RESULTS: The rate of VEGF expression was 56.5% in the tumor cells. The degree of VEGF expression was significantly correlated with local lymph node metastases (P=0.029) and the tumor extent (P=0.036). However, the degree of VEGF expression did not correlate with any clinicopathological characteristics. CONCLUSION: VEGF expression can be a useful prognostic factor of papillary thyroid carcinomas.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms* ; Vascular Endothelial Growth Factor A*

Neutropenic enterocolitis is observed in approximately 10~46% of patients with acute leukemia, as well as in patients with other diseases, like acquired immunodeficiency syndrom (AIDS), that lead to profound neutropenia. Patients who become neutropenic after combined chemotherapy are at special risk of developing neutropenic enterocolitis. With the recently increasing numbers of patients with solid tumors treated with high-dose chemotherapy, the frequency of this disease is expected to increase. However, this disease has been rarely reported in patients with colon cancer treated with leucovorin and 5-fluorouracil for adjuvant chemotherapy. We report a case of neutropenic enterocolitis after a treatment of 5-fluorouracil and leucovorin for sigmoid colon cancer.
Chemotherapy, Adjuvant ; Colon* ; Colonic Neoplasms* ; Drug Therapy* ; Enterocolitis, Neutropenic* ; Fluorouracil ; Humans ; Leucovorin ; Leukemia ; Neutropenia ; Sigmoid Neoplasms

Heterotopic pancreas can be defined as the occurrence of pancreatic tissue at aberrant anatomic sites that lack vascular, neural and anatomic community with the pancreas. A minority of heterotopic pancreas elicit clinical signs or symptoms that can vary according to its location and size, and the involvement of the overlying mucosa. We report here on a case of heterotopic pancreas that was removed by pancreatoduodenectomy under the erroneous diagnosis of distal common bile duct cancer.
Ampulla of Vater* ; Common Bile Duct* ; Diagnosis ; Jaundice ; Mucous Membrane ; Pancreas* ; Pancreaticoduodenectomy

PURPOSE: Papillary thyroid cancer (PTC) is known to have a favorable prognosis and low mortality. However, some PTC has aggressive propensity with loco-regional recurrence or distant metastasis, and it could cause poor quality of life. Many studies for predicting high-risk group in papillary thyroid cancer have been reported, however, more study is needed. The objective of this study is to assess the efficiency of inflammation indices including the Neutrophil-Lymphocyte Ratio (NLR) as a predictor for high-risk group in papillary thyroid cancer patients. METHODS: From January 2006 to November 2012, this study enrolled consecutive 164 patients who underwent total thyroidectomy and were confirmed with papillary thyroid cancer by histopathology. Among 164 patients, 23 were excluded because they had co-morbidities which could confound the inflammation related variables. We reviewed the medical records of 141 patients and assessed the correlation between inflammation indices including preoperative serum NLR and clinical prognostic parameters, including age at presentation, tumor size, extra-thyroidal extension, lymph node metastasis, TNM stage, and MACIS score. RESULTS: In the papillary thyroid cancer patients, preoperative value of NLR, ESR, CRP, platelet, and albumin showed no significant correlation with the risk factors. CONCLUSION: In this study, preoperative inflammatory parameters such as NLR had uncertain efficacy as risk factors for papillary thyroid cancer.
Blood Platelets ; Humans ; Inflammation ; Lymph Nodes ; Medical Records ; Mortality ; Neoplasm Metastasis ; Prognosis ; Quality of Life ; Recurrence ; Risk Factors ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: Thrombocytosis is reported in patients with various tumors, including stomach, colon, ovarian, lung and pancreatic cancers. Some clinical reports have shown thrombocytosis to be a poor prognostic factor in cancer patients. However, in hepatocellular carcinoma patients, the incidence and clinical significance of thrombocytosis have not been clearly verified. In this study, the clinical significance of platelet counts was investigated in patients with hepatocellular carcinomas. METHODS: 212 patients with surgically proven hepatocellular carcinomas were enrolled in this study. The incidence, relationship with other clinicopathological factors, and the prognostic value of thrombocytosis were retrospectively evaluated. RESULTS: The incidence of thrombocytosis (> or =400, 000/ul) was 2.8% (6/212). The platelet counts were elevated in patients with a large sized tumor (p< 0.001), advanced TNM stage (p=0.009) and gross tumor thrombi in the portal vein (p=0.009). There was no difference in the survival between patients with low and high platelet counts. CONCLUSION: The incidence of thrombocytosis in hepatocellular carcinoma patients was very low. The platelet counts were elevated in patients with advanced hepatocellular carcinomas, but no prognostic significance was shown in this study.
Blood Platelets* ; Carcinoma, Hepatocellular* ; Colon ; Humans ; Incidence ; Lung ; Pancreatic Neoplasms ; Platelet Count* ; Portal Vein ; Retrospective Studies ; Stomach ; Thrombocytosis

PURPOSE: Chronic inflammation induces cancer and cancer induces local tissue damage with systemic inflammation. Therefore, the aim of this study is to investigate the potential relationship between the severity of inflammation and prognosis in cancer patients. MATERIALS AND METHODS: This study enrolled 220 patients from January 2002 to December 2006 who underwent gastric surgery. We evaluated the relationship between preoperative inflammatory parameters (erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio) and other clinicopathological factors. Survival outcomes were compared according to the extent of inflammation. RESULTS: Significant elevation of erythrocyte sedimentation rate was related with old age, increased neutrophil-to-lymphocyte ratio, decreased hemoglobin, increased carcinoembryonic antigen, increased tumor size and advanced TNM stage. Neutrophil-to-lymphocyte ratio was significantly correlated with old age, increased erythrocyte sedimentation rate and advanced TNM stage. In the univariate analysis, elevated erythrocyte sedimentation rate and increased neutrophil-to-lymphocyte ratio had significantly poorer survival than those without elevation (all P<0.05). However, the multivariate analysis failed to prove erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio as independent prognostic factors. CONCLUSIONS: The elevation of erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio were correlated with poor prognosis in the univariate analysis and there was a strong correlation between inflammatory parameters (erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio) and tumor progression. Thus, erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio are considered useful as follow-up factors.
Blood Sedimentation ; Carcinoembryonic Antigen ; Follow-Up Studies ; Hemoglobins ; Humans ; Inflammation ; Multivariate Analysis ; Prognosis ; Stomach Neoplasms

Colorectal cancer is the third most common malignancy in Korea. In contrast, pericolic or mesenteric lymphoma is relatively rare. We experienced an extremely rare case of synchronous primary colon cancer in the ascending colon with T-cell lymphoma in the pericolic lymph node. A 79-year-old woman presented with complaints of epigastric and right lower abdominal pain combined with anorexia and nausea. Colonoscopic evaluation and biopsy were performed, and the diagnosis was cecal adenocarcinoma. She underwent right hemicolectomy with lymph node dissection. The pathology report revealed adenocarcinoma in cecum with metastasis to 1 regional lymph node out of 37 lymph nodes. In addition, there was malignant angioimmunoblastic T-cell lymphoma in 1 pericolic lymph node. There was no evidence of lymphoma in ileum, cecum and ascending colon, so the possibility of early phase of lymphoma was suggested.
Abdominal Pain ; Adenocarcinoma ; Aged ; Anorexia ; Biopsy ; Cecum ; Colon ; Colon, Ascending ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Ileum ; Korea ; Lymph Node Excision ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell ; Nausea ; Neoplasm Metastasis ; T-Lymphocytes