Neither the cause nor the correct treatment of Kienbocks disease has been clearly established, but its clinical and radiologic presentations have been distinctly defined. There are many controversies concerning therapeutic guidelines for the treatment of Kienbocks disease. The purpose of this study is to evaluate the clinical result of triscaphe fusion with radial styloidectomy of Kienbocks disease. Ten cases of stage III Kienbocks disease by Lichtmans classification were treated by triscaphe fusion with radial styloidectomy from September 1991 to March 1997. We followed up over 24 months and evaluated clinical results. In all cases, pain was relieved. The postoperative results according to Kuschners method revealed three excellent, six good and one fair. The triscaphe fusion and radial styloidectomy was considered as useful method of treatment which has clinical efficacy in Kienbocks disease.
Classification ; Osteonecrosis*

This report presents a case with gastric ulcer whose gastric mucosal biopsy revealed heavy aggregations of Russell body containing plasma cells in the lamina propria and in peptic detritus. A sixty four year old female received an endoscopic examination for currently aggravated peptic ulcer symytoms, It revealed a small round ulcer with nodular margin along the greater curvature of high body, suggesting of early gastric carcinoma. Endoscopic biopsies (two times) confirmed heavy collections of Russell body-containing plasma cells which were once misinterpreted as signet ring cell carcinoma. Immonohistochemically they were strongly positive to both kappa and lambda light chains by pgtroxidase-antiperoxidase method. Each infiltrated cell contained one or more refractile intracytoplasmic eosinophilic globules, bcing associated with extracellular ones and heavy matare lympho-plasma cell infiltration. Differential diagnosis from neoplastic signet ring cells in endoscopic biopsy was diseussed.
Biopsy ; Carcinoma, Signet Ring Cell* ; Diagnosis, Differential ; Eosinophils ; Female ; Humans ; Mucous Membrane ; Peptic Ulcer ; Plasma Cells* ; Plasma* ; Stomach Ulcer ; Stomach* ; Ulcer

No abstract available.
Humans ; Infant, Newborn* ; Leukocytes*

We reviewed a total of 15 cases of heterotopic pancreatic tissue within the gastrointestinal wall(intramural type), and compared with 3 extramural ones. Intramural heterotopic pancreatic lesions were located in the antrum(33%), pylorus(20%), and body of stomach(7%), and the remainders in the duodenum(40%). Only two cases presented with chinical symptoms by their existence. Two of them were situated within the submucosa, 3 in the muscularis, 6 in submucosa-muscularis, 2 in the muscularis-subserosa, and 1 in the susbmucosa-subserosa. Intramural type was featured with their structural heterogeneity compared to the extramural ones; 10 cases showed participation of gastrointestinal mucosal elements, and some accompanied tissue elements that were indistinguishable from submucosal epithelial heterotopia or microduplication cyst of the stomach. Langerhans islets were found in 67%, and one developed islet cell tumor. The above results suggest that the initially engrafted heterotopic pancreatic tissue becomes modified and presents with heterogeneity of endodermal and mesodermal tissue-derived components by its intramural growth during the gastrointestinal organogenesis; failure of opening of its drainage system into the gastrointestinal lumen may result in the increase of intraductal pressure with subsequent atrophy of the acinar tissue and various metaplastic changes of ductal epithelium, aside from induction of smooth muscle coat around the heterotopic tissue.
Cysts

Eight cases of combine hepatocellular-cholangiocarcinoma(HCC-CC) of the liver were analysed along with their growth patterns and histologic subtypes to draw a possible implication in understanding of their histogenesis. The relative incidence of combined HCC-CC among the surgically resected primary carcinomas of the liver(485 cases) was 1.6%. The combination patterns varied and were classified as follows; the multinodular tumor, each consisting of HCC or CC element(type 1) was found in 1 case, the single tumor mass with two distinct compartments of HCC and CC(type 2) in 3, and the single tumor with random mixture of two elements(type 3) comprised the remaining 4 cases. Of the 7 cases of single tumor mass(type 2 and 3) HCC and CC comprised the major component in 5 and 2 cases, respectively. The histologic features of both HCC and CC elements were not different from those of isolated HCC and CC, except for two of CC element in type 3 which disclosed the intermediated differentiation or socalled cholangiolocellular carcinoma in part. We conclude that there is no significant difference in the relative incidence of combined HCC-CC among primary carcinomas of the liver and their subtypes compared to that in other countries, regardless of high incidence of both HCC and CC in Korea. Also, we discussed a possible histogenisis along a hypothesis that some of the combined HCC-CC be the consequence of interposition of different cell type from a new subclone into the growth of an initial single cell type of primary carcinoma of the liver.
Incidence ; Carcinoma, Hepatocellular

No abstract available.
Zygapophyseal Joint*

External fixation was improved in its material, design and techniques as a specific method of open fracture treatment. Seventy-three, tibial open fracture, patients were treated with external fixator in Korea Veterans Hospital from January 1983 to April 1988. Each fixation method was divided into two types;one-plane unilateral frame and one-plane bilateral frame. 1. The duration of external fixation was 14.3 weeks in averge, 15.4 weeks in one plane unilateral frame and 13.2 weeks in one plane bilateral frame. 2. Secondary operation for bony union was performed 19 cases in one plane unilateral frame and 8 cases in one plane bilateral frame. 3. The union time was 23.6 weeks in average, 26.8 weeks in one plane unilateral frame and 21.4 weeks in one plane bilateral frame. 4. The common complications were delayed union and nonunion (7 cases) and pin tract infection (5 cases) in one plane unilateral frame, and pin tract infection ( 9 cases), joint stiffness (4 cases) and delayed union and nonunion (3 cases) in one plane bilateral frame. 5. External fixation gave rigid fixation and easy wound access, but did not give excellent bony union. 6. One plane bilateral frame showed more or less better result than one plane unilateral frame except some complications.
External Fixators ; Fractures, Open ; Hospitals, Veterans ; Humans ; Joints ; Korea ; Methods ; Wounds and Injuries

Basal Cell Nevus Syndrome ; Family Characteristics ; Female ; Follow-Up Studies ; Genetic Counseling ; Humans ; Mandible ; Mass Screening ; Mothers ; Odontogenic Cysts ; Recurrence ; Siblings ; Skin ; Young Adult

PURPOSE: The purpose of this study is to evaluate the differences of the clinicopathological features and survival rates in gastric cancer according to the sex of the patients. MATERIALS AND METHODS: We reviewed 5,784 cases of gastric cancer patients who underwent laparotomy at the Department of Surgery, Seoul National University Hospital fmm Jan. 1986 to Dec. 1995. We have analyzed clinicopathologic features including tumor location, Bonmann type, depth of invasicm, lymph node metastasis, distant metastasis, TNM stage, histologic differentiation and survival rates according to the sex of the patients. RESULTS: The mean age of female patients was 52.4 years, which is lower than that of male, 54.8 years. There were no differences in tumor location, Borrmann type, depth of invasion, lymph node metastasis, distant metastasis, TNM stage of tumor between male and female. But there were some differences in histologic differentiation; well- and moderately differentiated cancers were more common in male and signet-ring cell cancers were more common in female. Female shows slightly better prognosis than male. But the prognosis of young female was poorer than that of young male. CONCLUSION: In gastric cancer patients, differences in histologic differentiation and more aggressive nature of the signet-ring cell cancer in female may affect the survival differences according to the sex.
Female* ; Humans ; Laparotomy ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Seoul ; Stomach Neoplasms* ; Survival Rate

BACKGROUND: The use of caudal morphine for postoperative analgesia has been increased in popularity since 1981. The purpose of this study was to compare the effect of analgesia and incidence of side effects of a mepivacaine-morphine mixture with mepivacaine alone. METHODS: Forty patients were randomly divided into two groups. In group 1, caudal block was performed with 1% mepivacaine 1 ml/kg alone. In group 2, caudal block was performed with 1% mepivacaine 1ml/kg-morphine 0.03 mg/kg mixture. Postoperative five-point pain scores and side effects were measured. RESULTS: There were no significant differences in sedation dose, incidence of side effects and supplemental analgesics. Pain scores were significantly lower at postoperative 2 and 3 hours in mepivacaine-morphine mixture group. CONCLUSIONS: Caudal epidural mepivacaine-morphine (0.03 mg/kg) mixture is effective in children for control of postoperative pain without significant side effects.
Analgesia* ; Analgesics ; Child* ; Humans ; Incidence ; Mepivacaine ; Morphine* ; Pain, Postoperative