Intrahepatic Cholangiocarcinoma with Sarcomatous Change: Case Report

Cholangiocarcinomas have several histologic types, but intrahepatic cholangiocarcinoma with sarcomatous change is rare. A 71-year-old man was admitted to our hospital because of fever which had lasted two months. Ultrasonography (US) of the upper abdomen demonstrated a huge hepatic mass with central solid and peripheral cystic portions, and computed tomography (CT) revealed a heterogeneous hepatic mass with a central area in which enhancedment was delayed. Magnetic resonance imaging (MRI) disclosed a huge mass of predominantly low signal intensity at T1WI, and peripheral portions of high signal intensity and a central portion of intermediate signal intensity at T2WI. The pathologic diagnosis was cholangiocarcinoma with sarcomatous change.

A case of Wernicke-Korsakoff syndrome associated with severe hyperemesis gravidarum / 대한산부인과학회잡지

Hypermesis gravidarum is a complication defined as vomiting severe enough to require hospital admission during early pregnancy. Thiamine deficiency is known to lead to certain neurological seguelae including Wernicke-Korsakoff syndrome. Wernicke's encephalopathy is an illness of acute onset characterized by global confusion, paralysis of eye ball movements, and gate ataxia due to a deficiency of thiamine. The immediate administration of thiamine prevents progression of the disease and reverses brain lesions that have not yet progressed to the point of fixed structural change. We have experienced a case of Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum, which seemed to be developed by prolonged thiamine-free fluid therapy. We emphasize the need for thiamine supplementation in hyperemesis gravidarum patients.

Right Intrathoracic Stomach Secondary to Congenital Hiatal Hernia with Organoaxial Torsion: A Report of Two Cases

Right intrathoracic stomach associated with organoaxial torsion is a rare form of congenital hiatal hernia. We report the radiologic findings in two cases of complete or partial right intrathoracic stomach secondary to congenital hiatal hernia. The barium meal test demonstrated the presence of complete or partial right intrathoracic stomach and non-obstructive organoaxial torsion with the greater curvature lying against the right chest wall. The esophagogastric junction was located above the diaphragm. CT revealed a cystic mass in the right posterior mediastinum. This cystic lesion should be differentiated from other congenital mediastinal cysts.

Dynamization After Static Interlocking Intramedullary Nailing / 대한정형외과학회잡지

The purpose of this study is to make an emphasis the necessity of the dynamization after interlocking intramedullary nailing. We reviewed 75 cases of the fractures of the shaft of femur or tibia fixed with static interlocking intramedullary nailing. We excluded the cases in whom the locking screws were removed for the purpose of the relief of pain from the irriataion by those screws. The parameter we reviewed were the type of fracture, postoperative gap between the major fragments. Early callus formation, the union time, postoperative dynamization and controlled weight bearing. In those cases in which the contact surface between the major fragments was more than 50% and there noticed no early callus within 6 weeks after operation, the union time was shortened after dynamization, when the contact surface was less than 50% and there noticed no early callus, the union time was shortened after bone graft and dynamization which resulted in some shortening in the length in acceptable ranges. In cases with a major gap of more than 2mm, the union time was shortened after dynamization. The rate of early callus formation was a little higher in cases with postoperative controlled weight bearing than those to whom we did not permit a controlled weight bearing.