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1.  Anterograde jejunojejunal intussusception resulted in acute efferent loop syndrome after subtotal gastrectomy 
Postoperative intussusception is an unusual clinical entity in adults, and is rarely encountered as a complication following gastric surgery. The most common type after gastric surgery is retrograde jejunogastric intussusception, and jejunojejunal intussusception has been rarely reported. We report a case of anterograde jejunojejunal intussusception after radical subtotal gastrectomy with Billroth II anastomosis in a 38-year-old Korean woman with early gastric cancer, and include a review of the literature on this unusual complication.
PMCID: PMC2904898  PMID: 20632454
Intussusception; Postoperative complications; Gastrectomy
2.  Comparison of Hepatocellular Carcinoma in American and Asian Patients by Tissue Array Analysis 
Journal of Surgical Oncology  2012;106(1):84-88.
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Although some epidemiologic and etiologic differences between Asian and Western HCC are known, detailed comparative studies with pathologic correlations have not been performed.
Paraffin sections of resected HCC specimens from Memorial Sloan-Kettering Cancer Center and Korea University Medical Center were used to construct tissue microarrays. Immunohistochemical staining of microarray sections was performed using antibodies against markers of proliferation and regulators of cell cycle. Patient data were correlated with staining results.
When comparing cohorts, significant differences were found in expression of p53 and In the Asian group, more frequent positive staining for p53 (24%) was observed compared with the American group (9%; P = 0.037). For MDM2, 26% of American cases stained positive compared with 2% of Asian cases (P = 0.0003). No significant differences were found in expression of Ki67, p21, p27, cyclin D1, or bcl2. Female gender, vascular invasion, and lack of viral hepatitis infection correlated with positive MDM2 staining.
These data likely correlate with differences in molecular pathogenesis of HCC based on racial and regional differences. These findings may have implications in choice of molecular targeted therapies based on patient ethnicity.
PMCID: PMC3346847  PMID: 22234941
immunohistochemistry; South Korean; molecular characterization; HepPar1
3.  Metastatic hepatocellular carcinoma to the parotid gland: Case report and review of the literature 
Hepatocellular carcinoma, the most frequent primary hepatic tumor, metastasizes in more than 50% of cases. However, parotid gland metastatic HCCs are very uncommon. We report a patient in whom the finding of a left parotid mass revealed metastatic HCC.
A thirty-six-year-old male presented with a round palpable left neck mass that persisted for 3 months. He had received right hemihepatectomy for hepatocellular carcinoma (HCC). Preoperative evaluation revealed a benign tumor of the parotid gland. We performed superficial parotidectomy. Metastatic hepatocellular carcinoma of the parotid gland was diagnosed.
Although HCC metastases to the oral cavity have been reported, to date, only 4 cases HCC metastasis to the parotid gland have been reported. Although clinicians and cytopathologists alike both agree that salivary gland fine needle aspiration biopies (FNABs) are highly useful and safe diagnostic alternatives to biopsies and resections, we believe that in specific clinical situations, awareness of potential diagnostic pitfalls in salivary gland FNAB is a necessary part of the microscopic interpretations of these lesions.
Although rare, since HCC can metastasize to the parotid gland, high suspicion should be maintained in a patient presenting with a parotid mass with a history of HCC. In addition, since potential diagnostic pitfalls in salivary gland fine-needle aspiration (FNA) biopsies exist, incisional or excisional biopsy may be necessary for definite diagnosis of metastatic HCC to the parotid gland.
PMCID: PMC3537927  PMID: 23123420
HCC, hepatocellular carcinoma; FNA, fine-needle aspiration; Metastatic hepatocellular carcinoma; Parotid gland; Fine-needle aspiration
4.  Liver abscess developed after cadaveric liver transplantation due to ligation of an accessory right hepatic artery of the donor graft 
It is important that extrahepatic arteries are identified precisely at the time of graft procurement. We present a case where the accessory right hepatic artery of the liver was ligated leading to postoperative liver abscess formation in the liver graft. A forty-seven-year-old female patient diagnosed with liver cirrhosis underwent orthotopic cadaveric liver transplantation due to altered mentality. The donor graft showed a variant of the hepatic artery anatomy where an accessory right hepatic artery arose from the superior mesenteric artery. This artery was accidentally transected during procurement. Since the back bleeding test using perfusion fluid was good, the artery was ligated. Postoperative abdominal computed tomography scan revealed a 6 cm low attenuating lesion in the liver. The patient underwent conservative treatment. We believe that even small accessory arteries (1 to 2 mm) should be reconstructed whenever possible to avoid postoperative complications such as liver abscess.
PMCID: PMC3467392  PMID: 23091798
Liver abscess; Liver transplantation; Postoperative complications; Hepatic artery
5.  Fever of unknown origin as a presentation of gastric inflammatory myofibroblastic tumor in a two-year-old boy. 
Journal of Korean Medical Science  2002;17(5):699-703.
Gastric inflammatory myofibroblastic tumor (IMT) is an extremely rare lesion with mimicking malignant features and accompanied with various clinical manifestations. Here we present a 2-yr-old boy who had a gastric IMT with a huge extragastric mass, which closely resembled a neuroblastoma on imaging studies. He experienced intermittent fever and poor appetite for 6 weeks. Fever remained up to 38 degrees C even on the operation day. He underwent partial gastrectomy and distal pancreatectomy with splenectomy including the tumor. The preoperative fever disappeared and did not recur in the postoperative course.
PMCID: PMC3054930  PMID: 12378027

Results 1-5 (5)