No abstract available.
Animals ; Antibodies, Neutralizing* ; Immunization* ; Mice*

A buttonhole deformity of the finger is characterized by flexion of the pmximal interphalangeal joint and hyperextension of the terminal interphalangeal joint. When the central slip of the extensor tendon and the triangular ligament are ruptured,(or severed) on the base of the middle phalanx, buttonhole deformity will result.This article is based on clinical and follow up studies of 5 patients with buttonholedeformities. Five cases were treated by the modified Littler method and were followed from 4 months to 24 months postoperatively and good results were obtained in all cases.
Congenital Abnormalities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Ligaments ; Methods ; Tendons

Synovial chondromatosis is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue which disintegrates into the joint and continues to grow. Of the eight cases of synovial chondromatosis seen by the authors, three cases involved the knee, two of these were bilateral, three cases involved the elbow, one the hip joint and one the proximal phalanx of the right middle finger. The diagnosis of synovial chondroamtosis was made by histopathological findings of the excised mass. Most synovial chondromatosis cases obtained favorable results by removing masses from the joint and at the same time performing a partial synovectomy, except one case in which degenerative arth ritis had developed proeoperatively.
Cartilage ; Chondromatosis, Synovial ; Connective Tissue ; Diagnosis ; Elbow ; Fingers ; Hip Joint ; Joints ; Knee

PURPOSE: To assess the clinical and pathologic features of each type of intrahepatic cholangiocarcinoma,which is divided into three types according to gross appearance, and to determine the efficacy of CT in detectingthis tumor. MATERIALS AND METHODS: The pathologic and CT features of 53 surgically proven cases of intrahepaticcholangio-carcinoma were reviewed. On the basis of their gross appearance, the tumors were divided into threetypes, as follows: mass forming (n=33), periductal infiltrating (n=6), and intraductal growth type (n=14). CTscans were analyzed for sensitivity of detection and correlation between a tumors appearance and itshistopathology. RESULTS: The most common histopathologic feature of mass forming and periductal infiltrating typewas tubu-lar adenocarcinoma, while in the intraductal growth type, papillary adenocarcinoma (100%) was common.With regard to pattern of tumor spread, intrahepatic and lymph node metastasis were more common in the massforming and periductal infiltrating type than in the intraductal growth type. CT findings including intra-hepaticmass, ductal wall thickening or intraductal mass associated with segmental dilatation of intrahepataic bile ducts,corresponded with these morphologic types. CONCLUSION: This classification according to gross appearance is ofconsiderable value when interpreting the pathologic features of intrahepatic cholangiocarcinoma. CT seems to be auseful modality for the detection of tumors and may be consistent with their gross morphologic findings.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Bile ; Cholangiocarcinoma* ; Classification ; Dilatation ; Lymph Nodes ; Neoplasm Metastasis

BACKGROUND/AIMS: The aim of this study was to examine the incidence of proximal colon adenoma according to characteristics of distal colon adenoma. METHODS: Ninety-two colon adenoma patients who underwent total colonoscopy and endoscopic polypectomy were analyzed retrospectively. Adenoma was classified as proximal when located in proximal to splenic flexure. The advanced adenoma was defined as an adenoma larger than 10 mm or any size with a villous component or severe dysplasia. RESULTS: The incidence of proximal adenoma was increased significantly in those with old age (odds ratio (OR)=3.3), villous (OR=5.3) or dysplastic histology (OR=8.1) or the presence of advanced distal adenoma (OR=3.4). However, the incidence of advanced proximal adenoma was increased only in those with old age (OR=11.2). Nineteen in thirty-nine (48.7%) patients with proximal colon adenoma did not have distal colon adenoma. CONCLUSIONS: Various characteristics of distal colon adenoma couldn't exactly predict the presence of synchronous proximal adenoma and a greater percentage of subjects with proximal adenoma didn't have distal adenoma. So, colonoscopy could be a standard method for colon cancer screening in Korea.
Adenoma* ; Colon* ; Colon, Transverse ; Colonic Neoplasms ; Colonoscopy ; Humans ; Incidence* ; Korea ; Mass Screening ; Retrospective Studies ; Sigmoidoscopy

The authors report a case of cerebral salt wasting(CSW) syndrome followed by diabetes insipidus and meningitis after transsphenoidal approach for pituitary adenoma. Fluid and electrolyte imbalance occurs occasionally in neurosurgical patients due to DI or SIADH, however, CSW is different disease entity and the methods of treatment are different from those of DI or SIADH. A number of studies in recent years have shown that hyponatremia in many patients with intracranial disease might actually be caused by CSW in which a renal loss of sodium leads to hyponatremia and massive urinary water loss. CSW of this patient was resolved by fluid and salt replacement after 6 months.
Diabetes Insipidus ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Meningitis* ; Meningitis, Bacterial ; Pituitary Neoplasms* ; Pseudomonas* ; Sodium ; Wasting Syndrome*

PURPOSE: Basiliximab has become widely used in clinical practice for initial immunosuppression in renal transplantation cases, to reduce the incidence of acute rejection without adverse events. Herein, we report the early outcomes of renal transplantation using basiliximab at a single center. METHODS: This retrospective study included 148 renal allograft recipients at a single center. All patients were followed for longer than 1 year after transplantation, and treated with a calcineurin inhibitor and steroids for maintenance immunosuppression. The use of basiliximab and mycophenolate mofetil (MMF) was optional. We compared the incidence of episodes of acute graft rejection in kidney recipients who were treated with basiliximab as an initial immunosuppressive therapy with those who were treated without basiliximab. RESULTS: Basiliximab was used for initial immunosuppression in 58 patients. Patients maintained immunosuppression with triple (n=69) or double (n=79) regimens including a calcineurin inhibitor (cyclosporine A (n=111) or tacrolimus (n=37)) and methylprednisolone with or without MMF. Thirty-six (24.3%) patients had a rejection episode within 1 year after transplantation and twenty-six (17.6%) patients had an episode of infection. The patients who were treated with basiliximab had fewer rejection episodes (n=11, 18.9%) within the first year after transplantation than the patients who did not take basiliximab (n=25, 27.7%); this difference was not statistically significant. (P=0.245). However, basiliximab significantly affected the number of rejection episodes in the double regimen group (P=0.006), but not the number of rejections in the triple regimen group (P=0.432) and did not affect the number of infection episodes in both groups (P value of double, triple=0.291, 0.772) within one year after transplantation. CONCLUSION: The results of this study suggest that basiliximab might be more useful for graft recipients who are treated with double immunosuppression with a calcineurin inhibitor and steroid than for the recipients with triple immunosuppression including MMF.
Allografts* ; Calcineurin ; Graft Rejection ; Humans ; Immunosuppression ; Incidence* ; Kidney ; Kidney Transplantation ; Methylprednisolone ; Retrospective Studies ; Steroids ; Tacrolimus ; Transplants

OBJECTIVE: A prospective, randomized, controlled clinical study is performed to verify the effectiveness of epidural dexamethasone-soaked gelatin sponges to reduce postoperative pain following lumbar microdiscectomy. METHODS: Twenty-three patients (10 men and 13 women) undergoing lumbar microdiscectomy were included. Five pieces of gelatin sponge measuring 1 x 1 cm (Gelfoam; Pharmacia & Upjohn, Kalamazoo, MI, USA), soaked with either 5mg dexamethasone or an equal amount (2 mL) of saline, were left on the decompressed nerve root after unilateral hemilaminectomy, flavectomy and discectomy. RESULTS: Subjective visual analog scale(VAS) scores of leg pain in the dexamethasone group on the first, third and fifth postoperative days (2.5, 2.5, 1.7, respectively) were significantly lower than in the control group (5.0, 4.8, 3.6) ( P<0.05). No side effects related to the dexamethasone-soaked gelatin sponges were observed. CONCLUSION: The intraoperative application of dexamethasone-soaked gelatin sponges during lumbar microdiscectomy can provide effective postoperative analgesia without complications.
Analgesia ; Dexamethasone ; Diskectomy ; Gelatin* ; Humans ; Leg ; Male ; Pain, Postoperative ; Porifera* ; Prospective Studies

PURPOSE: To evaluate the radioloic findings of malignant retroperitoneal fibrosis. MATERIALS AND METHODS: Post-contrast CT (n=9) and urographic (n=7) findings of nine patients with malignant retroperitoneal fibrosis were retrospectively analyzed. Primary tumors were found to be advanced gastric cancer (n=6), early gastric cancer (n=1), breast cancer (n=1), and cervical cancer (n=1). We analyzed CT findings with regard to the site of soft tissue lesion, ureteral involvement, the presence or absence of hydronephrosis, and distant metastasis. The level and length of ureteral involvement, presence or abscence of ureteral stenosis, and ureteral displacement as seen on urography, were analyzed. RESULTS: On CT scans, enhanced soft tissue lesions (mass, 5 cases; plaque, 4 cases) encircling the abdominal aorta and IVC were noted in all cases. Thickening of the ureteral wall (n=8), hydronephrosis (n=9), and enlarged lymph node (n=5) were also seen. On urography, irregular stenosis and medial displacement of ureters from level L2 to S2 were noted in all cases. The length of ureteral involvement was 4-6.5cm. CONCLUSION: The common CT findings of malignant retroperitoneal fibrosis were enhanced soft tissue lesion encircling the abdominal aorta and IVC, hydronephrosis, and thickening of the ureteral wall. On urography, ureteral stenosis and medial displacement were seen.
Aorta, Abdominal ; Breast Neoplasms ; Constriction, Pathologic ; Humans ; Hydronephrosis ; Lymph Nodes ; Neoplasm Metastasis ; Retroperitoneal Fibrosis* ; Retrospective Studies ; Stomach Neoplasms ; Tomography, X-Ray Computed ; Ureter ; Urography ; Uterine Cervical Neoplasms

PURPOSE: Chronic rejection accounts for the majority of late renal graft losses and there is good evidence that both immunologic and non-immunologic factors are important in late graft loss. The hyperfiltration hypothesis postulates that kidneys with reduced renal mass will progress toward failure due to hypertrophy of the remaining nephron to meet the excess metabolic demand, eventually leading to nephron exhaustion. The impact of metabolic demand and renal mass supply on the early graft function, especially hyperfiltration phenomenon, remains uncertain. METHODS: In this study, we analyzed age, gender, body weight, height, body surface area (BSA), lean body weight (LBW), and serum creatinine (SCr) of both donors and recipients. We weighed the donated kidney and measured the recipient's SCr and LBW for six months postoperatively. Modified Cockcroft-Gault Equation standardized for BSA was used to calculate renal glomerular filtration rate (CrCl, mL/min/1.73 m2). The variables and the CrCl of the 3rd day and 6th month were analyzed with accordance to donor/recipient LBW ratio(D/R LBW) and graft weight/recipient LBW (GW/RLBW) by independent sample t-test and paired t-test using SPSS, and P<.05 was considered significant. RESULTS: The means of the 3rd day and 6th month CrCl were 76.90+/-24.35 and 73.41+/-10.80, respectively and there were no statistical differences (P=0.340). In D group (D/R LBW>1), the 3rd day and 6th month CrCl were 80.82+/-28.74 and 71.66+/-12.12, respectively. In R group (D/R LBW< or =1), the 3rd day and 6th month CrCl were 69.94+/-12.06 and 75.80+/-7.24, respectively. D group CrCl was decreased (P=0.093) and R group CrCl was increased slightly (P=0.169) during the study period, but there was no statistical significance. In H group (GW/RLBW>3), the 3rd day CrCl was 86.08+/-25.13, which was significantly decreased to 73.48+/-11.64 at the 6th month (P=0.023). In L group (GW/RLBW< or =3), the 3rd day and 6th month CrCl were 66.95+/-19.94 and 73.34+/-10.60 (P=0.158), respectively. the 3rd day CrCl of H group was higher than that of L group significantly (P=0.047), but 6th month CrCl showed no difference between the two groups (P=0.975). CONCLUSIONS: The 3rd day CrCl represents early graft function well. GW/RLBW has a strong correlation with early graft function. In L group with low early graft function, CrCl was tended to be increased to meet the metabolic demand for following the 6 months. Conversely, in H group with high early graft function, CrCl was decreased to reduce the excess graft function. So the 6th month CrCl represents adapted graft function. In this study, therefore, we postulate that the hyperfiltration or hypofiltration develops according to metabolic demand and renal mass supply.
Body Height ; Body Weight ; Creatinine ; Glomerular Filtration Rate ; Humans ; Hypertrophy ; Kidney ; Kidney Transplantation* ; Living Donors* ; Nephrons ; Tissue Donors ; Transplants*