In the treatment of flexor tendon injury of the hand, re-rupture after primary tendon repair is one of complications which occurs occasionally and so impose burden on both the patient and the surgeon. Authors experienced twelve cases of re-rupture after primary flexor tendon repair of 274 patients from Mar. 1989 to Mar.1996. The incidence of re-rupture after primary flexor tendon repair was 4.4% in author's series. One case happened with slip down injury, and in six cases re-rupture occurred during physical therapy with snapping click sound. However in five cases, the patients conldnt recognize any related causes. In majority of cases, re-ruptures were identified between three and five weeks after primary repair by the surgeon and the patient, so it could be suggested that the attention should be paid for the high possiblity of re-rupture during this period. Operative findings were the resorption and friability of repaired end with insecure suture fixation in two cases, rupture of suture material in four cases and loosening of the knot in six cases. From this study, the authors suggest the importance of knot, and recommend to make more than four knots on suture tie with attention to the tie direction, and advise careful physical therapy according to each patients' different situation. In the treatment of re-rupture, end-to-end re-anastomosis was available in seven cases (59%). In five cases (41%), tendon graft was needed. The clinical result of the re-rupture cases was evaluated by the Stickland evaluation method, and it was satisfactory in 67% of the patients who had the complication of re-rupture.
Hand* ; Humans ; Incidence ; Rupture ; Sutures ; Tendon Injuries ; Tendons* ; Transplants

We evaluate the effects of diltiazem in 19 patients with ischemic heart disease (15 patients) of classical anginal pectoris & 4 patients of variant angina) by means of clinical status & electrocardiographic changes and obtain the results as follows: 1. The pulse rate & blood pressure were decreased by diltiazem slightly but these decreases were not significant in statistical meaning. 2. Diltiazem administration of 4 weeks duration normalized EKG completely in 4 patients & partially in 3 patients among the 13 patients who showed abnormal resting EKG initially. 3. All 19 patients who received diltiazem showed clinical improvement; 9 patients had excellent responses, 7 patients good responses & 3 patients fair responses. 4. Diltiazem had side effects in 3 patients, drowsiness, mild euphoria & possibly tolerance respectively in each patients.
Angina Pectoris* ; Blood Pressure ; Diltiazem ; Electrocardiography ; Euphoria ; Heart Rate ; Humans ; Myocardial Ischemia ; Sleep Stages

Collet-Sicard syndrome is one of the syndromes of the multiple lower cranial nerve palsies, characterized by unilateral paralysis of 9th through 12th cranial nerves. The present report describes a 34-year-old woman who had hoarseness, dysarthria, and loss of taste developed after febrile illness. Brain MRI, both T1WI and T2WI, showed high signal intensity in the left jugular foramen. Gd-GTPA contrast injection revealed thickening and enhancement of the left tentorium. Angiography disclosed nonvisualization of the left transverse and sigmoid sinus, and reconstruction of the left internal and external jugular vein by collaterals from the angular, facial, and posterior fossa veins. The patient improved spontaneously two months later. This is the first report of Collet-Sicard syndrome resulting from jugular vein thrombosis.
Adult ; Angiography ; Brain ; Colon, Sigmoid ; Cranial Nerve Diseases ; Cranial Nerves ; Dysarthria ; Female ; Hoarseness ; Humans ; Jugular Veins* ; Magnetic Resonance Imaging ; Paralysis ; Thrombosis* ; Veins

Carotid artery angioplasty and stenting (CAS) has become increasingly accepted as an alternative therapy to carotid endarterectomy for treatment of carotid artery stenosis. Central retinal artery occlusion (CRAO) is one of the diseases presented due to carotid artery stenosis. But CRAO without cerebral ischemia after CAS is uncommon. An 80-year-old man was admitted to the hospital with the right centrum ovale ischemic stroke and right proximal carotid artery stenosis. We performed CAS with a distal protection device after pre-ballooning 3 times, without post-ballooning. Then, 12 hours after the CAS, the patient complained of blindness in the right eye and was diagnosed with CRAO. However, Diffusion weighted magnetic resonance imaging (DW-MRI) showed no significant findings in the brain. CRAO after CAS without intracranial infarction is a rare complication.
Aged ; Aged, 80 and over ; Angioplasty ; Arteries ; Blindness ; Brain ; Brain Ischemia ; Carotid Arteries ; Carotid Stenosis ; Diffusion ; Endarterectomy, Carotid ; Eye ; Humans ; Infarction ; Magnetic Resonance Imaging ; Retinal Artery ; Retinal Artery Occlusion ; Stents ; Stroke

No abstract available.
Thanatophoric Dysplasia*

No abstract available.
Thanatophoric Dysplasia*

Primary chondrosarcoma of the extraskeletal soft tissue is extremely rare. Extraskeletal chondrosarcoma was first described as entity in 1953 by Stout and Verner, who were able to collect a series of seven cases. Because of the rarity of this lesion in extremities, neither the clinical course nor the preferred method of treatment has been clearly established. Authors report a case of extraskeletal chondrosarcoma which occurred on the right forearm of a thirty-nine-year-old man. The lesion was completely excised with free resection margins. There was no recurrence or metastasis for four years follow up.
Chondrosarcoma ; Extremities ; Follow-Up Studies ; Forearm ; Methods ; Neoplasm Metastasis ; Recurrence

To evaluate the safe zone for the use of femoral artery puncture in the clinical practice and to understand the anatomic characteristics of the aortic arch (AA) and its major branches to build a foundation toward performing neuroendovascular surgery safely. The 40 formalin fixed adult Korean cadavers were investigated for inguinal area and AA respectively. The landmarks were the anatomical points on inguinal area and the lengths from each point to the bottom of femoral head (BOFH) were measured using a fluoroscopic view. We investigated several anatomical parameters on the AA, and its major branches with anatomical variations, curvatures, distances. The average length between BOFH and inguinal ligament of the right was 38.9+/-7.2 mm and left was 40.0+/-7.9 mm. The three major branches directly originated from AA in 21 (84%) of the cadavers. Average angle of AA curvature to the coronal plane was 62.2 degrees. Left common carotid artery (LSCA) and left subclavian artery originated from 12.3 mm and 22.8 mm on the left of the mid-vertebrae line. Mean distance from the brachiocephalic truck to the right common carotid artery was 32.5 mm. Mean distance from the LSCA to the left vertebral artery was 33.8 mm. Average angles at which the major branches arise from the AA were 65.3, 46.9 and 63.8 degrees. The safe zone for arterial puncture is considered to 0-20 mm above the BOFH on a fluoroscopic view. This study may provide comprehensive anatomical information to catheterize AA and its branches for safely performing transfemoral neuroendovascular approach.
Adult ; Aorta ; Aorta, Thoracic ; Cadaver ; Carotid Artery, Common ; Catheters ; Femoral Artery ; Formaldehyde ; Head ; Humans ; Ligaments ; Motor Vehicles ; Punctures ; Subclavian Artery ; Vertebral Artery

The paint gun is an industrial instrument which ejects paint through a small opening with pressure of l,500 to 3,000 Ib/inch. In case of the paint-gun injury, the paint penetrates through a tiny wound of skin and spreads widely along the fascial plane or tendon sheath. It destroys the tissues rapidly. Moreover, the toxicity of the paint material evokes acute inflammatory reaction which is accompanied by localized swelling, erythema, heat and sometimes generalized symptoms (i.e fever). Local toxic reaction leads to swelling, circulatory disturhance and foIlowed hy gangrene of the tissue. Sometimes tissue condition is too desperate to survive and bring about amputation unfortunately. Authors treated eleven patients of the paint gun injury f'rom March 1988 to April 1995. The paint materials were removed thoroughly via large skin incision as immediately as possible after the injury. Usually the wound is left to be open for seven to ten days and is followed by delayed primary wound closure. In our experience of three cases of delayed removal( two, five and seven days after injury), the outcomes were poor with problems of pain, sensory disturhance, limitation of finger motio, and two cases of digit amputation. On doing paint gun injection, right hand was used to hold the paint-gun and left hand was used to hold the cable. Our study showed right hands were injured mainly(nine cases). It means the paint gun injury is caused by inattention of work partner.
Amputation ; Erythema ; Fingers ; Gangrene ; Hand ; Hot Temperature ; Humans ; Paint* ; Skin ; Tendons ; Wounds and Injuries

PURPOSE: We expected the motion fraction could be checked, with simple radiographic examination, according to the guide-line of fluoroscopic technique, and recovery of the function also could be correlated with the improvement of the motion fraction. MATERIALS AND METHODS: We measured the motion fraction of the glenohumeral and scapulothoracic movement using fluoroscope in 30-degree intervals of arm elevation in the scapular plane. The ratio of glenohumeral to scapulothoracic movement (thetaGH/thetaST) was 1.6 for the full range of motion in scapular plane. During arm elevation, scapular tilting from the coronal plane was decreased from 42 degrees to 20 degrees tilting as well as internal rotation (scapular extension). We also measured the motion fraction (thetaGH/thetaST) and functional recovery of the shoulder in 11 patients after operative treatment of the shoulder instability in 15 patients from December 1996 to August 1997. RESULTS: We could find out a significant correlation between the recovery of motion fraction and shoulder function. These results would be applied in planing rehabilitation program after treatment of the shoulder instability. CONCLUSIONS: The measuring technique of glenohumeral to scapulothoracic movement (thetaGH/thetaST) with fluoroscopy could be applied to the simple radiographic measurement at the out-patient clinic in order to identify the pathology and recovery of shoulder motion after treatment
Arm ; Fluoroscopy ; Humans ; Outpatients ; Pathology ; Range of Motion, Articular ; Rehabilitation ; Shoulder*