Hand and wrist tuberculosis in adults are relatively rare disease. The purpose of treatment is to minimize the limitation of motion and to relieve the pain and swelling of involved joints. The treatments consist of curettage of bone, synovectomy and arthrodesis, which were combined with chemotherapeutic agents for tuberculosis. In the period from June 1989 to Oct. 1993, we performed operative treatment in twelve cases of hand and wrist tuberculosis(hand in 3, wrist in 9). We performed curettage and synovectomy in eight cases and arthrodesis in four. The length of follow up was over one year in all cases. Patients were evaluated by clinical examination, radiography and the Robins criteria for clinical results. The results were analysed, as follows, l. Eight patients who had tenosynovitis with moderate joint destruction were treated by curettage and synovectomy, and seven patients(87.5%) of them were evaluated "good" by Robins criteria. 2. Arthrodesis was performed in four patients who had severe joint destruction, and demonstrates "good" results in 75% of cases. 3. One patient who was treated by synovectomy, complaint intermittent pain after three years postoperatively, but no active lesion was visible on the bone scanning. 4. One patient who was performed wrist arthrodesis feels discomfort during lift up heavy products due to insufficient grip power. In conclusion, the synovectomy and curettage in early diagnosed and not so much advanced hand wrist tuberculsis is more preferable, but arthrodesis is inevitable in advanced cases with profound degree of bony destruction and nonviable cartilage in operative findings, for painless and powerful joint.
Adult ; Arthrodesis ; Cartilage ; Curettage ; Follow-Up Studies ; Hand Strength ; Hand ; Humans ; Joints ; Radiography ; Rare Diseases ; Songbirds ; Tenosynovitis ; Tuberculosis ; Wrist

PURPOSE: The purpose of this study was to present various clinical etiologies of hypermetabolic pelvic lesions on postoperative positron emission tomography/computed tomography (PET/CT) images for patients with rectal and sigmoid cancer. METHODS: Postoperative PET/CT images for patients with rectal and sigmoid cancer were retrospectively reviewed to identify hypermetabolic pelvic lesions. Positive findings were detected in 70 PET/CT images from 45 patients; 2 patients who were lost to follow-up were excluded. All PET findings were analyzed in comparison with contrast-enhanced CT. RESULTS: A total of 43 patients were classified into 2 groups: patients with a malignancy including local recurrence (n = 30) and patients with other benign lesions (n = 13). Malignant lesions such as a local recurrent tumor, peritoneal carcinomatosis, and incidental uterine malignancy, as well as various benign lesions such as an anastomotic sinus, fistula, abscess, reactive lymph node, and normal ovary, were observed. CONCLUSION: PET/CT performed during postoperative surveillance of rectal and sigmoid colon cancer showed increased fluorodeoxyglucose uptake not only in local recurrence, but also in benign pelvic etiologies. Therefore, physicians need to be cautious about the broad clinical spectrum of hypermetabolic pelvic lesions when interpreting images.
Abscess ; Carcinoma ; Colon, Sigmoid* ; Colorectal Neoplasms ; Electrons* ; Female ; Fistula ; Fluorodeoxyglucose F18 ; Humans ; Lost to Follow-Up ; Lymph Nodes ; Neoplasm Recurrence, Local ; Ovary ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Recurrence ; Retrospective Studies ; Sigmoid Neoplasms* ; Tomography, X-Ray Computed

Phenomenology has been developed by philosophers like Kant and Husserl since the late 18th century. Jaspers, a German psychiatrist, adopted it into psychopathology studies and accumulated data by closely observing and recording the patients' symptoms and signs. Among descriptions done even before the psychopathology or diagnostic criteria of disorders in the field of child psychiatry was established, we can find exact and valuable descriptions matching the autism spectrum disorder or attention deficit/ hyperactivity disorder. The diagnostic criteria of modern childhood psychiatric disorders were established based on these grounds. Phenomenological/descriptive methods in various psychiatric fields lead to medical study methods for social phenomenon such as oiettolie, hikikomori, and internet game addiction. Since Romanian orphans were adopted to the western world, descriptive studies along with neurobiological studies on the influence of stimulus deprivation on emotional and physical development are being conducted. While phenomenology, which was adopted by Jaspers to verify psychopathology, was developed mainly by observation and description, recent studies are explaining such descriptive phenomena even at the synapse level due to advances in neurobiology. Although phenomenological/descriptive psychiatry, describing precise and detailed experiences of patients, is less applied nowadays among modern study methods, we must remember that such descriptions may lead to biological studies and provide evidence to improve the accuracy of choosing and applying treatment methods.
Autistic Disorder ; Child ; Autism Spectrum Disorder ; Child Psychiatry* ; Child, Orphaned ; Humans ; Internet ; Neurobiology ; Psychiatry ; Psychopathology ; Romania ; Synapses ; Western World

Along with language, socialization is a unique feature of the human being. There is a continuous debate regarding whether the development of socialization is innate, and conducted by the environment in the growing process, or the result of the interaction of both aspects. If socialization is the result of the interaction with the environment or is an acquired developmental process, the following question rises. "Is there a 'critical period' for the development of socialization?" Although there are a huge number of studies seeking for treatment and solutions for developmental delay or deficits of socialization, it is very complicated question to answer. Historical figures such as 'Hugh Blair' of Borgue in England, and 'the wild boy of Aveyron' in France, seem to have innate socialization deficits. Nowadays patients with non-verbal learning disorder, social communication disorder, or autism spectrum disorder seem to have genetic defects. On the other hand, Harry Harlow's monkey experiments, hikikomori of Japan, Romanian orphans and patients with reactive attachment disorder seem to display social deficits due to environmental factors. However, it is not easy to clearly draw a line between innate or acquired factors. Therefore, rather than subdividing the diseases for etiological and pathophysiological approach to heterogenous groups with the common denominator of social deficit, and for the research of pathophysiology and treatment development, the authors suggest a comprehensive concept of "social dysfunction spectrum."
Autistic Disorder ; Child ; Autism Spectrum Disorder ; Child, Orphaned ; Communication Disorders ; England ; France ; Hand ; Haplorhini ; Humans ; Japan ; Learning Disorders ; Male ; Reactive Attachment Disorder ; Socialization

Intracranial atherosclerotic disease (ICAD) causes up to 10% of all ischemic strokes, and the rate of recurrent vascular ischemic events is very high. Important predictors of vulnerability in atherosclerotic plaques include the degree of stenosis and the underlying plaque morphology. Vascular wall MRI can provide information about wall structures and atherosclerotic plaque components. High-resolution (HR)-MRI in ICAD poses a greater challenge in the neurologic fields, because a high in-plane resolution and a high signal-to-noise ratio are required for vessel wall imaging of ICAD. Until now, plaque imaging of ICAD has focused on assessing the presence of a plaque and evaluating the plaque load. Going forward, evaluation of plaque vulnerability through analysis of imaging characteristics will be a critical area of research. This review introduces the acquisition protocol for HR-MRI in ICAD and the current issues associated with imaging.
Atherosclerosis ; Cerebral Arteries ; Constriction, Pathologic ; Magnetic Resonance Imaging* ; Plaque, Atherosclerotic ; Signal-To-Noise Ratio ; Stroke

Besides from medical data, the patients who were previously called as attention disorder, mental instability, moral imbeciles, or moral defectives, can also be identified by exploring literatures and historical figures. In the past, as we can notice from the titles, they were recognized as a 'moral defect group'. And rather than treating them, separation from the society was the main solution. After the endemic encephalitis from 1917 to late 1920s, however, many survivors suffered from behavioral problems similar to those of the previous 'moral defect group' and studies on the relationship between brain damage and behavior problems were started henceforth. After being known as the 'minimal brain dysfunction', it was developed into the current attention-deficit/hyperactivity disorder. While the disease concept changed and developed over time, after numerous trials and errors, treatment medication starting from central nervous system stimulants such as amphetamine and methylphenidate is used for treatment in children and adult patients with ADHD, and most recently non-stimulants such as atomoxetine has become the one of the first line treatment options. Although we went through a thorough verification process of the safety and efficacy of the medication by contemplating the historical development process, we believe that adjustment is needed for remaining concerns on medication abuse and slight differences in disease paradigm and therapeutic philosophy depending on cultures.
Adult ; Amphetamine ; Atomoxetine Hydrochloride ; Attention Deficit Disorder with Hyperactivity* ; Brain ; Central Nervous System Stimulants ; Child ; Encephalitis ; Humans ; Mental Disorders ; Methylphenidate ; Philosophy ; Survivors

Simultaneous double injury of the thumb at the interphalangeal joint and metacarpophalangeal joint occurring at the same time are seldom seen in medical practice. 72 year old male had posterior discation of interphalangeal joint and ulnar collateral ligament injury of metacarpophalangeal joint, as known as skier's thumb after he fell down from the bike. Open posterior dislocation of interphalangeal joint was stabilized by reduction and then skin suture was done. Metacarpophalangeal joint had totally ruptured ulnar collateral ligament with Stener lesion and bony fragment of base of proximal phalanx. The joint was subluxated and was not reduced due to jammed bony fragment. Displaced avulsion fracture of volar plate with ulnar collateral ligament injury was not reported by author's research. The author reduced bony fragment in joint and repaired ulnar lateral ligament. It has been 6 month after the operation and the patient is followed up. The patient has normal range of motion without instability of metacarpophalangeal and interphalangeal joint. We report our experience about simultaneous double injury of thumb and bony skier's thumb.
Collateral Ligaments ; Dislocations ; Humans ; Joints ; Male ; Metacarpophalangeal Joint ; Reference Values ; Skin ; Sutures ; Thumb ; Palmar Plate

No abstract available.
Lymphadenitis*

Autism spectrum disorder (ASD) is characterized by persistent deficits within two core symptom domains: social communication and restricted, repetitive behaviors. Although numerous studies have reported psychopharmacological treatment outcomes for the core symptom domains of ASD, there are not enough studies on fundamental treatments based on the etiological pathology of ASD. Studies on candidate medications related to the pathogenesis of ASD, such as naltrexone and secretin, were conducted, but the results were inconclusive. Oxytocin has been identified as having an important role in maternal behavior and attachment, and it has been recognized as a key factor in the social developmental deficit seen in ASD. Genetic studies have also identified associations between ASD and the oxytocin pathway. As ASD has its onset in infancy, parents are willing to try even experimental or unapproved treatments in an effort to avoid missing the critical period for diagnosis and treatment, which can place their child in an irreversible state. While therapeutic application of oxytocin for ASD is in its early stages, we have concluded that oxytocin would be a promising therapeutic substance via a thorough literature review focusing on the following: the relationship between oxytocin and sociality; single nucleotide polymorphisms as a biological marker of ASD; and validity verification of oxytocin treatment in humans. We also reviewed materials related to the mechanism of oxytocin action that may support its potential application in treating ASD.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Critical Period (Psychology) ; Diagnosis ; Humans ; Maternal Behavior ; Naltrexone ; Oxytocin* ; Parents ; Pathology ; Polymorphism, Single Nucleotide ; Secretin ; Social Change ; Biomarkers

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital anomaly of the genitourinary tract comprising uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Patients with HWW syndrome usually present symptoms such as dysmenorrhea, abdominal pain, pelvic mass, and purulent vaginal discharge. If not treated at an appropriate time, complications such as infertility, endometriosis, pyosalpinx, and subsequent pelvic adhesions may occur. Here, we report a case of HWW syndrome in a 7-year-old-girl who was also diagnosed as having central precocious puberty. She was brought to the pediatric department with chief complaints of lump in her breast and vaginal discharge. When she was around 2 months old, she was confirmed to have a single kidney on ultrasonography. We checked her past medical history and diagnosed her as having HWW syndrome based on the results of imaging studies, including abdominal ultrasonography and pelvic magnetic resonance imaging. She underwent treatment with gonadotropin-releasing hormone analogue for 2 years. During 24 months of follow-up, she showed no serious problems or complications. If renal anomalies are identified immediately after birth or in infancy, further screening tests should be conducted prior to menstruation for determining congenital abnormalities of the reproductive tract and vice versa.
Abdominal Pain ; Breast ; Congenital Abnormalities ; Dysmenorrhea ; Endometriosis ; Female ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Infertility ; Kidney ; Magnetic Resonance Imaging ; Mass Screening ; Menstruation ; Parturition ; Puberty, Precocious ; Ultrasonography ; Uterus ; Vaginal Discharge