Computerized Tomography can make accurate diagnosis in most of the mediastinal tumors and cysts by assessingtheir location, shape and internal architecture. Authors analysed and present CT findings of 89 surgically provenmediastinal tumpors and cysts that were studied and treated in Seoul National University Hospital during recent 5years. The results are as follows; 1. The most common tumor was teratoma(25 cases). Neurogenic tumor (20 cases),thymic tumor or cyst (16 cases), lymphoma(7 cases), bronchogenic cyst (6 cases), intrathoracic goiter (6 cases),pericardial cyst(3 cases) and cystic hygroma(2 cases) were next in order of frequency. 2. The most constant findings of teratoma was thick walled cystic area(100%), while pathognomonic fat and calcified density were seenonly in 52% and 48% of cases, respectively. 22 cases were located in anterior mediastinum, 2 cases were inposterior mediastinum and a case is in middle mediastinum. 3. There were 20 cases of neurogenic tumor consiting of6 neurilemmomas, 7 ganglioneuromas, 4 neurofibromas, 1 ganglioneuroblastoma, 1 neuroblastoma and 1 malignantschwannoma. Most of them were located in posterior mediastinum with exception of 2 neurilemmomas arising from leftvagus nerve and left recurrent laryngeal nerve in middle mediastinum. Cystic change was seen in 2 cases ofneurilemmoma and in a case of ganglioneuroma. Calcification was seen in 3 cases, of neuroblastoma, aneurilemmoma,and a ganglioneuroma. 4. There were 11 cases of thymoma showing homogeneous solid mass with speckeldcalcification in 4 cases and irregular cystic change in 3 cases. 2 cases were invasive thymoma and myastheniagravis was present in 4 cases. A case of thymolipoma and a case of thymic cyst were included. 5. Lymphoma(2Hodgkin's and 4 non-Hodgkin's) appeared as lobulated, matted mass in anterior mediastinum especially inprevascular area expnading bilaterally. 6. Intrathoracic goiter appeared as slingtly high density mass within termingled calcification and cystic area in 5 cases of secondary goiter and homogeneous high densitymass(100-110 H.U. in precontrast scan) in a case of primary goiter. 7. Among the 6 bronchogenic cysts, 3 werelocated in subcarinal area, 2 were above carina and one was in left hilar area. 3 cases showed high CT number morethan 70 H.U. and others showed water density. 8. 3 cases of pericardial cyst were located in right cardiophrenicangle and all of them showed water density. 9. 2 cases of cystic hygroma were located in superior mediastinum,with extension to lower neck and all of them showed water density.
Bronchogenic Cyst ; Diagnosis ; Ganglioneuroblastoma ; Ganglioneuroma ; Goiter ; Goiter, Substernal ; Granuloma ; Lymphangioma, Cystic ; Mediastinal Cyst ; Mediastinum ; Neck ; Neurilemmoma ; Neuroblastoma ; Neurofibroma ; Recurrent Laryngeal Nerve ; Seoul ; Teratoma ; Thymoma ; Water

The application of arthroscopic surgery in wrist is not widely advocated because of technical difficulty. We analysed 11(10 patients) wrists of which were performed arthroscopic synovectomy in wrist from July 1991 to September 1992 in Kyung Hee University Hospital. The age of the patients ranged from 23 to 55 years old. Follow up period was from 12 months to 26 months. The application for the arthroscopic synovectomy in that group of patients were based on such disabling clinical symptoms as severe pain, swelling, limitation of range of motion and roentgenographic type from mild to severe stage. Postoperative diagnosis was histologically confirmed with rheumatoid arthritis in nine wrists (nine patients) and gout in two wrists (one patient). The results were assessed subjectively and objectively with pain, swelling and range of motion. Satisfactory overall results were obtained and there were no complications. Conclusively, arthroscopic synovectomy in the wrist is effective produce to relieve pain of the rheumatoid arthritis and gout but arthroscopic synovectomy of wrist is technically demanded.
Arthritis, Rheumatoid ; Arthroscopy ; Diagnosis ; Follow-Up Studies ; Gout ; Humans ; Range of Motion, Articular ; Wrist

PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Dislocations ; Female ; Femur* ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Limb Salvage* ; Lung Neoplasms ; Male ; Multiple Myeloma ; Osteosarcoma ; Periprosthetic Fractures ; Prostatic Neoplasms ; Prostheses and Implants* ; Recurrence ; Thyroid Neoplasms ; Walking ; Weights and Measures

No abstract available.

BACKGROUND: One of the main disadvantages of caudal block is the long latent period before a satisfactory blockade is obtained. Many investigators have used various preparations of local anesthetic solutions to improve the speed of onset. This study was performed to evaluate the effectiveness of prewarming of lidocaine HCl for caudal block. METHODS: Fifty healthy young patients (ASA I) were allocated into two groups, A and B. In group A, the local anesthetic solution were injected at room temperature (25 degrees C), while in group B, they were injected at 37oC. All the caudal block were performed using 2% lidocaine HCl 20 ml with fentanyl 100ug and epinephrine 1:200,000. The onset time was defined as the period from completion of injection until the patient first noticed loss of sensation to pin-prick on perianal region. Assessment of sensory loss was made at 15 seconds interval. We have compared the onset of sensory blockade between groups. The duration of analgesia and any significant side effects were also recorded. RESULTS: The onset of sensory blockade was significantly faster in group B (3.5 +/- 0.5 minutes) than group A (6.2 +/- 0.9 minutes). The duration of analgesia were not significantly changed between groups. Side effects of urinary retention, pruritus and nausea were noted between both groups but the difference was not significant. CONCLUSIONS: We have found that the onset time was 44% faster with warm lidocaine-fentanyl mixture (37 degrees C) than with the room temperature (25 degrees C). The improved clinical usefulness was achieved with no increase in side effects. The technique is a safe and effective method to reduce the latency of onset.
Analgesia ; Epinephrine ; Fentanyl ; Humans ; Lidocaine ; Nausea ; Pruritus ; Research Personnel ; Sensation ; Urinary Retention

Ganglion is a common clinical entity, usually superficial in location, therefore easily diagnosed and most common tumors of the hand which represent 50 to 70% of all soft tissue tumors of the hand. The soft mucin filled cyst is attached to the adjacent underlying joint capsule, tendon, or tendon sheath. The most common ganglion is the ganglion on the dorsal side of wrist, with its origin at the scapulolunate ligament and is usually located between the extensor digitorum communis of the index finger and the extensor pollicis longus tendons. Intratendinous ganglion is very rare lesion that originates within the tendon, which has been reported 10 cases in earliest articles and 1 case in Korean article. We report one case of ganglion that arose within the extensor digitorum communis of the middle finger.
Fingers ; Ganglion Cysts ; Hand ; Joint Capsule ; Ligaments ; Mucins ; Tendons ; Wrist

The anterior fusion became the popular measure in the treatment of the tuberculosis of the spine. We analysed the 208 cases of the tuberculosis of the spine (174 anterior fusion) who were treated at our department during the period of 1966 to 1973 and compared these results with that obtained during the period of 1957 to 1966. Following has been observed from this comparison. 1. Spine was the most common site in bone and joint tuberculosis (51.7%) but with decreasing tendency. And it was followed by hip, knee, ankle and sacroiliac joints of order. 2. Common age incidence was below 30 years (72.7%) and most common in below 5 years (20.7%). 3. Average duration of disease was 2 years and 2 months. This value was 6 months lower than in previous study. 4. The most common site was changed from lumbar to thoracic vertebrae. 5. The incidence of sinus, cold abscess formation decreased but paraplegia increased in incedence due to high prevalence in thoracic vertebrae. 6. Anterior fusion was performed in 86.1% of the cases. 7. Postoperative complications was found in 17.2%. Adequate rnanagement of chest tube in thoracic areas and blood vessels in lumbosacral areas may be necessary.
Abscess ; Ankle ; Blood Vessels ; Chest Tubes ; Hip ; Incidence ; Knee ; Paraplegia ; Postoperative Complications ; Prevalence ; Sacroiliac Joint ; Spine ; Thoracic Vertebrae ; Tuberculosis ; Tuberculosis, Osteoarticular

PURPOSE: H. pylori infection was recently reported to be associated with unexplained iron-deficiency anemia(IDA) in children and adolescents. H. pylori-related IDA was thought to occur due to GI blood loss, scavenging of iron by H. pylori and iron malabsorption. The aim of this study was to examine how the status of H. pylori infection and age of children affected RBC indices, serum iron level and TIBC. METHODS: We performed esophagogastroduodenoscopy, and examined RBC indices, serum iron and TIBC on 178 pediatric patients with recurrent abdominal pain. H. pylori infection was assessed by CLO test and silver stain of gastric biopsy specimen. RESULTS: H. pylori infection was found in 42 of 178 patients(23.6%). In children with H. pylori infection, the prevalence of iron deficiency(ID) and IDA(39.0% and 10.3%, respectively) was higher than in children without H. pylori infection(29.6% and 4.1%, respectively), but there was no statistically significant difference. Serum iron level was lower(69.5+/-32.7 vs 77.3+/-34.1g/dL; P= 0.08) and TIBC was higher(380.8+/-50.4 vs 366.9+/-47.0g/dL; P=0.09) in children with H. pylori infection than in children without H. pylori infection. All RBC indices and iron saturation were lower in children with H. pylori infection than in children without H. pylori infection, but there was no significant difference between the two groups. In correlation analysis, serum iron, Hgb, Hct, MCV and MCH were significantly increased by age in children without H. pylori infection (P<0.05), but MCH and MCHC were decreased significantly(P<0.05) by age in children with H. pylori infection. In multiple regression analysis, the change of serum iron, MCH and MCHC by age was significantly influenced by the status of H. pylori infection(P<0.05). CONCLUSION: H. pylori infection decreases RBC indices and serum iron and increases TIBC in children. These changes become prominent as age increases. This age effect rnay be related to the duration of H. pylori infection. (J Korean Pediatr Soc 2000;43:755-762)
Abdominal Pain ; Adolescent ; Anemia, Iron-Deficiency ; Biopsy ; Child* ; Endoscopy, Digestive System ; Erythrocytes* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Iron* ; Prevalence ; Silver

No abstract available.
Rectal Prolapse*

PURPOSE: To evaluate US and CT characteristics of small renal cell carcinomas with diameter less than 3cm. MATERIALS AND METHODS: We retrospectively analysed US and CT findings of the small renal cell carcinomas which were surgically confirmed. We analysed echogenicity, peritumoral hypoechoic rim, intratumoral cysts on US. We analysed CT with viewpoints of tumor margin, growth pattern, renal contour change, attenuation on pre- and postcontrast scan, homogeneity, and perirenal changes. RESULTS: The US characteristics of the small renal cell carcinomas were hyperechogenicity(89%), peritumoral hypoechoic rim(66%) and intratumoral cysts(44%). They had relatively well-defined margin(90%), smooth and round contour(90%), endophytic growth pattern(65%), and outward bulging of renal contour(75%) on CT. They had iso- or high attenuation(87%) on precontrast CT, and were relatively homogeneous low-attenuated on postcontrast CT. CONCLUSION: The constellation of US and CT findings may be helpful in the diagnosis and understanding of the internal architecture of the small renal cell carcinomas.
Carcinoma, Renal Cell* ; Diagnosis ; Retrospective Studies