The metastatic malignant tumor of the hand is rare condition, and has difficulty in diagnosis at presentation due to simulating other diseases such as osteomyelitis, felon, paronychia, rheumatoid arthritis, and so forth. The treatment of them is very limited and the prognosis is poor. We experienced and going to report two cases of metastaic tumor of the hand, one was from rectal cancer which associated with rheumatoid arthritis and another was from brochogenic carcinoma.
Arthritis, Rheumatoid ; Diagnosis ; Hand* ; Osteomyelitis ; Paronychia ; Prognosis ; Rectal Neoplasms

Pleomorphic xanthoastrocytoma is histologically characterized by marked cellular pleomorphism of lipid-laden neoplastic astrocytes and bizarre giant cells showing mitotic figures and high cellularity. Inspite of its ominous-looking microscopic features, howerver, the prognosis is usually favorable. This tumor develops mainly in the supratentorial area of young people and frequently involves the leptomeninges. We experienced a case of pleomorphic xanthoastrocytoma in 18 year-old-male. In addition to the cellular pleomophism, the prominent reticulin fibers surround the individual tumor cells or the tumor cells nests. Immunohistochemical staining and electron microscopy revealed glial fibrillary acidic protein(GFAP) expression and pericytoplasmic basal lamina in the tumor cells.

Osteonecrosis of the femoral head seems to be due to circulatory disturbance of the femoral head, usually idiopathic in origin, but also associated with chronic alcoholism, gout, prolonged treatment with corticosteroids, sickle cell disease, Caisson's disease and surface and degenerative changes in the hip joint. Aims of this procedure are to decompress the femoral head hence allowing better circulation, to revitalize the dead head by insertion of vascularized pedicle bone and to give a mechanical support preventing further collapse of the femoral head. Authors reviewed 19 cases of the vessel pedicled iliac bone graft performed for the idiopathic osteonecrosis of femoral head from January, 1984 to April, 1988 with follow-up periods from 23 months to 66 months, average 37.5 months. The purpose of this follow-up note is to report the long term follow-up result and to show the critical points of this technique.
Adrenal Cortex Hormones ; Alcoholism ; Anemia, Sickle Cell ; Bone Transplantation ; Follow-Up Studies ; Gout ; Head ; Hip Joint ; Osteonecrosis ; Transplants

No abstract available.

No abstract available.
Cystadenoma*

No abstract available.
Cystadenoma*

We have experienced a reexpansion pulmonary edema(RPE) during general anesthesia. This patient has undertaken the decortication operation due to right sided massive pleural effusion and fibrothorax. Generally reexpansion pulmonary edema is believed to oceur only when a chronically collapsed lung is rapidly reexpanded by evacuation of large amount of air or fluid in pneumothorax and pleural effusion. The pathogenesis of RPE is unknown and is probably multifactorial. The implicated etiologies are chronicity of collapse, technique of reexpansion, increased pulmonary vascular permeability, airway obstruction, loss of surfactant and pulmonaty artery pressure changes. The outcome of RPE may be fatal, so physician treating lung collapse must be aware of the possible causes and endeavor to prevent the occurrence of this complieation.
Airway Obstruction ; Anesthesia, General* ; Arteries ; Capillary Permeability ; Humans ; Lung ; Pleural Effusion ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema*

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most useful diagnostic tool in biliary and pancreatic disease. However, ERCP cannot be performed successfully in all patients. Cannulation failure is the most common cause of failure of ERCP. Mechanical pathologies, such as peri-Vater diverticulum, cancer of the papilla of Vater, and impacted stone were the common causes of cannulation failure. We experienced two cases of carcinoma of the papilla of Vater in whom cholangiography and insertion of the nasobiliary tube were performed througth an artificial choledoehoduodenal fistula made by a needle type diathermy knife, beacuse cannulation to the duct was failed due to the tumor.
Catheterization ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Diathermy ; Diverticulum ; Fistula* ; Humans ; Needles ; Pancreatic Diseases ; Pathology

Neurilemmomas of the extremities are nerve sheath tumors involving peripheral nerves of the extremities. We analyzed MR images of 16 surgically proved tumors in 12 patients and compared the MR images with gross pathologic specimens in two tumors (2/16). Spin echo T1-weighted images were obtained in all the patients but T2-weighted images were obtained in six patients with a gradient echo technique. Gadolinium dimeglumine enhanced T1-weighted images were obtained in 11 patients (15/16). Signal on T1-weighted images was iso or slightly higher than that of the adjacent muscles. Signal on T2-weighted images ranged from homogeneous high to heterogeneous. After Gadolinium injection, all the 15 tumors showed enhancement. Small sized tumors were enhanced homogeneously but there was a tendency tobe enhanced heterogeneously to the central portion with peripheral rim enhancement as the size of the tumors increased. Pathologically, the enhanced portion was correlated the with solid protion was correlated the with solid portion of the tumors. Also encapsulation of the mass (12/16), suspended nerve strings (9/16) and bony erosion (1/16) were detected. MR characteristics of neurilemmoma include heterogeniety on enhanced T1 and T2 weighted images, encapsulation, and suspended nerve strings. Signal heterogeneity on enhanced T1 and T2 weignted images may be attributed to the variable cellularity, cystic changes, vascularity and focal hemorrhage of the tumors.
Extremities ; Gadolinium ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Muscles ; Nerve Sheath Neoplasms ; Neurilemmoma* ; Peripheral Nerves ; Population Characteristics

Neurilemmomas of the extremities are nerve sheath tumors involving peripheral nerves of the extremities. We analyzed MR images of 16 surgically proved tumors in 12 patients and compared the MR images with gross pathologic specimens in two tumors (2/16). Spin echo T1-weighted images were obtained in all the patients but T2-weighted images were obtained in six patients with a gradient echo technique. Gadolinium dimeglumine enhanced T1-weighted images were obtained in 11 patients (15/16). Signal on T1-weighted images was iso or slightly higher than that of the adjacent muscles. Signal on T2-weighted images ranged from homogeneous high to heterogeneous. After Gadolinium injection, all the 15 tumors showed enhancement. Small sized tumors were enhanced homogeneously but there was a tendency tobe enhanced heterogeneously to the central portion with peripheral rim enhancement as the size of the tumors increased. Pathologically, the enhanced portion was correlated the with solid protion was correlated the with solid portion of the tumors. Also encapsulation of the mass (12/16), suspended nerve strings (9/16) and bony erosion (1/16) were detected. MR characteristics of neurilemmoma include heterogeniety on enhanced T1 and T2 weighted images, encapsulation, and suspended nerve strings. Signal heterogeneity on enhanced T1 and T2 weignted images may be attributed to the variable cellularity, cystic changes, vascularity and focal hemorrhage of the tumors.
Extremities ; Gadolinium ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Muscles ; Nerve Sheath Neoplasms ; Neurilemmoma* ; Peripheral Nerves ; Population Characteristics