No abstract available.
Bile Duct Neoplasms* ; Bile Ducts* ; Bile*

PURPOSE: To evaluate the clinical result of two stage reimplantation of infected total knee arthroplasties, using an antibiotics impregnated articulating cement spacer. MATERIALS AND METHODS: Out of total 7 cases with infected total knee arthroplasties, 4 cases treated with two stage reimplantation, using an antibiotics impregnated articulating cement spacer were included in this study. After the treatment of infected total knee arthroplasties, the treatment of infection was evaluated by physical examination, radiologic studies, and hematologic studies. The results were evaluated using the Hospital for Special Surgery Knee Score (HSS). RESULTS: As results, 4 infected knee cases treated with two stage reimplantation did not have reinfection at the time of the follow up, and physical, laboratory, and radiologic studies were all within normal range. The range of motion of the reimplanted knees were from -5degrees in extension to 130 degrees in flexion, with an average of 117 degrees. The average score of the Hospital for Special Surgery Knee Score was 87. CONCLUSION: In conclusion, two stage arthroplasties, using antibiotics impregnated articulating cement spacer was an effective therapy not only for the treatment of the infection after the total knee arthroplasty but also effectiveness for recovery of the knee function.
Anti-Bacterial Agents* ; Arthroplasty* ; Follow-Up Studies ; Knee* ; Physical Examination ; Range of Motion, Articular ; Reference Values ; Replantation*

PURPOSE: Recently, many alternative forms of non-surgical treatment modalities were devised for the management of BPH and one of them is transurethral radiofrequency thermotherapy(TURT). In this study, we investigated the long term efficacy of TURT. MATERIALS AND METHOD: A total of 132 patients with symptomatic BPH were treated in a single session with TURT using Thermex-ll(47.5 degrees C, 150minutes) and 88 patients who were available to follow-up for more than 6 months after TURT were enrolled in this study. Among them, 65 patients were available to follow-up for more than 2 years. The baseline and post-treatment mean symptom score(Madson-Iversen), maximal flow rate(MFR), residual urine volume and prostate volume were compared. Improvement was defined as a reduction of more than 50% in at least one of two parameters(symptom score and maximal flow rate). We also investigated whether other treatment modalities were selected in 2 years after TURT. RESULTS: At 3 months follow-up, improvements were observed in 59.1%(52/88), and at 6 months 54.5%(48/88). However, improvements in both symptom score and maximal flow rate at 3 and 6 months after treatment were only 27.3% and 20.5%, respectively. Among 65 patients who were available to follow-up for more than 2 years, 27 patients(41.5%) had undergone transurethral resection of the prostate either with(19) or without medication(8). 28 patients (43.1%) received medical therapy such as alpha blocker during the last two years after TURT. The post-treatment values of the 10 patients who had not received adjuvant therapy were not significantly different from those at baseline. CONCLUSIONS: Although thermal treatment for BPH is an alternative option with minimal complication in selected symptomatic patients who are not clear candidates for surgery or high-risk patients, the long term effect of TURT is not sufficient to relieve the obstructive and irritative symptoms of BPH.
Follow-Up Studies ; Humans ; Hyperthermia, Induced* ; Prostate ; Prostatic Hyperplasia*

No abstract available.
Asthma* ; Dyspnea* ; Humans ; Respiratory Function Tests*

BACKGROUND: Mirror movement is common in young children, and it could be seen in normal adults. Several mechanisms including motor pathway reorganization involved in motor recovery after stroke. Motor pathway reorganization has been reported to be a mechanism in several studies of patients with mirror movement. However, the correlation of motor recovery and mirror movement has been debated. We studied the degree of mirror movement in stroke patients compared with a controlled group to look into their relationship. METHODS: Our controls were 50 adults without neurologic symptoms and signs. The hemiparetic group was comprised 94 patients who had incurred unilateral brain lesion: 36 patients were acute stroke patients, 58 patients were chronic stroke patients. Mirror movements were assessed by three different tasks: abduction of thumb, sequential finger tapping, and grasping. We analyzed mirror movements in controls and patients, and tried to find a correlation between the degree of mirror movement and the recovery of motor power in chronic stroke patients. RESULTS: In controls, male exhibited more frequent mirror movement than female at specific tasks, and there was no difference between tasks of right or left hand. In stroke patients, there was more mirror movement in the nonparetic hand than in the paretic one during the movement of contralateral hand. In acute stroke, the frequency of mirror movement had no variability according to the degree of motor power. The recovery of motor power at a late stage was not correlated with the degree of mirror movement. Consclusions: Motor pathway reorganization seems to be insignificant for motor recovery because the degree of mirror movement was not correlated with the recovery of motor power in this study.
Adult ; Brain ; Child ; Female ; Fingers ; Hand ; Hand Strength ; Humans ; Male ; Neurologic Manifestations ; Stroke* ; Thumb

PURPOSE: To compare 3D ultrasound (3D-US) with 2D ultrasound (2D-US) in terms of their usefulness and limitations in the diagnosis of breast masses. MATERIALS AND METHODS: We obtained 2D and 3D US images of 37 breast lesions present in 20 cases of fibroadenoma, nine of cancer, and eight of fibrocystic disease proven in a total of 26 cases [fibroadenoma (n=13), breast cancer (n=9), fibrocystic disease (n=4)] by histologic examination, and by clinical evaluation and clinical evaluation with sonographic imaging in eleven. When comparing 3D and 2D-US images we had no prior information regarding detection rate according to the size of lesions, whether or not internal and boundary echo patterns could be interpreted, accurate differentiation between tumorous and non-tumorous lesions, or the accuracy with which benign and malignant tumors could be differentiated. RESULTS: For lesions of 1 cm or less in diameter the detection rate of 3D-US was lower than that of 2D-US, but for lesions over 1 cm there was no difference between the two modalities. In fibroadenoma and breast cancer, 3D-US was more useful than 2D-US for the evaluation of both internal and boundary echo, but with fibrocystic disease and in the diagnosis of tumor/non-tumor, there was no significant difference. In breast cancer, however, 3D-US more accurately determined malignancy, and in fibroadenoma, because of the pseudospicule revealed by 3D-US, this modality was less exact in determining benignancy. CONCLUSION: In the evaluation of internal and boundary echo in breast mass diagnosis, 3D-US was more useful than its 2D counterpart. For lesions of 1 cm or less in diameter, however, the detection rate of 3D-US was low, and since in some benign cases a pseudospicule was apparent, the possibiliy of confusion with malignancy arose. For these reasons, the usefulness of 3D-US was limited.
Breast Neoplasms ; Breast* ; Diagnosis* ; Fibroadenoma ; Ultrasonography

There are many reports which show that contraction of the extraocular muscles results in an increase in intraocular pressure(IOP). Goldmann tonometer was used to record IOP after Tensilon injection in 22 patients, 10 myasthenics and 12 patients with other neurologic disease. There was a significant difference in IOP measured at 30 seconds after injection between two groups; 1-7(mean: 3.4) mmHg increase in myasthenics but no change, or 1-6 (mean: 1.7) mmHg decrease in patients with other neurologic disease. It is concluded that Tensilon tonometry is a valuable, sensitive and objective method in the diagnosis of myasthenia gravis.
Diagnosis* ; Edrophonium* ; Humans ; Manometry* ; Muscles ; Myasthenia Gravis*

BACKGROUND: Although a magnetic resonance imaging (MRI) is highly sensitive for changes associated with ischemic stroke, the detection of an acute ischemic lesion is usually impossible within 6 hours of the stroke onset on a conventional MRI. The perfusion MRI is a new imaging technique for diagnosing acute ischemic stroke. We evaluate the clinical usefulness of the perfusion MRI in predicting the final infarct extent in 18 patients with acute middle cerebral artery (MCA) territory ischemic stroke. METHOD: The perfusion MRI was performed within 6 hours after the stroke onset in all patients with a single-section dynamic contrast-enhanced T2*-weighted imaging in conjunction with a conventional routine MRI and MR angiography. Time-concentration curves and cerebral blood volume (CBV) maps were calculated from the dynamic MR imaging data by using numerical integration techniques. We compared findings of CBV maps with infarction on a follow-up CT or MRI. RESULTS: In 14 of 18 patients, the CBV in the occluded MCA territory were decreased. In the remaining 4 patients with a reversible ischemic neurologic deficit (RIND) or transient ischemic attack (TIA), the CBV were increased in 3 and normal in 1. Out of 14 patients with a decreased CBV, two had focal regions of increased CBV within the affected territory, indicating reperfusion hyperemia. The regions of increased or decreased CBV were eventually converted to infarction on follow-up images in all 14 patients. Out of 4 patients with RIND or TIA, one showed focal infarction in centrum semiovale on a follow-up image. CONCLUSIONS: The perfusion MRI was useful for the assessment of hemodynamic change about cerebral perfusion and may predict the extent of final infarction in acute MCA territory ischemic stroke. These results suggest that the perfusion MRI may play an important role in the diagnosis and management of acute ischemic stroke.
Angiography ; Blood Volume ; Diagnosis ; Follow-Up Studies ; Hemodynamics ; Humans ; Hyperemia ; Infarction ; Ischemic Attack, Transient ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Neurologic Manifestations ; Perfusion* ; Reperfusion ; Stroke*

A ganglion is the most common soft tissue tumor. But an intratendinous ganglion is a rare lesion of unknown etiology but with a natural history that originates within the tendon. A 52 year-old man complained of a palpable, non-tender mass in the dorsum of the right foot. We present a case of an intratendinous ganglion that developed in the extensor hallucis brevis tendon and which was treated successfully by excision.
Foot ; Ganglion Cysts* ; Humans ; Middle Aged ; Natural History ; Tendons* ; Toes*

PURPOSE: A conventional resuscitator is used as first-line equipment during cardiopulmonary resuscitation (CPR). However, resuscitation providers have difficulty in achieving adequate tidal volume during ventilation by conventional resuscitator (CR). This study was conducted to evaluate the usefulness of the newly-designed resuscitator (NR) during chest compression. METHODS: Fifty nine individuals participated in this study. NR was produced by insertion of a silicon implant in the CR. The NR was set at a tidal volume of 500 mL. Subjects completed four procedures: CR without compression, NR without compression, CR with compression, and NR with compression. Individual characteristics were obtained and the results were analyzed statistically. RESULTS: The mean volumes for the CR without compression were 482.03 mL, NR without compression 513.71 mL, CR with compression 461.93 mL, and NR with compression 496.12 mL. When the two types of resuscitators were used during chest compression, success rate of CR of 64.4% was observed, and success rate of NR was 94.9% (p<0.01). The physical aspects including hand size, volume, and grip power showed no correlation with the volume that we delivered. CONCLUSION: The NR can approximate the exact tidal volume and may be useful in preventing possible complications from inappropriately delivered tidal volumes.
Cardiopulmonary Resuscitation ; Hand ; Hand Strength ; Resuscitation ; Silicones ; Thorax* ; Tidal Volume* ; Ventilation