Six thumb reconstructions and one index reconstruction were performed by use of the wrap-around technique. All successful digital reconstructions were reviewed at an average of 37 months after surgery. There were complications related to the digits in three patients ; these included pin site infection (1), malrotation (1), and nail deformity (1). But we considered that function and cosmesis were excellent with a 100% viability rate. All patients regained protective sensation and sttained two-point discrimination (average 10mm). The wrap-around technique represents an esthetically and functionally excellent procedure of digit reconstruction for amputation at the level of metacarpo-phalangeal joint or distal to it.
Amputation ; Congenital Abnormalities ; Discrimination (Psychology) ; Fingers ; Humans ; Joints ; Sensation ; Thumb

No abstract available.
Female ; Hysterectomy, Vaginal*

No abstract available.
Holoprosencephaly*

PURPOSE: To evaluate the significance of color Doppler ultrasonography in patients of chronic prostatitis. MATERIALS AND METHODS: We analysed the pattern of color Doppler images and quantitative changes of vascular flow and flow velocity parameters(FVP) using a 7.0 MHz transrectal probe with findings of expressed prostatic secretion (EPS) from 22 patients with clinically suspected chronic prostatitis and 12 controls with clinically suspected prostatodynia retrospectively. RESULTS: Compared with 2 groups according to color Doppler flow grade, higher grades(grade 2 or 3) of flow increase were more frequently seen in prostatitis group(54.5%) than in control group(33.3%)(p <0.05). But no significant difference was found in flow velocity parameter(FVP: maximal flow velocity, minimal flow velocity, resistive index, and pulsatility index) between control and prostatitis group. Two months later follow up ultrasonography of 5 cases in the prostatitis group after treatment, all of 5 cases showed decrease the color Doppler flow compared with the initial color Doppler image grade. CONCLUSIONS: Grading of the amount of color flow with Doppler ultrasonography is of limited significance at efficacy decision after treatment in chronic prostatitis. But precaution should be taken to use color Doppler ultrasonography as objective diagnostic tool, although higher grades of flow increase were more frequently seen in prostatitis group than control group.
Follow-Up Studies ; Humans ; Prostatitis* ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color*

Laparoscopic surgery has many benefits over a conventional abdominal approach. These include less blood loss, low morbidity, shorter recovery time, shorter hospital stay, and shorter time interval to adjuvant therapy. With advances of laparoscopic instruments and surgical skills, laparoscopic surgery is becoming a dominant paradigm in the surgical management of gynecologic cancers. Advanced laparoscopic procedures including radical hysterectomy and trachelectomy with pelvic and para-aortic lymphadenectomy are now used in the management of early cervical cancer. For patients with apparent early-stage endometrial and ovarian cancer, laparoscopic complete staging operation including pelvic and para-aortic lymphadenectomy can be applied. Of several laparoscopic surgical procedures, laparoscopic pelvic and para-aortic lymphadenectomy is a cornerstone in the management of gynecological cancers cancers. The evaluation of lymph node status has an important role in diagnosis, treatment, and prognosis of gynecologic cancers because lymphatics are the main pathways of dissemination of gynecologic cancers. Laparoscopic pelvic and para-aortic lymphadenectomy is feasible and safe without increase of perioperative complications and decrease in patient's survival in gynecologic cancers, if it is performed by an experienced laparoscopic oncologic surgeon. During the last 10 years, laparoscopic procedures including pelvic and para-aortic lymphadenectomy in over 600 patients with gynecologic cancers were underwent in our department. We have found that the surgical and oncologic outcomes were similar or even better compared to conventional laparotomic procedures. In conclusion, the gynecologic oncologist should be familiar with lymphatic anatomy and laparoscopic skills to perform pelvic and para-aortic lymphadenectomy, because laparoscopic management of gynecologic cancers will be the choice of surgical treatment in the near future.
Humans ; Hysterectomy ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Ovarian Neoplasms ; Prognosis ; Uterine Cervical Neoplasms

PURPOSE: Percutaneous transluminal angioplasty(PTA) with a balloon catheter is a standard method of treatment for membranous obstruction of inferior vena cava(MOIVC). But, correct therapeutic approach has not been established for MOIVC patients whose lesion is associated with extensive thrombotic IVC occlusion. We tried to treat MOIVC associated with or without thrombus. MATERIALS AND METHODS: We treated 13 cases of MOIVC(associated with thrombus in 7 cases, no thrombus in 6 cases) with PTA, thrombolysis and self-expandable metallic stents. RESULTS: PTA was successful in 8 cases, but failed in 5 cases. The recurred cases were retreated with PTA, but follow up study revealed recoiling restenosis in 4 cases and intimal hyperplasia in 1 case at previous PTA site which could be overcome with a self-expandable metallic stent. The complication were occurred in 3 cases which were hemothorax, hemopericardium, and hemoperitoneum respectively. However, those were resolved by conservative treatment only. CONCLUSION: Recanalization and dilatation could be done in MOIVC patients with or without thrombosis for improvement of patient's symptom. Gianturco self-expandable metallic stent is sueful in treatment of recurred MOIVC after balloon dilatation and preventing reocclusion of the IVC after PTA.
Catheters ; Dilatation ; Follow-Up Studies ; Hemoperitoneum ; Hemothorax ; Humans ; Hyperplasia ; Pericardial Effusion ; Stents* ; Thrombosis

No abstract available.
Colpotomy ; Survival Rate ; Uterine Cervical Neoplasms ; Female ; Hysterectomy ; Laparoscopy ; Peritoneum ; Pelvis ; Vagina ; Recurrence ; Oncologists ; Treatment Outcome ; Neoplasm Recurrence, Local ; Randomized Controlled Trials as Topic

STUDY DESIGN: A prospective radiological assessment was conducted. OBJECTIVES: To analyze the changes in the height of the intervertebral disc, the slippage, slip angle, lumbar lordotic angle and sacral inclination after anterior lumbar interbody fusion and posterior pedicle screw fixation in a lumbar spondylolisthesis. SUMMARY OF LITERATURE REVIEW: The anterior lumbar interbody fusion causes changes in the lumbar sagittal alignment. METHODS: The mini-open anterior lumbar interbody fusion and pedicle screw fixation was undertaken in 33 cases from April 1995 to November 2003. MRI was done before and 6 months after surgery. The measuring factors were the heights of the intervertebral disc, slippage, slip angle, lumbar lordotic angle and sacral inclination. The measuring factors were independently assessed three times by three different orthopedic surgeons. The postoperative changes in measuring the factors were analyzed by a paired t-test statistically. RESULTS: The height of the intervertebral disc was increased by a mean of 14.0%, slippage was reduced by a mean of 2.8%, the slip angle was reduced by a mean of 16.0%, the lumbar lordotic angle was increased by a mean of 15.6% and the scaral inclination was increased by a mean of 3.0%. There was significance in the increase in the disc height, the reduction of slippage and the slip angle, and the increase in lumbar lordotic angle, but there were no significance regarding the changes in sacral inclina-tion. CONCLUSIONS: The anterior lumbar interbody fusion and the pedicle screw fixation significantly improved the height of the intervertebral disc, slippage, slip angle, and lumbar lordotic angle, except sacral inclination.
Intervertebral Disc ; Magnetic Resonance Imaging ; Orthopedics ; Prospective Studies ; Spine* ; Spondylolisthesis*

Myopathy due to hypothyroidism can be detected in its early stage, but as the symptom is mild, complications such as rhabdomyolysis are rare. Thrombotic thrombocytopenic purpura in hypothyroidism is not yet clearly defined, and rare cases of it are reported. Reported herein is a case of thrombotic thrombocytopenic purpura and rhabdomyolysis associated with acute renal failure in hypothyroidism. A 70-year-old male was admitted to the hospital due to general weakness and muscle pain. Later, based on the laboratory findings, he was diagnosed with rhabdomyolysis associated with acute renal failure and thrombotic thrombocytopenic purpura combined with hypothyroidism. Initially, he was treated with fluid resuscitation due to rhabdomyolysis combined with acute renal failure but eventually, the levothyroxine supplement lowered the thyrotropin-stimulating hormone level. As a result, the patient recovered from rhabdomyolysis and thrombotic thrombocytopenic purpura without receiving plasmapheresis treatment.
Acute Kidney Injury* ; Aged ; Humans ; Hypothyroidism* ; Male ; Muscular Diseases ; Myalgia ; Plasmapheresis ; Purpura, Thrombotic Thrombocytopenic* ; Resuscitation ; Rhabdomyolysis* ; Thyroxine

PURPOSE: The objective of this study was to determine the patterns of C-reactive protein (CRP) changes during the postoperative period after total knee replacement (TKR), and to determine the CRP changes associated with infection after TKR. MATERIALS AND METHODS: A retrospective analysis of the pattern of CRP changes during the first 6 postoperative months was conducted on 2,315 patients who underwent unilateral or simultaneous bilateral TKR. This data was also compared with the pattern of CRP changes which occurred in 19 patients with a deep prosthesis infection who were not enrolled in the main study. RESULTS: The CRP levels peaked 3 days postoperatively, and then decreased to baseline levels at 15-28 days postoperatively. Within 14 days postoperatively, the CRP levels were significantly higher in the simultaneous bilateral TKA group than in the unilateral group (p<0.01). Thereafter, no significant difference in CRP levels existed between two groups. After the 8th postoperative day, a significant difference in CRP level existed between patients with and without deep prosthesis infections. CONCLUSION: CRP changes post-TKR provide an effective means of monitoring of infections. In cases of non-inflammatory arthritis in which the CRP levels are significantly difference after the 8th postoperative day or are elevated after the 4th postoperative week, an infection should be suspected.
Arthritis ; Arthroplasty, Replacement, Knee ; C-Reactive Protein ; Humans ; Postoperative Period ; Prostheses and Implants ; Retrospective Studies