The sympathetic nervous system has been implicated in the maintenance of numerous pain syndromes. Interruption of sympathetic pathways has been widely applied to relieve pain. Neurolytic sympathetic block is often well tolerated, because numbness and motor weakness are uncommon and neuritis rarely develops. The classic targets for sympatholysis are the stellate or cervicothoracic ganglion for facial and upper extremity pain, celiac plexus for abdominal pin, and lumbar sympathetic chain for lower extremity pain. In addition, the thoracic ganglion is occasionally blocked for the treatment of hyperhidrosis and of pain emanating from the pleura and esophagus. The recognition of the clinical utility of cervical epidural nerve block in the management of head, face, neck, shoulder, and upper extremity pain has brought the technique into the mainstream of contemporary pain management practice. Lumbar epidural nerve block has great utility in the management of a variety of acute, chronic, and cancer-related pain syndromes. The nerve root sleeve is particularly accessible to precise local anesthetic blocks. Segmental information gained from such nerve root blocks can be helpful in sorting out confusing patterns of referred pain to the limbs. The pathway for insertion of spinal needles must be planned so as to avoid damaging neural structures. Spinal nerve roots are particularly delicate structures and do not take kindly to being impaled.
Celiac Plexus ; Esophagus ; Extremities ; Ganglion Cysts ; Head ; Hyperhidrosis ; Hypesthesia ; Lower Extremity ; Neck ; Needles ; Nerve Block ; Neuritis ; Pain Management ; Pain, Referred ; Pleura ; Shoulder ; Spinal Nerve Roots ; Stellate Ganglion ; Sympathetic Nervous System ; Upper Extremity

No abstract available.
Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary*

Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm that usually arises in the pleura and has been recently reported from unusual locations. We present a case of SFT that occurred in the scrotum. The patient was a 38-year-old man who presented with a painless, left, scrotal mass of five years' duration. Scrotal sonography and pelvic CT scan showed a soft-tissue mass of 11 cm in diameter. The resected tumor measured 11 8 7 cm and was well demarcated from the surrounding soft tissue. The cut surface revealed homogenously grayish-white and gelatinous appearance. No hemorrhage or necrosis was found. Microscopically, the tumor showed hypercellular spindle cell areas intermixed with hypocellular areas lying in a myxoid or collagenous stroma. The spindle cells had no mitosis or low mitotic figures, and little or no nuclear atypia. They exhibited a variety of growth patterns, including "patternless" pattern, and a prominent vasculature with hemangiopericytic pattern. Vimentin, CD34, and bcl-2 protein immunoreactivity were observed. Characteristic histologic and immunohistochemical features of this lesion were consistent with SFT. To arrive at a correct diagnosis of this lesion, especially when it occurs in unusual sites, immunohistochemical study including CD34 & bcl-2 protein is required in addition to characteristic histologic features.
Adult ; Collagen ; Deception ; Diagnosis ; Gelatin ; Hemangiopericytoma ; Hemorrhage ; Humans ; Mitosis ; Necrosis ; Pleura ; Scrotum* ; Solitary Fibrous Tumors* ; Tomography, X-Ray Computed ; Vimentin

Radiofrequency neurotomy of the lumbar medial branch, via a caudal approach, is a representative interventional procedure for lumbar zygapophysial joint pain, which can be performed more accurately and easily using a guide needle technique. We experienced a case of burn wound formation along the guide needle trajectory, where heat conduction through the guide needle was suggested to have resulted in the burn wound.
Arthralgia ; Burns* ; Hot Temperature ; Needles* ; Wounds and Injuries*

Eighty three rickets could be diagnosed at our department during eight years from August of 1969 to July of 1977. Among them fourteen children, whose radiographs and clinical description were precise with well-documented follow-up study of more than one year, were subjected to this analysis. Evaluation of the healing and correction of the lower leg deformity in these rachitic children obtained the following results. 1. Among fourteen rachitic children, thirteen patients (26 legs) showed varus and one patient (2 legs) showed valgus deformity. 2. Mean mechanical tibio-femoral angle showed shift from the initial 16.1°±5.3° to 5.5°+4.0° at final visit, which indicated the gradual correction of the deformity with the advance of the ages of children. The follow-up study after three years in this series showed that the correction became almost complete. 3. At the epiphyseo-metaphyseal region of the distal femur, the initial angle showed two distinct trends of change. The initial varus angle more than 7 or 8 showed the decrease at the later follow-up study, while the initial angle less than 7 or 8 showed the increase. 4. The epiphyseo-metaphyseal region of the proximal tibia showed the minimum change of angle. Mean angle of deviation from the vertical line was 3.7°±2.9° at first visit and 2.6°± 2.4°at final visit. The least degree of varus and the trend toward valgus observed in this region may refiect its compensatory activity against the varus deformity of the leg as a whole. 5. The epiphyseo-metaphyseal region of the distal tibia showed the maximum degree of varus at both initial and final check although the greatest degree of correction was attained. The initial mean varus angle of 23.9°±9.2° became 12.9°±7.1° at final visit. 6. The results of this study have shown that the correct evaluation of the rcchitic leg deformity is possible with measurement of the mechanical tibio-femoral angle and that the deviation angle of each epipyseo-metaphyseal region is preferable.
Child ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Genu Varum ; Humans ; Leg ; Rickets ; Tibia

Arteriovenous malformation of the brain is a congenital abnormal communication between arterial and venous channels without the interposition of the capillary system and it not infrequently cause severe intracranial hemorrhage and neurological deficits. The authors are reporting three cases of cerebral arteriovenous malformations which underwent surgical treatment using the operating microscope under mannitolization without hypotensive anesthesia.
Anesthesia ; Arteriovenous Malformations* ; Brain* ; Capillaries ; Intracranial Arteriovenous Malformations ; Intracranial Hemorrhages ; Mannitol

No abstract available.
Hepatitis B e Antigens* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis*

Takayasu's arteritis is an arteritis of undetermined etiology, which affects the aorta, proximal portion of its major branches, and causes narrowing, occlusion, or aneurismal dilatation of vessel. Authors report 2 cases of Takayasu's arteritis with brief review of the literature.
Aorta ; Arteritis ; Dilatation ; Takayasu Arteritis*

No Abstract available.
Chungcheongnam-do* ; Infection Control*

PURPOSE: The study aimed to identify influencing factors associated with the organizational commitment (OC) among hospital nurses. METHODS: A descriptive correlational design was utilized. The subjects of this study were 447 female nurses working for over 6 months in Seoul. The study was based on the data from a self-reported survey using structured questionnaires. The data were collected from September 10 to 30, 2009 and analyzed using Pearson's correlation coefficients and stepwise multiple regression analysis. RESULTS: The mean score of the OC was 2.45, slightly higher than the intermediate level. The mean score of the three-dimensional domain among the OC, affective commitment (AC) was 2.50, continuance commitment (CC) was 2.59, and normative commitment (NC) was 2.29. The influencing factors of nurses' AC were perceived organizational support (POS) (beta=.31, p<.001), supervisory trust, job burnout, nursing professionalism, and age, which accounted for 49.7%. The influencing factors of the CC were supervisory trust (beta=.20, p<.001), POS, and job burnout whereas the influencing factors of the NC were POS (beta=.40, p<.001), supervisory trust, nursing professionalism, and job burnout. CONCLUSION: It is necessary to develop supportive strategies that increase OC, which also improve the POS, nursing professionalism, and supervisory trust, and alleviate job burnout in hospital nurses.
Female ; Humans ; Surveys and Questionnaires