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

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

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.
Chungcheongnam-do* ; Infection Control*

BACKGROUND: Recently developed electrically stimulated gracilis neosphicter or artificial sphincter is quite a promising trial in fecal incontinence However, surgical technique is not simple, the devices are expensive and only specialists can perform the procedures successfully. The aim of this study is to evaluate the efficacy of a newly developed simple silicon device in incontinent dog model. METHODS: A New Colostomy Device (NCD; US Patent No. 5,569,216) for fixing in the stoma or rectum of human body, includes an internal balloon, a ring figured extemal balloon surrounding the internal balloon, a connecting tube disposed under the both infernal and external balloons and supply tube containing a pair of air passages and an enema fluid passage. It is designed to be inserted into the rectum and is held in place by an inflatable external balloon and drains irrigated fecal matter through a thin collapsible connecting tube which exist in the anal canal. Six mongrel dog with 22~26 kg of body weight were prepared. Anal incontinence was made by bilateral severing of the internal and external sphincters and puborectalis muscle under the general anesthesia. Marlex mesh ring was applied to the anal canal as Thiersch wire for the prevention of NCD expulsion in straining. After then, NCD with 2.5 cm of luminal diameter was inserted to the rectum proximal to the Malex mesh ring. Daily irrigation and evacuation was done with 800~1000 cc of tepid water in each dogs. Daily food contained 30 gm of Psyllium dextrose. RESULTS: Initially 6 dogs were observed for 7 days. Daily irrigation made evacuation of fecal matter well in each dogs. There was no prolapse of device through the anal orifice. Anoscopic examination after 7 days showed no rectal and anal mucosal injury. Two dogs were kept for 40 days as same manner. Sometimes spontaneous bowel movement without water irrigation was noted when the stool were loose. Weelky anoscopic examination revealed no evidence of mucosal injuries for 40 days also. There was no septic or other complication. CONCLUSION: NCD evacuated fecal matter well enough to empty the rectum in all incontinence dog model. Adequate sized NCD could be used for clinical trials in selected incontinence patients.
Anal Canal ; Anesthesia, General ; Animals ; Body Weight ; Colostomy* ; Dogs* ; Enema ; Fecal Incontinence ; Glucose ; Human Body ; Humans ; Phenobarbital ; Polypropylenes ; Prolapse ; Psyllium ; Rectum ; Silicones ; Specialization ; Water

Vivax malaria, which was once thought to be eradicable since more than 20 years ago, has made a dramatic resurgence since 1993 in the northern parts of Kyeonggi-do in the background of 0.13 of the annual parasite incidence in the population of 956,773 and 2 positives (0.07%) of asymptomatic parasitaemia among the 2,937 residents of mass blood survey in the area in 1969. The majority of the cases were soldiers infected in several counties located within 5 km from the Demilitarized Zone (DMZ) in 1994. Since then, malaria cases have increased and have tended to expand toward eastern and southern areas. Korean malaria is characterized by asymptomatic parasitaemia with long prepatent period, so malaria cases, including those manifesting as general fever should be treated with a combination of chloroquine and pyrimethamine to prevent the completion of sporogonic cycle in the mosquitoes. For the most effective control of vector mosquitoes, residual insecticides should be applied in the military houses and animal shelters with thermal fogging, including the control of the pre-stages of physiological age of the mosquitoes within 25 km from the DMZ. It is strongly suggested that military uniforms be treated with 0.5% permethrin complex (permethrin 39%+cyfluthrin 1%) or permethrin formulation. Further genetic studies are desired to determine the subspecies of Plasmodium vivax because Korean strain of malaria is likely to be a complex form of Plasmodium vivax vivax and Plasmodium vivax hibernans.
Animals ; Chloroquine ; Culicidae ; Fever ; Gyeonggi-do ; Humans ; Incidence ; Insecticides ; Korea* ; Malaria* ; Malaria, Vivax ; Military Personnel ; Parasites ; Permethrin ; Plasmodium vivax ; Pyrimethamine ; Weather

PURPOSE: This study was designed to evaluate usefulness of intravenous digital subtraction angiography (IV-DSA) in detection of peripheral arterial obstructive disease(PAOD) and in follow-up of percutaneous transluminal angioplasty(PTA). MATERIALS AND METHODS: 35 Patients who had clinical symptoms and signs of compromised lower extremity perfusion, was screened with IV-DSA and then performed confirmative conventional angiography. We obtained sensitivity, specificity and accuracy of IV-DSA by comparing the findings of IV-DSA with those of conventional angiography. 21 patients who had been performed successful PTA, were foliowed-up with IV-DSA in 3, 6, 12months. We studied patency rate and factors that influenced restenosis. RESULTS: The sensitivity, specificity and accuracy of IV-DSA were 100%, 97%, 97% in lilac artery, 92%, 96%, 93% in femoropopliteal artery, 85%, 75%, 70% in proximal tibioperoneal artery retrospectively. IV-DSA follow up after PTA showed patency rate of 67% in first 3month, 67% in 2nd 3month, 60% in next 6month. Longer length and more irregular surface of the stenotic site, and higher incidence of run-off of vessel and of residual stenosis in the patients with restenosis were noted. CONCLUSION: High sensitivity, specificity and accuracy of IV-DSA in evaluating PAOD suggest that IV-DSA is useful in screening, planning therapy and following up after PTA.
Angiography ; Angiography, Digital Subtraction ; Arterial Occlusive Diseases* ; Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Lower Extremity ; Mass Screening ; Perfusion ; Retrospective Studies ; Sensitivity and Specificity