PURPOSE: To make the guideline for diagnosis and treatment policy of various hepatocytic nodular lesions detected during the imaging diagnosis of cirrhotic liver and to get our own data about hepatocellular carcinoma based on Korean patients. MATERIALS AND METHODS: We retrospectively reviewed 40 confirmed hepatocellular carcinomas foilwed up with CT more than once without any treatment. Total numbers of follow-up were 50. First, we input the data of initial and follow-up diameter visible on CT images and follow-up interval of each mass to the computer, and got the mean growth rate curve and growth curve of hepatocelluiar carcinoma using a program of Quattro-pro, one of the spreadsheet. And then the doubling time was also calculated using Schwarz's formula. RESULTS: According to the growth rate curve, the tumor under 3 cm in diameter showed relatively show growing pattern but the one above 3 cm in diameter showed rapid growing pattern. Mean growth curve also showed rapid turning point around 3 cm. Overall mean doubling time was 82 days(mean +/- SD = 82.3 +/- 56.2): 119 days in the tumors smaller than 30 mm in diameter, 69 days larger than 30 mm in diameter. CONCLUSION: Hepatocellular carcinoma'is relatively slowly growing tumor and shows rapid increase of its growth rate when it is larger than 30 mm in diameter as a turning point. We think that this fact could make an important role to determine the treatment policy of various hepatocytic nodular lesions suspecting hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Diagnosis ; Follow-Up Studies* ; Humans ; Liver ; Retrospective Studies

Renal vein thrombosis is usually a complication of multiple underlying renal disease rather than primary process. High incidence of renal vein thrombosis in patients with nephritic syndrome, which suggest the nephrotic syndrome play a paramount role in the genesis of renal vein thrombosis or thromboembolic phenomena. But these are likely to relationship of “egg and chicken”, and then we cannot determine what is primary of these. Recently authors experienced a case that was questioned renal vein thrombosis with nephrotic-syndrome clinically, laboratory and preliminary radiologically, and this case in confirmed by selective left renal venography. Here we report a case of renal vein thrombosis with nephrotic syndrome which successfully managed with oral anticoagulants and reviewed literatures.
Anticoagulants ; Humans ; Incidence ; Nephrotic Syndrome* ; Phlebography ; Renal Veins* ; Thrombosis

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.
Arteries ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Perfusion

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.
Arteries ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Perfusion

Restoration of the M-P joint of a damaged or lost joint by trauma, tumor and others is necessary for adequate function of the hand. Several procedure have been described for restoration of the M-P joint. We experienced a case of vascularized joint transter for a lost joint by trauma. After 1 year and 2 months follow-up, there have been no degenerative change and no pain.
Follow-Up Studies ; Hand ; Joints

The relative rarity and anatomical position of presacral tumors may lead to difficulty in diagnosis and surgical treatment. The clinical features and surgical approach of 4such tumors(teratocarcinoma 1, endodermal sinus tumor 1, chordoma 1, neurilemmoma 1) have therefore reviewed. Low back pain or sacral pain was present in 3patients although all tumors were palpable on rectal examination. Surgical resection was carried out using the posterior transverse approach in Kraske's prone position. Complete surgical excision was performed in 3cases(chordoma, teratocarcinoma, neurilemmoma) and incomplete excision in 1 case(endodermal sinus tumor). A review of literature concerning these tumors and the surgical approach are presented.
Chordoma ; Diagnosis ; Endodermal Sinus Tumor ; Low Back Pain ; Neurilemmoma ; Prone Position ; Teratocarcinoma

The compartment syndrome was first described by Von Volkmann in 1872 and then many reports have been published. The anterior tibial compartment syndrome and the volar compartment syndrome of the forearm are well known, but the thenar compartment syndrome is very rare. A case of the thenar compartment syndrome developed with the CO poisoning was experienced and treated satisfactorily by the fasciotomy and secondary repair.
Compartment Syndromes ; Forearm ; Poisoning

Pain, traumatic arthritis, joint stiffness and joint subluxation are common sequelae of fracture dislocations of the proximal interphalangeal joints of the finger. Many kinds of methods were used to treat fracture dislocation of the proximal interphalangeal joint. The prognosis is greatly influenced by the method and the time of treatment. Authors treated 4 cases of fracture dislocations of the proximal interphalangeal joint with 3 different method. For a case with small bony fragment, we used the extension block splint of McElfresh. For a old case, we used the volar plate arthroplasty mothod of Eaton. And for two cases with large bony fragment, we used the force couple splint method of Agee after open reduction and internal fixation. The results were satisfactory.
Arthritis ; Arthroplasty ; Dislocations ; Fingers ; Joints ; Methods ; Prognosis ; Splints

A forty-seven-year-old male miner complained of paresthesia over right hypothenar area and ring and little fiugers for 3 months. On physical examination and electromyography, ulnar nerve dysfunction below elbow was noted. Intraoperatively, an anomalous muscle, the epitrochleoanconeus muscle, was found between the triceps muscle and flexor carpi ulnaris muscle, but it was clearly distinguished from them. Resection of the muscle and medial epicondylectomy were performed. The epitrochleoanconeus muscle is an anomalous muscle which arises from the medial epicondyle of the humerus and inserts into the medial border of the olecranon. The reports on ulnar nerve entrapment syndrome by this muscle were rare. On 14 months follow up, the symptoms and signs were improved.
Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Humerus ; Male ; Miners ; Olecranon Process ; Paresthesia ; Physical Examination ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve

Fractures of the upper end of the humerus are common and account for 4% to 5% of all fractures. They occur more frequently in older patients. In older patient the fracture often results from a minor fall and can be extremely disabling and their management often demands experienced surgical skill and judgement. Fortunately, in 80% of upper humeral fractures none of the four major segment is significantly displaced. These lesions are amenable to simple treatment by early function exercises. In 15% to 20% of upper humeral fractures one or more of the major segment is displaced. They are often unstable, may not be reduced by closed method. Many different methods of open reduction and internal fixation has been used and are still employed. These include wire loops, screw, staples, plates, intramedullary nail, but adequate internal fixation was not easily achieved due to the osteoporosis, displacement and shape of fragment. We treated 8 cases of surgical neck fractures by Rush pin and tension band wiring method. We consider this method as effective, simple and rigid fixation technique to attempt early exercise and to restore normal range of motion.
Exercise ; Humans ; Humeral Fractures ; Humerus ; Methods ; Neck ; Osteoporosis ; Reference Values