A preliminary study was conducted to evaluate the immediate postoperative recovery and socioeconomic efficacy with the surgical release of Carpal tunnel syndrome by double incision technique. Sixty cases of carpal tunnel syndrome were operated by one surgeon between 1993 and 1995 and 44 cases in 39 patients were available for this study. Surgery was done under axillary block and patients were evaiuated preoperatively, 3 weeks and 6 weeks each postoperatively. The evaluation was focused on the immediate recovery in terms of subjective symptoms of pain and paresthesia, local tenderness, strength of grip power and pinch power and postoperative disability. 1l was noted that surgical release of carpal tunnel syndrome utilizing double incision technique was as effective as seen in the endoscopic release in terms of quicker recovery of pain, local tenderness and strength. It was also noted that this double incision technique was as safe and economically beneficial as observed in the conventional open procedure.
Carpal Tunnel Syndrome ; Hand Strength ; Humans ; Paresthesia

Inflammatory myofibroblastic tumor(IMT) or inflammatory pseudotumor is a rare, solid tumor that most often affects children. This tumor is characterized by a spindle cell proliferation admixed with a variety of inflammatory cells. Although it has disputed nosology, a distinctive fibroinflammatory and even pseudosarcomatous appearance have been well appreciated. Herein, we report a case of IMT in the posterior mediastinum in a 19-year-old girl with clinical findings. The immunohistochemical and ultrastructural studies on the tumor cells are reported, and their distinctive characteristics are discussed in details.
Cell Proliferation ; Child ; Female ; Granuloma, Plasma Cell ; Humans ; Mediastinum* ; Myofibroblasts* ; Young Adult

We report a case of subclavian artery laceration caused by the removal of a pigtail pleural drainage catheter in a patient with a pneumothorax. The patient was successfully resuscitated through diagnostic angiography with subsequent balloon occlusion and primary repair of the injured subclavian artery. Although pigtail drainage of a pneumothorax is known to be safe and effective, proper insertion and removal techniques should be emphasized to reduce the risk of complications.
Angiography ; Balloon Occlusion ; Catheters* ; Drainage ; Hemothorax ; Humans ; Lacerations* ; Pneumothorax* ; Subclavian Artery* ; Thoracostomy

Scapholunate advanced collapse (SLAC) deformity most often occurs with chronic rotary scaphoid instability from scaphoiunate ligament tear and scaphoid fracture. Prior to 1984 when Watson HK reported his concept on SLAC wrist deformity, the most popular procedure for this pathology was scaphoid implant arthroplasty with or without midcarpal fusion. We have reviewed 15 cases of SLAC deformity treated with scaphoid excision and midcarpal fusion from 1984 to 1993. Among them, scaphoid implants made of silicone were inserted in 4 cases. Scaphoid implant arthroplsty without carpal fusion has been excluded. The mean period of follow-up was 8.8 years and the mean age of patients was 47.5 years. Males and right wrists were predominant. Wrist motion was 56% and grip power was 71% of the normal opposite side. On the average overall, 8 patients had no pain and 7 patients had mild pain. The grade of pain was minimal, 0.5 in grade (Rating system: no pain-0, mild- 1, moderate-2, severe-3). However, all of the 4 cases of limited carpal fusion with a scaphoid implant developed silicone particulate induced synovitis and pain. The procedure appears to be effective in maintaining function of the hand with minimal pain up to 5.8 years. However, silicone scaphoid implant appears not to be necessary and is not recommended with a limited carpal fusion for this pathology.
Arthroplasty ; Congenital Abnormalities ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Ligaments ; Male ; Pathology ; Silicones ; Synovitis ; Wrist

Purpose: To report the outcomes of extensively porous-coated femoral stems based on diaphyseal fixation caused by extensive bone loss and osteoporosis of the proximal femur in revision total hip arthroplasty. Materials and Methods: 14 cementless femoral revision procedures performed between Aug, 2000 and Apr, 2003 were reviewed retrospectively. The follow up period ranged from 24 to 53 months, with an average of 33 months. The average age at surgery was 52.3 years, there were 10 males and 4 females. The reasons for the revision surgery were aseptic loosening in 11(78.7%) hips, progressive osteolysis in 1(7.1%), septic loosening in 1(7.1%) and periprosthetic fracture in 1(7.1%). Results: The Harris hip score improved from 50.4 points preoperatively to 88.5 points postoperatively. The complications encountered were a greater trochanteric fracture in 2 hips (14.3%), periprosthetic fracture in 1(7.1%), dislocation of the hip in 2(14.3%), and minimal thigh pain in 2(14.3%). Radiographic evidence of a bone ingrown stem was found in 11 hips (78.6%), and 3 hips (21.4%) showed stable fibrous fixation. Stem subsidence > 5mm was noticed in 1 hip (7.1%) and > 10mm in 2 (14.3%) but there was no further progression after 1 year. Moderate stress-shielding was noticed in 4 hips(28.6%). To date, no significant wear or osteolysis has been observed. Conclusion: An extensively porous-coated revision stem appears to be a reasonable choice in the presence of proximal femoral bone loss as a short term follow up. However, the concerns related to the postoperative complications will require a longer term follow up.
Arthroplasty, Replacement, Hip* ; Dislocations ; Female ; Femur ; Follow-Up Studies ; Hip ; Humans ; Male ; Osteolysis ; Osteoporosis ; Periprosthetic Fractures ; Postoperative Complications ; Retrospective Studies ; Thigh

Splenic metastasis from solid cancer is a rare clinical event. Especially splenic metastasis from the lung is very rare. Most spleen metastases are found at autopsy and are part of a widely spread disease. Solitary splenic metastasis in the abscence of other metastases is extremely rare. The authors report the case of a 54-year-old man in whom the only discover distant metastasis from lung cancer was a splenic mass. The splenic lesion was detected after the resection of the primary lung lesion. The time from diagnosis to the development of splenic metastasis was 25 months. The rarity of a solitary spleen metastasis from lung cancer and the treatment modalities are discussed. When solitary spleen metastasis is suspected in a clinical setting, aggressive treatment is indicated, a splenectomy followed by combined modality treatment to prevent the spread and aggravation of the disease.
Autopsy ; Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Middle Aged ; Neoplasm Metastasis* ; Spleen ; Splenectomy

No abstract available.
Radiosurgery* ; Trigeminal Neuralgia*

Myelin is a specialized structure of the nervous system that both enhances electrical conductance and insulates neurons from external risk factors. In the central nervous system, polarized oligodendrocytes form myelin by wrapping processes in a spiral pattern around neuronal axons through myelin-related gene regulation. Since these events occur at a distance from the cell body, post-transcriptional control of gene expression has strategic advantage to fine-tune the overall regulation of protein contents in situ. Therefore, many research interests have been focused to identify RNA binding proteins and their regulatory mechanism in myelinating compartments. Fragile X mental retardation protein (FMRP) is one such RNA binding protein, regulating its target expression by translational control. Although the majority of works on FMRP have been performed in neurons, it is also found in the developing or mature glial cells including oligodendrocytes, where its function is not well understood. Here, we will review evidences suggesting abnormal translational regulation of myelin proteins with accompanying white matter problem and neurological deficits in fragile X syndrome, which can have wider mechanistic and pathological implication in many other neurological and psychiatric disorders.
Axons ; Cell Body ; Central Nervous System ; Fragile X Mental Retardation Protein* ; Fragile X Syndrome ; Gene Expression ; Myelin Proteins* ; Myelin Sheath* ; Nervous System ; Neuroglia ; Neurons ; Oligodendroglia ; Risk Factors ; RNA-Binding Proteins ; White Matter

BACKGROUND: To observe the clinical features and the outcomes from diagnostic work-up in definite multiple sclero-sis (MS) which was diagnosed by using a Poser's criteria. METHODS: We retrospectively evaluated 43 cases who were diagnosed as multiple sclerosis in Seoul National University Hospital by using Poser's criteria from January 1st, 1991 to December 30th , 1995. Among the 43 cases, 35 patients were classified to definite MS group, clinically or laboratory supported. We analyzed age, sex, initial symptom, age of onset, duration between initial symptom and definite MS diagnosis, total numbers of recurrence and symptoms, CSF profile, evoked potential study, follow-up duration and the MRI findings of the definite MS patients. RESULTS: Of 35 cases who were diagnosed as definite MS, 15 patients were male and 20 patients were female. The mean age of onset was 34.6 years, the mean duration between initial symptom onset and diagnosis of definite MS was 16.9 months, and the mean follow-up duration was 34.8 months. The most common site of initial involvement was spinal cord (24 cases), and then optic nerve (5 cases), brain stem (4 cases), and cerebrum (2 cases) were followed. Thoracic spinal cord (24 lesions) was more frequently involved than cervical cord (18 lesions). Moreover 32 cases (91.4%) had at least one time of spinal cord involvement and there is a tendency that the proportion of double spinal cord lesion is increasing with the number of spinal cord recurrence. CONCLUSIONS: Spinal cord involvement in multiple sclerosis is the most common symptom and double spinal cord involvement in MRI is frequently observed. We think that it would be the characteristics of the multiple sclerosis in Korea.
Age of Onset ; Brain Stem ; Cerebrum ; Diagnosis ; Evoked Potentials ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis* ; Optic Nerve ; Recurrence ; Retrospective Studies ; Seoul ; Spinal Cord

BACKGROUND: To observe the clinical features and the outcomes from diagnostic work-up in definite multiple sclero-sis (MS) which was diagnosed by using a Poser's criteria. METHODS: We retrospectively evaluated 43 cases who were diagnosed as multiple sclerosis in Seoul National University Hospital by using Poser's criteria from January 1st, 1991 to December 30th , 1995. Among the 43 cases, 35 patients were classified to definite MS group, clinically or laboratory supported. We analyzed age, sex, initial symptom, age of onset, duration between initial symptom and definite MS diagnosis, total numbers of recurrence and symptoms, CSF profile, evoked potential study, follow-up duration and the MRI findings of the definite MS patients. RESULTS: Of 35 cases who were diagnosed as definite MS, 15 patients were male and 20 patients were female. The mean age of onset was 34.6 years, the mean duration between initial symptom onset and diagnosis of definite MS was 16.9 months, and the mean follow-up duration was 34.8 months. The most common site of initial involvement was spinal cord (24 cases), and then optic nerve (5 cases), brain stem (4 cases), and cerebrum (2 cases) were followed. Thoracic spinal cord (24 lesions) was more frequently involved than cervical cord (18 lesions). Moreover 32 cases (91.4%) had at least one time of spinal cord involvement and there is a tendency that the proportion of double spinal cord lesion is increasing with the number of spinal cord recurrence. CONCLUSIONS: Spinal cord involvement in multiple sclerosis is the most common symptom and double spinal cord involvement in MRI is frequently observed. We think that it would be the characteristics of the multiple sclerosis in Korea.
Age of Onset ; Brain Stem ; Cerebrum ; Diagnosis ; Evoked Potentials ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis* ; Optic Nerve ; Recurrence ; Retrospective Studies ; Seoul ; Spinal Cord