No abstract available.
Neck* ; Umbilical Cord*

PURPOSE: This study aimed to determine whether deep vein thrombosis (DVT) predominantly occurred on a particular side in the pelvic and lower extremity veins. MATERIALS AND METHODS: Among 259 consecutive patients with leg swelling, 65 were confirmed to have DVT in the pelvis and lower extremities, and enrolled in this study. The serum levels of initial D-dimer, antithrombin III, tissue plasminogen activator, factor VIII, proteins C and S, anticardiolipin antibodies immunoglobulin (Ig) G and IgM and lupus anticoagulant were measured and analyzed retrospectively. Lower extremity venous system was divided into 11 anatomic segments on each side, and thrombotic involvement in each segment was recorded to determine the laterality of thrombotic involvement for each patient. The presence of thrombus in a specific vein was assigned using a Thrombus Scoring System (TSS) score of 1. Predominant direction was determined based on the TpSS score for each side. RESULTS: Left-side predominat DVT (57%) was most frequent. Patients with both-side equivalent DVT had the highest total TSS score (P=0.022). The predominant side was significantly different between men (right 44.1%) and women (left 74.2%) (P=0.022). Patients with both-side equivalent DVT had the highest mean age (69.3+/-9.9 years) as well as the highest mean levels of initial D-dimer (13.8+/-20.7 microg/mL) and anticardiolipin antibody IgM (13.4+/-22.8 MPL) indicating increased coagulability. CONCLUSION: In the current study, left-side predominant DVT is most frequent in pelvis and lower extremities, and this phenomenon is more apparent in women. And both-side equivalent DVT is associated with the most advanced age and hypercoagulability.
Antibodies, Anticardiolipin ; Antithrombin III ; Factor VIII ; Female ; Humans ; Immunoglobulin M ; Immunoglobulins ; Leg ; Lower Extremity* ; Lupus Coagulation Inhibitor ; Male ; Pelvis ; Retrospective Studies ; Thrombophilia ; Thrombosis ; Tissue Plasminogen Activator ; Veins* ; Venous Thrombosis*

Percutaneous method of Al pulley release for the trigger fingers using hypodermic needle or small sharp scalpel has been described by some authors. In our experience, however, these methods had some difficulties in handling the instruments and not easy to utilize proper technique. Therefore we designed a special scalpel for easy and safe percutaneous release of the Al pulley. The scalpel has a hook shaped end with a blade on the inner side. Insertion site through the skin should be 0.5cm distal to the Al pulley, and the hooked end is located at the proximal margin of the Al pulley followed by longitudinal cut of the pulley distally. We performed this procedure in 44 trigger fingers of 41 patients in our out-patient clinic. There were 9 males and 32 females with a mean age of 54.4 years (range, 24 to 83 years). Affected digits were 23 thumbs, 1 index, 13 middle, 5 ring and 2 little fingers. 9 of them were locked in flexion or extension. The duration of symptom was an average of 7.9 months. After a mean follow up of 11.3 months, 42 fingers (95.4%) were completely free of symptoms including triggering. One had mild residual triggering due to incomplete release of the pulley and another had re-release of the pulley for remaining flexion limitation. One finger showed mild bowstringing after release, which subsided in 3 months. One patient complained of persistent pain and tenderness over the release site. There were no injuries of nerves or vessels and no infections. The duration of discomfort after release ranged from 3 to 70 days (av. 18.5 days). All patients, except one, were satisfied with the treatment method and their results. We think that percutaneous release of trigger fingers using our special scalpel is a very effective and convenient procedure both to surgeons and patients. It can be easily and safely performed in out-patient clinic with successful results.
Female ; Fingers* ; Follow-Up Studies ; Humans ; Male ; Needles ; Outpatients ; Skin ; Thumb

The midcarpal joint has inherent instability in the sagittal plane. Several instability patterns of midcarpal joint due to ligament insufficiency have been presented. We ohserved the normal midcarpal and radiocarpal behaviors of ligament laxity in the sagittal plane to investigate the significance of dorsal and palmar stress test which has been used for evaluation of the non-dissociative carpal instahilities. We performed the dorsal and palmar displacement stress test on fifty pairs of normal wrist joints under the flouroscopic views. The midcarpal joints were subluxed, more on dorsal stress, with variable degrees. Dorsal subluxations in females and third decades were more prominent than males and fourth decades. Three types of radiocarpal instability on dorsal stress test could be observed. We think that displacement stress test in the sagittal plane should be interpreted in consideration of normal instability patterns in the evaluation of ahnormal midcarpal and radiocarpal instabilities since there are variable patterns and degrees of ligament laxity in normal wrist joints.
Exercise Test ; Female ; Humans ; Joints* ; Ligaments ; Male ; Wrist Joint

No abstract available.
Humans ; Twins* ; Umbilical Cord*

We studied the natural history of asymptomatic early avascular necrosis of the femoral head in forty-three patients(forty-three hips) who had been treated with arthroplasty due to progressed avascular necrosis of femoral head but had no symptoms in the other side. All initial lesions were classified with Ficat staging and International classification(ARCO). The duration until symptom onset and radiologic evidence of disease progression were evaluated. The average follow up period was over 37 months. Among forty-three hips, twenty-nine cases(67.4%) remained asymptomatic until last follow up but fourteen cases(32.6%) were symptomatic during the follow up, and twenty-six cases(60.5%) did not progress on the radiography but seventeen cases(39.5%) progressed to Ficat stage 3 or 4. Fifteen cases of IA, IIA, IB-cental and II B-central without lateral lesion did not occur symptom and didnt progress to Ficat stage 3 or 4 over a period of average 47 months(24-71 months). But fourteen cases of IB, IC, g B and II C progressed to Ficat stage 3 or 4 and they were all lateral lesion. These results suggest careful observation only can be done in the case of small involvement(less than 15%) and medial or central lesion relatively over a long period of time but for the large involvement(more than 30%) and especially lateral lesion, aggressive surgical treatment may be considered even though the early stage of disease for the prevention of progression. However it will need more period of time to accurately compare the results of various methods of treatment.
Arthroplasty ; Disease Progression ; Follow-Up Studies ; Head* ; Hip ; Natural History* ; Necrosis* ; Radiography

No abstract available.
Duodenal Ulcer* ; Vagotomy, Truncal*

Urachal carcinoma is an uncommon neoplasm associated with a poor prognosis. We have encountered two another cases of urachal adenocarcinoma recently 5 years after our first report. The common sign of urachal cancer was painless hematuria. We diagnosed the specific site of origin preoperatively by means of computerized tomography. One patient was performed partial cystectomy and another was total cystectomy with double barrel ureterocutaneostomy. A brief review of the literature of urachal adenocarcinoma was also made.
Adenocarcinoma* ; Cystectomy ; Hematuria ; Humans ; Prognosis

No abstract available.
Actinomycosis*

No abstract available.