Loss of radial nerve function in the hand results in a significant disability and so cannot extend the wrist, thumb & fingers according to the injury levels. Therefore the patient has great difficulty in grasping objects, especially power grip. Tendon transfers to restore function of extension of wrist and fingers are among the the best − most predictable transfers in the upper extremity. We performed 13 cases of tendon transfers for radial nerve palsy and extensive extensor ruptures from 1987 to 1993. The results were evaluated according to Arbitrary Value Method. Among 13 cases 30% of excellent, 46% of good, 24% of fair and no poor result were obtained and the better results were obtatined in low radial nerve lesion.
Fingers ; Hand ; Hand Strength ; Humans ; Methods ; Paralysis ; Radial Nerve ; Radial Neuropathy ; Rupture ; Tendon Transfer ; Tendons ; Thumb ; Upper Extremity ; Wrist

The parathyroid cyst is a relatively uncommon disease and usually identified during the operation for a presumed thyroid mass. Thirteen cases of parathyroid cyst (2 males, 11 females) treated from 1981 to 1993 were reviewed. Ages ranged from 17 to 59 years(mean, 41 years). Gross measurement of the tumor size varied from 1.0 to 10.0 cm in diameter with a mean of 4.8cm. All of the 13 patients presented with a chief complaint of painless anterior cervical mass. Only one complained of mild symptom of dyspnea and voice change due to huge cyst in paratracheal space. No functional cyst was identified. Diagnostic studies included ^99mTc thyroid scan (n=11), ultrasonography (n=10), computerized tomography (n=4) and fine needle aspiration(FNA) (preoperative, n=4; intraoperative, n=3). All diagnostic precedures but needle aspiration were nonspecific. Cysts were found in right inferior parathyroid(n=4), left inferior parathyroid (n=7), or anterior superior mediastinum (n=2). The FNA of the cyst contents revealed watery clear fluid with elevated parathyroid hormone level and was diagnostic in each cases. Four patients were treated initially with needle aspiration, of which only one patient was successful, and 3 patients who were unsuccessful to needle aspiration and the remaining 9 were effectively treated with surgical extirpation. Our experience suggested that needle aspiration may be of significant help in diagnosis and treatment of parathyroid cyst, but most of the patient could be treated successfully by surgical extirpation with an excellent chance for curability.
Biopsy, Fine-Needle ; Diagnosis ; Dyspnea ; Humans ; Male ; Mediastinum ; Needles ; Parathyroid Hormone ; Thyroid Gland ; Ultrasonography ; Voice

Using a rat model, this study examined the cerebral protective effect of moderate hypothermia and evaluated the effect on early local metabolic change of permanent focal cerebral ischemia. The middle cerebral artery(MCA) of the rat was approached subtemporally and was occluded, and its surface was cooled. Cerebral infarct size was measured at 1, 4 and 7 days after MCA occlusion in non-treated(n=27), 2-hour hypothermia(n=27) and 3-hour hypothermia(n=27) group, respectively, and regional cerebral glucose uptake(rCGU) was determined at 1 and 4 hour after MCA occlusion in the non-treated(n=8) and 3-hour hypothermia(n=8) group, respectively. Infarct size measured at 1, 4 and 7 days after MCA occlusion was 22.2%+/-4.4%, 14.3%+/-6.6%, 13.7%+/-5.3% in the non-treated group, 19.6%+/-10.0%, 12.5%+/-6.2%, 12.0%+/-6.9% in the 2-hour hypothermia group and 12.9%+/-5.6%, 8.3%+/-3.3%, 8.2%+/-2.3% in the 3-hour hypothermia group. In the 2-hour hypothermia group, no significant size reduction was seen, but in the 3-hour hypothermia group, infarct size had decreased to half of that of the non-treated group(p<0.05). This protective effect was observed untill 1 week after MCA occlusion. rCGU in the non-treated group measured at 1 hour after MCA occlusion had increased in the periphery of the ischemic core, but at 4 hours, periischemic hypermetabolism had disappeared and the area of low metabolism in the center had become larger. rCGU in the 3-hour hypothermia group measured at 1 hour after MCA occlusion(BT 26degreesC) showed a uniform decrease in all regions, supressing temporary periischemic hypermetabolism, and at 4 hours(BT 37degreesC) after occlusion, hypermetabolism was not prominent and the area of low metabolism in the center had narrowed. This study indicates that 3 hour moderate hypothermia immediately after MCA occlusion significantly reduces infarct size, and that this protective effect was associated with suppression of periischemic hypermetabolism occurring around 1 hour after MCA occlusion.
Animals ; Brain Ischemia* ; Glucose* ; Hypothermia* ; Metabolism ; Models, Animal ; Rats*

The purpose of this study was to examine the frequency of eutaneous disorders in patients with chronie renal failure presently on hemodialysis(HD). The results were as follows. 1. Cutaneous lesions were present in all 78(100% ) patients with chronic renal failure. 2. The frequency of msjor cutaneous problems associated with chronic renal failure was as follows: xerosis(82.1%), pruritus(74.4%), nail changes(74.4%), hyperpigmentation(70.5 % ), xerostomia(42.3'Yo), poor wound healing(37.2%), easy bruisability(30,8%), hypotrichosis(21.896), and purpura(14.1 % ). 3. Cutaneous problems which appeared after the initiation of HD were. appearance of new pigmented nevi or lentigines(9 patients), appearance or aggravation of acne(6), contact dermatitis at AV fistula site(2), gynecomastia(1), extensive flat warts(1), extensive tinea versicolor(1), and extensive vitiligo(1). 4. Among 55 patients with hyperpigmentation, 11 patients reported decreased pigmentation following HD. In 15 patients, hyperpigmentation worsened following HD, and in 9 patients hyperpigmentation first appeared after HD was initiated. 5. Cutaneous disorders favorably affected by HD were as follows: easy bruisability(3/ 24), xerostomia(3/33), gingival friability(2/7), and hypotrichosis(5/17). 6. Poor wound healing and xerosis were not improved by HD. 7. Among 58 pruritic patients, 7 patients were improved after HD, 7 patients became worse during each HD, and 3 patients were not pruritic only for 2 to 3 days after each HD. Four patients experinced pruritus only during each HD. 8. There was no significant statistical difference between the frequency of pruritus and xerosis and the levels of blood urea nitrogen, calcium, phosphorus, and parathyroid hormone.
Blood Urea Nitrogen ; Calcium ; Dermatitis, Contact ; Fistula ; Humans ; Hyperpigmentation ; Kidney Failure, Chronic* ; Nevus, Pigmented ; Parathyroid Hormone ; Phosphorus ; Pigmentation ; Pruritus ; Renal Dialysis* ; Renal Insufficiency ; Tinea ; Wound Healing ; Wounds and Injuries

No abstract available.
Child* ; Humans ; Killer Cells, Natural* ; Nephrosis, Lipoid*

For assessment of the feasibility of histopathological diagnosis on the basis of CT findings in suratentorial gliomas, 60 consecutive histologically proven cases were analysed. Benign astrocytomas(Kernohan's grade I, I-II, II) were 25, Oligodendrogliomas 6, malignant gliomas(Kernohan's grade III, III-IV, GM) 29 in number. Plain CT findings and degree of peritumoral edema were less significant than the patterns of contrast enhancement in predicting the histological malignancy. Calcification, if present, excluded the diagnosis of malignant gliomas. Combining the CT criteria of pattern of contrast enhancement, degree of peritumoral edema with angiographic signs of malignancy in addition to the clinical feature, a more confident histological diagnosis seemed allowable.
Diagnosis* ; Edema ; Glioma* ; Oligodendroglioma

The authors report our experiences with the use of Nd-YAG laser in extripation of selected intracranial tumors:5 Meningiomas, 1 Acoustic neurinoma, 1 Hemangioendothelioma and 1 Oligodendroglioma. The Nd-YAG laser is very helpful to coagulate the pathologic vessels. And because of it's excellent coagulation the Nd-YAG laser is particularly useful when applied in highly vascular tumor as well as in high contents of mesenchymal structures within the tumors.
Hemangioendothelioma ; Lasers, Solid-State* ; Meningioma ; Neuroma, Acoustic ; Neurosurgery* ; Oligodendroglioma

Recently the cause of hemifacial spasm and trigeminel neuralgia is known to be vascular compression-distortion in the root exit and entry zone of each nerve. The microvascular decompression of the 5th and 7th cranial nerves is a method of refined and non-traumatic surgical treatment of these disabling diseases. 33 patients with intractable hemifacial spasm and 7 patients with trigeminal neuralgia were treated by microvascular decompression and the follow-up results were evaluated. The surgical results in 33 cases of hemifacial spasm were as follow: Excellent-18, Good-7, Fair-6, Poor-2. Disturbance of hearing as a complication appeared in 6 cases, but improved gradually except one case. The surgical finding and results in 7 cases of trigeminal neuralgia were as follow: In 6 cases the causative vessel was SCA and in one case SCV indented the nerve root. All 7 patients with trigeminal neuralgia were relieved from facial pain after surgery.
Cranial Nerves ; Facial Nerve* ; Facial Pain ; Follow-Up Studies ; Hearing ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery* ; Neuralgia ; Trigeminal Neuralgia

Heat Shock Protein (HSP) is a genetic product reacting on stress. HSP is increased by physiological or environmental stress and expressed at gastrointestinal tumors such as stomach cancer, pancreatic cancer and large intestinal cancer, and at other various tumors such as lymphoma and breast cancer. The role of HSP is to interrupt the process of apoptosis interfering with formation of tumors, and weaken function of tumor control beyond that of immune surveillance. In case of causing the normal p53 to be mutated, it leads to morphological change of p53 protein and combine with HSP. But, it has not been clarified yet. We intend to examine the meaning of HSP 70 in bladder tumor by investigating the relations among HSP expression and tumor stage, tumor grade, P-gp (glycoprotein) expression as a product of multi-drug resistant gene, and p53 expression in 59 cases of bladder tumor. 1) There were HSP expressions of 8 cases (22%) among 36 superficial bladder tumors and of 9 cases (39%) among 23 invasive bladder tumors. 2) HSP positive reactions were observed in 1 case (8%) of 13 Grade I, and 6 cases (29%) of 21 Grade II and 10 cases (40%) of 25 Grade III. 3) Positive reactions of HSP were showed in 10 cases (40%) among 25 P-gp expression, and in 7 cases (21%) among 34 P-gp non-expression. 4) The p53 proteins were expressed in 12 cases (29%) among 42 ones of HSP non-expression and in 8 cases (47%) among 17 ones of HSP expression. 5) Positive reactions of HSP were showed in 9 cases (23%) among 39 ones of p53 non-expression, and in 8 cases (40%) among 20 ones of p53 expression. 6) 5 patients of 6 with negative expression of HSP and strong positive expression of p53 had poorly differentiated transitional cells, in which one of the patients accompanied with lung metastasis. In view of above study, HSP expression has no correlation with P-gp and stage in bladder tumor, but it has probable pertaining to tumor grade and p53. As it were, tumor cellular differentiation and p53 expression have weak correlations with HSP 70 expression. Meanwhile, judging from poor differentiation, in most cases of HSP non-expressed but p53 strongly expressed, HSP is insufficient to be a prognostic factor of bladder tumor independently, however, in case of using it, as supplementary one, concurrently with p53, it would be valuable prognostic factor in bladder tumor.
Apoptosis ; Breast Neoplasms ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Humans ; Intestinal Neoplasms ; Lung ; Lymphoma ; Neoplasm Metastasis ; P-Glycoprotein ; Pancreatic Neoplasms ; Stomach Neoplasms ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Pituitary apoplexy is defined as a complex series of clinical events occurring as a consequence of the fulminant expansion of the pituitary tumor by infarction, hemorrhage, or hemorrhagic infarction of the tumor and the adjacent pituitary tissue. It is one of the entities which need neurosurgical emergency care. Its incidence was, however, reported variously in many literatures due to different diagnostic criteria. We reviewed 150 histologically proven pituitary adenoma cases, operated from January 1980 to September 1986, to select 30 cases which showed clinical or operative findings compatible with pitultary apoplexy('pituitary apoplexy in a broad sense'). Authors analyzed their incidence, presidposing factor, clinical feature, diagnosis and treatment, especially in those who showed major attack with evident enurologic deficits('pituitary apoplexy in a strict sense'). The conclusions are as follows; 1) Among the 150 cases of pituitary tumor, 30 cases (20.0%) were diagnosed as pituitary apoplexy in a broad sense. Eleven cases (7.3%) out of them showed major attack. 2) The symptoms and signs of the 11 cases with major attack were sudden headache(11 cases), visual impairment (9 cases), cavernous sinus compression signs (7 cases), nausea and vomiting (6 cases), depressed consciouness (4 cases), and meningismus (3 cases). 3) In the clinical diagnosis of pituitary apoplexy, findings of plain skull radiologic view were very helpful. 4) With the medical treatment and surgery, good results were achieved in all cases except one patient showing visual impairment. 5) As the method of surgical treatment, the transsphenoidal approach is highly recommended.
Cavernous Sinus ; Diagnosis* ; Emergency Medical Services ; Hemorrhage ; Humans ; Incidence ; Infarction ; Meningism ; Nausea ; Pituitary Apoplexy* ; Pituitary Neoplasms ; Skull ; Stroke ; Vision Disorders ; Vomiting