Hand tumorsare many and varied, although benign tumors are common. The pathology and histology of these tumors are not unlike these characteristics of the tumor when it occurs elsewhere. Early diagnosis and proper treatment of all hand tumors have been emphasized since the growth of tumors and pain can cause disturbance of intrinsic function of the hand. For the period of 10 years from 1977 to 1986, 105 cases of hand tumor were treated surgically and the results of clinical observation were as follows ; l. Among 105 cases, benign tumor was 101 cases(96.2%) Bone origin tumor was 20 cases, in which enchondroma and enchondromatosis were 17 cases(70%). Soft tissue origin tumor was 85 cases, in which ganglion was 54 cases(63.5%). 2. Among 105 cases, 42 cases were male and 63 cases were female. In age distribution, it showed even distribution. 3. In the duration of wymptom, 51 cases were below 1 year(48.6%). 4. The tumor occured 85 cases in soft tissue, 14 in phalanx, 7 in metacarpal and 1 in carpal bone. 5. The tumors were treated by excision or curettage and bone graft with good improvement, but postoperatively recurred in 2 cases of Hemangioma. Ampuation was performed in 3 cases of malignant tumors without recurrence.
Age Distribution ; Carpal Bones ; Chondroma ; Clinical Study ; Curettage ; Early Diagnosis ; Enchondromatosis ; Female ; Ganglion Cysts ; Hand ; Hemangioma ; Humans ; Male ; Pathology ; Recurrence ; Transplants

Pulse oximetry is a noninvasive technique for measuring O2 saturation (SpO2) continuously. We applied pulse oximetry to 9 pediatric patients with tetralogy of Fallot during shunt surgery. Arterial oxygen tensions (PaO2) and saturations (SaO2) were also measured at the time of postinduction, just before the shunt, after the shunt and at the end of the operation. The SpO2 and SaO2 levels were identically changed in all 4 periods. The PaO2 was increased a little without statistical significance after the shunt procedure and at the end of the operation compared with the values before the shunt. However, SaO2 values increased with statistical significance after the shunt procedure and SpO2 values also showed similar increases with significance. In conclusion, continuous monitoring of SpO2 by pulse oximetry, instead of PaO2, is a very useful and reliable method to assess the improvement of perfusion after shunt, particularly in cyanotic cases.
Child, Preschool ; Human ; Infant ; Intraoperative Period ; *Oximetry ; Oxygen/blood ; Tetralogy of Fallot/blood/*surgery

It is believed that catecholamine secretion is increased during cardiopulmonary bypass. However, the periods of maximum increase in catecholamine levels during cardiopulmonary bypass are different among several authors. 15 patients having valvular surgery were studied. Plasma epinephrine and norepine- phrine were determined by high performance liquid chromatography at 8 stages of the operation. During bypass plasma catecholamine levels continued to rise and maximally increased until aortic cross clamp off, and decreased gradually. Norepinephrine also showed the same results initially, but then increased gradually after the end of bypass. During bypass the maximum increases in epinephrine and norepinephrine were sixfold and twofold respectively in comparison with the levels prior to induction, which suggests that the predominant humoral response to cardiopulmonary bypass appears to be adrenomedullary release of epinephrine. The catecholamine levels at the period of aortic cross clamp off was higher than that of the lowest body temperature. There was no correlation between the increases in catecholamines and mean arterial pressure. Temperautures and eatecholamines also showed no correlations.
Arterial Pressure ; Body Temperature ; Cardiopulmonary Bypass* ; Catecholamines ; Chromatography, Liquid ; Epinephrine* ; Humans ; Norepinephrine* ; Plasma

A 26-year-old man with renal cell carcinoma underwent (99m)Tc-HDP bone scintigraphy for detecting bony metastasis after left total nephrectomy for renal cell carcinoma. (99m)Tc-HDP bone scintigraphy showed small hot lesion in the first lumbar spine. About 12 months later, he underwent spinal MRI for lower back pain. A large mass was seen around spinous process of the first lumbar spine (L1) on spinal MRI and confirmed as metastatic renal cell carcinoma by bone biopsy. (99m)Tc-HDP bone scintigraphy and (18)F-FDG PET/CT were underwent for further evaluation. (99m)Tc-HDP bone scintigraphy showed cold lesion in the first lumbar spine which was initially hot and newly developed hot lesion in the twelfth thoracic spine, and which were shown as hypermetabolic lesions in (18)F-FDG PET/CT. We report a case of bony metastasis from renal cell carcinoma which is changed from hot lesion to cold lesion in (99m)Tc-HDP bone scintigraphy and compare with (18)F-FDG PET/CT.
Adult ; Biopsy ; Carcinoma, Renal Cell ; Cold Temperature ; Humans ; Low Back Pain ; Neoplasm Metastasis ; Nephrectomy ; Spine

A 59-year-old woman who was diagnosed with malignant pheochromocytoma underwent (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT). She had undergone left adrenalectomy for pheochromocytoma 4 years previously. Recent multiple metastatic pulmonary nodules were noted on the chest X-ray. After treatment with (131)I-metaiodobenzylguanidine ((131)I-MIBG) with 7.4 GBq, post-therapy (131)I-MIBG scintigraphy depicted multiple distant metastases including lung, liver, abdominal para-aortic and mesenteric lymph nodes. (18)F-FDG PET/CT also depicted multiple metastases in lung, liver, and abdominal para-aortic lymph nodes, but some lesions were not shown. In this case, (131)I-MIBG scintigraphy found additional lesions in metastatic malignant pheochromocytoma.
Adrenalectomy ; Electrons ; Female ; Humans ; Liver ; Lung ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Pheochromocytoma ; Thorax

PURPOSE: The aim of this study was to investigate the usefulness of (18)F-FDG PET/CT with neck ultrasonography (neck US) in patients with recurrent, papillary thyroid cancer. MATERIAL AND METHODS: This retrospective study (December 2006 to April 2008) enrolled sixty-one patients (ninety-one lesions) who underwent high-dose (131)I-ablation therapy after total thyroidectomy, and evaluated recurred papillary thyroid cancer. All lesions were confirmed by histopathology and compared histopathologic findings to PET, PET/CT, and neck US findings. RESULTS: In sixty-one patients (57 women, 4 men; age range, 24-81 years, mean 49 years; 61 papillary carcinomas), the sensitivity, specificity, accuracy of (18)F-FDG PET/CT was 87.2%, 64.0%, 78.1% on a patient basis and 92.3%, 66.7%, 80.9% on a lesion basis, respectively. The sensitivity, specificity, accuracy of (18)F-FDG PET was 71.8% (p=0.03), 59.0% (p=1.00), 67.2% (p=0.03) on a patient basis and 78.8% (p<0.01), 64.1% (p=1.00), 72.5% (p=0.02) on a lesion basis, respectively. The sensitivity, specificity, accuracy of neck US was 71.1% (p=0.07), 52.2% (p=0.75), 63.9% (p=0.05) on a patient basis and 71.2% (p<0.01), 61.5% (p=1.00), 67.0% (p=0.06) on a lesion basis, respectively. Combined (18)F-FDG PET/CT with neck US improved the sensitivity, specificity, accuracy to 94.7% (p=0.50), 82.6% (p=0.13), 90.2% (p=0.03) on a patient basis and 96.2% (p=0.50), 89.7% (p<0.01), 93.4% (p<0.01) on a lesion basis, respectively. CONCLUSION: (18)F-FDG PET/CT demonstrated significantly higher sensitivity than neck US for the detection of recurred papillary thyroid cancer lesions. Furthermore, combined (18)F-FDG PET/CT with neck US showed more improved sensitivity, specificity, accuracy for diagnosis of recurrent papillary thyroid cancer.
Female ; Humans ; Neck ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: To evaluate the clinical efficacy of the limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus. MATERIALS AND METHODS: From March 2000 to February 2006, we studied retrospectively 186 patients, 203 cases who were treated with open reduction and internal fixation through limited posterior approach and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. RESULTS: By Creighton-Nebraska score, Sanders type 2 was 86.4, type 3 was 74.3, type 4 was 62.4. And by circle draw test, type 2 was 8.9 cm, type 3 was 7.2 cm, type 4 was 5.9 cm. Bohler angle and Gissane angle were 7.6 degrees, 102.4 degrees, and it increased to 23.5 degrees, 128.6 degrees after postoperative 1 year. CONCLUSION: Limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus was considered to an effective treatment modality.
Calcaneus* ; Humans ; Intra-Articular Fractures* ; Retrospective Studies

Catheterization of the innominate vein or superior vena cava vein via the external and internal jugular veins was attempted in 68 pediatric patients weighing less than 20 kg in body weight who were scheduled for cardiovascular and pulmonary surgery. Both jugular veins were utilized in 63 cases, of these, and post operative X-ray confirmed a 19% malposition rate. Catheterization was performed in 45 cases throuhg the left external jugular veins and in 18 cases through the right external jugular vein,and the malposition rates were 25% and 6% respectively. The right internal jugular vein, utilized in 5 cases and, all provided successful results. Difficulty was encountered in passing of the catheter in 32% of the cases using both external jugular veins. Catheter curling was noted in 1 cases. No complications were encountered during and after catheterization.
Body Weight ; Brachiocephalic Veins ; Catheterization ; Catheters ; Central Venous Catheters* ; Central Venous Pressure ; Child* ; Humans ; Jugular Veins* ; Veins ; Vena Cava, Superior

The possibility of a central origin should be considered for late-onset concomitant esotropia. Concomitant esotropia has been reported to occur with spinocerebellar ataxia types 1, 2, and 3, but not with other degenerative cerebellar ataxia disorders. We report on a 28-year-old woman with ataxia in whom a detailed ophthalmologic examination revealed concomitant esotropia. She was subsequently diagnosed with dentatorubropallidoluysian atrophy (DRPLA). We suggest that the presence of concomitant esotropia could be used to differentiate DRPLA from other hereditary ataxias.
Adult ; Ataxia ; Atrophy ; Cerebellar Ataxia ; Esotropia ; Female ; Humans ; Spinocerebellar Ataxias ; Spinocerebellar Degenerations

OBJECTIVES: Patients with chronic renal failure have increased hemorrhagic tendency due to an uremic platelet dysfunction and complications from anticoagulants used in hemodialysis. They are also prone to have thrombotic complications in the cerebral vessels, coronary arteries and A-V fistula, due to hypercoagulability from changes in various factors. Recently, deficiencies in plasma protein C and S, which are physiological anticoagulants, have been reported to cause thrombosis. In chronic renal failure, plasma protein C and S activities are known to be decreased. METHODS: In the present study, activities and antigen concentrations of plasma protein C and S, as well as AT-III activities were investigated in three groups; the normal control group, the predialysis group of chronic renal failure patients treated conservatively, and the hemodialysis group. The findings were analyzed for their relationship to hypercoagulability. RESULTS: 1) The activities of plasma protein C, S and antithrombin-III were significantly lower in the predialysis chronic renal failure group as compared to the control. Antithrombin-III concentrations in the hemodialysis group assayed immediately prior to dialysis were significantly lower than those of the control group. But, protein C antigen concentrations in the hemodialysis group assayed immediately prior to dialysis were significantly higher than those of the control group. There was no significant difference between these groups in plasma protein C activities, and plasma protein S activities and antigen concentrations. 2) In the hemodialysis group, antithrombin-III activities, antigen concentration and activities of plasma protein C were significantly higher than after dialysis as compared to those before the dialysis. 3) There were no significant difference in plasma protein C, S and antithrombin-III activities and plasma protein C and S antigen concentrations in hemodialysis patients between with and without thrombosis at arterio-venous fistula site. However, plasma protein C and antithrombin-III activities were significantly lower in those with thrombosis as compared to those of the normal control group. There were no significant difference in plasma protein C and S activities and antigen concentrations in those without thrombosis as compared to those of the normal control group. 4) There were no significant diffrences in plasma protein C, protein S and antithrombin-III activities and antigen concentrations in dialysis patients with and without recombinant erythropoietin treatment. 5) There were no significant correlations between serum creatinine and creatinine clearance, and plasma antithrombin-III, protein C and protein S activities and antigen concentrations in predialysis group. CONCLUSION: These results suggest that the decrease in plasma antithrombin-III, protein C and S could be the factors causing hypercoagulability in chronic renal failure patients, and the decreased activities of these factors may return to normal by dialysis. In the hemodialysis group, there were no significant diffrences in plasma protein C and S and antithrombin-III activities and antigen concentrations between the group which showed clinical thrombosis and the group which did not. However, in those who had thrombosis, plasma protein C and antithrombin-III activities are significantly lower than the control group. Administration of recombinant human erythropoietin does not appear to affect the activities of plasma protein C and S and antithrombin-III. In predialysis chronic renal failure patients, there was no significant relationship between renal function and plasma protein C and S and antithrombin-III.
Anticoagulants ; Arteries ; Blood Platelets ; Coronary Vessels ; Creatinine ; Dialysis ; Erythropoietin ; Fistula ; Humans ; Kidney Failure, Chronic* ; Plasma ; Protein C* ; Protein S ; Renal Dialysis ; Thrombophilia ; Thrombosis