The finger flexor injuries are very difficult to treat satisfactorily. It is usually said that the earlier the treatment performed, the better result obtained. But the delicasy of the hand anatomy and its function as well as the absence of the hand surgeon in the first aid care make the problem more complex. Even if we made the primary treatment to the flexor tendon injuries, some disabilities are often remained. We have treated fifty eight cases of old flexor tendon injuries in forty eight patients, the results can be summarized as follows. 1. The cause of the tendon damage is due to the laceration injury in the majorities of the cases. T,he tendon injuries are especially common between the late second and the early third decade. 2. In the injury of the Zone II with pulley distortion, the pulley reconstruction using palmaris longus or fascia from other sites will prevent bowstring and help the tendon function. 3. The Zone II can be subdivided into two subspecific areas. The proximal area is from the distal palmar crease to the midoprtion of porximal phalanx and the distal one is from the midportion of the proximal phalanx to the insertion of the sublimis tendon. In the proximal area one can repair the injured tendon directly after removal of the A1 and about proximal half of the A2 pulley without any subsequent bowstring if the tendon and its tunnel is relatively well preserved. Thus one can convert this proximal portion of Zone II to Zone III. So the proximal area of the Zone II should be differentiated from the remaining distal part of the Zone II. 4. At six months after the operation the result of the operation was analyzed by the percentage of the recovery, which was calculated by the postoperative active range of the interphalangeal joints divided by one hundred seventy five degrees that means the available total range of motion of normal interphalangeal joints. Excluding the cases with the tenodesis or arthrodesis, the total result revealed good or excellent in about ninty percentages with this method. 5. There were two fingers that showed a postoperative lumbrical plus state in Zone II, which were recovered spontaneously within three to four months postoperatively. So it is considered that the relative shortening of the lumbrical muscles can be treated and overcome conservatively by the active use of the fingers, and there is no need to perform an lumbrical tenotomy to correct this kind of muscle imbalance.
Arthrodesis ; Fascia ; Fingers ; First Aid ; Hand ; Humans ; Joints ; Lacerations ; Methods ; Muscles ; Patella ; Patellar Ligament ; Range of Motion, Articular ; Tendon Injuries ; Tendons ; Tenodesis ; Tenotomy ; Tibia

Cutaneous plasmacytosis is a rare disorder characterized by disseminated, macular, red-brown skin eruptions, which commonly occur on the trunk. Histologically, polyclonal lymphoplasmacytic infiltrates are sometimes shown to be associated with variable extracutaneous manifestations. Cutaneous plasmacytosis should be differentiated from primary cutaneous plasmacytoma, because both diseases are clinicopathological similar. Most cases of cutaneous plasmacytosis have been reported in Japanese literature. However, this case deals with a Korean female patient who was diagnosed with cutaneous plasmacytosis and subsequently received systemic PUVA therapy.
Asian Continental Ancestry Group ; Female ; Humans ; Plasmacytoma ; PUVA Therapy ; Skin

PURPOSE: This study was aimed to review findings of gray-scale ultrasonography and to assess the diagnostic value of the resistive index (RI) in patients with acute epididymitis by comparing with that in normal volunteers. MATERIALS & METHODS: Gray-scale ultrasonogram was reviewed in nine patients with acute epididymitis for echogenicity, size and reactive hydrocele. Normal values of resistive index (RI) were obtained in 20 epididymides from 10 volunteers (aged 20-28, mean 23.7). Nine patients of epididymitis (aged 18-67, mean 37.2) were examinated with color Doppler sonography and RI was measured at 11 sites on epididymal arteries. For the prediction of acute epididymitis, accuracy, sensitivity and specificity were calculated at the cut-off value of RI in 0.65 and 0.70. RESULTS: Gray-scale ultrasonography showed echogenicity that was variable among the 9 cases (hype- rechoic 2 cases, isoechoic 2, hypoechoic 5), enlargement of epididymis in 8, and reactive hydrocele in 8 cases. Normal volunteers displayed color Doppler signals in 14 out of 20. The range of RI in normal volunteers were between 0.64 and 1.00 (mean, 0.79 +/- SD 0.10). In patients with acute epididymitis, color Doppler signals were detected in all patients. The range of RI in epididymitis were 0.40-0.68 (mean, 0.56 +/- SD 0.10). At cut-off RI value of 0.65, accuracy was 88%, sensitivity 81.8%, and specificity 92.7%. At cut-off value of 0.70, accuracy was 92%, sensitivity 100%, and specificity 85.7%. CONCLUSION: In addition to the findings of gray-scale ultrasonography, resistive index and color flow changes are valuable in diagnosing acute epididymitis.
Arteries ; Epididymis ; Epididymitis* ; Healthy Volunteers ; Humans ; Male ; Reference Values ; Sensitivity and Specificity ; Ultrasonography ; Volunteers

PURPOSE: The purpose of the study was done to identify the nursing care needs of patients in the recovery room. METHOD: The subjects in this study were 127 patients in a recovery room between 6/9/2001 and 24/9/2001. The instrument used for this study was the descriptive questionnaire developed by Shin Hyun-Jin (1999). The data was analysed by frequency, percentage, mean, standard deviation, t-test, ANOVA, and factor analysis using the SPSS program. RESULT: 1) Kaiser-Meyer-Olkin sample appropriateness was 0.799 and Bartlett's test of sphericity significant probability was 0.000. 2) The mean score for nursing care need of patients in the recovery room was 4.17+/-.51 of a total possible score of 5. The score of nursing need for different parameters was as follows: Educational need (4.31+/-.49), physical need (4.27+/-.47), emotional need (4.11+/-.52), environmental need (3.99+/-.56). 3) Differences in the needs for nursing care according to the demographics were significant for gender, marital status, operation experience, and departments consulted. General characteristic variables significantly related to nursing need were as follows: Physical need significantly related to the departments consulted (F=2.23, p=.036). Educational need significantly related to the marital status (F=2.55, P=.012), departments consulted (F=2.30, p=.031). Emotional need significantly related to the marital status (F=2.22, p=.028). Environmental need significantly related to the gender (t=-2.44, p=.016), marital status (F=2.01, p=.046), operation experience (t=-1.99, p=.048). CONCLUSION: Nursing care needs of patients in the recovery room are significantly related to educational need, physical need, emotional need and environmental need. Intervention plans and program need to be developed to improve strategies to meet nursing needs of patients in the recovery room.
Demography ; Humans ; Marital Status ; Nursing Care ; Nursing* ; Surveys and Questionnaires ; Recovery Room*

Dental Occlusion ; Humans ; Incisor ; Malocclusion ; Orthognathic Surgery ; Skull ; Skull Base

Uterine myomas are the most common benign tumor of the female genital organ. Uterine artery embolization is well reported of primary treatment of uterine myoma. A 29 year-old nulliparous woman was diagnosed as uterine myoma by ultrasonogram. We embolize both uterine artery after treatment with GnRH analog and then we experience a case of improvement of menorrhagia, with reduction in uterine myoma size. So we report that case with a brief review.
Adult ; Female ; Genitalia ; Gonadotropin-Releasing Hormone ; Humans ; Leiomyoma* ; Menorrhagia ; Ultrasonography ; Uterine Artery Embolization* ; Uterine Artery*

Uterine myomas are the most common benign tumor of the female genital organ. Uterine artery embolization is well reported of primary treatment of uterine myoma. A 29 year-old nulliparous woman was diagnosed as uterine myoma by ultrasonogram. We embolize both uterine artery after treatment with GnRH analog and then we experience a case of improvement of menorrhagia, with reduction in uterine myoma size. So we report that case with a brief review.
Adult ; Female ; Genitalia ; Gonadotropin-Releasing Hormone ; Humans ; Leiomyoma* ; Menorrhagia ; Ultrasonography ; Uterine Artery Embolization* ; Uterine Artery*

Renal cell carcinoma is associated with inferior vena cava tumor spread in 4~10% of cases and with extension of the tumor thrombus into the right atrium in less than 1% of cases. Because inferior vena caval involvement does not affect the ultimate survival in patients with nonmetastatic renal cell carcinoma, aggressive surgical resection is indicated. We experienced a case of complete tumor excision with radical nephrectomy and inferior vena caval and right atrial thrombectomy using adjunctive cardiopulmonary bypass(CPB) and deep hypothermic circulatory arrest(DHCA). During total circulatory arrest(TCA), we protected brain from ischemic insult using deep hypothermia, retrograde cerebral perfusion, thiopental, and high dose steroid. The patient recovered uneventfully except minor neuropsychiatric symptom for 3 weeks after operation.
Brain ; Carcinoma, Renal Cell* ; Circulatory Arrest, Deep Hypothermia Induced* ; Heart Atria* ; Humans ; Hypothermia ; Nephrectomy ; Perfusion ; Thiopental ; Thrombectomy ; Thrombosis ; Vena Cava, Inferior

No abstract available.
Lymphoma*

Vascular endothelial growth factor (VEGF)-C and its receptor, vascular endothelial growth factor receptor (VEGFR)-3, are responsible for lymphangiogenesis in both embryos and adults. In epilepsy, the expression of VEGF-C and VEGFR-3 was significantly upregulated in the human brains affected with temporal lobe epilepsy. Moreover, pharmacologic inhibition of VEGF receptors after acute seizures could suppress the generation of spontaneous recurrent seizures, suggesting a critical role of VEGF-related signaling in epilepsy. Therefore, in the present study, the spatiotemporal expression of VEGF-C and VEGFR-3 against pilocarpine-induced status epilepticus (SE) was investigated in C57BL/6N mice using immunohistochemistry. At 1 day after SE, hippocampal astrocytes and microglia were activated. Pyramidal neuronal death was observed at 4 days after SE. In the subpyramidal zone, VEGF-C expression gradually increased and peaked at 7 days after SE, while VEGFR-3 was significantly upregulated at 4 days after SE and began to decrease at 7 days after SE. Most VEGF-C/VEGFR-3-expressing cells were pyramidal neurons, but VEGF-C was also observed in some astrocytes in sham-manipulated animals. However, at 4 days and 7 days after SE, both VEGFR-3 and VEGF-C immunoreactivities were observed mainly in astrocytes and in some microglia of the stratum radiatum and lacunosum-moleculare of the hippocampus, respectively. These data indicate that VEGF-C and VEGFR-3 can be upregulated in hippocampal astrocytes and microglia after pilocarpine-induced SE, providing basic information about VEGF-C and VEGFR-3 expression patterns following acute seizures.
Adult ; Animals ; Astrocytes ; Brain ; Embryonic Structures ; Epilepsy ; Epilepsy, Temporal Lobe ; Hippocampus ; Humans ; Immunohistochemistry ; Lymphangiogenesis ; Mice ; Microglia ; Pyramidal Cells ; Receptors, Vascular Endothelial Growth Factor ; Seizures ; Status Epilepticus ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor C ; Vascular Endothelial Growth Factor Receptor-3