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

The authors report an unusual case of a primary chondroid chordoma arising from the base of the petrous temporal bone. A 43-year-old female presented with left sided facial weakness and left sided jugular foramen syndrome. The CT findings of a tumor arising from the base of left petrous temporal bone and it involved left cerebello-pontine angle, and extended through left jugular foramen to parapharyngeal space. The clinical and histopathologic differences between classical(typical) chordoma and its variant are highlighted. The rarity of primary chordomas at this site is stressed.
Adult ; Chordoma* ; Female ; Humans ; Temporal Bone*

Aphasia as clinical manifestation of cerebral multiple sclerosis is a rarity. We report here a clinical case of multiple sclerosis complicated by striking motor aphasia. A 11 year old male was admitted with sudden onset of aphasia and quadriparesis following appendectomy under the general anesthesia. A few hour after operation, above symptoms and bilateral pyramidal signs were developed. These findings were fluctuated but slowly remitted. Two weeks later second bout of multiple sclerosis developed, characterized by absent spontaneous speech, quadriparesis, multiple cranial nerve palsies internuclear ophthalmoplegia and bilateral pyramidal signs. The finding of E.E.G. disclosed paroxysmal slow waves in high amplitude on frontal region. Patient was treated with steroids and conservative management. Eleven weeks later, he was discharged with relatively good results.
Anesthesia, General ; Aphasia* ; Aphasia, Broca ; Appendectomy ; Child ; Cranial Nerve Diseases ; Humans ; Male ; Multiple Sclerosis* ; Ocular Motility Disorders ; Quadriplegia ; Steroids ; Strikes, Employee

No abstract available.
Candidemia* ; Humans

No abstract available.
Macrophages* ; Mistletoe* ; Tumor Necrosis Factor-alpha*

BACKGROUND: Hepatitis B virus(HBV) DNA integration is one of the cause of hepatocellular carcinoma (HCC). Epidemiologic evidences indicate that HBV infection is associated with the high risk of development of HCC. We wanted to evaluate the HBV DNA integration in hepatocellular carcinoma. So we detected HBV DNA by PCR in aseptically obtained 37 HCC tissues. METHODS: A total 37 surgical specimens from HCC patients were evaluated. Patient's serologic findings were analyzed retrospectively. Serologic markers were tested by radioimmunoassay. Genomic DNA was extracted from HCC paraffin blocks by microwave oven method. PGR was done. RESULTS: The sensitivity of HBV DNA PCR was 100 fg. Among 37 Patients tested, 30 cases of HCC patients had HBV DNA in their liver tissue. Among 25 HBs Ag positive patients, 23 had PCR positive results. All of the anti-HBc positive patients had HBV DNA. CONCLUSIONS: These findings are highly suggestive of HBV infection in the development of hepatocellular carcinoma. Detection of HBV DNA in patients with hepatocellular carcinoma is highly suggestive of HBV infection in the development of hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; DNA ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Liver ; Microwaves ; Paraffin ; Polymerase Chain Reaction* ; Radioimmunoassay ; Retrospective Studies

A 30 years old female patient was diagnosed valvular heart disease and double valve replacement was ndertaken. After operation, mediastinitis developed and we had done continuous mediastinal irrigation and had used IV antibiotics for 3 weeks. During outpatient follow-up, infection signs developed, so she readmitted and was reoperated because CT revealed mediastinal abscess. No infected material was observed at the operation. Infection signs continued for 3 weeks. Chest CT revealed giant pseudoaneurysm of ascending aorta. We resected the pseudoaneurysm and performed an aortoplasty with bovine pericardium under deep hypothermia and total circulatroy arrest. She recovered well and was discharged without any complication.
Abscess ; Adult ; Aneurysm, False ; Anti-Bacterial Agents ; Aorta* ; Female ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Hypothermia ; Mediastinitis* ; Outpatients ; Pericardium ; Thoracic Surgery* ; Tomography, X-Ray Computed

Of the case of malignant astrocytoma, spontaneous transdural extension is very rare. Only several cases of transdural extension of primary intracranial tumor are reported. However, these cases are through the foramina of the skull base. We have experienced a case of malignant astrocytoma which directly extended out through the dura and calvarium near the pterion of the left side.
Astrocytoma* ; Skull ; Skull Base

We have experienced 3 cases of localized cervical adhesive arachnoiditis. 2 of them had history of operation under spinal anesthesia. Paresthetic pain and weakness are the commonest presenting symptoms and signs in our cases. Myelographically, findings are simulating the intramedullary lesion in 2 cases. With surgical intervention, 2 cases have good results.
Adhesives* ; Anesthesia, Spinal ; Arachnoid* ; Arachnoiditis*

Cases of brain necrosis following the radiation therapy of brain tumor have been reported, and in the most cases postirradiating brain damage are usually interpreted as a recurrence of the tumor. The Authors report here a case of postirradiation brain necrosis in the left frontal astrocytoma 4 years after operation. Patient's manifestations are headache, vomiting, right sided hemiparesis and focal seizures which after developing generalized seizures in association with signs of increased intracranial pressure. CT scan showed a large cystic mass in the left frontal lobe which was verified to be necrosis on operation.
Astrocytoma ; Brain Neoplasms ; Brain* ; Frontal Lobe ; Headache ; Intracranial Pressure ; Necrosis* ; Paresis ; Recurrence ; Seizures ; Tomography, X-Ray Computed ; Vomiting