Twenty-four hands of eighteen patients of carpal tunnel syndrome were treated with two or times injection of 5 mg dexamethasone and three weeks splinting at the department of orthopedic surgery, Korea University Hospital From Jan. 1980 to Feb.1985. The results obtained were as follows; 1. Physical findings consisted of sensory disturbances in sixteen hands, positive Tinel sign in thirteen, positive Phalen test in eighteen and thenar atrophy in eight. 2. On electromyographic study, delay of motor conduction velocity of the median nerve was noted in twelve cases and sensory nerve velocity in fifteen. 3. Fifteen patients(eighteen cases) were followed up from 6 months to 30 months. Twelve cases(60%) were improved and three cases were recurred.
Atrophy ; Carpal Tunnel Syndrome ; Clinical Study ; Dexamethasone ; Hand ; Humans ; Korea ; Median Nerve ; Orthopedics ; Splints

Purpose: To evaluate the clinical and radiographic results of primary bipolar arthroplasty during average 9.8-year period, using a non-cemented Multilock femoral stem and a biarticular acetabular cup. Materials and Methods: This study included 24 patients (29 hips) who underwent primary bipolar hemiarthroplasties with Multilock femoral stems and biarticular cups and who could be followed for more than seven years. Clinically, we evaluated the Harris Hip scores and patient complaints of thigh and inguinal pain. We also evaluated the radiographic measurements around the femoral stems and the bipolar cups. Results: The average Harris Hip score improved from 57.4 points to 91.6 points; and 3 (10.3%) hips were associated with thigh pain and 4 (13.8%) hips with inguinal pain. Around the femoral stem there was a non-progressive radiolucent line less than 1 mm in length in 4 (13.8%) hips and osteolysis was present in 6 (20.6%) hips. With respect to the stability of the fixations, there was osseous ingrowth in 26 (89.7%) hips and fibrous ingrowth in 3 (10.3%) hips. Around the acetabulum there was osteolysis in 5 (17.2%) hips, proximal migration of the cup in 2 (6.9%) hips, and erosion of the acetabular cartilage in 10 (34.5%) hips. There were 3 (10.3%) biarticular cups, which were converted to total hip arthroplasties, but no femoral stems were revised. The overall failure rate of the primary operations was 10.3%. Conclusion: The current study demonstrated favorable results after bipolar hemiarthroplasties with Multilock femoral stems. However, the osteolysis that occurred around the femoral stems and the acetabula emerged as a problem after the total hip arthroplasties. In particular, it is expected that the osteolysis would increase over time and become the main cause for the need for surgical revision.
Acetabulum ; Arthroplasty ; Cartilage ; Follow-Up Studies* ; Hemiarthroplasty* ; Hip ; Humans ; Osteolysis ; Reoperation ; Thigh

No abstract available.

PURPOSE: To evaluate the pattern of distant lymph node metastasis in colorectal carcinoma and its correlation with distant organ metastasis. MATERIALS AND METHODS: We retrospectively reviewed abdominal CT scans of 46 patients with pathologically proven colorectal carcinoma. RESULTS: The incidence of distant lymphadenopathy in colorectal carcinoma was 30.4%(14/46). The most commonly involved distant lymph node was the left paraortic lymph node below the renal hilum(9/25). The most common type of distant lymphadenopathy was solitary type(7/14) and all of these lymphadenopathies were noted in the left paraortic lymph node below the renal hilum. Six cases of left sided colorectal carcinoma showed left paraortic lymphadenopathy with solitary type. The incidence of distant organ metastasis was 17. 4%(8/46) and markedly increased if distant lymphadenopathy was multiple and confluent, or confluent type(5/7). CONCLUSION: The incidence of distant lymphadenopathy in colorectal carcinoma was not high and the most common lymphadenopathy was the left paraaortic lymph node with solitary type below the renal hilum. The possibility of distant organ metastasis was high if distant lymphadenopathy was multiple and confluent, or confluent type.
Colorectal Neoplasms* ; Humans ; Incidence ; Lymph Nodes* ; Lymphatic Diseases ; Neoplasm Metastasis* ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Humans

To date, it is unclear whether cognitive intervention on episodic memory (EM) is effective in improving all or a subset of EM components in Alzheimer's disease (AD). Therefore, this study investigated effects of EM training on the elderly aged over 65 with AD. For this study, 13 AD patients and 16 healthy older adults were recruited. The pre- and post-test for components of EM was a memory task designed to test memory for object identity (“what”), spatial location (“where”), and temporal order (“when”). Training in the AD group consisted of 16 sessions of practice remembering temporal sequences of different objects being hidden in various locations. At pre-test, accuracy on the “where” and “when” conditions were impaired in the AD patients compared with the healthy elderly (p < 0.01). At post-test, accuracy on the “where” condition was significantly improved (p < 0.05) whereas, there were no significant improvements on the “what” and “when” conditions (p > 0.05). Interestingly, there were no significant improvements in standard neuropsychological measures. These findings suggest that AD, in its early stages, selectively impaired spatial and temporal memory rather than object memory. Additionally, it was observed that EM training in AD had different effects depending on the components of EM.

To date, it is unclear whether cognitive intervention on episodic memory (EM) is effective in improving all or a subset of EM components in Alzheimer's disease (AD). Therefore, this study investigated effects of EM training on the elderly aged over 65 with AD. For this study, 13 AD patients and 16 healthy older adults were recruited. The pre- and post-test for components of EM was a memory task designed to test memory for object identity (“what”), spatial location (“where”), and temporal order (“when”). Training in the AD group consisted of 16 sessions of practice remembering temporal sequences of different objects being hidden in various locations. At pre-test, accuracy on the “where” and “when” conditions were impaired in the AD patients compared with the healthy elderly (p < 0.01). At post-test, accuracy on the “where” condition was significantly improved (p < 0.05) whereas, there were no significant improvements on the “what” and “when” conditions (p > 0.05). Interestingly, there were no significant improvements in standard neuropsychological measures. These findings suggest that AD, in its early stages, selectively impaired spatial and temporal memory rather than object memory. Additionally, it was observed that EM training in AD had different effects depending on the components of EM.

To clarify possible causes, pathogenesis, and appropriate prevention method of remote intracerebral hemorrhage (RICH), we analyzed the clinical findings and the possible predisposing factors of six cases who developed RICH among the 206 surgical series of cerebral aneurysm operated in our hospital over recent 5-year period. The locations of aneurysm were anterior communicating artery in three cases and internal carotid artery in three other cases. The sites of RICH were dependent regions considering the operative position in five of six cases, con-tralateral cerebellum in three cases, bilateral cerebellum in one case, and contralateral occipital area in one case. Peripheral low density around the RICH, suggesting hemorrhagic infarction, was observed on computed tomography in four cases. No patient had preoperative hypertension; however, significant elevation of blood pressure was observed intraoperatively or postoperatively in three cases. The factors which could have induced brain shift(large amount of removed or drained cerebrospinal fluid, large amount of infused mannitol, too low PaCO2) were observed in all cases except one case. There was no case with coagulopathy or underlying occult lesion. Two patients in whom detection of RICH was delayed showed poor outcomes. The possible underlying mechanisms involved in such complication seem to be shifting of brain due to sudden decreased intracranial pressure and excessive removal of cerebrospinal fluid, and subsequent injury of blood vessels such as compression or breakdown of vein. Moreover, the sudden elevation of blood pressure may have played a role as contributing factor. Therefore, consideration should be given to the maintenance of an adequate volume of intracranial cerebrospinal fluid and the appropriate blood pressure to prevent this complication. Early detection and immediate treatment with awareness of the possibility of this complication should be borne in mind when treating these patients to prevent such complications and to obtain good results.
Aneurysm* ; Arteries ; Blood Pressure ; Blood Vessels ; Brain ; Carotid Artery, Internal ; Causality ; Cerebellum ; Cerebral Hemorrhage* ; Cerebrospinal Fluid ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Intracranial Aneurysm ; Intracranial Pressure ; Mannitol ; Veins

Since introduction of magnetic resonance imaging(MRI), six cases of multiple intracranial meningiomas without signs of neurofibromatosis were found among the forty eight cases of meningiomas. The incidence of multiple intracranial meningiomas in our series was 12.5% of all meningiomas. We analyzed six cases of multiple intracranial meningiomas that were evaluated by MRI. Two tumors were found in five patients, whereas the other one patient had more than ten tumors at different sites. The tendency of unihemispheric distribution was not seen and two cases had bilaterally located tumors and other two cases had tumors above and below the tentorium without tentorial involvement. Relatively high occurrence of meningioma in posterior fossa was observed. Half of the six cases had posterior fossa tumors and 6 tumors(28.6%) of the total 21 tumors were located in the posterior fossa. All the cases were female. Mean age on admission was 61.3 years, ranged from 44 to 77 years. All six patients were treated surgically and three of them underwent multiple staged operations. Histologically, of the 12 tumors removed, 5 were transitional, 4 were fibroblastic, 3 were meningothelial. The histological subtypes of tumors in each case were different in two cases, but identical in other three cases. The surgical results, although the follow-up periods(ranged 3 months to 2.5 years) were not long enough in some cases, were favorable.
Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Incidence ; Infratentorial Neoplasms ; Magnetic Resonance Imaging ; Meningioma* ; Neurofibromatoses

We reported 3 cases of intestinal anisakiasis. The patients had abdominal pain, nausea or vomiting, after eating raw sea-fishes 1 to 5 days before. Intestinal resection was performed under the impression of mechanical obstruction or cancer. The resected intestines showed marked edema, congestion or hemorrhage in the mucosa. Microscopically the larvae were found in the submucosa or inner muscle layer, and surrounded by phlegmonous inflammation with intense eosinophilic infiltration. The larvae were identified as Anisakis spp. by multiple sections.