BACKGROUND: This study was performed to evaluate the therapeutic effects of sympathetic block in management of reflex sympathetic dystrophy (RSD); renamed complex regional pain syndrome (CRPS) Type I, according to the duration of RSD, and to evaluate predictable factors responding to sympathetic block in patients suffering from RSD. METHODS: Prospectively designed this study was divided thirty patients with upper extremity RSD into three groups according to the duration of RSD; Group I (< or = 3 months), Group II (4 to 6 months) and Group III (>or = 7 months). All patients were received repeated stellate ganglion blocks (SGB) with 12 ml of 0.2% bupivacaine by paratracheal approach. We compared the therapeutic effects of SGB between the groups and the clinical signs on initial examination to receive the first SGB at pain clinic. RESULTS: Response rates to SGB were 84.6% in Group I, 62.5% in Group II and 44.4% in Group III. The early treatment less than 6 months was better prognosis (p<0.05). Presence of edema (p<0.001), temperature differences between both hands (hot>cold>no difference, p<0.001), and allodynia (p<0.05) were favorable prognostic factors responding to sympathetic block. Especially, warm skin and edema in RSD were near-perfect predictors of sympathetic blocks. CONCLUSIONS: We conclude that SGB is effective in management of upper extremity RSD, and the duration and the clinical signs of RSD are important to the prognosis and responsibility to sympathetic block. If patients suffering from RSD visit pain clinic before 6 months, and they have edematous warm hands with allodynia, majority of them will be improved from their pain after sympathetic block.
Bupivacaine ; Edema ; Hand ; Humans ; Hyperalgesia ; Pain Clinics ; Prognosis ; Prospective Studies ; Reflex Sympathetic Dystrophy* ; Reflex* ; Skin ; Stellate Ganglion* ; Upper Extremity*

No abstract available.
Emergencies* ; Humans

No abstract available.
Emergencies* ; Humans

No abstract available.
Emergencies* ; Humans

Abdominal actinomycosis is very rare infectious disease and seldom reported as a cause of abdominal mass. This disease is diagnosed by pathologic findings and culture result but it is very difficult to differentiate with other granulomatous illammatory disease, diverticular disease, malignancy, etc. The radiologic findings were non-specific and CT scan revealed the inflammatory mass with multiple small abscesses and fibrous change. The treatment of choice for actinomycosis is medical treatment with penicillin but surgical intervention may be needed when complication such as obstruction, fistula formation, abscess formation develop. We report a patient with abdominal actinomycosis that presented with transverse colonic obstruction and severe abdominal wall inflammation. This patient had no past operative history but got intrauterine contraceptive devices during last 10 years. We treated this patient by surgical resection and antibiotic therapy.
Abdominal Wall ; Abscess ; Actinomycosis* ; Colon* ; Colon, Transverse ; Communicable Diseases ; Fistula ; Humans ; Inflammation ; Intrauterine Devices ; Penicillins ; Tomography, X-Ray Computed

Although the ultrasonography is a useful imaging modality for evaluation of abdominal mass in an infant and child, CT has more advantages over te ultrasonography in assesssing anatomic detail, precise extent of tumor and differential diagnostic accuracy. The authors analyzed CT featurs of 85 cases of pathologically or clinicallyproven pediatric abdominal masses for recent 4.5 years at Keimyung University Dongsan Hospital. The reseults wereas follows: 1. The most common site was kidney (36 cases:42.4%), followed by nonrenal retroperitoneal masses(23cases:27.1%), hepatobiliary masses(15 cases:17.6%), gastrointestinal masses(9 cases: 10.6%), and genital massses(2cases: 2.3%) in order of frequency. 2. Hydronephrosis(17 cases:20%) and Wilms' tumor(17 cases:20%) were mostcommon and splenomegaly(8 cases:9.4%), neuroblastoma(5 cases: 5.9%), teratoma(4 cases:4.7%), rhabdomyosarcoma(4cases: 4.7%) were descending order of frequency. 3. The male to female ratio was 2;1, but female was predominantin teratoma, choledochal cyst and genital masses. Twenty three cases(27.1%) were under the age of one year. 4. Thediagnosis of hydronephrosis, assessment of its severity and localization of exact level of obstruction were easywith CT examination. 5. Characteristic CT features of Wilms' tumor were round or oval shaped, smooth marginated,large intrarenal mass with displaced or obstructed calyces, pseudocapsule and crescent sign; there were noevidence of retroperitoneal lymph node or contiguous extension, retrocrural lymph node enlargement, prevertebralmidline extension, or encasement of the aorta. 6. Typical CT findings of the neuroblastoma wre irregular shaped &marginated extrarenal mass with calcification frequently, accompained by retroperitoneal lymph node or contiguousextension, retrocrural lymph node enlargement, prevertebral midline extenstion and encasement of the aorta; therewere no evidence of pseudocapsule or crescent sign. 7. CT features of teratoma were characteristic, having atleast three or more of different tissue densities among fat, water, soft tissue and calcific densities. 8.Pathology and its extension of retroperitoneal space was demonstrated accurately by CT. 9. Mesenteric, omental andenteric cysts had similar CT appearance particularly very large cystic masses.
Aorta ; Child ; Choledochal Cyst ; Female ; Humans ; Hydronephrosis ; Infant ; Kidney ; Lymph Nodes ; Male ; Neuroblastoma ; Retroperitoneal Space ; Teratoma ; Ultrasonography ; Water ; Wilms Tumor

No abstract available.
Decompression, Surgical* ; Exophthalmos*

It is difficult to distinguish benign from malignant, pulmonary nodule by conventional roentgenologic examination. But CT makes it easier to evaluate adjacent parencymal invasion, pleural or mediastinal extenstion,or early metastasis to intra- or extrathoracic lymph node as well as distant organs, although only a solitaryperipheral pulmonary nodule is seen on plain radiograph. Authors reviewed CT of 22 cases of histopathologically confirmed primary lung cancer seen as a solitary peripheral pulmonary mass from May 1980 to Sep. 1984 at DongsanMedical Center, Keimyung University. The results are as follows: 1.The incidence was most common in the 6thdecade(36%). Male to female ratio was 10:1 and 2 females all had bronchioloalveolar cell carcinoma. 2. Thedistributions of histologic cell type were as follows: squamous cell carcinoma 40%, adenocarcinoma, small cellcarcinoma, bronchioloalveolar cell carcinoma and unclassified carcinoma 14% in each cases, and adenoid cysticcarcinoma 4% . 3. The CT findings were as follows: a) Superior and posterior basal segments of both lower lobeswere most frequently involved(68%). b) The mean diameter of the mass was 48mm, and most common in the range of30-49 mm in the greatest dimension(46%). c) The mean CT atttenuation value was 57 H.U., and most common in thegroup of 41-70 H.U. (64%). d) Lymph node metastasis was found in 13 (59%) of 22 cases, and the involved nodes wereas follows: hilar nodes 10 cases, paratracheal nodes 8 cases, subcarinal nodes 7 cases and extrathoracic nodes 3cases. In 2 of 3 cases with small cell carcinoma, diffuse multiple lymph nodes were involved. e) Distantmetastasis was seen relatively early in 3 cases; cerebral metastasis in 1 case of squamous cell carcinoma, rightaderenal metastasis without intrathoracic lymph node metastasis or invasion of adjacent structures in 1 case ofbronchioloalveolar cell carcinoma, and liver and bone metastases in 1 case of unclassified carcinoma. f) Adjacentpleural or mediastinal invasion was found in 7 cases(32%): pleural invasion along chest wall in 4 cases, andinvasion of adjacent mediastinal pleura in 3 cases of 2 squamous cell carcinoma and 1 unclassifed carcinoma. g)Calcifications witihin the mass were found in 5 cases (23%), and most common in squamous cell carcinoma(3 cases).In all cases, a few granular calcification were seen along the peripheral margin of the mass. h) Tumor necrosiswas seen in 4 cases(18%), and 3 cases were squamous cell carcinoma, and one of them showed irregular centralcavitation. i) The margins of tumor were irregularly lobulated with radiating spiculations in all except one ofadenoid cystic carcinoma, which revealed oval shaped, smooth clear margin. j) In 9(41%) of 22 cases, someenlargement of pulmonary vessels with perivascular linear infiltrations were found in the adjacent lungparenchymes of the mass, which were thought to be retrograde perivascular lymphangitic spread along pulmonaryvessels.
Adenocarcinoma ; Adenoids ; Carcinoma, Bronchogenic ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Epithelial Cells ; Female ; Humans ; Incidence ; Liver ; Lung Neoplasms ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Pleura ; Thoracic Wall

PURPOSE: The purpose of study was to examine and compare the clinical practicum stress, depression, and self-efficacy between Type D and non-Type D personality among nursing students. METHODS: This study used a descriptive correlational survey design. Subjects included a total of 120 nursing students (Type D personality: n=60, non-Type D personality: n=60) in Seoul, Korea. The collected data were analyzed using a descriptive statistics, χ² test, Fisher's exact test, independent t-test, ANCOVA, and Scheffe test as a post hoc test with SPSS/WIN 21.0 program. RESULTS: There were significant differences on clinical practicum stress (t=2.81, p=.029), depression (t=6.67, p<.001), and self-efficacy (t=9.84. p<.001) between non-Type D and Type D personality among nursing students. CONCLUSION: Type D personality in nursing students had higher clinical practicum stress and depression than them of non-Type D personality in nursing students. Nursing interventions or strategies for Type D personality in nursing students are needed to decrease clinical practicum stress and depression.
Depression* ; Humans ; Korea ; Nursing* ; Preceptorship* ; Seoul ; Students, Nursing* ; Type D Personality*

No abstract available.
Cartilage* ; Congenital Abnormalities*