Entrapment of the extensor pollicis longus tendon is reported rarely on Smith's fractures in children. In our case, a 15 year old boy with Smith's fracture received treatment of closed reduction at another hospital. When he visited our hospital, a wide gap at the fracture site was detected on radiograph and the thumb movement was limited. We have doubt the entrapment of the soft tissue, especially the tendon. We decided on open reduction. In the operation field, entrapment of the extensor pollicis longus tendon at the gap of the fracture site was found through dorsal approach. In addition, fracture treatment with K-wire fixation after reduction of extensonr pollicis longus tendon reduction was done. Therefore, we report this case with a review of the literatures.
Child ; Humans ; Tendons ; Thumb

A 43-year-old woman presented with dizziness, ataxia and right hearing difficulty. Her magnetic resonance images demonstrated an inhomogeneously contrast-enhanced large tumor growing into right cavernous sinus and Meckel's cave located totally within intradural retroclival region. She underwent retromastoid suboccipital craniotomy to resect the tumor mass and adjuvant gamma knife radiosurgery for remnant tumor at 1 month after operation. Adjuvant radiosurgery after surgical excision seems to be effective for the treatment of intradural extraosseous chordomas.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; Ataxia ; Cavernous Sinus ; Chordoma ; Craniotomy ; Cyclophosphamide ; Dizziness ; Doxorubicin ; Female ; Hearing ; Humans ; Magnetic Resonance Spectroscopy ; Podophyllotoxin ; Radiosurgery ; Vincristine

PURPOSE: Chronic prostatitis (CP) does not yet have a universally successful therapy. Alternative treatments including thermotherapy have been adopted in the multimodal management of pain and voiding dysfunction. We retrospectively analyzed the therapeutic efficacy of bipolar radiofrequency thermotherapy for patients who were unsatisfied with conventional medication for CP. MATERIALS AND METHODS: A retrospective study between October 2009 and September 2010 of 26 patients who were under 50 years old and diagnosed with CP (National Institutes of Health [NIH]-category III) was performed. Twenty patients were diagnosed with inflammatory CP (NIH-category IIIa) and the rest with noninflammatory CP (NIH-category IIIb). We used the Tempro system at an intraprostatic temperature of 55degrees C for 50 minutes with a medium heating rate. All patients also completed the NIH-Chronic Prostatitis Symptom Index (CPSI) before and after treatment. RESULTS: In the patients diagnosed with CP, the mean serum prostate-specific antigen (PSA) level was 0.9+/-0.3 ng/ml, the prostate volume was 27.1+/-5.5 g, and the average score for all 3 domains on the NIH-CPSI significantly decreased. The total scores decreased from 19.8+/-7.1 to 11.1+/-7.0, the pain domain decreased from 8.6+/-3.1 to 4.8+/-3.1, the voiding symptom domain decreased from 5.1+/-1.8 to 2.9+/-1.8, and the effect on the quality of life decreased from 6.1+/-2.2 to 3.4+/-2.2 (p<0.05). CONCLUSIONS: Bipolar radiofrequency thermotherapy for patients with CP intractable to conventional medication can provide significant improvement in the NIH-CPSI. Large, randomized controlled trials will also be required to confirm the efficacy of this therapy.
Academies and Institutes ; Heating ; Hot Temperature ; Humans ; Hyperthermia, Induced ; Prostate ; Prostate-Specific Antigen ; Prostatitis ; Quality of Life ; Retrospective Studies

Primary cricopharyngeal dysfunction is a rare, idiopathic, functional disorder of the upper esophageal sphincter (UES) characterized by dysphagia, frequent aspiration, and functional narrowing at the level of UES. It is caused by failure or partial relaxation of the sphincter, lack of pharyngoesophageal coordination, or reduced compliance of the muscular of the UES. We saw a 62-year-old man who presented with dysphagia and UES narrowing on videofluoroscopy swallowing study (VFSS). Physical, neurologic, and laboratory evaluations revealed no abnormal findings. Radiologic evaluation looking for any abnormalities that might provoke dysphagia was within normal limits. VFSS showed laryngeal aspiration, residue in vallecular and pyriform sinuses, and cricopharyngeal narrowing. Balloon catheter dilatation under endoscopic guidance was performed twice, after which, the dysphagia improved. Here, we describe the results of treatment with balloon dilatation in a patient with primary cricopharyngeal dysfunction.
Catheters ; Compliance ; Deglutition ; Deglutition Disorders ; Dilatation ; Esophageal Sphincter, Upper ; Humans ; Middle Aged ; Pyriform Sinus ; Relaxation

Hemorrhage following pancreatitis may become complicated during the disease course and with possibly fatal consequences. Radiologic findings are as follows: the presence of hematomas, hemorrhagic pseudocysts, extravasation of contrast media or the formation of arterial pseudoaneurysms. The digital subtraction angiography findings are as follows: contrast extravasation due to arterial rupture; pseudoaneurysm formation; and luminal irregularity. A pseudoaneurysm is considered to be treated as soon as detected due to its risk of rupture. Endovascular management, which includes embolization using coils, N-butyl cyanoacrylate, gelatin sponge, stents, and thrombin, is an effective option for the treatment for pancreatitis-related bleeding.
Aneurysm, False ; Angiography, Digital Subtraction ; Cyanoacrylates ; Embolization, Therapeutic ; Endovascular Procedures ; Extravasation of Diagnostic and Therapeutic Materials ; Gelatin ; Hematoma ; Hemorrhage ; Pancreatitis ; Phenobarbital ; Porifera ; Rupture ; Stents ; Thrombin

A 59-year-old woman was admitted to our hospital with polydipsia and general weakness. She had a 30-year history of bipolar disorder and was being treated with risperidone (4 mg/day) and lithium carbonate (1,200 mg/day). During her time in hospital, her urine output and serum osmolality increased, and her urine osmolality decreased. She was found to have myoglobulinuria, an elevated creatine kinase level, and abnormal renal function. Based on these findings, the patient was diagnosed with diabetes insipidus and rhabdomyolysis secondary to lithium therapy. After fluid therapy and the withdrawal of lithium, her clinical symptoms improved significantly. Her urine volume decreased gradually after treatment with amiloride. The effects of lithium on the muscle system are unknown. Hyperosmolarity caused by lithium-induced diabetes insipidus is considered a contributing factor in rhabdomyolysis.
Amiloride ; Bipolar Disorder ; Creatine Kinase ; Diabetes Insipidus ; Diabetes Insipidus, Nephrogenic ; Female ; Fluid Therapy ; Humans ; Lithium ; Lithium Carbonate ; Middle Aged ; Muscles ; Osmolar Concentration ; Polydipsia ; Rhabdomyolysis ; Risperidone

Parosteal lipoma is a rare kind of lipoma that occurring adipous tissue around the periosteum. It has been reported most commonly in the femur, the radius, the tibia and the fibular. Treatment consists of resecting the lipomatous tumor with further exeresis of the bone and periosteal excrescence in cases with hyperostosis. The authors report a rare case of parosteal lipoma occurring at the medial portion of the femur shaft with a review of the relevant literatures.
Femur ; Hyperostosis ; Lipoma ; Periosteum ; Radius ; Tibia

A 59-year-old woman was admitted to our hospital with polydipsia and general weakness. She had a 30-year history of bipolar disorder and was being treated with risperidone (4 mg/day) and lithium carbonate (1,200 mg/day). During her time in hospital, her urine output and serum osmolality increased, and her urine osmolality decreased. She was found to have myoglobulinuria, an elevated creatine kinase level, and abnormal renal function. Based on these findings, the patient was diagnosed with diabetes insipidus and rhabdomyolysis secondary to lithium therapy. After fluid therapy and the withdrawal of lithium, her clinical symptoms improved significantly. Her urine volume decreased gradually after treatment with amiloride. The effects of lithium on the muscle system are unknown. Hyperosmolarity caused by lithium-induced diabetes insipidus is considered a contributing factor in rhabdomyolysis.
Amiloride ; Bipolar Disorder ; Creatine Kinase ; Diabetes Insipidus ; Diabetes Insipidus, Nephrogenic ; Female ; Fluid Therapy ; Humans ; Lithium ; Lithium Carbonate ; Middle Aged ; Muscles ; Osmolar Concentration ; Polydipsia ; Rhabdomyolysis ; Risperidone

PURPOSE: Because no effective methods for performance of anastomosis have been established, use of laparoscopic total gastrectomy (LTG) has not been widely accepted. We aimed to establish the feasibility of using a newly developed purse-string suture instrument ("Lap-Jack"), which can be used in performance of intracorporeal anastomosis. METHODS: From April, 2010 to February, 2011, 50 patients with upper gastric cancer underwent LTG with intracorporeal Roux-en-Y esophagojejunostomy using the Lap-Jack. Retrospective data for gender, age at the time of surgery, past medical history, operative time, estimated blood loss, TNM staging, and postoperative complications were reviewed. RESULTS: Among the 50 patients, 33 were male and 17 were female. Median age was 59.9 years. The average operative time was 217.4+/-41.7 minutes. Based on the AJCC 7th edition of Gastric Cancer Staging, 19 patients were stage IA, three patients were IB, 12 patients were II, one patient was IIIA, three patients were IIIB, eight patients were IIIC, and two patients were IV. The overall morbidity rate was 18.0% without any mortality. Complications included wound problems (2.0%, n=1), pleural effusion (2.0%, n=1), urinary retention (4.0%, n=2), efferent loop obstruction due to adhesion (4.0%, n=2), postoperative ileus (2.0%, n=1), postoperative bleeding (2.0%, n=1), and intra-abdominal abscess (2.0%, n=1). No leakage or stenosis of esophagojejunostomy was reported. CONCLUSION: The Lap-Jack is feasible and suitable for use in performance of esophagojejunostomy during LTG.
Abdominal Abscess ; Constriction, Pathologic ; Female ; Gastrectomy ; Hemorrhage ; Humans ; Ileus ; Male ; Neoplasm Staging ; Operative Time ; Pleural Effusion ; Postoperative Complications ; Retrospective Studies ; Stomach Neoplasms ; Sutures ; Urinary Retention