In carpal injury, a good functional end result seems to correlate with final anatomic alignment of carpus after treatment. Some cases are often misdiagnosed and result in inadequate treatment. Forty six cases of carpal injuries were analysed which were treated for 9 years from 1975 to 1984 at the Department of Orthopedic Surgery, Seoul National University Hospital. The observations can be summarized as follows. 1. The male to female ratio was 3.5: 1 and 82% of total cases were in the third and fourth decades. 2. The most frequent cause of injury was fall from height with outstretched hand. 3. Trans-scaphoid perilunar dislocation and its variant were the most common diagnosis in this analysis. 4. All of the scapho-lunate dissociation showed volar flexion intercalated segmental instability with scapho-lunate gap more than 2 mm in our series. 5. In 11 cases of trans-scaphoid perilunar dislocation and its variant, carpal collapse was found in 10 cases. In 5 cases dorsiflexion intercalated segmental instability pattern and in one case volar flexion intercalated segmental instability pattern were found to be present. 6, There was an increase in scapho-lunate angle in all cases of dorsiflexion intercalated segmental instability, but a decrease in scapho-lunate angle is not a consistent finding in volar flexion intercalated segmental instability. 7. In 24 cases more than 6 months follow-up, excellent and good results were obtained in 20 cases. 8. As a result of above findings, authors conclude that scapho-lunate gap more than 2mm has diagnostic value in scapho-lunate dissociation but that dorsiflexion intercalated segmental instability or volar flexion intercalated segmental instability only means the changes in the relationship between carpal bones and does not have definite or specific diagnostic value for a specific carpal injury.
Carpal Bones ; Diagnosis ; Dislocations ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Orthopedics ; Seoul ; Wrist

Inflammatory pseudotumor of the liver is a rare benign tumor with microscopic finding of fibrous stroma and chronic inflammatory cell infiltration. Predominance of plasma cells, histiocytes, lymphocytes, some eosinophils and whorled pattern of fibrosis is often characteristic. Due to similar radiologic appearance of hepatocellular carcinoma, inflammatory pseudotumor of the liver was often misdiagnosed and hepatic resection is often performed before preoperative tissue diagnosis. We report a case of inflammatory pseudotumor, which was a 47-year-old woman with fever, upper aMominal pain and weight loss, diagnosed by sonoguided liver biopsy and treated with antibiotic therapy only without surgery. After two weeks of treatment, the radiologic image of the mass was almost disappeared with improvement of previous symptoms. This opportunity and the possible effectiveness of antibiotic treatment should keep in mind in the differential diagnosis of the hepatic mass with similar radiologic appearance of hepatocellular carcinoma.
Biopsy ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential ; Eosinophils ; Female ; Fever ; Fibrosis ; Granuloma, Plasma Cell* ; Histiocytes ; Humans ; Liver* ; Lymphocytes ; Middle Aged ; Plasma Cells ; Weight Loss

No abstract available.
Down Syndrome* ; Humans ; Psoriasis*

No abstract available.
Hair*

No abstract available.
Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia*

No abstract available.
Angiotensin II* ; Angiotensins* ; Animals ; Hemorrhage* ; Rats*

BACKGROUND: Ectopic thyroid gland is relatively rare condition and a developmental anomaly characterized by an aggregated of thyroid tissue in the midline anywhere from the base of the tongue to the mediastinum. The role of ectopic thyroid in the pathogenesis of non-goitrous sporadic cretinism and primary hypothyroidism has been emphasized. 19 cases of ectopic thyroid for 12 years was presented with Tc-pertechnetate or radioactive iodine, which were diagnosed by scintigraphy. METHODS: We wish to report these 19 cases and 12 cases of brief review of literatures on the incidence, etiology and development, symptomatology, diagnosis and treatment of ectopic thyroid gland was done. RESULTS: The most frequent incidental age was between the age 1 year and 29 years. And the frequency of ectopic thyroid was about 7 times more common in female(27 cases) than in male(4 cases). The location of ectopic thyroid were found to be lingual in 18 cases, sublingual in 9 cases, prelaryngeal in 1 case, and combine with lingual and sublingual in 3 cases. In chief complaints, palpable mass was most common and there were foreign body sensation on throat, dysphagia, dysphonia, and hoarseness. In 15 cases of hypothyroidism, l2 cases were taken thyroid hormone replacement therapy, 1 case was removed ectopic thyroid gland. In 2 of 10 cases of euthyroidism, replacement of thyroid hormone were done and 2 cases were removed ectopic thyroid gland, in 6 cases of unknown thyroid function, 1 case was removed ectopic thyroid gland and 131I therapy was done in 1 case, and others were observed with following up thyroid function test. CONCLUSION: These results suggest that the long terms thyroid function test, thyroglossal duct eyst and malignant change in ectopic thyroid tissue when finding the ectopic thyroid in thyroid scintigraphy were recommended highly.
Congenital Hypothyroidism ; Deglutition Disorders ; Diagnosis ; Dysphonia ; Foreign Bodies ; Hoarseness ; Hormone Replacement Therapy ; Hypothyroidism ; Incidence ; Iodine ; Mediastinum ; Pharynx ; Radionuclide Imaging ; Sensation ; Thyroid Dysgenesis* ; Thyroid Function Tests ; Thyroid Gland ; Tongue

Around two-thirds of all abdominal aortic aneurysms (AAA) are incidentally discovered. Open surgical repair of these aneurysms is considered the standard, traditional method of treatment. This report details the minimal invasive approach for a patient who presented with early gastric cancer and an AAA, and the patient underwent endovascular repair of the aneurysm prior to laparoscopic assisted distal gastrectomy. Esophagogastroduodenoscopy identified a malignant ulcer in the antrum and preoperative abdominal computer-tomography incidentally revealed a large AAA. The abdominal aortic aneurysm was the infra-renal type and the estimated size was 65 mm. Compared to open surgical intervention, the treatment of abdominal aortic aneurysm via endovascular aneurysm repair (EVAR) shortens the period of recovery. Also, intra-abdominal adhesion is avoided so that minimal invasive surgical intervention through the laparoscopic approach is possible for treating malignancy. EVAR is the recommended treatment for asymptomatic abdominal aortic aneurysm when this is associated with intra-abdominal malignancy.
Aneurysm ; Aortic Aneurysm, Abdominal ; Endoscopy, Digestive System ; Gastrectomy ; Humans ; Stomach Neoplasms ; Ulcer

"BACKGROUND: Between 80 to 85% of patients with hyperparathyroidsm have a solitary adenoma of the parathyroid glands and another 15% have a parathyroid hyperplasia. Preoperative localization of the parathyoid glands is generally accepted as warranted in patients who have failed an initial attempt at parathyroidectomy, ectopic locations and inexperienced surgeons. Different imaging techniques have been used for detection of abnormal parathyroid glands such as high resolution ultrasonography, computerized tomography, arteriography, venous sampling or magnetic resonance imaging and 201Tl/99mTc subtraction scintigraphy. But these methods have had varying rates of success, with low specificity and low sensitivity. Among the several different techniques available for parathyroid radionuclide imaging, the most common is the use of a dualradioisotope procedure combining of Tl with Tc. However, there are some controversies regarding the optimal technical aspects of this procedure, including the relative amount of injected dose of radiotracers, failed detection for small sized and deeper cervical located parathyroids, and not easy procedures. Recently, double phase Tc-sestamibi scintigraphy would be useful to solve these technical limitations, more convenient and have higher sensitivities. The purpose of this study was to compare the diagnostic accuracy of 99mTc-sestamibi with 201Tl/ 99mTc subtraction scintigraphy in the localization of hyperparathyroidism. METHODS: 9 patients with hyperparathyroidism underwent preoperative evaluation with double phase 99mTc-sestamibi scintigraphy and 201Tl/99mTc subtraction scintigraphy for attempted localization of abnormal parathyroid glands and surgical explorations. Imaging results were compared to surgical findings. RESULTS: Of 9 patients, 7 had a solitary parathyroid adenoma, 1 had a carcinoma and 1 had parathyroid hyperplasia. The 201Tl/99mTc subtraction scintigraphy preoperatively localized 8 of 9 patients(sensitivity: S9%) and 99mTc-sestamibi scintigraphy correctly localized all lesions for a sensitivity of 100%. In one case, 201Tl/99mTc subtraction scan show only a hot uptake at left upper parathyroid area, but 99mTc-sestamibi scan was shown the three site of hot uptake at left upper, both inferior parathyroid area. CONCLUSION: In patients with hyperparathyoridism, 99mTc-sestamibi scintigraphy may be used as the single imaging technique as it show a very high sensitivity and specificity in the preoperative localization of pathological parathyroid glands.
Adenoma ; Angiography ; Humans ; Hyperparathyroidism* ; Hyperplasia ; Magnetic Resonance Imaging ; Parathyroid Glands ; Parathyroid Neoplasms ; Parathyroidectomy ; Radionuclide Imaging* ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi* ; Ultrasonography

Hook plate fixation is a treatment method for the displaced distal clavicle fracture with favorable results regarding bone union and shoulder function, however possible complications include impingement syndromes, subacrormial erosions, acromial fractures, and periprosthetic fractures. In this report, we observed 3 cases of periprosthetic fracture after hook plate fixation. All cases of periprosthetic fractures were initiated at the medial end screw holes. The causes of these periprosthetic fractures appeared to be the off centered fixation of medial end screws near the anterior or posterior cortex which were specific during operations with hook plates with more than 6 holes and the increased stress on the medial end screw by over-reduced or inferiorly reduced position of the distal end of the clavicle by the hook plate.
Clavicle* ; Periprosthetic Fractures* ; Shoulder