Delayed diagnosis of the compartmental syndrome and subsequent delay in performing the fasciotomy can result in needless loss of function and possible amputation of the involved extremity. Unfortunately early evidence of this syndrome is difficult to assess. A direct measurement of the tissue pressure within a closed compartment has been developed which provides physicians with reliable information for determining the need for fasciotomy. In the 27 cases of the tibia fracture, tissue pressure was measured directly by method of the needle manometer in the Department of Orthopedic Surgery, Han Kang Sung Sim Hospital from March, 1979 to August, 1979. The results were as follows: 1. The highest mean tissue pressure per hour was 28 mmHg in anterior compartment at 24 hours after trauma, and 28.4 mmHg in deep post compartment at the same hours. 2. The highest pressure measured in all cases was 38 mmHg in anterior compartment at 24 hours and 39 mmHg in deep posterior compartment at 48 hours after trauma. 3. The return of increased tissue pressure to less than 10 mmHg took 122.6 hours in anterior and 124.4 hours in deep posterior compartment. 4. Tissue pressre was higher when there was associated fibula fracture. 5. Tissue pressure was higher in displaced fractures than in undisplaced fractures. 6. Tissue pressure was higher when fracture was in its upper one-third. 7. Tissue pressure was higher in comminuted fracture than simple fracture.
Amputation ; Delayed Diagnosis ; Extremities ; Fibula ; Fractures, Comminuted ; Methods ; Needles ; Orthopedics ; Tibia

PURPOSE: To demonstrate and evaluate the value of MRI findings of the TSH(Thyroid-Stimulating Hormone, TSH, Thyrotropin)-secreting pituitary adenoma. MATERIALS AND METHODS: The authors reviewed retrospectively the MR images of 4 patients with TSH-secreting pituiatary adenoma. Evaluation of the anatomical location, signal characteristics, enhancement patterns, size, shape and circunferential changes were made. RESULTS: No characteristic common MR findings in size, shape, signal intensity, and circumferential changes of TSH-secreting pituiatary adenoma waere observed among 4 cases(size; 5x7 mm to 10x11 mm, shape;ovoid to round, signal intensity;high in 1 case on T1 and T2WI, isosignal intensity in the other 3 cases, circumferential change; stalk deviation in 1 case, no stalk deviation in 3 cases). But, the tumors were centrally located at the anterior pituitary gland and showed relatively homogeneous signal intensity on MR images of all 4 patients. CONCLUSION: We conclude that centrally-located mass at the anterior pituitary gland with homogeneous signal intensity on MR image may be suggestive of the TSH-secreting pituitary adenoma, although the MR findings are not specific for the disease.
Adenoma ; Humans ; Magnetic Resonance Imaging* ; Pituitary Gland, Anterior ; Pituitary Neoplasms* ; Retrospective Studies

No abstract available.
Prescriptions*

Thyroid nodules are the most common endocrine disease requiring surgical management. Various techniques for evaluating thyroid nodules have been developed and are being utilized, but it is difficult to differentiate the few malignant lesions from the numerous benign nodules. We reviewed 187 patients with thyroid nodules who were admitted to and operated on at the Department of General Surgery, Buchon Sejong General Hospital, from January 1990 to December 1996. The results are summarized as follows: 1) The incidence of benign nodules was 83.9%, and that of malignant nodules was 16.0% among the 187 cases of thyroid nodules. 2) The sexual distribution revealed female preponderance of 6.5:1 for benign nodules and 14:1 for malignant nodules. 3) The peak-incidence was in the 4th decade to both patients with benign nodules and patients with malignant nodules. 4) As to the duration of illness, 39.6% of cases were resolved within 3 months, 77.5% of cases within 1 year. 5) The most common subjective symptoms were a palpable mass (100%), fatigue, palpitation, and headache, in order of frequency. 6) Eight four percent (84%) of the nocules were unilateral, 46.5% were on the right, 37.4% were on the left, and 12.8% were bilateral. 7) The most common (36.9%) nodule size was 2~3 cm. 8) There was a single nodule in 142 (75.9%) cases and multiple nodules in 45 (24.1%) cases. There was no difference in the incidence of cancer between single and multiple nodules. Also, 35.7% of the benign tumors and 80.0% of the malignant ones were solid. 9) On thyroid scanning, 86.0% of the benign nodules and 93.3% of the malignant nodules were cold nodules. 10) The histopathologic classifications of the benign nodules in decreasing order of frequency were adenomatous goiter, 121 cases (77.1%); follicular adenoma, 20 cases (12.7%); Graves' disease, 6 cases (3.8%); Hashimoto's thyroiditis, 6 cases (3.8%), cyst, 3 cases (1.9%); and subacute thyroiditis, 1 case (0.6%). The malignant diseases were papillary carcinoma, 26 cases (86.7%); follicular carcinoma, 3 cases (10.0%); and medullary carcinoma, 1 case (3.3%). 11) Benign nodules were treated with a lobectomy (69.4%), a lobectomy with isthmectomy (17.8%), a near total thyroidectomy (11.5%) or a total thyroidectomy (1.3%). Malignant nodules were treated with a lobectomy (23.3%), a lobectomy with isthmectomy (20.0%), a total thyroidectomy (20%), a total thyroidectomy with radical neck dissection (20%) a near total thyroidectomy (13.3%), or a near total thyroidectomy with radical neck disection(RND) or modified RND (3.3%). 12) The postoperative complications were transient hypocalcemia (6.4%), permanent hypocalcemia (2.1%), transient hoarseness (1.6%), permanent hoarseness (0.5%), and hematoma (0.5%).
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Classification ; Endocrine System Diseases ; Fatigue ; Female ; Goiter ; Graves Disease ; Headache ; Hematoma ; Hoarseness ; Hospitals, General ; Humans ; Hypocalcemia ; Incidence ; Neck ; Neck Dissection ; Postoperative Complications ; Thyroid Gland* ; Thyroid Nodule* ; Thyroidectomy ; Thyroiditis ; Thyroiditis, Subacute

Thyroid nodules are the most common endocrine disease requiring surgical management. Various techniques for evaluating thyroid nodules have been developed and are being utilized, but it is difficult to differentiate the few malignant lesions from the numerous benign nodules. We reviewed 187 patients with thyroid nodules who were admitted to and operated on at the Department of General Surgery, Buchon Sejong General Hospital, from January 1990 to December 1996. The results are summarized as follows: 1) The incidence of benign nodules was 83.9%, and that of malignant nodules was 16.0% among the 187 cases of thyroid nodules. 2) The sexual distribution revealed female preponderance of 6.5:1 for benign nodules and 14:1 for malignant nodules. 3) The peak-incidence was in the 4th decade to both patients with benign nodules and patients with malignant nodules. 4) As to the duration of illness, 39.6% of cases were resolved within 3 months, 77.5% of cases within 1 year. 5) The most common subjective symptoms were a palpable mass (100%), fatigue, palpitation, and headache, in order of frequency. 6) Eight four percent (84%) of the nocules were unilateral, 46.5% were on the right, 37.4% were on the left, and 12.8% were bilateral. 7) The most common (36.9%) nodule size was 2~3 cm. 8) There was a single nodule in 142 (75.9%) cases and multiple nodules in 45 (24.1%) cases. There was no difference in the incidence of cancer between single and multiple nodules. Also, 35.7% of the benign tumors and 80.0% of the malignant ones were solid. 9) On thyroid scanning, 86.0% of the benign nodules and 93.3% of the malignant nodules were cold nodules. 10) The histopathologic classifications of the benign nodules in decreasing order of frequency were adenomatous goiter, 121 cases (77.1%); follicular adenoma, 20 cases (12.7%); Graves' disease, 6 cases (3.8%); Hashimoto's thyroiditis, 6 cases (3.8%), cyst, 3 cases (1.9%); and subacute thyroiditis, 1 case (0.6%). The malignant diseases were papillary carcinoma, 26 cases (86.7%); follicular carcinoma, 3 cases (10.0%); and medullary carcinoma, 1 case (3.3%). 11) Benign nodules were treated with a lobectomy (69.4%), a lobectomy with isthmectomy (17.8%), a near total thyroidectomy (11.5%) or a total thyroidectomy (1.3%). Malignant nodules were treated with a lobectomy (23.3%), a lobectomy with isthmectomy (20.0%), a total thyroidectomy (20%), a total thyroidectomy with radical neck dissection (20%) a near total thyroidectomy (13.3%), or a near total thyroidectomy with radical neck disection(RND) or modified RND (3.3%). 12) The postoperative complications were transient hypocalcemia (6.4%), permanent hypocalcemia (2.1%), transient hoarseness (1.6%), permanent hoarseness (0.5%), and hematoma (0.5%).
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Classification ; Endocrine System Diseases ; Fatigue ; Female ; Goiter ; Graves Disease ; Headache ; Hematoma ; Hoarseness ; Hospitals, General ; Humans ; Hypocalcemia ; Incidence ; Neck ; Neck Dissection ; Postoperative Complications ; Thyroid Gland* ; Thyroid Nodule* ; Thyroidectomy ; Thyroiditis ; Thyroiditis, Subacute

PURPOSE: The purpose of this study was to analyze the radiologic findings of primary epiploic appendagitis, with particular attention to the correlation of ultrasonographic, clinical, CT, MR and surgical findings. MATERIALS AND METHODS: Among 14 patients with primary epiploic appendagitis who presented with the rapid onset of a very localized pain and tenderness, we performed ultrasonography in all, CT in eight, and MRI in four of these eight. Surgery was performed in two patients. Follow-up examinations were performed using US, CT and MRI (n=2), US and CT (n=2), US alone (n=2), and with regard to clinical features (n=12). RESULTS: US performed in 14 patients revealed the presence in all of small, well-defined, ovoid, noncompressible hyperechoic (n=12) or isoechoic (n=2) solid masses attached to the colonic wall, without bowel wall change and without communication with bowel lumen. CT performed in 8 patients showed varying hyperattenuating fatty lesions in the same location in the abdomen, without other inflammatory process. MRI findings of four patients were helpful for further evaluation of internal architecture. CONCLUSION: In primary epiploic appendagitis, US findings were sufficiently characteristic to allow accurate diagnosis and valuable for the differential diagnosis of other acute conditions of the abdomen.
Abdomen ; Colon ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

PURPOSE: The aim of this study was to determine if postoperative adjuvant chemotherapy (CT) alone and concurrent chemoradiation (CCRT), following radical surgery, improved the disease free survival (DFS) and overall survival (OS) in rectal cancer AJCC stage II and III patients. MATERIALS AND METHODS: A total of 144 patients with AJCC stage II and III rectal cancer who had had radical surgery between 1989 and 1999 were included in the study. Of these patients, 72 had been treated with postoperative CT, and the other 72 with postoperative CCRT. The chemotherapy regimen consisted of oral UFT on a daily basis for 1~12 months (median 12 months) or 5-FU (500 mg/m2 for 5 days) intravenous (IV) chemotherapy with 4 week intervals for 1~18 cycles (median 6 cycles). Radiation of 4,500 cGy was delivered to the surgical bed and regional pelvic lymph nodes area, followed by 540~1,440 cGy (median 540 cGy) boost to the surgical bed. The follow-up period ranged from 20 to 150 months, with a median of 44 months. RESULTS: The 5-year OS was 60.9% and 68.9% (p=0.0915), and the 5-year DFS was 56.1% and 63.8% (p=0.3510) for postoperative CT and postoperative CCRT, respectively. In the stage II patients, the 5-year OS was 71.1% and 92.2%, and the 5-year DFS was 57.3% and 85.4% for postoperative CT and CCRT, respectively. The OS was significantly improved (p=0.0379) but the DFS was not with postoperative CCRT compared to the postoperative CT (p=0.1482). In the stage III patients, the 5-year OS was 52.0% and 55.0%, and the 5-year DFS was 47.8% and 49.8% for postoperative CT and postoperative CCRT. There were no statistically significant differences between postoperative CT and CCRT (p=0.4280 and p=0.7891) in OS and DFS. The locoregional relapses were 16.7% and 12.5% for postoperative CT and CCRT, respectively. The distant relapses were 25.0% and 26.4% for postoperative CT and CCRT, respectively. CONCLUSION: These results showed that postoperative CCRT compared with CT alone improved OS in stage II patients. Although there was no statistical significance, the addition of postoperative RT to CT reduced locoregional relapses compared to CT alone.
Chemotherapy, Adjuvant* ; Disease-Free Survival ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Humans ; Lymph Nodes ; Rectal Neoplasms* ; Recurrence

No abstract available.
Antibodies* ; Chlamydia trachomatis* ; Chlamydia* ; Humans ; Neisseria gonorrhoeae* ; Neisseria* ; Prevalence*

No abstract available.
Antibodies* ; Chlamydia trachomatis* ; Chlamydia* ; Humans ; Neisseria gonorrhoeae* ; Neisseria* ; Prevalence*

BACKGROUND: This study was designed to investigate the correlation between pain and non-pain sensation of the cutaneous nociceptors in healthy adults use 250 Hz and 5 Hz evoking neuroselective sinusoidal current to A delta and C-fiber separately. METHODS: Fifty healthy adult volunteers who have no history of neurological illness were examined. Twenty-five of them were male, and twenty-five were female. Their ages ranged from 20 to 46 years, with a mean equal to 29.5 years old. The thresholds for both current perception and nociceptive perception were measured bilaterally in volar aspect of wrist using a Neurometer CPT/C (Quantitative Sensory Nerve Testing Device). The manual mode for current perception threshold and the staircase method for nociceptive current perception threshold was performed individually. RESULTS: The mean values of the threshold for perception evoked by 250 Hz were 0.30 mA in left and 0.31 mA in right, 0.17 mA in left and 0.14 mA in right at 5 Hz respectively. The mean values of the nociception threshold were 0.52 mA in both site at 250 Hz and from 0.35 mA to 0.32 mA at 5 Hz (Table 1). There were no differences between left and right wrist (Fig. 1). Also a significant positive correlation between current perception and nociception thresholds was found (p<0.05) (Fig. 2, 3). There appeared to be different between genders in perception threshold evoked by 250 Hz and nociception threshold evoked by 5 Hz in left (p<0.05) (Table 2). CONCLUSIONS: There exists a meaningful correlation between both sensations of non-pain and pain perception thresholds obtained from all subjects. The measurement of the current perception threshold is considered to be a unique and valuable resource in evaluation of patient with neurologic condition, as well as in serial evaluation of patient to assess the outcome of therapeutic intervention.
Adult* ; Female ; Humans ; Male ; Nociception* ; Nociceptors ; Pain Perception ; Sensation ; Volunteers ; Wrist