Tuberculosis and lymphoma, these 2 diseases can present with lyphadenopathy in anywhere of the body. Therefor differentiation of tuberculosis from lymphoma is often difficult. CT scans of 17 patients with tuberculosis and 23 patients with lymphoma were retrospectively reviewed to evaluate the efficacy of CT scans in differentating adenopathy between tuberculosis and lymphoma, All the patients underwent abdominal CT scans with contrast enhancement before treatment. The size, internal architecture, distribution of lymph nodes, and associated findings on CT scans were analyzed. As compared with lymphoma, tuberculous lymphadenopathy showed 1) female preponderance (65%), 2) predilection for portocaval lymph nodes (47%), 3) internal low attenuation in lymph nodes (82%), 4) cold abscess formation (24%). Characteristics of lymphoma on CT scans included 1) male prepondrance (78%), 2) conglomeration of lymph nodes (39%), 3) homogenous internal lymph node structure (83%). These results suggest that evaluation of the characteristics of lymphadenopathy on CT scans is helpful for differentiating between tuberculosis and lymphoma.
Abscess ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis*

Tuberculosis and lymphoma, these 2 diseases can present with lyphadenopathy in anywhere of the body. Therefor differentiation of tuberculosis from lymphoma is often difficult. CT scans of 17 patients with tuberculosis and 23 patients with lymphoma were retrospectively reviewed to evaluate the efficacy of CT scans in differentating adenopathy between tuberculosis and lymphoma, All the patients underwent abdominal CT scans with contrast enhancement before treatment. The size, internal architecture, distribution of lymph nodes, and associated findings on CT scans were analyzed. As compared with lymphoma, tuberculous lymphadenopathy showed 1) female preponderance (65%), 2) predilection for portocaval lymph nodes (47%), 3) internal low attenuation in lymph nodes (82%), 4) cold abscess formation (24%). Characteristics of lymphoma on CT scans included 1) male prepondrance (78%), 2) conglomeration of lymph nodes (39%), 3) homogenous internal lymph node structure (83%). These results suggest that evaluation of the characteristics of lymphadenopathy on CT scans is helpful for differentiating between tuberculosis and lymphoma.
Abscess ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Male ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis*

BACKGROUND: To evaluate the effects of thoracic epidural anesthesia, with or without bilateral vagotomy, epinephrine-induced arrhythmias were studied in 31 rabbits anesthetized with 1 MAC enflurane. METHODS: Logdose protocol was used for the infusion of epinephrine; its arrhythmic dose being defined as the smallest infusion rate produced four or more continuous or intermittent arrhythmias within 15 seconds. RESULTS: The values (geometric mean) of arrhythmic doses and the plasma concentration of epinephrine during arrhythmia were as follows: 10.21 g.kg 1.min 1 and 83.16 ng/ml in epidural control group; 118.90 g.kg 1.min 1 and 677.76 ng/ml in epidural lidocaine group (p<0.05); 6.34 g.kg-1.min 1 and 96.42 ng/ml in intravenous lidocaine group; 8.65 g.kg 1.min-1 and 44.64 ng/ml in vagotomized-epidural control group; and 12.03 g.kg 1.min 1 and 95.35 ng/ml in vagotomized- epidural lidocaine group. CONCLUSIONS: The data suggest that thoracic epidural anesthesia raises the threshold for enflurane- epinephrine arrhythmias in rabbits and that this effect is eliminated by bilateral vagotomy.
Anesthesia, Epidural* ; Arrhythmias, Cardiac* ; Enflurane ; Epinephrine ; Lidocaine ; Plasma ; Rabbits* ; Vagotomy*

PURPOSE: Hands are the chief organs for physically manipulating the environment, using anywhere from the roughest motor skills to the finest, and since the fingertips contain some of the densest areas of nerve endings on the human body, they are continuously used organ with complex functions, and therefore, often gets injured. To prevent any functional loss, a detailed anatomical knowledge is required to have a perfect surgical treatment. Also it is necessary to have a thorough understanding of arrangements of the human extensor tendons and intertendinous connections when tenoplasty or tendon transfer is required. We performed a study of the arrangements of the human extensor tendons and the configuration of the intertendinous connections over the dorsum of the wrist and hand. METHODS: A total of 58 hands from Korean cadavers were dissected. The arrangements of extensor indicis proprius, extensor digitorum communis, and extensor digiti minimi tendons and intertendinous connections were studied. RESULTS: The most common distribution patterns of the extensor tendons of the fingers were as follows: a single extensor indicis proprius(EIP) tendon which inserted ulnar to the extensor digitorum-index(EDC-index); a single EDC-index; a single EDC-middle; a double EDC-ring; an absent EDC-little; a double extensor digiti minimi(EDM), a single EDC-index(98.3%), a single EDC-middle(62%), a double EDC-ring(50%), and an absent(65.5%) or a single (32.8%) EDC-little. A double(70.6%) EDM tendons were seen. Intertendinous connections were classified into 3 types: type 1 with thin filamentous type, type 2 with a thick filamentous type, and type 3 with a tendinous type subdivided to r shaped 3r type and y shaped 3y type. The most common patterns were type 1 in the 2nd intermetacarpal space, type 2 in the 3rd intermetacarpal space, and type 3r in the 4th intermetacarpal space. And in the present study, we observed one case of the extensor digitorum brevis manus(EDBM) on the boht side. CONCLUSION: A knowledge of both the usual and possible variations of the extensor tendon and the intertendinous connection is useful in the identification and repair of these structures.
Cadaver ; Fingers ; Hand ; Human Body ; Humans ; Motor Skills ; Nerve Endings ; Tendon Transfer ; Tendons ; Wrist

Microangiopathic hemolytic anemia (MAHA) occurs occasionally as a paraneoplastic syndrome in some solid tumors, but MAHA accompanied by signet ring cell carcinoma of an unknown origin is very rare. In this study, we present the case of an 80-yr-old man who was admitted to the hospital because of a 1-month history of lower back pain and dyspnea. He was diagnosed with MAHA on the basis of the laboratory findings that revealed anemia with schistocytes, decreased haptoglobin levels, and a negative direct Coombs' test. Bone marrow examination, which was performed because of the progression of anemia, revealed bone marrow metastases of signet ring cell carcinoma with extensive bone marrow necrosis. However, the primary origin of this signet ring cell carcinoma was not found. When the cause of progressive MAHA is unknown, the possibility of cancer-associated MAHA must be excluded by performing additional tumor workup, including the detection of tumor markers, gastric and colorectal endoscopic examinations, bone marrow examinations, and positron emission tomography-computed tomography or bone scans.
Aged, 80 and over ; Bone Marrow Neoplasms/complications/*diagnosis/pathology ; Carcinoma, Signet Ring Cell/complications/*diagnosis/pathology ; Endoscopy, Gastrointestinal ; Haptoglobins/metabolism ; Humans ; Immunohistochemistry ; Male ; Necrosis/etiology ; Neoplasm Metastasis ; Positron-Emission Tomography ; Purpura, Thrombotic Thrombocytopenic/*diagnosis/etiology ; Tomography, X-Ray Computed ; Tumor Markers, Biological/analysis

Microangiopathic hemolytic anemia (MAHA) occurs occasionally as a paraneoplastic syndrome in some solid tumors, but MAHA accompanied by signet ring cell carcinoma of an unknown origin is very rare. In this study, we present the case of an 80-yr-old man who was admitted to the hospital because of a 1-month history of lower back pain and dyspnea. He was diagnosed with MAHA on the basis of the laboratory findings that revealed anemia with schistocytes, decreased haptoglobin levels, and a negative direct Coombs' test. Bone marrow examination, which was performed because of the progression of anemia, revealed bone marrow metastases of signet ring cell carcinoma with extensive bone marrow necrosis. However, the primary origin of this signet ring cell carcinoma was not found. When the cause of progressive MAHA is unknown, the possibility of cancer-associated MAHA must be excluded by performing additional tumor workup, including the detection of tumor markers, gastric and colorectal endoscopic examinations, bone marrow examinations, and positron emission tomography-computed tomography or bone scans.
Aged, 80 and over ; Bone Marrow Neoplasms/complications/*diagnosis/pathology ; Carcinoma, Signet Ring Cell/complications/*diagnosis/pathology ; Endoscopy, Gastrointestinal ; Haptoglobins/metabolism ; Humans ; Immunohistochemistry ; Male ; Necrosis/etiology ; Neoplasm Metastasis ; Positron-Emission Tomography ; Purpura, Thrombotic Thrombocytopenic/*diagnosis/etiology ; Tomography, X-Ray Computed ; Tumor Markers, Biological/analysis

To evaluate the effectiveness of centralizing device, three groups of patients on whom cemented total hip arthroplasty with three types of implant was performed respectively were analyzed and compared; SL stems without centralizing device were used in Group I, Interlok stems with central sleeve in Group II, and MS-30 stems with distal centralizer in Group III .The size of each group was 20. Cement mantle thickness, the amount of displacement of stem tip, and axis alignment of femoral stem on A-P radiograph checked at 2 weeks after operation were assessed. More optimal cement mantle thickness (3~6mm) was achieved in Group II (P=0.046) and Group III (P=0.01) than in Group I. Centralizing effect of the distal femoral stem in the intramedullary canal was significantly better (P<0.05) in Group III ( 4.55% ) than in Group I (11.60%) and Group II (12.35%). Neutral alignment of femoral stem was achieved in 15% of Group I, in 90% of Group II, and in 95% of Group III. Compared to stem without centralizing device, cemented femoral stem with distal centralizer resulted in 1) significantly more centralized distal femoral stem, 2) significantly more neutrally aligned femoral stem,and 3) significantly more optimal cement mantle thickness at zone V. Compared to stem without centralizing device, cemented femoral stem with central sleeve resulted in 1) significantly more neutrally aligned femoral stem, and 2) significantly more optimal cement mantle thickness at zone VI.
Arthroplasty, Replacement, Hip ; Axis, Cervical Vertebra ; Humans

PURPOSE: The purpose of this study was to evaluate the early and midterm results of superficial femoral artery (SFA) stenting with self-expanding nitinol stents and to identify the factors affecting patency. MATERIALS AND METHODS: SFA stenting was performed in 165 limbs of 117 patients from January 2009 to December 2013. Patients were followed-up for the first occurrence of occlusion or stenosis based on computed tomography and duplex scan results and a decrease in ankle brachial index of >15%. RESULTS: During the follow-up period (mean, 15.3+/-3.2 months), no early thrombotic reocclusions occurred within 30 days, but in-stent restenosis developed in 78 limbs. The primary patency rates at 6, 12, 18, and 24 months were 78%, 66%, 42%, and 22%, respectively, and the secondary patency rates were 85%, 72%, 58%, and 58%, respectively. TASC II C or D lesions, stent length >8 cm, number of patent tibial arteries and diabetes were significantly associated with reintervention. CONCLUSION: The midterm results of stenting for SFA occlusive disease were disappointing because the primary and secondary patency rates at two years were 22% and 58%, respectively. Reintervention after SFA stenting remains a major problem, particularly in patients with diabetes mellitus or long TASC II C or D lesions.
Ankle Brachial Index ; Constriction, Pathologic ; Diabetes Mellitus ; Endovascular Procedures ; Extremities ; Femoral Artery* ; Follow-Up Studies ; Humans ; Stents* ; Tibial Arteries

Benign recurrent intrahepatic cholestasis (BRIC) is a rare desease, which usually manifests between the age of 10 and 20. Its main clinical feature is multiple recurrent episodes of cholestasis without extrahepatic bile duct obstruction. We report here a case of nonfamilial benign recurrent intrahepatic cholestasis. The patient has experienced recurrent jaundice with pruritus since childhood. Main bile duct obstrution was excluded by abdominal CT and endoscopic retrograde cholangiopancreatography. Other causes of cholestasis were not found. Hepatic histology revealed bile plug which were mainly concentrated in the centrilobular region, and increased number of mononuclear cells in the portal triad, but hepatic parenchyma showed no inflammation and necrosis. In the last anicteric period, she was healthy and the liver function test and biopsy specimen were normal.
Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis ; Cholestasis, Intrahepatic* ; Humans ; Inflammation ; Jaundice ; Liver Function Tests ; Necrosis ; Pruritus ; Tomography, X-Ray Computed

Benign recurrent intrahepatic cholestasis (BRIC) is a rare desease, which usually manifests between the age of 10 and 20. Its main clinical feature is multiple recurrent episodes of cholestasis without extrahepatic bile duct obstruction. We report here a case of nonfamilial benign recurrent intrahepatic cholestasis. The patient has experienced recurrent jaundice with pruritus since childhood. Main bile duct obstrution was excluded by abdominal CT and endoscopic retrograde cholangiopancreatography. Other causes of cholestasis were not found. Hepatic histology revealed bile plug which were mainly concentrated in the centrilobular region, and increased number of mononuclear cells in the portal triad, but hepatic parenchyma showed no inflammation and necrosis. In the last anicteric period, she was healthy and the liver function test and biopsy specimen were normal.
Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis ; Cholestasis, Intrahepatic* ; Humans ; Inflammation ; Jaundice ; Liver Function Tests ; Necrosis ; Pruritus ; Tomography, X-Ray Computed