The efficacy of injection sclerotherapy for treatment of acute esophageal variceal bleeding is well established. But several complications of endoscopic sclerotherapy have been reported. One of the complications is mesenteric venous thrombosis which develops when vasopressin is user for the sclerotherapy. We report a case of superior mesenteric venous thrombosis with developed after endoscopic sclerotherapy for control of esophageal variceal bleeding.
Esophageal and Gastric Varices ; Sclerotherapy* ; Vasopressins ; Venous Thrombosis*

Mature cystic teratomas, commonly called dermoid cysts, are the most common benign germ cell tumors of ovary in women of reproductive age. Mature cystic teratoma that constitutes 10-25% of ovarian tumors and 95% of teratoma, is germ cell tumor of the ovary. This occurs frequently in women less than 20 years old, but it can be found upto 10-20% in postmenopausal women. And in women over the age of 50, a mature cystic teratoma is likely to change into malignant form. Traditional surgical methods of mature cystic teratoma treatment include transabdominal cystectomy, oophorectomy, hysterectomy and(or) bilateral salphingooophorectomy. Recently laparoscopic approach replaces transabdominal surgeries in many cases. Vaginal removal of mature cystic teratoma is unique and rare. Compared with laparotomy, transvaginal approach is characterized by shorter hospital stay and lower morbidity rate. Compared with laparoscopic operation, transvaginal approach has advantages of no visible operative scar and lower intra-operative tumor spillage. The decision for surgical methods is related with patients' situations and surgeon's preference. We report 1 case of vaginal removal of mature cystic teratoma as a part of vaginal hysterectomy in old age patient.
Cicatrix ; Cystectomy ; Dermoid Cyst ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Laparotomy ; Length of Stay ; Neoplasms, Germ Cell and Embryonal ; Ovariectomy ; Ovary ; Teratoma* ; Young Adult

BACKGROUND: To determine mean clitoral and glans size of Korean female newborn. MATERIALS AND METHODS: The size of glans and clitoris of 68 Korean female newborns born at Yeungnam University Medical Center were measured from May in 1999 to August in 1999. RESULTS: The mean size of the 68 newborns were 2.38+/-1.14 mm in glans length, 2.55+/-1.48 mm in glans width and 4.66+/-1.93 mm in clitoral length. In the premature infants the mean clitoral size was 1.92+/-1.58 mm in glans length, 1.78+/-1.24 mm in glans width and 3.86+/-2.16 mm in clitoral length. In the full term infants 2.53+/-1.12 mm in glans length, 2.75+/-1.58 mm in glans width and 4.94+/-1.89 mm in clitoral length. In low birth weight infants clitoral size was measured 1.55+/-1.10 mm in glans length, 2.04+/-2.03 mm in glans width and 3.29+/-1.87 mm in clitoral length. In normal birth weight infants 2.53+/-1.13 mm in glans length, 2.68+/-1.48 mm in glans width and 4.92+/-1.91 mm in clitoral length. In high birth weight infants 1.54+/-0.50 mm in glans length, 1.63+/-0.53 mm in glans width and 3.18+/-1.04 mm in clitoral length. CONCLUSION: There was no significant correlation between gestational age and clitoral size or glans size, but significant negative correlation was found between birth weight and clitoral size or glans size.
Academic Medical Centers ; Birth Weight ; Clitoris ; Female* ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn* ; Infant, Premature

BACKGROUND: This study was undertaken to evaluate the diagnostic sensitivity of several muscles in repetitive nerve stimulation test (RNST) for myasthenia gravis (MG) patients. MATERIALS AND METHODS: The study population consisted of 39 MG patients classified by modified Ossermann's classification. Using Stalberg's method, RNST was systematically performed in facial (orbicularis oculi and nasalis) and upper extremity (flexor carpi ulnaris, abductor digiti quinti and anconeus) muscles. RESULTS: The significant electrodecremental response of RNST were noted in orbicularis oculi (58.9%), nasalis (51.3%), flexor carpi ulnaris (42%), anconeus (41%) and abductor digiti quinti muscles (27%). Among the 3 muscles of upper extremity (abductor digiti quinti, flexor carpi ulnaris and anconeus), the positive electrodecremental response of anconeus muscles was significantly higher than other two muscles (p<0.05) in type IIa, IIb and there were no statistical differences of the positive electrodecremental response between orbicularis oculi and nasalis muscles. The facial muscles showed more prominent decremental responses than upper extremity muscles in type I MG(p<0.05). In type IIa MG patients, there were no significant statistical differences between facial and upper extremity muscles but significant statistical differences among upper extremity muscles. In type IIb MG patients, there were no significant statistical differences in all tested muscles in spite of the increased positive electrodecremental response of RNST. CONCLUSION: On the basis of this study, RNST would be initially performed for the orbicularis or nasalis in type I MG and for the anconeus in type IIa or IIb MG.
Classification ; Facial Muscles ; Humans ; Muscles* ; Myasthenia Gravis* ; Upper Extremity

BACKGROUND: P wave dispersion(PWD) is defined as the difference between the maximum and minimal P wave duration in any of the 12 leads of the surface ECG. The prolongation of atrial conduction time and the inhomogeneous propagation of sinus impulse are known electrophysiologic features in patients with paroxysmal atrial fibrillation(PAF). The purpose of this study was to determine the role of P wave dispersion for the prediction of PAF and to evaluate the effectiveness of prophylactic antiarrhythmic therapy. MATERIALS AND METHODS: The study population included 20 patients with a history of idiopathic PAF and 20 age and sex matched healthy control subjects. We measured the maximum P wave duration(P maximum) and P wave dispersion from 12 lead ECG. RESULTS: P maximum and P dispersion in idiopathic PAF were significantly higher than normal control group(97.2+/-12, 48.5+/-9msec vs, 76.5+/-11, 21+/-8msec, respectively p<0.001, <0.001). After 12-month follow up period P maximum and P dispersion were significantly reduced than those of initial state(77.2+/-13, 26.4+/-9msec vs. 97.2+/-12, 48.5+/-9msec, respectively p<0.001,<0.001). CONCLUSION: P dispersion and P maximum were significantly different between patients with idiopathic PAF and healthy control group. Those are easily accessible, non-invasive simple electrocadiographic markers that could be used for the prediction and prognostic factors of idiopathic PAF.
Atrial Fibrillation* ; Electrocardiography ; Follow-Up Studies ; Humans

BACKGROUND: The causes of ADHD(attention deficit hyperactivity disorder) are various, it is impossible to understand the whole characteristics of ADHD, only with simple intellignece testing scales. We compared cognitive characteristics of ADHD group with normal controls with Korean Kaufman Assessment Battery for Children(K-ABC), It is well known to evaluate neuropsychological and cognitive aspects of the children. MATERIALS AND METHODS: Age and sex matched 40 ADHD patients and 40 normal controls tested with the K-ABC. Each subscales compared between pre-treatment patients and controls, pre-treatment and post-treatment in patient group, post-treatment patients and controls. RESULTS: Significant differences are ovserved in sequential processing, simultaneous processing, cognitive processing and achievement between pre-treatment patients and controls, and in gestalt closure between pre-treatment and post-treatment patients group. But there are no significant differences between pre-treatment patients and controls in gestalt closure and reading/decoding. CONCLUSIONS: Methylphenidate improved the scores of simultaneous scale, which means improvement of executive functions such as divided attention, analysis and organization. Methylphenidate also reduced distractibility.
Attention Deficit Disorder with Hyperactivity ; Child ; Executive Function ; Humans ; Intelligence* ; Methylphenidate* ; Weights and Measures

We report the result of a high-dose intravenous immunoglobulin therapy in a Henoch-Sch?nlein purpura patient with severe abdominal pain and nephrotic syndrom who did not respond to methylprednisolone pulse therapy. Kidney bbiopsy showed diffuse mesangial cell proliferative glomerulonephritis with fibrocellular crescent formation in approximately 50% of glomeruli. Mesangium of all glomeruli were strong positive for IgA and C3 antibodies. High-dose intravenous immunoglobulin treatment was introduced and dramatic improvement of gastrointestinal symptom and proteinuria as well as hematuria was noted. Immunoglobulin administration should be considered in Henoch-Schnlein purpura patients with sterois-resistant intractable dastrointestinal manifestation and renal involvenment.
Abdominal Pain ; Antibodies ; Glomerulonephritis ; Hematuria ; Humans ; Immunization, Passive ; Immunoglobulin A ; Immunoglobulins* ; Kidney ; Mesangial Cells ; Methylprednisolone ; Nephrotic Syndrome ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch

Fibromuscular dysplasia is an uncommon condition of idiopathic, non-inflammatory and non-atherosclerotic disease of the musculature of arterial walls. The disease is rare, but it commonly affects young and middle aged women. Isolated intracranial cerebral fibromuscular dysplasia is extremely rare because cerebral fibromuscular dysplasia usually affects extracranial vessels. A 26-year-old woman was admitted with right hemiplegia and global aphasia. Brain MRI and MRA demonstrated acute left middle cerebral artery territory infarction with a multifocal stenosis and dilatation of the left middle cerebra artery and left internal carotid. The characteristic conventional cerebral angiographic findings demonstrated a typical string-of-beads appearance in the left distal internal carotid artery and proximal portion of the left middle cerebral artery, which suggested a medial type fibromuscular dysplasia. We report a case of isolated intracranial fibromuscular dysplasia with left middle cerebral artery territory infarction. Fibromuscular dysplasia should be considered as a stroke risk factors in children and young adults, especially in patients with no known cardiovascular risk factors.
Adult ; Aphasia ; Arteries ; Brain ; Carotid Artery, Internal ; Cerebral Infarction ; Child ; Constriction, Pathologic ; Dilatation ; Female ; Fibromuscular Dysplasia ; Hemiplegia ; Humans ; Infarction ; Middle Aged ; Middle Cerebral Artery ; Risk Factors ; Stroke ; Young Adult

There are debates about whether peripherally induced movement disorders exist. We report a case of upper limb tremor induced by peripheral nerve injury. A 25-year-old male patient presented with pain and tremor of the left upper extremity, 2 days after a car accident. Magnetic resonance images of the brain and cervical spine were normal. His past medical history was unremarkable and there were no family members with symptoms of movement disorders. He suffered from an aggravating tremor for about 10 minutes, four to six times a day. We treated the patient with medication, epidural infusion, cervical nerve root block and trigger point injection of the trapezius muscle. The pain subsided 50% and the incidence of tremor attacks was reduced to once or twice a day. The role of peripheral trauma in the genesis of movement disorders has not been generally accepted. It is unclear whether peripheral trauma can induce dystonia and other movement disorders. It has been proposed that peripheral trauma can alter sensory input and induce cortical and subcortical reorganization that generates a movement disorder. Some studies provide evidence for central reorganization following peripheral injury.
Accidents, Traffic ; Adult ; Brain ; Dystonia ; Humans ; Incidence ; Magnetic Resonance Spectroscopy ; Male ; Movement Disorders ; Muscles ; Pain, Intractable ; Peripheral Nerve Injuries ; Spine ; Tremor ; Trigger Points ; Upper Extremity

A 78-year-old woman presented with weakness of the extremities, dysarthria, dizziness, and sensory impairment. Magnetic resonance imaging showed acute bilateral medial medullary infarction. Contrast enhanced magnetic resonance angiography demonstrated stenosis or occlusion of both intracranial vertebral arteries. We present a rare case of bilateral medullary infarction seen on diffusion-weighted imaging.
Aged ; Brain ; Constriction, Pathologic ; Dizziness ; Dysarthria ; Extremities ; Female ; Humans ; Infarction ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Vertebral Artery