BACKGROUND AND OBJECTIVES: Hyperfunctional voice disorders caused by the over-adduction of the vocal cords have various supraglottic movements during phonation. These various hyperkinetic supraglottic movements will be able to affect the vocal sound production. The aim of this study is to evaluate the relation between supraglottic movements and movement of extralaryngeal muscles using surface laryngeal EMG. MATERIALS AND METHODS: The subject who had normal anatomic and physiologic laryngeal function produced the vocal sounds of the 3 types of supraglottic movement. In each type, when three different pitch sounds were produced, surface laryngeal EMG was recorded and perceptual and acoustic analysis of vocal sound were performed. RESULTS: Voice with contracted supraglottic movement had strained sound in perceptual analysis, increased jitter and shimmer in MDVP, and increased amplitude in surface laryngeal EMG. Voice with lowered and widened supraglottic movement had resonant sound in perceptual analysis, decreased jitter and shimmer in MDVP, decreased amplitude in surface laryngeal EMG. CONCLUSION: Voice was different with various types of supraglottic movements and surface laryngeal EMG findings were also different with various types of supraglottic movements.
Acoustics ; Muscles ; Phonation ; Vocal Cords ; Voice ; Voice Disorders

STUDY DESIGN: Retrospective study. PURPOSE: To estimate the usefulness of bone scan and magnetic resonance imaging (MRI) for the diagnosis of new fracture in osteoporotic vertebral fractures. OVERVIEW OF LITERATURE: The diagnosis of new fractrure in osteoporotic vertebral fractures requires simple X-ray and supplementary studies. METHODS: We analyzed 87 vertebrae in 44 patients, who diagnosed with osteoporotic vertebral fractures using bone scan and MRI within 2 months interval between August 2001 and July 2008. We compared hot uptakes in bone scan with MRI findings such as new fractures, old fractures and degenerative lesions. RESULTS: Hot uptakes in bone scan was matched to 48 new fractures, 26 old fractures and 13 degenerative lesions in MRI findings. It was 55% of concordance between hot uptakes in bone scan and new fractures in MRI. The rate of new vertebral fractures confirmed by MRI according to 1 level hot uptakes in bone scan was 96%, 2 levels was 50% and 3 more levels was 36%. CONCLUSIONS: The diagnosis of new fracture in osteoporotic vertebral fractures requires simple X-ray and supplementary studies such as bone scan and MRI. We recommend more careful interpretation in multiple osteoporotic vertebral fracture patients about hot uptake lesions of bone scan.
Fractures, Compression ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine

PURPOSE: The aim of this study is to decide the optimal level of fusion with comparing the results between the short segment fusion and long segment fusion treated with pedicle screw instrumentation, including fractured vertebra in thoracolumbar junctional fractures. MATERIALS AND METHODS: From February 2000 to November 2009, fifty three patients with junctional fracture of thoracolumbar spine were treated with pedicle screws and posterior fusion at our hospital. They were divided into two groups, the short segment group and long segment group. Preoperatively, immediate postoperative and last follow-up lateral radiological evaluation was done by measuring the correction and loss of segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle. In addition, operation time and amount of intraoperative bleeding were measured. RESULTS: There were no significant differences of statistical analysis regarding the radiological variables between the two groups, especially the loss of corrected segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle (p>0.05). However, operative time in the short segment group (234 minutes) was shorter than the long segment group (284 minutes), and there was statistical significance (p=0.002). CONCLUSION: We recommend the short segment transpediculr instrumentation one level above and one level below, including the fractured vertebra for thoracolumbar junctional fracture with 6 points or less of the load-sharing score.
Follow-Up Studies ; Hemorrhage ; Humans ; Kyphosis ; Operative Time ; Spine

Basal cell carcinoma (BCC) represents the most common cutaneous malignancy in caucasions. Most of the tumors usually occur on sun-exposed skin, and they are small and easily treated. Giant BCC is a rare variant of this tumor and is defined as a lesion greater than 5 cm at its largest diameter. For the development of giant BCC, several risk factors, including patient neglect, aggressive histological features and long duration, have been identified. We observed a very large BCC on the face and scalp of an elderly woman. She had been reclusive for a long time, and this problem might have played a crucial role in the development of the giant BCC.
Aged ; Carcinoma, Basal Cell* ; Female ; Humans ; Risk Factors ; Scalp ; Skin

Crossed renal ectopia, without fusion, is a very rare congenital anomaly of the urinary tract, and can be frequently accompanied with hydronephrosis due to vesico-ureteral reflux (VUR) or ureteropelvic junction stenosis, renal atrophy, or ectopic ureterocele. We report a case of vesicoureteral reflux is reported in an infant with crossed renal ectopia without fusion.
Atrophy ; Constriction, Pathologic ; Humans ; Hydronephrosis ; Infant ; Ureterocele ; Urinary Tract ; Vesico-Ureteral Reflux

BACKGROUND: We examined the usefulness of urine osmolality, as a predictive factor in the treatment of monosymptomatic nocturnal enuresis (NE) with combination therapy of imipramine and desmopressin. METHODS: From May 2014 to April 2015, 59 monosymptomatic NE patients participated in this study. Early morning urine osmolality was measured at 1 week and 1 day before combination therapy of imipramine and desmopressin, and at 1 week and 2 weeks after therapy. The response to combination therapy was evaluated at 3 months after treatment. The mean period of combination therapy was 6.4+/-4.2 weeks. Therapeutic response was classified as complete (0-1 wet night/week), partial (over 50% reduction of night) and non-responders (less than 50% reduction of night). RESULTS: The cumulative rate of the complete and partial responders was 76.3%. Among the 3 groups, the statistically lowest value of pre-treatment urine osmolality was observed in the complete responder group (p<0.001). Urine osmolality increased in all groups after treatment, however, statistically the greatest difference between pre and post-treatment urine osmolality was observed in the complete responder group (p=0.024). No serious side effects were observed. CONCLUSION: Early morning urine osmolality and change of urine osmolality between pre and post-treatment have predictive values in the response to combined imipramine and desmopressin for treatment of monosymptomatic NE.
Deamino Arginine Vasopressin* ; Enuresis ; Humans ; Imipramine* ; Nocturnal Enuresis* ; Osmolar Concentration*

Skin lesions can sometimes be the presenting sign of metastatic cancers. We report a case of skin metastasis resembling pyogenic granuloma from hepatocellular carcinoma, which is a common malignancy in Korea. A 79-year-old male presented with a 1 month history of a dark-reddish nodule on his left cheek, which was thought to be pyogenic granuloma. On histopathologic examination, it was composed of tumor cells and intervening sinusoids and therefore showed characteristics of hepatocellular carcinoma. We confirmed hepatocellular carcinoma upon abdomen computer tomography. We present this case along with a review of previous reports of cutaneous metastasis from hepatocellular carcinoma.
Abdomen ; Aged ; Carcinoma, Hepatocellular* ; Cheek ; Granuloma, Pyogenic* ; Humans ; Korea ; Male ; Neoplasm Metastasis* ; Skin

OBJECTIVE: This paper describes our experience and implant technique for cranioplasty of a large cranial defects using a porous polyethylene implant(Medpor) and compares the results with polymethylmethacrylate(PMMA). METHODS: Sixteen cranioplasties were performed using Medpor(n=10) and PMMA(n=6) implants between June 2003 and January 2005. The criterion for patient enrollment was a defect larger than 10cm in diameter. This study compared the operation times and complications. RESULTS: The operation times ranged from 105 to 250minutes(Mean 180 degrees +/-44minutes) in Medpor and from 185 to 460minutes (mean 128minutes) in PMMA. The absolute operation times were shorter using the Medpor implant and the differences were statistically significant(P=0.030). Satisfactory cosmetic results were obtained in all cases using the Medpor implant and with no implant-related complications. Bone ingrowth to the medpor implant was presumed to be the result on an increase in Houndsfield units of the implant, particularly at the marginal areas in the serial follow-up brain computed tomography images. CONCLUSION: It is believed that the properties of a Medpor implant make this implant an good alternative to the existing methods of a cranial contour correction. However, a further follow-up study will be needed.
Brain ; Follow-Up Studies ; Humans ; Polyethylene* ; Polymethyl Methacrylate

Interruption of the aortic arch is an uncommon congenital cardiovascular malformation invariably accompanied by other cardiovascular anomalies. This carries a 76% mortality rate in the first month of life. We recently experienced a case of interruption of the aortic arch with patent ductus arteriosus in a 21-year-old man with systolic murmur. he did not showed any other symptoms or signs. Cardiac catheterization with angiography showed interruption of the aortic arch with many systemic arterial collaterals and patent ductus arteriosus.
Angiography ; Aorta* ; Aorta, Thoracic ; Cardiac Catheterization ; Cardiac Catheters ; Ductus Arteriosus, Patent* ; Humans ; Mortality ; Systolic Murmurs ; Young Adult

Cutaneous metastases of internal malignancies are rare and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% in patients of all malignancies. Furthermore, cutaneous metastasis from adenocarcinoma of the stomach has been found to be exceedingly rare. A 39-year-old woman presented with multiple, asymptomatic, erythematous nodules on her scalp and back. A biopsy taken from the nodule showed a signet ring cell type of adenocarcinoma. A gastroendoscopic examination and biopsy was done and showed the same histologic findings. The diagnosis of cutaneous metastasis of signet-ring cell gastric carcinoma was made. It is clinically worth reporting that the first symptom was skin lesions of the scalp and back.
Adenocarcinoma ; Adult ; Biopsy ; Diagnosis ; Female ; Humans ; Incidence ; Neoplasm Metastasis ; Scalp ; Skin* ; Stomach