A relationship between preceding acute paralytic poliomyelitis and the later development of motor neuron disease has only occasionally been suggested since it was first postulated by Charcot in 1875. The authors recently experienced a 20-year-old male who was considered to have postpoliomyelitis muscular atrophy. We report this case in view of its rarity and necessity of differential diagnosis from other neuromuscular disorders. Clinical presentation included slowly progressive muscle wasting of left thigh for 4 years, mild weakness of left arm and both thigh, intermittent fasciculation, and previous history of acute paralytic poliomyelitis. Electromyographic findings showed fibrillation potentials, positive sharp waves, fasciculations, giant motor unit potentials and reduced interference patterns. Muscle biopsy revealed scattered small angulated fibers, individual myofiber degeneration and mild inflammatory cell infiltration.
Arm ; Biopsy ; Diagnosis, Differential ; Fasciculation ; Humans ; Male ; Motor Neuron Disease ; Poliomyelitis ; Postpoliomyelitis Syndrome* ; Thigh ; Young Adult

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

Plexiform schwannoma is a rare benign tumor arising from the peripheral nerve sheath and characterized by a multinodular and plexiform growth pattern. This tumor usually arises sporadically. In rare cases, plexiform schwannomas have been associated with neurofibromatosis type 2. Plexiform schwannoma should be differentiated from plexiform neurofibroma, because the latter is pathognomonic tumor of neurofibromatosis type 1 and has a potential of malignant transformation. We report a case of multiple plexiform schwannomas associated with bilateral acoustic neuromas and meningioma.
Meningioma ; Neurilemmoma* ; Neurofibroma, Plexiform ; Neurofibromatoses* ; Neurofibromatosis 1 ; Neurofibromatosis 2* ; Neuroma, Acoustic ; Peripheral Nerves

This study was undertaken to examine the possibility of predicting the stage of brain abscess presoperatively,which may markedly influence on the decision how to manage the patients suffering from intracerebral abscesses. Atotal of 17 patients with brain abscesses, who were treated with surgery and diagnosed pathologically, wereretrospectively analyzied with particular attention to the correlation of CT and histopathologic findings. Wefound that preoperative CT findings could not provede any possibility on the decision of abscess staging.Therefore, we suggest that the sequential CT scans should be done in patients with susupectd brain abscess forevaluation of abscess staging.
Abscess ; Brain Abscess ; Brain ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Advanced or recurrent laryngeal cancers after chemoradiotherapy were mainly treated by total laryngectomy because of inadequate surgical margin, multifocal recurrent site, and delayed diagnosis. Recently, voice preservation through conservative laryngeal surgery in case of advanced or recurrent laryngeal cancer with strict application of surgical indication became possible. In this study, authors studied the usefulness of surpracricoid partial laryngectomy (SCPL) for advanced or recurrent laryngeal cancers is discussed. MATERIALS AND METHOD: Twenty-five laryngeal cancer cases of cricohyoido-epiglottopexy (CHEP) or cricohyoidopexy (CHP) from May 1996 through April 2001 were analysed retrospectively. In recurrent cases after radiotherapy, there were 8 cases with glottic T1, 6 with T2, 3 with T3, one with T4, one with supraglottic T2 and T3. In advanced cases without radiotherapy, there were 3 cases with glottic T3 and 2 with supraglottic T3. Evaluation of oncological and functional results were conducted. The mean follow-up period was 29.1 months. RESULTS: Local recurrence occurred in 1 patient (4.3%) and cricoid perichondritis in 5 patients (21.7%), laryngocutaneous fistula in 1 patient (4.3%) after the operation. Four patients (17.3%) had to be treated with completion laryngectomy. Voice function was preserved in 19 patients (82.7%). CONCLUSION: Our experience with supracricoid partial laryngectomy with CHEP or CHP suggests that this technique can be a valuable alternative to the total laryngectomy in the recurrent or advanced laryngeal cancer.
Chemoradiotherapy ; Delayed Diagnosis ; Fistula ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms* ; Laryngectomy* ; Radiotherapy ; Recurrence ; Retrospective Studies ; Voice

No abstract available.
Mosaicism* ; Trisomy*

BACKGROUND AND OBJECTIVES: Pharyngocutaneous fistula is a common serious complication following laryngectomy and pharyngectomy. However, the etiology or predisposing factors of pharyngocutaneous fistula are still unclear. The authors investigated variable predisposing factors related to pharyngocutaneous fistula by reviewing medical records. SUBJECTS AND METHOD: Two hundred ninety six of 340 cases who had been performed laryngeal and hypopharyngeal surgery were investigated. Forty nine of 296 cases (15.6%) developed pharyngocutaneous fistula. We analyzed clinical parameters such as age, gender, primary site, radiotherapy, interval between radiotherapy and surgery, neck dissection, DM (diabetes mellitus), preoperative albumin, hemoglobin etc. RESULTS: Reconstruction on surgery and peroperative albumin concentration were statistically significant factors associated with pharyngocutaneous fistula (p<0.05). CONCLUSION: Pharyngocutaneous fistula may be preventable by correcting the predisposing factors.
Causality ; Fistula* ; Laryngectomy ; Medical Records ; Neck Dissection ; Pharyngectomy ; Radiotherapy

The authers describe a case of huge tentorial meningioma in 32 year old female patient. Her clinical complaints were bifrontal headache and visual impairment. CT scan revealed huge supratentorial and infratentorial enhanced tumor mass. The tumor mass was removed in one stage.
Adult ; Female ; Headache ; Humans ; Meningioma* ; Tomography, X-Ray Computed ; Vision Disorders

No abstract available.
Catheters*

OBJECTIVE: Recently, there are many reports that glutamate receptors have close relationships with a pathophysiology of schizophrenia. The purpose of this study was to assess the effects of D-cycloserine, which is glycine site partial agonist in NMDA receptor on psychopathologic symptoms and cognitive functions. METHODS: This study was done for chronic schizophrenic inpatients taking typical antipsychotics for more than 4 months. Exclusion criteria were patients with over 8 points according to Simpson-Angus scale for EPS or those with over 17 points of Hamilton Depression Scale. Patients were randomized to classify into two groups; D-cycloserine group (n=13) and placebo group (n=13). Each group received D-cycloserine 100 mg or placebo separately for 8 weeks. Psychopathology was evaluated with PANSS at baseline, 2nd week, fourth week and eighth week. Cognitive function was evaluated with KWIS at baseline and eighth week. RESULTS: Total 26 patients completed this trial. The average period of morbidity was 10.39+/-3.87 years and the average doses of antipsychotic was 1228.35+/-720.30 mg based on chlorpromazine equivalent. In positive subscale, negative subscale, general psychopathology subscale, total PANSS scale and KWIS, there were no significant differences between D-cycloserine and placebo groups. However, negative subscale scores had decreased from 24.92+/-3.64 (Baseline) to 23.46+/-3.41 (week 8) (p=0.077). CONCLUSION: There were no clear changes in positive symptom, negative symptom, memory, language function, and performance intelligence when D-cycloserine 100 mg was given with antipsychotic medication. However, some patients showed clear improvement in negative symptom, especially blunted affect. Therefore, D-cycloserine combination therapy could be effective for negative symptom. In future, study that can show effectiveness in psychopathology and cognitive function according to drug dosage is needed.
Antipsychotic Agents ; Chlorpromazine ; Cognition* ; Depression ; Glycine ; Humans ; Inpatients ; Intelligence ; Memory ; N-Methylaspartate ; Psychopathology ; Receptors, Glutamate ; Schizophrenia*