Low-grade nasopharyngeal papillary adenocarcinoma is an unusual nasopharyngeal tumor. This malignant tumor originates in the epithelium and exhibits adenocarcinomatous differentiation and indolent behavior. Macroscopically, these tumors are pedunculated polypoid masses that arise on the roof of the nasopharynx. Microscopically, they are characterized by papillary and glandular epithelial proliferation. We report a case of a 25-year-old woman who presented with a papillary adenocarcinoma on the roof of nasopharynx; in describing the case, we have focused on the histological features and endoscopic management of the tumor. The tumor was completely excised via nasal endoscopic approach. Immunohistochemical analysis of the tumor was performed based on a differential diagnosis of metastatic papillary thyroid carcinoma. The testing involved thyroid transcription factor-1, thyroglobulin, and epithelial membrane antigen analysis. The patient remained disease-free for over 6 months after the surgical excision performed via nasal endoscopic approach.
Adenocarcinoma, Papillary ; Adult ; Carcinoma ; Diagnosis, Differential ; Epithelium ; Female ; Humans ; Mucin-1 ; Nasopharynx ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms

The carpal tunnel syndroms is the most common peripheral nerve entrapment syndrome. The typical symptom is pain, numbness and paresthesia in the median nerve territory of the hand and progressive thenar atrophy. When the symptom is mild and its duration is short, conservative treatment such as splinting or local steroid injection is considered, but when neurological deficit is promiment and conservative treatment is not effective, surgical decompression is indicated.Authors reviewed 15 patients (23 cases) of carpal tunnel syndrome treated with surgical decomression at the Department of Orthopedic Surgery, Kyung-pook National University Hospital from March 1983 to October 1988. The follow up results are as follows; 1. Preoperatively, Tinel sign was present in 17 cases. Phalen test was positive in 17 cases. Sensory disturbance was present in 8 cases. Thenar muscle atrophy was present in 19 cases. Motor weakness was present in 13 cases. 2. Preoperatively, delay of motor conduction velocity of median nerve was noted in 15 cases (65.2%) and sensory nerve conduction velocity in 20 cases (86.9%). Denervation findings such as fibrillation or sharp waves were seen in 15 cases (65.2%). 3. The operative findings were as follows; Synovial hypertrophy in 12 cases, hypertrophy of transcarpal ligament in 4 cases, pseudoneuroma in 3 cases, ganglion in 2 cases, neurilemmoma in 1 case, gout in 1 case. 4. As the operative findings, median nerve had evidence of compression beneath the transcarpal ligament, consisting of flattening. narrowing and decreased epineurial vascularity. 5. External neurolysis was performed in all cases. 6. In case of long duration and severe thenar atrophy, internal neurolysis would be recommendable. 7. Fllow up period was ranged from 7 months to 6 years. 8. 19 cases (82.6%) were excellent or good results.
Atrophy ; Carpal Tunnel Syndrome ; Decompression, Surgical ; Denervation ; Follow-Up Studies ; Ganglion Cysts ; Gout ; Hand ; Humans ; Hypertrophy ; Hypesthesia ; Ligaments ; Median Nerve ; Muscular Atrophy ; Neural Conduction ; Neurilemmoma ; Orthopedics ; Paresthesia ; Peripheral Nerves ; Splints

No abstract available.
Appendicitis* ; Diagnosis*

No abstract available.
Fallopian Tubes* ; Female ; Mucous Membrane* ; Sterilization*

No abstract available.
Ectoderm* ; Ectodermal Dysplasia*

There are many women who want larger and brighter eyes that will give a favorable impression. Surgical methods that make the eye larger and brighter include double eyelidplasty, epicanthoplasty, as well as lateral canthoplasty. Double eyelidplasty produces changes in the vertical dimension of the eyes, whereas epicanthoplasty and lateral canthoplasty create changes in the horizontal dimension of the eyes. Epicanthoplasty, a surgical procedure which enlarges the eye horizontally, is performed at the inner corner of the eye, whereas lateral canthoplasty enlarges the outer edge of the eye. In particular, if the slant of the palpebral fissure is raised and the horizontal dimension of the palpebral fissure is short, adjusting the slant of the palpebral fissure through lateral canthoplasty can achieve an enlargement of eye width and smoother features. Depending on the patient's condition, even better results can be achieved if this procedure is performed in conjunction with other procedures, such as double eyelidplasty, epicanthoplasty, eye roll formation surgery, fat graft, and facial bone contouring surgery. In this paper, the authors will introduce in detail their surgical method for a cosmetic lateral canthoplasty that lengthens the lateral canthal angle and corrects the outer tail of the eyes, in order to ease the unfavorable impression.
Facial Bones ; Female ; Humans ; Methods ; Tail* ; Transplants ; Vertical Dimension

BACKGROUND: Hospital-wide surveillance showed an up to 9% increase in the incidence rate of the nasal transmission of methicillin-resistant Staphylococcus aureus (MRSA) among health care workers (HCWs) in a tertiary care hospital where MRSA is endemic. The purpose of this study was to investigate the knowledge of and attitude towards nasal transmission of MRSA and hand-washing practice among HCWs and determine the behavioral factors associated with the nasal transmission of MRSA. METHODS: In a 750-bed tertiary care hospital, nasal swabs from HCWs were obtained, and questionnaires with 25 questions were distributed to HCWs who were divided into 2 different groups: MRSA carriers and non-carriers. The questionnaires focused on the HCWs' knowledge about the mode of MRSA transmission and precautions against MRSA infection and their self-reported compliance for hand hygiene. RESULTS: The total number of respondents for the surveillance culture and survey were 253 (51 MRSA carriers and 202 non-carriers). There was significant difference between the 2 groups on the knowledge of precautionary measures used for the MRSA patients in the hospital (P=0.026). Compared to the MRSA carriers, the non-carriers washed their hands significantly more frequently after ventilator care (P=0.004) and used more alcohol sanitizers (P=0.023). However, no significant difference was observed in hand-washing practices of both the groups before the medical procedures, their knowledge about the mode of transmission of MRSA, and the duration of hand washing. CONCLUSION: Non-carriers replied more accurately to the questions on knowledge about the management and treatment of MRSA, and they considered interventions such as surveillance cultures and questionnaires to be an effective method in lowering the incidence of nosocomial infections. Compared to the MRSA carriers, the non-carriers showed higher hand-washing compliance.
Compliance ; Cross Infection ; Cross-Sectional Studies ; Surveys and Questionnaires ; Delivery of Health Care ; Drug Resistance ; Hand ; Hand Disinfection ; Humans ; Incidence ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Tertiary Healthcare ; Ventilators, Mechanical

In general, the long head of the biceps brachii originates from the superior glenoid labrum and the supraglenoid tubercle, crosses the rotator cuff interval, and extends into the bicipital groove. However, rare anatomic variations of the origins of the long head have been reported in the past. In this report, we review the clinical history, radiologic findings, and arthroscopic identifications of 3 anatomic variants of the biceps tendon long head. As the detection of long head of biceps tendon pathology during preoperative radiologic assessment can be difficult without prior knowledge, surgeons should be aware of such possible anatomic variations.
Anatomic Variation ; Head* ; Pathology ; Rotator Cuff ; Shoulder ; Tendons

BACKGROUND: Infantile Hypertrophic Pyloric Stenosis (IHPS) is one of the most common surgical problems of early infancy and one for which an eminently successful surgical treatment has been available since the work of Ramstedt in 1912. A clinical study was begun to access further the accuracy of ultrasonography in identifying hypertrophic pylorus. METHODS: This study is a retrospective clinical analysis of 31 cases of IHPS treated at the Department of Surgery of Pohang St. Mary's Hospital from Jan. 1990 to Dec. 1997. RESULTS: (1) The most prevalent age group was between 3 weeks and 8 weeks in 24 cases (77.4%), and the ratio of males to females was 5.2:1. (2) Among the 31 cases, new born babies were 21 cases (67.7%). (3) In 30 cases (96.8%), the gestational age was between 37 weeks and 42 weeks, and the birth weight was more than 3.5 kg in 21 cases (67.7%). The body weight percentile at admission was lower than the 50 percentile in 31 cases. (4) Among the 31 cases, breast-fed infants were 15 cases (48.4%), milk-fed 13 cases (41.9%), and mixed-fed 3 cases (9.7%). B type blood group was 23 cases (74.2%), and O type was 4 cases (12.9%). (5) In 4 cases (12.9%), an inguinal hernia was noted as an associated anomaly. (6) The onset of symptoms was neonatal (1 week-12 weeks) in all 31 cases, and the duration of the symptoms was between 1 week and 2 weeks in 18 cases (58.1%). (7) Non-bile stained, projectile vomiting was noted in all 31 cases (100.0%), an olive-shaped mass in right upper quadrant of the abdomen was felt in 27 cases (87.1%), and visible peristalsis on the epigastrium was noted in 25 cases (80.6%). (8) On laboratory tests, 17 patients had leukocytosis, and anemia was observed in 2 cases. Hypokalemia was observed in 9 cases (29.0%), hypochloremia in 4 cases (12.9%), and moderate to severe alkalosis (CO2 content > 25 mEq) in 7 cases. (9) Among the 25 cases, for which an the ultrasonographic evaluation was performed, the length of the stenotic canal was from 16 mm to 20 mm in 23 cases (92.0%), and the thickness of the stenotic portion was from 5 mm to 6 mm in 21 cases (84.0%). (10) All 31 cases were surgically treated by using a Fredet-Ramstedt pyloromyotomy, and the mortality was nil. The average hospitalization was 9.4 days. (11) There was 1 case of duodenal perforation and 1 case of intermittent non-projectile vomiting after the operation. CONCLUSIONS: We conclude that early accurate diagnosis, adequate preoperative preparation of the fluid & electrolyte imbalance, immediate surgical correction, and scheduled careful oral feeding are important in treatment of IHPS. Ultrasonographic determination of pyloric muscle length and thickness is the most accurate of the currently available techniques. A Fredet-Ramstedt pyloromyotomy is a safe and successful surgical procedure.
Abdomen ; Alkalosis ; Anemia ; Birth Weight ; Body Weight ; Diagnosis ; Female ; Gestational Age ; Gyeongsangbuk-do ; Hernia, Inguinal ; Hospitalization ; Humans ; Hypokalemia ; Infant ; Leukocytosis ; Male ; Mortality ; Peristalsis ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Retrospective Studies ; Ultrasonography ; Vomiting

BACKGROUND AND OBJECTIVES: The caveolin is known as a mediator of cell death or survival of injured cell and inhibitor of various signaling pathways. We examined expression of caveolin-1 involved by protein kinase A(PKA) signaling pathway in the differentiated mouse vestibular cell line(UB/UE-1) after gentamicin toxicity. MATERIALS AND METHOD: We observed caveolae in the vestibular hair cell of healthy guinea pig through electron microscope. UB/UE-1 cells were cultured at 95% CO2, 5% O2, 33DegreeC for 2days and at 95% CO2, 5% O2, 39DegreeC for 24 hours for differentiation. Cells were treated with 1 mM of gentamicin, 0.02 mM H89 (PKA inhibitor), and then incubated for 24 hours. Caveolin-1 expression was examined by western blot and PKA activity by PepTag? assay. RESULTS: Caveolae were observed in the vestibular hair cell of healthy guinea pig by electron microscope. Caveolin-1 was expressed spontaneously in differentiated UB/UE-1 cells and increased after gentamicin treatment. PKA is overactivated by gentamicin treatment. The gentamicin induced caveolin-1 expression and PKA overactivation was inhibited by H89. CONCLUSION: Our results indicate that gentamicin induced caveolin-1 expression is mediated by PKA signaling pathway. We conclude that the caveolae/caveolin through a PKA signaling pathway is the important mechanism of gentamicin induced ototoxicity.
Animals ; Blotting, Western ; Caveolae ; Caveolin 1* ; Cell Death ; Cell Line* ; Gentamicins* ; Guinea Pigs ; Hair Cells, Vestibular ; Mice ; Protein Kinases