The sheaths of tendons are an uncommon site of tuberculous invclvement as compared to other parts of the body. But tuberculou, tenosynovitis occurs often enough to varrant particular attention and study. We report a case of tuberculous tenosynovitis occuring in a 49-year-old woman who had multiple yellowish palpable nodules and swellings distributed along the tencon of flexor digitorum superficialis on the left palm for 3 month. Histopathologic findings showed multip e tuberculoid granulomas in the mid-and deep-dermis. Eosinophilic homogenous trabeculated structure(remnants of tendon sheath resistant to necrosis) was present within the area of caseation. Acid-fast stain showed a crowd of acid-fast bacilli in the deep dermis. The cultures from the skin biopsy spec mens on Ogawa media(3% KH PO4) at 24C, 32C and 37C were all negative. She was treated with surgical excision of granulation tissue and involved tendon sheath followed by systemic administration of INH, RIF and ethambutol for 1 year. The lesions were markedly improved and showed no relaps, during last 5 months of follow up period.
Biopsy ; Dermis ; Eosinophils ; Ethambutol ; Female ; Follow-Up Studies ; Granulation Tissue ; Granuloma ; Humans ; Male ; Middle Aged ; Skin ; Tendons ; Tenosynovitis

No abstract available.
Adult* ; Esophageal Atresia* ; Fistula* ; Humans

PURPOSE: To determine whether neoadjuvant androgen deprivation therapy (NADT) improves clinical outcomes in patients with prostate cancer treated with definitive radiotherapy. MATERIALS AND METHODS: We retrospectively reviewed medical records of 201 patients with prostate cancer treated with radiotherapy between January 1991 and December 2008. Of these, 156 patients with more than 3 years of follow-up were the subjects of this study. The median duration of follow-up was 91.2 months. NADT was given in 103 patients (66%) with median duration of 3.3 months (range, 1.0 to 7.7 months). Radiation dose was escalated gradually from 64 Gy to 81 Gy using intensity-modulated radiotherapy technique. RESULTS: Biochemical relapse-free survival (BCRFS) and overall survival (OS) of all patients were 72.6% and 90.7% at 5 years, respectively. BCRFS and OS of NADT group were 79.5% and 89.8% at 5 years and those of radiotherapy alone group were 58.8% and 92.3% at 5 years, respectively. Risk group (p = 0.010) and radiation dose > or =70 Gy (p = 0.017) affected BCRFS independently. NADT was a significant prognostic factor in univariate analysis, but not in multivariate analysis (p = 0.073). Radiation dose > or =70 Gy was only an independent factor for OS (p = 0.007; hazard ratio, 0.261; 95% confidence interval, 0.071-0.963). CONCLUSION: NADT prior to definitive radiotherapy did not result in significant benefit in terms of BCRFS and OS. NADT should not be performed routinely in the era of dose-escalated radiotherapy.
Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Prostatic Neoplasms* ; Radiotherapy* ; Radiotherapy, Intensity-Modulated ; Retrospective Studies

BACKGROUND: It is one of anesthesiologist's important tasks to know the accurate recovery state of a patient after general anesthesia. Postanesthetic recovery score (PARS) has been widely used as a measure of evaluating recovery state because it is simple, easy to apply and applicapable to all situations. In this study, we investigated whether there were correlations between PARS and PAR-stay time, and examined factors influencing PAR-stay time. METHODS: Two hundreds and five patients were selected randomly. PARS was measured in each patient immediately after he or she arrived at PAR. Correlations between PARS and PAR-stay time were studied. And other variables such as age, sex, physical status, operation site and anesthetic time were studied as influencing factors on PAR-stay time. RESULTS: There were no significant correlations between PARS and PAR-stay time. PARS was influenced by the operation site only. And PAR-stay time was influenced by the patient's age only. CONCLUSIONS: In evaluating the postanesthetic recovery state, it seems to be important to consider not only PARS but also other factors such as patient's age.
Anesthesia, General ; Humans ; Recovery Room*

No abstract available.
Down Syndrome*

Prenatal Ultrasonographic findings of meconium peritonitis show calcificalion, and abdominal echogenic masses such as pseudocyst. Also, we can find availability of 3 dimensional ultrasonography above these descriptions. We present a case of meconium peritonitis in uterus which was diagnosed by means of prenatal 2D & 3D ultrasonography with brief review of literatures.
Meconium* ; Peritonitis ; Ultrasonography ; Uterus

This study is intended to the diagnostic accuracy and reproducibility rate according to the input devices and the video signals, potential technical problems of the telepathology system and possible physical and psychological impacts. Web based in telepathology system had been developed and in use, but their functional capability and diagnostic accuracy are considered to be inferior to those of conventional optical microscope. We devised a telepathology system using our existing microscope equipped with CCD camera unit that has no restriction of network speed. Total 55 histopathologic cases from various organs were selected. Three pathologists are involved in making diagnoses. The resulting diagnostic accuracies were 1CCD camera with composite video signal was 86.2%, 3CCD camera with composite video signal was 93.1% and 3CCD camera with component video signal was 95.0%. The 3CCD camera with component video signal resulted 95.0% diagnostic accuracy and was superior to 1CCD and 3CCD camera with composite video signal. At this time of problems were not noted in the monitor quality.
Diagnosis ; Telepathology*

PURPOSE: The purpose of this study was to evaluate the role of immediate postoperative radiotherapy (RT) in adult patients with a low-grade oligodendroglioma (LODG). MATERIALS AND METHODS: A total of 74 patients, older than 15 years, were treated in our institution between April 1990 and March 2006 for newly diagnosed LODGs. After surgery, 43 patients were treated with immediate RT with a total dose of 54~55.8 Gy with 1.8 Gy fractions (RT group) and 31 patients were followed with no adjuvant RT (OP group). All patients were closely observed until tumor progression or death with frequent work-ups including neurological examinations and MRI. Primary endpoints were overall survival and progression-free survival. The median follow-up duration of survivors was 6.2 years in the RT group and 5.8 years in the OP group. RESULTS: Median progression-free survival was 13.2 years in the RT group and 4.6 years in the OP group; multivariate analysis confirmed improved outcome with the use of immediate RT (hazard ratio, 0.22; 95% confidence interval-CI, 0.09~0.55; p<0.001). Median overall survival was 14.9 years in the RT group and 9.8 years in the OP group; the use of adjuvant RT was also associated with a trend toward better overall survival after immediate RT based on multivariate analysis (hazard ratio, 0.3; 95% CI, 0.08~1.17; p=0.082). No severe RT related complications were observed. CONCLUSION: Immediate RT following surgery appears to be an effective treatment modality for supratentorial LODGs. However, the potential benefit of adjuvant RT for overall survival needs to be tested prospectively in the future.
Adult ; Brain Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Neurologic Examination ; Oligodendroglioma ; Survivors

OBJECTIVE: Unruptured intracranial aneurysms are now being detected with increasing frequency in clinical practice. Results of the largest studies, including those of the International Study of Unruptured Intracranial Aneurysms, indicate that surgical and endovascular treatments are rarely justified in small aneurysms. However, we have encountered several cases of rupture of small and very small aneurysms in our clinical practice. This retrospective study analyzed the incidence and clinical characteristics of very small ruptured aneurysms. MATERIALS AND METHODS: A total of 200 patients with aneurysmal subarachnoid hemorrhage between January 2012 and December 2014 were reviewed. Various factors were analyzed, including the aneurysm location and size as well as the associated risk factors. RESULTS: The mean age of patients was 56.31 +/- 13.78 (range, 25-89) years, and the male to female ratio was 1:2.1. There were 94 (47%) small-sized (< 5 mm), 91 (45.5%) medium-sized (5-9.9 mm), and 15 large-sized (> 10 mm) aneurysms. Of these, 30 (15%) aneurysms were very small-sized (< 3 mm). The most frequent site of aneurysms was the anterior communicating artery (ACoA). However, the proportion of aneurysms at the ACoA was significantly high in very small aneurysms (53.3%, p = 0.013). Hypertension was a significant risk factor for rupture of very small aneurysms (p < 0.001). CONCLUSION: About half of our cases of ruptured aneurysms involved the rupture of small and very small aneurysms. The most common site of rupture of very small aneurysm was the ACoA. Rupture of small and very small aneurysms is unpredictable, and treatment may be considered in selected high-risk patients according to factors such as young age, ACoA location, and hypertension.
Aneurysm ; Aneurysm, Ruptured ; Arteries ; Female ; Humans ; Hypertension ; Incidence* ; Intracranial Aneurysm* ; Male ; Retrospective Studies ; Risk Factors ; Rupture* ; Subarachnoid Hemorrhage

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin