No abstract available.
Fistula*

No abstract available.
Drainage* ; Heart Septal Defects, Atrial*

Thoracic disc herniation is uncommon disease and its diagnosis and treatment still remain difficult. We present a case of thoracic disc herniation at T7-8 vertebral level presenting with signs of spinal cord compression. The lesion was diagnosed by magnetic resonance image(MRI) and iopamidol-enhanced computed tomography(CT). The patient was operated by transthoracic transpleural approach using the surgical microscope. the operative result was excellent. A brief review of the literature is given.
Diagnosis ; Humans ; Magnetic Resonance Imaging ; Spinal Cord Compression

We have investigated endocrine functions of 2 patients with Wilson's disease who showed oligomenorrhea or amenorrhea, The serum basal levels of hypothalamic, pituitary, thyroid, adrenal cortical and ovarian hormones were determined. Then stimulation tests were performed with GnRH(50 microgram/m2), TRH(7 microgram/Kg) and insulin(0.l U/Kg) in one intravenous bolus, Levels of LH, FSH, prolactin, GH, TSH, total testosterone, l7 beta-estradiol, free T3, T4, DHEA-S and cortisol were measured by standard radioimmunoassays. The endocrine profiles which represent functions of hypothalamus, pituitary, thyroid and adrenal cortex was all proved to be normal. Serum estradiol and total testosterone levels were 59.0 microgram/ml ( normal ; 60-130 microgram/ml) and 2.9 ng / dl (normal ; 0.l5-1.1 ng/dl) in one case, and 20.5 microgram / ml and 0.69 ng / dl in the other respectiviely. Low estradial and high total testosterone levels seen in these cases suggested ovarian dysfuncton. Interference of ovarian follicular aromatase activity due to passible copper intoxication could explain these findings as the cause of the menstrual irregularity of patients with Wilson's disease.
Adrenal Cortex ; Amenorrhea ; Aromatase ; Copper ; Estradiol ; Female ; Hepatolenticular Degeneration* ; Humans ; Hydrocortisone ; Hypothalamus ; Oligomenorrhea ; Prolactin ; Radioimmunoassay ; Testosterone ; Thyroid Gland

Hereditary nonpolyposis colorectal cancer(HNPCC) is an autosomal dominantly inherited disease associated with a marked increase in cancer susceptibility, especially cancer of the colorectum. The frequency of HNPCC in the general population is yet to be determined, but HNPCC may account for as much as 2% to 5% of colorectal cancer, Colorectal cancer in HNPCC differs from sporadic colorectal cancer by an early age of cancer onset, proximal predominance of colorectal cancer, an excess of synchronous and metachronous colorectal cancer, and excess extra-colonic cancers. We have found 5 HNPCC families since 1992 when we reported first HNPCC family (KHU-Hl) In order to register the patients of HNPCC and to review the clinicopathologic feature and appropriate management, we have analysed 5 HNPCC families. Five HNPCC families included 16 colorectal cancer patients(14 males and 2 females). The average age of first diagnosis was 39. Among 16 patients, 8 patient were operated at the KyungHee University hospital and their operative and pathologic records were available. Two synchronous and seven metachronous cancers were founded, so that eight patients had 15 colorectal cancer lesions. Ten cancers were located proximal to splenic flexure and five were distal. Partial resection of colon was performed in seven cases except one when the first diagnosis was made and recurrence was founded in 5 patients. Recurrence was treated by total colectomy in 3 cases and subtotal colectomy in two. In conclusion, we re-confirmed that HNPCC patient should be treated by no less than a subtotal colectomy because of high multiplicity and high recurrence rate of partial resection.
Colectomy ; Colon ; Colon, Transverse ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis* ; Diagnosis ; Humans ; Male ; Recurrence

Relapsing polychondritis is an uncommon disease associated with inflammation in cartilaginous tissues throughout the body, particularly affecting the cartilaginous structures of ears, nose, joints, and respiratory tract. Several autoimmune diseases, including vasculitis, are associated with the concurrent relapsing polychondritis. However, ankylosing spondylitis primarily affecting the sacroiliac joints and spine is rare in patients with relapsing polychondritis. We report on a 54-year-old man with concurrently relapsing polychondritis and ankylosing spondylitis.
Autoimmune Diseases ; Ear ; Humans ; Inflammation ; Joints ; Middle Aged ; Nose ; Polychondritis, Relapsing* ; Respiratory System ; Sacroiliac Joint ; Spine ; Spondylitis, Ankylosing* ; Vasculitis

PURPOSE: We performed this study to assess pain in patients seen in member outpatient orthopaedic clinics of the Korean Knee Society (KKS). MATERIALS AND METHODS: We organized a committee for the study of knee joint pain. The committee designed a questionnaire form consisting of 11 items related to pain. One hundred thirty-five regular members of the KKS asked all patients visiting their respective outpatient clinics during May 2007 to complete the questionnaire form. Although 12,418 patients agreed to fill out the questionnaire form, we only analyzed the questionnaire forms of 9,578 patients who answered completely. RESULTS: 1. Approximately 85% of patients visiting outpatient orthopaedic clinics complained of pain. 2. The average degree of pain was more than moderate, and 72% of patients simply desired to be free of pain. 3. Seventeen percent of patients thought their physicians underestimated their pain. 4. Regarding agreement in the assessment of pain between physicians and patients, there was low level of agreement by numeric rating scale, but a high level of agreement based on a mild/moderate/severe grading scale. 5. Approximately one-third (36.2%) of patients had used additional treatments for pain relief on top of their prescribed medications. CONCLUSION: Eighty-five percent of patients complained of pain, and two-thirds of them were primarily focused on its relief in their visit to the outpatient clinic. Hence, we should heed pain management itself as an important goal in treating orthopaedic patients.
Ambulatory Care Facilities ; Humans ; Knee ; Knee Joint ; Outpatients ; Pain Management ; Surveys and Questionnaires

IgG4-related sclerosing disease is a disease entity that has recently attracted attention, manifesting as a multiorgan disease characterized by high serum IgG4 levels, extensive IgG4-positive plasma cells and lymphocyte infiltration of the affected organs, with the pancreas (autoimmune pancreatitis) and kidney as representative targets. In cases of renal involvement, parenchymal lesions are predominant, such as renal cortical lesions or diffuse renal enlargement. However, mass-like lesions involving the renal pelvis are very rare, and mass forming or pelvic involvement types should be distinguished from lymphomas, metastatic cancers and other genitourinary malignancies to avoid unnecessary surgery. Herein, we report a case of IgG4-related sclerosing disease involving the kidney as an unusual involvement pattern presenting as a mass-like lesion with pelvic and perirenal involvement.
Immunoglobulin G ; Kidney ; Kidney Diseases* ; Kidney Pelvis ; Lymphocytes ; Lymphoma ; Pancreas* ; Plasma Cells ; Unnecessary Procedures

The primary T-cell lymphoma of the stomach is a extremely rare disease, only about 33 cases were described in the literature since 1986. Recent studies have proved a strong relation between Helicobacter pylori infection and several gastric diseases such as peptic ulcer, chronic gastritis, gastric cancer, and lymphoma. We report a case of primary gastric T-cell lymphoma with H. pylori infection in a 63-year-old male who had a history of epigastric fullness for 2 years. Gastroscopy showed a round ulcer of 1cm in size on anterior side of gastric angle. The gastroscopic biopsy revealed diffuse large cell malignant non-Hodgkin' s lymphoma on light microscopic examination, and T-cell immunophenotype with immunohistochemical study. The result of CLOtest was positive. No lymphadeno-pathy was found with chest roentgenogram and computed omography of abdomen and pelvis. Bone marrow examination showed normal finding.
Abdomen ; Biopsy ; Bone Marrow Examination ; Gastritis ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Lymphoma ; Lymphoma, T-Cell* ; Male ; Middle Aged ; Pelvis ; Peptic Ulcer ; Rare Diseases ; Stomach ; Stomach Diseases ; Stomach Neoplasms ; T-Lymphocytes* ; Thorax ; Ulcer

A 6-year old boy was admitted with high fever and redness of the right eyelids and the surrounding area. He had previously suffered cerebral contusion, basal skull fracture and pneumocephalus following a traffic accident which required six months' hospitalization. Since then, and prior to admission, he had twice suffered probable bacterial meningitis and had been treated at an outstanding hospital. At the time of this admission, the patient again developed high fever, with redness of the right eyelid and surrounding area. His symptomatology suggested bacterial meningitis and cerebrospinal fluid culture revealed Streptococcus pneumoniae sensitive to penicillin. In accordance with the clinical course of meningitis and accompanying sinusitis, the appropriate antibiotic and its duration of usage were determined. Recurrent episodes of bacterial meningitis in this child raised the possibility of anatomical defect as an a contributory factor. Computerized tomographic(CT) cisternography suggested leakage of cerebrospinal fluid and revealed herniated frontal brain tissue protruding through a gap in the right frontal skull base, three dimensional CT(3-D CT) confirmed this defect, which was 3X4cm in size. After recovery from meningitis, surery to prevent recurrent meningitis, was performed. To locate pathologic areas, the subfrontal approach,involving bicoronal skin incision and bifrontal bone flap was used. Multiple fracture lines and a large bony defect on the orbital roof were observed, together with a dural defect, through which cerebromalatic tissue was herniated as encephalocele. Using lyophilized dura, the dural defect was made watertight; the bony defect was packed with autologous fats and covered with titanium mesh. The patient improved after surgery. Recurrent meningitis with anatomical pathologic focus after head trauma requires surgical intervention.
Accidents, Traffic ; Brain ; Cerebrospinal Fluid ; Child ; Contusions ; Craniocerebral Trauma ; Encephalocele ; Eyelids ; Fats ; Fever ; Hospitalization ; Humans ; Male ; Meningitis* ; Meningitis, Bacterial ; Orbit* ; Penicillins ; Pneumocephalus ; Sinusitis ; Skin ; Skull Base ; Skull Fractures* ; Skull* ; Streptococcus pneumoniae ; Titanium