No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Maxillary Sinus*

It is well known that the presence of arachnoid cysts (ACs) in young patients is a risk factor for developing a chronic subdural hematoma (CSDH) after a minor head injury. Although there have been controversies with the treatment, most authors recommend only draining the CSDH if the AC is asymptomatic. This judgement is based on the facts that this surgical approach has shown good clinical outcomes, and the AC usually remains unchanged after the surgery. Our case demonstrates that the AC of a young patient who developed a CSDH after a minor head injury completely disappeared after a burr hole drainage of the CSDH. Although the chances of an AC disappearing are low, this case shows that an AC might disappear after only draining a CSDH when a rupture of the AC membrane is identified. In such cases, we recommend first draining only the CSDH for the treatment of AC-associated CSDHs.
Arachnoid Cysts ; Arachnoid ; Craniocerebral Trauma ; Drainage ; Hematoma, Subdural, Chronic ; Humans ; Membranes ; Risk Factors ; Rupture

Thoracopagus is very rare congenital anomaly with an incidence estimated at 1 in 50,000 deliveries or 1 in 600 twin deliveries. If twining is initiated after the embryonic disc and the rudimentary amnionic sac have been formed, and if division of the embryonic disc is incomplete, conjoined twins result. We experienced a case of thoracopagus in 28 years old woman. We present this case with a brief review of literatures.
Adult ; Amnion ; Female ; Humans ; Incidence ; Twins, Conjoined

BACKGROUND: There were several reports that thyroid autoimrnune disease commonly found in myasthenia gravis patients. We performed this study to determine the prevalence of thyroid autoimmune disease as well as analyze correlation between acetylcholine receptor antibody and various thyroid autoantibadies among the myasthenia gravis patients in Korea. METHOD: The patient group, 48 patients, diagnosed as myasthenia gravis from January 1985 to December 1995 at the department of Neurology, Internal medicine at Dongsan Medical Center was compaired to the control group, 40 patients, with no age and sex difference from the patient group. The samples were collected from both group for the measure of the values of acetylcholine receptor antibody, thyroid autoantibody and thyroid hormones. RESULT: 1) The values of acetylcholine receptor antibody in myasthenia gravis group and control group were 5.78+-0.7nM and 0.05+-0.06nM respectively. Of 48 patients with myasthenia gravis, 38 patients have been measured acetylcholine receptor antibody value > 0.5nM, Their mean average value was 7.24+-0.66nM. 2) The severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM and severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM showed thyroglobulin antibody value of 159.6+-79.91IU/mL versus 56.86+-32.99IU/mL. also thyroid microsomal antibody value showed 159.0+-79.9IU/mL and 23.633+-0.19IU/mL respectively. 3) Of 48 myasthenia gravis patients, 12 patients (24%) had high value of antithyroglobulin antibody or anti-microsomal antibody and 5 patients (10%) had both antibodies at the same times. In contrast, only 3 patients (8%) were observed with high value of either one of antibodies. Patient with both antibodies was not observed in normal control group. CONCLUSION: According to the datas we have obtained, appearence of the thyroid autoantibody is significantly greater in severe myasthenia gravis group than normal control group. Therefore it is suggested that the prevalence of thyroid autoimmune disease is higher in severe myasthenia gravis group than mild myasthenia gravis group or normal control group.
Acetylcholine* ; Antibodies ; Autoimmune Diseases ; Humans ; Internal Medicine ; Korea ; Myasthenia Gravis* ; Neurology ; Prevalence* ; Sex Characteristics ; Thyroglobulin ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Hormones

Lymphorrhea is a rare but potentially severe complication that occurs after various surgical procedures. Untreated lymphorrhea may lead to wound dehiscence, infection, and prolonged hospital stay. Currently, there is no standard effective treatment. Early management usually includes leg elevation, drainage, and pressure dressing. However, these methods are associated with prolonged recovery and high recurrence rates. We report a case of lymphorrhea from a calf wound after endoscopic great saphenous vein (GSV) harvesting for coronary artery bypass grafting (CABG). The patient presented with intractable oozing from the postoperative wound on the right calf. Lymphorrhea perGsisted for 6 weeks despite negative-pressure wound therapy with a long-acting somatostatin. We performed unilateral pedal lymphangiography that confirmed wound lymphorrhea, followed by glue embolization. No recurrence was observed after 8 months of follow-up. This case report demonstrates the successful use of lymphangiography with glue embolization in the control of lymphorrhea after GSV harvesting for CABG.

The aim of this study was to evaluate the change of supraspinatus muscle and tendon as well as biceps tendon after pitching in Korean professional baseball league pitchers by the application of sonoelastography. A total of 10 pitchers from Korean professional league were evaluated their supraspinatus muscle and tendon and long head of biceps tendon of dominant arm by sonoelastography at all-star break period. After one month later, re-evaluations were performed after pitching in the game. The strain ratio of supraspinatus muscle and tendon (red portion, soft; blue portion, hard), thickness of supraspinatus and long head of biceps tendons were evaluated. For the correlation analysis with pitching, numbers of pitches, maximal velocity, maximal difference of velocity and ratio of breaking balls among pitches were investigated. The strain ratios of supraspinatus muscle, thickness of supraspinatus and long head of biceps tendon were decreased but not statistically significant. However, the strain ratio of red portion in supraspinatus tendon was significantly increased. There were no correlations between sonoelastograpic findings and pitches.
Arm ; Baseball* ; Elasticity Imaging Techniques* ; Head* ; Tendons*

A gastric duplication cyst is an extremely rare developmental anomaly, comprising 2~8% of all alimentary duplication cysts with most being reported in children. However, this condition should be included in a differential diagnosis of partially obstructing cystic masses of the stomach. Moreover, the possibility of a malignancy within it should be considered particularly in adults. The excision of duplication cysts has become feasible with the introduction of laparoscopic gastric surgery. We report a 17-year-old female suffering from postprandial abdominal discomfort and nausea. Two cystic lesions in her stomach were found by preoperatively endoscopic ultrasonography (EUS) and the computed tomography (CT). Laparoscopic wedge resections of the gastric lesions were performed, and the postoperative pathologic examination disclosed multiple gastric duplication cysts with no evidence of a malignancy. The patient made an uneventful postoperative recovery and has remained a asymptomatic for 8 months after surgery.
Adolescent ; Adult* ; Child ; Diagnosis, Differential ; Endosonography ; Female ; Humans ; Laparoscopy ; Nausea ; Stomach

A 49-year-old woman was admitted with a three-month history of myalgia and progressive proximal and distal muscle weaknesses. Physical examination showed diffuse enlargement of the thyroid gland and mild muscle atrophy. Serum creatine kinase was slightly increased and electromyography showed a myopathic pattern. Muscle biopsy showed nonspecific myopathic changes. Serum thyroid-stimulating hormone was very low, whereas thyroxine (T4) was greatly increased as well as anti-thyroglobulin, anti-microsome, and TSH-receptor antibody. The patient's symptoms were improved during the treatment with propilthiouracil.
Biopsy ; Creatine Kinase ; Electromyography ; Female ; Graves Disease* ; Humans ; Hyperthyroidism ; Middle Aged ; Muscle Weakness ; Muscular Atrophy ; Muscular Diseases* ; Myalgia ; Physical Examination ; Thyroid Gland ; Thyrotropin ; Thyroxine

PURPOSE: To evaluate the antiadhesive effects and safety of an oxidized regenerated cellulose (Interceed) after thyroidectomy. METHODS: Seventy-six thyroidectomized patients were prospectively randomized into two groups with regard to the use of Interceed. We evaluated each group for their adhesive symptoms using four subjective and four objective items at the 2nd week, 3rd and 6th month after thyroidectomy. All patients were examined for vocal cord motility by indirect laryngoscope at each period. RESULTS: Total adhesion scores at each postoperative follow-up period decreased with time, but were not significantly different in each group. The median score for swallowing discomfort for liquid was significantly lower in the Interceed group than in the control group 2 weeks after surgery. In addition, the severity of skin adhesion to the trachea was reduced in the Interceed group compared with the control group 6 months after surgery. During the study, there were no adverse effects or significant differences in postoperative complications between the groups. CONCLUSION: Interceed appeared to be safe and effective in improving neck discomfort at early postoperative periods and preventing skin adhesion to the trachea 6 months after thyroidectomy.
Adhesives ; Cellulose ; Cellulose, Oxidized ; Deglutition ; Follow-Up Studies ; Humans ; Laryngoscopes ; Neck ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Skin ; Thyroidectomy ; Trachea ; Vocal Cords

OBJECTIVE: To investigate the relationship between severity of peripheral polyneuropathy (PPN) and degree of depression and quality of life in chronic renal failure (CRF) patients on hemodialysis (HD). METHOD: Forty seven chronic renal failure patients on hemodialysis were recruited (22 male, 25 female, mean age of 63.17+/-12.52) and etiology, disease duration, hemodialysis duration, creatinine and hemoglobin were recorded. Motor and sensory nerve conduction studies were carried out on bilateral median, ulnar, tibial and peroneal nerves for diagnosis of polyneuropathy according to our laboratory criteria. The Korean version of Beck depression inventory (BDI) questionnaire translated into Korean for diagnosis of depression, and Korean version of Short Form 36 health survey (SF-36) questionnaire for measurement of general health level were measured in those diagnosed with uremic PPN. RESULTS: Out of 52 patients, 47 were diagnosed with polyneuropathy and mean score for BDI was 18.49+/-9.18. Mean scores for each of Mental Component Summary (MCS) and Physical Component Summary (PCS) of SF-36 were 50.84+/-15.42 and 47.41+/-18.68. The correlation between the scores and polyneuropathy were analyzed by Pearson coefficient. The MCS score was the significant (p<0.05) correlation parameter with depression (R=-0.635) and the PCS score was the only parameter with a significant (p<0.05) correlation with polyneuropathy (R=-0.340). CONCLUSION: Uremic polyneuropathy is commonly observed in chronic renal failure patients on hemodialysis. Depression in CRF with uremic PPN is affected by psychological factors other than the PPN itself.
Creatinine ; Depression ; Female ; Health Status ; Health Surveys ; Hemoglobins ; Humans ; Kidney Failure, Chronic ; Male ; Neural Conduction ; Peroneal Nerve ; Polyneuropathies ; Quality of Life ; Renal Dialysis ; Surveys and Questionnaires