Cartilage ; Cleft Lip ; Congenital Abnormalities ; Ear ; Humans ; Palate ; Rhinoplasty ; Transplants ; Young Adult

Tuberculous spondylitis is not rare disease. Today the posterior instrumentation and posterior or posterolateral fusion concomitant with the anterior decompression and anterior interbody fusion have been used for the treatment of spinal tuberculosis. The authors experienced a case of tuberculous spondylitis complicated with descending aortic pseudoaneurysm. An aneurysm is defined as a localized dilatation of an artery that is at least one-half the size greater than is expected for that artery. Pseudoaneurysm occurring after previous operation, trauma, and infection. Erosion of the thoracic aorta with the development of an fistula in the presence of infection is an unusual and difficult problem to manage. We report a case and review related articles briefly.
Aneurysm ; Aneurysm, False* ; Aorta, Thoracic ; Arteries ; Decompression ; Dilatation ; Fistula ; Rare Diseases ; Spondylitis* ; Tuberculosis, Spinal

Although the management of fractures of the calcaneus still remains controversial, open reduction and internal fixation is gaining in popularity as the method of choice for the treatment of displaced intraarticular calcaneal fractures. However, open methods can make several complications such as neurovascular injury and infection. Thus we have performed the new technique of arthroscopic reduction and minimal internal fixation for displaced intraarticular calcaneal fractures in 5 cases. The results were evaluated between 12 and 16 months after surgery. A Bohler angle was restored to 25degrees-40degrees in all cases. Anatomical reduction of articular surface were obtained from 4 cases out of 5. No complications were found except 1 peroneal tendinitis. The clinical results by Creighton-Nebraska health foundation assessment for fractures of the calcaneus were 3 excellent, 1 good and 1 fair. Even though this was a few case and a short term follow-up study, the arthroscopic assisted management of displaced intraarticular calcaneal fracture induced a little complications and satisfactory results.
Calcaneus ; Follow-Up Studies ; Tendinopathy

BACKGROUND: Incohorenet lamps or pulsed/continuous wave lasers have effectively been used for photodynamic therapy (PDT). OBJECTIVE: To assess the safety and efficacy of the various light sources, such as halogen, xenon arc, and the 585nm pulsed dye laser, in photodynamic therapy for treatment of actinic keratosis. METHODS: PDT, using 5-aminolaevulinic acid (5-ALA), was used on 18 patients who had been diagnosed with actinic keratoses. A single treatment consisting of a topical application of 20% 5-aminolaevulinic acid for 4 hours, followed by halogen, xenon arch lamp and the 585nm pulsed dye laser was administered. RESULTS: Of the 227 lesions, 95/106 (89.6%), 68/77 (88.3%), and 39/44 (88.6%) lesions showed complete response to the halogen lamp, xenon arc lamp, and 595nm dye laser respectively, and 10/106 (9.4%), 9/77 (11.7%), and 5/44 (11.4%) lesions showed partial response to the above, respectively. Only one lesion (1.0%) showed no response to the halogen lamp. In all cases, cosmetic outcome was excellent, and anatomical function was preserved. Topical 5-ALA based PDT is an effective and useful treatment modality for various premalignant diseases, to the halogen lamp, xenon arc lamp, or 585nm pulsed dye laser were used. CONCLUSIONS: Treatment of actinic keratosis with various light sources, following topical application of 5-ALA is effective. However, advantages of the laser treatment may include recovery times, excellent postreatment cosmesis, and high efficacy rate.
Actins* ; Humans ; Keratosis, Actinic* ; Lasers, Dye* ; Photochemotherapy* ; Xenon

The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.
Blast Crisis* ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Fever ; Follow-Up Studies ; Hemorrhage ; HLA-DR Antigens ; Humans ; Hydroxyurea ; Karyotype ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Male ; Middle Aged ; Pancytopenia ; Peroxidase ; Sepsis ; Splenomegaly

No abstract available.
Calcium* ; Estrogens* ; Female ; Humans ; Hypogonadism* ; Metabolism* ; Ovulation Induction* ; Ovulation*

PURPOSE: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. MATERIALS AND METHODS: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of 99mTc-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. RESULTS: GBEF was significantly reduced in diabetes with autonomic neuropathy (43+/-12.3%) and without autonomic neuropathy (57.5+/-13.2%) compared with normal controls (68+/-11.6%, p <0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p <0.05). Fasting blood glucose level, age, sex, hemoglobin A1c, body mass index, serum lipid level were not different in these two diabetic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. CONCLUSION: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy.
Blood Glucose ; Body Mass Index ; Diabetic Neuropathies* ; Fasting ; Female ; Gallbladder* ; Humans ; Injections, Intravenous ; Male ; Meals ; ROC Curve ; Sensitivity and Specificity ; Technetium Tc 99m Disofenin*

PURPOSE: Small breast cysts, which can be resolved by fine-needle aspiration, are often presented as hypoechoic masses on ultrasound examinations. They can be misinterpreted as benign tumors and cause unnecessary follow-ups or biopsies. The aim of this study was to find out the proportion of atypical breast cysts, which can be resolved by needle aspiration, among hypoechoic masses less than 1 cm in size and to investigate the relationship between the characteristics of a mass and its probability of being cystic. METHODS: Between March 2003 and May 2003, we found and aspirated 119 hypoechoic masses less than 1 cm in size from 104 consecutive patients. RESULTS: Mass size ranged from 2.5 mm to 9.8 mm, with a median size of 5.5 mm. Among the 119 hypoechoic masses, 40 masses (33.6%) were cystic and 79 masses (66.4%) were solid. Among the 40 cystic masses, 37 were completely resolved by needle aspiration, one mass was reduced to half, and the 2 remaining masses were reduced to a third of their sizes. In patients in their 20's, 11.1% of the hypoechoic masses were cystic masses, the ratios for patients in their 30's, 40's, 50's, and 60's were 11.4%, 32.0%, 76.2%, and 75%, respectively (P<0.001). With decreasing internal echo of mass, the likelihood of being a cyst increased (P=0.026). However predicting the probability of being a cyst by the margin, the degree of posterior acoustic enhancement, and the location of the mass was difficult (P>0.05). CONCLUSION: Needle aspiration must be considered in small hypoechoic masses not speculated as definite solid masses.
Acoustics ; Biopsy ; Biopsy, Fine-Needle* ; Breast Cyst ; Follow-Up Studies ; Humans ; Needles ; Ultrasonography ; Ultrasonography, Mammary

Ganglioneruroblastoma and neuroblastoma are among commonest types of childhood malignancy and a number of unique paraneoplastic syndromes have associated with both localized and disseminated neuroblastoma. The coincidence of neuroblastoma and myoclonic encephalopathy or other paraneoplastic syndromes occurs relatively rare, and therefore, failure to recognize this association could result in delays in both diagnosis and treatment, and the result could prove to be unfortunately fatal. The mechanism which underlies the remote damaging effect of neural crest tumor, especially neuroblastoma, on the nervous system resulting in myoclonic encephalopathy is by no means clear. In addition the nature and the extent of the pathologic lesion are inconsistent. We experienced a case of myoclonic encephalopathy associated with an occult mediastinal ganglioneuroblastoma in a 22-month-old girl who was hospitalized for inability to walk without support and tilting of the head to the left side. She became increasingly ataxic, and during the hospitalization myoclonic jerks of upper extremities and head along with chaotic, rapidly flickering, multidirectional spontaneous eye movements, were noted. Laboratory data included normal complete blood count, urinalysis, BUN and creatinine, electrolytes and bone marrow. Chest X-ray and chest CT revealed a relatively well marginated right posterior mediastinal mass. In a 24 hours urine excretion test, VMA and catecholamines were increased. Over the next 2 weeks, a surgical exploration revealed a right posterior mediastinal mass. Microscopically the mass proved to be a ganglioneuroblastoma, extending to right innominate artery and right axillary lymph nodes. Within 2 weeks after the surgery, radiotherapy (2,400 rads) and chemotherapy (CTX, DTIC, VCR) were started, but corticosteroid was not used. She has been free of tumor and abnormal neurological systemic symptoms and signs for 1 1/2 year since the completion of chemotherapy. In the 3 1/2 years follow-up period, her neurologic symptoms has completely resolved by the completion of 2 years chemotherapy. We report a case of mycoclonic encephalopathy associated with hidden ganglioneuroblastoma in 22-month-old girl.
Blood Cell Count ; Bone Marrow ; Brachiocephalic Trunk ; Catecholamines ; Creatinine ; Dacarbazine ; Diagnosis ; Drug Therapy ; Electrolytes ; Epilepsies, Myoclonic* ; Eye Movements ; Female ; Follow-Up Studies ; Ganglioneuroblastoma* ; Head ; Hospitalization ; Humans ; Infant ; Lymph Nodes ; Myoclonus ; Nervous System ; Neural Crest ; Neuroblastoma ; Neurologic Manifestations ; Paraneoplastic Syndromes* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed ; Upper Extremity ; Urinalysis

This article consists of a clinical analysis of 171 cases of intussusception treated at the Department of General Surgery and Pediatrics of Pusan Adventist Hospital, during a five year period from Jan. 1991 to Dec. 1995. The results were as follows ; 1) On the age and sex distribution, the age incidence under 1 year old was the most common(73.1%), and male to female ratio was 1.48 : 1. 2) The seasonal variation was Autumn(35.1%), Spring(32.1%), Summer(19.9%), and Winter(12.9%). 3) On the hematologic laboratory finding, 68% were revealed leukocytosis above 10,000/mm3 in serum. 4) In etiology, idiopathic type was common(98.5%), and Meckel's diverticulum was rare(1.5%). 5) The frequent Symptoms and signs were abdominal pain and irritability(84.2%), bloody stool(83.6%), vomiting(80.7%), palpable abdominal mass(48.5%). 6) On comparison of barium reduction to methods of the operation in relation to duration of symptoms, within 12 hours was 81.4% : 15.7% and above 24 hours was 49% : 51% 7) The common anatomical type of intussusception was ileo-colic type (36.9%), and the common types of bowel resection were ileoileo type and ileoileocolic type(80%). 8) The methods of the operation were manual reduction(53.8%), bowel resection(30.8%), and spontaneous reduction(15.4%). 9) Postoperative complications occurred in 10 cases ; febrile convulsion 3 cases, wound infection 2 cases, and wound dehiscence, intestinal obstruction, pulmonary complication each 1 case. 10) The overall recurrence rate was 5.3% (8 cases); 6.6% (7 cases) were after barium reduction, and 1.5% (1 case) was after manual reduction.
Abdominal Pain ; Barium ; Busan ; Child* ; Female ; Humans ; Incidence ; Infant* ; Intestinal Obstruction ; Intussusception* ; Leukocytosis ; Male ; Meckel Diverticulum ; Pediatrics ; Postoperative Complications ; Recurrence ; Seasons ; Seizures ; Seizures, Febrile ; Sex Distribution ; Wound Infection ; Wounds and Injuries