PURPOSE: The purpose of this study was to find the predictors for successful arthrocentesis for anterior disc displacement without reduction(ADD without Reduction) of the temporomandibular joint (TMJ). PATIENTS AND METHODS: Arthrocentesis and lavage was carried out in 25TMJs of 22patients whose MRI findings were all anterior disc displacement without reduction. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predectors which was analyzed were age, duration of painful locking, MMO, the degree of pain, perioperative clicking and the amounts of irrigation fluid. RESULTS: 18cases (72%) was included to criteria for success. There were no significant differences in age, duration of locking, MMO and the degree of pain statistically. But In 15cases(83%) of successful cases, amouts of irrigated solution recovered to normal MMO were less than 150ml. And In 8cases (44%) of successful cases, perioperative clicking was appeared. CONCULSION: Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.
Humans ; Magnetic Resonance Imaging ; Mouth ; Pain, Postoperative ; Temporomandibular Joint Disorders* ; Temporomandibular Joint* ; Therapeutic Irrigation*

PURPOSE: The aim of this study was to elucidate the current incidence of varicoceles in unselected Korean children and adolescents. MATERIALS AND METHODS: 4271 Korean school boys aged 7-18, resided in Namhaegun, Gyungnam province were investigated. The study population comprised more than 95% (4271/4403) of all boys in the respective age in a rural country with a total population of 61,820 (29,840 males and 31,980 females). All examinations were carried out by a single urologist from March to June 2000. The patients with varicocele were divided according to the classification of Dubin-Amelar. RESULTS: No case of varicocele was encountered in 1,233 boys between 7 to 10 years, while the incidence in the 3,038 boys aged 11 to 18 years was 9.61% (292 boys). There was a peak varicocele incidence from aged 14 to 16 (11.78-13.52%). The proportion of varicocele grades were grade I 21.58% (63/292), grade II 44.68% (131/292), grade III 33.56% (98/292). There were 2 cases of bilateral varicoceles. Other abnormalities found were 7 cryptorchidism (0.16%) and 27 hydroceles (0.63%). In 33 older boys (aged between 16-18) with varicocele, semen analyses were performed and two boys had subnormal sperm concentration. CONCLUSIONS: Our finding of peaking at ages 14 to 16 was parallel with the old Danish report,11 but our incidence was substantially lower than the report of 16.2%.
Adolescent* ; Child* ; Classification ; Cryptorchidism ; Epidemiology ; Gyeongsangnam-do ; Humans ; Incidence ; Male ; Prevalence* ; Semen Analysis ; Spermatozoa ; Varicocele*

PURPOSE: This study addressed the feasibility and effect of surgical treatment of metachronous periampullary carcinoma after resection of the primary extrahepatic bile duct cancer. The performance of this secondary curative surgery is not well-documented. METHODS: We reviewed, retrospectively, the medical records of 10 patients who underwent pancreaticoduodenectomy (PD) for secondary periampullary cancer following extrahepatic bileduct cancer resection from 1995 to 2011. RESULTS: The mean age of the 10 patients at the second operation was 61 years (range, 45-70 years). The primary cancers were 7 hilar cholangiocarcinomas, 2 middle common bile duct cancers, and one cystic duct cancer. The secondary cancers were 8 distal common bile duct cancers and 2 carcinomas of the ampulla of Vater. The second operations were 6 Whipple procedures and 4 pylorus-preserving pancreaticoduodenectomies. The mean interval between primary treatment and metachronous periampullary cancer was 20.6 months (range, 3.4-36.6 months). The distal resection margin after primary resection was positive for high grade dysplasia in one patient. Metachronous tumor was confirmed by periampullary pathology in all cases. Four of the 10 patients had delayed gastric emptying (n = 2) or pancreatic fistula (n = 2) after reoperation. There were no perioperative deaths. Median survival after PD was 44.6 months (range, 8.5-120.5 months). CONCLUSION: Based on the postoperative survival rate, PD may provide an acceptable protocol for resection in patients with metachronous periampullary cancer after resection of the extrahepatic bile duct cancer.
Ampulla of Vater ; Bile Ducts, Extrahepatic* ; Cholangiocarcinoma ; Common Bile Duct ; Cystic Duct ; Gastric Emptying ; Humans ; Medical Records ; Neoplasms, Second Primary ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Pathology ; Reoperation ; Retrospective Studies ; Survival Rate

Gallstone ileus is a well-known complication of cholelithiasis, but is relatively rare. Most ectopic gallstones are located in the small bowel; they are rarely found in the stomach and duodenum. We describe the imaging findings of a case of intragastric gallstone, as well as a case in which duodenal obstruction was caused by a large gallstone (Bouveret's syndrome).
Cholelithiasis ; Duodenal Obstruction ; Duodenum ; Gallstones* ; Ileus ; Stomach

Laryngeal schwannoma is extremely rare. We report the CT and MRI findings of a case occurring in a 65-year-oldwoman, and describe the pathologic correlation. Pre-contrast CT scanning revealed a right supraglot-tic mass witha slightly hyperdense central part and a hypodense peripheral part. Post-contrast CT scanning re-vealed anenhanced hyperdense central part and a rim-like hypodense peripheral part. The density of the pe-ripheral part waslower than that of muscle. The mass showed homogeneous low signal intensity on T1-weighted MR images, homogeneoushigh signal intensity on T2-weighted MR images, and an enhanced high signal intensity central part and a lowsignal intensity peripheral part on gadolinium enhanced T1-weighted images. The enhanced central part correlatedwith Antoni A areas and the peripheral part, showing low attenuation, correlated with Antoni B areas.
Gadolinium ; Magnetic Resonance Imaging ; Neurilemmoma* ; Tomography, X-Ray Computed

STI571 (imatinib mesylate, Gleevec(TM)), a selective inhibitor of the bcr-abl, c-kit, platelet-derived growth factor receptor tyrosine kinases, is a new anticancer drug used for chronic myelogenous leukemia and gastrointestinal stromal tumors. Cutaneous adverse reactions of periorbital edema and exfoliative dermatitis related to STI571 are rare and there have been no previous reports in the Korean literature. We herein report a case of periorbital edema and exfoliative dermatitis due to STI571 and discuss the possible mechanism of periorbital edema related to STI571.
Dermatitis, Exfoliative* ; Drug Eruptions* ; Edema* ; Gastrointestinal Stromal Tumors ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Mesylates* ; Phosphotransferases ; Receptors, Platelet-Derived Growth Factor ; Tyrosine ; Imatinib Mesylate

We experienced a case of postoperative quadriparesis secondary to operative position in a patient with pre-existing, asymtomatic,cervical neurilemmoma. The patient was admitted with chronic otitis media for mastoidectomy on right side. There was no specific event throughout operation and anesthesia but developed quadriparesis one hour after arrival on ward. With magnetic resonance imaging, the patient was dignosed to have cervical neurilemmoma. On seventh postoperative day the patient had second operation,cervical laminectomy and tumor removal. Ten days after second operation he was discharged without any complication. Eight months later he had mastoidectomy on the left side and was discharged without any sequale.
Anesthesia ; Anesthesia, General* ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Neurilemmoma ; Otitis Media ; Quadriplegia*

BACKGROUND/AIMS: Hepatocytes on the hepatic lobule mipate from portal zone to centrilobular mea as the DNA synthesis within it. And also, the xenobiotic reactions reveal characteristic differences associated with zone specific metabolism in the liver acinus. In this study, the zonal distribution of ethylnitrosourea (ENU)-induced hepatic precancerous lesion was stereologically investigated. METHODS: Nine B6C3F1 mices were given I.p. injection of ENU (60 ug/pn body weight) when the pups were 15 days old prior to sacrifices at 8 weeks of life. All the 150 consecutive sections, 3 p m in thickness, were stained with hematoxylin and eosin and identified the basophilic precancerous lesions with 80-165 p m diameter in equatorial plane by the Zeiss microprojector. And then the distances from the center of selected foci to terminal hepatic vein or portal vein branches were estimated under the microscopic fields. As a control group, the same estimations were performed from the random points by the appointments of random digit table. RESULTS: Mean distance between ENU-induced 52 hepatocellular foci and the nearest terminal hepytic vein was 181.15+112.39 p m (Mean+ SD), but that of randomly selected 104 points was 291.73+157.98pm (Mean+5D) (Students t-test, p<0.0005). Substantially, 52.7% of ENU-induced 52 hepatocellular foci were within 300 p m from the terminal hepatic vein, but randomly selected 104 points were only 50.9% (Shapiro Wilk W test, w=0.819857, p=0.048038). Mean distance from ENU-induced 52 foci to portal vein was 398.85+149.98pm (Mean+SD), but that from the randomly selected 104 points was 315.87+145.79 pm (Mean+SD)(Students t-test, p<0.0005). CONCLUSION: Stereologically, ENU-induced mice liver cell foci distribute non-randomly to Zone III, centrilobular zone of mouse hepatic acini where promote invasion toward terminal hepatic veins.
Animals ; Appointments and Schedules ; Basophils ; Cholestasis ; DNA ; Eosine Yellowish-(YS) ; Ethylnitrosourea ; Fluconazole ; Hematoxylin ; Hepatic Veins ; Hepatocytes ; Liver ; Metabolism ; Mice* ; Portal Vein ; Veins

Erlotinib (Tarceva(R)) is a new anti-cancer agent which acts by inhibiting epidermal growth factor receptor (EGFR) signal transduction. It is currently used in the treatment of advanced stage non-small cell lung cancer and pancreatic cancer. We report a case of acneiform eruption and paronychia induced by erlotinib in a 69-year-old man. The patient visited our clinic with multiple erythematous papules and pustules on the face, periungual erythema and pus discharge, xerosis, fissures on the sole. He had taken erlotinib for the treatment of recurred lung cancer for 4 weeks. The skin lesions were partially improved with oral pyridoxine, corticosteroid and topical antibiotics.
Acneiform Eruptions* ; Aged ; Anti-Bacterial Agents ; Carcinoma, Non-Small-Cell Lung ; Erythema ; Humans ; Lung Neoplasms ; Pancreatic Neoplasms ; Paronychia* ; Pyridoxine ; Receptor, Epidermal Growth Factor ; Signal Transduction ; Skin ; Suppuration ; Erlotinib Hydrochloride

Ectopic nail is characterized by growth of nail-like tissue in a location other than the nail bed. It is an extremely rare disorder that can be either congenital or acquired from incidents such as trauma. An 8-year old female presented with a complaint of a nail-like lesion on the dorsal surface around the center of the right fifth toe. It had been present for 3 years, while the patient continuously clipped it upon growth. The fifth toe was initially injured by a chair that had fallen on that toe 4 years prior to her visit. There was no associated bony deformity or other physical changes in the nail. A clinical diagnosis of ectopic nail was made and it was surgically excised under local anesthesia. The histopathological examination revealed a normal nail unit and there was no recurrence during the 6 month follow-up period.
Anesthesia, Local ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Nails ; Recurrence ; Toes