No abstract available.
Cervix Uteri* ; Female ; Humans ; Mass Screening* ; Uterine Cervical Neoplasms*

A 68-year-old man was admitted due to abdominal pain. He was diagnosed as having recurrent pancreatitis with a pseudocyst, which is communicated through the main pan- creatic duct. An endoscopic pancreatic sphincterotomy and insertion of a nasopancreatic tube into the main pancreatic duct via transpapillary drainage were performed. As a result, the pseudocyst disappeared and the pain was relieved. Thus it was concluded that transpapillary drainage via the main pancreatic duct is a safe and effective treatment for pancreatic pseudocysts, which is communicated through the main pancreatic duct.
Abdominal Pain ; Aged ; Drainage* ; Humans ; Pancreatic Ducts* ; Pancreatic Pseudocyst* ; Pancreatitis

Neurofibroma may present as a solitary lesion or as multiple lesions. Although there is no site of predilection for solitary lesions, occurrence on the hand is rare. Plexiform neurofibroma can develop in isolation or more commonly as a part of neurofibromatosis type 1. In those that apper in isolation, trauma has been suggested as a precipitating factor. A 68-year-old male farmer had experienced repetitive prior episodes of trauma in the involved finger. He presented with a painless mass on the dorsal aspect of the fifth finger. Physical examination showed a protruding mass measuring approximately 15x20 mm which was not tenderness to palpation and any skin changes or pigmentation. Ultrasonography showed a cystic mass on the dorsal aspect of the middle phalanx. Microsurgical dissection was applied in order to seperated the lesion from the ulnar side of the dorsal branch of the digital nerve. Pathologic examination of the specimens revealed neurofibroma. At three-month follow-up, motor and sensory function were intact, and range of motion was fully recovered. Traumatic solitary neurofibroma is a rare tumor of the hand, especially in the finger. Hand surgeons should be aware of the diagnostic possibilities of this tumor based on examination, history taking and imaging studies.
Aged ; Fingers* ; Follow-Up Studies ; Hand ; Humans ; Male ; Neurofibroma* ; Neurofibroma, Plexiform ; Neurofibromatosis 1 ; Palpation ; Physical Examination ; Pigmentation ; Precipitating Factors ; Range of Motion, Articular ; Sensation ; Skin ; Ultrasonography

BACKGROUND: Dermoid cysts of the auricular area are extremely rare. We report on six cases of auricular dermoid and epidermoid cyst, and differentiate dermoid cyst from epidermal cyst along with a review of the literature. METHODS: Three cases involved a gradually enlarging mass of the superior and anterior aspect of the helix of their ear. Another two cases were located in the posterior aspect of the ear. RESULTS: During the operation, a tumor was found just under the skin, not fixed mastoid or adjacent cartilage. Histologically, all specimens contained desquamated squamous epithelium and keratin in the lumen. However, two cases of posterior masses showed the presence of adnexal structures and three cases did not. CONCLUSION: A key in diagnosis of the dermoid cyst is the presence of adnexal structures. If the wall does not bear adnexal structures, the term epidermoid or keratin cyst is applied. Acquired cysts are most commonly of traumatic origin and result from an implantation or downward displacement of an epidermal fragment. Finally, the congenital epidermoid cyst grew at the upper part of the auricle; however, the dermoid cyst grew at the lower and posterior part of the auricle.
Cartilage ; Dermoid Cyst* ; Diagnosis ; Ear ; Epidermal Cyst ; Epithelium ; Mastoid ; Skin

Yearly Well-Baby Contest has been held in order to recognize the importance pf the childanjx growth and development. The total number of the infants (6 months to 24 months) who participated in this Kyungpook regional contest, held on April 1976, were 149 comprising 130 infant boys and 19 infant girls. After throughful investigation of the several important parameters including their physical development (body length, weight, head and chest circumference), nutritional status (arm circumference, Kaup index, hemoglobin and signs of the vitamin D deficiency) and the feeding history, the following results were obtained. Comparing their body length and weight with Korean Children Growth Standard (K.S.) and Japanese Children Growth Standard (J.S.), their body length were superior to those of K.S. (3.11cm to 9.4cm) and J.S. (2.3cm to 6.27cm) and their body weight superior t those of K.S. (1.99kg to 4.41kg) and J.S.(1.56kg to 3.21kg). Their arm circumference were superior to those of Korean Mean Value (1973, Hong) by 1.57cm to 2.3cm and no significant difference was noted between both sex and each age groups. The Kaup index was above 20 in 15.4% of male infant and 21.1% of female infants. Mixed feeding was the most common form of the infant feeding comprising 41.6%, followed by breast feeding in 39.6% and bottle feeding in 18.8%. Weaning was started within 6months of age in 54.4% of the infants and the majority(92.6%) of the infants within 12 months of age. In one third of the infants (32.2%) there were signs of the vitamin D deficiency including Harrisonanjx groove, rachitic rosary etc., and no difference was noticed between different types of feeding. One third (32.9%) of the infants showed anemia, using the criteria of anemia as being hemoglobin less than 10.5mg%. Incidence was the highest among breast-fed infants (47.5%), followed by mixed-fed infants in 24.2% and bottle-fed infants in 21.4%. In 19.2% of the infants supplemental vitamin D was given and only 6.7% of the infants was given iron as supplement. The conclusion arrived from these results indicated that their physical growth was quite good but nutritional status was inadequate, represented in many infants sych as signs of the vitamin D deficiency and anemia. It is hoped that by education and guidance of the mothers, especially about the proper feeding method, infants growth and development could be improved further.
Anemia ; Arm ; Asian Continental Ancestry Group ; Body Weight ; Bottle Feeding ; Breast Feeding ; Child ; Education ; Feeding Methods ; Female ; Growth and Development* ; Gyeongsangbuk-do* ; Head ; Hope ; Humans ; Incidence ; Infant* ; Iron ; Male ; Mothers ; Nutritional Status ; Thorax ; Vitamin D ; Vitamin D Deficiency ; Weaning

BACKGROUND: Two results have been conflict regarding the pH of gastric contents in obese and lean surgical patients. Obese patients have been considered to have lower pH of gastric contents than lean surgical patients since the study by Vaughan, whereas Harter reported no significant difference in the pH's of obese and lean surgical patients. The author wanted to investigate whether gastric content pH differs or not between obese and lean surgical patients aged from 20 to 60 years. METHODS: Forty patients scheduled for elective abdominal hysterectomy under general endotracheal anesthesia were studied. Group I (n = 20) was composed of lean patients whose body mass indices (BMIs) were between 20 and 25, whereas Group II (n = 20) was composed of obese patients whose BMIs were above 30. Every patient was fasted between 8 and 14 hours preoperatively. Within 10 minutes of endotracheal intubation, gastric contents were withdrawn with a 20 cc syringe connected to a 16F nasogastric tube placed in the stomach. pH and the incidences of pH <2.5, and pH <1.8 were compared. RESULTS: No significant difference in pH (P = 0.199) or in the incidences of pH less than 2.5 (P = 0.23) or 1.8 (P = 0.52) were observed between obese and lean patients. CONCLUSIONS: Obese and lean patients have similar fasting gastric pH's, as long as the obesity is not too severe (BMI under 40).
Anesthesia ; Fasting ; Humans ; Hydrogen-Ion Concentration* ; Hysterectomy ; Incidence ; Intubation, Intratracheal ; Obesity ; Stomach ; Syringes

PURPOSE: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia(CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A(BTA, Botox(R), Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. METHODS: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1mL solution was administered in a 1mL tuberculin syringe. RESULTS: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. CONCLUSION: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.
Adult ; Botulinum Toxins ; Cicatrix ; Deglutition ; Denervation ; Depression ; Female ; Follow-Up Studies ; Head ; Humans ; Muscle Contraction ; Muscles ; Neck ; Neck Muscles ; Neck Pain ; Posture ; Skin ; Thyroid Gland ; Thyroidectomy ; Torticollis ; Tuberculin

BACKGROUND: When using the anterior approach for performing superficial parotidectomy, the first thing to do is to find the buccal branch of the facial nerve and the parotid duct. The buccal branch usually runs transversely with the parotid duct from the anterior border of the parotid gland. We wanted to check the relationship between the two structures during the operation and to get clinically helpful information. METHODS: Twelve patients with parotid mass were treated with superficial parotidectomy between May 2012 and August 2012. The outline of superficial and deep lobes of the parotid gland, parotid duct, and the buccal branch of the facial nerve were drawn on the transparent film by tracing the structures intraoperatively. RESULTS: In 7 (58.3%) of 12 cases, the buccal branch of the facial nerve was located more caudally than the parotid duct at the anterior border of the superficial lobe of the parotid gland. In 3 cases (25%), the buccal branch was located more cephalically than the parotid duct. The mean distance between two structures were 2.54+/-1.48 mm. In 11 cases, the parotid duct was located deeper than the buccal branch. CONCLUSION: The buccal branch of the facial nerve tends to be located more caudally than parotid duct and runs more superficially than parotid duct in all cases. We identified the relationship between the parotid duct and the buccal branch of the facial nerve during the operations on living subjects, not from the cadavers, so it would be a clinically helpful study which supplied more accurate anatomical information.
Cadaver ; Facial Nerve* ; Humans ; Parotid Gland ; Salivary Ducts*

First described in 1975 by Lennert and Muller-Hermelink, progressively transforming germinal centers(PTGC) are follicular structures that are at least two to three times the diameter of a reactive follicle and are composed of small B lymphocytes with scattered centroblasts and follicular dendritic cells. PTGC may resemble the nodules of lymphocyte predominance Hodgkin's disease(NLPHD) and are often seen in lymph nodes involved by NLPHD. The distinction between NLPHD and PTGC are difficult because of their histologic similarities. Many authors performed an immunohistochemical study to determine whether there might be immunophenotypic differences between these two processes to aid in the differential diagnosis. We experienced PTGC in sibling and two cases is presented with the review of literatures.
B-Lymphocytes ; Dendritic Cells, Follicular ; Diagnosis, Differential ; Humans ; Lymph Nodes* ; Lymphocytes ; Neck* ; Siblings

BACKGROUND: Pharmacological ACTH test provide information only about the ability of the adrenal gland to respond to unusual stimuli and may not reflect the daily cortisol secretion. There were some controversies in the diagnosis of mild adrenal insufficiency by using a pharmacological dose of ACTH. The purpose of the present study was to assess and compare the effect of low dose 1 pg ACTH and high dose 249 pg ACTH in the evaluation of adrenal function. The intravenous injection of a pharmacological dose(250 pg) of ACTH has been used as a standard test in the initial assessment of adrenal function. So we low dose ACTH to evaluate the adrenal function and compare the result of high dose ACTH. METHOD: Basal serum cortisol sampling was done at 2:00 p.m.. And after 1 pg ACTH iv bolus injection, cortisol sampling was done at 20, 30, 45 and 60 min respectively. On the next day same procedure was repeated at same time, but 249 mg ACTH was given instead of the low dose. Normal adrenal function was diagnosed with the criteria of stimulated serum cortisol concentration over 20 mg/dL. Total 65 patients took part in this study. Three hypopituitarism patients and one Addisons disease were included. Sixty-one patients had the history of glucocorticoid ingestion or had physical findings of cushingoid features with symptoms suggest the adrenal insufficiency. RESULTS: Sixteen patients showed normal response to both low dose and high dose ACTH. Thirty-six patients were not stimulated to both low dose and high dose ACTH. The remaining thirteen patients revealed normal response to high dose ACTH, but not to low dose ACTH. CONCLUSION: It appears that low dose ACTH stimulation test is more sensitive and specific than high dose ACTH and is capable of revealing mild adrenal insufficiency.
Addison Disease ; Adrenal Glands ; Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Diagnosis ; Eating ; Humans ; Hydrocortisone ; Hypopituitarism ; Injections, Intravenous