No abstract available.
Skin Neoplasms* ; Skin*

To analyze the improvement of shouder function after arthroscpic subacrominal decompression and open repair for complete rotator cuff tear, we performed a prospective study in 14 patients using self evaluation form from the American Shouder and Elbow Society(ASES). All patients were treated with arthrscopic biplanar subacromial decompression and open repair by use of bony trough and followed for more than 1 year from November 1994 to June 1996 in Dankook university hospital. All patients were assessed preoperatively and at final follow-up using the standardised method of research committee of American shoulder & elbow surgeons. Tears of the rotator cuff were divided into medium(8 shoulders), large(3 shoulders) and massive(3 shoulders). Most of the patients were heavy laborers. Average age was 56.2 years (51-73 years). There were 9 male and 5 female patients. The dominant arm was affected in 8 shoulders. Postoperative abduction brace was used in all cases and passive range of mortion exercise was started from postoperative third day. At average follow-up of 17 months, average pain scores decreased to 0.8+/-1.1 from 6.9+/-2.3. Scores of ASES evaluation form increased to 87.3+/-12.2 from 35.8+/-16.3(p<0.05). As to the range of mortion, only internal rotation improved from T12 to T8(p<0.05). Thirteen patients achieved excellent or good result. Twelve patients returned to initial occupations. Arthroscopy is helpful to define the tear size which may affect the surgical approach and open repair by use of bony trough and tunnel is useful to recovery of shoulder function.
Arm ; Arthroscopy ; Braces ; Decompression* ; Diagnostic Self Evaluation ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Occupations ; Prospective Studies ; Rotator Cuff* ; Shoulder

Castleman's disease, or giant Iymph node hyperplasia, is a Iymphoproliferative disorder which is characterized by Iymphoid hyperplasia with capillary proliferation, and divide histologically into two 0varieties, hyaline vascular and plasmal cell form. Some system manifestations are occasionally accompanied with the diseases, but peripheral neuropathy is a rarely reported manifestatlon of them and not in Korea. The present report describes a 40 year old female patient who had been admitted to Yonsei university medicai center because of progressive quadriparesis. On examination, she revealed various other manifestations such as hyperpigmentation, Iymphadenopathy, pitting edema, and bilateral papilledema. The electrophysiologic studies and sural nerve biopsy showed severe sensori-motor peripheral neuropathy showing features of mixed demyelinatlon and axonal degeneration. The Iymph node biopsy showed features compatible with Castleman's disease of hyaline vascular type. The recovery was poor over four month period despite of treatment with corticosterold.
Adult ; Axons ; Biopsy ; Capillaries ; Edema ; Female ; Giant Lymph Node Hyperplasia ; Humans ; Hyalin ; Hyperpigmentation ; Hyperplasia ; Korea ; Papilledema ; Peripheral Nervous System Diseases* ; Quadriplegia ; Sural Nerve

Plexiform schwannoma is a rare benign tumor arising from the peripheral nerve sheath and characterized by a multinodular and plexiform growth pattern. This tumor usually arises sporadically. In rare cases, plexiform schwannomas have been associated with neurofibromatosis type 2. Plexiform schwannoma should be differentiated from plexiform neurofibroma, because the latter is pathognomonic tumor of neurofibromatosis type 1 and has a potential of malignant transformation. We report a case of multiple plexiform schwannomas associated with bilateral acoustic neuromas and meningioma.
Meningioma ; Neurilemmoma* ; Neurofibroma, Plexiform ; Neurofibromatoses* ; Neurofibromatosis 1 ; Neurofibromatosis 2* ; Neuroma, Acoustic ; Peripheral Nerves

No abstract available.
Drainage* ; Pancreatic Pseudocyst*

Diabetic complications such as cystopathy and retrograde ejaculation are slowly progressive disease without any specific signs and symptoms so it is difficult to diagnose its complication and prevent it. Diabetic autonomic neuropathy is known as a neurologic lesion with combined involvement in cardiovascular and genitourinary systems. The purpose of this study is to assess correlation between diabetic cystopathy and heart rate variation on consecutive EKG waves and to detect early cystopathy in patients with decreased heart rate variation. We have studied 12 cases of diabetic cystopathy and 9 cases of retrograde ejaculation who were managed in Seoul Eulji Hospital from Mar. 1992 to Aug. 1993 and concluded as follows. Diabetic patients with autonomic neuropathy shows decreased heart rate variability(HRV) (CV%: 2.16+/-0.97) than diabetic patients without autonomic neuropathy (CV%: 3.29+/-0.58, P <0.0001 ), it means that decreased HRV on consecutive EKG waves well correlates to diabetic autonomic neuropathy such as cystopathy and retrograde ejaculation so we think that the measurement of HRV provides a simple test to be concerned urologic complications such as cystopathy or retrograde ejaculation.
Diabetes Complications ; Diabetes Mellitus ; Diabetic Neuropathies ; Ejaculation ; Electrocardiography* ; Heart Rate ; Humans ; Male ; Seoul ; Urogenital System

BACKGROUND/AIMS: Foreign body (FB) removal is a common indication of therapeutic endoscopy in children. The trend is becoming wider and more rational in application. The spectrum of upper gastrointestinal FB's in children during a recent 2 year period was reviewed in Taegu, Kyungbook Province in order to obtain a the consensus of recent trend of indications and techniques of endoscopic FB removal in children. METHODS: Esophagogastroscopy was performed on 78 children who had been referred to 3 University Hospitals in Taegu for FB ingestion from Oct. 1996 to Sep. 1998. RESULTS: Age between 1~2 year was the peak age group; 22 cases (28%). Male to female ratio was 1.9:1. Thirty four cases (44%) were in the esophagus, 44 cases (56%) in the stomach. The majority (49%) of the FB's were coins, 26 of 34 esophageal FB's and 12 of 44 gastric FB's. Others were 14 sharp/pointed objects, 12 big/long objects, 7 toxic objects, etc. In 67 children (86%) the FB was successfully removed and spontaneous passage through the pylorus was observed in 9 children. CONCLUSIONS: Endoscopic FB removal can be performed safely and effectively in children with minimal or no complications by an experienced endoscopist. Proper arrangement should be conducted with consideration to the property of FB's, expected complication, and the possibility of an emergency situation.
Child* ; Consensus ; Daegu* ; Eating ; Emergencies ; Endoscopy ; Esophagus ; Female ; Foreign Bodies* ; Hospitals, University ; Humans ; Korea* ; Male ; Numismatics ; Pylorus ; Stomach ; Upper Gastrointestinal Tract*

Protein energy malnutrition occurs when inadequate protein and calories are ingested. PEM is not confined to children and is common in hospitalized patients. PEM is diagnosed by a weight loss and hypoalbuminemia. We report a case of PEM in a 27-year-old man after Whipple's operation. He had brittle hair, loss on the scalp and brownish colored papules with desquamation on extremities. Also he had erosion and fissuring on the perioral area and beef tongue. Treatment with zinc sulfate, albumin and vitamin resulted in a good response.
Adult ; Child ; Extremities ; Hair ; Humans ; Hypoalbuminemia ; Protein-Energy Malnutrition* ; Scalp ; Tongue ; Vitamins ; Weight Loss ; Zinc Sulfate

A long nose with a drooping tip is a major aesthetic problem. It creates a negative and aged appearance and looks worse when smiling. In order to rectify this problem, the underlying anatomical causes should be understood and corrected simultaneously to optimize surgical outcomes. The causes of a drooping tip of a long nose are generally classified into two mechanisms. Static causes usually result from malposition and incorrect innate shape of the nasal structure: the nasal septum, upper and lower lateral cartilages, and the ligaments in between. The dynamic causes result from the facial expression muscles, the depressor septi nasi muscle, and the levator labii superioris alaeque nasi muscle. The depressor septi nasi depresses the nasal tip and the levator labii superioris alaeque nasi pulls the alar base upwards. Many surgical methods have been introduced, but partial approaches to correct such deformities generally do not satisfy East Asians, making the problem more challenging to surgeons. Typically, East Asians have thick nasal tip soft tissue and skin, and a depressed columella and alar bases. The authors suggest that multifactorial approaches to static and dynamic factors along with ancillary causes should be considered for correcting the drooping tip of the long noses of East Asians.
Asian Continental Ancestry Group* ; Cartilage ; Congenital Abnormalities ; Esthetics ; Facial Expression ; Humans ; Ligaments ; Muscles ; Nasal Septum ; Nose* ; Rhinoplasty ; Skin ; Smiling

BACKGROUND: Antibiotics are used prophylactically in surgery to prevent postoperative infection. However, antibiotics administered in large doses can cause a bleeding diathesis as a result of platelet dysfunction. We wondered whether these antibiotics might impair platelet function by interfering with the initial step of platelet activation: the binding of agonists to their specific receptors on the platelet surface. METHODS: In 30 patients (male 18, women 12) undergoing primary elective knee arthroscopic surgery, the whole blood coagulation system was prospectively evaluated before, and 10 and 40 minutes after administration of 1 g of augmentin. All patients who had abnormal preoperative coagulation profiles or who received anticoagulant or antiplatelet, antibiotics therapy within 7 days prior to surgery were precluded. RESULTS: At 10 minutes after augmentin administration 25 of 30 patients had a significant impairment in all phases of whole blood coagulation as monitored by thromboelastography. In contrast, three of 30 patients had a significantly decreased coagulation time. Two of 30 patients had no significant changes of TEG variables. TEG variables were restored toward baseline in fourty minutes after augmentin administration. CONCLUSIONS: Augmentin can cause a significant but transient change in the viscoelastic properties of blood. Coagulation parameters of the TEG should be measured prior to augmentin administration to prevent and prospect a bleeding diathesis as a result of platelet dysfunction.
Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Arthroscopy ; Blood Coagulation ; Blood Platelets ; Disease Susceptibility ; Female ; Hemorrhage ; Humans ; Knee ; Platelet Activation ; Prospective Studies ; Thrombelastography*