Hibernoma is a very rare, benign soft fatty tumor that derived from remnants of fetal brown tissue. The following case of hibernoma break out occurred from a patient who had received surgical resection of neurilemmoma. There has never been a case that reported about hibernoma accompanied by neurilemmoma. It is anticipated that this experience would be helpful to other physicians who are interested in this rare type of tumor.
Humans ; Lipoma ; Muscles ; Neurilemmoma

No abstract available.
Craniocerebral Trauma* ; Head* ; Protons*

The shoulder injury was resulted from muscle imbalance between acceleration and deceleration during the throwing. The agonist-antagonist muscle strength relationship for throwing was formerly described as functional ratios of eccentric external rotator to concentric internal rotator moments and eccentric internal rotator to concentric external rotator moments. The purpose of this study was to measure the ratio of concentric and eccentric strength of the shoulder rotators by isokinetic muscle performance in Korean throwing college athletes for descriptive data. On 10 dominant shoulders of asymptomatic throwing college athletes applying Cybex II isokinetic dynamometer, concentric and eccentric muscle strength of the rotators were measured at the speed of 90degrees/s, 180degrees/s, 240degrees/s. Maximal torque ratio of the eccentric strength of the external rotator against the concentric strength of the internal rotator was 1.25, 1.13, 1.21 at the each speed. The functional external eccentric-to-internal concentric ratio was similar with previous published studies. There was no significant difference between each speed. Eccentric strength of the external rotator was higher than concentric strength of the internal rotator during internal and external rotation at all speeds. This functional assessment of strength testing that reflected the importance of eccentric external rotation strength for the dynamic shoulder joint stability during the throwing. Therefore, the increase of the eccentric strength of the external rotator would be helpful to prevent the shoulder injury and to treat for rehabilitation of injured shoulder.
Acceleration ; Athletes ; Deceleration ; Humans ; Muscle Strength ; Muscles ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Torque

OBJECTIVE: We evaluated the effect of intrawound application of vancomycin powder for infection prophylaxis in wounds caused by instrumented spinal surgery. METHODS: From July 2012 to December 2012, 74 instrumented spinal fusion procedures were performed by 1 neurosurgeon at a single institute. We divided the patients into 2 groups, depending on the use of local application of vancomycin powder: Group A (intrawound application of vancomycin powder with perioperative intravenous cefazolin) and Group B (perioperative intravenous cefazolin alone). A retrospective cohort comparative study was conducted between the 2 groups. The age, sex, comorbidities, smoking, surgical procedure, and surgical site infection (SSI) of consecutive patients were analyzed. RESULTS: Among the 74 patients, 34 patients were assigned to group A and 40 patients to group B. No wound infections were found in group A. However, in group B, 5 cases of SSI (12.5%) were found. A statistically significant reduction in SSI incidence was observed in group A (p<0.033). The 5 cases of SSI in group B consisted of 3 cases of deep wound infection and 2 cases of superficial wound infection. All SSIs were found in cases of posterior approach surgery and tended to be more frequent in older patients. CONCLUSION: Adjunctive intrawound local application of vancomycin powder is a simple uncomplicated procedure and can result in a significant reduction of SSI in instrumented spinal fusions. Furthermore, culture of the drainage tip is very important for confirmation of deep wound infection.
Cefazolin ; Cohort Studies ; Comorbidity ; Drainage ; Humans ; Incidence ; Retrospective Studies ; Smoke ; Smoking ; Spinal Fusion* ; Spine ; Vancomycin* ; Wound Infection

PURPOSE: A number of flap for nipple reconstruction have been well described in the literature. However, most of these techniques do not permit the reconstruction of a projecting nipple and all are hampered to some extent by long-term loss of nipple projection. The objective of this study is to evaluate the long-term result and clinical efficacy of nipple reconstruction using skate flap technique after breast reconstruction. METHODS: A retrospective chart review was carried out on 23 patients who underwent 25 nipple reconstructions. In those patients with greater than 10 mm nipple projection, reconstruction with skate flap and full-thickness skin graft and/or tattooing was performed. Maintenance of nipple projection was then carefully assessed over one-year follow-up. The following factors were analyzed: type of breast reconstruction, type of areola reconstruction, follow-up period, decrease in nipple projection, complication, and whether secondary nipple reconstruction was necessary and/or performed. RESULTS: Breast reconstructions were performed in 17 patients with free transverse rectus abdominis musculocutaneous flap, 3 patients with extended latissimus dorsi musculocutaneous flap, and 3 patients with expander and implant. The mean follow-up after nipple reconstruction was 17 months. Mean loss of projection were 17.0 +/- 13.99%, 25.0 +/- 12.70%, 30.0 +/- 12.57% and 30.8 +/- 12.49% at 3, 6, 9 months and over one year, respectively. The greatest decrease in projection was noted in the first 3 months following surgery. CONCLUSION: These results indicated that nipple reconstruction with skate flap showed about 70 percent of the projection achieved over one year postoperation. Therefore, the skate flap may be a reliable method of nipple reconstruction in those patients with greater than 10 mm nipple projection.
Breast ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Nipples ; Rectus Abdominis ; Retrospective Studies ; Skin ; Tattooing ; Transplants

OBJECTIVE: The aim of this study was to predict the relationship between the symptomatic disc herniation level and the osteophyte level or decreased disc height in patients with cervical disc herniation. METHODS: Between January 2011 and December 2012, 69 patients with an osteophyte of the cervical spine underwent surgery at a single center due to soft cervical disc herniation. Data including soft disc herniation level, osteophyte level in the posterior vertebral margin, Cobb's angle, and symptom duration were retrospectively assessed. The patients were divided into three groups according to the relationship between the degenerative change level and the level of reported symptoms. RESULTS: Among the 69 patients, 48 (69.6%) showed a match between osteophyte level and soft disc herniation level. Disc herniation occurred at the adjacent segment to degenerative osteophyte level in 12 patients (17.4%) and at both the adjacent and the osteophyte level in nine (13.0%). There was no significant difference in Cobb's angle or duration among the three groups. Osteophyte type was not significant. The mean disc height of the prominent degenerative change level group was lower than the adjacent segment level, but this was not significant. CONCLUSION: Soft cervical disc herniation usually occurs at the level an osteophyte forms. However, it may also occur at segments adjacent to that of the osteophyte level. Therefore, in patients with cervical disc herniation, although a prominent osteophyte alone may appear on plain radiography, we must suspect the presence of soft disc herniation at other levels.
Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Osteophyte ; Radiography ; Retrospective Studies ; Spinal Fusion ; Spine

PURPOSE: Peripheral arterial disease (PAD) is an increasing health problem, as we progress towards an aging society. The diseases known as risk factors of PAD are diabetes mellitus (DM), hypertension, and dyslipidemia, and PAD occurs consistently in patients with diabetes. The patients with PAD do not receive proper treatment at the proper moment, because PAD is almost asymptomatic, and most of the diagnosis is delayed. We aimed to determine the prevalence, risk factors and co-morbidities of PAD in patients who are managed for DM and hypertension in our referral center. METHODS: Patients with diabetes and hypertension were selected from the Gachon University Gil Hospital. Data of the patients, including demographics and presence of risk factors, were collected using an interviewer-administered questionnaire. For PAD of the low limbs, the ankle-brachial index (ABI) was used, and the PAD of low limbs was defined as <0.9 ABI. For carotid artery stenosis (CAS), carotid duplex ultrasound was analyzed, and CAS was defined as > or =50% internal CAS. RESULTS: Logistic regression analysis showed that old age (>70) and diabetes were independent risk factors of PAD. As the risk factor number increased, the prevalence of PAD became higher. CONCLUSION: The prevalence of PAD is continuously increasing. Old age and diabetes were independently associated with a high risk of all-cause PAD patients. For timely and proper management of PAD, large-scale research is needed. Based on research, we should make a detailed plan about early screening, and treatment of PAD.
Aging ; Ankle Brachial Index ; Carotid Stenosis ; Demography ; Diabetes Mellitus ; Dyslipidemias ; Extremities ; Humans ; Hypertension ; Logistic Models ; Mass Screening ; Peripheral Arterial Disease ; Prevalence ; Surveys and Questionnaires ; Referral and Consultation ; Risk Factors

Maffucci syndrome is a non-hereditary disease, in which benign cartilage tumor called enchondroma occurs throughout the body, causing various symptoms. In particular, when chondrosarcoma occurs in the skull base, various neurologic symptoms can appear. Many of these symptoms have been diagnosed and reported by neurosurgeons. This paper presents a rare case of Maffuci syndrome. The patient is a 34-year-old female who first visited the otolaryngology outpatient department for ear fullness without any other neurological symptoms. The initial diagnosis was adult onset otitis media with effusion (OME), but further examination and biopsy revealed skull base chondrosarcoma. Moreover, the mass was extensively invading the skull base, so surgical treatment would have been dangerous; thus, careful follow-up has been conducted for the patient in the outpatient clinic. This report highlights the importance of nasopharyngoscopy as well as other imaging tests to observe nasopharyngeal masses in OME patients with congenital or acquired diseases, which are known to sporadically develop tumor.

No abstract available.
Pseudohypoparathyroidism*

OBJECTIVE: To evaluate the therapeutic effect of a Tibia Counter Rotator (TCR) with toe-out gait plate (GP) upon tibial internal torsion by a comparative analysis of transmalleolar angle (TMA) and gait analysis with GP alone. METHODS: Twenty participants with tibial internal torsion were recruited for this study. Each 10 participants were included in group A with TCR and GP application and in group B with GP application only. The TMA and the kinematic results were used for the evaluation of the therapeutic effects of orthoses. RESULTS: Within each group, TMA showed a significant increase after treatment. Group A showed a continuous improvement up to six months, however, group B showed an improvement up to five months only. Group A showed a significantly higher correction effect than group B after treatment. Regarding kinematic data, both groups showed a significantly decreased mean ankle adduction angle after treatment. However, group A showed a significantly lower mean ankle adduction angle than group B after six months. CONCLUSION: The group with TCR and GP showed a significantly better outcome and continued correction force compared to the group with GP only. Our results suggest that TCR with GP may be useful therapeutic orthoses for children with tibial internal torsion.
Ankle ; Child* ; Foot Orthoses ; Gait* ; Humans ; Orthotic Devices ; Tibia*