PURPOSE: We evaluated the effect of nerve decompression for restoration of plantar sweating and sensation in diabetic neuropathic feet, and we selected diabetic neuropathic patients with the possibility of overlying entrapmental neuropathy. MATERIALS AND METHODS: From June 2002 to May 2003, we have investigated and follow-up examed 10 patients with diabetic neuropathic feet, with decreased sensation in their lower limb, who underwent peripheral nerve decompression. The surgical procedure was multiple neurolysis of the common peroneal nerve, posterior tibial nerve and its three branches of one limb. We compared the operated limb with the opposite, unoperated limb. We performed history taking, physical examination, sweat secretion test, touch sensory test using Semmes-Weinstein monofilaments and electrodiagnostic study, pre-operatively and post-operatively. RESULTS: On 6 months after the operation, the post-operative tests showed that there were noticeable improvements to sensation, statistically (P<0.05), but there was no change in the sweat secretion test. According to the Cseuz criteria, 7 patients out of the 10 patients who received the multiple neurolysis showed excellent or good results. CONCLUSION: We observed that the peripheral nerve neurolysis could be benefit for improving sensation and alleviating pain of the diabetic neuropathic feet with nerve entrapmental symptoms, but there was no change in the sweat secretion on short-term follow-up. To identify whether the effect will be continued or not, additional follow-up will be required.
Decompression ; Diabetic Foot* ; Extremities ; Follow-Up Studies ; Foot ; Humans ; Lower Extremity ; Nerve Compression Syndromes ; Peripheral Nerves ; Peroneal Nerve ; Physical Examination ; Sensation ; Sweat ; Sweating ; Tibial Nerve

Congenital hypopituitarism is a possible cause of neonatal cholestasis, but the mechanism is still unknown. The pathogenesis of cholestasis may be due to hormone deficiency, which has effects on the physiological maturation of bile acid synthesis and transport. We experienced a case presenting with cholestasis and recurrent hypoglycemia associated with congenital hypopituitarism. Cholestasis resolved with thyroxine and hydrocortisone replacement therapy
Bile ; Cholestasis* ; Hydrocortisone ; Hypoglycemia ; Hypopituitarism* ; Thyroxine

PURPOSE: To compare the radiologic findings of pyogenic abscess(PA) and inflammatory cancer(IC) of the breast, as seen on mammograms, US, and MR images and to evaluate the usefulness of the differential diagnostic findings of MRI for differentiation of PA and IC of the breast. MATERIALS AND METHODS: We retrospectively analyzed the mammographic, US and MR findings of nine histopathologically proven cases of PA and four cases of IC of the breast. Parenchymal density, mass density, skin thickening and calcification were evaluated by mammography, and the extent of lesion and its morphologic characteristics and changes of dermal lymphatics by US and MRI. The latter was also used to analyse signal intensity and enhancement pattern. RESULTS: Mammographic findings for both lesions were nonspecific. US showed that the pyogenic abscess was a hypoechoic and anechoic complex lesion with posterior acoustic enhancement, while inflammatory cancer was a spiculated lesion with a heterogeneous hypoechoic echotexture. On 3D-GRE dynamic enhanced M-RI, PA was shown in six cases(66.7 %) to be a lesion with superficial periareolar involvement, in contrast to the deep parenchymal spread seen in all cases of IC. A central non- enhanced portion with an irregular thick peripheral enhanced rim was seen in eight cases of PA(88.9 %) , and in all cases of IC an inhomogeneously enhanced spiculated lesion in parenchyma and a diffusely enhanced dermal and subcutaneous layer was apparent. An MRI time-intensity curve showed that the enhancement pattern was slow in five cases of PA(55.6 % ) and irregular in four(44.4 %), while for IC it was rapid in three cases(33.3 %) and irregular in one(11.1 % ). CONCLUSION: As compared with mammography and US, 3D-GRE dynamic MRI was a useful method for the differential diagnosis of PA and IC of the breast. The characteristic MR findings of PA were a central non-enhanced portion with an irregularly thick peripheral enhanced rim, located mainly in the superficial periareloar area and spreading into the parenchymal layer. An inhomogeneously enhanced spiculated solid mass in the parenchyma associated with diffuse dermal thickening and lymphatic dilatation was more suggestive of IC.
Abscess* ; Acoustics ; Breast* ; Diagnosis* ; Diagnosis, Differential ; Dilatation ; Magnetic Resonance Imaging* ; Mammography ; Retrospective Studies ; Skin

PURPOSE: Nutrition status is regarded as an important factor for postoperative morbidity in cancer surgery. The aim of this study was to evaluate the impact of the malnutrition risk, determined by Seoul National University Hospital-Nutrition Screening Index (SNUH-NSI), on operative morbidity after gastrectomy for gastric cancer. METHODS: This study enrolled 246 patients who had undergone gastrectomy for gastric cancer at Seoul National University Hospital from March 2009 to February 2010. We collected general patient information, SNUH-NSI at administration and related parameters (serum albumin, cholesterol, total lymphocyte counts, hemoglobin and body mass index), operative method, hospital stay and operative morbidity. RESULTS: The patients' mean age was 59.6+/-11.3 years, and 9.4% (n=23) of patients were rated as severe malnutrition risk. There was no difference in operative morbidity by age or sex. The patients with high risk of malnutrition by SNUH-NSI or with advanced gastric cancer showed higher operative morbidity (P<0.01). There were no relationships between biochemical parameters and operative morbidity. On multivariate analysis, the significant independent risk factors were severe malnutrition by SNUH-NSI (OR 2.627, 95% CI 1.033~6.679; P<0.05) and advanced gastric cancer (OR 2.023, 95% CI 1.074~3.811; P<0.05). CONCLUSION: Overall nutritional status, rather than single data, is more related to operative morbidity in gastrectomized patients. Especially severe malnutrition as determined by SNUH-NSI, is an independent risk factor for operative morbidity. Nutritional support to severely malnourished patient by SNUH-NSI is expected to be an effective approach in preventing complications after gastrectomy.
Cholesterol ; Gastrectomy ; Hemoglobins ; Humans ; Length of Stay ; Lymphocyte Count ; Malnutrition ; Mass Screening ; Multivariate Analysis ; Nutritional Status ; Nutritional Support ; Risk Factors ; Stomach Neoplasms

47,XYY is a rare sex chromosomal disorder. Approximately 1.45 per 1,000 live births have on XYY chromosome pattern. The extra Y chromosome is paternal in origin and RESULTS: from nondisjunction in the second meiotic division. Although the phenotype is normal on the newborn, an increased incidence of minor anomalies has been reported. Recently, a 37-year-old primigravid woman received amniocentesis at 17 weeks gestation at a private clinic and was diagnosed as having a fetus with 47,XYY. We performed amniocentesis again at 20 weeks of pregnancy and confirmed fetal karyotype to be 47,XYY using the conventional cytogenetics and fluorescence in situ hybridization (FISH) techniques. As she did not want to terminate her pregnancy, she was put under antenatal care but ended up in vaginal delivery in 40 weeks. As a result of physical examination, the neonate showed a normal phenotype except for a mild hypospadia and a simian crease.
Adult ; Amniocentesis ; Child* ; Chromosome Disorders ; Cytogenetics ; Female ; Fetus ; Fluorescence ; Humans ; Hypospadias ; In Situ Hybridization ; Incidence ; Infant, Newborn ; Karyotype ; Live Birth ; Male ; Phenotype ; Physical Examination ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis* ; Y Chromosome

BACKGROUND AND OBJECTIVES: The aim of this study is to evaluate the outcomes and prognosis of traumatic facial paralysis in patients treated with facial nerve decompression via transmastoid approach. SUBJECTS AND METHOD: The authors retrospectively reviewed 20 patients who suffered from temporal bone fractures resulting in facial paralysis and received surgical facial nerve decompression treatment via transmastoid approach from 2004 to 2012. RESULTS: In 14 patients, the House-Brackmann grade improved to 1, 2, or 3. The preoperative average House-Brackmann grade of 4.95 improved from 4.95 to the postoperative average House-Brackmann grade of 3.15. Statistically significant improvements were found in all groups whether the operation was performed within two weeks, or from two weeks to four weeks, or after four weeks. CONCLUSION: Postoperative results of facial nerve decompression in traumatic temporal bone fracture can be excellent. Surgeons can expect better outcomes with early diagnosis and lesser nerve damage.
Decompression ; Early Diagnosis ; Facial Nerve ; Facial Paralysis ; Humans ; Prognosis ; Retrospective Studies ; Temporal Bone

OBJECTIVE: To evaluate the factors affecting long-term prognosis for dysphagia in tonsil cancer patients, after treatment. METHOD: This was a retrospective study of subjects who underwent a videofluoroscopic swallowing study (VFSS) following treatment for stage 3 or 4 tonsil cancer. Data including sex, age, cancer characteristics, and methods of cancer treatment were collected. To evaluate the swallowing-related outcome, we collected data including findings regarding the last VFSS, method of feeding, and history of aspiration pneumonia requiring in-patient care. We evaluated the correlation between these data and the characteristics of cancer and treatment methods. RESULT: Among 32 subjects included in this study, eight had aspiration or penetration confirmed by the last VFSS. There were no significant differences in swallowing-related factors according to the presence of aspiration or penetration in the last VFSS. Patients who underwent curative tonsillectomy retained more residues on the last VFSS than those who did not. CONCLUSION: Among subjects with tonsil cancer, history of curative tonsillectomy was correlated with more pharyngeal residue. However, other cancer- or treatment-related factors did not affect the outcome of swallowing.
Deglutition ; Deglutition Disorders ; Humans ; Methods ; Palatine Tonsil ; Pneumonia, Aspiration ; Prognosis ; Retrospective Studies ; Tonsillar Neoplasms ; Tonsillectomy

PURPOSE: This study aimed to analyze the effect of screening by using endoscopy on the diagnosis and treatment of gastric cancer. MATERIALS AND METHODS: The clinicopathologic characteristics of gastric cancer were compared in individuals who underwent an endoscopy because of symptoms (non-screening group) or for screening purposes (screening group). The distributions of gastric cancer stages and treatment modalities in 2006 and 2011 were compared. RESULTS: The proportion of patients in the screening group increased from 45.1% in 2006 to 65.4% in 2011 (P<0.001). The proportion of stage I cancers in the entire patient sample also increased (from 60.5% in 2006 to 70.6% in 2011; P=0.029). In 2011, the percentages of patients with cancer stages I, II, III, and IV were 79.9%, 8.2%, 10.9%, and 1.1%, respectively, in the screening group, and 47.9%, 10.8%, 29.8%, and 11.5%, respectively, in the non-screening group. The proportion of laparoscopic and robotic surgeries increased from 9.6% in 2006 to 48.3% in 2011 (P<0.001), and endoscopic submucosal dissection increased from 9.8% in 2006 to 19.1% 2011 (P<0.001). CONCLUSIONS: The proportion of patients diagnosed with gastric cancer by using the screening program increased between 2006 and 2011. This increase was associated with a high proportion of early-stage cancer diagnoses and increased use of minimally invasive treatments.
Diagnosis ; Early Detection of Cancer ; Endoscopy ; Humans ; Mass Screening* ; Stomach Neoplasms*

Hemolytic uremic syndrome (HUS) is a rare disorder characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS arises from a wide spectrum of conditions, and chemotherapeutic agents have been reported to be associated with HUS, including Mitomycin, Cisplatin, Bleomycin, and Gemcitabine. A 76-year-old man treated with Gemcitabine due to non-small cell lung cancer developed clinical and laboratory findings compatible with HUS. Gemcitabine was ceased and hemodialysis and plasma exchange were utilized and he recovered. A high level of suspicion for HUS is necessary when cancer patients are treated with Gemcitabine, and prompt recognition and treatment are also essential.
Acute Kidney Injury ; Aged ; Anemia, Hemolytic ; Bleomycin ; Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Deoxycytidine ; Hemolytic-Uremic Syndrome ; Humans ; Lung ; Lung Neoplasms ; Mitomycin ; Plasma Exchange ; Renal Dialysis ; Thrombocytopenia