Generalized plane xanthoma is less common and usually involves the eyelids, lateral side of the neck, upper trunk, and extremities. Lesions, however, may appear on any portion of the body. Cutaneous xanthomas may occur in hyperlipidemic and in normolipidemic states. Generalized normolipidemic plane xanthoma is often associated with multiple myeloma, other reticulo-endothelial malignancies and monoclonal gammopathy with unknown significance(MGUS). We wish to report two eases of generalized plane xanthoma associated with IgG monoclonal gammopathy of unknown significance.
Extremities ; Eyelids ; Immunoglobulin G ; Multiple Myeloma ; Neck ; Paraproteinemias* ; Xanthomatosis*

Ureteroscopic management of ureteral calculi is an established successful technique with low complication. We performed 140 ureteroscopies for stone removal from January 1990 to April 1995. The stone were removed successfully in 131 cases (94%), and complication occurred in 37 cases (27%). In 9 cases, complete removal of stone was failed due to upward migration of stone (3 cases), not mobilization of stone (3 cases), inability to introduce ureteroscope into the intramural ureter (2 cases), inadequate illumination due to bleeding (1 case). Complications of ureteroscopic removal of stone were ureteral perforation (8 cases), tearing of ureteral mucosa (5 cases), gross hematuria (19 cases), infection (3 cases) and fever (2 cases). All complications were treated successfully with conservative treatment. We conclude that ureteroscopic removal of stone is still primary useful treatment of middle and lower ureteral stones and can be done safely if certain guide lines such as proper selection of patient, adequate use of lithotriptor, careful dilatation of ureteral orifice are kept strictly.
Dilatation ; Fever ; Hematuria ; Hemorrhage ; Humans ; Lighting ; Mucous Membrane ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy

Pseudocyst of the auricle presents as a non-inflammatory, fluctuant swelling on the upper half or third section of the ear, due to intracartilaginous accumulation of fluid. Histological examination shows an intracartilaginous cavity without an epithelial lining. The etilogy and pathogenesis of this disorder remains unknown, but the lesion is likely to be due to localized de-generation of cartilage. The degenerated cartilage is replaced by a vascular fibrous tissue from which there is serious exudation, and a clinical cystic swelling is formed. We describe in this report three cases of pseudocyst of the auricle, of which one was treated successfully by surgical excision and a pressure dressing, and the others by aspiration and steroid injection therapy. In all cases, the skin lesions had not recurred, and the patients were left with an excellent cosmetic result.
Bandages ; Cartilage ; Ear ; Humans ; Skin

Microcystic meningioma is a rare variant of meningiomas. This unusual variant was originally described by Masson, who labeled it "humid". The computed tomographic scan or magnetic resonance images of these tumors resemble those of a glial or metastatic tumor with cystic or necrotic changes. There is no definitive method for differentiating cystic meningiomas from these more common tumors. But immunohistochemically, they share a similar pattern of positive staining for epithelial membrane antigen and vimentin with other meningiomas. Our case was a 34-year-old woman with a tumor mass on the right frontal area. She was admitted to hospital because of generalized tonic seizure. Grossly all of the tumor could be removed, and histopathologically this tumor was revealed to be a microcystic meningioma.
Adult ; Female ; Humans ; Meningioma* ; Mucin-1 ; Seizures ; Vimentin

A total of 150women with singleton pregnancies who were delivered between 37 and 42weeks gestation had ultrasound scans on elective cesarean section day. The biparietal diameter(BPD), head circumference(HC), abdominal circumference(AC) and femur length(FL) were measured in all cases. Equations of estimated fetal body weight(BWT) for Korean term fetuses using AC alone, BPD/AC, AC/FL, HC/AC/FL, BPD/AC/FL, BPD/HC/AC/FL were made by stepwise multiple regression analysis and were compared with foreign equations such as Campbell(AC), Shepard(BPD/AC), Hadlock I(AC/FL), Hadlock II(HC/AC/FL), Hadlock III(BPD/AC/FL), and Hadlock IV(BPD/HC/AC/FL). The results were as follows. 1. The equations of BWT by sonographic measurement were Equation1 (AC) logeBWT=6.105936+0.005957X(AC) (R=0.876) Equation2 (BPD,AC)logeBWT=6.53614548+0.00004963X(ACXBPD) (R=0.929) Equation3 (AC,FL) logeBWT=6.25336442+0.00751602X(FL)+0.00005155X(ACXFL) (R=0.950) Equation4(HC,AC,FL) logeBWT=6.39631346+0.00004823X(ACXFL)+0.00002023X(FLXHC) (R=0.953) Equation5(BPD,AC,FL) logeBWT=5.99934074+0.00871394X(BPD)+0.00005132X(ACXFL) (R=0.960) 2. When BPD, AC and FL were measured, the addition of HC didn,t affected to accuracy of EFW 3. The best results of all equations were obtained with our equation 5(Mean error=2.36gm, Mean absolute error=96.39gm, Mean deviation + SD(%)=0.07+0.37) and among foreign equations, the best results were with Hadlock III equation(Mean error=18.35gm, Mean absolute error=107.82gm, Mean deviation + SD(%)=-0.46+0.42) 4. The equations using AC/FL (our equation 3, Hadlock I) are more accurate than those using BPD/AC (our equatione 2, Shepard) when utilizing two parameters. Therefore, equation using AC/FL is recommended when the BPD is unobtainable at term or labor 5. The percentage of cases in which the EFW was within +5% and +200gm of the actual birth weight was highest at our equation 5 for 82% and 89%, Hadlock IV equation for 79%, 88%. 6. Our equations had relatively an equal tendency to under- and overestimate fetal weight, but foreign equations, especially Campbell and Hadlock II equations tended to underestimate. 7. Analysing according to actual birth weight, our all equations gave the most accurate estimates of fetal weigh for birth weight group between 3000-3499gm, but for birth weight group above 3500gm, that was not. At birthweight group above 3500gm, the equations depend on femur length are more accurate than the equations independ on fumr length.
Birth Weight ; Cesarean Section ; Female ; Femur ; Fetal Weight* ; Fetus ; Head ; Pregnancy ; Ultrasonography

PURPOSE: To determine the usefulness of carbon dioxide(CO2) indirect portography during TIPS procedure. MATERIALS AND METHODS: We evalvated eight patients who had undergone TIPS due to variceal hemorrhage or ascites caused by portal hypertension. All patients but one with complete situs inversus underwent wedged right hepatic venography for visualization of the portal vein using CO2. For CO2 indirect portal venography, 50cc of CO2 was injected by hand without prior injection of a small amount of CO2. In three patients a 5-F angiographic catheter was wedged into the right hepatic vein, and in the other five a 9-F sheath from a Ring 's transjugular access set was adjunctively wedged into the right hepatic vein over the 5-F catheter. The time required for portal vein puncture was defined as the time between the indirect portal venography procedure and the first procedure after successful portal vein puncture. RESULTS: All patients successfully underwent TIPS without any immediate complication. The portal vein was visualized by CO2 in 7 of 8 patients (87.5 %). Two of three patients who underwent indirect portography with only a 5-F catheter wedging demonstrated opacification of the right portal vein; in the remaining patient the portal venous system was not visualized. Of the five patients who underwent indirect portography with an adjunctive 9-F sheath wedged in the right hepatic vein, four showed opacification from the peripheral to the main portal vein, and in the other, the only right peripheral portal vein was opacified. The mean time for portal vein puncture was 20.5 minutes. CONCLUSION: For visualization of the portal venous system during TIPS procedure, the use of CO2 indirect portography is feasible.
Ascites ; Carbon ; Carbon Dioxide ; Catheters ; Hand ; Hemorrhage ; Hepatic Veins ; Humans ; Hypertension, Portal ; Phlebography ; Portal Vein ; Portasystemic Shunt, Surgical ; Portography* ; Punctures ; Situs Inversus

The aim of this study was to evaluate the effect of mouthrinse products containing deep sea water. We used original deep sea water (DSW) and processed deep sea water desalinated by reverse osmosis at one time (DDW-1), by reverse osmosis at two times (DDW-2) and concentrated by reverse osmosis (CDW). We made 2 kinds of mouthrinse products containing CDW and other agents for smell and taste and one product without deep sea water. The negative control was distilled water. In vivo study, the dental plaque index scores and the gingival index scores were reduced after 4 weeks mouthrinsing three times daily with 4 kinds of deep sea water and 3 kinds of mouthrinse products(p<0.05). The pH of dental plaque in 1 minute after mouthrinsing was not higher than 5.5 in all solutions, but the pH in 20 minutes after mouthrinsing was higher than 5.7 in DSW, CDW and 3 kinds of products which had higher mineral contents. In vitro study, the mouthrinse solutions containing the higher mineral contents were also the more effective in reduction of methyl mercaptan which is one of the causes of halitosis. The 2 kinds of products containing deep sea water killed Streptococcus mutans (ATCC 25175) in culture plates in one minute. These results indicate the usability of deep sea water in mouthrinses for oral hygiene management.
Dental Plaque ; Dental Plaque Index ; Halitosis ; Hydrogen-Ion Concentration ; Oral Hygiene ; Osmosis ; Periodontal Index ; Seawater* ; Smell ; Streptococcus mutans ; Water

BACKGROUND: This study investigated the effect of type of surgery on consumption of propofol and remifentanil and recovery index. METHODS: Fifty female patients (ASA physical status 1, 2) scheduled for thyroidectomy (Group I) or mastectomy (Group II) received total intravenous anesthesia (TIVA) with propofol and remifentanil. The anesthesia was maintained with target-controlled infusion (TCI) of propofol and remifentanil under bispectral index (BIS) monitoring. The effect site concentration of propofol was controlled for maintaining BIS values within the range of 45-50. The effect site concentration of remifentanil was controlled for maintaining blood pressure and heart rate within 20% of baseline values. Blood pressure, heart rate, BIS, effect site concentration of propofol and remifentanil were measured before induction, during induction, at the beginning of operation, at the end of operation, and during recovery. The time from discontinuation of propofol to eye opening and regaining of orientation, total amount of propofol and remifentanil used, and the amount of drug per body weight kilogram per hour were investigated. RESULTS: There were no significant differences between Group I and II on the amount of remifentanil used. Although the amount of propofol consumed per body weight kilogram per hour was larger in Group II, there were no significant differences of recovery index between Group I and II. CONCLUSIONS: There were no significant differences in the amount of propofol and remifentanil consumed and recovery index in thyroidectomy and mastectomy under TIVA. The larger amount of propofol consumed per body weight per hour in Group II was thought as a result of shorter operation time than Group I.
Anesthesia* ; Anesthesia, Intravenous* ; Blood Pressure ; Body Weight ; Female ; Heart Rate ; Humans ; Mastectomy* ; Propofol* ; Thyroidectomy*

BACKGROUND: Basal cell carcinoma (BCC) is a slow-growing, locally invasive malignant epidermal skin tumor. Several studies of differences in age, site distribution and male to female ratio have been conducted among different histological subtypes of BCC. OBJECTIVE: We analyzed the five major subtypes of BCC with regard to gender, age, and anatomical distribution. METHODS: We retrospectively included 246 cases of BCC diagnosed from January 2000 to March 2011. The diagnoses and classifications of histopathological subtypes (nodular, superficial, micronodular, infiltrative, or morphemic) of BCC were confirmed by three dermatologists. Gender, age at diagnosis, and location were recorded and analyzed by histopathological subtypes. RESULTS: We recorded 246 cases (M : F=11.08) with a mean age of 64.0 years. Of the BCCs, 61.0% were nodular, 15.4% were superficial, 11.4% were micronodular, 10.2% were infiltrative, and 2.0% were morpheic. The nodular subtype was diagnosed at a mean age of 64.9 years, whereas the superficial subtype was diagnosed at an earlier age (60.3 years) and more frequently occurred in women (M : F=1 : 1.5) than the nodular subtype. Compared with the nodular subtype (4%), the superficial subtype (26.3%) occurred more frequently in the trunk (p-value<0.0001). CONCLUSION: The results showed differences in anatomical distribution, gender, and mean age according to histological subtypes. Superficial BCC occurred more commonly on the trunk, more often in women, and was seen in younger patients than that of the nodular subtype.
Carcinoma, Basal Cell ; Female ; Humans ; Male ; Retrospective Studies ; Skin