Carotidynia is defined as an atypical craniofacial pain syndrome caused by the dilatation or distension of the extracranial arteries. We report an unusual case of carotidynia mimicking trigeminal neuralgia caused by an arterioscle-rotic tortous carotid artery. A 68-year-old woman suffered from frequent episodes of severe electrical shock-like radiating pain around her left ophthalmic and maxillary division of the trigeminal nerve for 5 years. Initially, under the impression of trigeminal neuralgia, carbamazepine was tried. She was reevaluated due to an unsatisfactory pharmacological response. On examination, no abnormalities were found on the craniofacial region except for a tortous pulsating tender mass on the region of the left carotid artery. Routine laboratory findings and a connective tissue study were normal. Neck sonography and a 4-vessel angiography showed a tortous left internal carotid artery with stenosis extending near to the skin. The patient was treated for 2 weeks with a nonsteroidal anti-inflammatory agent, steroids, a prophylctic beta blocker, and a TCA antidepressant. The pain gradually subsided.
Aged ; Angiography ; Arteries ; Carbamazepine ; Carotid Arteries ; Carotid Artery, Internal ; Connective Tissue ; Constriction, Pathologic ; Dilatation ; Facial Neuralgia ; Female ; Humans ; Neck ; Skin ; Steroids ; Trigeminal Nerve ; Trigeminal Neuralgia*

No abstract available.
Diagnosis* ; Evoked Potentials, Somatosensory* ; Trigeminal Nerve Injuries* ; Trigeminal Nerve*

In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward. We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy.
Breast Neoplasms/radiography ; Case Report ; Cholesterol ; Diagnosis, Differential ; Esthetics ; Female ; Granuloma, Foreign-Body/etiology/*radiography/*ultrasonography ; Human ; Injections/adverse effects ; Mammography ; Middle Age ; Paraffin

Deep infection after total hip arthroplasty is one of the most serious post operative complications. Treatment of infection of the hip joint can be made very difficult by poor response to antibiotic therapy. Infection rates of total hip arthroplasty have decreased due to prophylactic antibiotics, sterilization of surgical instruments, cleaner operation environments, Improvement of surgical methods and proper patient selection. Recently, post operative infection rates of primary or revision arthroplasties were reported to still be as high as 1% to 2%. Therefore, the aim of this article is to review the recent literature and to evaluate the cause, environment diagnosis and treatment of infection after total hip arthroplasty.
Anti-Bacterial Agents ; Arthroplasty ; Hip ; Hip Joint ; Patient Selection ; Sterilization ; Surgical Instruments

The use of high-pressure air instruments has become more common. Consequently, there have been a number of cases of orbital emphysema caused by contact with high-pressure air. In this case, a 62-year-old male patient visited an emergency medical center after his left eye was shot by an air compressor gun that was used to wash cars. Lacerations were observed in the upper and lower eyelids of his left eye. Radiological examinations revealed orbital emphysema, optic nerve transection, pneumocephalus, and subcutaneous emphysema in the face, neck, shoulder, and mediastinum. Canalicular injury repair was performed, and the emphysema resolved. However, there was near-complete vision loss in the patient's left eye. Because most optic nerve transections occur after a severe disruption in bone structure, pure optic nerve transections without any injury of the bone structure, as in the present case, is extremely rare.
Compressed Air ; Emergencies ; Emphysema ; Eyelids ; Humans ; Lacerations ; Male ; Mediastinum ; Middle Aged ; Neck ; Optic Nerve Injuries* ; Optic Nerve* ; Orbit ; Pneumocephalus ; Shoulder ; Subcutaneous Emphysema

PURPOSE: The relationship between menopausal status at diagnosis and the prognosis in breast carcinoma remains uncertain. However, it is widely considered that breast cancer in young women is more lethal than in older patients. We therefore attempted to determine whether menopausal status could be a useful prognostic factor for breast cancer. METHODS: A retrospective study was conducted of premenopausal women who had undergone a definite operation between Jan. 1997 and Dec. 1998 in the Department of Surgery, Samsung Medical Center. Clinical features, histopathologic findings, and prognostic factors were evaluated and compared with those for the equivalent surgical group of postmenopausal women. RESULTS: There were 207 cases (86.3%) of infiltrating ductal carcinomas, 10 (4.2%) of infiltrating lobular carcinomas, 6 (2.5%) of ductal carcinomas in situ, and 16 (6.7%) of special type cancers which showed good prognosis. There were some differences in these incidences from those of the postmenopausal women, but they were not statistically significant (P>0.05). Tumor size and lymph nodal status showed no difference between the two groups (P=0.288), nor were there any significant differences in terms of TNM stage, ER/PR status, nuclear or histologic grade (P>0.05). CONCLUSION: There were little differences in pathologic and prognostic factors between premenopausal and postme no-pausal breast cancer patients. Premenopausal status and young age did not have poorer prognostic factors and were predicted to have not worse prognosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Incidence ; Prognosis ; Retrospective Studies

Monoclonal gammopathy of undetermined significance(MGUS) is one of the monoclonal plasma cell disorder. According to the recent reports, polyneuropathy associated with MGUS may be treatable disease due to potential relationship between the monoclonal protein and immune-mediated nerve damage. It is reported that plasmapheresis is highly effective in the treatment of polyneuropathy associated with IgG type MGUS. We present 53-year-old male with slowly progressive motor weakness and sensory change since 1 year ago. Electrophysiologic studies were compatible with demyelinating neuropathy showing conduction block and temporal dispersion in upper and lower extremities. Abnormal arc against anti-lamda on serum immunoelectrophoresis and M-band in the gamma region on serum protein electrophoresis were shown. After the combined therapy of plasmapheresis (5 times) and steroid, clinical and electrophysiologic findings were markedly improved. We report a case of demyelinating neuropathy associated with IgG lamda type MGUS, which showed good response to combined therapy of plasmapheresis and steroid.
Electrophoresis ; Humans ; Immunoelectrophoresis ; Immunoglobulin G* ; Lower Extremity ; Male ; Middle Aged ; Monoclonal Gammopathy of Undetermined Significance* ; Paraproteinemias* ; Plasma Cells ; Plasmapheresis ; Polyneuropathies

PURPOSE: The relationship between menopausal status at diagnosis and the prognosis in breast carcinoma remains uncertain. However, it is widely considered that breast cancer in young women is more lethal than in older patients. We therefore attempted to determine whether menopausal status could be a useful prognostic factor for breast cancer. METHODS: A retrospective study was conducted of premenopausal women who had undergone a definite operation between Jan. 1997 and Dec. 1998 in the Department of Surgery, Samsung Medical Center. Clinical features, histopathologic findings, and prognostic factors were evaluated and compared with those for the equivalent surgical group of postmenopausal women. RESULTS: There were 207 cases (86.3%) of infiltrating ductal carcinomas, 10 (4.2%) of infiltrating lobular carcinomas, 6 (2.5%) of ductal carcinomas in situ, and 16 (6.7%) of special type cancers which showed good prognosis. There were some differences in these incidences from those of the postmenopausal women, but they were not statistically significant (P>0.05). Tumor size and lymph nodal status showed no difference between the two groups (P=0.288), nor were there any significant differences in terms of TNM stage, ER/PR status, nuclear or histologic grade (P>0.05). CONCLUSION: There were little differences in pathologic and prognostic factors between premenopausal and postme no- pausal breast cancer patients. Premenopausal status and young age did not have poorer prognostic factors and were predicted to have not worse prognosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Incidence ; Prognosis ; Retrospective Studies

PURPOSE: Fractional exhaled nitric oxide (FeNO) has been widely reported as a marker for airway inflammationin, and FeNO have shown increased levels in the non-asthmatic patients with other atopy related diseases, such as rhinitis. Bronchial hyperresponsiveness is a characteristic feature of asthma, which is often associated with airway inflammationin allergic rhinitis. It has been suggested that asthma is associated with rhinitis, which is a link between the upper and the lower airways, beyond allergy associated inflammation in the respiratory tract. To evaluate the usefulness of FeNO measurement, as a risk factor of allergic and nonallergic rhinitis in children with asthma. METHODS: Fifty-three children included in this study were diagnosed as asthma from April through August 2005 in the Department of Pediatrics, Kyung Hee University School of Medicine. They conducted FeNO monitoring, total eosinophil count and serum immunoglobulin E at that time. We put a question to the participants' parents about the doctor diagnosed participants' manifestations (sneezing, nasal congestion, nasal itching, rhinorrhea), via a telephone interview survey or at the outpatient department in July 2011. Statistical analyses were performed using IBM SPSS ver. 18.0. RESULTS: The overall prevalence of rhinitis, among the 53 children, was 67.9%. The means of FeNO differed significantly between the two groups, being higher in children who have rhinitis symptoms and lower in asymptomatic children. (mean+/-SD, 29.4+/-24.6 to 13.6+/-11.8 parts per billion; P=0.003; T-test) CONCLUSION: To take the measurement of FeNO value in asthmatics may be a tool in the predictor of the causes of rhinitis.
Aluminum Hydroxide ; Asthma ; Carbonates ; Child ; Eosinophils ; Estrogens, Conjugated (USP) ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Inflammation ; Interviews as Topic ; Nitric Oxide ; Outpatients ; Parents ; Pediatrics ; Prevalence ; Pruritus ; Respiratory System ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors

PURPOSE: To evaluate clinical results of autologous osteochondral graft in osteochondral lesions of the talus. MATERIALS AND METHODS: Twenty feet in twenty patients underwent osteochondral autologous transfer in the osteochondral lesions of the talus. Sixteen were men and four were women. The mean age was 40.8 years old. The mean follow up was 2 years 9 months. Eighteen cases were medial, one case was lateral and one case was both, respectively. The average duration of symptom was 4 years 3 months. AOFAS ankle/hindfoot score (AOFAS score), visual analogue scale (VAS), Lysholm knee score were evaluated preoperatively and at the final follow up. RESULTS: Postoperative AOFAS score was 87.3 (range, 69-100), which was significantly improved from preoperative AOFAS score of 62.0 (p=0.000). Postoperative VAS was 2.9 (range, 0-7), which was significantly improved from preoperative VAS of 7.5 (p=0.000). Postoperative Lysholm knee score was 92.4 (range, 80-100). All osteotomy of medial malleolus was united by the 4th month after surgery. Postoperative VAS was conversely correlated with the follow up period (p=0.024). There was no complications associated with surgery. CONCLUSION: Autologous osteochondral grafts in osteochondral lesion of the talus demonstrated excellent results with a short-term follow up.
Female ; Follow-Up Studies ; Foot ; Humans ; Knee ; Male ; Osteotomy ; Talus* ; Transplants*