Ectrodactyly (lobster-claw hand or foot), ectodermal dysplasia and cleft lip or palate constitute a rare clinical syndrome of congenital anomalies, commonly called ectrodactyly- ectodermal dysplasia-clefting (EEC) syndrome. Clinical manifestations of EEC syndrome are variable. This disorder is transmitted by autosomal dominant inheritance and thought to be controlled by single gene. This patient is two month old female who has typical ectrodactyly or lobster-claw hand and foot and cleft palate compatible with EEC syndrome. A brief report of a case with review of literature is given.
Cleft Lip ; Cleft Palate ; Ectoderm ; Ectodermal Dysplasia ; European Union ; Female ; Foot ; Hand ; Humans ; Palate ; Wills

No abstract available.
Animals ; Dopamine* ; Models, Animal* ; Parkinsonian Disorders* ; Rats* ; Receptors, Dopamine*

In order to study the changes of blood sugar and electrolyte during cardiopulmonary bypass(CPB) in open heart surgery, 28 patients were selected and observed. The results are as follows: 1) The levels of blood sugar were increased significantly(p<0.01) in all patients compared to the controls as the operation advanced to the end of the CPB. But there was no significant correlation the with the CPB. 2) The increase in blood sugar level was greater in the TOF group and it was at significantly increased(p<0.01) after the CPB and was maintained higher at the end of the CPB. 3) The changes of electrolyte and arterial blood gas values during CPB were not remarkable.
Blood Glucose ; Blood Platelets* ; Hematocrit* ; Humans ; Platelet Count* ; Thoracic Surgery

Pericardial cysts are uncommon benign congenital mediastinal lesions and they are most often found in either cardiophrenic angle. We present here one case of atypically located pericardial cyst that was located in the subpulmonary region. The clinicians should take into consideration this entity in the differential diagnosis of cystic lesion of the mediastinum. The diagnostic difficulties that are encountered and the utility of video-assisted thoracoscopy are described.
Diagnosis, Differential ; Mediastinal Cyst* ; Mediastinum ; Pericardium ; Thoracoscopy

BACKGROUND: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. METHODS: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. RESULTS: Spread levels to the cephalad for patients in the two groups were 4.88 +/- 0.78 segments and 4.53 +/- 0.49 segments, respectively. Spread levels to the caudad for patients in the two groups were 4.59 +/- 0.93 segments and 4.47 +/- 0.51 segments, respectively. The results showed no significant difference in the spread level between the two groups. CONCLUSIONS: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.
Epidural Space ; Fluoroscopy ; Humans ; Injections, Epidural ; Intervertebral Disc Displacement ; Iohexol ; Neck Pain ; Pain Clinics ; Pain Management

BACKGROUND: Thoracic sympathetic block surgery is a safe and effective procedure for palmar hyperhydrosis, and this maintains sufficient moisture and prevents compensatory hyperhidrosis. To avoid compensatory hyperhidrosis, the authors performed sympathetic block surgery just above the R4 level to maintain sympathetic tone affecting the caudal area. MATERIAL AND METHOD: A total of 71 subjects (45 males and 26 females) were categorized into two groups. Group 1 (31 patients, mean age: 25.5 years) had clips placed both on the upper and lower part of R4 sympathetic ganglion, and group 2 (40 patients, mean age: 25.9 years) underwent clipping of the upper part of R4. Telephone surveys were done to collect data on 8 categories, and the average follow up interval was 24.9 months (group 1) and 18.9 months (group 2). RESULT: For group 1, 41.9% experienced no sweating and 48.4% replied they experienced some sweating depending on the surrounding conditions. Group 2 showed that 60% experienced no sweating and 35% replied they experienced some sweating depending on the surrounding conditions. 58.1% in group 1 experienced sweating right after the surgery, and 40.0% in group 2 experienced the same. Group 1 (38.1%) and group 2 (37.5%) replied they experienced no hand dryness and more patients in group 2 than in group 1 had hand dryness, but without uncomfortable symptoms. 71.0% (group 1) and 62.5% (group 2) replied they had no compensatory hyperhidrosis or related symptoms. One patient in group 1 and two in group 2 reported they regretted undergoing the procedure. The regions of compensatory hyperhidrosis were the back, thigh and chest in group 1 and the group 2 reported the back, chest, and abdomen in the order of frequency. Fewer incidences of the gustatory hyperhidrosis were noted in group 2. Most of the patients were satisfied with their treatment. CONCLUSION: Clipping the upper part of the R4 ganglion or R4 sympathetic block are both effective for treating palmar hyperhidrosis and these treatments decrease the occurrence or symptoms of compensatory hyperhidrosis. The upper R4 sympathetic block procedure is easier and safer with fewer incidences of gustatory hyperhidrosis and a higher percentage of patient satisfaction.
Abdomen ; Endoscopy ; Follow-Up Studies ; Ganglia, Sympathetic ; Ganglion Cysts ; Hand ; Humans ; Hyperhidrosis* ; Incidence ; Male ; Patient Satisfaction ; Reflex ; Sweat ; Sweating ; Sweating, Gustatory ; Sympathetic Nervous System ; Telephone ; Thigh ; Thorax

PURPOSE: Recent progress in the surgical therapy for lung cancer is one of the best examples of the successful evolution of clinical medicine. We reviewed our experience to evaluate the surgical outcomes in patients with non-small cell lung cancer. MATERIALS AND METHODS: We reviewed clinical records of 236 consecutive patients with proven primary non-small cell lung cancer who underwent complete removal of the primary tumor together with hilar and mediastinal lymph nodes from 1995 to 2005. The clinical characteristics, surgical methods, and recurrence patterns were analysed. RESULTS: The patients of stage III and IV were 71 cases (35.9%) and 2 cases (1.0%) respectively, and neoadjuvant therapy was done in 62 patients. Lobectomy was the most common procedure (69.7%) performed and pneumonectomy was the least (5.6%). In 81 patients (40.9%) the recurrence was noted and the regional recurrence (27 cases, 13.6%) was less than systemic recurrence (54 cases, 27.3%). The main sites of regional recurrence were hilum (11 cases, 40.7%) and ipsilateral mediastinum (9 cases, 33.3%). CONCLUSION: These data indicated that our surgical methods were useful and effective
Carcinoma, Non-Small-Cell Lung* ; Clinical Medicine ; Humans ; Lung Neoplasms ; Lymph Nodes ; Mediastinum ; Neoadjuvant Therapy ; Pneumonectomy ; Recurrence*

PURPOSE: Usually papillary microcarcinoma (PMC) grows very slowly with a good prognosis, although it frequently metastasizes to regional lymph nodes and shows multiple tumor formation in the thyroid. Therefore, how to treat papillary microcarcinoma has been controversial. Recently several studies reported that some ultrasonographic features may potentially reflect the biological aggressiveness of a lesion. We investigated which ultrasonographic findings can reflect aggressive characteristics and whether US can helpful in selecting the appropriate surgical treatment of PMC. METHODS: We retrospectively reviewed the preoperative ultrasonographic findings and pathologic risk factors of 68 patients who had undergone surgical treatment for PMC at the Wallace Memorial Baptist Hospital from January 2004 to December 2005. RESULTS: The incidences of multifocality, extrathyroidal extension, and lymph node metastasis of PMC were 42.6%, 48.5% and 20.6%, respectively. The Mean sizes of PMC were no significant differences according to age, multifocality, extrathyroidal extension, lymph node metastasis, stage and AMES risk group, and tumor size more than 5 mm was not linked to pathologic prognostic factors. Cases demonstrating multiple nodules in the unilateral or bilateral lobes, as well as those with fine strong calcifications in the tumor on US, were directly linked to multifocality on pathologic finding. US is insensitive technique for detecting lymph node metastasis and it's sensitivity was only 14.3%, but it's positive predictive value and specificity were high (100%). CONCLUSION: The date suggested that complete surgery with appropriate nodal dissection should be performed in patients with PMC which their US demonstrating multiple nodules in the unilateral or bilateral lobes, fine strong calcifications echoes in tumor and US-detected node metastasis.
Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Protestantism ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; Thyroid Gland* ; Ultrasonography*

BACKGROUND: The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. MATERIAL AND METHOD: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37oC (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. RESULT: In the group that was rapidly thawed, the expression of TUNEL (+) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. CONCLUSION: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopreserved arterial allografts. The expression of TUNEL (+) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.
Allografts ; Aorta* ; Arteries ; Cryopreservation ; Edema ; In Situ Nick-End Labeling ; Rupture ; Transplants

PURPOSE: Infantile spasms are considered malignant epilepsy of infancy. Primary objectives of treatment are complete control of seizure attack and prevention of further brain damage. The aim of this study is to assess prednisolone(PDL) efficacy in infantile spasms. METHODS: From June 1985 to July 1994, 20 children with infantile spasms who were diagnosed at Kyung Hee University Hospital and were medicated 2mg/kg PDL analyzed retrospectively. RESULTS: 1) The ratio of male to female was 1.9:1. 2) Mean age at onset of infantile spasms is 7.8 month old and mean age at treatment of infantile spasms is 10.3 month old. Mean duration from onset of the disease to the beginning of the treatment is 1.3 months. 3) The most common type of infantile spasms is flexor type which is 10 cases (50.0%) 4) Among the associated conditions, brain atropy is the most common condition (45.0%). 5) Of forteen cases with developemental delay, six cases were controlled and four of the six cases without developmental delay were controlled. 6) EEG findings were improved in sixteen patients (80.0%) 7) The most common combined anticonvulsant is valproic acid. CONCLUSIONS: The effectiveness of PDL in infantile spasm is 42.9% in group with developmental delay. On the other hand, that is 66.7% in group without developmental delay. Also, because PDL have a merit of cheap and easy for oral medication, it will be necessary that PDL can be selected for hormonal anticonvulsant in infantile spasm. But,it must keep in mind that high dose or longterm PDL can elicit serious side effects.
Brain ; Child ; Electroencephalography ; Epilepsy ; Female ; Hand ; Humans ; Infant ; Infant, Newborn ; Male ; Prednisolone* ; Retrospective Studies ; Seizures ; Spasms, Infantile* ; Valproic Acid