No abstract available.
Immunoglobulin M* ; Lymphoma* ; Paraproteinemias*

No abstract available.

Torticollis is an usual symptom that can be the result of various disorders, such as sternocleidomastoid muscle pathology, bony abnormalities of the cervical spine, disorders of the central or peripheral nervous system, various ocular diseases, and brain tumors, especially in children. A 12-month-old male visited our hospital because of torticollis. He was normal on systemic examination, with no neurological abnormality, and his cervical spine CT was also normal. About 4 weeks later, he revisited the emergency department due to vomiting with altered mental status, and was diagnosed with a cerebellar tumor with hemorrhage. Although torticollis is known to be an important sign of a posterior fossa tumor, associated neurological or ocular symptoms are usually present. We report here a patient with posterior fossa tumor where torticollis was the only initial presenting symptom.

Torticollis is an usual symptom that can be the result of various disorders, such as sternocleidomastoid muscle pathology, bony abnormalities of the cervical spine, disorders of the central or peripheral nervous system, various ocular diseases, and brain tumors, especially in children. A 12-month-old male visited our hospital because of torticollis. He was normal on systemic examination, with no neurological abnormality, and his cervical spine CT was also normal. About 4 weeks later, he revisited the emergency department due to vomiting with altered mental status, and was diagnosed with a cerebellar tumor with hemorrhage. Although torticollis is known to be an important sign of a posterior fossa tumor, associated neurological or ocular symptoms are usually present. We report here a patient with posterior fossa tumor where torticollis was the only initial presenting symptom.
Nervous System Diseases ; Torticollis

No abstract available.
Multiple Endocrine Neoplasia*

No abstract available.
Animals ; Calcium ; Glucose ; Insulin ; Magnesium ; Pancreas ; Rats

BACKGROUND: Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. METHODS: Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. RESULTS: At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P < 0.05). Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P < 0.05), but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P < 0.05). CONCLUSIONS: Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.
Breast Neoplasms ; Breast* ; Female ; Humans ; Insurance ; Korea ; Mammaplasty* ; Mastectomy ; Mastectomy, Simple ; National Health Programs* ; Seoul

Amylase-producing multiple myeloma is a rare disorder and has poor prognosis. Its characteristics are elevation of salivary type amylase, extensive extramedullary spread, extensive bone destruction, shorter survival time, and abnormal karyotype. Recently, we have experienced a case of amylase-producing IgG kappa type multiple myeloma in a 63-year-old woman. On admission, serum and urine amylase was 8,450U/L and 169,710U/L, 85% and 86% of which was determined to be the salivary type, respectively. The other cause of hyperamylasemia had not been detected. The presence of immunoglobulin and amylase in the myeloma cells was demonstrated immunohistochemically. Bone marrow aspiration smear revealed 59.1% plasma cells. The cytogenetic study of bone marrow cell showed normal karyotype. The patient died 3 months after chemotherapy with melphalan and prednisolone.
Abnormal Karyotype ; Amylases ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Female ; Humans ; Hyperamylasemia ; Immunoglobulin G* ; Immunoglobulins ; Karyotype ; Melphalan ; Middle Aged ; Multiple Myeloma* ; Plasma Cells ; Prednisolone ; Prognosis

To establish a simple recirculation model in rats without craniectomy and to determine the recirculation time necessary to benefits the infarction area with restoration of the blood flow in a series of 30 adult rats, the authors induced irreversible ischemia(group I) in 15 rats through unilateral occlusion of the middle cerebral artery(MCA) by inserting a 16mm length of 4-0 nylon surgical thread through the internal carotid carotid artery(ICA). Reversible ischemia(group II) was induced by pullin the thread that occluded the MCA with hours recirculation in 5 rats. The author again divided the rats into 4 hours(Ia and Iia), 6 hours(Ib and Iib) and 12 hours(Ic and Iic) groups designated as according to the sacrifice time of rats in group I and the starting time of recirculation in group II following the MCA occlusion. The percentage of the infarction area to the total brain was calculated by a computer image analysis system, and the infarction size between reversible and irreversible groups were compared. The results showed that although the total average infarction sizes of irreversible ischemic groups were larger than those of reversible ischemic groups, the difference of the infarction size between each group o irreversible and reversible ischemia was not significant(group Ia Vs. Iia:7.78+/-8.37% Vs. 3.28+/-1.98%; group Ib Vs. Iib: 9.07+/-4.72% Vs. 6.61+/-3.19;group Ic Vs. Iic: 8.35+/-4.47% Vs. 6.90+/-6.07%. p>0.05, one-way ANOVA test). However, the degree of difference of the infarction size between irreversible and reversible ischemia decrease along with the prolongation of ischemic duration(difference between group Ia and IIa:4.5%;group Ib and Iib:2.46%;group Ic and Iic:.45%. The author concludes that ischemic brain injury may be decreased by making a restoration of the blood flow within 4 hours after occlusion of a blood vessel in rats, and this kind of reversible ischemic model may be useful in various studies on the focal cerebral ischemia without manipulation of the brain tissue and blood vessel.
Adult ; Animals ; Blood Vessels ; Brain ; Brain Injuries ; Brain Ischemia ; Cerebral Infarction* ; Humans ; Infarction* ; Infarction, Middle Cerebral Artery* ; Ischemia ; Middle Cerebral Artery* ; Nylons ; Rats*

Necrotizing fasciitis is an uncommon infection of the subcutaneous soft tissue and fascia. The infection is expands rapidly and is highly lethal, so an early diagnosis and a radical debridement of all affected tissues until healthy tissue is encountered is imperative. There are many diagnostic methods such as simple X-ray study, ultrsonography, computerized tomography and diagnostic multiple incisions, but nothing can disclose the extent of affected tissue definitely. Recently someone advocated that magnetic resonance imaging(MRI) is useful to diagnose necrotizing fasciitis. We could determine the extent of underlying infection in a patient with perineal necrotizing fasciitis by using preoperative MRI, and treat it by one surgical resection. We propose that MRI can be used to diagnose the necrotizing fasciitis early and to disclose the extent of affected tissue, to help determine the extent of resection.
Debridement ; Early Diagnosis* ; Fascia ; Fasciitis, Necrotizing* ; Humans ; Magnetic Resonance Imaging*