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

BACKGROUND: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. METHODS: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. RESULTS: At the final follow-up, the mean Korean Showlder Society score and Constant scores were 88.96 +/- 12.1 and 86.6 +/- 11.9, respectively, in group A and 86.21 +/- 11.8 and 85.3 +/- 11.7, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was 1.6degrees in group A and 4.8degrees in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). CONCLUSIONS: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.
Aged* ; Decision Making ; Follow-Up Studies ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder Fractures* ; Sutures*

The purpose of this study was to evaluate the tooth color changes of resin bonding sites and their adjacent sites on orthodontic bracket bonding. Sixty extracted sound premolars were used and the tooth color was recorded according to the CIE L(*)a(*)b(*) color system using a spectrophotometer. The tooth colors of the twenty premolars were measured and compared before bracket bonding and after removal. On a further twenty premolars, the tooth color was measured before and after only primer application. In the change of L(*) values, according to the bracket bonding and primer application, the lightness was decreased, and in the change of a(*) and b(*) values, the color was changed into a more yellowish color. The color differences (delta E(*)) were calculated from the L(*)a(*)b(*) values and compared with the standard value of clinical detection (delta E(*)=3.7). The color differences between before the bracket bonding and after removal noted exceeded the standard value and those of between before and after the primer application were not larger than the standard value. Toothbrushing was performed after application of the primer to evaluate the color changes according to the primer abrasion. As a control, toothbrushing was performed on the last twenty premolars. The color differences noted were larger than the standard value after toothbrushing. Also, to evaluate the color changes of the tooth which is exposed to sun irradiation after bracket removal, additional photoaging was performed and the color was measured for all teeth. The additional color differences after photoaging were smaller than the standard value. The above results suggest that the tooth color changes after fixed orthodontic treatment.
Bicuspid ; Orthodontic Brackets ; Solar System ; Tooth* ; Toothbrushing

A carcinoid tumor of the stomach is uncommon, has no clinical symptoms, and is regarded as a benign. It is also incidentally found in most cases. 48-year-old woman with gastric carcinoid tumor was admitted. She had suffered from a anorexia and a dry mouth for 4-months. A gastroscopy revealed a polypoid mass on the greater curvature of the mid-body of the stomach which was subsequently thought to be an adenocarcinoma. An endoscopic mucosectomy revealed however, that it was a carcinoid tumor. A case of carcinoid tumor of the stomach is here by presented with a brief literature review.
Adenocarcinoma ; Anorexia ; Carcinoid Tumor* ; Female ; Gastroscopy ; Humans ; Middle Aged ; Mouth ; Stomach*

PURPOSE: To evaluate the clinical and radiographic findings of localized foreign body (FB) granulomas onmammograms. MATERIALS AND METHODS: This study involved 13 patients with localized FB granulomas on mammograms;their history of mammoplasty or other plastic procedures was obtained by telephone interviews. Two radiologistsanalyzed the location and morphology of FB granulomas and the presence of associated linear densities orparenchymal distortion on mammograms. Four patients underwent ultrasonography. RESULTS: No patient had a historyof mammoplasty. All 13, however, had a history of plastic procedure, three to 22 (average, 12) years previously,as follows : foreign materials including silicone liquid and oil such as paraffin been injected into the anteriorneck area of nine patients, the infra-auricular area of two, and the nose of two. Multiple small, high-density,flocculent nodules representing FB granulomas were distributed bilaterally in nine patients; they were noted inthe upper inner portion of 11 of 26 breasts. In eight patients, mammograms showed linear opacities suggestingfibrosis. There was no calcification or parenchymal distortion. Though in three cases, the masses were palpable.Ultrasonography revealed several anechoic nodules with posterior enhancement in subcutaneous fatty layers, and inone, 0.2cc of oil droplet had been aspirated under ultrasonographic guidance. CONCLUSION: Localized FB granulomasof the breast could be caused by the migration of FB from cervicofacial areas. Mammography showed characteristicdistribution of upper inner portions, and the findings were similar to those of mild interstitial mammoplasty.
Breast* ; Female ; Foreign Bodies* ; Granuloma ; Granuloma, Foreign-Body* ; Humans ; Interviews as Topic ; Mammaplasty ; Mammography ; Nose ; Paraffin ; Plastics ; Silicones ; Ultrasonography

A 31-year-old male patient was admitted to the department of neurology for progressive spastic paraparesis and sen-sory deficit in bilateral lower legs. On review of system, he had decreased libido and mild urinary frequency. On neuro-logic examination, he showed paraparesis, lower limb hypesthesia, bilateral hyperactive knee jerk and bilateral positive Babinski sign. The nerve conduction studies were sensori-motor demyelinating polyneuropathy. For spastic paraparesis and peripheral neuropathy, we approached adrenomyeloneuropathy and ascertained elevated serum very long chain fatty acids (VLCFA) level. (J Korean Neurol Assoc 19(4):427~430, 2001)
Adrenoleukodystrophy* ; Adult ; Fatty Acids* ; Humans ; Hypesthesia ; Knee ; Leg ; Libido ; Lower Extremity ; Male ; Neural Conduction ; Neurology ; Paraparesis ; Paraparesis, Spastic ; Peripheral Nervous System Diseases ; Polyneuropathies ; Reflex, Babinski

We report here on a rare case of hepatoid thymic carcinoma in a 34-year-old man. The patient complained of a high fever and headache, and a 6.6cm-sized anterior mediastinal mass was found on chest computed tomography (CT). There was no hepatic mass seen on abdominal CT. The resected mass consisted of epithelioid cells with abundant eosinophilic cytoplasm, pleomorphic vesicular nuclei and prominent nucleoli, and the mass was surrounded by thymic tissue. The tumor cells were immunopositive for cytokeratin 7, alpha-1-antitrypsin, hepatocyte staining, and epithelial membrane antigen, but they were negative for CD5, alpha-fetoprotein (AFP) and placental alkaline phosphatase, and this all led to a diagnosis of hepatoid thymic carcinoma rather than hepatoid yolk sac tumor. This entity should be included in the differential diagnosis of epithelioid thymic tumors.
Adult ; Alkaline Phosphatase ; alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Cytoplasm ; Diagnosis, Differential ; Endodermal Sinus Tumor ; Eosinophils ; Epithelioid Cells ; Fever ; Headache ; Hepatocytes ; Humans ; Keratin-7 ; Mucin-1 ; Thorax ; Thymoma ; Thymus Gland ; Thymus Neoplasms

OBJECTIVES: The purposes of this study are to examine the sociodemographic factors that increase the prevalence of insomnia, as well as to identify the relationship between the prevalence of insomnia and health conditions by navigating through the prevalence rates of insomnia in two different geographical regions with different socioeconomic structures. METHODS: A survey was conducted targeting 937 residents of Guri-si and Yangpyeong-gun in Gyeonggi Province, Korea. The Insomnia Severity Index was used to verify whether a respondent was experiencing insomnia. The Abbreviated Self-Rated Korean version of the Mini-International Neuropsychiatric Interview was used in diagnosis of mental diseases. Chi-square test was performed to determine the unique relationship between sociodemographic characteristics and the prevalence of insomnia. Multivariate logistic regression analysis was performed to examine the association of prevalence of insomnia with categorized relevant factors. RESULTS: The overall prevalence rate of insomnia for all respondents was 9.26%. The prevalence rate for Yangpyeong-gun was 11.75%, marking a significantly higher figure compared with the prevalence rate for Guri-si, which was 6.87%. Advanced age, female, other marital statuses than married, lower education, lower income, non-existence of private health insurance, and unemployment were risk factors for insomnia. The prevalence of insomnia showed strong association with physical and mental conditions, particularly with mental disorders, urologic diseases, and risk of injury from fall. CONCLUSION: The prevalence rates of insomnia in those two surveyed regions showed a meaningful difference even after controlling for sociodemographic characteristics. These findings suggest that such regional differences merits further attention and additional nationwide epidemiologic studies are needed.
Surveys and Questionnaires ; Diagnosis ; Education ; Epidemiologic Studies ; Female ; Gyeonggi-do* ; Humans ; Insurance, Health ; Korea* ; Logistic Models ; Marital Status ; Mental Disorders ; Mental Health ; Prevalence* ; Risk Factors ; Sleep Initiation and Maintenance Disorders* ; Unemployment ; Urologic Diseases

The relationship between obesity and ketonuria is not well-established. We conducted a retrospective observational study to evaluate whether their body weight reduction response differed by the presence of ketonuria after fasting in the healthy obese. We used the data of 42 subjects, who had medical records of initial urinalysis at routine health check-up and follow-up urinalysis in the out-patient clinic, one week later. All subjects in the initial urinalysis showed no ketonuria. However, according to the follow-up urinalysis after three subsequent meals fasts, the patients were divided into a non-ketonuria group and ketonuria group. We compared the data of conventional low-calorie diet programs for 3 months for both groups. Significantly greater reduction of body weight (-8.6 +/- 3.6 kg vs -1.1 +/- 2.2 kg, P < 0.001), body mass index (-3.16 +/- 1.25 kg/m2 vs -0.43 +/- 0.86 kg/m2, P < 0.001) and waist circumference (-6.92 +/- 1.22 vs -2.32 +/- 1.01, P < 0.001) was observed in the ketonuria group compared to the non-ketonuria group. Fat mass and lean body mass were also more reduced in the ketonuria group. In addition, serum free fatty acid concentration after intervention in the ketonuria group showed significant more increment than in the non-ketonuria group. The presence of ketonuria after fasting may be a predicting factor of further body weight reduction.
Adult ; Diet, Reducing ; Fasting/*physiology ; Female ; Humans ; Ketosis/*complications/*pathology ; Male ; Middle Aged ; Obesity/*complications/diet therapy/pathology/*urine ; Retrospective Studies ; Weight Loss/*physiology

To evaluate effect of coronary collateral circulation on left ventricular function in patients with acute myocardial infarction, global ejection fraction(EF), left ventricular end distolic pressure(LVEDP), peak creatine kinase(CK) level and regional wall motion were analysed and compared in 30 patients with acute myocardial infarction according to grade of coronary collateral circulation. Patients with total or near total(above 95% of diameter) occlsion of left anterior descending coronary artery without significant lesion in right coronary artery or left circumflex artery were selected and divided into 3 groups according to the degree of collateral circulation on coronary angiography, to be compared by the index of ejection fraction, peak creatine kinase level, left ventricular and diastolic pressure and regional wall motion. The result are as following : 1) There were no statistically significant differences in ejection fraction, peak creatine kinase level, left ventricualr and diastolic pressure among the groups. 2) Regional wall motion of infarct related area of G2+3 group(adequate collateral) were better than that of G0(no collateral) group(p<0.05). Therefore, adequate coronary collateral circulation in acute myocardial infarction is thought to have beneficial effect on left ventricular function especially in regional wall motion of infarct related area.
Arteries ; Blood Pressure ; Collateral Circulation* ; Coronary Angiography ; Coronary Vessels ; Creatine ; Creatine Kinase ; Humans ; Myocardial Infarction* ; Ventricular Function, Left*