From March 1987 to July 1989, six patients (five dadults and one child) with lung abscess (size, 5-13cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr catheter was inserted for drainage. Five of 6 had a dramatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days (average, 15.5days) in successful cases. One case of the failure in drainage was due to persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provided anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating patients with lung abscess.
Abscess ; Catheters* ; Drainage* ; Empyema, Pleural ; Humans ; Lung Abscess* ; Lung* ; Methods ; Punctures

PURPOSE: The excision of breast lesion with using ultrasound-guided Mammotome(R) is currently used for both the treatment and diagnosis of benign lesions. However sonographic evidence for tumor removal by Mammotome(R) excision does not confirm histological clearance of the resection margin. The purpose of this study was to evaluate the efficacy of ultrasound-guided Mammotome(R) for the removal of fibroadenomas by performing histological examination of an additional margin biopsy. METHOD: From March 2003 to May 2005, percutaneous removals of fibroadenoma with using ultrasono-guided Mammotome(R) biopsy were performed for 167 fibroadenomas in 154 women. Margin biopsies were additionally done after complete excision was achieved via ultrasonography. Histological evaluation was performed for these specimens. The patients were scheduled for follow-up ultrasound examination at 6 months. RESULTS: The mean tumor diameter was 1.32+/-0.54 cm. 45 (26.9%) lesions of the 167 lesions showed histological remained fibroadenoma on margin biopsies. The risk factors for remnant lesions were the age of a patient and the size of a lesion. No further ultrasonographic evidence of tumors was noted for 96.9% of the lesions at 6 months CONCLUSION: Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up for these lesions is still debatable. We suggest that excision of breast lesion using ultrasound-guided Mammotome(R) can be used as minimally invasive surgery for fibroadenoma. If a lesion is larger than 2cm in a young woman, the physician should be careful to achieve enough excision for a complete removal of tumor.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Fibroadenoma* ; Follow-Up Studies ; Humans ; Risk Factors ; Surgical Procedures, Minimally Invasive ; Ultrasonography

PURPOSE: The excision of breast lesion with using ultrasound-guided Mammotome(R) is currently used for both the treatment and diagnosis of benign lesions. However sonographic evidence for tumor removal by Mammotome(R) excision does not confirm histological clearance of the resection margin. The purpose of this study was to evaluate the efficacy of ultrasound-guided Mammotome(R) for the removal of fibroadenomas by performing histological examination of an additional margin biopsy. METHOD: From March 2003 to May 2005, percutaneous removals of fibroadenoma with using ultrasono-guided Mammotome(R) biopsy were performed for 167 fibroadenomas in 154 women. Margin biopsies were additionally done after complete excision was achieved via ultrasonography. Histological evaluation was performed for these specimens. The patients were scheduled for follow-up ultrasound examination at 6 months. RESULTS: The mean tumor diameter was 1.32+/-0.54 cm. 45 (26.9%) lesions of the 167 lesions showed histological remained fibroadenoma on margin biopsies. The risk factors for remnant lesions were the age of a patient and the size of a lesion. No further ultrasonographic evidence of tumors was noted for 96.9% of the lesions at 6 months CONCLUSION: Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up for these lesions is still debatable. We suggest that excision of breast lesion using ultrasound-guided Mammotome(R) can be used as minimally invasive surgery for fibroadenoma. If a lesion is larger than 2cm in a young woman, the physician should be careful to achieve enough excision for a complete removal of tumor.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Fibroadenoma* ; Follow-Up Studies ; Humans ; Risk Factors ; Surgical Procedures, Minimally Invasive ; Ultrasonography

The clinical and pathological features of warty dyskeratoma are presented. Warty dyskeratoma is a rarely encountered, solitary, benign cutaneous tumor occurring most often on the head and neck and to our knowledge, no cases associated with cutaneous horn have been published in western literature. We experienced a case of warty dyskeratoma with a cutaneous horn occurring in a 70-year-old male, who had a 1.3 cm-sized and slowly growing nodule on his neck. A brief review of the literature, was made especially in relation to the pathological findings and histogenesis of warty dyskeratoma.
Aged ; Animals ; Head ; Horns* ; Humans ; Male ; Neck

Interleukin-6(IL-6) stimulate osteoclast differentiation. 17beta-estradiol, 1,25-dihydroxyvitamin D3(1,25-(OH)2D3) and interleukin-1beta inhibit or stimulate osteoclast differentiation by decreasing or increasing the synthesis of interleukin-6(IL-6) from stromal/osteoblastic cells, respectively. Periodontal ligament(PDL) cells reside between the alveolar bone and the cementum and have osteoblastic characteristics. To estimate the effect of 17beta-estradiol and 1,25(OH)2D3 on IL-6 production of PDL cells, PDL cells were treated with 17beta-estradiol or 1,25-(OH)2D3 in the absence or the presence of IL-1beta. The concentration of IL-6 produced form PDL cells was determined by enzym linked immunosorbent assay(ELISA). In unstimulated PDL cells, we detected constitutive production of IL-6 at 1st and 2nd day. IL-1beta increased IL-6 synthesis at 1st day and 2nd day. 17beta-estradiol had no significant effect on the secretion of this cytokine, either constitutively or after stimulation with IL-1beta(0.05 ng/ml). 1,25-(OH)2D3(10(-8)M) decreased not only constitutive IL-6 production but also IL-1beta-induced IL-6 production at 2nd day. These results suggest that 1,25-(OH)2D3 may control IL-1beta-induced osteoclast differentiation by decreasing IL-1beta-induced IL-6 secretion of PDL cells.
Calcitriol* ; Dental Cementum ; Interleukin-1beta ; Interleukin-6* ; Osteoblasts ; Osteoclasts ; Periodontal Ligament*

BACKGROUND: Psychogenic movement disorders (PMD) are not easily distinguished from other organic diseases. We attempted to discover the important clinical clues for the correct diagnosis of PMD. METHODS: In our study, we include-ed patients who visited Youngdong Severance Hospital due to movement disorders from 1994 to 1998. Using medical records and video tape recordings, we performed a retrospective evaluation of the patients with PMD. We included documented and clinically established PMD according to degree of certainty of the diagnosis of PMD ( by Fahn, 1994). RESULTS: Twenty-five (1.6%) of 1520 consecutive patients with movement disorders were diagnosed with documented or clinically established PMD. They presented a variety of movement disorders including tremors (60%), dystonia (16%), myoclonus (12%), chorea (4%), parkinsonism (4%), and isolated gait problems (4%). The precipitating factors were reported by 23 of the 25 (92%) patients, and 16 (64%) patients were suspected to enjoy secondary gains. Ten of the 11 patients underwent a distractibility test, 15 of 17 patients underwent placebo trials, and 3 of 5 patients underwent an one-way mirror observation showing significant and dramatic amelioration of their symptoms. Long-term psychi-atric treatment was effective in 4 of 9 patients. CONCLUSIONS: In patients who are suspected to have PMD by the pres-ence of causative factors, acute onset, incongruity, inconsistency, and presence of secondary gain, efforts to provide objective evidence for the diagnosis of PMD must be made. Many of the patients with PMD refused psychiatric evalua-tion. Half of the patients improved through psychiatric treatment.
Chorea ; Diagnosis ; Dystonia ; Gait ; Humans ; Medical Records ; Movement Disorders* ; Myoclonus ; Parkinsonian Disorders ; Precipitating Factors ; Prognosis ; Retrospective Studies ; Tremor ; Videotape Recording

Midgut volvulus secondary to intestinal malrotation usually presents within the first month of life. Diagnostic delay may result in midgut infarction and mortality. In this retrospective study, we review seventeen cases of midgut volvulus to assess the importance of early recognition for midgut volvulus in pediatric patients of any age.. These patients were diagnosed as having a midgut volvulus by operation at Ewha Womans University Hospital. Eleven patients (64.7 %) were less than 1 month of age, and fifteen were boys (88.2 %). The mean gestational age was 38.3 weeks and the birth weight was 3.1 kg. Eight patients (47.1 %) had one or more combined anomalies such as heart malformation, brain ischemia, Down's syndrome or duodenal atresia. Vomiting was the most common symptom. Only thirteen patients underwent preoperative diagnostic procedures; 13 abdominal sonography demonstrated the whirlpool sign in 8 patients, upper gastrointestinal tract roentgenography showed a cork-screw pattern in 7 patients, and barium enema or small bowel series demonstrated positive findings in 7 patients. A Ladd's procedure was was formed on all patients.. There was no mortality or severe morbidity such as short bowel syndrome. Midgut volvulus should be included in the differential diagnosis in any infant or child who presents with the symptoms of acute abdomen, especially with vomiting.
Abdomen, Acute ; Barium ; Birth Weight ; Brain Ischemia ; Child* ; Diagnosis, Differential ; Down Syndrome ; Enema ; Female ; Gestational Age ; Heart ; Humans ; Infant ; Infarction ; Intestinal Volvulus* ; Mortality ; Radiography ; Retrospective Studies ; Short Bowel Syndrome ; Upper Gastrointestinal Tract ; Vomiting

A case of ARC syndrome was found in a newborn male with persistent cholestasis. He showed renal dysfunction, failure to thrive, and ichthyosis as well as arthrogryposis. The patient who had a dead sibling with similar symptoms has not been described previously in our country.
Arthrogryposis ; Cholestasis ; Failure to Thrive ; Humans ; Ichthyosis ; Infant, Newborn ; Jaundice, Obstructive* ; Male ; Siblings*

OBJECTIVE: To compare clinical features of minilaparoscopic radiofrequency myolysis (MLRFM) with laparoscopic-assisted vaginal hysterectomy (LAVH) in the treatment of uterine myoma. METHODS: Between 1st January 2006 and 31th March 2009, 125 patients underwent LAVH and 125 patients underwent MLRFM by same surgeon at the University of Chosun Hospital, Department of Gynecology. We compared the age of patients, indication for treatment, myoma size, major symptom, duration of procedure, amounts of blood loss and postoperative transfusion, length of hospital day, postoperative complication and satisfaction between the two groups. RESULTS: There were significant differences in duration of procedure between the LAVH group and the MLRFM group (69.0+/-31.6 minutes vs 43.5+/-19.8 minutes) and in the amounts of blood loss during procedure (215.2+/-215.0 mL vs 0.8+/-8.9 mL). The amounts of postoperative transfusion was 0.3+/-0.7 pints, 16 of the 125 (12.8%) for the LAVH group and no one underwent postoperative transfusion for the MLRFM group. There was significant difference in length of postoperative hospital day between the LAVH group and the MLRFM group (5.0+/-1.2 days vs 2.3+/-1.2 days). In the comparison of postoperative complications, there was no significant complication for the LAVH group, but there was major complications requiring readmission and reoperation for the MLRFM group. In MLRFM group, postoperative myoma size decreased compared to preoperative size. CONCLUSION: We conclude that there was no treatment of choice in uterine myoma. When considering treatment of uterine myoma, we should choose appropriate method after analyzing patient characteristics, general condition, uterine myoma characteristics case by case.
Female ; Gynecology ; Humans ; Hysterectomy, Vaginal ; Myoma ; Postoperative Complications ; Reoperation

Laryngeal trauma is rare compared to other head and neck traumas, but it occurs, it can be life threatening. As for treatment, a laryngeal fracture that involves displacement of cartilage or extensive injury requires appropriate surgical treatments. For severe laryngeal fractures, conservative management is usually preferred with placing a stent to prevent laryngeal stenosis. But the downside of placing stents in the larynx includes the risk of granulation and infection. In this report, the authors describe a 35-year-old patient, who was diagnosed with blunt laryngeal trauma and treated by Horizontal partial laryngectomy. The patient's post-operative breathing and voice were fair, and airway stenosis did not occur afterwards.
Adult ; Cartilage ; Constriction, Pathologic ; Fractures, Cartilage ; Head ; Humans ; Laryngeal Cartilages ; Laryngectomy* ; Laryngostenosis ; Larynx ; Neck ; Respiration ; Stents ; Voice