Tuberculosis of the esophagus is rare. We experienced four patients with esophageal tuberculosis proven by esophagoscopic biopsy or surgical specimens. Case 1 was a patient with primary esophageal tabereulosis, case 2 was a patient with teberculous esophagobronchial fistula and case 3,4 were patients with esoyhageal perforation due to tuberculous traetion diverticulum of the esophagus. The clinical, radiological and esapbagoscopic findings may be nonspecific in diagnosis of esophageal tuberculosis. Therefore early diagnosis should be rested on a high index of suapieion and a cautious attention.
Biopsy ; Diagnosis ; Diverticulum ; Early Diagnosis ; Esophagus* ; Fistula ; Humans ; Tuberculosis

Enemas are sometimes used in hospital and domicilliary practice and occasionally by patients themselves without a valid indication. The present repart is one in which enernas were done for 3 months by a patient himself to treat his hemorrhoid and resulted in severe inflamimatory change with large-siaed illdefined shallow ulceration in rectum and sigmoid colon. This patient, a 53 year old male, entered the hospital with the complaint of diarrhea with passage of bloody muct.. Colonoscopic examination revealed severe inflammatory change, friable mucosa and several relatively large-sized ill-defined shallow ulceration in rectum and sigmoid colon. A biopsy was performed and microscapic examination revealed intense infiltrates and plasma cells and crypt abscess with decreased goblet cells in the lamiina propria. The submucosa showed edema with infiltrates of chronic inflammatory cells and neutrophils. Conservative treatment with discontinue of enemas and fluid supply was performed. And his symptoms were improved. After second week, follow-up colonoscopy revealed inflammatory changes were improved.
Abscess ; Biopsy ; Colitis* ; Colon, Sigmoid ; Colonoscopy ; Diarrhea ; Edema ; Enema* ; Follow-Up Studies ; Goblet Cells ; Hemorrhoids ; Humans ; Male ; Middle Aged ; Mucous Membrane ; Neutrophils ; Plasma Cells ; Rectum ; Ulcer

Today, the duodenal tuberculosis is a very rare disease. Final diagnosis of duodenal tuberculosis is difficult due to inconsistent symptoms and nonspecific duodenal lesions. We found 2 cases of duodenal tuberculosis by gastrascopy. In gastroscopic findings, there were undetermined ulcers and irregular nodular mucosal changes.
Diagnosis ; Rare Diseases ; Tuberculosis* ; Ulcer

No abstract available.
CREST Syndrome*

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in South Korea. To decrease its mortality rate, its early detection is very important. Screening for HCC detection has been accepted as the management modality for patients with chronic liver disease. Reported herein is a case involving the marked rapid growth of HCC detected at an advanced stage in a screening test with a 3 months interval. A 49-year-old male patient with chronic hepatitis B was admitted to the hospital due to a liver mass detected on CT scan. The patient underwent a first CT scan 3 months earlier, and no tumor was detected. Follow-up CT scan was performed and showed a 9.1 cm HCC with portal vein thrombosis. Percutaneous liver biopsy was performed, and the diagnosis of hepatocellular carcinoma was confirmed. In the pertinent guidelines, the recommended screening interval for HCC is 6-12 months, but the screening interval and additional diagnostic methods should be considered due to the variation in the HCC growth rate according to the patient's clinical characteristics.
Biopsy ; Carcinoma, Hepatocellular ; Early Detection of Cancer ; Follow-Up Studies ; Hepatitis B, Chronic ; Humans ; Liver ; Liver Diseases ; Male ; Mass Screening ; Middle Aged ; Portal Vein ; Republic of Korea ; Thrombosis

Sudden hearing loss is a rare complication after general anesthesia.The variety of etiologies and the difficulty in treatment must be a challenge to anesthesiologists.In this patient who was otherwise normal in her right ear, sudden sensorineural hearing loss occurred immediately after general anesthesia.The possible causes of her sensorinerual hearing loss we supposed are the inner ear dysfunction by drilling noise or the pressure change of middle ear cavity or the microvascular circulatory deficiency related to head-rotated position.After steroid, prostaglandin injection and stellate ganglion block therapy, remarkable improvement of hearing was observed.
Anesthesia, General ; Ear ; Ear, Inner ; Ear, Middle ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Mandrillus ; Noise ; Stellate Ganglion

Benign symmetrical lipomatosis, also known as Madelung's disease, is a rare condition characterized by massive fatty deposits arranged symmetrically around the neck, shoulders, and arms. Patients usually complain of their cosmetic appearance, but treatment can be considered for decreased neck motion and/or aerodigestive problems. Surgical lipectomy and liposuction are treatment of choice, but recurrence is common. Because the distribution of the lesion tends to be wide and diffuse, single operation is not sufficient for improving contour and functional problems, especially in severely affected case. We experienced a progressed patient who suffered from limitation of neck motion, dyspnea including sleep apnea due to massive deposits on whole neck. We performed 2 staged operations for the purpose of removing as much lipomatous tissue as possible. After 2 staged excisions, patient's appearance and aerodigestive problems are much improved and recurrence is not observed.
Arm ; Dyspnea ; Humans ; Lipectomy ; Lipomatosis ; Lipomatosis, Multiple Symmetrical* ; Neck ; Recurrence ; Shoulder ; Sleep Apnea Syndromes

BACKGROUND: The purpose of our study was to analyze scientific papers published by South Korean plastic surgeons in journals included in the Science Citation Index Expanded (SCIE), and to evaluate the publication and research activities of Korean plastic surgeon. METHODS: We conducted a survey of SCIE papers in the field of plastic surgery published by South Korean authors between 2001 and 2010 using Web of Science software. We further analyzed these results according to the number of publications per year, journals, institution, and type of papers. We also compared the total number of citations to published scientific papers. We analyzed the rank of South Korea among other countries in representative journals. RESULTS: Overall, 667 papers were published by South Korean authors between 2001 and 2010. The number of publications increased dramatically from 2003 (n=31) to 2010 (n=139). Subsequently, the ten most productive Korean medical colleges were identified. All published papers received 2,311 citations and the citation to paper ratio was 3.49. The rank of Korea among other countries in terms of the number of published papers remained in the top 10 during the recent 10 years. CONCLUSIONS: Publication output of Korean plastic surgeon over the last 10 years showed a remarkable growth in terms of quantity and quality. Currently, Korea is among the top six countries in representative plastic surgery journals. Korean plastic surgeons have played a central role in this progress, and it is anticipated that they will continue to do so in the future.
Korea ; Publications ; Republic of Korea ; Surgery, Plastic

PURPOSE: Osteoma is one of the common benign tumors of the skull vault and facial skeleton. Although most of the osteomas cause no symptoms, forehead osteomas may lead to facial disfigurement. Osteoma usually happens in solitary lesion and multiple osteomas which don't combine with syndrome are very rare. We report an experience of treatment of non-syndromic multiple osteomas in the skull. METHODS: A 54-year-old female patient visited due to the multiple palpable hard masses on her forehead in 2010. In 2002 of her first visit, masses started to appear on her forehead and she was diagnosed as the osteoma by excisional biopsy. She visited again because the mass size and number increased. In preoperative CT scanning, there were above 160 of osteomas, so surgery was planned. Enterogastroduodenoscopy and colonoscopy was conducted to rule out Gardener's syndrome, however there was no abnormality such as multiple polyposis. RESULTS: Under general anesthesia, coronal approach was conducted. There were numerous osteomas in frontal and parietal bone. The multiple osteomas were removed by burring and the patient recovered without any postoperative complications. CONCLUSION: Multiple osteomas in the skull were rarely reported, although it can accompanied with Gardener's syndrome. We report a case of non-syndromic multiple osteomas in skull vault.
Anesthesia, General ; Biopsy ; Colonoscopy ; Female ; Forehead ; Humans ; Middle Aged ; Osteoma ; Parietal Bone ; Skeleton ; Skull

PURPOSE: Insulin like growth factor-1 (IGF-1) is known to promote the proliferation and migration of penile cavernous smooth muscle cells in rat. The purpose of this study was to investigate whether IGF-1 could restore erectile function in the aging rat. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into two groups: young (4~5 months; n=10) and old (24 months; n=30). The old group was further divided into vehicle only (phosphate buffered saline plus 0.1% bovine serum albumin; n=10) and IGF-1 treatment (100 microgram; n=20) groups. Half of the IGF-1 dose (50 microgram) was injected on the first day, and half was injected on the third day. After 2 and 4 weeks of treatment, erectile function was evaluated by hemodynamic study, and corpus cavernosal histology was examined by histomorphometric analysis. RESULTS: The ratio of peak intracavernosal pressure to systemic arterial blood pressure was significantly lower in the vehicle-only old rats (63.1 8.5%) compared to young rats (74.6 3.2%) (p=0.016). However, after 4 weeks of treatment, the ratio was significantly increased in the IGF-1 treatment group (77.2 7.0%) compared to the vehicle-only group (p<0.05). The percentage of smooth muscle was significantly lower in the vehicle-only old rats (12.8 2.2%) compared to young rats (17.8 3.7%) (p=0.047), whereas, it was significantly increased in the IGF-1 treatment group (19.4 3.3%) compared to the vehicle-only group (p=0.014). CONCLUSIONS: Intracavernosal injection of IGF-1 in the old rats resulted in increased intracavernosal pressure and higher percentage of cavernosal smooth muscle. These results suggest that intracavernosal injection of IGF-1 appears to restore smooth muscle integrity and improve erectile function in aged rats.
Aging* ; Animals ; Arterial Pressure ; Hemodynamics ; Humans ; Insulin* ; Insulin-Like Growth Factor I ; Male ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Penile Erection ; Rats* ; Rats, Sprague-Dawley ; Serum Albumin, Bovine