No abstract available.
Circumcision, Male* ; Female ; Male ; Sensation*

A 51-year-old man underwent laparoscopic cholecystectomy for gallbladder stones. He had developed fever, chills, and abdominal pain four days after the procedure. In the drain tube, bile was persistently observed. An endoscopic retrograde cholangiopancreatography (ERCP) showed a leakage from the small duct into the right intrahepatic duct. We determined that the bile leak was caused by an injury to the ducts of Luschka. An endoscopic sphincterotomy (ES) using a 5-F nasobiliary tube (NBT) was performed, and the leak was resolved in five days. Herein, we report a bile leak caused by an injury to the ducts of Luschka after laparoscopic cholecystectomy. The leak was treated with ES using 5-F NBT, and the resolution of the leak was confirmed without repeated endoscopy.
Abdominal Pain ; Bile Ducts ; Bile* ; Chills ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Drainage* ; Endoscopy ; Fever ; Gallbladder ; Humans ; Middle Aged ; Sphincterotomy, Endoscopic

Schwannomas are benign tumors derived from the Schwann cells of the nerve sheath. These are rare tumors that can be found in any part of the body although fewer than 4% of these tumors involve the nasal cavity and paranasal sinuses. Here, we present three cases of sinonasal schwannoma. The tumor masses were removed by endoscopic excision under general anesthesia. Pathological examination of the excised specimens confirmed schwannoma and the tumor cells were immunoreactive for S-100 protein. The patients are doing well with no evidence of recurrence.
Anesthesia, General ; Humans ; Nasal Cavity ; Neurilemmoma ; Nose ; Paranasal Sinuses ; Recurrence ; S100 Proteins ; Schwann Cells

OBJECTIVES: To investigate the effect of LH receptor in folliculogenesis, we confirm the expression level of LH receptor (LH-R) mRNA in human granulosa cells (GCs) and its expression levels were analyzed by comparison to embryo developmental rate and pregnancy rate. MATERIALS AND METHODS: GCs were obtained at the time of oocyte retrieval from the patients undergoing IVF-ET program. The patients were divided into two groups: Group I (n=20) is poor responder (retrieved oocyte(s)< or =3ea), Group II (n=80) is normal responder (retrieved oocytes>3ea). After the extraction of total RNA, semiquantitative RT-PCR was performed and the expression level of LH-R mRNA was normalized by beta-actin. Statistical analysis was performed by using Chi(2) test, Student's t-test and Pearson correlation. RESULTS: In Group II, the relative values of LH-R mRNA (0.680 vs. 0.463, p<0.005) and pregnancy rate (54.7% vs. 23.1%, p<0.05) were significantly higher than in Group I. Number of retrieved oocyte(s) was gradually increased when the expression of LH-R mRNA was increased (p<0.05). But the quality of retrieved oocyte and transferred embryo were not related with the expression of LH-R mRNA. When the pregnancy rate was compared with FSH only group and FSH combined with hMG group in the ovarian stimulation protocol, FSH combined with hMG group was significantly higher than FSH only group in Group I (37.5% vs. 0%), and the expression of LH-R mRNA was significantly higher in hMG combined group than FSH only group (p<0.05). CONCLUSION: Expression level of LH-R mRNA has important role in ovarian function related with the response to gonadotrophin in human folliculogenesis. Furthermore these data might provide the evidence that additional use of hMG is helpful to poor responders.
Actins ; Embryonic Development ; Embryonic Structures ; Female ; Granulosa Cells ; Humans ; Oocyte Retrieval ; Oocytes ; Ovulation Induction ; Pregnancy Rate ; Pregnancy* ; Receptors, LH* ; RNA ; RNA, Messenger

The most common disease process involving the frontal sinus is infection secondary to inadequate drainage through the frontal recess. Obstruction of the frontal recess may result from rhinosinusitis, allergic rhinitis, nasal polyposis, tumor and traumatic injury. The principle treatments are not only ventilation and drainage but also removal of predisposing factors. If there is no response to conservative treatment, surgical treatment is considered. To prevent closure of the frontal recess, external approach, endoscopic approach, grafts, indwelling tubes and mucoperiosteal flaps have been used. Insertion of silicone tube in frontal recess is a simple and easy method of drainage through frontal recess. We report a case of traumatic recurrent frontal sinusitis which was treated by endoscopic sinus surgery with silicone T-tube insertion.
Drainage ; Frontal Sinus ; Frontal Sinusitis ; Rhinitis ; Rhinitis, Allergic, Perennial ; Silicones ; Transplants ; Ventilation

Squamous papilloma is a benign epithelial tumor that can develop in any mucosal site of the upper aerodigestive tract. While this tumor is found mainly in the squamocilliary junction, its distribution does not occur randomly. However, in many cases, squamous papilloma is asymptomatic, and only a small number of cases are diagnosed. We experienced a patient presented with the complaint of snoring. This patient was diagnosed as having squamous papilloma of the soft plate on the nasopharyngeal surface. The patient might have been misdiagnosed as having merely a simple snoring problem, as nothing was found upon macroscopic examination. Nevertheless, squamous papilloma was detected through fiberoptic nasopharyngolaryngoscopy. This patient was successfully treated with laser-assisted uvulopalatoplasty, and we report this case, along with the associated literature.
Humans ; Nasopharyngeal Neoplasms ; Palate, Soft ; Papilloma ; Snoring

Arteriovenous malformation (AVM) consists of an abnormal connection between artery and vein without any interposed capillary bed, and is usually congenital. However, acquired AVM is quite rare, and is usually caused by injury, which induces direct arteriovenous shunting. Acquired digital AVM is a distinct entity, which was first described by Kadono et al. in 2000, and was thought to result from shunts between an artery and a vein in a finger tip. We report a case of acquired digital AVM in a 44-year-old women. The patient showed punctate hyperketatotic ectasia on the pulp of the right thumb. Histological finding showed dilated venous and arterial vessels in upper and lower dermis, and shunts between arteriols and venules.
Adult ; Arteries ; Arteriovenous Malformations* ; Capillaries ; Dermis ; Dilatation, Pathologic ; Female ; Fingers ; Humans ; Thumb ; Veins ; Venules

OBJECTIVES: To find the main cause of facial nerve dysfunction in vestibular schwannoma (VS) surgery and review the prognosis of facial function in relation to tumor size, preoperative facial function and surgical approach. METHODS: We reviewed the surgical outcome of 134 patients with VS treated in our department between 1994 and 2008. All patients included in the study had postoperative facial paralysis after surgical management of their VS. There were 14 women and 7 men. The mean age was 48.5 years, with a mean follow-up period of 57 months. RESULTS: Twenty-one patients (sustained facial palsy, 4; newly developed facial palsy, 17) had facial nerve paralysis after surgery: ten patients in large VS and eleven patients in small VS. In large VS group, 4 patients had facial nerve function of HB grade II, 3 patients had HB grade III, and 3 patients had HB grade IV. In small VS group, 9 patients had HB grade II and 2 patients had HB grade IV. Middle cranial fossa approach rather than translabyrinthine approach for the preservation of hearing, led to facial nerve deterioration and the patients who had facial nerve paralysis perioperatively, had resulted in permanent facial paralysis. CONCLUSION: The tumor size in VS is certainly one of the most important prognostic factors. However, VS tumor size alone should not be considered a unique prognostic indicator. The surgical approach used, which may be related to tumor size, based on the surgeon's experience, can be a deciding factor, and the status of the facial nerve injured by the tumor can influence postoperative facial nerve function.
Cranial Fossa, Middle ; Facial Nerve ; Facial Paralysis ; Female ; Follow-Up Studies ; Hearing ; Humans ; Male ; Neuroma, Acoustic ; Paralysis ; Prognosis

Dermatomyositis is a rare disease of unknown origin that combines an inflammatory myopathy with characteristic cutaneous findings. Scalp disease has rarely been considered as a manifestation of dermatomyositis and is often misdiagnosed as being scalp paosiasis or seborrheic dermatitis. We report a case of 27-year-old woman who presented with brownish alopecic patches on the scalp, and chronic proximal muscle weakness.
Adult ; Cicatrix* ; Dermatitis, Seborrheic ; Dermatomyositis* ; Female ; Humans ; Muscle Weakness ; Myositis ; Rare Diseases ; Scalp

PURPOSE: The purpose of this study is to investigate peculiar patterns of facial asymmetry following incomplete recovery from facial paralysis that require optimal physical therapy for effective facial rehabilitation, and to decrease the incidence of avoidable facial sequelae. MATERIALS AND METHODS: This study involved 41 patients who had facial sequelae following the treatment of various facial nerve diseases from March 2000 to March 2007. All patients with a follow-up of at least 1 year after the onset of facial paralysis or hyperactive function of the facial nerve were evaluated with the global and regional House-Brackmann (HB) grading systems. The mean global HB scores and regional HB scores with standard deviations were calculated. Other factors were also analyzed. RESULTS: Four patterns of facial asymmetry can be observed in patients with incomplete facial recovery. The most frequently deteriorated facial movement is frontal wrinkling, followed by an open mouth, smile, or lip pucker in patients with sequelae following facial nerve injury. The most common type of synkinesis was unintended eye closure with an effort to smile. CONCLUSION: We described common configurations of facial asymmetry seen in incomplete recovery following facial nerve injury in an attempt to develop an optimal strategy for physical therapy for complete and effective facial recovery, and to decrease the incidence of avoidable sequelae.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Face/physiopathology ; Facial Asymmetry/*physiopathology ; Facial Nerve/pathology ; Facial Nerve Injuries/physiopathology/therapy ; Facial Paralysis/physiopathology/*therapy ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Treatment Outcome