No abstract available.
Humans ; Stroke*

Adult intussusception is rare involving of only 1% of the causes of bowel obstruction. We report a case of a 39-year-old female with intussusceptions due to inverted Meckel's diverticulum. She visited our hospital for diffuse abdominal pain during 1 week and aggravated abdominal pain for 2 days. Vital signs were stable, and there was periumbilical tenderness. She had no history of abdominal operation. CT scan showed a 3.7x2.1 cm of fatty mass with focal intussusception in the distal ileum. When the emergency operation was performed, the patient was found to be suffering from ileocolic intussusception. A manual reduction of intussusception showed inverted Meckel's deverticulum at 65 cm proximal to the ileocecal valve, and the segmental resection of small bowel including a Meckel's diverticulum was performed. Pathologic examination revealed a Meckel's diverticulum containing a 0.6x0.6 cm sized aberrant pancreas.
Abdominal Pain ; Adult ; Emergencies ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Meckel Diverticulum ; Pancreas ; Stress, Psychological ; Vital Signs

This retrospective study comprised of 141 patients with zygoma fracture caused by various types of accidents and treated in the department of Plastic and Reconstructive Surgery, Pusan National University Hospital during past 10 years from April, 1986 to March, 1996. The medical records of these 141 patients were reviewed and analysed retrospectively in order to obtain the annual variation of clinical pattern of zygomatic bone fracture and to help understand change of therapeutic tendency during 10 years in our hospital. The statistical items were the age, sex, distribution of cause, fracture sites, diagnostic method, the accompanied facial bone injury, intervals between onset of accident and time of operation, and the approach methods with fixation materials. The following results were obtained. 1. Mean age of patients was 33.6 years, and age range was 3 to 75 years. Most injuries occurred in young male with the highest incidence in the third decade of life. Male predominated more than female in the ratio of 4:1. Annual variation was not observed. 2. Traffic accident(47.5%) was the most common cause of injuries and incidence has been increased since 1993. Relative incidence of assault has been increased since 1994. Otherwise, incidence of industrial accident has been decreased since 1993. 3. The most common anatomical site of the zygomatic bone fracture was group III type fracture(44%) in Knight and North Classification. According to Larsen and Thomsen classification, type B(predicted unstable fracture : 68.1%) was the most common. Annual variation was not observed. 4. Associated facial bone fractures were mainly maxillary fracture followed by nasal, panfacial and blow-out(in odder of frequency). And head injury was the most common non-maxiilofacial bone injury accompanying zygomatic bone fracture. Annual variation was not observed. 5. The most prevalent time interval between onset and surgical intervention was within seven days and the most prevalent time interval between surgical intervention and discharge was within 2-3 weeks. 6. Open reduction was used for 75.1% of total cases. The most common reduction approach incision of the zygomatic bone fracture was bicoronal approach in conjunction with subciliary incision that had been mainly used since 1991 and the most common fixation material used was microplate and screw that had been used since 1989.
Accidents, Occupational ; Busan ; Classification ; Craniocerebral Trauma ; Facial Bones ; Female ; Fractures, Bone ; Humans ; Incidence ; Male ; Maxillary Fractures ; Medical Records ; Retrospective Studies ; Zygoma

No abstract available.
Glioblastoma*

No abstract available.
Abscess* ; Citrobacter* ; Humans ; Paronychia*

Mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland is a very rare malignant tumor characterized by rapidly progressive clinical course and radioresistance. A 63-year-oid woman had mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland diagnosed by fine needle aspiration cytology (FNA), and the diagnosis was confirmed by histological examination. She had complained of a fixed, egg-sized mass of the anterior neck with hoarseness for 1 year. The findings of FNA consisted of sheets and clusters of polygonal epithelial cells with hyperchromatic, pleomorphic nuclei and eosinophilic, abundant, laminated cytoplasm. These findings were consistent with squamous cell carcinoma. Also, foci of papillary carcinoma were noted, and the cells exhibited nuclear groovings and intranuclear cytoplasmic inclusions. Total thyroidectomy specimen showed a diffusely infiltrating tumor in the left thyroid which was composed of mixed papillary carcinoma and well-differentiated squamous cell carcinoma. In junction between two components, squamous metaplasia of papillary carcinoma was noted.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Child* ; Cytoplasm ; Diagnosis ; Eosinophils ; Epithelial Cells ; Female ; Giant Cell Tumors ; Giant Cells ; Glomerulosclerosis, Focal Segmental* ; Hoarseness ; Humans ; Inclusion Bodies ; Metaplasia ; Neck ; Ribs ; Thyroid Gland ; Thyroidectomy

Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary’s angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary’s angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order:synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.

Seventy-nine children and 433 adults were treated for epidural hematoma at our hospital during the last 10 years. The authors have tried to compare the various clinical characteristics and significant prognostic factors of epidural hematoma in children and adults. The result confirmed that children with traumatic epidural hematoma are less likely to have direct relationship with various causes of head trauma, associated extracranial injuries, skull fractures, temporal region hematomas, and immediate surgeries, but tend to have high preoperative GCS scores, prompt pupil responses, require only conservative treatments, have short durations of coma, and have good outcome. The cause of injury, amount of hematoma and focus of bleeding on surgery are found to be significant prognostic factors in adults, but are not in children. In cases with same scores of preoperative Glasgow Coma Scale(GCS) and durations of coma, very severe neurologic status(below 7 of GCS, both dilated fixed pupil) had a worse outcome in children as well as in adults without significant difference between them. The clinical index on preoperative GCS and pupillary response used when deciding the operation time were different in children compared to adults. Operations performed in delayed fashion in children under close observation for changes in GCS and pupillary response showed good outcome. However, adults require operations as early as possible because of possible rapid progression.
Adult* ; Child* ; Coma ; Craniocerebral Trauma ; Hematoma* ; Hemorrhage ; Humans ; Pupil ; Skull Fractures

One hundreds eighty cases of traumatic intracerebral hematoma(TICH) among 1,633 head injury patients diagnosed with computerized tomography in neurosurgical department from Jan. 1990 to Jun. 1996. were classified into two TICH groups; TICH group associated with other traumatic intracranial lesions and TICH group without other traumatic intracranial lesions. The incidence of TICH was 11.0% and percentage of TICH with other traumatic intracranial lesions among 180 cases of TICH was 66.7%. TICH group with other traumatic intracranial lesions showed worse initial level of consciousness, more likely to have abnormal pupillary reflex, higher incidence of delayed traumatic intracerebral hematomas(DTICH), greater amount of hematoma, increased chance of surgery and worse outcome. In TICH group with other traumatic intracranial lesions, the factors affecting prognosis were initial Glasgow coma scale(GCS) score, pupillary reflex, amount of hematoma and treatment modality. In TICH only group, the factors affecting prognosis were initial GCS score, pupillary reflex, amount of hematoma and DTICH. The patients with 12-15 of GCS score, normal pupillary reflex, absence of DTICH, and amount of hematoma below 10cc, the presence of other traumatic intracranial lesions were found to be important prognostic factor. The overall mortality was 27.7% but in TICH group with other traumatic intracranial lesions, the mortality was 35.0% compared to 13.3% in TICH only group. It is concluded from this study that in the case with other traumatic intracranial lesions, TICH showed worse initial neurological status and prognosis compared to those without other lesions. Thus, these patients, although in conditions of good general clinical index at admission, should be considered to provide intensive care and treatment because these associated lesions will play as a bad prognostic factor.
Coma ; Consciousness ; Craniocerebral Trauma ; Hematoma* ; Humans ; Incidence ; Critical Care ; Mortality ; Prognosis ; Reflex, Pupillary

A retrospective review of 54 patients with multiple intracranial aneurysms seen over a 5 year period was performed. Among the 252 patients with aneurysms, the incidence of multiple aneurysms was 21.4%. Multiple aneurysms were slightly more common in women with a female to male ratio of 1.35:1. But there was no different ratio for patients with three or more aneurysms. Common clinical features were headache(96%), meningeal sign(83%), and change of consciousness level(52%). The most common Fisher's grade was III(63%), according to brain CT finding. Common locations of multiple aneurysms were the PcomA(35.7%), MCA(24.8%), AcomA(17.8%), and ICA bifurcation(7.7%). However, the aneurismal locations with the highest incidence of rupture were the MCA(53.1%). AcomA(52.1%), basilar bifurcation(50%). The PcomA(34.7%) was the least likely site for rupture. On the distribution of multiple aneurysms according to location, unilateral and midline located multiple aneurysms were 49%. Size was more important than irregularity of the shape in identifying the site of rupture. Most ruptured aneurysms were 5mm or larger in size. Postoperative mortality was 4.4% and the most common cause of postoperative mortality was cerebral vasoapasm.
Aneurysm ; Aneurysm, Ruptured ; Brain ; Consciousness ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Retrospective Studies ; Rupture