Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Myasthenia Gravis* ; Neck ; Thymectomy* ; Thymus Hyperplasia ; Thyroid Gland ; Thyroidectomy*

PURPOSE: Lawn trimmers are widely used to cut the weeds around graves in South Korea, but they can cause ocular injury. We investigate at the emergency room the incidence and the clinical features of ocular trauma induced by lawn trimmers. METHODS: The authors analyzed 106 patients who visited Konyang University Hospital's emergency room from March 1, 2007, to October 31, 2011, because of ocular trauma caused by a lawn trimmer. Patients were sorted into two groups, severe ocular injury and mild ocular injury. RESULTS: Over a 5-year period, 106 patients with ocular trauma caused by a lawn trimmer underwent clinical study. Most of the patient (103 patients) were males, and the average age of the patients was 51.75+/-11.66 years. The incidence of ocular trauma peaked in the sixth decade of life. Most injuries occurred between July and September. Severe ocular injury developed in 46.2% of all patients. As age increased, so did the severity of the ocular injury. The impacting object was a small stone in 43.4% of all patients. Nobody wore protective gear. The most common diagnosis were corneal abrasion, followed by intraocular foreign body, corneal laceration, and sclera laceration. Fifty-four patients were followed up, and thirty-six patients of them had severe injury. The most common complication was a traumatic cataract. CONCLUSION: Ocular trauma induced by a lawn trimmer is more severe than general ocular trauma. We suggest that everyone using a lawn trimmer should wear protective gear and follow safety guidelines.
Cataract ; Emergencies ; Eye Foreign Bodies ; Eye Injuries ; Foreign Bodies ; Humans ; Incidence ; Lacerations ; Male ; Republic of Korea ; Sclera

OBJECTIVE: The goal of this study was to evaluate the clinical course of total hysterectomized patient with benign gynecologic disease using minilaparotomy. METHODE: 45 benign gynecologic diseased patients who hysterectomized with Pfannelstiel's skin incision and PCA (patient controlled analgesics). 30 patients were laparotomized, and 15 patients were minilapartomized. We analyzed the data of this patients for age, parity, duration of operation, the weight of the uterus, change of the hemoglobin, removal time of foley catheter, starting time of regular diet, initial time of ambulation and discharge date. RESULT: Minilaparotomy hysterectomized patients have lesser bleeding and show more rapid recovery of bowel movement and bladder function. And they experience lesser pain than the other group. CONCLUSION: Minilaparotomy is a safe and feasible route of hysterectomy for a selected group of patients.
Catheters ; Diet ; Female ; Genital Diseases, Female ; Hemorrhage ; Humans ; Hysterectomy* ; Laparotomy* ; Parity ; Passive Cutaneous Anaphylaxis ; Skin ; Urinary Bladder ; Uterus ; Walking

No abstract available.
Estrogens* ; Humans* ; Pituitary Neoplasms* ; Receptors, Estrogen*

Pelvic actinomycosis is a chronic, progressive, granulomatous and suppurative disease caused by an anaerobic or microaerobic Gram-positive organism, not fungi. Actinomyces species exhibit branching, filamentous growth and appear in the human skin, oral cavity, gastrointestinal tract. Actinomyces infection in human is relatively rare, however, prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor of pelvic actinomycosis. Pelvic actinomycosis can mimick pelvic malignancy leading to mutilating surgical excision, and diagnostic problems necessitated a laparotomy in many patients. The pathohistological diagnosis is based on the characteristic microscopic image and specific staining of sulfur granule. Adequate surgical excision and administration of antibiotics show good prognosis. We experienced 2 cases of pelvic actinomycosis with the intestinal obstruction, confirmed patho- histologically after laparotomy.
Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Diagnosis ; Fungi ; Gastrointestinal Tract ; Humans ; Intestinal Obstruction* ; Intrauterine Devices ; Laparotomy ; Mouth ; Prognosis ; Risk Factors ; Skin ; Sulfur

Pelvic actinomycosis is a chronic, progressive, granulomatous and suppurative disease caused by an anaerobic or microaerobic Gram-positive organism, not fungi. Actinomyces species exhibit branching, filamentous growth and appear in the human skin, oral cavity, gastrointestinal tract. Actinomyces infection in human is relatively rare, however, prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor of pelvic actinomycosis. Pelvic actinomycosis can mimick pelvic malignancy leading to mutilating surgical excision, and diagnostic problems necessitated a laparotomy in many patients. The pathohistological diagnosis is based on the characteristic microscopic image and specific staining of sulfur granule. Adequate surgical excision and administration of antibiotics show good prognosis. We experienced 2 cases of pelvic actinomycosis with the intestinal obstruction, confirmed patho- histologically after laparotomy.
Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Diagnosis ; Fungi ; Gastrointestinal Tract ; Humans ; Intestinal Obstruction* ; Intrauterine Devices ; Laparotomy ; Mouth ; Prognosis ; Risk Factors ; Skin ; Sulfur

BACKGROUND/AIMS: Pneumatic dilation is the most effective non-surgical treatment option for the patients with achalasia. The aim of this study was to determine the predictors of outcome after pnematic dilation in patients with primary achalasia. METHODS: Thrity-five patients with primary achalasia between May 1996 and April 2001 were included. They were divided into two groups; responder and nonresponder. Esophageal manometry, scintigraphy and barium esophagogram was performed before dilation and 4 weeks after dilation. RESULTS: Seven patients having symptomatic relapse were treated with repeated pneumatic dilation. Remaining 28 patients (83%) had no recurrence during follow-up period (mean duration 16 month, range 6~43 month). Among the factors evaluated in the initial examination, only young age affected outcome (p=0.039). The post treatment retention fraction at 5, 20 minutes were the most valuable factors for predicting the clinical response (p<0.05). CONCLUSIONS: Older patients are more likely to have sustained response. Radionuclide esophageal emptying test remains a useful objective study evaluating esophageal transit before and after pneumatic dilation in the patients with achalasia and may have an important role in the follow-up evaluation of treatment for achalasia.
Barium ; Esophageal Achalasia* ; Follow-Up Studies ; Humans ; Manometry ; Radionuclide Imaging ; Recurrence

PURPOSE: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission. METHODS: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (ρ) were performed. RESULTS: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p < 0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (ρ=0.195) and between NLR and length of ICU admission (ρ=0.092) were observed. CONCLUSION: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).
Emergencies ; Emergency Medicine ; Emergency Service, Hospital ; Humans ; Logistic Models ; Lymphocyte Count ; Neutrophils ; Pneumonia, Aspiration* ; Prognosis ; ROC Curve ; Sensitivity and Specificity