Torn discoid lateral meniscus has been numerously reported in diagnosis and treatment. But discoid meniscus in children of which clinical pictures were thought to be different from adults was rarely known. We experienced 2 cases of discoid meniscus tear in children whose ages were below 4 years old and report with references.
Adult ; Child ; Child, Preschool* ; Diagnosis ; Humans ; Menisci, Tibial*

STUDY DESIGN: A review of literature including definition, diagnosis and treatment of neuropathic pain. OBJECTIVES: To review and discuss the treatment guideline for neuropathic pain. SUMMARY OF LITERATURE REVIEW: Neuropathic pains are characterized by partial or complete somatosensory change caused by various disorders affecting central and peripheral nervous system, and are especially problematic because of their severity, chronicity and resistance to simple analgesics. MATERIALS AND METHODS: Review of literature. RESULTS: Tricyclic antidepressants and the anticonvulsants gabapentin and pregablin were recommended as first-line treatments for neuropathic pain. Opioid analgesics and tramadol were recommended as second-line treatments that can be considered for first-line use in selected clinical circumstances. Other medications such as dual reuptake inhibitors of both serotonin and norepinephrine would be used in severe cases. More invasive interventions (e.g., spinal cord stimulation) may sometimes be helpful. CONCLUSIONS: Treatment must be individualized for each patient and aggressive, combinatory pharmacotherapy and multidisciplinary approach are recommended for the treatment of neuropathic pain.
Amines ; Analgesics, Opioid ; Anticonvulsants ; Antidepressive Agents, Tricyclic ; Cyclohexanecarboxylic Acids ; gamma-Aminobutyric Acid ; Humans ; Neuralgia ; Norepinephrine ; Peripheral Nervous System ; Serotonin ; Spinal Cord ; Tramadol

Gastric bezoars are large masses or concretions, composed with plant fiber, hair and miscellaneous foreign bodies, found in the stomach and occur usually as sequele of gastric surgery. We experienced 2 cases of fat bezoars which developed after drinking of melted beef fst. They had postprandial epigastric fullness and pain, those were relieved on supine and left recumbent position. Upper gastrointestinal series showed a large movable mass in the stomach in hoth cases. On gastrofibercopic examination, a large egg sized white bezoar was cordirmed in both cases and a gastrie ulcer at antrum associated in one case. In attempt to removal of the bezoars, we tried to break them, but failed because of its character. The patients were treated with pancreatic lipase containg digestives, Pancreon-F and Azintal. From one day after this treatment, symptoms were completely relieved. Five days later, we confirmed disappearance of bezoars by gastrofiberscopy. and upper gastrointestinal barium
Barium ; Bezoars* ; Drinking ; Foreign Bodies ; Hair ; Humans ; Lipase* ; Ovum ; Plants ; Stomach ; Ulcer

Renal osteodystrophy is well recognized complication of end stage renal disease(ESRD) and is associated with a marked morbidity. To evaluate bone loss in renal osteodystrophy, we measured bone mineral density(BMD) in distal radius by quantitative computed tomography in 43 ESRD patients on starting hemodialysis(HD) and in 84 healthy controls matched for age and sex. We also measured intact parathyroid hormone(iPTH), serum total alkaline phosphatase(T-ALP), osteocalcin(OC) and urine deoxypyridinoline(U-DPD) as bone turn-over markers. 1) The mean age of ESRD patients and control groups were 49.8 and 49.7 years. M:F ratio were 1:1.1 and 1:1.3 on each groups. There was no significant differences on each groups. 2) Serum T-ALP and OC were 263.9+/-264.5U/L, 43.5+/-27.6ng/mL in ESRD patients and 167.4+/-46.6U/ L, 8.8+/-3.9ng/mL in control groups. These were significantly higher in ESRD patients(P<0.001, P< 0.001), while U-DPD were not significant difference on each groups(5.3+/-4.1 vs 5.4+/-1.9nM/mM. Cr.). 3) Serum iPTH and aluminum were 296.8+/-263.4pg/mL, 10.1+/-11.6ng/mL in ESRD patients. 4) Total density, trabecular density and cortical density were 340.4+/-83.6, 172.9+/-48.4, 477.2+/-123.5mg/ cm3 in ESRD patients and 393.2+/-49.1, 210.6+/-32.9, 541.3+/-76.2mg/cm3 in control groups. BMD was statistically significantly reduced in ESRD patients (P<0.001, P<0.001, P<0.001, respectively). Z score of total density and trabecular density were -0.62+/-1.12, -0.91+/-0.95 in ESRD patients and 0.19+/-0.68, 0.06+/-0.59 in control groups. It was significantly reduced in ESRD patients(P<0.001, P<0.001, P<0.001, respectively). 5) In ESRD patients, serum T-ALP, iPTH, OC, U-DPD were not correlated with BMD and Z score. But in control groups, serum OC was correlated inversly with BMD, and U-DPD was only correlated inversely with trabecular density. 6) In ESRD patients(n=22) who were having iPTH above 300pg/mL, serum OC and U-DPD were significantly higher than in ESRD patients(n=21) who were having iPTH below 300pg/mL(52.6+/-28.8ng/ mL, 6.8+/-5.1nM/mM.Cr. vs. 33.9+/-23.3ng/mL, 3.7+/-1.9 nM/mM.Cr. P<0.05, P<0.05 repectively). But serum aluminum, and T-ALP were not significant difference on each groups. BMD and Z score were also not difference on each groups. 7) In ESRD patients who were having iPTH above 300pg/mL, iPTH and serum OC were inversely correlated with BMD but U-DPD were only inversely correlated with trabecular density. In ESRD patients who were having iPTH below 300pg/mL, bone turn-over markers were not correlated with BMD. In ESRD patients on starting HD, BMD were significantly reduced, but serum T-ALP, OC, iPTH and U-DPD were not correlated with BMD. In ESRD patients who were having iPTH above 300 pg/mL, BMD were significantly inversely correlated with serum OC, iPTH.
Aluminum ; Bone Density* ; Humans ; Kidney Failure, Chronic* ; Radius ; Renal Dialysis* ; Renal Osteodystrophy

In recent years, there appears to have been an increased incidence or recognition of sebaceous carcinomas of the ocular adnexa, which had been previously believed very rare. A 55-year-old male visited our hospital in April 1973 with a large lump in the right lower eyelid which had showed progressive enlargement of one year's duration. A biopsy was carried out and the histopathological examination revealed sebaceous carcinoma. He was treated with a total dosage of 6,000 rads of electron-beam by LINAC machine in October 1973, and the result was excellent.
Biopsy ; Eyelids ; Humans ; Incidence ; Male ; Middle Aged

BACKGROUND AND OBJECTIVES: Septoplasty with or without turbinate surgery is performed by many otorhinolaryngologists. However, the surgical methods largely rely on clinical judgement alone. The purpose of this study is to investigate the correlation between deviated nasal septum and inferior turbinate with compensatory hypertrophy on paranasal sinus computed tomography (CT) and to suggest a guideline for septal and turbinate surgery. SUBJECTS AND METHOD: Paranasal sinus CT scans of twenty patients with nasal septal deviation and compensatory hypertrophy of inferior turbinate were taken and reviewed. Measurements of thickness of mucosa and medial conchal bone, projection angle of inferior turbinate, distance between medial conchal bone and lateral nasal line, and interval between median line and conchal bone were obtained. Each measurement was compared with that of opposite side of nasal cavity and normal control subjects. RESULTS: The thickness of medial mucosa and conchal bone of inferior turbinate of concave side were more increased than those of the other side (p<0.05). The projection angles of conchal bone from lateral nasal wall in each side were different and the distances between medial conchal bone and lateral nasal line were more increased in concave side (p<0.05). CONCLUSION: Septoplasty and concomitant inferior turbinate surgery that manipulates conchal bone and soft tissue is necessary for the patients with a complaint of nasal obstruction. Reduction of medial mucosa and out-fracture of hypertrophied inferior turbinate are proper for the concomitant inferior turbinate surgery. The data gathered using CT images are important in making a decision regarding turbinate surgery in septoplasty.
Humans ; Hypertrophy* ; Mucous Membrane ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum ; Tomography, X-Ray Computed ; Turbinates*

BACKGROUND AND OBJECTIVES: Chronic upper airway obstruction attributable to adenotonsillar hypertrophy is the most common cause of sleep disordered breathing (SDB) in children. The objective of this study was to evaluate the long-term effects of adenotonsillectomy on the degree of SDB and growth in children with SDB. SUBJECTS AND METHOD: Forty-three children (mean age, 6.1+/-2.4 years) clinically diagnosed as SDB were enrolled, and they were scheduled for adenotonsillectomy (T&A ) based on their response to the validated, 22-item sleep related breathing disorder (SRBD) scale and a physical examination that showed adenotonsillar hypertrophy. Weight, height, and BMI (body mass index) were evaluated before and three years after T&A. RESULTS: SRBD scales decreased significantly after T&A(p<0.001). Their Z scores (standard deviation scores) for weight, height, and BMI of 43 children were significantly higher three years after T&A compared with before T&A (p<0.01). CONCLUSION: Children with SDB who underwent adenotonsillectomy showed significant long-term increases in weight, height, and BMI as well as a significant long-term improvement in quality of the sleep.
Adenoidectomy ; Airway Obstruction ; Child ; Humans ; Hypertrophy ; Physical Examination ; Respiration ; Sleep Apnea Syndromes ; Sleep Wake Disorders ; Tonsillectomy ; Weights and Measures

PURPOSE: Recently, it is suggested that the inhibitian of apoptosis is associated with tumorigenesis of colon. Bcl-2 gene is an important inhibitory regulator of apoptosis, and bcl-2 acts antagonistly with the wild type p53 gene, one of the tumor suppressor genes, in apoptosis. To detnmine the role of bcl-2 and p53 gene in colonic tumorigenesis, we performed the study. MATERIALS AND METHODS: We tested the tissue obtained by polypectomy and surgical resection by immunohistochemical staining for Bcl-2 and p53. RESULTS: We found that in normal colonic tissue, the Bcl-2 was sparcely expressed, and the p53 was expressed sporadically. The rate of positivity of staining was below 5%. However, in colonic adenoma and colon cancer tissue, Bcl-2 and p53 were expressed more than in nonnal colonic tissue(p<0.05). (Scoring in Colonic adenoma: Bcl-2 6.2+/-1.1, p53 5.7+/-1.0; Scoring in Colonic carcinoma: Bcl-2 4.7+/-1.0, p53 8.3+/-0.9) CONCLUSION: Our results suggested that the bcl-2 and p53 play an important role in colonic tumorigenesis.
Adenoma* ; Apoptosis ; Carcinogenesis ; Colon* ; Colonic Neoplasms ; Genes, bcl-2 ; Genes, p53* ; Genes, Tumor Suppressor

BACKGROUND/AIMS: The prognosis of chronic liver disease is closely related to the development of hepatic fibrosis. Liver biopsy is the gold standard method to assess inflammatory activity and fibrosis stage, but this is associated with morbidity and mortality. This study aimed to evaluate the diagnostic value of serum hyaluronic acid, 7S domain of type IV collagen and AST/ALT ratio as markers of hepatic fibrosis in chronic hepatitis B and cirrhosis. METHODS: This study included 100 patients with chronic hepatitis B and cirrhosis. Liver biopsy and histopathologic classification were done. Serum hyaluronic acid and 7S domain of type IV collagen were measured by one step sandwich binding protein assay and radioimmunoassay using polyclonal antibody to 7S domain of type IV collagen, respectively. RESULTS: The serum concentrations of hyaluronic acid, 7S domain of type IV collagen and AST/ALT ratio in the cirrhosis group (139 +/- 98.4 ng/mL, 6.9 +/- 3.5 ng/mL, 1.6 +/- 1.5) were significantly higher (p<0.01) than those in the normal and fatty liver group (20.2 +/- 12.5 ng/mL, 3.5 +/- 0.5 ng/mL, 0.7 +/- 0.3), mild hepatitis group (32.3 +/- 52.7 ng/mL, 3.9 +/- 1.4 ng/mL, 0.7 +/- 0.4), and moderate to severe hepatitis group (68.2 +/- 72.3 ng/mL, 5.3 +/- 2.4 ng/mL, 0.8 +/- 0.4). At the cutoff value of 77 ng/mL for hyaluronic acid and 6.3 ng/mL for 7S domain of type IV collagen and 0.62 for AST/ALT ratio, the sensitivities were 81.8%, 63.6%, 90.9% and specificities were 87.3%, 88.6%, 53.1% for discriminating cirrhosis (fibrosis score: 4) from the mild to severe fibrosis (fibrosis score: 0-3). CONCLUSIONS: Serum hyaluronic acid, 7S domain of type IV collagen and AST/ALT ratio measurement may be clinically useful as markers of hepatic fibrosis in chronic hepatitis B and cirrhosis.
Adult ; Alanine Transaminase/*blood ; Aspartate Aminotransferases/*blood ; Biological Markers/blood ; Collagen Type IV/*blood ; Female ; Hepatitis B, Chronic/blood/*pathology ; Humans ; Hyaluronic Acid/*blood ; Liver/*pathology ; Liver Cirrhosis/blood/*pathology ; Male ; Prognosis ; Sensitivity and Specificity

Intramyocardial hematoma is known to be associated with myocardial infarction, chest trauma, coronary artery bypass operation, and complication of percutaneous coronary intervention (PCI). We describe here a rare case of 50-year-old man with a huge right ventricular (RV) wall hematoma which was newly developed two hours after PCI. The patient was treated conservatively with a successful outcome. We discuss plausible mechanisms for the development of RV wall hematoma and treatment options for the case.
Coronary Artery Bypass ; Heart Ventricles ; Hematoma ; Humans ; Middle Aged ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Thorax