Purpose: To evaluate and introduce the technique of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia for the treatment of calcific tendinitis of the rectus femoris around the hip joint. Materials and Methods: Between March 2003 and May 2005, C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia were performed on 5 patients and a local excision were performed in 1 patient for the treatment of calcific tendinitis of the rectus femoris. The minimum follow-up period was 6 months. The radiology evaluation revealed the presence and size of the calcification. The clinical evaluation involved checking the level of pain relief, range of motion, recurrence, complications. Results: The hip pain improved immediately after treatment. There were no recurrences or complications. Conclusion: The combined treatment of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia is an effective method for treating calcific tendinitis of the rectus femoris, which can induce rapid symptom relief without any surgical morbidity.
Anesthesia, Local ; Follow-Up Studies ; Hip Joint* ; Hip* ; Humans ; Quadriceps Muscle* ; Range of Motion, Articular ; Recurrence ; Tendinopathy*

Although the incidence of leprosy is decreased considerably, the deformity and disability of it is serioues. In the hand, combined median and ulnar nerve affection is most common, and it leads to many problems including opposition dysfunction and claw hand deformity. And opposition dysfunction is most significant disability in the hand function, so its correction or reconstruction is mandatory We performed 20 cases of opponensplasty from Oct. 91 to Apr. 94 at National Medical Center, and analyzed its results according to new assessment criteria invented by authors, and evaluated the efficacy of the operative treatments. The results were as follows: 1. The patients were 9 males and 11 females, average age was 48 years old, and average duration of paralysis was 28 years. The mean follow-up period was 2.8 years. And most common type of nerve affection was combined low median and high ulnar nerves. 2. We performed 18 cases of Burkhalter opponensplasty using extensor indicis proprius and 2 cases of Riordan opponensplasty using ring finger sublimis at the leprosy hands. 3. According to authors assessment criteria for leprosy hand, the result of operative treatment was excellent in two, good in ten, fair in seven, and poor in two patients. So we obtained more than good results in 50% patients. 4. We could obtain good result with Burkhalter opponensplasty in leprosy hand, especially when combined with proper preoperative physical therapy and adjuvant operation for release of contracture and joint stiffness.
Animals ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Hand Deformities ; Hoof and Claw ; Humans ; Incidence ; Joints ; Leprosy ; Male ; Paralysis ; Tendon Transfer ; Ulnar Nerve

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare and recently recognized disease of unknown etiology, characterized by remission and exacerbation of multiple bone lesions which radiologically and pathologically have the appearance of hematogenous osteomyelitis. The natural history appears to be slow and spontaneous resolution of the osseous lesions without specific treatment. And antimicrobial agents seem to have no beneficial effect. In proper clinical setting, CRMO should be considered, because recognition of this entity would help us to avoid costly and potentially harmful diagnostic and therapeutic interventions. We report a case of a 48-year-old adult who had chronic recurrent multifocal osteomyelitis.
Adult ; Anti-Infective Agents ; Humans ; Middle Aged ; Natural History ; Osteomyelitis

In this article, Table 1's data was given incorrectly. Metodopramide should be corrected as Metoclopramide.

PURPOSE: For choledocholithiasis, many doctors routinely use ERCP/EST to avoid the need for common bile duct exploration. But, ERCP/EST has some weakpoints. So it may not be a first choice for management, especially in secondary hospitals. Therefore, we investigated and reviewed results of LCBDE as a first treatment for common bile duct stones. METHODS: This study was a retrospective analysis of 60 cases that could be reviewed by their medical charts and who underwent LCBDE performed by the same surgeon at the Yeosu Chonnam Hospital between March, 1996 and August, 2009. The clinical data were compared between each two groups (1996~1999 vs 2000~2009 years, primary closure vs T tube drainage). RESULTS: Between groups A and B, there were no significant differences in preoperative status of the patient except for age (60.5 vs 72.6). The average operative time was decreased in group B (171.6 mins vs 143.0 mins) and the number of trocars was decreased in group B (4 vs 3.2). There were 13 postoperative complications. Among them, 11 were cases of bile leakage. All of the bile leakage cases were in group B. And there were more bile leakages in the primary repair group than in T tube drainage group (50% vs 8.9%). But, 10 cases of bile leakage were improved completely by observation and conservative treatment. CONCLUSION: LCBDE is a safe and useful treatment that has several advantages and can overcome problems not solved by ERCP. Fatal complications were not increased in the primary repair group compared with the T tube drainage group.
Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Drainage ; Humans ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Surgical Instruments

BACKGROUND: Silicosis is more likely to occur in people working in the mining industry. However, workers suffering from silicosis have recently been reported frequently in other areas. We present a case of silicosis occuring in a 43-year-old man who had worked for 20 years in a workplace producing dental porcelain. CASE: The man was admitted to the emergency room with acute chest pain caused by pneumothorax. Chest X-ray indicated numerous small opacities spread over the whole lung field and a large opacity in the right middle lung field. According to ILO classification, the shape of the small opacities was t/s, the profusion rate was 2/3 and the large opacity was classified into the B category. Following this diagnosis of silicosis, the patient's medical history and work exposure history were examined. According to his medical history, he had undergone closed thoracostomy in 2006 because he had suffered pneumothorax twice (in 2005 and 2006) and his smoking history was 7 pack years. In particular, he had been exposed to silica dust for 20 years in his workplace. CONCLUSION: Despite the absence of any specific risk factor that caused pneumothorax, the patient suffered this condition three times. All clinical results and the progress of his physical symptoms, including radiologic findings from chest X-ray and computed tomography, clearly supported the diagnosis of silicosis. Except for exposure to silica dust in the workplace, no other risk factors causing silicosis were found. Therefore, he was finally diagnosed as having silicosis caused by exposure to silica dust in the workplace and followed by pneumothorax.
Adult ; Chest Pain ; Dental Porcelain ; Dust ; Emergencies ; Humans ; Lung ; Mining ; Pneumothorax ; Risk Factors ; Silicon Dioxide ; Silicosis ; Smoke ; Smoking ; Stress, Psychological ; Thoracostomy ; Thorax

Bowen's disease is a squamous cell carcinoma in situ and has the potential to progress to a squamous cell carcinoma. The authors treated two female patients (a 39-year-old and a 41-year-old) with Bowen's disease in the vulva area using topical photodynamic therapy (PDT), involving the use of 5-aminolaevulinic acid and a light-emitting diode device. The light was administered at an intensity of 80 mW/cm2 for a dose of 120 J/cm2 biweekly for 6 cycles. The 39-year-old patient showed excellent clinical improvement, but the other patient achieved only a partial response. Even though one patient underwent a total excision 1 year later due to recurrence, both patients were satisfied with the cosmetic outcomes of this therapy and the partial improvement over time. The common side effect of PDT was a stinging sensation. PDT provides a relatively effective and useful alternative treatment for Bowen's disease in the vulva area.
Adult ; Bites and Stings ; Bowen's Disease* ; Carcinoma, Squamous Cell ; Female ; Humans ; Photochemotherapy* ; Recurrence ; Sensation ; Vulva*

BACKGROUND: Pain at the site of rocuronium injection is a common side-effect in pediatric patients. This prospective, randomized, double-blind study evaluated the efficacy of a combination of nitrous oxide and lidocaine pretreatment on withdrawal response during rocuronium injection in children. METHODS: Sixty six pediatric patients, ages 5 to 12 years, were randomly assigned to two groups. The oxygen group received 100% oxygen, and the nitrous oxide group received 50% N2O in oxygen over 2 min. After anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and manual occlusion of the forearm was performed, 1% lidocaine 1 mg/kg was injected over 15 sec. After the occlusion was released, 0.1% rocuronium 0.6 mg/kg was injected over 5 sec. Patient response to rocuronium injection was graded using a 4-point scale. RESULTS: Overall incidence of withdrawal movements was significantly lower in the nitrous oxide group (1 patients; 3.1%) than in the oxygen group (8 patients; 25.8%) (P = 0.013). No patient in the nitrous oxide group displayed arm or generalized movement (grade 3 or 4) associated with rocuronium injection. CONCLUSIONS: This study demonstrated that a combination of inhaled 50% N2O in O2 and 1 mg/kg lidocaine pretreatment significantly reduced the incidence of rocuronium-induced withdrawal movements in pediatric patients compared with lidocaine pretreatment alone.
Androstanols ; Anesthesia ; Arm ; Child ; Double-Blind Method ; Forearm ; Humans ; Incidence ; Lidocaine ; Nitrous Oxide ; Oxygen ; Prospective Studies ; Thiopental

Reinke's edema begins with a chronic diffuse edema on the surface of the lamina propria of the vocal folds. It frequently occurs in women, smokers, professional voice users, and in patients with gastroesophageal reflux disease. Herein, we report the case of a patient who experienced ventilation difficulties during general anesthesia using positive pressure mask ventilation.
Airway Management* ; Airway Obstruction ; Anesthesia, General ; Edema* ; Female ; Gastroesophageal Reflux ; Humans ; Masks ; Mucous Membrane ; Ventilation ; Vocal Cords ; Voice

Xanthogranulomatous epididymitis is an atypical form of severe destructive epididymal infection, characterized by massive inflammatory cell and foamy histiocyte microscopically. We report two cases of xanthogranulomatous epididymitis that presented as epididymal inflammation with fluid collection in old aged patients, and resulted in orchiectomy. We suggest that xanthogranulomatous epididymitis should be considered as one of the differential diagnosis in epididymitis with abscess formation.
Abscess ; Diagnosis, Differential ; Epididymitis* ; Histiocytes ; Humans ; Inflammation ; Male ; Orchiectomy