No abstract available.
Amnion* ; Hydrocortisone* ; Pregnancy*

OBJECTIVE: This study evaluated the prognostic factors that influence the surgical outcomes of elderly patients older than 65 years old with an aneurysmal subarachnoid hemorrhage. METHODS: Ninety-two patients older than 65 years old, who were operated in our hospital between 1998 and 2005, were reviewed retrospectively. The clinical outcomes were evaluated using the modified Rankin Scale three months after surgery. RESULTS: The preoperative neurological status, such as the Hunt-Hess grade (p<0.001), World Federation of Neurological Surgeons (WFNS) grade (p<0.001), and the Fisher grade (p=0.001), was significantly associated with the surgical outcomes in this series. The vasospasm (0.016) and ventriculostomy (0.039) are factors influencing the surgical outcomes. However, the other factors including hypertension (0.831), smoking (0.228), accompanying disorder (0.706), size of aneurysms (0.177), location of aneurysms (0.755), shunt operation (0.356), and timing of surgery (0.194) had no influence on the surgical outcome. CONCLUSION: In elderly patients with intracranial aneurysms, the preoperative neurological status, vasospasm, and ventriculostomy are the most significant prognostic factors.
Aged* ; Aneurysm* ; Humans ; Hypertension ; Intracranial Aneurysm ; Retrospective Studies ; Smoke ; Smoking ; Subarachnoid Hemorrhage* ; Ventriculostomy

No abstract available.
Anetoderma* ; Granuloma Annulare* ; Humans ; Infant*

Lichen planus is a chronic papulosquamous disease that affects the skin and mucous membranes. It is characterized by pruritic violaceous papules that are most commonly seen on the extremities of middle aged adults, but the elderly are rarely affected. Hypertrophic lichen planus usually occurs on the extremities and especially on the shins, and it tends to be the most pruritic variant. An 82-year-old female presented with severe pruritic multiple papules and plaques on the both the upper and lower extremities for 1 year. At first, the lesions began as small, polygonal papules that formed verrucous plaques over several months. Histopathologic examination showed marked hyperkeratosis, irregular acanthosis and wedge-shaped hypergranulosis. The vacuolar alteration and the lymphocytic inflammatory infiltrate were accentuated at the base of the rete ridge. From these findings, we diagnosed these lesions as hypertrophic lichen planus. The lesions were treated with topical steroid and intralesional injection of steroid, and they were slightly improved after 2 months of therapy.
Adult ; Aged ; Aged, 80 and over ; Extremities ; Female ; Humans ; Injections, Intralesional ; Lichen Planus ; Lichens ; Lower Extremity ; Middle Aged ; Mucous Membrane ; Skin

Glomus tumors are benign cutaneous neoplasm, occurring in the vascular hamartomatous tubercles of the glomus body, which is a myoarterial apparatus typically found in the reticular dermis of the skin. Histopathologically, glomus tumors are composed of neoplastic cells that resemble normal glomus cells, arranged around a varying number of thin-walled, sometimes branching capillaries. Immunohistochemically, neoplastic cells in glomus tumors clearly exhibit smooth muscle characteristics with expression of muscle-specific actin and alpha-smooth muscle actin; whereas, the expression of CD34 is rare. In this report, we present two cases of benign glomus tumors on the subungual area and palm. Tumor cells of glomus tumor in two patients were both positive for smooth muscle actin (SMA) and CD34 immunohistochemical staining. We thought that coexpression of SMA and CD34 adds support to the interpretation of these lesions as a family of perivascular neoplasms.
Actins ; Capillaries ; Dermis ; Glomus Tumor ; Humans ; Muscle, Smooth ; Muscles ; Skin

BACKGROUND: Acute pain can severely interfere with the activities of daily living (ADL) of patients with herpes zoster, but until now, little has been published in the Korean medical literature about the impact of herpes zoster on the ADL. OBJECTIVE: The objective of this study was to identify the nature and severity of the acute pain of herpes zoster patients and its relationship to the patients' ADL. METHODS: 86 patients with herpes zoster and who visited our hospital from August 2009 to June 2010 were evaluated in regard to age, gender, the dermatomal distribution, the associated diseases, the severity and nature of the pain and the ADL. The nature of the pain was measured by the Short Form McGill Pain Questionnaire. To access interference of pain with the ADL, we used the Zoster Brief Pain Inventory (ZBPI) and the Zoster Impact Questionnaire (ZIQ). RESULTS: The mean onset of pain was 5.6+/-3.2 days before the visit, and the mean onset of skin lesion was 4.2+/-2.2 days before the visit. The most common nature of the pain of herpes zoster was shooting pain (55.8%), followed by stabbing pain (54.7%). But there was no significant difference of gender, age, the dermatomal distribution, the clinical severity and the associated disease according to the severity and nature of the pain. For every 1.0 point increase in the pain score, there was a 0.257 and 0.105 point increase in the ZBPI and ZIQ scores, respectively, on the multivariate linear regression model. CONCLUSION: This study will help to choose appropriate treatments to reduce the pain of patients who suffer with herpes zoster.
Activities of Daily Living ; Acute Pain ; Herpes Zoster ; Humans ; Linear Models ; Pain Measurement ; Quality of Life ; Skin

BACKGROUND: Acute pain can severely interfere with the activities of daily living (ADL) of patients with herpes zoster, but until now, little has been published in the Korean medical literature about the impact of herpes zoster on the ADL. OBJECTIVE: The objective of this study was to identify the nature and severity of the acute pain of herpes zoster patients and its relationship to the patients' ADL. METHODS: 86 patients with herpes zoster and who visited our hospital from August 2009 to June 2010 were evaluated in regard to age, gender, the dermatomal distribution, the associated diseases, the severity and nature of the pain and the ADL. The nature of the pain was measured by the Short Form McGill Pain Questionnaire. To access interference of pain with the ADL, we used the Zoster Brief Pain Inventory (ZBPI) and the Zoster Impact Questionnaire (ZIQ). RESULTS: The mean onset of pain was 5.6+/-3.2 days before the visit, and the mean onset of skin lesion was 4.2+/-2.2 days before the visit. The most common nature of the pain of herpes zoster was shooting pain (55.8%), followed by stabbing pain (54.7%). But there was no significant difference of gender, age, the dermatomal distribution, the clinical severity and the associated disease according to the severity and nature of the pain. For every 1.0 point increase in the pain score, there was a 0.257 and 0.105 point increase in the ZBPI and ZIQ scores, respectively, on the multivariate linear regression model. CONCLUSION: This study will help to choose appropriate treatments to reduce the pain of patients who suffer with herpes zoster.
Activities of Daily Living ; Acute Pain ; Herpes Zoster ; Humans ; Linear Models ; Pain Measurement ; Quality of Life ; Skin

A calcifying aponeurotic fibroma is a rare benign fibrous tumor with well-characterized histopathological features. Calcifying aponeurotic fibromas are generally slowly-growing lesions related to tendons and aponeuroses in the distal extremities of children and adolescents. While the neoplasm is usually asymptomatic, cases of progressive local discomfort have been reported. The exact etiology of this neoplasm is unknown, and there is frequently no history of trauma or local irritating factors. A 10-year-old female presented with a 2.5x2.0 cm, subcutaneous mass on the right sole 4 years after she bumped against a table. The histopathologic examination showed a poorly circumscribed fibrotic mass with foci of chondroid differentiation and calcification. These findings were consistent with the diagnosis of a calcifying aponeurotic fibroma. After total excision of the mass, there has been no recurrence of the lesion in 8 months of follow-up.
Adolescent ; Child ; Extremities ; Female ; Fibroma ; Follow-Up Studies ; Gait ; Humans ; Recurrence ; Tendons

We present a case of congenital cystic adenomatoid malformation (CCAM) in a 25-year-old male who was presented with chronic cough. Chest radiography revealed an abnormal mass-like shadow in the right lower pulmonary zone. A contrast enhanced computed tomography showed an 11 cm solid, cystic mixed mass on the right lower lobe. A right lower lobectomy was performed by video-assisted thoracoscopic surgery without complications. The gross specimen showed a massive cavitation with multiloculated cysts of varying size, consistent with CCAM, along with noticeable granulomatous inflammation. Non-tuberculosis mycobacteria were isolated from a bronchial wash specimen, and the resected tissue homogenates were positive for Mycobacterium avium-intracellulare complex by polymerase chain reaction.
Cough ; Cystic Adenomatoid Malformation of Lung, Congenital ; Humans ; Inflammation ; Male ; Mycobacterium ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Polymerase Chain Reaction ; Thoracic Surgery, Video-Assisted ; Thorax

OBJECTIVE: Postoperative motion preservation and prevention of adjacent segment degeneration is well recognized after placing artificial cervical disc prosthesis in patients with degenerative cervical disc disease. The authors investigated postoperative changes in motion dynamics in two different types of artificial cervical disc prosthesis, Bryan and Prestige LP cervical disc prosthesis, and compared them. METHODS: Twenty five patients underwent anterior cervical discectomy and implantation of artificial cervical disc prosthesis: 10 with Bryan and 15 with Prestige LP. Radiological assessments, including overall sagittal alignment angle, range of motion (ROM) of overall sagittal, functional spine unit (FSU) angle, segmental ROM of FSU and ROM of adjacent segment (Upper and Lower level) using static and dynamic lateral radiographs, were performed preoperatively and postoperatively. The mean postoperative follow up period was 18.6 months (range 10.4~28.5) in Bryan and 9.2 months (range 6.5~12.6) in Prestige LP. RESULTS: The overall sagittal alignment angle was decreased 2.9degrees in Bryan group (p=0.033) and increased 5.7degrees in Prestige LP group (p=0.017). The FSU angle at treated level was decreased 0.4degrees in Bryan group (p=0.929) and increased 2.9degrees in Prestige LP group (p=0.008). The ROM of overall sagittal was decreased in both groups (Bryan: 8.6degrees p=0.075, Prestige LP: 2.9degrees p=0.182). The segmental ROM of FSU was increased 1.0degrees in Prestige LP group (p=0.191) but, decreased 0.6degrees in Bryan group (p=0.929). The ROM of adjacent segment was decreased in both groups (Bryan: upper p=0.023 lower p=0.050, Prestige LP: upper p=0.570 lower p=0.132). The postoperative radiological results of comparison between two different artificial disc showed that overall sagittal alignment angle and FSU angle were more increased in Prestige LP (p=0.005, p=0.026, respectively). CONCLUSION: The segmental ROM of FSU was preserved and ROM of adjacent segment was decreased in both groups. This means that postoperative adjacent segment disease may be prevented regardless of types of implants. On comparison study, postoperative cervical curvature was more lordotic in Prestige LP. Therefore, Prestige LP is more suitable to maintain postoperative cervical lordosis. The limitation of our study is small number of case and short and unequal follow up period between two types of implants. Further long term study will be needed.
Animals ; Arthroplasty ; Diskectomy ; Follow-Up Studies ; Humans ; Lordosis ; Prostheses and Implants ; Range of Motion, Articular ; Spine