No abstract available.
Thyroid Gland* ; Thyroid Nodule*

The Morel-Lavallée lesion (MLL) is a closed soft-tissue degloving injury, resulting in characteristic hemo-lymphatic fluid collection between the fascia and subcutaneous layers. The MLL was managed routinely with drainage and compression bandages, but sclerotherapy can be used in patients with chronic lesions refractory to first-line therapy. This paper presents a case of extensive recurrent chronic MLL treated with sclerotherapy using Abnobaviscum, which has been used to treat adhesion in malignant pleural effusion.

It is well known that metastatic bone tumor is very rare below knee and elbow joint. Recently, we experienced two cases of metastatic tumor from kidney and lung to the tibia at Koryo General Hospital.
Elbow Joint ; Hospitals, General ; Kidney ; Knee ; Lung ; Tibia

Parathyroid hyperplasia is a pathologic finding that can be found in hyperparathyroidism. Unlike parathyroid adenoma, treatment of parathyroid hyperplasia is still quite controversial. In addition, the relative merits of two alternative surgical approaches-subtotal parathyroidectomy versus total parathyroidectomy with autotransplantation have not been clearyly elucidated. The records of 10 patients who had parathyroid hyperplaisa and who underwent parathyroid surgery at the Department of Surgery, Hanyang University Hospital, between April 1992 and April 2003 were retrospectively reviewed. The 10 patients were comprised of 3 males and 7 females. The age distribution was between 29 and 73 years. The presenting clinical manifestations were associated with bone pain in 8 patients, muscle weakness in 4, headache in 4, gastrointestinal symptoms in 3, renal symptoms in 3 and psychologic symptoms in 2. The serum parathyroid hormone level was elevated in all patients. The serum alkaline phosphatase level was elevated in seven among the ten patients. Histopathologic findings revealed chief cell hyperplasia in all patients. Postoperative transient hypocalcemia occurred in 5 patients and they were supplied with oral calcium and calcitriol for several months. There were no major complications. The results indicate that a subtotal parathyroidectomy can be performed without mortality or morbidity and provides good control of primary parathyroid hyperplasia, A total prathyroidectomy with autotransplantation can be performed without mortality or morbidity and provides good contril of secondary and tertiary parathyroid hyperplaisa.
Age Distribution ; Alkaline Phosphatase ; Autografts ; Calcitriol ; Calcium ; Female ; Headache ; Humans ; Hyperparathyroidism ; Hyperplasia* ; Hypocalcemia ; Male ; Mortality ; Muscle Weakness ; Parathyroid Hormone ; Parathyroid Neoplasms ; Parathyroidectomy ; Retrospective Studies ; Transplantation, Autologous

The acromioclavicular and coracoclavicular ligament are usually injured by traffic accident or during sports. So, various methods of treatment has been introduced. Fourty four cases of acromioclaviclar and coracoclavicular ligament injuries were admitted and treated at Koryo General Hospital from March 1985 to February 1989. 26 cases were treated by operative method, 18 cases by conservative method in Grade 1, 2 and 3 injuries. The following results were obtained. 1. These injuries were more prevalent in male and more in left side. 2. The most common cause of injuries was traffic accident. 3. Among 44 cases, 13 cases were Grade 1, 9 cases Grade 2 and 22 cases Grade 3 by Allman's classification. 4. 18 cases were treated conservatively and 26 cases operatively. Conservatively treated 18 cases include 15 cases by Kenny-Howard sling and 3 cases by skillful neglect. And operatively treated 25 cases include 12 cases by modified Phemister method(46.2%), 2 cases by modified Bosworth method(7.7%), 2 cases by acromioclavicular plate method(7.7%), 2 cases by Stewart method(7.7%) and one case by Mumford method(3.8%). 5. There were good functional results with the K-wire fixation method after the acurate diagnosis by operative method in the Grade 2 injury. And in the Grade 3 injury we could get the functional results with the modified Phemister method.
Accidents, Traffic ; Classification ; Diagnosis ; Hospitals, General ; Humans ; Ligaments ; Male ; Methods ; Sports

The authors report a rare case of gunshot injury to the head by a nail-gun which was treated by stereotactic surgery. In the case, a 23-year-old male patient, presented with semicomatose mentality and decerebrated rigidity. The large nail was located in the 3rd ventricular area in the mid-line with vertical stature. The entry point was identified 1cm anterior to the coronal suture line and just lateral to the sagittal suture line. The foreign body was removed stereotactically with the guidance of gluoroscope. But the died of initial severe brain damage.
Brain ; Craniocerebral Trauma ; Foreign Bodies ; Head* ; Humans ; Male ; Sutures ; Young Adult

Conventional radiographs and simple CT scans fail to provide accurate information about the structural integrity of a fracture site. In recent years, special 3-dimensional CT scanning has been progressively developed, and we applied this technique to thoracolumbar compression fractures. Posterolateral spinal fusion with iliac bone graft was attempted in all patients; Comparative pre- and post-operative change in these fractures was then an-alysed, using 3-dimensional CT. The results of this study suggest that this imaging is a useful non-invasive technique to assess compression fracture and determine prognosis.
Fractures, Compression* ; Humans ; Prognosis ; Spinal Fusion ; Tomography, X-Ray Computed ; Transplants

BACKGROUND: Policy-makers are required to know the current patterns of resource use and the costs of stroke. However, the scientific evidence, on which health policy-making can be based, is not sufficient. Our study aimed to investigate resource utilization and costs during the one year after stroke. METHODS: Among patients with acute ischemic stroke (7 days from onset) who were admitted from July of 2001 to July of 2002, 223 were interviewed one year after the onset of stroke through a home visit by an experienced research nurse. Resource utilization and related costs were investigated. RESULTS: The average length of stay was 25 days. The average first inpatients costs was won 2, 230, 000. After discharge, the average outpatient visit was 22 days. The average expenditure per patient during the one year from onset of stroke was won 5, 235, 000. The hospital charge was 59% of the total cost, the cost for hiring a care-giver was 14%, and the fee for the outpatient clinic was 13%. Thirty-nine percent (won 2, 051, 000) of the total expenditure was consumed in the first month, 12% was in the second, 8% was in the third, and around 5% monthly was after 3 months. CONCLUSIONS: Our study is the first one to investigate the resource utilization and the related costs in stroke patients in Korea. The results of this study should not be generalized to all Korean stroke patients, but this study may serve as a reference for inferring the real status in Korea and may be a starting point for further nationwide resource utilization and costs studies.
Ambulatory Care Facilities ; Delivery of Health Care* ; Fees and Charges ; Health Expenditures ; Hospital Charges ; House Calls ; Humans ; Inpatients ; Korea ; Length of Stay ; Outpatients ; Stroke*

BACKGROUND: Liver failure due to ischemia-reperfusion injury is a serious problem in liver transplantation and radical wide resection of the liver. This injury is believed to be closely related to the generation of oxygen free radicals. Gabexate mesilate, a synthetic protease inhibitor, has an effect on the suppression of extracellular release of oxygen free radicals in the microvascular endothelium, as well as on protease inhibition. In order to understand the effects of gabexate mesilate on ischemia-reperfusion injury to the liver, we performed animal experiment with rats. METHODS: We divided the rats into two ischemia-reperfusion groups:the experimental group which received a 30 minutes ischemic injury along with the infusion of gabexate mesilate and a control group which received only the injury. Each group was subdivided into 4 sub-groups:ischemic injury only and ischemic injury plus 60, 120 or 180 minutes reperfusion injury. The test parameters were TNF-a and IL-6 in the serum, and superoxide dismutase(SOD), catalase, and malondialdehyde(MDA) in liver and lung tissues. RESULTS: The group receiving gabexate mesilate had a significantly higher level of liver SOD and liver catalase and a significantly lower level of liver MDA and lung MDA than the control groups. The TNF-a levels in the gabexate mesilate groups were significantly lower in the early phase, and a comparison of the IL-6 levels between two main groups yielded no significant results. The levels of lung catalase and SOD showed no significant difference between the two main groups. CONCLUSIONS: Protease inhibitor has the beneficial effect of liver ischemia-reperfusion injury suppression due to an increase in antioxidants or oxygen-free-radical suppression. The roles of TNF-a and IL-6 in liver reperfusion injury was not clear in our investigation. However, TNF-a might have an effect in the early phase. The mechanism of reperfusion injury to the lung in liver ischemia-reperfusion injury might be different from that to the liver.
Animal Experimentation ; Animals ; Antioxidants ; Catalase ; Endothelium ; Free Radicals ; Gabexate ; Interleukin-6 ; Liver Failure ; Liver Transplantation ; Liver* ; Lung ; Oxygen ; Protease Inhibitors* ; Rats* ; Reperfusion Injury* ; Superoxide Dismutase ; Superoxides

OBJECTIVES: To report two cases of neuropathy due to methyl bromide intoxication. METHODS: Workers, engaged in the fumigating process, complained fatigue, general weakness, ataxia, and hypersomnia. We evaluated them with blood tests, neurophysiologic studies and MRI and investigated their occupational history. RESULTS: Increased signal intensities were found in the medulla oblongata and paraver mian of cerebellum in MRI and after 11 days, high signal intensities were reduced in the following MRI. In the other case, polyneuropathy and rlght lower brainstem lesion were observed In the NCV and BAEP studies. CONCLUSIONS: We confirmed that worker's symptoms were related to methyl bromide exposure in the fumigation. It is necessary that we should evaluate present condition of fumigating process and prepare appropriate methods to protect workers engaged in the fumigation.
Ataxia ; Brain Stem ; Cerebellum ; Disorders of Excessive Somnolence ; Fatigue ; Fumigation* ; Hematologic Tests ; Magnetic Resonance Imaging ; Medulla Oblongata ; Polyneuropathies