Isolated lateral ventricle after ventriculoperitoneal shunt for hydrocephalus can occur by obstruction of foramen of Monro. Two cases of isolated lateral ventricles after ventriculoperitoneal shunt are reported. Patients showed neurological deterioration and brain CT scan revealed unilateral dilatation of lateral ventricle after ventriculoperitoneal shunt. They were successfully managed by another shunt system into dilated lateral ventricle.
Brain ; Cerebral Ventricles ; Dilatation ; Humans ; Hydrocephalus ; Lateral Ventricles* ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Audiometry ; Carpal Tunnel Syndrome* ; Condoms* ; Diagnosis ; Hand ; Mass Screening ; Median Nerve ; Neural Conduction ; Occupations ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Ulnar Nerve ; Vibration ; Wrist

No abstract available.
Humans

OBJECTIVES: Elevated serum uric acid (UA) has been known to be associated with the prevalence of metabolic syndrome (MetS). However, no prospective studies have examined whether serum UA levels are actually associated with the development of MetS. We performed a prospective study to evaluate the longitudinal effects of baseline serum UA levels on the development of MetS. METHODS: A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010. MetS was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Cox proportional hazards models were performed. RESULTS: During 52 466.1 person-years of follow-up, 2428 incident cases of MetS developed between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% confidence intervals) for incident MetS for the second, the third, and the fourth quartile to the first quartile of serum UA levels were 1.09 (0.92-1.29), 1.22 (1.04-1.44), and 1.48 (1.26-1.73), respectively (p for trend <0.001). These associations were also significant in the clinically relevant subgroup analyses. CONCLUSIONS: Elevated serum UA levels were independently associated with future development of MetS in Korean men during the 5-year follow-up period.
Adult ; Cohort Studies ; Follow-Up Studies ; Humans ; Incidence ; Male ; Metabolic Syndrome X/*blood/*epidemiology ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Factors ; Uric Acid/*blood

Paraduodenal hernias are a rare congenital malformation, but they are the most common internal hernias. They develop secondary to a failure in midgut rotation, which may lead to small bowel obstruction or other clinical manifestations. The authors recently experienced a case of a left paraduodenal hernia presenting with unusual symptoms of left flank pain and vomiting.
Adult ; Hernia/*complications/*diagnosis/pathology/surgery ; Humans ; Intestinal Obstruction/*etiology/surgery ; Male

No abstract available.

Splenic abscess is an uncommon but frequently fatal condition. Signs and symptoms are variable and do not always include left upper quadrant pain or tenderness. Unexplained thrombocytosis in a septic patient with persistent left pleural effusion is suggestive of splenic abscess. We report a case of splenic abscess with complicated multiple fistulas by Klebsiella pneumoniae which was successfully managed by antibiotic therapy, and percutaneous catheter drainage.
Abscess* ; Catheters ; Drainage ; Fistula* ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Pleural Effusion ; Thrombocytosis

PURPOSE: Lymph node metastasis is one of the most important prognostic factors in breast cancer. Survival of patients with axillary node positive breast cancer is worse than that of patients with axillary lymph node negative breast cancer. Recently, some authors suggest that axillary dissection may be avoidable if sentinel nodes of the breast cancer do not harbour metastasis. However, 15-20 % of patients with lymph node negative breast cancer recurs within 10 years. Micrometastasis, which was missed or not detected in routine histologic examination, is thought to be one of the reasons for recurrence of axillary node negative breast cancer patients. METHODS: We investigated the frequency of micrometastasis and any clinical significance of micrometastasis in the breast cancer by immunohistochemical staining with anti-cytokeratin antibody from July, 1996 to November, 1990. 70 patients who underwent curative resection for axillary node negative breast cancer were studied retrospectively. We used paraffin blocks of lymph nodes which did not show metastasis by conventional pathological examination. After preparation of tissue blocks with a serial sectioning technique, specimens were stained by an immunohistochemical method using anti-cytokeratin antibody. Hematoxylin-eosin stainings were also repeated. We define metastasis less than 2mm as a micrometastasis. RESULTS: The results showed that micrometastasis were found in 8 of 70 cases(11.4%). There was a significant relationship between the micrometastasis and tumor size. With median follow-up of 20 months, we found 3 recurrences in 70 patients. : 2 recurrences(3.2%) in the 62 axillary node negative breast cancer patients and 1 recurrences(12.5%) in 8 micrometastasis patients. CONCLUSIONSThe results showed that micrometastasis of lymph node in breast cancer might increase the rick for development of breast cancer recurrence. But, there was no significant relationship between the micrometastasis and recurrence of breast cancer because of small numbers of recurrences and relatively short follow-up period. Long tern follow-up will be needed for further evaluation.
Animals ; Breast Neoplasms* ; Breast* ; Charadriiformes ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Paraffin ; Recurrence ; Retrospective Studies

To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6+/-10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6+/-6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had transmural infarctions and 8 had subendocardial infarctions. Indications of operations were primary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6+/-0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5%. Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak points in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.
Cardiopulmonary Bypass ; Coronary Artery Bypass ; Diagnosis ; Emergencies ; Female ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Myocardial Revascularization ; Risk Factors ; Survival Rate ; Transplants ; Ventricular Septal Rupture

Fibromatosis of the breast is a rare tumor. We describe here a case of mammary fibromatosis in a 37-year-old woman. The mass from the right breast was 3 cm at the greatest dimension. The lesion was poorly circumscribed, firm and white-gray on the cut surface. Histologically, the lesion infiltrated into the lobules of the breast, and the tumor was composed of relatively uniform fibroblasts and collagen. Neither mitotic activity nor cellular atypia was seen. On the immunohistochemistry, the cells were positive for vimentin and they were focally positive for smooth muscle actin. Staining results for estrogen receptor and progesterone receptor were negative.
Actins ; Adult ; Breast Neoplasms ; Breast* ; Collagen ; Estrogens ; Female ; Fibroblasts ; Fibroma* ; Humans ; Immunohistochemistry ; Muscle, Smooth ; Receptors, Progesterone ; Vimentin