The diagnosis of a Battered Child Syndrome is made by the pediatrician, surgeon and the radiologist because almost parents deny the diagnosis or refuse to answer the doctor's questions. The imaging modalities play a key role in the investigation and documentation of the battered child syndrome, because of the high frequency of the typical skeletal lesion. Although physical abuse is denied by parents, the recognition of this entity is possible by the primary diagnostic imaging study in the suspected child abuse. The imaging studies are either a bone scan and x-ray series or a complete radiolographic skeletal survey by X-ray series. In an expected intracranial injury, a CT scan of the head is mandatory We experienced a case of Battered Child Syndrome in a 6 month-old male infant who had subdural hemorrhage and fractures of skull and ribs in different stages of healing and repair. The brief review of the literature was made.
Battered Child Syndrome* ; Child ; Child Abuse ; Diagnosis ; Diagnostic Imaging ; Head ; Hematoma, Subdural* ; Humans ; Infant ; Male ; Parents ; Ribs ; Skull ; Tomography, X-Ray Computed

A retrospective review was performed of 297 patients admitted to Chung Ang Gil Hospital between June 1995 and December 1996 with a diagnosis of blunt chest trauma. Of these patients, 34% suffered either immediate or delayed complications. Immediate complications included hemothorax in 58.8%, pneumothorax in 26.5%, and pulmonary contusion in 20.5%. Delayed complications occurred in 9.1% of patients overall; these included pulmonary contusion in 12.7%, pneumonia in 9.8%, pulmonary embolism in 2%, poeumothorax in 2%, and hemothorax in 2%. The mean age of the patients were 43 years. 210 patients(70.7%) were under age 50 and 87(29.3%) were 50 years of age or older. Male to female ratio was 1.9:1. Mean Initial Revised Trauma Score (RTS) and the Injury Severity Score (ISS) were 7.10+/-0.94 and 14+/-8.69, respectively. There were associated injuries in 225(75.8%) patients. Overall mortality rate was 7.1% and the mortality rate was significantly greater in patients with a RTS<6, ISS>or=16, associated injuries, advanced age(50 years of age or older), and pulmonary complications. Pulmonary complications were significantly greater in patients with a RTS<6, ISS>or=16, and an associated injuries.
Contusions ; Diagnosis ; Female ; Hemothorax ; Humans ; Injury Severity Score ; Male ; Mortality* ; Pneumonia ; Pneumothorax ; Pulmonary Embolism ; Retrospective Studies ; Thorax*

Verrucous carcinoma of the oral cavity is a rare tumor representing 4.5-9.0% of oral squamous tumors. Involvement of the lip is less common within the oral cavity. It presents as a slowly enlarging, exophytic warty growth with extensive local invasion, though well-differentiated and rarely metastaticl. We herein repart a case of verrucous carcinoma on the lower lip in a 31-year-old man.
Adult ; Carcinoma, Verrucous* ; Humans ; Lip* ; Mouth

Cutaneous metastasis from renal cell carcinoma is not unusual, occurring in 3 to 7%, although it may be overlooked. We report a case of metastatic renal cell carcinoma in a 74-year-old man who was presented with a 1.5 x 1.5 x 0.5 cm-sized nodule on the right zygoma for 3 months. A skin biopsy demonstrated the typical clear cell adenocarcinoma with PAS(+) granules in the cytoplasm and honeycombed or glandular configuration, compatible with metastatic renal cell carcinoma. Kidney ultrasonogram and abdomina1 CT scanning showed a large cystic mass on the upper pole of the left kidney. Furthermore radiologic studies revealed multiple metastatic lesions in the lung, liver and brain. He died 4 months later.
Adenocarcinoma, Clear Cell ; Aged ; Biopsy ; Brain ; Carcinoma, Renal Cell* ; Cytoplasm ; Humans ; Kidney ; Liver ; Lung ; Neoplasm Metastasis ; Skin ; Tomography, X-Ray Computed ; Ultrasonography ; Zygoma*

PURPOSE OF STUDY: To compare on bone formation between ovariectomized rats and normal rats after graft of alloplastic bone material. MATERIAL AND METHODS: Twenty female rats were used in this study. They were divided into two groups by each ten rats. One group was ovariectomized and grafted alloplastic bone material. Other group was non-ovariectomized and grafted alloplastic bone material. After a healing time of 4 weeks, the animals were sacrificed and decalcified preparations were routinely processed for histologic evaluations. RESULTS: Ovariectomy group was significantly lesser bone formation compared with non-ovariectomy group. CONCLUSIONS: Ovariectomy acts as a negative factor in new bone formation.
Animals ; Female ; Humans ; Osteogenesis ; Ovariectomy ; Rats ; Transplants

Nitric Oxide(NO) has been known to be endothelium-derived relaxing factor in blood vessels, and to be nonadrenergic-noncholinergic(NANC) neurotransmitter involved in the relaxation of corpus cavernosum smooth muscle of man and rabbit. This study was initiated to determine NANC inhibitory neurotransmission in the canine corpus cavernosum. Using organ bath, isometric tension measurements were made in strips of canine corpus cavernosum. Transmural electrical stimulation of corporal tissue strips, in the presence of adrenergic blockade with bretylium and muscarinic receptor blockade with atropine, caused frequency-dependent relaxation. This relaxation was inhibited significantly by nitric oxide synthase inhibitor, N-nitro-L-arginine methyl ester(L-NAME). Our findings suggest that there should be nonadrenergic-noncholinergic neurotransmitter in the canine corpus cavernosum smooth muscle and it could be nitric oxide. Canine erectile tissue might serve as in vitro model for further investigation of corpus cavernosal smooth muscle pathophysiology.
Atropine ; Baths ; Blood Vessels ; Electric Stimulation ; Endothelium-Dependent Relaxing Factors ; Muscle, Smooth* ; Neurotransmitter Agents ; Nitric Oxide Synthase ; Nitric Oxide* ; Receptors, Muscarinic ; Relaxation* ; Synaptic Transmission

Takayasu's arteritis(TA) is a nonspecific areritis of unknown etiology affecting segmentally the aorta and its main branches, which result in stenosis, occlusion or aneurysm of involved arteries. The clinical manifestations present with a variety of symptoms such as headache, dyspnea on exertion, pain and weakness of extremities, pulse deficit, and hypertension according to involves arteries. Usually it can be managed by medical or surgical treatment, and recently by percutaneous transluminal balloon angioplasty. The type III classified by Lupi-Herrena and associates is the most frequent variety of TA. However the case of type III involving both subclavin arteries and both renal arteries has rarely been reported. We experienced a case of TA involving both subcalvian arteries, and both renal arteries presented with paroxysmal hypertension and right flank pain, in which the stenosis of both subclavian arteries were managed by percutaneous transluminal balloon angioplasty and the stenosis and occlusion of both renal arteries were successfully managed by aorto-renal bypass surgery with autogenous right iliac artery and synthetic vessel(Gortex). The patient was discharged uneventfully.
Aneurysm ; Angioplasty, Balloon ; Aorta ; Arteries* ; Constriction, Pathologic* ; Dyspnea ; Extremities ; Flank Pain ; Headache ; Humans ; Hypertension ; Iliac Artery ; Renal Artery* ; Subclavian Artery ; Takayasu Arteritis*

BACKGROUND AND OBJECTIVES: As septal surgery is being performed more and more often, the incidence of septal perforation as a complication arising from the surgery has also increased. In septal surgery, if corresponding mucoperichondrial tears occurred on both sides, autologous cartilage is usually placed between the injured mucopercondrium. However, septal perforation is sometimes found after septal surgery even after this effort. The aims of this study were to introduce a new technique for the prevention of septal perforation during septal surgery using inferior turbinate mucosa and fibrin glue and to determine its usefullness by evaluating the treatment outcome. MATERIALS AND METHODS: Between June 2005 and May 2007, 358 cases of septal surgery were performed. Bilateral mucoperichondrial tears on corresponding areas occurred in 26 cases. In Group 1 (15 cases), autologous cartilage was inserted between injured mucoperichondrium. In Group 2 (11 cases), autologous cartilage was inserted and then was repaired using fibrin glue and inferior turbinate mucosa. The authors compared the perforation rate between the two groups. RESULTS: In Group 1, septal perforation occurred in 7 of 15 patients (46.7%) and in Group 2, 1 of 11 patients (9.0%) had perforation. Perforation rates were significantly lower in Group 2. CONCLUSION: The technique of using fibrin glue and inferior turbinate mucosa may be an easy, effective method for the prevention of septal perforation during septal surgery.
Cartilage ; Fibrin ; Fibrin Tissue Adhesive ; Humans ; Incidence ; Mucous Membrane ; Turbinates

BACKGROUND AND OBJECTIVES: In radiofrequency surgery, energy is usually delivered to the submucosal tissue of the palate through a special probe in order to reduce the volume and rigidity (palatal channeling). However, the same probe can be used to make cuts in the free edge of the soft palate, as in laser-assisted uvulopalatoplasty [radiofrequency-assisted uvulopalatoplasty (RAUP)]. The objective of the current study was to evaluate the role of RAUP with tonsillectomy for the treatment of mild or moderate obstructive sleep apnea (OSA). MATERIALS AND METHODS: Eighty-two patients with mild to moderate obstructive sleep apnea (5< or =AHI<30, BMI<30) were included in this clinical trial. All patients received RAUP with tonsillectomy. Patients were followed for six months and were asked to respond to a questionnaire regarding standard visual analogue score pattern. Assessment was performed prior to the surgery and was repeated six month postoperatively. Visual analogue scores were measured for the parameters of pain, speech deficits, dysphagia and snoring (according to the partner). The Epworth sleepiness scale (ESS) was also utilized. Polysomnography was conducted preoperatively and was repeated six months postoperatively. RESULTS: There were significant differences in improvement of snoring, ESS and AHI before and after the procedure, and the success rate of the surgical treatment was 62%. Postoperative pain, speech disturbance, dysphagia were decreased two weeks after the operation. CONCLUSION: The results of the study suggest that RAUP with tonsillectomy is an effective treatment for patients with mild to moderate obstructive sleep apnea.
Deglutition Disorders ; Humans ; Pain, Postoperative ; Palate ; Palate, Soft ; Polysomnography ; Sleep Apnea, Obstructive ; Snoring ; Tonsillectomy ; Surveys and Questionnaires

BACKGROUND/AIMS: The correct histological diagnosis of gastric adenoma is important, because it has been reported to be precancerous lesion and associated with focal gastric carcinoma. However, there is some discrepancy between the histology of the forceps biopsy and that of the endoscopic resection. In this study, we compared the histologic findings of gastric mucosal elevated lesion between the specimens of forceps biopsy and endoscopic resection. METHODS: We reviewed retrospectively 137 cases of gastric mucosal elevated lesion which had been removed by the resection such as polypectomy or endoscopic mucosal resection. All patients had undergone forceps biopsy before endoscopic resection. We compared the histologic findings of the specimens by forceps biopsy with those by resection. RESULTS: The histologic fidings were accordant at 101 of the 137 cases (73.7%), and different at 30 cases (21.9%). Among the 86 cases with adenoma in the biopsied specimens, 10 cases (11.6%) were finally diagnosed as gastric cancer in the resected specimens. CONCLUSIONS: Because biopsy specimens may not be presentative of the entire lesion, endoscopic resection of gastric mucosal elevated lesion is needed for accurate histologic diagnosis and treatment if adenoma is suspected.
Adenoma ; Biopsy* ; Diagnosis ; Humans ; Retrospective Studies ; Stomach Neoplasms ; Surgical Instruments*