Hereditary theory was first proposed by Joachimsthal in 1905. However, a family history of congenital muscular torticollis is uncommon. This is a report of two female children who are interrelated and have congenital muscular torticollis. They are sisters. No environmental factor could be identified that would predispose the the children to congenital muscular torticollis. In this family, it is apparent that genetic factors are influencing the development of this condition. The cause of congenital muscular torticollis is unknown, but heredity may play a more important role than has previously been supected.
Child ; Female ; Heredity ; Humans ; Siblings ; Torticollis

Tibia valga has been described as a consequence of non-displaced fractures of the proximal metaphysis of the tibia in children. There has been considerable speculation about the cause of this deformity. Four cases of estabilished valgus deformity following injury to the proximal tibia metaphysis in children are presented. In one case of them, it was showed that an infolding of a portion of the periosteum of the tibiain medial opening of this fracture. It was treated by surgical clearence of the infolding periosteum and varus osteotomy with slight over-correction and partial fibulectomy. The recurrence of valgus deformity was absent during post operative one year. In another case, roentgenogram showed an asymmetrical growth arrest line of the pmximal tibia. The presence of asymmetrical growth arrest lines in the pmximal metaphysis of the tibia demonstrates that the valgus deformity in this patient was caused by overgrowth of the medial portion of the proximal tibial epiphyseal plate. In the remainder, we observed the deformity developed without any specific cause.
Child ; Congenital Abnormalities ; Growth Plate ; Humans ; Osteotomy ; Periosteum ; Recurrence ; Tibia

We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.
Cysts

The authers describe a case of huge tentorial meningioma in 32 year old female patient. Her clinical complaints were bifrontal headache and visual impairment. CT scan revealed huge supratentorial and infratentorial enhanced tumor mass. The tumor mass was removed in one stage.
Adult ; Female ; Headache ; Humans ; Meningioma* ; Tomography, X-Ray Computed ; Vision Disorders

No abstract available.
Humans

Reverse total shoulder arthroplasty (RTSA) is an effective surgical method for rotator cuff tear arthropathy, irreparable cuff tear, complex fracture of the proximal humerus, and revision after anatomical total shoulder arthroplasty. As the scope of application and the number of trials have increased recently, there have been reports of scapular notching, glenoid loosening, infection or peri-scapular fractures. On the other hand, there are no reports of concomitant fractures of the coracoid and acromion after RTSA. The authors experienced two cases with concomitant fractures of the coracoid and acromion after RTSA. This paper reports these cases with a literature review and discusses the causes.

BACKGROUND: To decrease the risk of pulmonary aspiration of gastric contents, patients are routinely asked not to eat or drink anything for at least 6 to 8 hours before surgery. We studied to evaluate whether the volume and pH of gastric fluid immediately after induction of anesthesia is correlated with water ingestion. METHODS: Fifty patients, scheduled for elective surgery, were randomly divided into two groups. Control group(n=25) were fasted overnight and received no water. Experimental group(n=25) were fasted overnight and received 150 ml water approximately 2 hours before the induction of anesthesia. Gastric fluid was obtained via multiorifice gastric tube with the patient in three different positions. The volume of gastric fluid was recorded and its pH was measured. RESULTS: The gastric volumes were no differences between the two groups. The gastric pH values were significant differences. The incidence of patients with the high risk factors of gastric volume greater than 25 ml and pH less than 2.5 was decreased in experimental group. CONCLUSIONS: We concluded that surgical patients could be permitted to ingest 150 ml water approximately 2 hours before the induction of anesthesia.
Adult* ; Anesthesia ; Eating* ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Risk Factors ; Water*

PURPOSE: To determine patient's use of alternative cancer therapies, as well as the characteristics of the patients who used these therapies, descriptive study was conducted at the one college hospital in Seoul. MATERIALS AND METHODS: Of 950 eligible patients who discharged from October 1, 1996 to Febrary 28, 1997, 283 patients were completed semistructured questionnaire telephone survey finally(response rate is 29.8%). RESULTS: Alternative therapies were used by 53.0% of patients. The preferred was dietary therapies and oriental(herbs, acupucture) therapies, folk therapies, drug therapies were other popular methods. Any patient characteristics except time prolongation after diagnosis were not associated with use of alternative therapies. The patients were seeking for alternative therapy because they thought conventional medical treatments were not enough to expect to improve their health, The major source of information was relatives and friends, not the mass media. 46.6% of the patients used althenative therapy said that it were not effective but 30.4% of them said it would help to slow the progression of their disease or strengthen their resistance. 45.0% of them were satisfied with it. CONCLUSION: A significant proportion of cancer patients use one or more forms of alternative therapy. The physicians should recognize and give due consideration to the patients underlying desire for better control of his disease, and should be able to advise his patients on the use of alternative therapy.
Complementary Therapies* ; Diagnosis ; Drug Therapy ; Friends ; Humans ; Mass Media ; Surveys and Questionnaires ; Seoul ; Telephone

A median-to-ulnar nerve communication in the forearm (Martin-Gruber anastomosis, MGA) is not rare. Awareness of this anastomosis is important in the clinical and electrodiagnostic evaluation of median and ulnar nerves. According to the muscles innervated by the crossover, three types have been classified. However, there are very few detailed studies of their incidence and combinations. Thus we studied detailed electrophysiologic aspects of MGA to determine their incidence and types. The crossing fibers were detected bilaterally with surface recording electrodes over thenar, hypothenar, and first dorsal interosseous muscles of 112 unselected subjects. 49 males and 63 fema]es. MGA was found in 37(33%) subjects, in 52(23%) limbs. The anomaly was bilateral in 15(41%) of the subjects. Type II was seen in all the MGAdetected 52 limbs (100%), type I in 24 (4696), and type m in 2(4%). From the viewpoint of MGA-detected pattern the pure form of type- II was in 27 limbs(52%), the combination of type II and I in 23(44%), the combination of type I, II and m in 1(2%), and the combination of type Il and m in 1(2%). The mean amplitude and amplitude ratio of the anomalous response were highest at the first dorsal interosseous muscle, which were 3.5mV and 22%. Since the crossing fibers in MGA innervate most commonly the first dorsal interosseous, recordig of this muscle is essential to evaluate the contribution of MGA to median and ulnar nerve lesions.
Electrodes ; Extremities ; Forearm ; Humans ; Incidence ; Male ; Muscles ; Ulnar Nerve

Since the development of magnetic stimulation as a way of assessing the functions of corticospinal pathways, diseases involving central motor pathways have been investigated by motor evoked potentials(@). However, studies correlating MEP findings and the neurological deficits were rarely carried out in patients with stroke. In this study, transcranial magnetic stimulation of the motor cortex and lower cervical area was performed in 50 patients with acute stroke and 23 healthy volunteers. Follow-up tests were performed in 22 patients about I month@ later. The amplitudes of @ were significantly reduced (P=0.0001), and central motor conduction time (CMCT) was significantly delayed (P=0.0004) in stroke patients compared to the normal controls. The abnormalities of MEP were closely related to the initial motor deficits. The cortical MEP findings in patients with cortical infarction and pontine infarction were more severe than those obtained in patients with subcortical I lesion. Initial MEP findings showed good correlation with the final functional outcome of the patients. The shortened latencies of follow-up MEP were significantly (P=0.0266) related to the improvement of the patients' motor deficit. These results illustrate that the results of magnetic stimulations are related to the prognosis of patients with stroke, and suggest that MEP may be I used in the monitoring their neurological or functional progress.
Efferent Pathways ; Evoked Potentials, Motor* ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Infarction ; Motor Cortex ; Prognosis ; Stroke* ; Transcranial Magnetic Stimulation