No abstract available.
Caroli Disease*

PURPOSE: The purpose of this study was to analyze any effectiveness, advantages, and the procedure of an ultrasound-guided suprascapular nerve block via the proximal approach in patients suffering from shoulder pain. MATERIALS AND METHODS: A total of 51 patients treated with nerve block between November 2015 and November 2016 were analyzed. We identified the suprascapular nerve that branches off the superior trunk of the brachial plexus, and found the suprascapular nerve, which is located in the fascial layer between the inferior belly of the omohyoid muscle and the serratus anterior muscle. We then performed a nerve block. We evaluated the visual analogue scale (VAS) of pre- and post-nerve block, and the visualization of the nerve, depth from the skin to the nerve, angle of needle entry, as well as complications. Moreover, we measured the visualization of the nerve, depth from the skin to the nerve in a classic approach, and compared it with the proximal approach. RESULTS: There was significant improvement (p < 0.05) in the mean VAS, from 7.1 to 3.4, without any major complications. Compared with the classic approach, we were able to identify the suprascapular nerve much better (classic 25.5%/proximal 96.1%), and the mean distance from the skin to the nerve (classic 38 mm/proximal 12 mm) was significantly short (p < 0.05), and the mean angle of needle entry was 19 degrees in the proximal approach. CONCLUSION: In an ultrasound-guided suprascapular nerve block by proximal approach, the nerve and needle tip can be more easily identified, which increases accuracy; with a small amount of local anesthetic, more effective pain control can be achieved. Hence, this approach is an effective alternative pain control method for patients suffering from shoulder pain.
Brachial Plexus ; Humans ; Methods ; Needles ; Nerve Block* ; Shoulder ; Shoulder Pain ; Skin ; Ultrasonography

Langerhans cell histiocytosis is a rare disease entity in which various tissue are infiltrated by proliferating histiocytes. Involvement of alimentary tract is rare (<5%), especially in the stomach. Only seven cases of gastric Langerhans cell histiocytosis have been reported in Enlglish literature. Diabetes insipidus is the most common endocrinologic complication. We report a case of Langerhans cell histiocytosis involving stomach and pituitary stalk. The diagnosis of gastric Langerhans cell histiocytosis and diabetes insipidus was based on gastric mucosal biopsy specimen from a Korean man with suspicious hypertrophic gastric folds of gastric body, water deprivation test and sella MRI.
Biopsy ; Diabetes Insipidus ; Diagnosis ; Histiocytes ; Histiocytosis, Langerhans-Cell* ; Magnetic Resonance Imaging ; Pituitary Gland ; Rare Diseases ; Stomach ; Water Deprivation

No abstract available.
Classification* ; Risk Factors* ; Trophoblastic Neoplasms* ; Trophoblasts*

Oncocytic Schneiderian papilloma (OSP) is a rare neoplasm of the nose and paranasal sinuses, and is often mistaken histologically for papillary adenocarcinoma or even rhinosporidiosis. Recently, we experienced a case of oncocytic Schneiderian papilloma of the left maxillary sinus developed in 53-year-old female patient. She complained of unilateral nasal obstruction, bloody rhinorrhea and frontal headache. The tumor mass was resected surgically through intranasal endoscopic and Caldwell-Luc's approach. We report its clinical manifestations and histologic characteristics.
Adenocarcinoma, Papillary ; Female ; Headache ; Humans ; Maxillary Sinus* ; Middle Aged ; Nasal Obstruction ; Nose ; Papilloma* ; Paranasal Sinuses ; Rhinosporidiosis

PURPOSE: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. MATERIALS AND METHODS: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. RESULTS: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). CONCLUSION: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.
Follow-Up Studies ; Humans ; Range of Motion, Articular ; Shoulder ; Tenodesis

Nonsurgical drainage of malignant obstructive jaundice is an interesting alternative to surgical drainage in the palliative treatment of pancreaticobiliary neoplasms. Biliary drainage by endoprosthesis is as effective and better supported than percutaneous external drainage, but more difficult to control. Endoscopic retograde biliary drainage (ERBD) is a safe and effective biliary drainage procedure, and is indicated with malignant obstructive jaundice in patients on whom endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) can be performed. A nonoperative method of palliation was used in patients with malignant obstructive jaundice, in whom a biliary endoprosthesis could not be placed endoscopically due to complete obstruction of the bile duct. A guide wire was manipulated through the lesion by a percutaneous transhepatic route, after puncturing the tumor by a fine needle, and retrieved from the duodenum through an endoscope. A stent was then passed through the endoscope over the guide wire across the stricture.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Drainage ; Duodenum ; Endoscopes ; Humans ; Jaundice, Obstructive ; Needles* ; Palliative Care ; Punctures* ; Sphincterotomy, Endoscopic ; Stents*

Patients with lysosomal acid lipase (LAL) deficiency and glycogen storage disease (GSD) demonstrated hepatomegaly and dyslipidemia. In our case, a 6-year-old boy presented with hepatosplenomegaly. At 3 years of age, GSD had been diagnosed by liver biopsy at another hospital. He showed elevated serum liver enzymes and dyslipidemia. Liver biopsy revealed diffuse microvesicular fatty changes in hepatocytes, septal fibrosis and foamy macrophages. Ultrastructural examination demonstrated numerous lysosomes that contained lipid material and intracytoplasmic cholesterol clefts. A dried blood spot test revealed markedly decreased activity of LAL. LIPA gene sequencing identified the presence of a novel homozygous mutation (p.Thr177Ile). The patient's elevated liver enzymes and dyslipidemia improved with enzyme replacement therapy. This is the first report of a Korean child with LAL deficiency, and our findings suggest that this condition should be considered in the differential diagnosis of children with hepatosplenomegaly and dyslipidemia.
Biopsy ; Child* ; Cholesterol ; Diagnosis, Differential ; Dyslipidemias ; Enzyme Replacement Therapy ; Fibrosis ; Glycogen Storage Disease ; Hepatocytes ; Hepatomegaly ; Humans ; Liver ; Lysosomes ; Macrophages ; Male ; Sterol Esterase*

Patients with lysosomal acid lipase (LAL) deficiency and glycogen storage disease (GSD) demonstrated hepatomegaly and dyslipidemia. In our case, a 6-year-old boy presented with hepatosplenomegaly. At 3 years of age, GSD had been diagnosed by liver biopsy at another hospital. He showed elevated serum liver enzymes and dyslipidemia. Liver biopsy revealed diffuse microvesicular fatty changes in hepatocytes, septal fibrosis and foamy macrophages. Ultrastructural examination demonstrated numerous lysosomes that contained lipid material and intracytoplasmic cholesterol clefts. A dried blood spot test revealed markedly decreased activity of LAL. LIPA gene sequencing identified the presence of a novel homozygous mutation (p.Thr177Ile). The patient's elevated liver enzymes and dyslipidemia improved with enzyme replacement therapy. This is the first report of a Korean child with LAL deficiency, and our findings suggest that this condition should be considered in the differential diagnosis of children with hepatosplenomegaly and dyslipidemia.
Biopsy ; Child* ; Cholesterol ; Diagnosis, Differential ; Dyslipidemias ; Enzyme Replacement Therapy ; Fibrosis ; Glycogen Storage Disease ; Hepatocytes ; Hepatomegaly ; Humans ; Liver ; Lysosomes ; Macrophages ; Male ; Sterol Esterase*

Spontaneous herniation of the spinal cord is a very rare. It's clinical symptom presents with progressive myelopathy. A 42-year old male patient who presented the progressive left leg weakness and Brown-Seqaurd syndrome is presented. MRI showed a typical finding of dural defect and herniation of the cord on the level of T3-4. Repair of dural defect using an artificial dura and reposition of cord herniation were undertaken after three level laminectomies with SSEP monitoring. Postoperatively, symptoms were improved rapidly. In our knowledgement,this is first case being reported in Korea. This entity, although rare, should be considered in the differential diagnosis of myelopathy in the absence of a mass lesion.
Adult ; Brown-Sequard Syndrome ; Diagnosis, Differential ; Humans ; Korea ; Laminectomy ; Leg ; Magnetic Resonance Imaging ; Male ; Spinal Cord Diseases ; Spinal Cord*