1.Comparison of Electroencephalography, Neuroimaging Studies and Surgical Outcome between Mesial and Neocortical Temporal Lobe Epilepsies.
Journal of Korean Epilepsy Society 2001;5(2):151-155
PURPOSE: To compare the diagnostic value of electroencephalography (EEG), MRI and PET studies and surgical outcome in patients with medically refractory temporal lobe epilepsy due to hippocampal sclerosis (HS) versus temporal lobe lesions (TLL). METHODS: Records of 122 consecutive patients who underwent surgery for epilepsy from January 1993 to April 2000 were retrieved from the MGH Epilepsy Surgery Database. Fifty eight patients with temporal lobe epilepsy due to pathologically proven HS or TLL were identified and presurgical interictal and ictal EEG, MRI, and 2-[(18)F]fluoro-2-deoxy-D-glucose (FDG)-PET data and surgical outcome were reviewed. Patients with dual or normal pathology were excluded. Pathologically proven HS was present in 32 patients, and 26 patients has temporal lobe lesions (cortical dysplasia in 6 patients, vascular malformation in 6, gliomas in 5, DNET in 4, heterotopia in 1, other pathologies in 4). Comparisons of the diagnostic value of EEG, MRI and FDG-PET studies were performed in 43 patients who were seizure-free after epilepsy surgery. Among 43 patients, HS was in 24 patients and TLL in 19. RESULTS: The occurrence of abnormal interictal and ictal EEG, MRI and FDG-PET findings in the side of operation was not significantly different between patients with HS and with TLL respectively. There was no significant difference in at least one year follow-up surgical outcome between the two groups. CONCLUSIONS: Diagnostic value of presurgical interictal and ictal EEG, MRI and FDG-PET findings, and surgical outcome were not different in patients with mesial versus neocortical temporal lobe epilepsies.
Electroencephalography*
;
Epilepsy
;
Epilepsy, Temporal Lobe*
;
Follow-Up Studies
;
Glioma
;
Humans
;
Magnetic Resonance Imaging
;
Neuroimaging*
;
Pathology
;
Sclerosis
;
Temporal Lobe*
;
Vascular Malformations
2.Additional Diagnosis of Brain Death by Transcranial Doppler.
Kwang S LEE ; Young J KIM ; Young B CHOI ; Beum S KIM
Journal of the Korean Neurological Association 1993;11(4):527-532
Ever since transplant surgery became a common procedure. The early diagnosis of irreversible cessation of cerebral function has become an important need We analysed the findings of transcranial doppler of five cases. Two was diagnosed brain death by currently accepted criteria. Two cases showed absence of intracranial blood flow and normal to disturbed flow status of the cervical carotid artery. Three cases showed reverberating flow pattern with reflux phenomenon. Transcranial doppler investigation seems to provide a practical, non-invasive. And reliable disgnostic evidence for the arrest of cerebral circulation.
Brain Death*
;
Brain*
;
Carotid Arteries
;
Diagnosis*
;
Early Diagnosis
3.Extracranial Metastasis of Supratentorial Ependymoma without Recurrence of Primary Focus.
Han Kyu KIM ; Soon Chul KIM ; Kyoung Ki CHO ; Kwang Myung KIM ; David J SEEL ; Je G CHI
Journal of Korean Neurosurgical Society 1981;10(2):731-738
A case of supratentorial ependymoma in a 48-year-old man. After operation and radiological treatment, metastasis to scalp and cervical lymph node occurred, without recurrence of primary focus. 11 cases of intracranial ependymoma with extracranial metastasis were reviewed. Metastasizing intracranial ependymomas are 3 times as frequent in males and originate above tentorium. The most effective transmission of metastasis of ependymoma is through the blood stream and the frequent sites of metastasis are lungs, pulmonary hilus, mediatinum, liver, scalp, vertebra, femoral bone and cervical lymph nodes. Our case is the oldest among reported cases and metastasized to relatively rare site.
Ependymoma*
;
Humans
;
Liver
;
Lung
;
Lymph Nodes
;
Male
;
Middle Aged
;
Neoplasm Metastasis*
;
Recurrence*
;
Rivers
;
Scalp
;
Spine
4.A Case of Hemimasticatory spasm.
Yong J KIM ; Kwang S LEE ; Jung H NA ; Beum S KIM ; Young Jin KO
Journal of the Korean Neurological Association 1994;12(1):175-178
Hemimasticatory spasm is a rare disorder that often accompanies facial hemiatrophy and is characterized by spasm in one or more of the jaw-closing muslces supplied by the fifth cranial nerve. We report a clinical and electrophysiological observation of a patient of hemimasticatory spasm, who presented involuntary spasm on masseter muscle and hemiatrophy of the face on the right side for 7 years.
Facial Hemiatrophy
;
Humans
;
Masseter Muscle
;
Spasm*
;
Trigeminal Nerve
5.Chemocauterization of Congenital Fistula from the Accessory Parotid Gland.
J Hun HAH ; Bong Jik KIM ; Myung Whun SUNG ; Kwang Hyun KIM
Clinical and Experimental Otorhinolaryngology 2008;1(2):113-115
Congenital sialo-cutaneous fistula arising from the accessory parotid gland is extremely rare. Although the fistula tract can be successfully excised after making a skin incision along the skin tension line around the fistula opening, a facial scar inevitably remains. We here report a case of sialo-cutaneous fistula that was treated with chemocauterization with trichloroacetic acid (TCA). TCA cauterization is an easy and effective option for the treatment of congenital fistula from an accessory parotid gland, especially from the aesthetic point of view.
Cicatrix
;
Fistula
;
Parotid Gland
;
Skin
;
Trichloroacetic Acid
6.Follicular Thyroid Carcinoma Presenting as Bilateral Cheek Masses.
Dong Wook KIM ; J Hun HAH ; Soo Youn AN ; Hak CHANG ; Kwang Hyun KIM
Clinical and Experimental Otorhinolaryngology 2013;6(1):52-55
Mandibular metastasis of thyroid carcinoma is extremely rare. We present the case of a 46-year-old woman who had bilateral huge cheek masses that had grown rapidly over several years. Intra-oral mucosal tissue biopsy and imaging work-up including computed tomography scan and magnetic resonance imaging were performed and the initial diagnosis was presumed to be central giant cell granuloma. Incidentally detected thyroid lesions were studied with ultra-sonography guided fine needle aspiration and diagnosed as simple benign nodules. Due to continuous oral bleeding and the locally destructive feature of the lesions, we decided to excise the mass surgically. To avoid functional deficit, a stepwise approach was performed: Firstly, the larger left mass was excised and the mandible was reconstructed with a fibular free flap. The final pathologic diagnosis was follicular thyroid cancer. Postoperative I-131 thyroid scan and whole body positron-emissions-tomography were performed. Right side mass was revealed as a thyroid malignancy. Multiple bony metastases were detected. Since further radioactive iodine therapy was required, additional total thyroidectomy and right side mandibulectomy with fibular free flap reconstruction was performed. The patient also underwent high dose radioactive iodine therapy and palliative extra-beam radiotherapy for the metastatic lumbar lesion. Follicular thyroid carcinoma should be considered as a differential diagnosis for mandibular mass lesions.
Adenocarcinoma, Follicular
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Biopsy
;
Biopsy, Fine-Needle
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Cheek
;
Diagnosis, Differential
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Female
;
Free Tissue Flaps
;
Granuloma, Giant Cell
;
Hemorrhage
;
Humans
;
Iodine
;
Magnetic Resonance Imaging
;
Mandible
;
Mucous Membrane
;
Neoplasm Metastasis
;
Thyroid Gland
;
Thyroid Neoplasms
;
Thyroidectomy
7.Investigation on Patients' Understanding and Concern about the Disease and Recovery Rate in Thyroidectomy Patients to Enhance Satisfaction of Hospitalization.
Chang Myeon SONG ; Heejin KIM ; Tack Kyun KWON ; Myung Whun SUNG ; Kwang Hyun KIM ; J Hun HAH
Korean Journal of Otolaryngology - Head and Neck Surgery 2010;53(9):557-563
BACKGROUND AND OBJECTIVES: Diagnosis of thyroid disease requiring surgery and subsequent thyroidectomy may affect patients' emotion and quality of life. The purpose of this study is to evaluate the patients' understanding and concern about the disease and recovery rate after thyroidectomy, and therefore to enhance the satisfaction of hospitalization. SUBJECTS AND METHOD: MethodZZSeventy-seven patients undergoing thyroidectomy in a tertiary hospital from April 2009 to October 2009 were enrolled. Questionnaires were filled out on the admission day, discharge day, and 2 weeks after operation. Questionnaires consisted questions regarding the understanding of the disease, details of concern, recovery rate after surgery, and satisfaction on hospitalization duration. Retrospective chart review was also performed. RESULTS: Many patients (42.9%) acquired their knowledge of thyroid cancer through the internet. The possibility of voice change was the major concern before surgery (46.8%), whereas the major postoperative concern was adjuvant therapy (37.7%). The patient group with higher understanding of the disease showed higher recovery rate than the others at the time of discharge (mean postdischarge surgical recovery 67.4% vs. 55.3%, p=0.01). The patient group with lower understanding wanted longer hospitalization than the other group at discharge (p<0.001). CONCLUSION: Patient education about the thyroid disease may reduce patients' anxiety and therefore may enhance subjective recovery rate and satisfaction of hospitalization.
Anxiety
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Cognition
;
Hospitalization
;
Humans
;
Internet
;
Patient Education as Topic
;
Quality of Life
;
Surveys and Questionnaires
;
Retrospective Studies
;
Tertiary Care Centers
;
Thyroid Diseases
;
Thyroid Neoplasms
;
Thyroidectomy
;
Voice
8.Morphology of the temporalis muscle focusing on the tendinous attachment onto the coronoid process
Sun Kyoung YU ; Tae-Hoon KIM ; Kwang Yeol YANG ; Christopher J. BAE ; Heung-Joong KIM
Anatomy & Cell Biology 2021;54(3):308-314
The temporalis muscle is usually described as a single layer originating at the temporal line, converging to a tendon, and inserting onto a narrow site of the coronoid process. However, recent studies have shown that the temporalis muscle can be divided into two or three separate segments and the distal attachment continues inferiorly beyond the coronoid process. Therefore, the aims of this study were to analyze the morphology of the temporalis muscle focusing on the tendinous attachment onto the coronoid process and to provide educational values. The temporalis muscle was carefully dissected in 26 cadavers and classified based on the muscle fascicle direction. Each divided part was sketched and measured based on bony landmarks to elucidate its tendinous insertion site onto the coronoid process, and the results obtained were reviewed through the literature. The temporalis muscle ends at two distinct terminal tendons with wider insertion sites than usually presented in textbooks and atlases and separates into two parts that combine to act as a single structural unit. The superficial part is a large fan-shaped muscle commonly recognized as the temporalis muscle. This converges infero-medially to form the superficial tendon and the lateral boundary of the retromolar triangle. Meanwhile, the deep part is a narrow vertically oriented rectangular muscle that converges postero-laterally to form the deep tendon and the medial boundary of the retromolar triangle. These results indicate that understanding the temporalis muscle’s insertion site onto the coronoid process will be useful clinically with educational values during surgical procedures.
9.Morphology of the temporalis muscle focusing on the tendinous attachment onto the coronoid process
Sun Kyoung YU ; Tae-Hoon KIM ; Kwang Yeol YANG ; Christopher J. BAE ; Heung-Joong KIM
Anatomy & Cell Biology 2021;54(3):308-314
The temporalis muscle is usually described as a single layer originating at the temporal line, converging to a tendon, and inserting onto a narrow site of the coronoid process. However, recent studies have shown that the temporalis muscle can be divided into two or three separate segments and the distal attachment continues inferiorly beyond the coronoid process. Therefore, the aims of this study were to analyze the morphology of the temporalis muscle focusing on the tendinous attachment onto the coronoid process and to provide educational values. The temporalis muscle was carefully dissected in 26 cadavers and classified based on the muscle fascicle direction. Each divided part was sketched and measured based on bony landmarks to elucidate its tendinous insertion site onto the coronoid process, and the results obtained were reviewed through the literature. The temporalis muscle ends at two distinct terminal tendons with wider insertion sites than usually presented in textbooks and atlases and separates into two parts that combine to act as a single structural unit. The superficial part is a large fan-shaped muscle commonly recognized as the temporalis muscle. This converges infero-medially to form the superficial tendon and the lateral boundary of the retromolar triangle. Meanwhile, the deep part is a narrow vertically oriented rectangular muscle that converges postero-laterally to form the deep tendon and the medial boundary of the retromolar triangle. These results indicate that understanding the temporalis muscle’s insertion site onto the coronoid process will be useful clinically with educational values during surgical procedures.
10.Six Cases of Reconstruction with Latissimus Dorsi Pedicled Flap for Head and Neck Defects in the Era of Free Flap Reconstruction.
Hyunchung CHUNG ; Ik Joon CHOI ; Kwang Hyun KIM ; J Hun HAH
Korean Journal of Otolaryngology - Head and Neck Surgery 2011;54(2):174-178
Reconstruction with free flaps has become the choice of reconstruction for most patients with head and neck defects. However, pedicled flaps, such as pectoralis major pedicled flap and latissimus dorsi pedicled flap (LDPF), can also be used instead in selected patients. We performed LDPFs in 6 patients from November 2007 to September 2009. Five of the patients were females with either vascular diseases or large skin defects, or they were highrisk old patients. One male patient received LDPF as a salvage after tongue reconstruction with a free flap failed. Various types of head and neck defects were effectively managed with LDPF without complications. LDPF can be one option for head and neck reconstruction especially in patients who may hve high risk in undergoing free flap reconstruction.
Female
;
Free Tissue Flaps
;
Head
;
Humans
;
Male
;
Neck
;
Skin
;
Surgical Flaps
;
Tongue
;
Vascular Diseases