No abstract available.
Thyroid Gland* ; Thyroid Nodule*

The authors presented 9 cases of surgically treated CSF rhinorrhea, two of which were spontaneous and 7 were traumatic delayed. The duration of leakage was longer than 1 month in most cases and seven of the nine cases were complicated by meningitis. The leakage site was most accurately detected by metrizamide computed tomographic cisternography(MCTC) and the most frequent leakage site was the cribriform plate. Good surgical results were obtained by direct repair and/or shunt without recurrence during follow-up period from 7 months to 2 years.
Cerebrospinal Fluid Rhinorrhea ; Ethmoid Bone ; Follow-Up Studies ; Meningitis ; Metrizamide ; Recurrence

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis

To evaluate the effectiveness and to find out which grade(clinical and computed tomography) of subarachnoid hemorrhage(SAH) patients are most effected with the medication of the calcium antagonist, we did this study. We selected 339 cases(study cases) among a total of 603 cases of SAH who were admitted to our hospital from Sept. 1982 to Aprial 1991. The criteria of study cases are patients who were admitted and who had a brain computed tomography(CT) taken within 3 days after the SAH and who had a clinical grade(Hung & Hess) on admission between I-IV. We divided study cases into 3 groups. Group I:surgery was done more than 7 days after the SAH and together with non-surgical patients, no medication was used(N=126). Group II:surgery was done more than 7 days after teh SAH and together with non-surgical patients medication of the calcium antagonist was given orally(N=120). Group III:surgery was done more than 7 days after the SAH and together with non-surgical patients, medication of nimodipine intravenously was given, and also patients, medication of nimodipine intravenously was given, and also patients who received surgery did within 3 days after the SAH were given intravenous injection and cisternal irrigation of nimodipine(N=93). We compared the overall management outcome and the incidence of delayed ischemic dificit(DID) and unfavorable outcome due to DID in each group. We also analyzed the causes of unfavorable outcome according to the clinical grade on admission and the amount of blood in the cistern seen on the brain CT in each group. The results of this study showed that overall management outcome was improved by using the calcium antagonist. The calcium antagonist reduced the incidence of DID as well as the unfavorable outcome related to DID. In clinical grade III patients on admission, the unfavorable outcome due to DID was significantly lower in group II and III than in I(group I vs. II:p<0.05, group I vs. III:P<0.01). In cases with a large amount of blood in the cistern seen on the brain CT, the unfavorable outcome was significantly lower in groups II and III than in I(group I vs. II:p<0.01, group I vs. III:p<0.05). We conclude that the overall management outcome of aneurismal SAH patients may be improved by using a calcium antagonist and the effect of the calcium antagonist is prominent in clinical grade III patients on admission and patients with a large amounts of blood in the cistern seen on the brain CT.
Aneurysm* ; Brain ; Calcium* ; Humans ; Incidence ; Injections, Intravenous ; Nimodipine ; Subarachnoid Hemorrhage*

PURPOSE: Tracheostomy is used to aid airway management in perdiatric respiratory care. This study was designed to review causes and outcomes of pediatric tracheostomy. METHODS: We performed a retrospective chart review of 153 patients, less than 18 years of age, who underwent tracheostomy between January 1995 and July 2010. Age at tracheostomy, indications, durations, complications and mortality were evaluated. RESULTS: Subglottic stenosis (19%) was the most common indication for tracheostomy. The median age at tracheostomy was 1.3 years (range, 22 days to 17.8 years). Seventy-three (47.7%) tracheostomies were performed in children under 1 year of age. Respiratory diseases were significantly more prevalent in patients under 1 year of age, while neuromuscular disease were more frequently found in patients older than 1 year (P=0.013). Stoma or tracheal granuloma formation (36.6%) was the most common complication of pediatric tracheostomy. Decannulation was accomplished in 61 (39.9%) patients with median cannulation time of 141 days (range, 1 to 2,529 days). Overall mortality rate was 10.5% (n=16), but only one patient (0.7%) died from tracheostomy-related complications. CONCLUSION: Respiratory diseases, such as subglottic stenosis and neuromuscular disease, are the main cause of pediatric tracheostomy. Although complications, like stoma or tracheal granuloma formation occur, tracheostomy in children is a safe way to aid airway management.
Airway Management ; Catheterization ; Child ; Constriction, Pathologic ; Granuloma ; Humans ; Neuromuscular Diseases ; Retrospective Studies ; Tracheostomy

OBJECTIVES: High incidence of hypocalcemia after thyroidectomy is a major determinant in delay of discharge. Even though many studies have focused on the search for reliable early predictors of postoperative hypocalcemia, definitions of hypocalcemia are diverse; therefore, interpretation and application of previously reported findings may not be easy. We aimed to elucidate diverse patterns of post-thyroidectomy hypocalcemia and to provide reliable early predictors for these different types of hypocalcemia. METHODS: Retrospective chart review was performed and eligible 112 patients of thyroidectomy were categorized into four groups according to symptomatic and/or biochemical hypocalcemic criteria. A mismatch of occurrence and the timing of symptomatic or biochemical abnormalities were evaluated. Predictive values of commonly used biomarkers were compared in each group; levels of serum total calcium and ionized calcium, and intact parathyroid hormone (PTH). RESULTS: Among 62 hypocalcemic patients, 45 patients (72.5%) experienced both symptomatic and biochemical abnormalities during hospitalization. A mismatch on the timing of initial detection of symptomatic and biochemical hypocalcemia was observed in 21 patients (46.6%). Intact PTH level measured at 1 hour was a useful indicator in prediction of symptomatic hypocalcemia with 79.7-87.4% of diagnostic accuracy. Serum ionized calcium measured next morning after surgery was a reliable predictor of biochemical hypocalcemia with 77.9-94.8% of diagnostic accuracy. CONCLUSION: For the safety of patients, the possibility of both symptomatic and biochemical hypocalcemia should be considered together before deciding early discharge. Using intact PTH for symptomatic hypocalcemia and day-1 ionized serum calcium level for biochemical hypocalcemia will be helpful for the reliable prediction of heterogeneous nature of postoperative hypocalcemia.
Calcium ; Early Diagnosis ; Hospitalization ; Humans ; Hypocalcemia ; Incidence ; Parathyroid Hormone ; Retrospective Studies ; Thyroidectomy ; Biomarkers

We undertook a retrospective analysis of 30 patients admitted to the Department of Neurosurgery Dongsan Medical Center Keimyung University utilizing Magnetic Resonanace Imaging(MRI) to make diagnosis and surgical indication of degenerative cervical spine lesions. All patients were taken T1 Weighted Image(T1W1) T2 Weighted Image(T2WI) and gradient echo image on 2.0 Tesla unit. Pre- and postoperative MRI were obtained seven of 15 cases with myelopathy. All patients could be evaluated the extent and degree of disc herniation, osteophytes and cord compression. A focal area of High-Signal-Intensity(HIS) was observed on T2WI in 15 patients with mydlopathy predominantly. HIS diminished postoperatively in the patients who improved clinically and remained the same in one case whose condition remained unchanged after decompression. We think MRI with high resolution images in the initial procedure of choice in decision-making of patients with degenerative cervical spine lesion. Furthermore HIS of the spinal cord produced by compressive lesions appears to be an important indicator for predicting prognosis of patients with myelopathy.
Decompression ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Neurosurgery ; Osteophyte ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spinal Cord Diseases ; Spine*

BACKGROUND: The aim of the study was to evaluate the biochemical effects of recombinant human thyroid stimulating hormone (rhTSH) as an adjunct to radioiodine (RI) treatment of a differentiated thyroid carcinoma (DTC). We retrospectively reviewed the clinical response rates of DTC patients treated with RI after thyroid hormone withdrawal and compared with those after rhTSH stimulation. METHOD: We included the patients treated with RI for locally recurrent DTC from February 1, 2002 to August 31, 2005 and followed with diagnostic studies at our hospital. Forty totally (or near totally) thyroidectomized adults were included in this study. Nine patients underwent RI treatment after rhTSH stimulation while euthyoid on L-thyroxine (LT4), and 31 patients were treated with RI after thyroid hormone withdrawal. The clinical response was defined as >25% decrease in serum thyroglobulin (Tg) level on LT4 3 months after the RI treatment. RESULTS: In each group, serum Tg levels were significantly decreased 3 months after the RI treatment. And we found that 77.8 and 71.0% of those prepared by rhTSH and LT4 withdrawal, respectively, had clinical responses 3 months after the RI treatment by our criteria and there was no significant difference in response rates between two groups (P=0.238). CONCLUSIONS: Given the biases that exist in retrospective studies, at the current time we cannot recommend the routine use of rhTSH to prepare RI treatment of DTC. However, our study provided preliminary evidence that rhTSH effectively aided RI treatment of DTC at least to an equivalent degree as LT4 withdrawal.
Adult ; Bias (Epidemiology) ; Humans* ; Retrospective Studies* ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyrotropin ; Thyrotropin Alfa ; Thyroxine

BACKGROUND: The aim of the study was to evaluate the biochemical effects of recombinant human thyroid stimulating hormone (rhTSH) as an adjunct to radioiodine (RI) treatment of a differentiated thyroid carcinoma (DTC). We retrospectively reviewed the clinical response rates of DTC patients treated with RI after thyroid hormone withdrawal and compared with those after rhTSH stimulation. METHOD: We included the patients treated with RI for locally recurrent DTC from February 1, 2002 to August 31, 2005 and followed with diagnostic studies at our hospital. Forty totally (or near totally) thyroidectomized adults were included in this study. Nine patients underwent RI treatment after rhTSH stimulation while euthyoid on L-thyroxine (LT4), and 31 patients were treated with RI after thyroid hormone withdrawal. The clinical response was defined as >25% decrease in serum thyroglobulin (Tg) level on LT4 3 months after the RI treatment. RESULTS: In each group, serum Tg levels were significantly decreased 3 months after the RI treatment. And we found that 77.8 and 71.0% of those prepared by rhTSH and LT4 withdrawal, respectively, had clinical responses 3 months after the RI treatment by our criteria and there was no significant difference in response rates between two groups (P=0.238). CONCLUSIONS: Given the biases that exist in retrospective studies, at the current time we cannot recommend the routine use of rhTSH to prepare RI treatment of DTC. However, our study provided preliminary evidence that rhTSH effectively aided RI treatment of DTC at least to an equivalent degree as LT4 withdrawal.
Adult ; Bias (Epidemiology) ; Humans* ; Retrospective Studies* ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyrotropin ; Thyrotropin Alfa ; Thyroxine