Authors have reviewed a series of 41 cases of fibrous dysplasia which were treated surgically at the Department of Orthopedic Surgery, College of Medicine, Seoul National University. After mean follow-up of 25 months, we summarized the results as follows; 1. Among the 41 patients, 20 were male patients(M:F= 1:1.05). The average age was 20.2 years old. It was the most common in the 2nd decade(44%). The most common site was femur (53.6%) followed by tibia (28.6%) in monostotic type. Each polyototic patient had 3.8 locations in average. 2. The results were better in skeletally mature patients (86%) than in immature patients (42%). 3. Satisfactory results seemed to be expected in monostotic type (71%) than polyostotic type(33 %) 4. Satisfactory results seemed to be expected in sclerotic type(78%) than cystic type(50%) or ground glass appearance type (62%). 5. Autograft(71%) was superior to xenograft(40%) in our study. However, xenograft only or xenograft with autograft can be a recommendable method of treatment for a very large lesion or for a patient with insufficient graft donor site.
Autografts ; Femur ; Follow-Up Studies ; Glass ; Heterografts ; Humans ; Male ; Methods ; Orthopedics ; Seoul ; Tibia ; Tissue Donors ; Transplants

BACKGROUND: To identify the prevalence and risk factors of poststroke depression(PSD) in patients admitted to department of rehabilitation medicine after stroke, to compare functional recovery of depressed patients and that of non-depressed patients, and to recognize the most useful depression scale that can predict functional recovery. METHOD: Of the hospitalized stroke patients in the department of Rehabilitation Medicine, 24 patients who were communicable were included in this study. To evaluate PSD, Beck depression inventory(BDI) and Korean form of Geriatric depression scale(KGDS) were used as self-rating scales. Hamilton depression scale(HAM-D) was used as an objective scale. Functional Independence measure(FIM) was measured at admission and discharge to evaluate functional recovery. RESULTS: In the 24 subjects, 17 patients(70.8%) and 9 patients(37.5%) were depressive by BDI and HAM-D. Of the 19 elderly patients, 16(84.2%) were depressive by KGDS. Factors such as age, level of education, religion, etiology or location of stroke were not significantly associated with PSD. And FIMscores were not significantly different in the depressed patients and non-depressed patients. The correlation coefficients of BDI, KGDS, HAM-D and FIMgain or efficiency were not statistically significant. CONCLUSION: The prevalence of PSDwas high in our study, but no association was found between PSD and functional recovery.
Aged ; Depression* ; Education ; Hip* ; Humans ; Inpatients* ; Prevalence ; Rehabilitation* ; Risk Factors ; Stroke ; Weights and Measures

Foreign body aspiration (FBA) is a common accident and remains a serious problem in young children. Undiagnosed and retained FBA could be a life-threatening risk and causes serious complications especially for young children. To prevent complications, prompt diagnosis and removal of foreign body is mandatory. Chest computerized tomography (CT) has recently become a very useful noninvasive diagnostic modality for bronchial FBA. We present here three different patients with bronchial FBA, which had been diagnosed by chest CT and completely removed under ventilating bronchoscopy without complication. The authors reviewed the literature and discussed the usefulness of chest CT on bronchial FBA in children.
Bronchoscopy ; Child ; Diagnosis* ; Foreign Bodies* ; Humans ; Thorax ; Tomography, X-Ray Computed*

Nodular fasciitis is a benign myofibroblastic proliferative lesion of the soft tissue. It appears typically as a rapidly growing painless solitary mass over several weeks' duration. It may be confused with a malignant tumor, especially with a sarcomatous lesion due to its aggressive clinical behavior and histological features. Only 7-20% of theses tumors are located in the head and neck since the retroauricular lesion is extremely rare. We report on a patient with nodular fasciitis as a retroauricular mass with a review of literature.
Fasciitis ; Head ; Humans ; Myofibroblasts ; Neck

BACKGROUND AND OBJECTIVES: To investigate the effectiveness of fine needle aspiration (FNA) conducted by the otolaryngologists, we compared the ultrasound (US)-guided FNA results conducted by a radiologist (RD-US), the US-guided FNA results (ENT-US), and the palpation guided FNA results (ENT-palpation) conducted by an otolaryngologist. SUBJECTS AND METHOD: 1646 patients who underwent FNA were classified according to the site and periods of investigation (2007-2015), and their sampling adequacy was retrospectively reviewed. They were also divided into three groups (ENT-US, ENT-palpation, and RD-US); each group was then investigated for sampling adequacy. Results of further surgical excisional biopsy were compared with the those of the FNA results to investigate the diagnostic accuracy of all three groups. RESULTS: The sampling adequacy identified by the groups showed the result of ENT-US at 87.9%, ENT-palpation at 87.1% and RD-US at 91.3%. The periodical inadequacy rate failed to show any significant differences between the groups. The sensitivity of ENT-palpation was lower than other two groups. Diagnostic accuracy identified by the groups showed the result of ENT-US at 95.2%, ENT-palpation at 93.6%, and RD-US at 97.4%. CONCLUSION: FNA performed by otolaryngologists demonstrates the effectiveness of diagnosis and treatment, and that doing so would improve economic efficiency. Therefore, it is recommended that well-trained otolaryngologists conduct FNA actively.
Biopsy ; Biopsy, Fine-Needle* ; Diagnosis ; Humans ; Methods ; Palpation ; Retrospective Studies ; Ultrasonography

Benign metastasizing pleomorphic adenoma is an extremely rare neoplasm, although the pleomorphic adenoma is the most common neoplasm affecting the salivary glands. Metastasis commonly develops many years after the excision of the primary tumor and is usually proceeded by local recurrences. This is a case of pleomorphic adenoma in the parotid gland without a local recurrence. We describe a case of metastasizing pleomorphic adenoma in a 69 year-old woman. The literature concerning the subject is reviewed. The treatment of choice for the metastatic pleomorphic adenoma appears to be complete surgical excision.
Adenoma, Pleomorphic* ; Aged ; Female ; Humans ; Neoplasm Metastasis ; Parotid Gland ; Recurrence ; Salivary Glands

Spontaneous intra-abdominal hemorrhage from uterine leiomyomas is rarely encountered. We present a case of a 46-year-old who presented to the emergency room with acute abdominal pain as same as that has experienced for 5-6 times. On examination, the abdomen was diffusely tender, with rebound tenderness in the suprapubic area and in both iliac fossae. Pregnancy test was negative. She had an acute abdomen, dizziness, decreasing hematocrit, and a pelvic mass with free fluid in the pelvic cavity. On transvaginal sonography, 6.3 x 6.1 cm sized hyperechoic mass was visible beside the uterus and CDS. This mass had an ill-defined margin. Large amount of fluid was visible in the CDS and uterovesical pouch. Hemoperitoneum was confirmed by culdocentesis. Magnetic Resonance Imaging revealed a mass with cystic components, diffusely heterogeneous signal intensity and T1 high signal intensity in the left superolateral aspect of uterus. An moderate amount of fluid was found in the pelvic cavity. The patient underwent an exploratory laparotomy. A ruptured, pedunculated, cystic degenerated uterine myoma with active bleeding was found, as well as approximately a liter of free, blood-stained peritoneal fluid and blood-clots. Myomectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, preoperative diagnosis of a perforated, uterine fibroid with spontaneous intra-abdominal hemorrhage is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.
Abdomen ; Abdomen, Acute ; Abdominal Pain ; Ascitic Fluid ; Diagnosis ; Dizziness ; Emergency Service, Hospital ; Female ; Hematocrit ; Hemoperitoneum* ; Hemorrhage ; Humans ; Laparotomy ; Leiomyoma* ; Magnetic Resonance Imaging ; Middle Aged ; Pregnancy ; Pregnancy Tests ; Uterus

Agenesis of corpus callosum is the cerebral malformations whose prognosis is uncertain. But the complete agenesis shows more poor prognosis than partial agenesis. So, the type of agenesis can affect significantly the antepartum management. Recently, there has been a development in diagnostic tools like MRI to overcome these limitations of antenatal ultrasonography. We report a case of agenesis of corpus callosum which was diagnosed by prenatal MRI. This case was confused with Dandy-Walker complex in prenatal ultrasonography and supported in diagnosis by prental MRI.
Agenesis of Corpus Callosum* ; Dandy-Walker Syndrome ; Diagnosis ; Magnetic Resonance Imaging* ; Prognosis ; Ultrasonography ; Ultrasonography, Prenatal

OBJECTIVE: The aim of the present study was to investigate the clinical usefulness of serum CA 125 and CA 19-9 levels for diagnosing and determining the severity of endometriosis. METHODS: A total of 112 women who underwent gynecologic surgery between January 1998 and August 2004 were selected in this study. 81 patients had histologically confirmed endometriosis and the remaining 31 had benign ovarian tumor but no obvious evidence of endometriosis. Blood samples were collected in all patients before the operation and the mean values and standard deviations of both serum CA 125 and CA 19-9 levels were measured in various stages of disease. Both tumor markers were also measured in the control group. The results were compared to determine the usefulness of CA 125 and CA 19-9 in diagnosing and predicting the severity of endometriosis. As a results, new cutoff values of serum CA 125 and CA 19-9 in endometriosis were obtained. RESULTS: The mean levels of serum CA 125 and CA 19-9 in patients at stage III and IV of endometriosis were significantly higher than in patients without endometriosis, and increased in accordance with the advancement of the clinical stage. Statistically appropriate cutoff values of CA 125 and CA 19-9 were calculated to be 20 IU/mL and 10 IU/mL, respectively. The sensitivity and specificity of CA 125 at this cutoff value for endometriosis were 72% and 71%, respectively. The sensitivity and specificity were 59% and 55% respectively in the case of CA 19-9. CONCLUSION: CA 125 is a useful marker for diagnosing and determining the severity of endometriosis. CA 19-9 shows limitation in diagnosing endometriosis, but is indeed a potential marker in predicting the severity of disease.
Endometriosis* ; Female ; Gynecologic Surgical Procedures ; Humans ; Sensitivity and Specificity ; Biomarkers, Tumor

BACKGROUND: This study compared the results of 24 hour ambulatory blood pressure monitoring with the clinical blood pressure measurements, and we investigated the relationship of the blood pressure measurement and left ventricular hypertrophy, as determined by routine 12 lead electrocardiography. METHODS: We studied 204 healthy adults with no prior history of heart disease or antihypertensive medication. The clinic blood pressure was measured 3 times and the average was taken. We compared the clinic blood pressure with the daytime blood pressure of the 24 hour ambulatory blood pressure monitoring, and we compared the blood pressure with the sum of the voltage of the S wave on V1 and the R wave on V5. RESULTS: The average of the daytime ambulatory blood pressure of all the patients was 135.33+/-13.73 mmHg for the systolic pressure and 86.55+/-10.14 mmHg for the diastolic pressure. The average of the clinic blood pressure measurement was 140.10+/-17.41 mmHg for the systolic pressure and 88.84+/-10.14 mmHg for the diastolic pressure. The clinic blood pressure averaged higher than the daytime ambulatory blood pressure by 5 mmHg on the systolic pressure and 2 mmHg on the diastolic pressure (p<0.001). The normal ambulatory blood pressure limits were estimated as those that best correlated with 140/90 mmHg at the clinic. The estimated value was 135/87 mmHg for the daytime ambulatory blood pressure (p+/-0.001). The incidence of white coat hypertension was 10.8%. The sum of the voltage on electrocardiography showed a positive linear relationship with all the blood pressure measurements. The daytime systolic blood pressure showed the strongest correlation with the 24 hour ambulatory blood pressure monitoring (r=0.283, p+/-0.001). CONCLUSIONS: We found a linear relation and we analyzed the differences between the clinical and 24 hour ambulatory blood pressure. A daytime ambulatory blood pressure value of 135/87 mmHg was a suitable upper normal limit for the corresponding cutoff value of the clinic blood pressure. Left ventricular hypertrophy showed the strongest relationship with the daytime systolic blood pressure among the results of the 24 hour ambulatory blood pressure monitoring.
Adult ; Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Electrocardiography* ; Heart Diseases ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Incidence ; White Coat Hypertension