No abstract available.
Arthroplasty, Replacement, Knee* ; Humans

Granular cell tumor is not uncommon and is a well recognized entity which may arise at virtually any site of the body. However, occurrence in the thyroid is extremely rare and has not been described well. Only three cases could be found in the English literatures. We report a case of granular cell tumor of the thyroid in a 30 year-old woman. The tumor was illdefined, infiltrative and was composed of diffuse sheets of polygonal to fusiform cells with abundant eosinophilic granular cytoplasm. The tumor showed evidence of Schwann cell differentiation in immunohistochemical and ultrastructural examinations. Differentiation from more common thyroid tumors having oncocytic granular cytoplasm should be made by immunohistochemistry or electron microscopy.
Adult ; Cell Differentiation ; Cytoplasm ; Eosinophils ; Female ; Granular Cell Tumor* ; Humans ; Immunohistochemistry ; Microscopy, Electron ; Thyroid Gland*

OBJECTIVES: We investigated the prevalence and functional impairment of premenstrual dysphoric disorder (PMDD) and premenstrual syndrome(PMS) in young women. METHODS: A total of 1063 female college students were recruited from two urban areas(Seoul and Suwon) of Korea. Questionnaires for sociodemographic data and risk factors of PMDD, attitude about menstruation, and the Premenstrual Symptoms Screening Tool(PSST) were applied. RESULTS: The prevalence of severe moderate to severe PMS and PMDD were 16.9% and 11.7%, respectively. There were differences in the alcohol and coffee consumption, severity of menstrual cramp, and family history of PMS among the moderate to severe PMS, PMDD, and no/mild PMS groups. Although some participants did not fulfill diagnostic criteria for PMDD, they showed significant functional impairment. Participants with negative attitude about menstruation reported premenstrual symptoms more frequently than those with positive or ambivalent attitude about menstruation. CONCLUSION: These results suggest that PMS and PMDD were prevalent and associated with functional impairment in young females. Some participants reported significant functional impairments although they did not meet the full DSM-IV diagnostic criteria for PMDD. Negative attitude about menstruation was associated with more premenstrual symptoms experiences.
Coffee ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Korea ; Mass Screening ; Menstruation ; Muscle Cramp ; Premenstrual Syndrome ; Prevalence ; Questionnaires ; Risk Factors

Incidence of non-contiguous multiple spine fracture was increased from 3.2%~4.5% at 1960th and 70th to 5.7% ~23.8% at 80th and 90th. But there is no reports in Korea which has high incidence of traffic and industrial accidents. In 345 consecutive patients with acute spine fracture, we found that 43 patients (12.5%) had multiple non-contiguous spine fractures. At the 43 patients studies 37 (87.4%) sustained fractures at 2 levels while 6 had more than 3 levels of injury, 26 were injured by fall from heights, 27 (62.8%) had 2.33 associated injuries on an average, and 12 (27.9%) had a neurologic deficit. There are five patterns account for 26 (50%) of the total number of patients. In 19 patients (44.2%), there was a mean 29.3 days delay (from 3 to 233 days) in diagnosis of the minor lesions. In 19 delay diagnosed minor lesions, it confirmed by bone scan in 12 patinets(63.6%). Two patients died within 24 hours after accident, and 41 patients (41 major and 50 minor fractures) were treated in our hospital. Among them, 21 (51.2%) needed modification of treatment by the presence of non-con- tiguous multiple spine fractures. According to above findings, the physician must be aware of the possible noncontiguous multiple spine fractures when examine and treat the patients with spine fracture.
Accidents, Occupational ; Diagnosis ; Humans ; Incidence ; Korea ; Neurologic Manifestations ; Spine

In our series with old electrical burn around the the wrist, there are several characteristics: for example, bad scarring in palm and volar aspect of wrist and distal forearm, large multiple defects of the flexor tendons, low median and ulnar nerve palsy, and occasionally insufficient blood supply. Between 1992 and 1995, we treated 8 cases of 7 patients with staged reconstruction. 4 patients with bilateral involvements had below-elbow amputee of contralateral upper extremity. The common approachs in each were soft tissue coverage, staged tendon reconstructiuon, and opponensplasty. The length of time between the injury and tendon reconstruction was 9 months on an average. Soft tissue coverage consisted of: 1. free tissue transfer (n=3), 2. abdominal (n=3) or groin (n=2). Total numbers of flexor tendon reconstruction were 26. Among them, staged reconstruction using silicone prosthesis were done in 18 tendons and primary tendon graft following tenolysis were done in 8 tendons. The time between first and second stage tendon reconstruction was 4.13 months. In all cases, opponen-splasty using extensor indicis proprius (n=4), extensor pollicis longus (n=2), and extensor digiti mini- mi (n=l), were performed. Good functional improvement of the hand were obtained in all cases. Patient s satisfaction were much better than the degree of functional improvement of the hand.
Amputees ; Burns* ; Cicatrix ; Forearm ; Groin ; Hand ; Humans ; Prostheses and Implants ; Silicones ; Tendons ; Transplants ; Ulnar Neuropathies ; Upper Extremity ; Wrist*

Twenty-five patients with unstable fracture or fracture-dislocation of the thoracolumbar and lumbar spines were treated with Cotrel-Dubousset instrumentation. Internal fixation was done in two ways; long rodding in seventeen patients and short rodding in eight. Short segment posterolateral or posterior autogenous iliac bone graft was done in all cases. The amount of correction of the collapsed anterior vertebral body height and the local kyphotic angle at the immediate post-operation were similar between the two groups, but loss of correction at last follow-up was more severe in the short rodding group. Instrument failure was also more common in the short rodding group. In conclusion, it was found that short segment stabilization of spine fractures with Cotrel-Dubousset instrument can effectively reduce fracture but can not maintain reduction until fusion. Therefore, long rodding was reconfirmed to be the better method of stabilization of the thoracolumbar and lumbar spines fractures.
Body Height ; Follow-Up Studies ; Humans ; Methods ; Spine ; Transplants

A 50 year old woman has lost her vision on the right eye abruptly, after subcutaneous Paraffin injection on-the forehead, for cosmetic correction of skin folds. The cause of blindness seems to be due to central retinal artery occlusion and probably to the thrombosis of ophthalmic vein too. It is likely that occlusion of the artery has develoded by compression of tile vessels from outward, but spastic occlusion of the arteries in hypersensitive reaction could not be ruled out.
Arteries ; Blindness* ; Female ; Forehead* ; Humans ; Middle Aged ; Muscle Spasticity ; Paraffin* ; Retinal Artery Occlusion ; Skin ; Thrombosis ; Veins

Myasthenia gravis is an autoimmune disorder, caused by the presence of anti-ac- etylcholine receptor antibody or acetylcholine-receptor deficiency and involved neuro- muscular endplate. The clinical course and outcome of myasthenia gravis are variable during pregnancy. The special caution and adequate management for myasthenic mother and myasthenia gravis occurred newborn of myasthenic mother are essential for good perinatal outcomes. We experienced a case of myasthenia gravis associated with pregnancy who underwent cesarean section. We present this case with a brief review of literatures.
Cesarean Section ; Female ; Humans ; Infant, Newborn ; Mothers ; Myasthenia Gravis* ; Myasthenia Gravis, Neonatal ; Pregnancy*

PURPOSE: To determine the prevalence and characteristics of the hypoechoic halo sign in peripheral cholangiocarcinoma. MATERIALS AND METHODS: Seventeen sonograms of 17 patients with peripheral cholangiocarcinoma histologically proven by either percutaneous needle biopsy (n=16) or surgical biopsy (n=1) were retrospectively reviewed. The size, margin, homogeneity and internal echogenicity of the masses as well as their peritumoral ductal dilatation and intratumoral calcification were ascertained, and the presence of a hypoechoic halo, and if present, its thickness and type, were also determined. We arbitrarily defined a 'thin' and 'thick' halo respectively, as one with a thickness less than of less than 3 mm, and 3 mm or more, and classified halos as 'intratumoral', 'extratumoral', or 'mixed'. RESULTS: Tumor diameter ranged from 4 to 13.5 (mean, 7.3) cm, and the margin was well-defined in 15 cases (smooth: n=2; lobulated: n=13) and irregular in two. Echogenicity was slightly heterogeneous in 11 cases, severely heterogeneous in three, and homogeneous in three, while the central portion was hyperechoic in eight cases, isoechoic in seven, and hypoechoic in only two. A hypoechoic halo was detected in 10 of 15 tumors(67%) with isoechoic centers. In evaluating the halo, two cases in which the mass was hypoechoic were excluded. All ten hypoechoic halos were at least 3 (range, 4-13; mean, 8.3) mm thick; in two cases the presence of a halo was equivocal, and in three there was no halo. Eight of ten halos were the mixed type, two were intratumoral, and none were extratumoral. Peritumoral ductal dilatation was seen in four cases (24%), but no internal calcification was observed. CONCLUSION: US showed that the margins of peripheral cholangiocarcinomas were mostly well-defined and smooth (12%) or lobulated (76%), and that masses were mainly heterogeneous (64%). A hypoechoic halo, which in all cases was thick and in 80% of cases was mixed, was noted in 67% of tumors with a hyper (47%) or isoechoic (41%) center. A halo of this kind may be useful in isoechoic mass detection and also in the differentiation of hyperechoic peripheral cholangiocarcinoma from hepatic hemangioma, the most common hyperechoic benign tumor.
Biopsy ; Biopsy, Needle ; Cholangiocarcinoma* ; Dilatation ; Hemangioma ; Humans ; Prevalence ; Retrospective Studies

Depressive disorder is a chronic disabling condition with recurrent episodes. Medication noncompliance is a significant problem for effective management of depressive disorder. However, compliance with antidepressant medication is poor. There are difficulties in assessing compliance accurately. Various methods for assessing compliance are in use. A patient's compliance with antidepressant may be affected by many factors including the clinical characteristics of depression, pharmacologic properties of antidepressants, patients' characteristics, accessibility treatment, and doctor-patient relationships. For enhancing the treatment compliance, psychotherapeutic considerations in patient-therapist relationship are needed.
Antidepressive Agents ; Compliance ; Depression ; Depressive Disorder ; Medication Adherence