Massive ovarian deema is a tate conditian. It is a benign enlargement of the ovary caused by accumulation of fluid, which is thought to result from intermittent partial toraion of the ovarian pedicle. Histologically, the ovaries were characterized by diffuse edema of medulla and inner cortex. Two cases of massive ovanan edema are reported with brief review of the literatures.
Edema* ; Female ; Ovary

BACKGROUND: Since its introduction in 1987, the laparoscopic cholecystectomy has become the treatment of choice for most patients with symptomatic cholelithiasis. However, about 20% of the patients requiring a cholecystectomy present with acute cholecystitis, and the safety of a laparoscopic cholecystectomy in these patients has been questioned. With increasing experience, many studies have reported that a laparoscopic cholecystectomy in patients with acute cholecystitis is safe and cost effective. This study was to review retrospectively the results of laparoscopic cholecystectomies in patients with acute inflamed gallbladders. METHODS: From July 1993 through Fabruary 1997, laparoscopic cholecystectomies were attempted in 250 patients with or without symptomatic gallbladder disease. Acute cholecystitis, confirmed by clinical, laboratory, operative, and histological findings, was present in 61 patients. The preoperative factors that may be useful in predicting conversion to an open operation were analyzed. RESULTS: The frequency of conversion to an open operation was 19.7% for acute inflammation and 3.2% for chronic inflammation. Patients who had a laparoscopic cholecystectomy done within 72 hours of the onset of symptoms had a lower rate of conversion to open procedures. Patients who had a laparoscopic cholecystectomy done and who had a white blood cell count over 15 10(9)/L, persistant high fever (>38.0degrees C) over 3 days, and managed diabetes mellitus for over 3 years had a high rate of conversion to open procedures. There were no bile-duct injuries and no mortalites. CONCLUSIONS: Laparoscopic intervention appears to be a safe and beneficial option in the management of patients with acute cholecystitis. Surgeons should have extensive experience with both routine laparoscopic cholecystectomy and conventional open biliary tract surgery. A greater number of patients with inflammation require conversion to an open operation compared with the number of patients with no obvious inflammation who require conversion. Conversion to an open operation was frequent for patients with empyema, with symptoms that had lasted for longer than 72 hours prior to the operation, with white blood cell counts over 15 10(9)/L, with persistant high fever (>38.0degrees C) over 3 days and with managed diabetes mellitus for over 3 years, suggesting that once this diagnosis of acute cholecystitis is made, excessive time should not be spent in a laparoscopic trial dissection before conversion to an open operation.
Biliary Tract ; Cholecystectomy* ; Cholecystectomy, Laparoscopic ; Cholecystitis, Acute* ; Cholelithiasis ; Diabetes Mellitus ; Diagnosis ; Empyema ; Fever ; Gallbladder ; Gallbladder Diseases ; Humans ; Inflammation ; Leukocyte Count ; Retrospective Studies

Mirror writing is script that runs in the direction opposite to normal, with individual letters also reversed. A Right handed woman suddenly developed mirror-writing. After traumatic brain injury without definitive lesions on MRI, she could not discriminate between right and left by herself. Several theories, including motor, visual dominance, spatial disorientation and supplementary motor hypotheses, have been proposed to explain such. We believe that availability of mirror engrams induce reversal of normal left-to-right writing pattern including mirror-writings.
Brain Injuries ; Female ; Functional Laterality ; Hand ; Humans ; Magnetic Resonance Imaging* ; Writing

Cystic entrapment of infraspinatus branch of suprascapular nerve is a rare cause of shoulder pain with infraspinatus atrophy. We discuss the ultrasonographic diagnosis and ultrasonography- guided aspiration of the cyst as a treatment. Case: A 37-year-old, ship-yard laborer had experienced left shoulder discomfort and pain without trauma history. Physical examination showed profound selective atrophy of left infraspinatus muscle. Simple X-ray of shoulder showed normal findings. Electrodiagnostic examination revealed delayed motor latency of infraspinatus branch of suprascapular nerve and denervation potentials of infraspinatus muscle exclusively. Ultrasonographic finding showed 13.5X21.5 mm sized cystic mass around left infraspinatus notch. Ultrasonography-guided aspiration was done, and then electrical stimulation therapy and strengthening exercise of left shoulder were performed. Symptoms were improved. We report a rare case of cystic entrapment of infraspinatus branch of suprascapular nerve in a patient without traumatic insult.
Adult ; Atrophy ; Denervation ; Diagnosis ; Electric Stimulation Therapy ; Humans ; Physical Examination ; Shoulder ; Shoulder Pain ; Ultrasonography*

PURPOSE: To evaluate the efficacy of swept source optical coherence tomography (SS-OCT) by comparing the measurement of central corneal thickness (CCT) to the measurement obtained using Orbscan II, anterior segment optical coherence tomography (AS-OCT) and ultrasound pachymetry. METHODS: One examiner measured the CCT in 65 eyes of 65 healthy subjects using Orbscan II, AS-OCT, SS-OCT and ultrasound pachymetry. The mean values and correlations were analyzed. RESULTS: The average CCT measurements obtained using Orbscan II, AS-OCT, SS-OCT and ultrasound pachymetry were 534.83 ± 38.46, 517.80 ± 32.48, 528.22 ± 33.71 and 528.02 ± 34.90 µm, respectively. A significant linear correlation was observed among Orbscan II, AS-OCT, SS-OCT and ultrasound pachymetry (r > 0.894, p < 0.001). There was no significant difference between the SS-OCT and ultrasound pachymetry (p = 0.782). CONCLUSIONS: The results of the 4 methods were significantly correlated and the SS-OCT reached a high level of agreement when CCT was determined using ultrasound pachymetry. The CCT measurements using SS-OCT is a better alternative for ultrasound pachymetry than Orbscan II and AS-OCT.
Healthy Volunteers ; Tomography, Optical Coherence* ; Ultrasonography

No abstract available.
Ovarian Neoplasms* ; Transfection*

No abstract available.
Lung Neoplasms* ; Lung*

Innervation anomalies are well-known sources of erroneous interpretation in motor nerve conduction studies. The extensor digitorum brevis (EDB) muscle is supplied by the deep peroneal nerve and is commonly used as recording point in peroneal motor conduction study. If the compound muscle action potentials (CMAPs) are not evoked with EDB muscle recording without any symptoms or signs of peroneal neuropathy, we should lead one to consider either technical pitfall or anomalous innervation. We experienced an anomalous innervation in a woman in whom the bilateral EDB muscles were innervated exclusively by the tibial nerve. This was proved using a monopolar needle electrode for recording in extensor digitorum brevis (EDB) and flexor digitorum brevis (FDB) muscles, which encoded acceptable shape of CMAPs on tibial nerve stimulation. To avoid erroneous interpretation of electromyographic and nerve conduction studies, one should be aware of this possible innervation anomaly ("all tibial foot").
Action Potentials ; Electrodes ; Female ; Humans ; Muscles ; Needles ; Neural Conduction ; Peroneal Nerve ; Peroneal Neuropathies ; Tibial Nerve*

Osteomas are benign, slow-growing osteogenic lesions frequently found in the craniomaxillofacial region. They can be classified as peripheral, central, or extraskeletal. Reactive mechanisms to trauma or infection, as well as muscle traction, are thought to play a major role in the development of peripheral osteomas. In the present report, a 41-year-old woman presented with a slow-growing, painless mass on her left eyebrow. She had suffered trauma 15 years prior. In the computed tomography scan, a 2.5 × 2 × 0.7-cm radio-opaque tumor was detected just medial to the left supraorbital foramen, and a peripheral osteoma was clinically diagnosed. An elective operation under general anesthesia was planned. Following a suprabrow incision, subcutaneous and intramuscular dissection was performed. In the surgical plane deep to the corrugator muscles and superficial to periosteum, a branch of the supratrochlear nerve was encountered and preserved using a vessel loop. The osteoma beneath the periosteum was extracted in multiple fragments using a chisel and mallet to minimize trauma to the nerve. Contour and facial symmetry were corrected. To use a suprabrow incision, the surgeon must understand neighboring anatomical structures, including the course of the supratrochlear and supraorbital neurovascular bundles. When these structures are located adjacent to tumor lesions, careful surgical maneuvers should be performed to preserve them.
Adult ; Anesthesia, General ; Eyebrows ; Female ; Forehead ; Humans ; Muscles ; Osteoma ; Periosteum ; Traction

Schwannoma is a slow-growing, well-demarcated, benign soft tissue tumor of the peripheral nerve sheath. It commonly develops in the head and neck region, usually in the parapharyngeal space. In this case, a 42-year-old woman visited the outpatient department to manage a painless mass on her left cheek. She had no history of concern and no neurological symptoms were observed. In the enhanced computed tomography scan, a 2.8 × 2.8 × 1.8 cm, heterogeneously enhanced tumor was detected in the left masseter muscle. A tumor resection under general anesthesia was planned. For the resection, a facelift incision was chosen; branches of the facial nerve were identified and retrogradely dissected. A well-marginated, yellowish, solid mass was found in the left masseter muscle. The mass was excised and given a histopathological diagnosis of schwannoma. A definite diagnosis of schwannoma, originating in the masseter muscle, is difficult to arrive at with radiographic findings alone; it is often misdiagnosed as intramuscular hemangioma. Histopathological examinations, including fine-needle aspiration or histological biopsy after surgery, are necessary. Using a facelift incision with retrograde facial nerve dissection, tumor resection in an intramasseteric lesion can be performed efficiently, without nerve damage, or leaving conspicuous scars on the face.
Adult ; Anesthesia, General ; Biopsy ; Biopsy, Fine-Needle ; Cheek ; Cicatrix ; Diagnosis ; Facial Nerve ; Female ; Head ; Hemangioma ; Humans ; Masseter Muscle ; Neck ; Neurilemmoma ; Outpatients ; Peripheral Nerves ; Rhytidoplasty