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*

Joubert syndrome first described by Joubert et al. in 1969 is a very rare congenital disorder, characterized by episodic hyperpnea, abnormal eye movement, hypotonia, ataxia, and mental retardation. This syndrome generally represents as autosomal recessive inheritance and main neuropathological finding is agenesis or aplasia of the cerebellar vermis. This patient represents significant generalized muscle hypotonia which is not affected by any other tone-modifying maneuvers. And so there is no significant neuromotor improvement with neurodevelopmental treatment such as Bobath method, Vojta method, or proprioceptive nerve facilitation technique and so on. We report the Joubert syndrome showing typical features with delayed development.
Ataxia ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Eye Movements ; Humans ; Intellectual Disability ; Muscle Hypotonia* ; Wills

OBJECTIVE: To investigate the effect of electromyography (EMG)-biofeedback treatment in children with spastic-diplegic cerebral palsy. METHOD: Twenty patients with spastic diplegia, who could recognize the auditory and visual stimulation, were recruited. Ten patients underwent EMG-biofeedback treatment with neurodevelopmental treatment (NDT) for 12 weeks, 3 times a week, total 1 hour a day, but age-, sex- and functional-matched ten controls underwent only NDT. Before and after the treatment, active range of motion, spasticity, muscle strength and Functional Independence Measure for Children (WeeFIM) and Gross Motor Function Measure (GMFM) were measured. RESULTS: In experimental group, there was a significant increase in active range of motion of hip and ankle joints (p<0.05). Spasticity of ankle joint was decreased, but it was not statistically significant (p>0.05). Muscle strength of ankle dorsiflexor and hip extensor muscles was significantly improved (p<0.05). WeeFIM and GMFM scores significantly increased in an experimental group (p<0.05). CONCLUSION: EMG-biofeedback treatment in children with spastic-diplegic cerebral palsy might be an effective adjuvant to NDT through the muscle reeducation.
Ankle ; Ankle Joint ; Biofeedback, Psychology* ; Cerebral Palsy* ; Child* ; Electromyography ; Hip ; Humans ; Muscle Spasticity ; Muscle Strength ; Muscles ; Photic Stimulation ; Range of Motion, Articular

We studied diabetic central neuropathy(DCN) that is not well-known neurologic disorder. for confirming its existence and then presenting objective diagnostic criteria and methods. Thirtysix diabetics(NIDDM: 30, IDDM: 6), men age 53.1 years, 21 males and 15 females, were com pared with 36 controls, mean age 51.5 years, 18 males and 18 females, electrophysiologically. First, we diagnosed peripheral polyneuropathy(PN) in diabetics by means of Diabetic Neuropathy Staging(DNS) developed at the University of Michigan and classified diabetics into two group; group I indicates diabetics with PN. group II diabetics without PN. Second, we studied central(cortico-cervical and cortico-lumbar) motor conduction time(CMCT) by means of magnetic motor-evoked potential (MEP) and central somatosensory conduction time by means of somatosensory-evoked potentials(SEP) stimulating on median and posterior tibial nerves. There were no significant differences(P>0.05) statistically in cortico-cervical CMCT between diabetics and controls. There were significantly more prolonged(P<0.01) in cortico-lumbar CMCT between diabetics and controls. In median nerve-evoked 3-channel SEP, N13-N20 (cortico-cervical) interpeak latency was significantly more prolonged(P<0.01) in diabetics than controls. In tibial nerve-evoked 2-channel SEP, P38-N22(cortico-lumbar) interpeak latency was significantly more prolonged(P<0.01) in diabetics than controls. In 30 patients(83.3%) of 36 diabetics, the study revealed central conduction delay in view of that above 2 or more abnormalities representing central conduction delay, that is, central neuropathy. In 10 patients(33.3%, M: 7, F:3) of diabetics with central neuropathy(30 patients), even though they had no PN, central conduction delay was revealed. Conclusively, in view of representing central conduction delay in 83.3% of patients, we believer that more active evaluations are needed in diabetics representing nonspecific central neurologic symptoms, for example, psychomotor slowing or cognitive dysfunctions, and MEP and SEP are useful in diagnosing DCN.
Diabetes Mellitus, Type 1 ; Diabetic Neuropathies ; Diagnosis* ; Female ; Humans ; Male ; Michigan ; Nervous System Diseases ; Neurologic Manifestations ; Tibial Nerve