Endometriosis in the abdominal wall following Cesarean section is one of the very rare condition among the extrapelvic endometriosis. Although benign, endometriosis possesses the unique ability to invade tissue and to disseminate or metastasize by hematogeneous, lymphatic route, or direct implantation. We reported the case with brief review of the literature.
Abdominal Wall* ; Cesarean Section* ; Endometriosis* ; Female ; Pregnancy

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

BACKGROUND: There are many reports showing that a thoracic paravertebral block (TPB) can be used for post-thoracotomy pain control. However, the proper concentration of local anesthetics for TPB has not been established. The aim of this study was to define the proper concentration of bupivacaine for TPB after a thoracotomy. METHODS: Sixty patients were allocated randomly into one of the following three groups: thoracic paravertebral 0.5%, 0.25%, or 0.125% bupivacaine at a rate of 0.1 ml/kg/h (kg: ideal body weight). The resting and coughing visual analogue scale (VAS) score, cumulative dose of fentanyl, and the 5 point satisfaction scale were checked. RESULTS: 0.5% and 0.25% bupivacaine showed lower VAS score and cumulative dose of fentanyl than 0.125%. There was no difference in the satisfaction scale between the 3 groups. There was no difference between the 0.5% and 0.25% bupivacaine in all parameters measured. CONCLUSIONS: 0.25% bupivacaine used for TPB is more effective when used for pain control after a thoracotomy than 0.5% and 0.125% bupivacaine.
Anesthetics, Local ; Bupivacaine* ; Cough ; Fentanyl ; Humans ; Thoracotomy*

We report a case of rabbit syndrome in a 28-year-old man with chronic active epilepsy and mental retardation. He developed fine and rhythmic perioral involuntary movements with mild parkinsonism several months after he had been administered with neuroleptics. His movements had a rhythmic pattern consisting of 2-3 Hz with a resting period for 1- 2 seconds. They were remarkably reduced with benztropine. Parkinsonism also improved with benztropine.
Adult ; Antipsychotic Agents ; Benztropine ; Dyskinesias ; Epilepsy ; Humans ; Intellectual Disability ; Parkinsonian Disorders

The optimal management of uveal melanoma is still a matter of controversy. To determine the effect of Gamma Knife surgery on patients with uveal melanoma, the authors reviewed the outcome of five operations performed between September 1993 and August 1996. The mean age of the patients was 60.7(range 42 to 76) years; the median follow-up period was 10 months, and four patients were followed up for more than 6 months. The mean tumor volume was 3442mm3(mean diameter 15.3mm) and all patients were irradiated with a mean maximum dose of 74Gy (range 60-80Gy), using a 50% isodose on the tumor margin. In one patient, the tumor disappeared completely 32 months after Gamma Knife surgery; because the tumor did not regress, one patient subsequently required enucleation, and two remained stable. During a mean follow-up period of 10 months, vision was preserved in two patients, but one went blind; in one, enucleation was performed because the tumor did not regress. These results suggest that in cases of uveal melanoma Gamma Knife surgery can effectively control local tumors, can spare the eyeball, and may prevent loss of vision.
Follow-Up Studies ; Humans ; Melanoma* ; Tumor Burden

PURPOSE: This cross-sectional survey was conducted to described the compliance of Breast Self-Examination of middle-aged women using a convenient sample, and to examine relationships between the compliance of BSE and Health Beliefs, and the influencing factors on the compliance of BSE. METHODS: The subjects were 373 literate volunteers who were from 41 to 60 years of age who visited 6 public health centers. From June 7, 2004 to August 20, 2004, data were collected by 5 research assistants using a self-report questionnaire. The questionnaire was used to obtain information on the general characteristics, knowledge, health beliefs, and compliance of BSE. RESULTS: The findings of this study suggested that there were significant differences in the scores of the perceived susceptibility and severity between compliers and non-compliers of the BSE. BSE compliance was significantly correlated with knowledge, perceived susceptibility, and perceived severity. The most powerful predictor of BSE compliance was the perceived susceptibility. The perceived susceptibility, the perceived severity, the knowledge and educational level accounted for 41.8% of the variance in middle aged women's BSE compliance. CONCLUSION: Increase in knowledge about breast cancer, with a concomitant increase in both perceived susceptibility and perceived severity could produce a subtle cue or motivating force sufficient to affect a behavior change. Further research is needed to examine the qualitative difference between BSE and other early detection behaviors.
Patient Compliance/*psychology ; Middle Aged ; Korea ; Humans ; *Health Knowledge, Attitudes, Practice ; Female ; Cross-Sectional Studies ; Breast Self-Examination/*psychology ; Adult

To difine the relation between plasma atrial natriuertic peptide (ANP) levels and hemodynamic changes, we measured plasma concentration of atrial natriuertic peptide in 19 patients with heart disease undergoing cardiac catherization and in 15 normal subjects. The following results were obtained; 1) There were significantly increased plasma levels of atrial natriuertic peptide in patients with elevated mean pulmonary arterial wedge pressure. 2) A significant step-up in atrial natriuertic peptide concentration was seen between the femoral venous and right atrial plasma (P<0.01) and between the right atrial and pulmonary arterial plasma (P<0.05). 3) Peripheral venous atrial natriuretic peptide levels were significantly correlated with mean pulmonary arterial pressure and pulmonary wedge pressure (r=0.05, r=0.65, P<0.05). 4) Plasma atrial natriuretic peptide levels in pulmonary artery were significantly correlated with mean pulmonary arterial pressure (P<0.05).
Arterial Pressure ; Heart Diseases* ; Heart* ; Hemodynamics* ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure

OBJECTIVE: Immediate contralateral epidural hematoma (EDH) and traumatic intracerebral hematoma (T-ICH) after craniectomy for traumatic subdural hematoma (SDH) are rare but devastating post-operative complications. Their clinical features and outcomes are not well studied. In this report, we present the clinical features and outcomes of immediate contralateral acute hematoma cases requiring a second operation. METHODS: This study includes 10 cases of immediate contralateral EDH and T-ICH following bilateral craniectomy for the evacuation of traumatic SDH and contralateral hematoma between 2004 and 2015. Their medical records and radiographic findings were reviewed and analyzed retrospectively. RESULTS: Ten of the 528 patients (1.89%) who underwent craniectomy for the evacuation of traumatic SDH developed post-operative EDH (n=5), T-ICH (n=5). The trauma was caused by a fall in 5 patients and by a traffic accident in 5 patients. The patients who suffered trauma due to pedestrian accidents died. Seven patients had a low admission Glasgow Coma Scale (GCS; GCS≤8) score in the preoperative state (average admission GCS, 7.7; average discharge GCS, 3.4; and average discharge Glasgow Outcome Scale, 2.0). Severe intra-operative brain swelling was noted in all patients, while skull fracture was observed in 8. Multiple associated injuries and medication for heart disease were characteristic of patients who died. CONCLUSION: The prognosis of delayed contralateral hematoma was very poor. Multiple associated injuries, past medical history and traffic accidents, especially pedestrians were seemed to be associated with higher mortality rates. Finally, contralateral skull fractures can indicate high risk of delayed contralateral acute intracranial hematoma.
Accidents, Traffic ; Brain Edema ; Decompression* ; Decompressive Craniectomy ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Heart Diseases ; Hematoma* ; Hematoma, Subdural ; Hematoma, Subdural, Acute* ; Humans ; Medical Records ; Mortality ; Pedestrians ; Prognosis ; Retrospective Studies ; Skull Fractures

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

OBJECTIVE: The purpose of this large prospective study is to assess the association between the disappearance of the lateral spread response (LSR) before and after microvascular decompression (MVD) and clinical long term results over two years following hemifacial spasm (HFS) treatment. METHODS: Continuous intra-operative monitoring during MVD was performed in 244 consecutive patients with HFS. Patients with persistent LSR after decompression (n=22, 9.0%), without LSR from the start of the surgery (n=4, 1.7%), and with re-operation (n=15, 6.1%) and follow-up loss (n=4, 1.7%) were excluded. For the statistical analysis, patients were categorized into two groups according to the disappearance of their LSR before or after MVD. RESULTS: Intra-operatively, the LSR was checked during facial electromyogram monitoring in 199 (81.5%) of the 244 patients. The mean follow-up duration was 40.9+/-6.9 months (range 25-51 months) in all the patients. Among them, the LSR disappeared after the decompression (Group A) in 128 (64.3%) patients; but in the remaining 71 (35.6%) patients, the LSR disappeared before the decompression (Group B). In the post-operative follow-up visits over more than one year, there were significant differences between the clinical outcomes of the two groups (p<0.05). CONCLUSION: It was observed that the long-term clinical outcomes of the intra-operative LSR disappearance before and after MVD were correlated. Thus, this factor may be considered a prognostic factor of HFS after MVD.
Decompression ; Follow-Up Studies ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery ; Prospective Studies