No abstract available.
Intestinal Obstruction* ; Ultrasonography*

No abstract available.
Pregnancy*

OBJECTIVE: The goal of this study was to compare the therapeutic and the functional value between translaminar approach and transforaminal approach of epidural steroid injection in patient with refractory radicular pain. METHOD: Among 31 patients with unilateral herniated nucleus pulposus (HNP) which was confirmed by physical examination and magnetic resonance imaging (MRI), 17 patients received a transforaminal approach and 14 patients received a translaminar approach. All patients were evaluated by independent observer and were checked by visual analogue scale (VAS), functional score before and 1 day, 2 weeks and 4 weeks after injection. RESULTS: The VAS of transforaminal approach was significantly lower than that of translaminar approach after 2 weeks and after 4 weeks (p<0.05), although there were no statistical difference before and 1 day after injection. The functional score of transforaminal approach was significantly higher than that of translaminar approach after 4 weeks (p<0.05), although there were no statistical difference before and 1 day, 2 weeks after injection. The translaminar approach needs more frequent injection (p<0.05). CONCLUSION: This study suggests that both translaminar approach and transforaminal approach could be valuable to the initial management of refractory radicular pain, but the duration of therapeutic effects was relatively short in translaminar approach. Transforaminal approach will be the promising treatment of refractory radicular pain, because it has better therapeutic efficacy, safety and longer duration of therapeutic effects than translaminar approach.
Humans ; Magnetic Resonance Imaging ; Physical Examination

Hairy cell leukemia is an uncommon lymphoreticular disorder which primarily involves bone marrow, spleen, and peripheral blood. Patients, mostly men, present with splenomegaly and pancytopenia usually. A 62-year-old man was admitted with an abdominnal mass which had grown slowly for 20 years. On physical examination, an enlarged spleen was palpated without tenderness. An abdominal CT scan showed a diffusely enlarged spleen, which measured 20 cm in greatest dimension. In the peripheral blood, many atypical lymphocytes with abundant, delicate, surface projections were noted. They had tartrate-resistant acid phosphatase(TRAP) activity. Thrombocytopenia (60,000/mm3) was observed in the complete blood counts, Other laboratory data were within normal limits. He underwent splenectomy. The submitted spleen measured 26x15x5 cm and weighed 2150 gm. It was well encapsulated and the outer surface was smooth. Cut surfaces were diffusely dark-red. White and red pulps were indistinct. There was no mass-like lesion. Microscopically, the spleen consisted of monotonous mononulcear cells which involved red pulp. The white pulp was diminished, and could be barely recognized. Cells had small round nuclei and abundant cytoplasm. Ultrastructurally, cells with numerous slender surface projections were noted. In Korea, hairy cell leukemia is exceedingly rare. We report a case of hairy cell leukemia with characteristic pathologic features of spleen as well as those of peripheral blood.
Male ; Humans

In case of soft-tissue defects with bone and tendon exposure on foot, ankle and lower leg, it is often impossible to achieve wound closure by a simple skin graft. The sural artery flap is a fasciocutaneous flap supplied by the sural artery that accompanies the sural nerve and connects with a septocutaneous perforator of the peroneal artery via a suprafascial network of vessels. For the coverage of the defects, we operated 30 cases using modified superficial sural fasciocutaneous island flap based on the proximal or distal. and we covered convoluted wound site with this flap with plicated fascia. We reconstruct complicated skin defects on the foot region(13) and the distal portion of the leg(17). The size of flap varied from 3 x 4 cm2 to 10 x 9 cm2. All 30 flaps survived completely, but minor complications, such as venous congestion, hematoma disappeared after a few days. The main advantage of this flap is a constant and reliable blood supply without sacrifice of a major artery. but disadvantage of this flap is hypoesthesia at the lateral part of the foot. In conclusion, dissection of the superficial sural fasciocutaneous island flap is quite easy and requires less time, and involves less risk to the patient. The nonbulky fasciocutaneous island flap appearance particularly indicated small to medium sized defects with or without convoluted wound surface. The contours of the recipient and donor sites are acceptable aesthetically.
Ankle ; Arteries ; Fascia ; Foot ; Hematoma ; Humans ; Hyperemia ; Hypesthesia ; Leg ; Skin ; Sural Nerve ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries

BACKGROUNDS AND OBJECTIVE: It has been known that tumor size, regional neck metastasis state and tumor thickness are the prognostic factors of oral cavity or oropharyngeal cancer. Additionally, DNA flow cytometry has also been reported to be one of the pronosic factors. We would like to evaluate the prognostic value of DNA flow cytometry in early oral cavity or oropharyngeal squamous cell carcinoma. MATERIALS AND METHODS: We analyzed the relation between tumor thickness or neck metastasis and survival rate in 59 patients with early oral cavity or oropharyngeal cancer. Among those patients, DNA flow cytometry was performed in 28 cases and the prognostic value of the parameters of DNA flow cytometry was analyzed. RESULTS: Overall, a 2-year survival rate of the patients was 90.1%. Neither tumor thickness nor neck metastasis state was related to the overall survival rate. Tumor thickness was not related to neck metastasis state, either. Of the parameters of the DNA flow cytometry, only the S phase fraction of aneuploidy was related to the overall survival rate (p=0.0288). Also the total proportion of aneuploidy was weakly related to the state of neck metastasis (p=0.0518). CONCLUSION: These results indicate that DNA flow cytometry can be used as a good complementary factor for predicting the overall survival or neck metastasis in patients with early primary oral cavity or oropharyngeal squamous cell carcinoma.
Aneuploidy ; Carcinoma, Squamous Cell* ; DNA* ; Flow Cytometry* ; Humans ; Mouth* ; Neck ; Neoplasm Metastasis ; Oropharyngeal Neoplasms ; S Phase ; Survival Rate

PURPOSE: To evaluate the changes and normal ranges of the artery-bronchus ratio (ABR) during respiration MATERIALS AND METHODS: We analyzed HRCT of 10 healthy adults. The HRCT findings of ten healthy adults were analysed. CT scanning was performed with 1 mm collimation at 3 mm intervals during full inspiration and full expiration, with a range during inspiration from 2 cm to 4 cm above the carina and from 4 cm above to 2 cm below the right hemidiaphragm. The range during expiration was from 1 cm to 3 cm above the carina and from 4 cm above to 2 cm below the right hemidiaphragm. ABiR (defined as the diameter of pulmonary artery divided by the inner diameter of the bronchus), ABoR (defined as the diameter of pulmonary artery divided by the outer diameter of the bronchus) and BLR (defined as the inner diameter of the bronchus divided by the outer diameter of the bronchus) were measured on the display console. RESULTS: The mean inner diameter of the bronchi was 2.04+/-0.73 mm during inspiration and 1.68+/-0.51 mm during expiration, while the mean diameter of the arteries was 3.95+/-1.03 mm during inspiration and 4.37+/-1.09 mm during expiration. The diameters of the bronchi were thus seen to increase during inspiration, and the diameters of the pulmonary arteries, to decrease. The mean thickness of the bronchial wall was 1.07+/-0.19 mm during inspiration and 1.06+/-0.24mm during expiration; thus, no change in thickness was seen during respiration (p<0.05). Mean ABiR was 2.01+/-0.60 (range 1.15-4.58) during inspiration and 2.59+/-0.74(range 1.16-4.9) during expiration, and in all cases the inner diameter of the bronchus was less than that of the accompanying pulmonary artery. Mean ABoR was 0.91+/-0.19 during inspiration and 1.09+/-0.22 during expiration. while for BLR, the corresponding fingures were 0.46+/-0.06, and 0.44+/-0.09. CONCLUSION: HRCT is a useful tool for evaluating changes in the pulmonary arteries and bronchi during respiration.
Adult ; Arteries ; Bronchi ; Humans ; Pulmonary Artery ; Reference Values ; Respiration* ; Tomography, X-Ray Computed

Symptomatic cerebral amyloid angiopathy (CAA) is characterized by lobar cerebral hemorrhage, transient neurological symptoms, and dementia with leukoencephalopathy in the absence of hypertension or coagulopathy. Contrary to its common appearance in English literature, pathologically confirmed CAA has rarely been reported in Korea. A 77-year-old normotensive, nondemented woman was admitted for a case of incidentally found intracerebral lobar hemorrhage at the left occipito-parietal area. On neurological examination, she displayed symptoms of a drowsy mentality and Gerstmann syndrome. Light-microscopically, medium to large cortical and meningeal vessels appeared to be thickened with amorphous glassy materials showing apple-green birefringence under polarized light on Congo red stain, which is consistent with CAA. The amyloid deposits were detected in the medium-sized vessels of the leptomeninges and cerebral cortex, but not in the capillaries and small arterioles in the white matter. Electron microscopy revealed amyloid fibrils and basal lamina duplication, indicating damaged vessels. Careful cortical biopsy during evacuating hematoma for histopathologic and ultrastructural examination is essential for diagnosis of CAA in case of clinical probability because the ignored sampling procedure and sampling error of patchy, segmental distribution of affected vessels might be ascribed to rare incidence of CAA in Korea.
Aged ; Amyloid ; Arterioles ; Basement Membrane ; Biopsy ; Birefringence ; Capillaries ; Cerebral Amyloid Angiopathy* ; Cerebral Cortex ; Cerebral Hemorrhage ; Congo Red ; Dementia ; Diagnosis ; Female ; Gerstmann Syndrome ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Korea ; Leukoencephalopathies ; Microscopy, Electron ; Neurologic Examination ; Plaque, Amyloid ; Selection Bias

PURPOSE: This study was performed to assess the compatibility of cone beam computed tomography (CBCT) synthesized cephalograms with conventional cephalograms, and to find a method for obtaining normative values for three-dimensional (3D) assessments. MATERIALS AND METHODS: The sample group consisted of 10 adults with normal occlusion and well-balanced faces. They were imaged using conventional and CBCT cephalograms. The CBCT cephalograms were synthesized from the CBCT data using OnDemand 3D software. Twenty-one angular and 12 linear measurements from each imaging modality were compared and analyzed using paired-t test. RESULTS: The linear measurements between the two imaging modalities were not statistically different (p>0.05) except for the U1 to facial plane distance. The angular measurements between the two imaging modalities were not statistically different (p>0.05) with the exception of the gonial angle, ANB difference, and facial convexity. CONCLUSION: Two-dimensional cephalometric norms could be readily used for 3D quantitative assessment, if corrected for lateral cephalogram distortion.
Adult ; Cephalometry ; Cone-Beam Computed Tomography ; Humans

We report a case of renal sarcoidosis accompanied by hypercalcemia and renal insufficiency. A 52-year-old woman presented to hospital with nausea, pruritus, general weakness and weight loss. Laboratory tests revealed a serum creatinine was 3.6mg/dL, calcium ll.lmg/dL(ionized calcium 5.6mg/dL), hemoglobin 10.2g/dL, parathyroid hormone <3.0pg/mL, 24 hour urinary protein 1,127mg/day and 24 hour urinary calcium 489mg/day. Chest X-ray showed normal and both kidneys were within normal size with mild increased echo-genicity on renal ultrasound. Renal biopsy showed interstitial nephritis with mononuclear cell infiltration and mild interstitial fibrosis. Non-caseating granuloma with epitheloid and giant cells were seen. Following corticosteroid therapy, renal function and hypercalcemia were dramatically improved. Within 1 month, calcium level was normal and the creatinine level fell to 2.0mg/dL and subsequently remained stable while corticosteroid was progressively tapered off. She has been followed up for 11 months with normal seum calcium level and the creatinine level of 1.9mg/dL.
Acute Kidney Injury* ; Biopsy ; Calcium ; Creatinine ; Female ; Fibrosis ; Giant Cells ; Granuloma ; Humans ; Hypercalcemia* ; Kidney ; Middle Aged ; Nausea ; Nephritis, Interstitial ; Parathyroid Hormone ; Pruritus ; Renal Insufficiency ; Sarcoidosis* ; Thorax ; Ultrasonography ; Weight Loss