Median raphe cyst is known as congenital lesion of the perineum and genitalia, but its etiology is unclear. Most investigators believe that the median raphe cyst represent defects in the embryologic developenient bf the male genitalia. Simple surgical excision is effective in most cases. We report our experience with two cases of median raphe cyst without specific symptoms. Even though median raphe cyst is asymptomatic, surgical therapy is worth applicable because it relieve a patient from cosmetic and psychotic problem.
Genitalia ; Genitalia, Male ; Humans ; Male ; Perineum ; Research Personnel

No abstract available.
Otoacoustic Emissions, Spontaneous*

In order to establish the predicted normal values of the systolic time intervals the duration of the systolic time intervals measured from simultaneous recordings of the electrocardiogram, the phonocardiogram and the carotid pulse tracing. The subjects studied were 160 healthy males and 160 females. The mean ages of males and females were 29 and 31 years old, respectively. The transformation period was not closely related to heart rate, and its mean values for males and females were 58 and 56 msec., respectively, and the mean for males and females combined was 57 msec. The remainder of the systolic time intervals, however, showed a significant linear and inverse relation to heart rate. Thus, based upon these data regression equations for the prediction of the normal values of electromechanical systole, left ventricular ejection time, mechinical systole, precjection period andisovolumiccontraction time for males, females, and males and females combined were obtained.
Adult ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Reference Values* ; Systole*

This report dealt with the case of 58 year old male with thrombotic thrombocytopenic purpura syndrome. The patient had an occlusion of the left middle cerebral artery on the carotid angiogram. The clinical course of the case with disseminated intravascular coagulation was fulminant. Literatures on pathophysiology, treatment, pathology and clinical course disseminated intravascular coagulation were reviewed.
Disseminated Intravascular Coagulation* ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery* ; Pathology ; Purpura, Thrombotic Thrombocytopenic

Actinomycosis is a chronic, granulomatous suppurative disease caused by Actinomyces species. Actinomyces is an anaerobic, gram positive organism that requires special techniques for culture and isolation. Actinomycosis is characterized by formation of multiple abscesses, draining sinuses, abundant granulations (sulfur granule) and dense fibrous tissue. The three major clinical presentations include the cervicofacial, thoracic, and abdominal regions. Since A. israelii is a normal inhabitant of the oral cavity, to make a definitive diagnosis it must be recovered from closed tissue spaces, draining sinuses, or abscesses, or it must be shown to be invasive in histopathologic sections. The drug of choice is penicillin. Because of the dense fibrous tissue surrounding the colonies of organisms and the concentration of organisms in clusters, high doses of pharmacologic agents must be used for long periods, and radical surgical excision should accompany antibiotic therapy if possible. We report three cases of abdominal actinomycosis, preoperatively impressed as appendicitis and pelvic abscess, which was diagnosed by a histological study of operative specimens. The possible pathogenic mechanisms causing clinical symptoms are discussed.
Abscess ; Actinomyces ; Actinomycosis* ; Appendicitis ; Diagnosis ; Mouth ; Penicillins

As the incidence of victims of traumatic craniocerebral injury in children has increased in modern times, we retrospectively analyzed 103 cases of surgically treated craniocerebral injuries among patients under the age of 15 who were admitted from January 1991 to December 1994. We classified the materials, i.e. 1) cause and incidence of craniocerebral injury, 2) clinical symptoms, 3) diagnosis and operation, 4) outcome and complication, and 5) period of hospitalization. The results were as follows: 1) The male to female ratio was 1.9:1(male patients 68, female patients 35). 2) The incidence peaked at the age of 6 and was mostly distributed from the age of 6 to 10. 3) As for time distribution most of the accidents occurred between 3 and 6 in the afternoon. 4) The main cause of craniocerebral injuries was attributed to traffic accidents (54 cases, 52.4%) and the second most common cause was falls from heights(30 cases, 29.1%). 5) In 85 cases, the Glasgow coma scale 13-15 before operation was observed. 6) Depression fractures were found to be the most common lesion in our cases. 7) In 48 cases(46.6%) a craniotomy was the operative procedure performed and in 40 cases(38.8%) an elevation of the depressed bone was performed. 8) In 93 cases, the Glasgow outcome scale 4-5 after operation was observed. 9) The many sequelae of operation were neurological deficit, cognitive impairent, and post-traumtic seizure. 10) The average period of hospitalization was 18.7 days(s.d=18.1). The cause and incidence of surgically treated pediatric head injuries were similar to those of total pediatric head injuries. A high GCS score at admission predicts a good outcome and fewer sequelae. However, papillary abnormalities and a neurological deficit at admission were poor prognostic factors. This study confirms that pediatric head injuries treated surgically provide better results than in adults.
Accidents, Traffic ; Adult ; Child ; Craniocerebral Trauma* ; Craniotomy ; Depression ; Diagnosis ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head* ; Hospitalization ; Humans ; Incidence ; Male ; Retrospective Studies ; Seizures ; Surgical Procedures, Operative

Hamstring injuries are common forms of muscle strains in athletes but a complete rupture of a proximal hamstring origin is rare. Often there is a considerable delay in diagnosis and stringent treatment because of its rarity, difficulty in clinical diagnosis, and initial attempts of conservative care. We report two cases of acute complete rupture of the proximal hamstring tendons treated with early surgical repair. The diagnosis and treatment of this unusual injury are discussed.
Acute Disease ; Adolescent ; Adult ; Football/*injuries ; Humans ; Male ; Martial Arts/*injuries ; Rupture ; Tendon Injuries/diagnosis/*surgery ; Thigh ; Young Adult

Recently, a combination of a partial mastectomy, axillary dissection, and radiation has been accepted as therapy for early-stage breast cancer because various significant trials have demonstrated that the combination therapy and the radical mastectomy produce comparable actuarial survival rates. The authors reviewed the cases of 62 patients who were treated for stage I and II breast cancer, 22 with breast-preserving surgery (quadrantectomy, axillary dissection and latissimus dorsi myocutaneous flap) and 40 with a modified radical mastectomy at Pusan National University Hospital during the period of 2.5 years from January 1994 to June 1996. The results are as follows: 1) The mean age of the breast-preserving group was 44.8 years, and that of the modified radical mastectmy group was 51.2 years. 2) The mean size of tumor mass was 2.1 cm and 2.5 cm, respectively. The most frequent site was the upper outer quadrant in both groups. 3) According to TNM classification, 8 patients (36.4%) had stage I tumors and 12 patients (54.5%) had stage II tumors in the breast-preserving group. The respective numbers of patients were 8 (20.0%) and 31 (77.5%) in the modified radical mastectomy group. 4) In the breast-preserving group, the number of axillary lymph-node metastasis was 0 in 16 cases (72.7%), 1~3 in 5 cases (22.7%), and 4 in 1 case (4.6%). In the modified radical mastectomy group, the number was 0 in 23 cases (57.5%), 1~3 in 13 cases (32.5%), and 4 in 4 cases (10.0%). 5) In the breast-preserving group, a local recurrence developed in one case at 12 months after the operation, and a salvage mastectomy was done. In the modified radical mastectomy group, a local recurrence developed in two cases, one at 14 months and the other at 16 months after the operation, and a wide excision was done. 6) Complications associated with axillary dissection were impaired arm mobility, arm edema, seroma, and skin necrosis. However, complications were well treated with no difficulty. 7) The overall subjective cosmetic results in the breast-preserving group were excellent in 7 cases (31.8%), good in 12 cases (54.1%), fair in 3 cases (13.7%), and poor in 0 cases. Postoperative asymmetry of the nipple is a problem to be solved. 8) The fear of recurrence was observed in 10 cases (45.5%) in the breast-preserving group and in 18 cases (45.0%) in the modified radical mastectomy group. 9) The complications associated with radiotherapy in the breast-preserving group were transient radiation dermatitis, breast fibrosis, radiation pneumonitis, and limited motion of shoulder. Our review shows a high loco-regional control rate (95.5%) and a satisfactory cosmetic result (86.3%) in the breast-preserving group for early-stage breast cancer. Thus breast-preserving procedures seem to be acceptable alternatives to a modified radical mastectomy in highly selective group of patients with early-stage breast cancer.
Arm ; Breast Neoplasms* ; Breast* ; Busan ; Classification ; Dermatitis ; Edema ; Humans ; Mastectomy ; Mastectomy, Modified Radical* ; Mastectomy, Radical ; Mastectomy, Segmental ; Necrosis ; Neoplasm Metastasis ; Nipples ; Pneumonia ; Radiation Pneumonitis ; Radiotherapy ; Recurrence ; Seroma ; Shoulder ; Skin ; Superficial Back Muscles ; Survival Rate

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
Classification* ; Constriction, Pathologic* ; Drug Therapy ; Fluorescein ; Fluorouracil ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Silicon ; Silicones ; Tears

We saw a case of minoxidil induced pericardial effusion in a 36 years old female who developed generalized edema, weakness and hypertrichosis after taking minoxidil for 1 year. Her chest PA showed globular shaped cardiac enlargement and pulmonary congestion. Echocardiography of the heart showed moderate amount of pericardial effusion. 10 days later after cessation of the drug administration and conservative managements, her chest PA showed marked improvement of heart size and pulmonary congestion. 20 days later her blood pressure became normal with the continued use of other antihypertensive drugs.
Adult ; Antihypertensive Agents ; Blood Pressure ; Echocardiography ; Edema ; Estrogens, Conjugated (USP) ; Female ; Heart ; Humans ; Hypertrichosis ; Minoxidil* ; Pericardial Effusion* ; Thorax