No abstract available.
Humans ; Male ; Military Personnel*

No abstract available.
Humans ; Male ; Military Personnel*

Both atypical Brown syndrome (ABS) and inferior rectus restriction of double elevator palsy (DEP) are characterized by monocular limitations of upgaze in primary, abducted position as well as abducted position. Futhermore, they exhibit resistance of elevation in adduction during forced duction test and should be considered in the differential diagnosis. We gained several differential points from 6 year-old female with ABS and a 12 year-old female with DEP due to inferior rectus restriction (IRR). In forced duction test under general anesthesia, ABS exhibited resistance of elevation in adduction and IRR of DEP showed resistance of elevation in all upward direction. DEP showed an impairment of Bell`s phenomenon and mild pseudoptosis preoperatively in which ABS never showed. ABS displayed divergence in upgaze producing V-pattern, and further limitation of upgaze in adduction than DEP. Superior oblique lengthening procedure using silicone expander was performed for ABS. Ipsilateral inferior rectus and contralateral superior rectus recession were performed for IRR of DEP. The results for elevation in adduction, primary position and abduction were satisfactory in both diseases. In conclusion, the direction of resistance in forced duction test, Bell` s phenomenon, the degree of elevation in abducted and abducted position, presence of pseudoptosis and divergence in upgaze producing 3 V-pattern may be helpful to differentiate ABS from IRR of DEP.
Anesthesia, General ; Child ; Diagnosis, Differential* ; Elevators and Escalators* ; Female ; Humans ; Paralysis* ; Silicones

OBJECTIVES: The multiple sleep latency test (MSLT) is commonly used as a valid objective measure of sleepiness. The procedure of MSLT is well standardized but the sleep onset criterion is somewhat variable. One epoch of stage 1 sleep is the most commonly used criterion, and the criterion of three epochs of stage 1 sleep is also used. The purpose of this study was to compare the two criteria used to determine sleep onset. METHODS: We retrospectively analyzed 60 consecutive MSLT that were performed according to a standaridized protocol. We scored each test using the two different criteria for sleep onset and then statistically analyed the results. RESULTS: Using the different criteria, 20 patients among 60 showed changes in mean sleep latency (33.3%). The extent of change ranged from 1.3% to 38.5% (mean 15.9%). Non-narcoleptic patients showed a significantly higher incidence of change than other sleep disorder patients. CONCLUSION: Changes in mean sleep latency occurred according to the different criteria of sleep onset. But the difference arising from different criteria was statistically not significant in patients with moderate to severe sleepiness. Considering that 1 epoch criterion for sleep onset is more sensitive in detecting clinically significant sleepiness, the authors suggest that the 1 epoch criterion is more reliable than the 3 epochs criterion.
Humans ; Incidence ; Retrospective Studies

No abstract available.
Alexander Disease*

BACKGROUND: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results. METHODS: We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up. RESULTS: Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication. CONCLUSIONS: We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.
Ankylosis ; Arm ; Arthroscopy ; Classification ; Follow-Up Studies ; Fracture Fixation ; Glenoid Cavity ; Humans ; Methods ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies ; Scapula

The clinicopathologic features and the comparative analysis of diagnostic methods in 42 patients having intestinal tuberculosis were studied. In all the cases, clinical and colonoscopic diagnosis was confirmed by histological examination. Abdominal pain was the most common symptom (54%). Twenty nine patients had active pulmonary tuberculosis which was confirmed by a chest X-ray, or an AFB smear and a culture of sputum. A transverse ulcer with surrounding hypertrophic mucosa and multiple erosion was the usual colonoscopic findings. The granulomas were usually located in the just upper and lower portion of muscularis mucosa. The direct smear and culture of the fresh biopsy material showed AFB in 11 (32.4%) and 12 cases (36.4%) respectively. Ziehl-Neelsen staining in serially sectioned slides from formalin-fixed, paraffin- embedded tissue revealed AFB in 15 cases (35.7%). An immunohistochemical stain for Mycobacterium bovis was done in all cases and 13 cases were positive (31%). A polymerase chain reaction (PCR) was done and showed positivity in 4 out of 20 cases of fresh biospy material and 12 out of 40 cases in paraffin embedded tissue. For the conclusive diagnosis of intestinal tuberculosis, a Ziehl-Neelsen stain is the most sensitive, fast, and cost-effective method. The diagnostic accuracy will be increased when other diagnostic methods such as tissue culture and PCR are coupled with this simple staining method.
Abdominal Pain ; Biopsy ; Diagnosis* ; Granuloma ; Humans ; Intestines ; Mucous Membrane ; Mycobacterium bovis ; Paraffin ; Polymerase Chain Reaction ; Sputum ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

No abstract available.
Lymphedema*

BACKGROUND: It is well known that non-rapid eye movement(NREM) sleep activates the occurrence of interictal epileptiform discharges(IED) in many epileptic syndromes. We performed this study to assess the effect of NREM sleep on IED in epileptic patients with organic brain lesions. MATERIALS AND METHODS: We analyzed awake and sleep electroencephalopathy(EEG) recorded simultaneously after partial sleep deprivation in 50 patients. We calculated the awake and sleep spike index (ASI and SSI, spikes/epoch), and the percentage increase of ASI and SSI during sleep. RESULTS: In the 50 patients, the IEDs were recorded exclusively during the awake state in 1 (2%) patient, and during the sleep state in 13(26%) patients. The SSI was higher in 44 (88%) patients, and the ASI was higher in 5 (10%) patients. The mean ASI and the SSI in patients with organic brain lesions were 0.058+/-0.121 and 0.148+/-0.187, and it was 0.081+/-0.150 and 0.174 +/-0.226 in patients without organic brain lesions. There were significant increases in the spike index (P<0.05) during NREM sleep in both groups (n=36), but no significant difference in the percent increase of spike index (P>0.05). CONCLUSION: The IEDs were activated significantly during NREM sleep both in patients with and without organic brain lesions, but there were no differences in the degree of activation in both groups. The activating effect of NREM sleep was not correlated with clinical factors such as, frequent nocturnal seizures, frequent generalized tonic clonic seizures, type of epilepsy and taking anticonvulsants. We conclude that the routine EEG used to evaluate epileptiform discharges in epileptic patients should include sleep recordings after partial sleep deprivation.
Anticonvulsants ; Brain ; Electroencephalography* ; Epilepsy ; Humans ; Seizures ; Sleep Deprivation

Dermatofibrosarcoma protuberans(DFSP) is a rare, distinctive cutsneous tumor originating in the dermis that appears as a raised uninodular or multinodular lesion on the trunk or the proximal extremities. In about 10% of the cases, DFSP arises in childhood and it is rarely evident already at birth. Histopathologically, DFSP shows the chsracteristic storiform and cartwheel patterns, with the fibroblasts arranged radially about a small central hub of fibrous tissue. We report herein a case of childhood DFSP in a 7-year-old boy.
Child ; Dermatofibrosarcoma* ; Dermis ; Extremities ; Fibroblasts ; Humans ; Male ; Parturition