The tongue is located inside the oral cavity at rest, and the structural interrelations between the tongue and the oral cavity is essentially important for normal tongue function. Macroglossia is clinically diagnosed whenever the tongue does not fit the oral cavity, thus patients complain of noisy breathing, drooling, speech and swallowing dysfunction, malocclusion, and social ridicule. Partial glossectomy for macroglossia volume has been assumed to be difficult. In this study, we attempted to measure the tongue volume with the plaster tongue model in a 7-year-old macroglossia patient. This method is reliable and simple for measuring the tongue volume in macroglossia.
Child ; Deglutition ; Glossectomy* ; Humans ; Macroglossia* ; Malocclusion ; Mouth ; Respiration ; Sialorrhea ; Tongue*

It is necessary to confirm disease pathologically even though there are several methods of diagnosis for breast abnormality. Ultrasound guided core needle biopsy (UGCNB) of breast lesions with automated gun is widely accepted as a simple and accurate procedure for avoiding open biopsy. From January 1996 to February 1998, 121 breast lesions of 117 women detected with mammogram, ultrasound, physical examination or any combination were selected. UGCNB was performed in all 121 cases with 7.5 MHz transducer and Manan Pro-mag 2.2 automated biopsy gun (2.2 cm excursion). After local anesthesia, 5-6 cores were obtained through 2mm skin incision site. Lesions categorized as probably benign to highly suspicious were included as indications for core biopsy. 67.5% of the 117 patients were in age thirties and forties. The results of the biopsy were benign in 65 lesions and malignant in 56. 15 patients showing benign results which were contrary to clinical findings and pathologic results, underwent open biopsy. Four patients who had previously been diagnosed as being benign, were found to be malignant (false-negative 3.3%). Primary results of four cases of false negative were intraductal papilloma, severe inflammatory change, atypical ductal hyperplasia, and insufficient sampling, respectively. In case of insufficient sampling resulted from small gauge needle (18G), correct diagnosis was possible in all lesions with large needle (14G). Also excisional biopsy was required in women having intraductal papilloma, severe inflammation and atypical ductal hyperplasia which were difficult to differenciate from malignancy. The UGCNB is excellent biopsy method for multiple breast lesions. The method has demonstrated a 96.7% sensitivity specificity 100%, and positive predictive value (PPV) of 46.3%. We also conclude that UGCNB is proved To be an useful alternative to surgical biopsy on simpler procedure with no adverse cosmetic results.
Anesthesia, Local ; Biopsy ; Biopsy, Large-Core Needle* ; Breast* ; Diagnosis ; Female ; Humans ; Hyperplasia ; Inflammation ; Needles ; Papilloma, Intraductal ; Physical Examination ; Sensitivity and Specificity ; Skin ; Transducers ; Ultrasonography*

No abstract available.

Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome, is an anti-neutrophil cytoplasmic antibody associated vasculitis, accompanied by asthma, hypereosinophilia, nonfixed pulmonary infiltrates, and sinusitis. Peripheral neuropathy is common in patients with EGPA; however, a few cases of EGPA with central nervous system (CNS) involvement have been reported. A 45-year-old female referred for right side weakness and posterior neck pain was diagnosed as EGPA with subarachnoid hemorrhage and mononeuritis multiplex. She was effectively treated with a high dose glucocorticoid, cyclophosphamide, and intravenous immunoglobulin. EGPA with CNS involvement is uncommon and causes significant morbidity and mortality. Therefore more rapid and accurate diagnostic evaluation may be required. EGPA should be considered in patients with neurological symptoms and hypereosinophilia.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Central Nervous System ; Churg-Strauss Syndrome ; Cyclophosphamide ; Eosinophils* ; Female ; Humans ; Immunoglobulins ; Middle Aged ; Mononeuropathies* ; Mortality ; Neck Pain ; Peripheral Nervous System Diseases ; Sinusitis ; Subarachnoid Hemorrhage* ; Vasculitis

The premammillary artery (PMA) is a branch of the posterior communicating artery (PCoA). While the PMA is known to originate from the PCoA as demonstrated by most anatomical studies, it originates directly from the internal carotid artery in approximately 1% of patients. Cerebral aneurysms associated with the PMA have rarely been reported. We report an extremely rare case of a ruptured PMA aneurysm that was managed using endovascular treatment.
Aneurysm* ; Arteries* ; Carotid Artery, Internal* ; Humans ; Intracranial Aneurysm

BACKGROUND: Intestinal ischemia remains a devastating event despite improvements in clinical recognition and in diagnostic and therapeutic modalities. The ischemic bowel diseases encompass a wide clinical spectrum from mild, reversible disease to severe, irreversible injury. The clinical picture is characterized initially by poorly localized whether an increased serum lactate level is a recognized danger signal marker for intestinal ischemia in patients who present at the emergency department because of abdominal complaints. METHODS: Patients who came to our emergency department with abdominal pain and the risk factors of intestinal ischemia between Apr. 1999 and Nov. 1999 were included in this study. The data analysis included age, sex, final diagnosis, pathogenesis of bowel ischemia, and serum lactate level. RESULTS: The serum lactate level in the intestinal ischemia group was 28.54+/-22.51mg/dl; in non-ischemia group, it was 15.49+/-22.52mg/dl. This difference between the two groups was significatn(p<0.05). An increased serum lactate level had a sensitivity of 88.2% and specificity of 59.2%, a positive likelihood ratio of 4.92, and a negative likelihood ratio of 0.47 as a marker of bowel ischemia. These results do not represent a very meaningful revision of bowel ischemic provability, but may make a small contribution to management of the disease, depending upon their magnitude and the clinical context in which they are applied. CONCLUSION: In patients with abdominal complaints, an increased serum lactate level is usually a useful aid as a diagnostic marker of bowel ischemia.
Abdominal Pain ; Diagnosis ; Early Diagnosis* ; Emergency Service, Hospital ; Humans ; Ischemia* ; Lactic Acid* ; Risk Factors ; Sensitivity and Specificity ; Statistics as Topic

To attempt a rigorous definition of the structure of the accessory spleen (AS) in the Chinese hamster, we examined twenty-one animals, and found AS in 5 animals (23.8%), which were over 7-month-old. The AS had no connection with the main spleen and was seen as a dark red oval organ (0.7 mm x 1.5 mm), which was embedded in the adipose tissue near the tail of the pancreas. It was demarcated from the adipose tissue and some pancreatic tissue. The organ was encapsulated by thin collagenous connective tissue and smooth muscle fibers, and contained lymphatic nodules, reticular fibers, nodular central arterioles, macrophages and megakaryocytes. Notably the incidence of AS appeared to increase with age in the Chinese hamsters.
Adipose Tissue/anatomy & histology ; Age Factors ; Animals ; Connective Tissue/anatomy & histology ; Cricetinae ; Cricetulus/*anatomy & histology ; Erythrocytes/cytology ; Lymphocytes/cytology ; Muscle, Smooth/anatomy & histology ; Pancreas ; Spleen/*anatomy & histology/cytology

No abstract available.
Glomus Tumor*

Postoperative pain control is very important not only for the relief of pain. but in the prevention of respiratory acidosis, pulmonary complications, emotional disturbances and sleeping disturbances etc. Jn spite of its significance there are a few studies on postoperative pain control in medical literature. Techniques have been developed for postoperative pain control since the 19 century, for example analgesics, inhalational agents, regional block, hypnosis and accupuncture. However none of these techniques was satisfactory because of various complications. The intermittent intramuscular injection of narcotics (e.g. meperidine) has been used most widely pto the present. There have been many complications, induding addiction, from this method. Our study was done in the recovery room with intramuscular injections of Thalamonal to fully awake patients, with 20 cases each having operation done in the upper abdomen, lower abdomen, and in other sites. We evaluated the results for the requirement of meperidine after the adminstration of Thalamonal. This was compared with the control group. There were 85% of cases that did not require the injection of meperidine. One case was complicated by hypotension, but this patient was improved with routine management for , hypotension. Other complications were not found.
Abdomen ; Acidosis, Respiratory ; Affective Symptoms ; Analgesics ; Humans ; Hypnosis ; Hypotension ; Injections, Intramuscular* ; Meperidine ; Narcotics ; Pain, Postoperative* ; Recovery Room

BACKGROUND: In 1997 the Korean Association of Medical Journal Editors (KAMJE) instituted a program to evaluate member journals. Journals that passed the initial evaluation were indexed in the KoreaMed. Here, we report changes in measures of quality of the KAMJE member journals during the last 20 years. METHODS: Quality measures used in the study comprised 3 assessment categories; self-assessment by journal editors, assessment of the journals by KAMJE reviewers, and by Korean health science librarians. Each used detailed criteria to score the journals on a scale of 0 to 5 or 6 in multiple dimensions. We compared scores at baseline evaluation and those after 7 years for 129 journals and compared improvements in journals indexed vs. not-indexed by the Web of Science (Science Citation Index Expanded; SCIE). RESULTS: Among 251 KAMJE member journals at the end of 2015, 227 passed evaluation criteria and 129 (56%) had both baseline and 7-year follow-up assessment data. The journals showed improvement overall (increase in median [interquartile range; IQR] score from baseline, 0.47 [0.64]; 95% confidence interval [CI], 0.44–0.61; P < 0.001) and within each category (median [IQR] increase by editor's assessment, 0.17 [0.83]; 95% CI, 0.04–0.26; P = 0.007; by reviewer's, 0.45 [1.00]; 95% CI, 0.29–0.57; P < 0.001; by librarian's, 1.75 [1.08]; 95% CI, 1.77–2.18, P < 0.001). Before the foundation of KAMJE in 1996, there were only 5 Korean medical journals indexed in the MEDLINE and none in SCIE, but 24 journals in the MEDLINE and 34 journals in SCIE were indexed by 2016. CONCLUSION: The KAMJE journal evaluation program successfully contributes improving the quality of the member journals.
Follow-Up Studies ; Humans ; Librarians ; Self-Assessment