Macroglossia can cause dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical treatment, and create masticatory, speech and airway management problems. To determine whether a reduction glossectomy is necessary, it will important to identify the signs and symptoms of macroglossia. Development of dentoskeletal changes directly related with tongue size, such as an anterior open bite or a Angle Class III malocclusion tendency, would indicate that reduction glossectomy may be beneficial. For reduction glossectomy, several techniques have been reported. However, in most techniques the tip of tongue is removed. So its excision causes the loss of most mobile and sensitive portion of the tongue, and creates ankylosed, globular tongue. To avoid such problems, central tongue reduction technique have been proposed. This article will introduce central tongue reduction for anterior openbite case associated with macroglossia.
Airway Management ; Congenital Abnormalities ; Glossectomy ; Macroglossia* ; Malocclusion ; Malocclusion, Angle Class III ; Open Bite ; Tongue*

To identify the factors influencing the charges per case of acute appendicitis and normal spontaneous vaginal delivery (NSVD), the personal data-base files and hospital-characteristics-reporting data files of Korea Medical Insurance Corporation were analyzed. One hundred and twenty-nine institutions were selected. The results of this study were as follows: 1. The differences of charges per case with respect to hospital ownership, location, and equipment levels were statistically significant. 2. The results of multiple regression analysis revealed that bed capacity was the most significant variable in both diseases. 3. Ownership was significant variable in acute appendicitis. In NSVD, ownership and hospital equipment level were statistically significant. In conclusion, bed capacity was statistically the most significant variable in the analysis of charges per case. And we thought that the results of this study would influence the policy of the hospital bed supply.
Appendicitis* ; Information Storage and Retrieval ; Equipment and Supplies, Hospital ; Humans ; Insurance ; Korea ; Ownership

BACKGROUND: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. METHODS: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. RESULTS: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. CONCLUSIONS: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.
Arthroscopy* ; Dislocations ; Elbow ; Humans ; Joint Instability ; Recurrence* ; Reoperation ; Risk Factors* ; Shoulder* ; Surgeons ; Suture Anchors* ; Sutures*

In the published article by Choi et al., a part of expression of the Abstract and the Conclusion section in the main body text have been corrected. Underlined text should be read carefully.

We experienced a case of a 38 year old women in whom an alpha-fetoprotein producing carcinoma originated in the rectum. The patient had symptoms of hematochezia and bowel habit change, and a rectal examination revealed an ulcerative mass at the midrectum. The mass size was 6.5 cm 6 cm. The serum alpha-fetoprotein measured preoperatively was 9336 ng/ml, and the serum (carcinoembryonic antigen) was 6.4 ng/ml. The serum level of alpha-fetoprotein decreased to 830 ng/ml thirteen days after a low anterior resection. The tumor mass was a poorly differentiated adenocarcinoma. Using an immunohistochemical staining method, we detected alpha-fetoprotein producing cells in the tumor mass. During the follow up, the serum alpha-fetoprotein level began to increase continuously, and an abdomin opelvic CT scan showed a systemic, local tumor recurrence. Based on our experience with this patient and a review of the literature on the few cases previously reported, it seems that alpha-fetoprotein producing colorectal carcinamas have a tendency to produce frequent blood-borne metastasis and are associated with a poor prognosis.
Adenocarcinoma ; Adult ; alpha-Fetoproteins* ; Colorectal Neoplasms ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Humans ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms* ; Rectum ; Recurrence ; Tomography, X-Ray Computed ; Ulcer

PURPOSE: This study aimed to find out whether there are relationships among anatomic characteristics of inferior oblique muscle insertion, corneal diameter, axial length and inferior oblique recession landmark. METHODS: Thirty-one Korean cadaver orbits were dissected to expose the full length of extraocular muscles and sclera, and then we measured the length from the recession landmark of inferior oblique to the lateral edge of insertion of inferior rectus and to the inferior edge of insertion of lateral rectus. RESULTS: The mean of angles between the inferior oblique muscle insertion and lateral rectus direction is 27.9+/-9.0degrees and the range is from 15 degrees to 50 degrees . There is a statistically significant correlation between cord length of 8 mm recession landmark of inferior oblique and angles of inferior oblique insertion with lateral rectus direction. We divided the shapes of inferior oblique insertion into straight and convexed curves. Twelve insertions are straight and thirteen insertions are curved. There is no statistically significant correlation between shape of inferior oblique insertion and cord length from recession landmark. In corneal diameter and axial length, we found correlations with cord length of 8 mm and 10 mm recession landmark of inferior oblique. CONCLUSIONS: We conclud that there are some correlations among anatomic characteristics, axial length and corneal diameter with recession landmark of inferior oblique.
Cadaver ; Muscles ; Orbit ; Sclera

No abstract available.
Humans ; Hydronephrosis* ; Radioisotope Renography*

The two main diseases of inflammatory bowel disease are Crohn's disease and ulcerative colitis. The pathogenesis of inflammatory disease is that abnormal intestinal inflammations occur in genetically susceptible individuals according to various environmental factors. The consequent process results in inflammatory bowel disease. Medical treatment consists of the induction of remission in the acute phase of the disease and the maintenance of remission. Patients with Crohn's disease finally need surgical treatment in 70% of the cases. The main surgical options for Crohn's disease are divided into two surgical procedures. The first is strictureplasty, which can prevent short bowel syndrome. The second is resection of the involved intestinal segment. Simultaneous medico-surgical treatment can be a good treatment strategy. Ulcerative colitis is a diffuse nonspecific inflammatory disease that involves the colon and the rectum. Patients with ulcerative colitis need surgical treatment in 30% of the cases despite proper medical treatment. The reasons for surgical treatment are various, from life-threatening complications to growth retardation. The total proctocolectomy (TPC) with an ileal pouch anal anastomosis (IPAA) is the most common procedure for the surgical treatment of ulcerative colitis. Medical treatment for ulcerative colitis after a TPC with an IPAA is usually not necessary.
Colitis, Ulcerative ; Colon ; Crohn Disease ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Rectum ; Remission Induction ; Short Bowel Syndrome

In this report, a case of a 70-year-old man with a large ganglion cyst formed after anterior transposition of the left ulnar nerve is presented. Three months after the index surgery, the patient presented with a painless superficial ovoid, soft mass measuring 5x4x2 cm in size located at the posteromedial aspect of the left elbow, the previously operated site. Magnetic resonance imaging showed a well demarcated cystic mass with a stalk connecting to the elbow joint. Excisional biopsy was performed and pathologic findings showed that the cystic wall had no definite lining cells with myxoid degeneration compatible with findings of ganglion cyst.
Aged ; Biopsy ; Cubital Tunnel Syndrome ; Elbow ; Elbow Joint ; Ganglion Cysts* ; Humans ; Magnetic Resonance Imaging ; Ulnar Nerve*

Leprosy is a multisystemic infectious disease showing various cutaneous manifestations by the reaction between Mycobacterium leprae (M. leprae) and host immunity. We de-scribe a 20-year-old woman with clinical multiple papulonecrotic skin eruptions resembling papulonecrotic tuberculid (PNT) and pityriasis lichenoides et varioliformis acuta (PLEVA). This kind of skin eruption is a new manifestation which has not been reported so far in lepromatous leprosy (LL).
Communicable Diseases ; Female ; Humans ; Leprosy ; Leprosy, Lepromatous* ; Mycobacterium leprae ; Pityriasis Lichenoides ; Skin Manifestations* ; Skin* ; Tuberculosis, Cutaneous ; Young Adult