The occurence of pseudarthroses associated with neurofibromatosis is a well documented phenomenon, with the majority of reported cases in the tibia but quite rare in forearm,Only ten cases in the English-literature and one case in Korean-literature of this lesion revealed appearing in the bones of the forearm till now. Of these, four in solitary pseudarthroses of the ulna(4.5.15), five in a solitary lesion of the radius(7.8.10.16.17), and only two cases was on the both bones of the forearm(9.14). We are presenting the case report of a Korean adult male with the clinical stigmata and a positive familial history of neurofibrormotosis who had congenital pseudarthroses of both the radius and ulna of the right forearm. Therefore, the present case is the third to be reported. We treated him with by production of an one-bone forearm using a dual a onlay bone graft positioned in neutral of supination and pronation. A stable, functional extremity with good union of pseudarthroses were encountered.
Adult ; Christianity ; Extremities ; Forearm ; Humans ; Inlays ; Male ; Neurofibromatoses ; Neurofibromatosis 1 ; Pronation ; Pseudarthrosis ; Radius ; Supination ; Tibia ; Transplants ; Ulna

Purpose: To evaluate surgical outcome and effectiveness of inferior oblique (IO) myectomy on unilateral superior oblique palsy (SOP) as a primary treatment. Methods: This study is a retrospective review of the medical records of 99 patients who had undergone IO myectomy due to SOP as a first-line treatment. Sixty-five patients with hyperdeviation of 15 prism diopters (PD) or less were categorized into group 1, 22 patients with hyperdeviation between 16 PD to 20 PD into group 2, and 12 patients with hyperdeviation higher than 20 PD into group 3. Preoperative hyperdeviation, postoperative hyperdeviation, and improvement of head tilting were then compared between the 3 groups. Surgery was determined to be successful when the post-op residual hyperdeviation is less than 5 PD, or when the improvement of hyperdeviation and head tilting was noted, for the patients who had preoperative deviation less than 5 PD, and without hypercorrection. Results: All groups showed significant improvement of hyperdeviation, and the amount of correction was larger in group with larger preoperative hyperdeviation. 80.3%, 95.0%, and 90.9% of patients showed improvement of head tiling and success rate was 87.7%, 77.3%, and 50.0% in group 1, 2, and 3 respectively. Group 1 and 2, group 2 and 3 had no significant difference in success rate but only group 1 and 3 had significant difference. Conclusions Considering success rate with improvement of head position, self-titrating and possibility of overcorrection, IO myectomy could be an effective option as a first-line surgical treatment for unilateral SOP with hyperdeviation of 20 PD or less. However, due to a 50% success rate in patients with hyperdeviation larger than 20 PD, a secondary operation must be considered following IO myectomy, or a two-muscle procedure must be considered as a primary treatment.

No abstract available.
Colonoscopy* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

No abstract available.
Diabetic Neuropathies*

Profound reduction of anterograde coronary flow with concomitant ischemia is seen occasionally during percutaneous coronary intervention despite technically successful procedure. We found interesting coronary flow pattern in a patient with acute myocardial infarction, showing angiographic no reflow phenomenon after direct PTCA. The coronary blood flow pattern of the angiographic no-reflow phenomenon in this case was characterized by minimal systolic flow and sharp deceleration of diastolic flow. Coronary flow reserve calculated by the ratio of adenosine induced maximal hyperemic velocity and basal velocity was reduced. The Dopplertipped guide wire was useful for observation of phasic coronary flow pattern of angiographic no-reflow phenomenon.
Adenosine ; Deceleration ; Humans ; Ischemia ; Myocardial Infarction* ; No-Reflow Phenomenon ; Percutaneous Coronary Intervention

BACKGROUND: During clinical practice we found that left ventricular systolic function(LVSF) has been normalized in some patients with cardiomyopathy. We investigated the echocardiographic and clinical factors affecting normalization of LVSF in these patients. METHOD: The patients with LV systolic dysfunction(EF<40%) were evaluated with echocardiography, coronary angiography and/or 201-Thallium SPECT and follow-up echocardiography(FUE) one year later. They had no coronary, valvular, congenital heart diseases. Consecutive 50 patients with improved LVSF(EF> or =55%) in FUE were defined to Group 1(mean age 57+/-16, male 21, female 29, mean follow-up 18+/-6 month) and another consecutive 50 patients with sustained decreased LVSF(EF<40%) and no increment of EF over 10% in FUE were defined to Group 2(mean age 56+/-14, male 32, female 18, mean follow-up 20+/-6 month). RESULTS: By univariate analysis, significant factors affecting normalization of LVSF were female sex, non-smoker, first experience of dyspnea, absence of bundle branch block in ECG, end-diastolic dimension of LV(LVEDD), end-diastolic volume of LV(LVEDV), LA size, less sphericity, presence of pericardial effusion, peak and end systolic wall stress. By multivariate analysis, LVEDD(Group 1: 61+/-7, Group 2: 71+/-7mm, p<0.001), LVEDV(Group 1: 139+/-59, Group 2: 190+/-51ml, p<0.01), absence of bundle branch block in ECG and 1st attack of symptom were significant. By Receiver operating characteristics curve analysis, area under curve of LVEDD and LVEDV were 0.859(95%CI: 0.775-0.920) and 0.805(95%CI: 0.681-0.896), respectively. LVEDD< or =64mm predicted normalization of LVSF with a sensitivity 76% and a specificity 86%. CONCLUSION: Determination of cardiac dimension and volume by echocardiography is very important to predicting normalization of LV systolic function in primary myocardial disease. And this results suggest that myocardial structural integrity may be important for recovery of LV function in clinical setting.
Bundle-Branch Block ; Cardiomyopathies* ; Coronary Angiography ; Dyspnea ; Echocardiography* ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Male ; Multivariate Analysis ; Pericardial Effusion ; ROC Curve ; Sensitivity and Specificity ; Statistics as Topic ; Tomography, Emission-Computed, Single-Photon

Microphthalmos is a uncommon congenital ocular anomaly and the term is justified in that in all cases the eyes are smaller than normal. Microphthalmos is classified as various forms according to degrees of developmental abnormality. The authors experienced a case of microphthalmos with a large cyst in one eye and colobomatous microphthalmos in the other eye.
Coloboma ; Microphthalmos*

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

Staphylococcus species are one of prevalent pathogens found in hospitals. Microbes that are a primary cause of nosocomial infection were isolated from a dental and medical environment it may assist the reader to explain what this is and how it differs from the 'dental health care providers and ward health care providers'. To investigate the distribution of staphylococcus species in this environment, we used vitek II to measure drug sensitivity, and further performed biochemical testing. The isolation rate of staphylococcus species from the dental and medical environment was 100% but from dental health care providers and ward health care providers were 44.4% and 33.3%, respectively. In the analyses, staphylococcus species showed resistance to diffusion of cefoxitin and oxacillin discs. These staphylococci may be sufficiently positive for the mecA gene. Our results suggest that staphylococci might be an important cause of nosocomial infection in the dental clinic.
Adenosine ; Anti-Infective Agents ; Cefoxitin ; Cross Infection ; Delivery of Health Care ; Dental Clinics ; Diffusion ; Health Personnel ; Humans ; Oxacillin ; Staphylococcus