OBJECTIVE: This study was designed to evaluate the effect of nasogastric tube on swallowing function in stroke patients with dysphagia. METHOD: Twelve stroke patients with dysphagia were included in this study. We evaluated the Functional Dysphagia Scale using videofluoroscopic swallowing study. Swallowing tasks were composed of swallowing 5 cc of thick food and same volume of fluid on nasogastric tube insertion state and then nasogastric tube removal state. RESULTS: As the result of measuring oral phase score before and after removing nasogastric tube, all of 12 patients showed no significant difference. There was statistically significant increase in score of residue in piriform sinuses on thick food swallowing after removing nasogastric tube (p<0.05). After removing nasogastric tube, aspiration was decreased on fluid swallowing in cases of 2 patients, while aspiration on thick food swallowing was increased in cases of 2 patients, compared with nasogastic tube insertion state. CONCLUSION: As the result of this study, the stroke patients with dysphagia on nasogastric tube were increased on fluid aspiration due to rapid descending and inhibition of epiglottic closure compared with the removal state of nasogastric tube. And there was significant increased in scores of residue in piriform sinuses on thick food swallowing and aspiration pneumonia after removing nasogastric tube.
Deglutition Disorders* ; Deglutition* ; Humans ; Pneumonia, Aspiration ; Pyriform Sinus ; Stroke*

The amniotic band syndrome is a collection of congenital deformities presurmably due to rupture of amniotic sac. It appears to cause fetal injury through three basic mechanisms including malformation, disruption, and deformation. The associated anomalies vary firom minor digital defect to major craniofacial and visceral defects. They can be categorized as neural tube-like defects, craniofacial anomalies, limb anomalies, abdominal and thoracic wall defects, visceral anomalies, and constriction bands. We had expericnced a case of severe congenital craniofacial anomaly due to amniotic bands diagnosed by ultrasonogram in the antenatal period is presented with a brief review of the literatures.
Amniotic Band Syndrome* ; Congenital Abnormalities ; Constriction ; Extremities ; Infant, Newborn ; Rupture ; Thoracic Wall ; Ultrasonography

OBJECTIVE: To obtain a effect of intraarticular injection of Sodium Hyaluronate in the patient with degenerative osteoarthritis without restriction of activities of daily living. METHOD: Twenty-five patients were participated in this study. These patients are diagnosed as degenerative osteoarthritis by clinical symtoms and radiographic findings. Sodium hyaluronate, 2.5 ml, 3 mg/ampule, were injected intraarticulary without local anesthesia once a week for 5 times consecutively. For evaluation of the effectiveness of sodium hyaluronate, we assess the parameters for subjective and objective symtoms scored from 0 to 3 on 3 items, and for activities of daily living scored from 0 to 4 on 4 items. And then, we compared these data between pre-injection and at post-injection 2, 4, and 5 weeks. Changes of subjective and objective symtoms, and activities of daily living are assessed using Kellgren's X-ray grading of degenerative osteoarthritis. Improvement of the subjective pain is recorded by visual analogue scale. RESULTS: 1. Subjective and objective symtoms, and activities of daily living with time progression were significantly increased at post-injection 4, 5 weeks compared with pre-injection status (P<0.05). 2. Subjective and objective symtoms, and activities of daily living according to Kellgren's X-ray classification were significantly increased at stage II and III (P<0.05). 3. Visual analogue scale is significantly decreased after injection (P<0.05). CONCLUSION: Intraarticular injection of sodium hyaluronate showed improvement of patient's subjective and objective symtoms, and activities of daily living. The improvement was pronounced in the cases of high grade of degenerative osteoarthritis (stage II, III) according to Kellgren's X-ray classification as well as low grade (Stage I).
Activities of Daily Living ; Anesthesia, Local ; Classification ; Humans ; Hyaluronic Acid* ; Injections, Intra-Articular ; Knee* ; Osteoarthritis* ; Sodium*

Intrabronchial nerilemmoma is very rare disease. Neurilemmoma has been thought to arise from schwann cell, has been reported to occur in almost any anatomic location. The incidence of primary neurogenic tumors of the lung has been estimated to be 0 to 2 percent of all lung tumors. These tumors are predominantly(75%) associated with neurofibromatosis of von Recklinghausen's disease. To our knowledge, no case of benign solitary endobronchial neurilemmoma has been reported in Korea. This paper presents a case of benign solitary endobronchial neurilemmoma with a brief review of the pertinent literature. A 19 year old female visited our medical hospital with the symptoms of chest discomfort and pain. Bronchoscopy and chest CT scan revealed a mass on the left upper 1obar bronchus. Left upper lobectomy was performed successfully and histological section revealed a neurilemmoma.
Bronchi ; Bronchoscopy ; Female ; Humans ; Incidence ; Korea ; Lung ; Neurilemmoma* ; Neurofibromatoses ; Neurofibromatosis 1 ; Rare Diseases ; Thorax ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: Initial symptoms for esophageal perforation have not been clarified, but when there is no early diagnosis and proper treatment to follow immediately after the diagnosis, it is fatal for the patients. Therefore, this study attempted to discover the factors that influence the prognosis of esophageal perforation to contribute to the improvement of the treatment result. MATERIAL AND METHOD: The subjects of this study are 32 patients who came to the hospital with esophageal perforation from October, 1984 to June, 2000. This study examined the items for clinical observation such as patients' sex, age, cause of the perforation, perforation site, the time spent until the beginning of the treatment, symptoms caused by the perforation and its complication, and treatment methods. This study tried to find out the relationship between the survival of patients and each item. RESULT: There were 24 male and 8 female patients and their mean age was 49.7 +/- 16.4. For the causes of perforation, there were 14 cases(43%) of iatrogenic perforation, which ranked first, caused by the medical instrument operation and surgical damage. As for the perforation sites, thoracic esophagus was the most common site(26 cases of 81.2%) and chest pain was the most frequent symptom. The complication caused by esophageal perforation showed the highest cases in the order of mediastinitis, empyema, sepsis and peritonitis. After the treatment, there were 23 cases of survival and 9 cases of mortality. The total mortality rate was 28.1% and the main causes of mortality were sepsis and acute respiratory distress syndrome(ARDS). As for the treatment, 8 cases(25.0%) treated the perforation successfully using conservative treatment only. As for the surgical treatment, there were 5 cases(15.6%) of cervical drainage, 7 cases (21.8%) of primary repair and 12 cases(37.5%) of esophageal reconstruction after performing an exclusion-diversion. There were 18 cases(56.2%) of complete treatment of esophageal perforation at its initial treatment and in 14 cases(43.8%) of treatment failure at its initial treatment, patients were completely cured in the next treatment stage or died during the treatment. The cases of perforation in thoracic esophagus, complication into severe mediastinitis or sepsis and the cases of failure at initial treatment showed a statistically significant mortality rate (p<0.05). CONCLUSION: Based on the above results, it is thought that a proper choice for initial treatment choice depending on the perforation site and the prevention of serious complication such as mediastinitis or sepsis can shorten the treatment period for the patients with esophageal perforation and improve the convalescence.
Chest Pain ; Convalescence ; Diagnosis ; Drainage ; Early Diagnosis ; Empyema ; Esophageal Perforation* ; Esophagus ; Female ; Humans ; Male ; Mediastinitis ; Mortality ; Peritonitis ; Prognosis ; Sepsis ; Treatment Failure

OBJECTIVE: The aim of this study was to find out the factors related to the recovery of hand motor function in patients with subcortical hemorrhage. METHOD: We investigated 21 patients with subcortical hemorrhage prospectively. We used their CT and/or MR imaging for the localization and estimation of the size of lesion. The Hand Movement Scale (HMS) was used for evaluation of the hand function. Proprioception, initial shoulder and hand recovery were also measured every month for at least 6 months during the follow up periods. RESULTS: There are 13 patients with putaminal hemorrhage and 8 patients with thalamic hemorrhage. There is no difference in general characteristics between the two groups. When recovery began within 4 weeks after onset, only thalamic hemorrhage patients showed significantly good recovery. Initial shoulder shrug, especially within 4 weeks after onset, could be one of the prognostic factors of good hand motor recovery. Putaminal hemorrhage patients, who had higher scores on the hand movement scale, showed early recovery of proprioceptive function. CONCLUSION: Among many other factors which can be involved in the recovery of hand function in patients with subcortical hemorrhage, the time of initial hand motor recovery, the time of initial shoulder shrug, and proprioceptive function were most important.
Follow-Up Studies ; Hand* ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Proprioception ; Prospective Studies ; Putaminal Hemorrhage ; Shoulder

OBJECTIVE: To identify changes in gray and white matter concentrations (GMC, WMC), and their relation to heterotopic neuron numbers in mesial temporal lobe epilepsy (mTLE). MATERIALS AND METHODS: The gray matter or white matter concentrations of 16 left and 15 right mTLE patients who achieved an excellent surgical outcome were compared with those of 24 healthy volunteers for the left group and with 23 healthy volunteers for the right group, by optimized voxel-based morphometry using unmodulated and modulated images. A histologic count of heterotopic neurons was obtained in the white matter of the anterior temporal lobe originating from the patients' surgical specimens. In addition, the number of heterotopic neurons were tested to determine if there was a correlation with the GMC or WMC. RESULTS: The GMCs of the left and right mTLE groups were reduced in the ipsilateral hippocampi, bilateral thalami, precentral gyri, and in the cerebellum. The WMCs were reduced in the ipsilateral white matter of the anterior temporal lobe, bilateral parahippocampal gyri, and internal capsules, but increased in the pons and bilateral precentral gyri. The heterotopic neuron counts in the left mTLE group showed a positive correlation (r = 0.819, p < 0.0001) with GMCs and a negative correlation (r = -0.839, p < 0.0001) with WMCs in the white matter of the anterior temporal lobe. CONCLUSION: The present study shows the abnormalities of the cortico-thalamo-hippocampal network including a gray matter volume reduction in the anterior frontal lobes and an abnormality of brain tissue concentration in the pontine area. Furthermore, heterotopic neuron numbers were significantly correlated with GMC or WMC in the left white matter of anterior temporal lobe.
Adult ; Brain/*pathology ; Epilepsy, Temporal Lobe/*pathology ; Female ; Humans ; *Image Processing, Computer-Assisted ; *Magnetic Resonance Imaging ; Male ; Neurons/*pathology ; Temporal Lobe/pathology

BACKGROUND: The several forms of treatment of Graves disease-thyroidectomy, antithyroid drugs and radioiodide therapy-are in wide use now. But which therapy is best is a matter of debate. Some authors reported that in patients who underwent thyroidectomy, higher titers of serum antimicrosomal antibody were associated with 1) higher formation rates of germinal centers, 2) more lymphocyte infiltration in the thyroid tissue, 3) higher incidence of hypothyroidism, and 4) lower incidence of recurrence. We were interested in the relationship of thyroid autoantibody titers, ADCC(antibody-dependent cell-mediated cytotoxicity) activity and the clinical response to antithyroid medication. METHODS: We measured ADCC activities from patients in Graves disease(n-48), Hashimoto thyroiditis(n=17) and normal control(n=9). The patients of Graves disease were followed up for more than 1 year, and they were grouped into A(n=17, well responsed group to antithyroid medication) and B(n=31, poorly responsed group). We examined ADCC activities of patients' sera by chromium release assay. RESULTS: 1) Mean age of patients with Graves disease was 34.4210.4 years and 15 patients were male(31%). 2) Results of thyroid function tests of the Graves' patients were T 585.9 +/- 255.3 ng/dL, T4 21.3 +/- 12.2 mg/dL, TSH 0.11 +/- 0.06mIU/mL. Concentrations of antimicrosomal antibody, antithyroglobulin antibody and thyrotropin binding inhibitory immunoglobulin were 1279.1 +/- 1486.7 IU/mL, 488.1 +/- 751.1 IU/mL, and 38.5 +/- 33.4U/L respectively. 3) There was no significant difference between levels of thyroid hormones or concentrations of thyroid autoantibodies and ADCC activities in graves patients. 4) The ADCC activity of the Graves patient group(24.49%) was significantly higher than that of the normal control group(3.76%), and significantly lower than that of the Hashimotos thyroiditis group(36.34%). 5) There was no significant difference in ADCC activity between group A(18.24 +/- 13.44%) and B(27.91 +20.02%). CONCLUSION: From this results, we suggested that ADCC activity seems to be no value as a prognostic factor in predicting the response to antithyroid drugs in Graves disease patients. But, further studies, larger number of patients and long-term follow up, are needed.
Antibody-Dependent Cell Cytotoxicity ; Antithyroid Agents ; Autoantibodies ; Chromium ; Follow-Up Studies ; Germinal Center ; Graves Disease* ; Humans ; Hypothyroidism ; Immunoglobulins ; Incidence ; Lymphocytes ; Recurrence ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormones ; Thyroidectomy ; Thyroiditis ; Thyrotropin

No abstract available.
Duodenal Ulcer* ; Humans ; Recurrence*

Sebaceous trichofolliculoma, which is a variant of trichofolliculoma, is a rare disease that clinically show a centrally depressed lesion usually singly on the nose, and histologically a centrally located cavity, lined by squamous epithelium, with numerous sebaceous lobules connected to them. We describe a case of sebaceous trichofolliculoma in a 27-year-old woman who had several brown papules on the nose. We think that this is the first report of sebaceous trichofolliculloma in Korean literature.
Adult ; Epithelium ; Female ; Humans ; Nose ; Rare Diseases