No abstract available.
Thyroid Gland* ; Thyroid Nodule*

No abstract available.
Aged ; Cysts/*pathology ; Humans ; Immunohistochemistry ; Liver Diseases/*pathology ; Male ; Muscle, Smooth/pathology ; Tomography, X-Ray Computed

We report a rare case of third cranial nerve palsy due to a ruptured left internal carotid artery (ICA) bifurcation aneurysm. A 70-year-old man was stuporous with left ophthalmoplegia (unilaterally fixed dilated pupil, abducted eyes, and ptosis). A computed tomography demonstrated extensive hemorrhage spreading around the left sylvian fissure and basal cistern with a ipsilateral predominance, and intraventricular hemorrhage without focal mass effect. A computed tomographic angiography demonstrated a 3mm sized aneurysmal sac which arose from the left ICA bifurcation. The aneurysmal clipping was performed at 1 day after onset. In operative field, there was no direct compression of the oculomotor nerve by the aneurysmal fundus. Postoperatively, he recovered to alert mental status, but left ophthalmoplegia recovered partially at the 1 year follow-up.
Aged ; Aneurysm* ; Angiography ; Carotid Artery, Internal* ; Follow-Up Studies ; Hemorrhage ; Humans ; Oculomotor Nerve Diseases* ; Oculomotor Nerve* ; Ophthalmoplegia ; Paralysis ; Pupil ; Stupor

OBJECTIVE: To identify the risk factors for secondary lymphedema after breast cancer surgery. Lymphedema, a sequelae of breast cancer therapy, changes functional abilities and may affect a patient's psychosocial adjustment and overall quality of life. It is generally underreported and undertreated. METHOD: Six hundred two patients who had undergone breast cancer surgery between January 2000 and December 2005 were examined. The circumferences of the upper extremities were measured and lymphedema was defined as difference of greater than 2cm between the affected and normal arms. The effects of age, body mass index, diabetes, hypertension, side of tumor, sugery method, radiotherapy, chemotherapy, TNM stage, involvement of axillary lymph nodes, menopausal state and laboratory findings on the development lymphedema were investigated and analyzed by t-test, chi-square test and multiple logistic regression analysis. RESULTS: 121 out of 602 patients had lymphedema. Those patients with lymphedema had a higher body mass index. Univariate analysis indicated an increased occurrence of lymphedema due to those with body mass index, radiotherapy, T2 stage, N3 stage and axillary lymph node invasion. Multivariate analysis revealed that body mass index and radiotherapy were independently associated factors for lymphedema after breast cancer surgery. CONCLUSION: The patients who had radiotherapy or BMI greater than 25 must be considered as potential candidates to have lymphedema after breast cancer surgery. Therefore, these patients should be informed during the follow-up period about this morbidity, the preventive measure, and the treatment.
Arm ; Body Mass Index ; Breast ; Breast Neoplasms ; Humans ; Hypertension ; Logistic Models ; Lymph Nodes ; Lymphedema ; Multivariate Analysis ; Quality of Life ; Risk Factors ; Upper Extremity

PURPOSE: We studied the clinical outcome of nasolacrimal probing according to the age and silicone tube intubation for congenital nasolacrimal duct obstruction. METHODS: We analyzed a total of 76 patients (99 eyes) who had undergone nasolacrimal duct probing performed in the office under topical anesthesia and 18 patients (20 eyes) who had undergone silicone tube intubation under general anesthesia between February 1997 and March 2001. Patients who had undergone probing were grouped according to their age at the time of probing: 6 months or less (group 1), 7 to 12 months (group 2) and 13 months or older (group 3). RESULTS: The overall success rate by probing was 84%. The success rate of probing in those under 6 months of age was 88%; in those from age 7 to 12 months, 86%; and in those 13 months or older, the rate decreased to 76%. The decrease in success rate after 13 months was statistically significant (P<0.05). The success rate of silicone tube intubation was 95%. CONCLUSION: We concluded that early office probing under 12 months of age for congenital nasolacrimal duct obstruction is an effective method for treatment of symptomatic nasolacrimal duct obstruction. In case over 13 months of age, probing is also considered as the first choice of treatment although its success rate is lower than the former. Silicone tube intubation is an effective method in case of failure of repeated probing and over 20 months of age.
Anesthesia ; Anesthesia, General ; Humans ; Intubation* ; Nasolacrimal Duct* ; Silicones*

To evaluate the change of colloid osmotic pressure(COP) and the correlation between COP and other parameters during pediatric open heart surgery at Seoul National University Children's Hospital, COP, protein, albumin, hemoglobin, and hematocrit, were measured immediately after induction(T1), before cardiopulmonary bypass(CPB)(T3), duringT4, T5), and after bypass(T.6, T7) and immediately after(T8) and 24 hour after(T9) arrival at intensive care unit (ICU) in l0 pediatric patients aged from l year to 13 years. Above parameters of priming solution(T2) were also measured. The results were as followings; l) The good correlation between COP and protein(r=0.87), albumin(r=0.86), hemoglobin(r=0. 80), hematocrit(r=0.77) were showed. 2) The COP of priming solution was 9.42.6 mmHg and this was definitely lower than normal value. 3) The COP during CPB was in the range from 11 to 12 mmHg(mean values) and this value was also significantly lower than normal value. 4) The COP increased from the time of weaning from CPB, but the COP at the arrival at ICU was 18.0+/-1.2 mmHg and this value was still significantly lower than normal value. 5) The COP at 24 hours after arrival at ICU was 21.7+/-1.2 mmHg and this value was not significantly different fron normal value. Thus, the results suggest that the priming solution shuold be improved to maintain COP during and immediatelt after CPB.
Colloids* ; Heart* ; Hematocrit ; Humans ; Intensive Care Units ; Osmotic Pressure* ; Reference Values ; Seoul ; Thoracic Surgery* ; Weaning

PURPOSE: To examine how SCUBA diving activities in high-pressure underwater environment affect their intraocular pressure (IOP), visual field (VF), retinal nerve fiber layer (RNFL), and the shape of optic disc. METHODS: We performed visual acuity and refractory test, IOP test, VF test, RNFL photography, optical coherent tomography, and 3D optic disc photography for a group of 32 people and a control group of 32 non-divers, and analyzed the differences between the two groups. For the diver group, we conducted a questionnaire survey on the patterns of diving and diving experience, and analyzed their correlation with results of test. RESULTS: Compared to the Control, the diver group showed significant difference in the mean IOP (diver group: 15.71 +/- 2.54 mmHg, control group: 14.23 +/-2.15 mmHg, p = 0.019), and abnormal visual field (diver group: 7 eyes (11.3%), control group: 0 eye (0%), p = 0.006). 85.7% of abnormal visual field belonged to early defect. The diver group did not showed significant difference in the shape of optic disc (p = 0.546), but the optic nerve atrophy in shape of optic disc test field (diver group: 8 eyes (12.9%), control group: 2 eyes (3.1%), p = 0.042) was significantly different. CONCLUSIONS: Divers who did SCUBA diving activities need to have a glaucoma test regularly. Additional research and large cross or longitudinal study are needed to evaluate causes that scuba diving activities affect.
Atrophy ; Diving ; Eye ; Glaucoma ; Intraocular Pressure ; Nerve Fibers ; Optic Nerve ; Photography ; Surveys and Questionnaires ; Retinaldehyde ; Visual Acuity ; Visual Fields

PURPOSE: Segmental parenchymal excretion delay on Tc-99m DISIDA scan is caused by intrahepatic bile duct obstruction. However, the diagmostic value for intrahepatic bile duct obstruction is unknown. We conducted this study to assess the positive predictive value of segmental excretiom delay for the diagnosis of intrahepatic bile duct obstruction, and additional benefit over other noninvasive radiologic studies. MATERIALS AND METHODS: The study population consisted of 43 patients (48 scans) Who showed segmental parenchymal excretion delay on Tc-99m DISIDA scan. The results of abdominal CT or ultrasonography, which was done within 1 month of Tc-99m DISIDA scan, were compared with scintigraphic findings. RESULTS: The etiology of segmental parenchymal excretion delay was determined by ERC or PTC in 31 scans, and follow-up studies in 13 scans. No causes were identified in 4 scans. The positive predictive value of segmental parenchymal excretion delay for intrahepatic bile duct obstruction was 92% (44/48). On the other hand, 13% (5/38) of CT and 28% (5/18) of ultrasonography were normal. In 18% (7/38) of CT and 17% (3/18) of ultrasonography, only intraheipatic bile duct dilatation was noted without any diagnostic findings of intrahepatic bile duct obstruction. CONCLUSION: Segmental parenchymal excretion delay on Tc-99rn DISIDA scan had a high positive predictive value for the diagnosis of intrahepatic bile duct obstruction. Tc-99m DISIDA scan may be useful for the diagnosis of intrahepatic bile duct obstruction, especially in patients with nondiagnostic CT or ultrasonography. The diagnostic usefulness need to be confirmed by further prospective studies. KW: Tc-99m DISIDA, Segmental parenchymal excretion delay, Intrahepatic bile duct obstruction.
Bile Ducts ; Bile Ducts, Intrahepatic ; Diagnosis ; Dilatation ; Follow-Up Studies ; Hand ; Humans ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVE: There are differences in the clinical characteristics and surgical results between upper (L1-2 and L2-3) and lower (L3-4, L4-5, and L5-S1) lumbar disc herniations. We conducted this study to compare the clinical features and surgical outcomes between the two types of lumbar disc herniations. METHODS: We retrospectively reviewed the clinical features of patients who underwent microdiscectomies from 2008 to 2012. We evaluated the clinical characteristics such as age, preoperative autonomic dysfunction, the presence or absence of previous lumbar surgery and fusion required during surgery. Visual Analogue Scale (VAS) scores about back pain and leg pain were evaluated preoperatively and at the final follow-up. RESULTS: Upper lumbar group (n=15) was significantly older than lower lumbar group (n=148). The incidence of autonomic dysfunction was significantly higher in upper lumbar group. The number of patients with a previous lumbar surgery was significantly greater in upper lumbar group. There was no statistical significance for fusion required during surgery between two groups. Both groups showed a significant decrease in the VAS scores of leg pain. VAS scores of back pain were significantly decreased in lower lumbar group. But this was not seen in upper lumbar group. Both groups showed significant improvement of Oswestry Disability Index score. CONCLUSION: Upper lumbar group had different clinical characteristics from those of lower lumbar group and these include older age, a higher incidence of autonomic dysfunctions and a higher incidence of patients with previous lumbar surgery. There were no significant differences in surgical outcomes, except for back pain, between two groups.
Back Pain ; Follow-Up Studies ; Humans ; Incidence ; Leg ; Retrospective Studies

PURPOSE: To develop a protocol for treatment of injuries to lacrimal punctum and canaliculus associated with eyelid burns. METHODS: We retrospectively reviewed the records of seven patients who required the treatment of punctal and canalicular injuries caused by medial eyelid burns. RESULTS: Four patients were treated with punctoplasty and bicanalicular silicone tube intubation within 3 weeks of injury. One patient was treated at 2 months and punctum of upper eyelid was not found, requiring punctoplasty and monocanalicular silicone tube intubation of lower eyelid. Silicone tube removal was performed over a range of 3 to 6 months. Two patients were treated after 3 months of injury by conjunctivodacryocystorhinostomy. Six patients showed good passage by syringing after surgery. CONCLUSIONS: Early evaluation and treatment of canalicular burn injuries can avoid complex surgical procedures such as conjunctivodacryocystorhinostomy, and silicone tube removal is recommended before 6 months after surgery.
Burns* ; Eyelids* ; Humans ; Intubation ; Retrospective Studies ; Silicones