The fibrosis involved in gluteus maximus causing limitation of flexion and adduction of the hip has become a recognized clinical entity since the first report by Fernandez de Valderrma in 1969. Its most constant and characteristic histologic feature was substitution of the fibrous tissue in the definitive etiology was unknown but presumed to be multiple intramuscular injections. Authors present three cases of the fibrosis involving gluteus maximus. In two cases Z-lengthening was performed on the thickened fibrous bands with good results.
Fibrosis ; Hip ; Injections, Intramuscular

Various kinds of bone cements mixed with antibiotics have been widely used for treatment and prevention of infections, especially combined with bone defects. But bone cements have some disadvantages in that they are rather expensive and capable of incurring some complications such ss fibrosis of surrounding soft tissue or local erosion of bone, and furthermore, they must be removed after infection is controlled for bone graft to fill up the defects because they do not have properties of osteoconduction or osteoinduction. So we have come to the idea of using theoretically advantageous plaster of paris to take place of bone cements, and performed in-vitro experiment upon the effectiveness of plaster of paris pellets containing antibiotics, then obtained good results comparable to those from many experimental studies using bone cements. By this, we think that it would be possible in the future to treat and prevent infections supervening bone defects with plaster of paris mixed up with antibiotics. The results are as follows : 1. Sustained release of large amount of antibiotics from plaster of paris enough to exert inhibitory activity on abcterial growth, and there was a direct relationship between concentrations of eluted antibiotics and diameters of inhibitory zones. 2. Tobramycin was capable of inhibiting the growth of S. aureus, E. coli, and Ps. aeruginosa for 7 days at maximum. 3. Cephradine inhibited the growth of S. aureus and E. coli but did not affect that of Ps. aeruginosa. 4. The maximum antibacterial activity wss reached within first 24 hours from the start of elution of antibiotics from plaster of paris.
Anti-Bacterial Agents ; Bone Cements ; Bone Regeneration ; Calcium Sulfate ; Cephradine ; Fibrosis ; Tobramycin ; Transplants

Malignant growth of the small bowel accounts for approximately 1 to 3 percent of malignant tumors of the gastrointestinal tract. Leiomyosarcomas are the second most common primary tumor of the small bowel, their frequency being one-third to one-half of adenocarcinoma. The common clinical symptoms of leiomyosarcoma of the small intestine are hemorrhage and abdominal pain. Accurate diagnosis cannot be based on solely on the roentgenographic finding, although in certain situations the dignosis of leiomyosarcoma may be suggested strongly. We report a case of bleeding leiomyosarcoma located in the second portion of the duodenum which was first recognized by endoscopic examination and confirmed by explolaparotomy.
Abdominal Pain ; Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Hemorrhage ; Intestine, Small ; Leiomyosarcoma*

BACKGROUND AND OBJECTIVES: Several prognostic factors are known to be related to the recovery of sudden sensorineural hearing loss (SSNHL). Recent studies have suggested that cardiovascular risk factors (CVRFs) are associated with the occurrence of SSNHL. However, the value of CVRFs as a predictor of recovery in patients with SSNHL has been rarely evaluated. We aim to evaluate the prognostic value of CVRFs in relation to hearing recovery of SSNHL. SUBJECTS AND METHOD: A total of 278 patients who were diagnosed and treated for SSNHL and who underwent blood sampling and follow-ups for more than 3 months were reviewed retrospectively. We reviewed CVRFs such as age, body mass index, blood pressure, cholesterol, smoking history, the presence of diabetes mellitus and other related underlying diseases. Patients were divided into three groups (low, medium, and high CVRF groups) according to the CVRF grades. Hearing thresholds were repeatedly measured on the initial visit, 1 week, 1 month and 3 months after treatment. Treatment outcome was analyzed by comparing hearing recovery rate and post-treatment audiometric changes among the three CVRF groups. RESULTS: Seventy (25.2%), 129 (46.4%) and 79 (28.4%) patients were included into the low, medium and high CVRF groups, respectively. The hearing threshold was significantly reduced at 3 months after treatment in all three groups (p<0.001). The hearing recovery rate of the low CVRF group was significantly higher than that of the medium and high CVRF group (p=0.011). On the last visit, the high CVRF group significantly showed more poor hearing improvement than the low CVRF group did (p=0.045). CONCLUSION: Our findings suggest that the presence of CVRFs may be a poor prognostic sign for hearing recovery in patients with SSNHL.
Blood Pressure ; Body Mass Index ; Cholesterol ; Diabetes Mellitus ; Follow-Up Studies ; Hearing Loss, Sensorineural* ; Hearing* ; Humans ; Methods ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Treatment Outcome

Inflammatory pseudotumor is a rare, benign lesion of various organ and tissue that usually occurs in children and young adults. We report on a 35-year-old male patient with retroperitoneal inflammatory pseudotumor who was completely cured by surgical resection and steroid therapy.
Adult ; Child ; Granuloma, Plasma Cell* ; Humans ; Male ; Young Adult

BACKGROUND: Cryptotia correction by V-Y advancement of a temporal triangular flap was introduced in 2005. However, despite the several advantages of V-Y advancement, visible scars at the donor site are problematic. As a result, a Z-plasty technique was considered for skin deficiency in mild cases. Therefore, we introduce a new surgical scheme for cryptotia correction based on considerations of techniques and complications that arose in our clinic. METHODS: Between 2000 and 2013, 26 patients (35 cases) of cryptotia were treated. Seventeen patients had unilateral cryptotia and nine had bilateral cryptotia. Two corrective methods were used, Z-plasty or V-Y advancement, based on the severity. In mild cases, Z-plasty was used for correction and in severe cases, V-Y flap advancement was used for more skin supplement. RESULTS: Follow-up periods ranged from 6 months to 1.5 years. The results obtained were relatively favorable. Nine cases of mild deformity were corrected by Z-plasty, and the other 26 cases with mild or severe deformities were corrected by V-Y advancement. In Z-plasty cases, there was one hypertrophic scar and in V-Y advancement cases, seven resulted in visible scarring and three in skin sloughing. CONCLUSION: The main advantage of Z-plasty is a lower likelihood of visible scarring at the donor site. In mild cases, Z-plasty may be a good alternative, but in severe cases, V-Y advancement is probably the best option for more skin supplement.
Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Skin ; Tissue Donors

Tracheoesophageal fistula is a rare disease of abnormal communication between esopha- gus and respiratory system. The common causes are the acquired origins in adult such as trauma, infection of the adjacent organs, malignant tumor, and foreign body. Among the traumatic origins, chemical drug, the procedure of the dilatation on the stenotic area, blunt trauma(fall, collisions), penetrating trauma(bullet, knife), and pressure injury are much more common than others. Recently, trauma and foreign body in the esophagus and bronchus are becoming the main cause of the tracheoesophageal fistula, however the frequency of the development of tracheoesophageal fistula caused by the infectious diseases is getting decreased. Fibrinogen-thrombin glue stimulates the healing process of the wound and the ulcer. We treated a 52-year-old male patient with nan-inalignant tracheoesophageal fistula, who had symtoms of pharyngolaryngeal and chest discomfort concomitant with a paroxysmal cough on swallowing food which were caused by fish bone. The diagnosis of tracheoesophageal fistula was made by the esophagogram, chest CT, and esop aecopy. By using the therapeutic endoscopy with an injection of the fibrinogen-glue, the tracheoesopeal fistula was obliterated completely with dramatic symptomatic improvement. Here we conqluded that this method would be the one of the best methods for the treatment of tracheoesophageal fistula.
Adhesives* ; Adult ; Bronchi ; Communicable Diseases ; Cough ; Deglutition ; Diagnosis ; Dilatation ; Endoscopy ; Esophagus* ; Fibrinogen* ; Fistula ; Foreign Bodies ; Humans ; Intestines* ; Male ; Middle Aged ; Rare Diseases ; Respiratory System ; Stomach* ; Thorax ; Thrombin* ; Tomography, X-Ray Computed ; Tracheoesophageal Fistula* ; Ulcer ; Wounds and Injuries

BACKGROUND: Hepatitis B virus (HBV) is major source of chronic liver disease in Korea. However this virus might have different nucleotide sequence according to races, different region, etc. Recently the novel method that allows sensitive amplification with dramatically decreased mis-incorporation has developed. We determined to get the major form of HBV nucleotide sequence from whole sequencing data of 26 Korean HBV carriers. METHODS: HBV DNA were collected from 26 Korean chronic HBV carriers. We used the novel PCR with pfu for the amplification of HBV DNA, and specific primers were made with combination sequence bases of non-HBV part and HBV parts which were located head and tail in the virion. Then whole length of HBV were directly sequenced and analysed. RESULT: HBV DNA was consisted of 3215 bases in 20 cases of 26 Korean chronic HBV carriers. And the remainder had smaller or larger number due to deletion, insertion or both in pre-S2 and S gene. They were 99.03% homology of their nucleotide sequence and belong to genotype C. The variability of nucleotide sequence was significantly higher in the singly coding region (SCR) than doubly coding region (DCR), and also high in pre-S1 and pre-S2 gene among the DCR. Hot-spots were more frequently found in the SCR, pre-S1 and pre-S2 gene. CONCLUSION: In Korean chronic HBV carriers, HBV is consisted of 3215 nucleotides, and belongs to genotype C. And it might exist one genotype with the variability in Korea.
Base Sequence* ; Clinical Coding ; Continental Population Groups ; DNA ; Genome* ; Genotype* ; Head ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Liver Diseases ; Nucleotides ; Polymerase Chain Reaction ; Polymerization* ; Polymers* ; Virion

BACKGROUND: In treating minor-form or microform cleft lip, obtaining an optimal result is a challenge because of the visible scarring caused by traditional surgery. We present a refined method using muscle overlapping with a minimal skin incision in patients younger than 3 years, a group characterized by thin muscle. METHODS: The surgical technique involves restoration of the notched vermillion using Z-plasty, formation of the philtral column using overlapping of an orbicularis oris muscle flap through an intraoral incision, and correction of the cleft lip nasal deformity using a reverse-U incision and V-Y plasty. A single radiologist evaluated ultrasonographic images of the upper lip. RESULTS: Sixty patients were treated between September 2008 and June 2014. The age at the time of operation ranged from 6 to 36 months (mean, 26 months). The follow-up period ranged from 8 to 38 months (mean, 20 months) in minor-form cases and from 14 to 64 months (mean, 37 months) in microform cases. A notched cupid's bow was corrected in 10 minor-form cases and 50 microform cases. Ultrasonographic images were obtained from 3 patients with minor-form cleft lip and 9 patients with microform cleft lip 12 months after surgery. The average muscle thickness was 4.5 mm on the affected side and 4.1 mm on the unaffected side. CONCLUSIONS: The advantages of the proposed procedure include the creation of an anatomically natural philtrum with minimal scarring. This method also preserves the continuity and function of the muscle and provides sufficient augmentation of the philtral column and nostril sill.
Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Lip ; Methods ; Microfilming* ; Skin* ; Surgical Flaps

A series of 89 patients diagnosed between 1988 and 1993 with computerized tomography(CT) as having subdural hematoma was studied retrospectively in order to evaluate the age of the subdural hematomas according to its appearance on CT scans. In all the patients, the interval from onset of injury to performance of CT scans was more than 2 days. The patients were divided into 4 groups based on the difference in density of the hematoma as seen on the CT scans;hyperdensity(16.9%), isodensity(30.3%), hypodensity(19.1%), and mixed-density(33.7%) groups. The mean interval from onset of injury to diagnosis in hyperdensity, hypodensity, mixed density, and isodensity groups was 15.7+/-18.3 days, 18.8+/-27.9 days, 35.6+/-62.1 days, and 47.6+/-52.1 days, respectively. The configuration of the hematomas on CT scans was crescentic in 74.2%, planoconvex in 12.4%, and biconvex in 13.5%. As the interval became longer, the hematomas tended to take on a planoconvex or biconvex shape rather than the crescentic shape;when the interval from onset of injury to diagnosis was within 7 days, crescentic shape was observed in 91%, within 8 to 21 days, 69%, and over 21 days, 58%. It is concluded from these findings that subdural hematomas undergo a progressive change in their attenuation as the hematomas age, changing from the initial hyperdense stage, go through a hypodense stage, and eventually to an isodense stage. These changes of attenuation values correlates fairly well with the rebleeding theory. The appearance of the hematomas as seen on CT scans also tended to change from the initial crescentic shape to the planoconvex or biconvex shape with time. However, given the possible variations of attenuation values and shapes of subdural hematomas, assumption of the age of the hematomas based on CT findings alone should be made with caution.
Diagnosis ; Hematoma ; Hematoma, Subdural* ; Hematoma, Subdural, Chronic ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed