Synovial sarcoma is a very rare malignant tumor which arising from the synovial lining connective tissue, tendon sheaths and bursae. However, there are a few case reports of this tumor arising from the bone. We have experienced 3 cases of the tumor from the bone, i. e. the head of the left fibula, the sacrum and the right ileum, and the distal end of the left femur. Microscopically they showed typical slit like spaces, lined by epitheloid cells or cuboidal cells and one could easily find out spindle, polygonal, or giant cells. The proximal third of the left fibula was excised, and the other case arising from the sacrum & right ilium was treated with radiation therapy. Another case refused hip disarticulation, The effectiveness of the treatment is uncertain.
Connective Tissue ; Disarticulation ; Femur ; Fibula ; Giant Cells ; Head ; Hip ; Ileum ; Ilium ; Sacrum ; Sarcoma, Synovial ; Tendons

The appendiceal tuberculosis is a rare from of skeletal tuberculosis in child and adults, arising from a focus or foci in posterior compartment of spine. This from may be unilateral and may be isolated or present at multiple levels, characterieed by slight change of the disk space and deformity, but large psravertebral abscess are invariable. Extradural extension may lead to the development of paraplegia. We had experienced one case of appendiceal tuberculosis at L1 and treated with antituberculosis medication and radical curettage, followed with body jacket cast.
Abscess ; Adult ; Child ; Congenital Abnormalities ; Curettage ; Humans ; Paraplegia ; Spine ; Tuberculosis

Background: The aim of this study was to assess whether the anteroposterior coverage of the acromion reflecting acromial morphology affects the rotator cuff tear (RCT) and tear size, in addition to the lateral coverage. Methods: Medical records of 356 patients with RCTs, concentric osteoarthritis, and calcific tendinitis identified using threedimensional computed tomography between January 2016 and December 2017 were retrospectively analyzed. The patients were divided into group A (those with RCTs) and group B (those with concentric osteoarthritis or calcific tendinitis). Subsequently, group A was subdivided into three categories according to the size of RCTs: small-to-medium, large, and massive. The lateral coverage was measured through the lateral acromial angle (LAA) and critical shoulder angle (CSA), whereas the anteroposterior coverage was measured via the acromial tilt (AT), acromiohumeral interval (AHI) in the sagittal view, and anteroposterior coverage index (APCI) as a new radiologic parameter. Results: Between groups A and B, CSA (34.5° ± 3.4° and 30.8° ± 3.4°, respectively), APCI (0.83 ± 0.10 and 0.75 ± 0.08, respectively), and AHI (6.3 ± 2.0 mm and 7.8 ± 1.8 mm, respectively) were significantly different (all p < 0.001), whereas LAA and AT did not show a significant difference between the groups (p = 0.089 and p = 0.665, respectively). The independent predictive radiologic parameters of the RCT were the CSA, APCI, and AHI (p < 0.001, p < 0.001, and p = 0.043, respectively); among these, the APCI showed the highest regression coefficient (odds ratio = 2.82). The parameters associated with the size of RCTs were CSA (p = 0.022) and AHI, of which AHI, in particular, had the most significant effect on both small-to-medium and large tears (all p < 0.001). Conclusions Large CSA, high APCI, and low AHI were predictors of RCTs, with the APCI showing the strongest correlation. In addition to the large CSA, low AHI also correlated with the size of RCTs and affected the entire size groups. We suggest that both the lateral coverage and anteroposterior coverage of the acromion should be considered essential factors for predicting the presence of RCTs and tear size.

No abstract available.
Microsurgery* ; Radiosurgery* ; Trigeminal Neuralgia*

This is to report a case of immediate reconstruction after hemimandibulectomy by using of bicorticocancellous block bone harvested from the iliac crest in the case of an ameloblastomaon the mandible. Because the lesion involved condylar area, it was reconstructed with titanium artificial condyle attached to A/O metal plate. Three weeks after the operation, infection developed with suppuration and was well treated with adequate antibiotic therapy and drainage. The patient has been followed up over a four-year period and taken an orthopantomogram every three or six month for the examination of mandibular movement, the potentiality of recurrence and the remodeling of the grafted bone. At present, the patient is satisfied with her appearence and has a normal occlusion with proper masticatory function, and there is no sign of recurrence.
Ameloblastoma* ; Drainage ; Humans ; Mandible ; Mandibular Osteotomy ; Recurrence ; Suppuration ; Titanium ; Transplants*

No abstract available.
Carpal Tunnel Syndrome* ; Humans

Fecal impaction is defined as a large compacted mass of feces in the rectum or colon that cannot be passed by the patient. Fecal impaction may be caused by predisposing conditions such as mechenical impediments, neurologic diseases, psychiatric disorders, endocrine diseases, and some medications. And ninety percent of fecal impaction occur in rectum and sigmoid flexure. Recently, we experienced a case of fecal impaction in young female who had no predisposing conditions. A 30-year-old woman was adimtted with abdominal distension and constipation. She was diagnosed fecal impaction in splenic flexure and transverse colostomy was taken. After colostomy was repaired, recurrent fecal impaction was occurred and second transverse colostomy was done. After all, right hemicolectomy was done due to recurrent fecal impaction. She have one or two bowel movements a day after surgery.
Adult ; Colon ; Colon, Sigmoid ; Colon, Transverse ; Colostomy ; Constipation ; Endocrine System Diseases ; Fecal Impaction* ; Feces ; Female ; Humans ; Rectum

BACKGROUND/AIMS: Because colonoscopy is a painful procedure, analgesics and sedatives may be necessary as premedication. Midazolam reacts quicker, has a more excellent amnesic effect and fewer complications compared to diazepam. The effects of midazolam depend on dose, age, and rapidity of injection. According to several studies, side effects of midazolam were more common in high-dose injections (more than 5 mg) compared to low dose injections (0.03-0.05 rng/kg). Moreover, low dose injections were found to be as effective as high dose injections. However, there was no report about the effect and the side effects of midazolam in Korea. Therefore, we performed this study to determine the effect of low dose midazolam as premedication for colonoscopy. METHODS: We performed colonoscopy in 99 consecutive patients who were randomly selected (midazolam group: 50, placebo group: 49) prospectively from July 1996 to September 1996. Premedication was administered through intravenous injection of midazolam or saline 0.03 mg/kg, combined with intramuscular injections of meperidine 50 mg, and intravenous injections of Buscopan 20 mg in all patients. Blood pressure, puise rate, and O2 saturation by oxymeter were checked before, during, and 30 minutes after colonoscopy. The degree of amnesia, discomfort, cooperation and acceptance of the re-examination were checked.
Amnesia ; Analgesics ; Blood Pressure ; Butylscopolammonium Bromide ; Colonoscopy* ; Diazepam ; Humans ; Hypnotics and Sedatives ; Injections, Intramuscular ; Injections, Intravenous ; Korea ; Meperidine ; Midazolam* ; Premedication ; Prospective Studies

PURPOSE: Heart rate variability(HRV) is the clinical consequence of various influences of the autonomic nervous system(ANS) on heart beat. HRV can estimate the potential physiologic rhythm from the interval between consecutive beats (RR interval or HRV data). It is known as RSA which represents respiration-related HR rhythmic oscillation. Previous studies demonstrated a specific breathing pattern (0.1Hz, 6breaths/min) to improve a physiological body condition related to the stress. In this paper, the level of stress would be evaluated in terms of three phases of the dental treatment, combined with 6breaths/min. METHODS: These phases include before, during and after tooth extraction or anesthesia or something.36 patients'stresses were assessed using HRV stress analyzer in each phase in Kangdong Sacred Heart Hospital, and Chuncheon Sacred Heart Hospital, Hallym University Medical Center from Jun. to Sept. of 2007. HRV 5-min data collected were analyzed in time-domain and frequency-domain to evaluate the activity of autonomic nervous system (ANS) which represents the level of stress. RESULTS: All HRV parameters including HF (high frequency), LF (low frequency) and LF/HF ratio showned a significant change affecting the ANS balance. There was a 6.4% difference between R(LF/HF)s on general breathing pattern for balance of Autonomic nervous system, but on controlled breathing pattern, 0.1Hz, was made narrow till 1.4%. The activity of ANS has increased by 1.4% on general breathing pattern, and by 2.9% on controlled breathing pattern, 0.1Hz. CONCLUSION: After analysis of preoperative stress changes and effect of breathing pattern of 0.1 Hz on the stress in 36 patients who have undergone third molar extraction, following was concluded. In the preoperative stage, the sympathetic change was the greatest after the anesthetic injection, and stress was relieved by controlling the breathing pattern to a frequency of 0.1Hz.
Academic Medical Centers ; Anesthesia ; Autonomic Nervous System ; Gangwon-do ; Heart ; Heart Rate ; Humans ; Molar, Third* ; Respiration* ; Tooth Extraction

BACKGROUND: Varix bleeding in children is infrequent but it is potentially fatal. It has characteristics different from adult age varix bleeding. But there was little clinical data about it. The purposes of this study is to detect its characteristics of varix bleeding in pediatric patients, and to help an emergency physician make a decision about the management. METHODS: We reviewed medical records of 32 patients who visit Seoul National University Hospital Pediatric Emergency center from Jan. 1, 1995 to Dec. 31, 1996. RESULTS: 1) The peak age was between 1 and 5 years of age, and the ration of males to females was 1: 1. 2) As a underlying cause, intrahepatic disease were more common than extrahepatic diseases(87.1%:12.9%). 3) 10 patients(31.3%) had URI symptoms as a precipitating factor. 4) Varix bleeding has a circardian rhythm, and occured more often during the night. 5) In Child Classification for the hepatic reserve fuction, Child C was the most common(75%). 6) Endoscopic eliminations were performed in 14 patients(43.8%). 7) According to shock classification. the ration of conservative to vasopressin treatment in class I and class II were 13(40.6%)/10(31.3%) and 6(18.8%)/3(9.4%), respectively. 8) Fever was the most common complication(43.8%), and the mortality rate was 3.1%. CONCLUSION: We suggest that the only conservative management can show a good result far pediatric varix bleeding compared to other treatment modalities.
Adult ; Child ; Classification ; Emergencies* ; Esophageal and Gastric Varices* ; Female ; Fever ; Hemorrhage* ; Humans ; Male ; Medical Records ; Mortality ; Precipitating Factors ; Seoul ; Shock ; Varicose Veins ; Vasopressins