As gastroduodenoscopy performed more frequently, case reports of human echinostomiasis are increasing in Korea. A Korean woman presented at a local clinic with complaints of abdominal pain and discomfort that had persisted for 2 weeks. Under gastroduodenoscopy, two motile flukes were found attached on the duodenal bulb, and retrieved with endoscopic forceps. She had history of eating raw frog meat. The two flukes were identified as Echinostoma hortense by egg morphology, 27 collar spines with 4 end-group spines, and surface ultrastructural characters. This report may prove frogs to be a source of human echinostome infections.
Animals ; Duodenal Diseases/*parasitology ; Duodenum/*parasitology ; Echinostoma/*isolation & purification ; Echinostomiasis/*diagnosis ; Endoscopy ; Female ; Humans ; Korea ; Middle Aged

Charcot-Marie-Tooth (CMT) disease can be divided mainly into demyelination and axonopathy based on the results of the electrophysiological study. Mitofusin 2, encoded by MFN2 gene, has a crucial role in the fusion of mitochondria, which is known to associate with CMT type 2A as one of the axonal forms. We describe a 44-year-old man with progressive weakness on bilateral legs after noticing foot drop in his early teen. When we examined him at 45 years of age, he presented atrophy on entire legs and with distal muscle weakness on limbs. The nerve conduction study revealed severely decreased amplitude on motor nerve ranging from 0.2 to 4.5 mV, while conduction velocity remained more than 30.4 m/s. The whole-exome sequencing revealed a novel variant c.2228G>T in MFN2 by efficient genetic analysis tool, MutationDistiller. This report will not only expand the mutation spectrum of CMT2A but also introduce a time-saving genetic analysis tool.

OBJECTIVE: The purpose of this study was to determine the efficacy of short segment fixation following postural reduction for the re-expansion and stabilization of unstable burst fractures in patients with osteoporosis. METHODS: Twenty patients underwent short segment fixation following postural reduction using a soft roll at the involved vertebra in cases of severely collapsed vertebrae of more than half their original height. All patients had unstable burst fracture with canal compromise, but their motor power was intact. The surgical procedure included postural reduction for 2 days and bone cement-augmented pedicle screw fixations at one level above, one level below and the fractured level itself. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. RESULTS: The mean follow-up period was 15 months. The mean pain score (visual analogue scale) prior to surgery was 8.1, which decreased to 2.8 at 7 days after surgery. The kyphotic angle improved significantly from 21.6+/-5.8degrees before surgery to 5.2+/-3.7degrees after surgery. The fraction of the height of the vertebra increased from 35% and 40% to 70% in the anterior and middle portion. There were no signs of hardware pull-out, cement leakage into the spinal canal or aggravation of kyphotic deformities. CONCLUSION: In the management of unstable burst fracture in patients with severe osteoporosis, short segment pedicle screw fixation with bone cement augmentation following postural reduction can be used to reduce the total levels of pedicle screw fixation and to correct kyphotic deformities.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteoporosis ; Spinal Canal ; Spine

We report a case of perivalvular abscess in a 66-year-old man with infective endocarditis, diagnosed by late gadolinium-enhanced (LGE) cardiovascular magnetic resonance (CMR) imaging. No clinical features suspicious of infective endocarditis were noted, however, transthoracic echocardiography revealed non-specific echogenic focal wall thickening at mitral-aortic intervalvular fibrosa. Perivalvular abscess in the aortic valve was demonstrated as focal wall thickening between the anterior mitral leaflet and the non-coronary cusp of the aortic valve with peripheral enhancement and central low signal intensity on LGE CMR imaging. Other features suggestive of infective endocarditis, such as neither vegetation nor valvular perforation were present. The perivalvular abscess did not grow after intensive intravenous antibiotics therapy, and the patient was discharged without surgical treatment. CMR with LGE provided an early accurate diagnosis of perivalvular abscess. The diagnosis of perivalvular abscess using LGE CMR imaging was not previously reported in Korea.
Abscess* ; Aged ; Anti-Bacterial Agents ; Aortic Valve ; Diagnosis ; Echocardiography ; Endocarditis* ; Humans ; Korea ; Magnetic Resonance Imaging*

PURPOSE: Multiple early gastric cancers were found in 6.9~11.7% of patients with early gastric cancer. The goal of this study was to clarify the clinicopathologic features of and to investigate treatment strategy for multiple early gastric cancer. MATENRIALS AND METHODS: Of 967 patients with an gastric adenocarcinoma who were treated by surgical resection during the period of 1993~1998 at the Department of Surgery, Korea University College of Medicine, 267 patients had early gastric cancer. A retrospective analysis of the clinicopathologic differences between the main and the accessory lesions in multiple early gastric cancer was carried out. A comparative analysis was also conducted between solitary early gastric cancer and multiple early gastric cancer. RESULTS: Of 267 patients with early gastric cancer, multiple early gastric cancers were found in 12 patients (4.5%), including 10 men and 2 women. Eleven patients with multiple early gastric cancer had one accessory lesion and 1 patient had 2 accessory lesions. Of the 13 accessory lesions, 7 (53.8%) were located in the same region as the main lesion. The most frequent combination of macroscopic types for the main lesion and the accessory lesion were depressed and depressed types (6 cases, 46.1%). The most frequent histologic type of main lesion was a well differentiated adenocarcinoma in 7 (58.3%) of the 12 cases; the accessory lesion was also well differentiated in 4 of those 7 cases. Of the 13 accessory lesions, 4 (30.8%) had been overlooked preoperatively; most of them were located in the lower third of the stomach and were IIb or IIc type and measured less than 1 cm in diameter. Lymph node metastasis was detected in 1 patient (8.3%). The clinicopathologic features of multiple early gastric cancer were not different from those of solitary early gastric cancer. CONCLUSION: In multiple early gastric cancer, the main and the accessory lesions showed similar differentiation, and lymph node metastasis was less frequent than in solitary early gastric cancer. Therefore, limited procedures, including endoscopic mucosal resection, may be indicated if each lesion of the multiple early gastric cancer fits the criteria for treatment strategy.
Adenocarcinoma ; Female ; Humans ; Korea ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Stomach ; Stomach Neoplasms*

This is a case report and review of literature of a rare mixed odontogenic tumor, ameloblastic fibro-odontoma in the posterior area of the mandible. The ameloblastic fibro-odontoma which was developed by hyperplasia of dental epithelium and mesenchymal tissue. This tumor was classified from ameloblastic odontoma by Hooker, in 1967. At first and characterized by mixed appearance of odontoma and ameloblastic fibro-odontoma, But, on the point of pathologic feature, there are many controversial opinions among scholars up to the present. The patients of this case report was refereed to our department via the pedodontic department for the treatment of hard mass on the premolar area of the left mandible. And then, on the clinical and radiographic examination at first visit, we had tentative diagnosis that the lesion was benign mixed odontogenic tumor of defined mass margin that was amelblastic fibro-odontoma. The tumor mass was removed by surgical enucleation and curettage and extracted left mandibular second premolar which was impacted on the lesion. And the removed tumor mass was confirmed to ameloblastic fibro-odontoma on the post-operative biopsy. The patients has well done follow-up check postoperatively and shown no sign of recurrence up to the present.
Ameloblasts* ; Bicuspid ; Biopsy ; Curettage ; Diagnosis ; Epithelium ; Follow-Up Studies ; Humans ; Hyperplasia ; Mandible* ; Odontogenic Tumors ; Odontoma ; Recurrence

Maxillofacial infection often place the oral and maxillofacial surgeon in situations where timely decisions have to be made. These decisions can be lifesaving. Odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often repond to surgical and antimicrobial management. Otheriwise odontogenic infections have the potential to spread via the fasical spaces in the head and neck region. They can compromise vital structures in this region or involve distant structures. The classic signs of maxillofacial infections include pain, swelling, fever, dysphagia, and dehydration. The goals of management should be to correct these conditions. We have undertaken clinical studies on infections in the oral and maxillofacial regions (facial space) by analyzing hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Kyung Hee University Hospital past 5 years from 1991. To 1995. And bacterial cultures and antibiotics sensitivity test were performed and the comparative analysis of the antibiotics was done. The results were as follows: 1. The most frequent cause of oral and maxillofacial infection was odontogenic 68% and in 23% patients with signs and symptom aggrevated after teeth extraction. 2. The most common fascial spaces involved was buccal space 36.1%, followed by submandibular space 12.3% and 3 cases were Ludwig's angina. 3. Antibiotics were administrated in all cases and surgical incision and drainage was performed in 88.6%. 4. The most causative organisms isolated from the pus cultures were streptococci group 51.1%.
Anti-Bacterial Agents ; Deglutition Disorders ; Dehydration ; Drainage ; Fever ; Head ; Humans ; Ludwig's Angina ; Neck ; Suppuration ; Surgery, Oral ; Tooth

Nd:YAG laser is well absorbed to water, melanin, hemoglobin and thus, Nd:YAG laser may be used for bleeding control and extraction site sterilization where is easily contaminated by saliva and blood. Additionaly, Nd:YAG laser have analgesic effect by elevation of pain threshold. On the basis of Nd:YAG laser effects, we applied the Nd:YAG laser on extraction socket of 50 patients who visited to our department for lower third molar extraction and evaluated the effects of Nd:YAG laser on the bleeding control, pain relief, swelling reduction after tooth extraction. For the objective assesment on Nd:YAG laser effects, we made up the other 50 patients(control group) who were treated by conventional extraction method and compare the subjective and objective symptoms(pain relief, swelling and oozing time) between each group. The results were as follows: 1. The Nd:YAG laser was effective to relief of postextraction pain and most effective to 2 hours after extraction when local anesthesia disappears. 2. The Nd:YAG laser application was non-effective to reducing the facial swelling after extraction. 3. The Nd:YAG was effective to decrease the oozing time after extraction and the average time was 4 hours.
Anesthesia, Local ; Equidae ; Hemorrhage ; Humans ; Lasers, Solid-State* ; Melanins ; Molar, Third ; Pain Threshold ; Saliva ; Sterilization ; Tooth Extraction

BACKGROUND: We evaluated the role and effects of prolotherapy in patients presenting with lower back pain and detected sacral asymlocation, by retrospectively analyzing the results of prolotherapy performed at our institute. METHODS: Twenty-three patients with referred pain in the lower back rather than distinct radiculopathy, were detected to have sacral asymlocation by simple X-ray from May 2004 through July 2005. The patients were treated with prolotherapy and manipulation by the Ongley's method around the lumbosacral junction, iliolumbar ligament, and sacroiliac joint. They were treated for approximately one to two week intervals, and during this period were rechecked by X-ray and evaluated using the visual analogue scale (VAS). RESULTS: A total of 23 patients were included in the study (10 male and 13 female), and the average age was 41 years. The average VAS at the time of visit was 8.5, the average treatment time was 4.7 days, and the average VAS after treatment was 2.1. CONCLUSIONS: Back pain, and associated leg and buttock pain, originate from several causes. In these case analyses, instability around the lumbosacral area and sacral asymlocation might have been important causes of patient back pain and associated buttock and leg pain. We therefore applied prolotherapy as well as manipulation techniques devised by Ongley to these patients, and obtained good results.
Back Pain* ; Buttocks ; Diagnosis* ; Humans ; Leg ; Ligaments ; Low Back Pain ; Male ; Pain, Referred ; Radiculopathy ; Retrospective Studies ; Sacroiliac Joint

A 70-year-old female presented with progressive gait disturbance. Neurologic examination revealed sensory impairment, hyporeflexia, and sensory ataxia. Nerve conduction study demonstrated mildly decreased velocity in motor nerves. Brain magnetic resonance imaging showed high signal intensities in the corticomedullary junction on diffusion weighted imaging. Neurocognitive function test implied mild cognitive impairment. Based on eosinophilic intranuclear inclusions in pathology, neuronal intranuclear inclusion disease was confirmed. Neuronal intranuclear inclusion needs to be considered when abnormal nerve conduction studies are consistent with abnormal brain imaging findings.