BACKGROUND AND PURPOSE: Hypertension and alcohol consumption are well known independent risk factors of spontaneous intracerebral hemorrhage (ICH). However, it is uncertain whether controlling of them reduces the volume of ICH. Furthermore, it remains also unkown whether other factors such as age, sex, education level, smoking, diabetes mellitus, and previous history of stroke are related to the volume of ICH. This study was designed to evaluate the relations of those things with the volume of ICH. METHODS: We prospectively assessed above items in 103 consecutive patients with ICH aged 33 to 87 years (mean age : 64 years, 50 men and 53 women ). We divided the volume of ICH with the use of CT scan into small (<10cc, n=71) and large (>=l0cc, n=32) groups. RESULTS: The patients with previous history of stroke significantly have a smaller volume of ICH compared to those without (p=0.04). However, the other factors (age, sex, education level, antihypertensive medication, alcohol consumption, smoking, and diabetes mellitus) were not significantly correlated with the volume of ICH to multivariate analysis. The patients with previous history of stroke tended to receive more regular antihypertensive medication than these without (p-0.06). CONCLUSION: The patients with previous history of stroke have a smaller volume of ICH possibly due to adequate antihypertensive treatment. However, the other factors which we evaluated were not significantly correlated with the volume of ICH.
Alcohol Drinking ; Cerebral Hemorrhage* ; Diabetes Mellitus ; Education ; Female ; Humans ; Hypertension ; Male ; Multivariate Analysis ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke ; Tomography, X-Ray Computed

Cholangiocarcinoma is a rare tumor among all populations of the world and accounts for less than 2% of cancers found at autopsy and between 10% and 20% of all primary liver cancers. The tumor originates either from the intrahepatic small duct radicles(peripheral type) or the major hepatic ducts at or near the junction of the right and left hepatic ducts(hilar type). Included in the latter are the small intraduct carcinomas arising at the bifurcation of the hepatic ducts. (continue...)
Autopsy ; Cholangiocarcinoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Hemobilia* ; Hepatic Duct, Common ; Humans ; Jaundice, Obstructive* ; Liver Neoplasms

PURPOSE: To evaluate the clinical effects of excimer laser refractive surgery on eyes with residual refractive error after implantation of ReSTOR(R) multifocal intraocular lenses. METHODS: We retrospectively reviewed the medical records of 10 eyes of 6 patients who had undergone cataract surgery with implantation of multifocal intraocular lenses. Photorefractive keratectomy (PRK) (5 eyes) and laser-assisted in situ keratomileusis (LASIK) (5 eyes) was performed on 10 eyes with residual refractive error. RESULTS: After cataract surgery and before laser surgery, the mean spherical equivalent (SE) was -0.34 +/- 0.89 D and the mean astigmatism was 2.08 +/- 0.55 D. Six months after laser surgery, the mean SE was -0.33 +/- 0.30 D (p = 0.354) and the mean astigmatism was 0.23 +/- 0.28 D. The changes in astigmatism between paired preoperative and postoperative values were statistically significant (p < 0.0001). At 6 months after surgery, uncorrected distance visual acuity significantly improved to 0.11 +/- 0.10 (log MAR) (p < 0.0001) There were no significant changes in the best corrected distance visual acuity and uncorrected near visual acuity (p = 0.073, p = 0.100). CONCLUSIONS: On the basis of predictability and stability, excimer laser surgery appears to be a clinically useful procedure to correct residual refractive error after implantation of ReSTOR(R) multifocal intraocular lenses.
Astigmatism ; Cataract ; Eye ; Humans ; Keratomileusis, Laser In Situ ; Laser Therapy ; Lasers, Excimer ; Lenses, Intraocular ; Medical Records ; Photorefractive Keratectomy ; Refractive Errors ; Refractive Surgical Procedures ; Retrospective Studies ; Visual Acuity

No abstract available.
Groin* ; Pelvis* ; Rectus Abdominis*

Estlander's method was popular for lower lip reconstruction after wide excision of malignant tumor of lower lip. This operative method is safe, easy and has good result, but it is necessary to perform a secondary commissuroplasty because of round and small commissure. Several methods have been suggested for secondary commissuroplasty. We have performed commissuroplasty with three triangular flaps according to Ichiro's report.5 This method uses two opposing triangular mucosal flaps in the vermilion area and one small triangular skin flap on the commissure. We can obtain satisfactory results in terms of aesthetic and functional consideration. Thus, we report the usefulness of three triangular flaps as a secondary commissuroplasty after reconstruction of the lip by Estlander's method.
Lip* ; Skin ; Surgical Procedures, Operative*

Benign symmetrical lipomatosis(BSL) is a rare disease of unknown origin characterized by symmetrical and diffuse deposits of nonencapsulated fatty tissue. It is located on the neck, the shoulder, the proximal regions of the extremities and the abdomen. It is strongly associated with alcoholism. Other associated diseases include liver disease, dyslipidemia, gout, abnormal glucose tolerance, and malignancies of the upper airways. BSL is found mainly in middle-age, mediterranean men. Imaging using either computed tomography or magnetic resonance imaging is often recommended. Dietary restriction provides no relief. Abstinence from alcohol may delay further progression but does not cause regression of the deformity. The only effective therapy for BSL is surgical removal but recurrence is common. Physicians should be aware of this condition because of its association with metabolic disease and malignancies
Abdomen ; Adipose Tissue ; Alcoholism ; Congenital Abnormalities ; Dyslipidemias ; Extremities ; Glucose ; Gout ; Humans ; Lipomatosis* ; Lipomatosis, Multiple Symmetrical ; Liver Diseases ; Magnetic Resonance Imaging ; Male ; Metabolic Diseases ; Neck ; Rare Diseases ; Recurrence ; Shoulder

Benign symmetrical lipomatosis(BSL) is a rare disease of unknown origin characterized by symmetrical and diffuse deposits of nonencapsulated fatty tissue. It is located on the neck, the shoulder, the proximal regions of the extremities and the abdomen. It is strongly associated with alcoholism. Other associated diseases include liver disease, dyslipidemia, gout, abnormal glucose tolerance, and malignancies of the upper airways. BSL is found mainly in middle-age, mediterranean men. Imaging using either computed tomography or magnetic resonance imaging is often recommended. Dietary restriction provides no relief. Abstinence from alcohol may delay further progression but does not cause regression of the deformity. The only effective therapy for BSL is surgical removal but recurrence is common. Physicians should be aware of this condition because of its association with metabolic disease and malignancies
Abdomen ; Adipose Tissue ; Alcoholism ; Congenital Abnormalities ; Dyslipidemias ; Extremities ; Glucose ; Gout ; Humans ; Lipomatosis* ; Lipomatosis, Multiple Symmetrical ; Liver Diseases ; Magnetic Resonance Imaging ; Male ; Metabolic Diseases ; Neck ; Rare Diseases ; Recurrence ; Shoulder

Pyoderma gangrenosum(PG) is an uncommon cutaneous vascular disease that typically presents as a painful and destructive ulceration on the anterior surface of the legs. The etiology of PG is currently unknown. But, the association with many immunologic disorders and its clinical response to immunomodulating agents suggest an immune etiology. A common feature of patients with PG is the presence of pathergy(the induction of lesion following injury of the skin). The trauma of surgery can be sufficient to induce pathergy, thus paradoxically limiting the usefulness of surgical treatment of PG. For that reason, medical treatments have been commonly used, while surgical treatments have been regarded not suitable. However, the use of the classic systemic agents is limited by their side effects and contraindications. Moreover, the large, problematic ulcers take too long to heal with medical management only. We present our experience in closing large wounds with the goal of decreasing morbidity, drug side effects and hospital stay by combination of medical and surgical therapy(split thickness skin graft). And authors advocate that surgical management is not a contraindication and may be considered as a selective modality in treatment of PG.
Humans ; Leg ; Length of Stay ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Ulcer ; Vascular Diseases ; Wounds and Injuries

Angiosarcoma is a rare and highly malignant tumor of vascular origin which may occur in any region of the body. About one third of them are cutaneous angiosarcoma distinguished from others. The tumor primarily affects the elderly individuals, usually located on the head and neck, especially scalp and frequently metastasizes to lung. This paper reports a 58-year-old man with localized angiosarcoma of the scalp, which was dark-purple, soft, fixed and a hairless mass. The mass was confirmed as angiosarcoma without metastasis at the time of initial diagnosis and was completely removed followed by radiotherapy. 3 months after operation, the patient died from pulmonary complications which were associated with metastatic tumors to the lung. This case illustrates the need of awareness for the aggressive nature of this tumor and to suspect metastasis when pulmonary complications occur.
Aged ; Diagnosis ; Head ; Hemangiosarcoma* ; Humans ; Lung ; Middle Aged ; Neck ; Neoplasm Metastasis* ; Radiotherapy ; Scalp*

Open structure rhinoplasty combines the open(external) approach to rhinoplasty with innovative nasal restructuring techniques especially for the lower third of the nose. It involves minimal resection of the nasal structure, dome-dividing maneuvers with reconstitution of the lateral crural strip, and columellar strut and tip-grafting methods. A total of 14 patients are presented, 1 with congenital flat nose, 1 with congenital nasal deformity, 1 with congenital bulbous tip and deviation, and 11 with posttraumatic nasal deformities, with age between 14 and 41 years old and a follow-up period of 2 years. These patients underwent humpectomy, septal cartilage shield graft, corrective rhinoplasty, and augmentation rhinoplasty through a transverse midcolumellar incision with bilateral marginal incisions. These incisions provide the exposure necessary to precisely assemble a structurally sound nasal skeleton. The nasal tip graft and alar cartilage realignment are essential for determining nasal tip projection. We used sutured-in-place tip graft in 3 patients. The aesthetic results were excellent with improved nasal dorsal profile including nasal tip projection. The open structure rhinoplasty, however, has its disadvantages. The procedure is more time consuming, mainly because the nasal restructuring maneuvers and transcolumellar incision require meticulous execution. Nevertheless if proper techniques are used, columellar scar is rarely noticed and almost disappears with the lapse of time. In conclusion, unlike all closed techniques, the open approach to rhinoplasty permits accurate diagnosis and precise realignment of deformed nasal structures(both cartilage and bone) during the operation.
Adult ; Cartilage ; Cicatrix ; Congenital Abnormalities ; Diagnosis ; Follow-Up Studies ; Humans ; Nose* ; Rhinoplasty* ; Skeleton ; Transplants