No abstract available.
Otitis Media* ; Otitis* ; Tuberculosis*

A 24-year-old man with tuberculosis meningitis developed acute paraplegia and sensory disturbances 5 weeks after receiving conventional antituberculous therapy. Magnetic resonance imaging revealed an intradural extramedullary long segmental mass mimicking en plaque meningioma at the T2-T6 vertebrae levels. Prompt surgical decompression was performed. A histology examination of the mass revealed a tuberculoma. After surgery, the patient showed improved motor power and a normal bladder function. Intradural extramedullary tuberculoma of the spinal cord is rare complication of tuberculosis meningitis, which can occur as a response to conventional antituberculous therapy.
Diagnosis, Differential ; Humans ; Male ; Meningeal Neoplasms/*diagnosis ; Meningioma/*diagnosis ; Spinal Cord Diseases/*diagnosis/surgery ; Thoracic Vertebrae ; Tuberculoma/*diagnosis/surgery ; Tuberculosis, Meningeal/*diagnosis/surgery ; Young Adult

No abstract available.
Cartilage* ; Rabbits* ; Ribs*

No abstract available.
Humans ; Pericardial Effusion*

PURPOSE: Although there have been studies emphasizing the re-education of North Korean (NK) doctors for post-unification of the Korean Peninsula, study on the content and scope of such re-education has yet to be conducted. Researchers intended to set the content and scope of re-education by a comparative analysis for the scores of the preliminary examination, which is comparable to the Korean Medical Licensing Examination (KMLE). METHODS: The scores of the first and second preliminary exams were analyzed by subject using the Wilcoxon signed rank test. The passing status of the group of NK doctors for KMLE in recent 3 years were investigated. The multiple-choice-question (MCQ) items of which difficulty indexes of NK doctors were lower than those of South Korean (SK) medical students by two times of the standard deviation of the scores of SK medical students were selected to investigate the relevant reasons. RESULTS: The average scores of nearly all subjects were improved in the second exam compared with the first exam. The passing rate of the group of NK doctors was 75%. The number of MCQ items of which difficulty indexes of NK doctors were lower than those of SK medical students was 51 (6.38%). NK doctors' lack of understandings for Diagnostic Techniques and Procedures, Therapeutics, Prenatal Care, and Managed Care Programs was suggested as the possible reason CONCLUSION: The education of integrated courses focusing on Diagnostic Techniques and Procedures and Therapeutics, and apprenticeship-style training for clinical practice of core subjects are needed. Special lectures on the Preventive Medicine are likely to be required also.
Clinical Competence ; Democratic People's Republic of Korea ; Diagnostic Techniques and Procedures ; Education ; Foreign Medical Graduates ; Humans ; Lectures ; Licensure ; Managed Care Programs ; Prenatal Care ; Preventive Medicine ; Refugees* ; Students, Medical

Adult ; Antitubercular Agents ; adverse effects ; Humans ; Isoniazid ; adverse effects ; Male ; Pulmonary Fibrosis ; chemically induced ; diagnosis

Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery.An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxillomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

Cast formation of biliary sludge leading to obstruction and cholangitis have been reported in patients who received orthotopic liver transplantation. The pathogenesis of biliary cast after orthotopic liver transplantation appeared to be multifactorial. Cold ischemic damage, immunologic attack to the bile duct and bile stasis may have played a role. On the other hand, only three cases of biliary cast have been reported in non-transplanted patients. We described the successful endoscopic removal of this complication in a 70-year-old man whose biliary sludge aggregated into firm casts occupying the extrahepatic ducts which has been developed after cholecystectomy and segmentectomy for intrahepatic cholangiocarcinoma. We speculated on the hemolysis and prolonged fasing as the initiating events but the exact pathogenesis of biliary cast remains to be clarified.
Aged ; Bile ; Bile Ducts ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Hand ; Hemolysis ; Humans ; Liver Transplantation ; Mastectomy, Segmental ; Cholangiocarcinoma

Cast formation of biliary sludge leading to obstruction and cholangitis have been reported in patients who received orthotopic liver transplantation. The pathogenesis of biliary cast after orthotopic liver transplantation appeared to be multifactorial. Cold ischemic damage, immunologic attack to the bile duct and bile stasis may have played a role. On the other hand, only three cases of biliary cast have been reported in non-transplanted patients. We described the successful endoscopic removal of this complication in a 70-year-old man whose biliary sludge aggregated into firm casts occupying the extrahepatic ducts which has been developed after cholecystectomy and segmentectomy for intrahepatic cholangiocarcinoma. We speculated on the hemolysis and prolonged fasing as the initiating events but the exact pathogenesis of biliary cast remains to be clarified.
Aged ; Bile ; Bile Ducts ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Hand ; Hemolysis ; Humans ; Liver Transplantation ; Mastectomy, Segmental ; Cholangiocarcinoma

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the relationship between the expression of Bcl-2, Bax, p27 and lymph node metastasis (LNM) in papillary thyroid cancer (PTC). SUBJECTS AND METHOD: The thyroid tissue samples were obtained randomly from the department of pathology at Kangbuk Samsung Hospital. The specimens were from 72 patients, comprising 25 patients with thyroid nodular hyperplasia (TNH), 23 PTC without LNM, and 24 PTC with LNM between January 2006 and May 2008. Immunohistochemical staining for Bcl-2, Bax, and p27 was performed, and quantified blindly by three pathologists who had no clinical information of the patients. Immunohistochemical expression was scored as high (>25% of cells stained) or low (0-25%). RESULTS: Expression of Bcl-2 was scored as high for 1 (4%) TNH, 3 (13%) PTC without LNM and 4 (17%) PTC with LNM cases. Expression of Bax was scored as high for 0 (0%) TNH, 9 (39%) PTC without LNH and 16 (67%) PTC with LNM cases. Expression of p27 was scored as high for 13 (52%) TNH, 12 (52%) PTC without LNM and 13 (54%) PTC with LNM cases. Expression of Bax in the PTC with LNM group was scored higher than TNH (p<.01) and PTC without LNM (p<.05). There was no statistically difference in the immunoreactivity for Bcl-2 and p27 among the three groups. However, some positive expressions of p27 were noted at the cytoplasm of the PTC. CONCLUSION: Our results suggest that immunohistochemical analysis of Bax may be helpful in the diagnosis of PTC and in the evaluation of lymph node metastatic potential in PTC.
Carcinoma, Papillary ; Cytoplasm ; Factor IX ; Humans ; Hyperplasia ; Lymph Nodes ; Neoplasm Metastasis ; Thyroid Gland ; Thyroid Neoplasms