The blood blister-like aneurysm (BBA) of the internal carotid artery (ICA) is a rare but clinically important cause of subarachnoid hemorrhage (SAH), which accounts for 0.5% of incidences of ruptured intracranial aneurysms. BBA is a thin-walled, broad-based aneurysm that lacks an identifiable neck and is one of the most difficult lesions to treat. In this paper, a case is presented of a 57-year-old woman with SAH. Her cerebral angiography demonstrated a small BBA on the dorsal wall of her right ICA. Endovascular treatment that consisted of a stent-within-a-stent was attempted, but the replacement of the second stent failed, and the aneurysm became bigger. Surgery was performed by clipping the BBA with a Sundt slim-line encircling graft clip. The patient completely recovered with no complications. This treatment may be a salvageable option for BBA, especially when endovascular treatment has failed.
Aneurysm ; Carotid Artery, Internal ; Cerebral Angiography ; Endovascular Procedures ; Female ; Humans ; Incidence ; Intracranial Aneurysm ; Middle Aged ; Neck ; Stents ; Subarachnoid Hemorrhage ; Transplants

Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.
Amines ; Arachnoid ; Carbamazepine ; Cerebellopontine Angle ; Cranial Nerves ; Craniotomy ; Cyclohexanecarboxylic Acids ; Deception ; Deglutition ; Ear ; Female ; gamma-Aminobutyric Acid ; Glossopharyngeal Nerve ; Glossopharyngeal Nerve Diseases ; Humans ; Mastication ; Middle Aged ; Neurologic Examination ; Palatine Tonsil ; Pharynx ; Tongue

PURPOSE: The recurrence of a groin hernia presents few surgical options for repair. We investigated the safety and efficacy of herniorrhaphy using PerFix(R) plug for patients with recurrent groin hernias. METHODS: Between October 2000 and December 2004, 30 herniorrhaphies for recurrent groin hernia were performed and followed-up. The operation time, length of hospital stay, time of analgesic use, complication rates, and recurrence were investigated. RESULTS: Surgery had been initially performed in 26 patients with the non-mesh method, and with mesh in 4 patients; 12 patients had a direct recurrence at the medial side of the inguinal area near the pubic tubercle, 7 patients had a direct recurrence at other sites, and 11 patients had an indirect recurrence. Eight patients had urinary retention and 2 patients had minor wound complications. Hospital stays and analgesic use were comparable to non-recurrent groin hernia operations, although operation time was significantly longer in recurrent group, and there were no recurrences during the 70 months of followup. CONCLUSION: Comparing open or laparoscopic preperitoneal approach, the PerFix(R) plug method is simple and effective for recurrent groin hernia repair.
Follow-Up Studies ; Groin ; Hernia ; Herniorrhaphy ; Humans ; Length of Stay ; Recurrence ; Urinary Retention

PURPOSE: We evaluated retrospectively the outcomes of inoperable squamous cell lung cancer patients treated with radiotherapy to find out prognostic factors affecting survival. MATERIALS AND METHODS: Four hundred and eleven patients diagnosed as squamous cell lung cancer between November 1988 and December 1997 were the basis of this analyses. The planned dose to the gross tumor volume was ranged from 30 to 70.2 Gy. Chemotherapy was combined in 72 patients (17.5%) with the variable schedule and drug combination regimens. Follow-up period ranged from 1 to 113 months with the median of 8 months and survival status was identified in 381 patients (92.7%). Overall survival rate was calculated using the Kaplan-Meier method. RESULTS: Age ranged from 23 years to 83 years with the median 63 years. The male to female ratio was about 16:1. For all 411 patients, the median overall survival was 8 months and the 1-year survival rate (YSR), 2-YSR, and 5-YSR were 35.6%, 12.6%, and 3.7%, respectively. The median and 5-YSR were 29 months and 33.3% for Stage IA, 13 months and 6.3% for Stage IIIA, and 9 months and 3.4% for Stage IIIB, respectively( p=0.00). The median survival by treatment aim was 11 months in radical intent group and 5 months in palliative, respectively ( p=0.00). Of 344 patients treated with radical intent, median survival of patients (N=247) who received planned radiotherapy completely was 12 months while that of patients (N=97) who did not was 5 months ( p=0.0006). In the analyses of the various prognostic factors affecting to the survival outcomes in 247 patients who completed the planned radiotherapy, tumor location, supraclavicular LAP, SVC syndrome, pleural effusion, total lung atelectasis and hoarseness were statistically significant prognostic factors both in the univariate and multivariate analyses while the addition of chemotherapy was statistically significant only in multivariate analyses. The acute radiation esophagitis requiring analgesics was appeared in 49 patients (11.9%) and severe radiation esophagitis requiring hospitalization was shown in 2 patients (0.5%). The radiation pneumonitis requiring steroid medication was shown in 62 patients (15.1%) and severe pneumonitis requiring hospitalization was occurred in 2 patients (0.5%). During follow-up, 114 patients (27.7%) had progression of local disease with 10 months of median time to recur (range : 1~87 months) and 49 patients (11.9%) had distant failure with 7 months of median value (range : 1~52 months). Second malignancy before or after the diagnosis of lung cancer was appeared in 11 patients. CONCLUSION: The conventional radiotherapy in the patients with locally advanced squamous cell lung cancer has given small survival advantage over supportive care and it is very important to select the patient group who can obtain the maximal benefit and to select the radiotherapy technique that would not compromise the life quality in these patients.
Analgesics ; Appointments and Schedules ; Diagnosis ; Drug Therapy ; Esophagitis ; Female ; Follow-Up Studies ; Hoarseness ; Hospitalization ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Multivariate Analysis ; Neoplasms, Second Primary ; Pleural Effusion ; Pneumonia ; Pulmonary Atelectasis ; Quality of Life ; Radiation Pneumonitis ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Tumor Burden

No abstract available.
Humans

Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are 40~50's in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows; If the odds ratio of below 29 year of age is 1.0 then that of 30~39 is 1.74 (p=0.33), 40~49 is 2.47 (p=0.10), 50~59 is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of 0~9 is 5.08 (p<0.01), 10~19 is 12.37 (p<0.01), 20~29 is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of 100~120 is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below 29 micron/1 gamma-GT is 1.0 then that of 30~s59 is 2.11 (p<0.01), 60~90 is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then 150~199 is 1.49 (p=0.05), 200~250 is 1.09 (p=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and serum triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.
Alcoholism ; Alkaline Phosphatase ; Antigens, Surface ; Bilirubin ; Blood Glucose ; Cross-Sectional Studies* ; Diabetes Mellitus ; Diagnosis ; Early Diagnosis ; Fasting ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Male ; Malnutrition ; Metabolism ; Obesity ; Odds Ratio ; Overweight ; Prevalence* ; Substance-Related Disorders ; Tetracycline ; Transferases ; Triglycerides ; Ultrasonography*

To obtain the useful information for the status of working environment and health management of workers in manufacturing industries, comparision of results on the status of working environmental and health management of workers for 32 manufacturing industries in Chunam area from 1988 to 1989 was carried out. The results were as follows: 1. The rate of over-PEL(Permissible Exposure Limit) to for hazardous factors decreased significantly 23.5% in 1988, 18.3% in 1989 (p<0.05) and, the highest rate of over-PEL was the stone and sand handling industry, the highest rate of over-PEL was the dusty worplace as 38.5% in 1988, 35.2% in 1989. 2. The rate of workers exposed to hazardous factors in 1988 and in 1989 was 22.4% respectively, the rate of workers checked up special health examination was 40.1% in 1988, 75.3% in 1989. In stone and sand handling an dmedicochemical industries, none of workers exposed to hazardous factors was subjected to special health examination in 1988, but 75% of workers exposed to hazardous factors had checked up in 1989. 3. The 6 industries appointed as part-time factory physician among 17 industries which were supposed to have factory physician according to the Safety and Healthy Act of Korea, 6 out of 24 industries only appointed industrial hygienist, furthermore 4 out of 6 hygienists had another duty in addition to occupational hygiene itself.
Hygiene ; Korea ; Silicon Dioxide

OBJECTIVE: The objective of this study was to determine the correlations between changes in thrombogenesis or thrombolysis related factors, and the acute increase of a spontaneous intracerebral hemorrhage (sICH). MATERIALS AND METHODS: From January 2009 to October 2011, 225 patients with sICH were admitted to our hospital within 24 hours of onset. Among them, 111 patients with hypertensive sICH were enrolled in this study. Thrombogenic or thrombolytic factors were checked at admission. The authors checked computed tomography (CT) scans at admission and followed up the next day (between 12-24 hours) or at any time when neurologic signs were aggravated. Cases in which the hematoma was enlarged more than 33% were defined as Group A and the others were defined as Group B. RESULTS: Group A included 30 patients (27%) and group B included 81 patients (73%). Factors including activated partial thromboplastin time, prothrombin time, fibrinogen, and D-dimer showed a greater increase in group A than in group B. Factors including antithrombin III, factor V, and factor X showed a greater increase in group A than in group B. CONCLUSION: Based on the results of this study, it seems that the risk of increase in hematoma size can be predicted by serum thrombogenic or thrombolytic factors at admission.
Antithrombin III ; Cerebral Hemorrhage* ; Factor V ; Factor X ; Fibrinogen ; Hematoma ; Humans ; Neurologic Manifestations ; Partial Thromboplastin Time ; Prothrombin Time

OBJECTIVE: Radiofrequency facet rhizotomy(RFFR) has been widely performed for treatment of chronic neck pain caused by cervical dorsal ramus syndrome(CDRS). To evaluate the therapeutic effectiveness of RFFR in the patients with CDRS, we analyzed patients with various cervical pathologic conditions. METHODS: The therapeutic results in forty-four patients who underwent RFFR for CDRS from January, 2000 to December, 2002 were analyzed according to the underlying pathologic conditions causing CDRS. The pathologic conditions were sprain (33 cases), herniated nucleus pulposus (6), foraminal stenosis (4), and compression fracture (1). The therapeutic results were evaluated one month after the operation and graded as excellent, good, fair or poor. Treatments were considered successful if the therapeutic results were graded as either excellent or good. RESULTS: The overall success rate in all patients was 72.7%. The success rate for treatment of cases with cervical sprain was 87.9%, but treatment of cases with herniated nucleus pulposus, foraminal stenosis, and fracture showed unsatisfactory results (mean success rate was 27.3%). Some patients complained of transient hypesthesia (4 cases) or transient dull pain at the electrode insertion sites (2 cases). CONCLUSION: RFFR is an effective and safe treatment for CDRS caused by cervical sprain, regardless of the patient's age, the duration of the symptoms, and the presence of radiating pain.
Constriction, Pathologic ; Electrodes ; Fractures, Compression ; Humans ; Hypesthesia ; Neck Pain ; Rhizotomy* ; Sprains and Strains

Chronic cough is defined as a cough that lasts for more than three weeks. In most patients, chronic cough is caused by four conditions: postnasal drip, asthma, chronic bronchitis, gastroesophageal reflux. Psychogenic chronic cough is not a frequent disorder. Furthermore, chronic vocal tic disorder is a very rare cause of chronic dry cough. A 22- year-old male suffered from chronic dry cough for last two years. His character showed obsessive- compulsive disorder. He has been shrugging both shoulders inadvertently since his childhood. Consequently, he was diagnosed as having chronic motor tic disorder. But after contracting respiratory tract infection, his motor tic disappeared and chronic dry cough was developed concomitantly. He had no history of smoking, chronic rhinitis, sinusitis, asthma, and gastroesophageal reflux. Physical examinations were normal. Chest X-ray, paranasal sinus view, metacholine bronchial provocation test, and esophago-gastroscopy were normal. Chronic cough was never relieved despite empirical treatment. Psychiatric consultation suggested chronic vocal tic disorder. The frequency of cough was diminished two days after administeration of valium and haloperidol and thereafter his complaint disappeared in one month. Here we report a very rare case of chronic motor tic disorder which was transformed into chronic vocal tic disorder presenting as a chronic cough. As far as we know, this is the first case of its kind in Korea.
Asthma ; Bronchial Provocation Tests ; Bronchitis, Chronic ; Cough ; Diazepam ; Gastroesophageal Reflux ; Haloperidol ; Humans ; Korea ; Male ; Physical Examination ; Prader-Willi Syndrome ; Respiratory Tract Infections ; Rhinitis ; Shoulder ; Sinusitis ; Smoke ; Smoking ; Thorax ; Tic Disorders ; Tics