Weber-Christian disease is a relapsing, febrile, nodular, nonsuppurative inflammation of the subcutaneous fat tissue. Many authors reported these cases which illustrate the great variability of the clinical manifestation, such as acute or chronic, fulminating or transient, febrile or non febrile, systemic or cutaneous. Two of our cases have had recurrent painful subeutaneous nodules without fever for several years. Biopsy showed a nonspecific inflammatory panniculitis with lymphocytes chiefly, and small amount of histiocytes and foamy cells. It should be suggested Weber-Christian disease when subcutaneous nodules appear recurrently same areas of the whole body surface except anterior aspects of tibia even if no fever as systemic manifestation. Treatment with steroid and chloroquine diphosphete produced good improvement.
Biopsy ; Chloroquine ; Fever ; Histiocytes ; Inflammation ; Lymphocytes ; Panniculitis ; Panniculitis, Nodular Nonsuppurative* ; Subcutaneous Fat ; Tibia

The purpose of this study was the long-term clinical and radiological evaluation of conservatively treated condylar fractures in children. This study was therefore undertaken to analyze the long-term effects of treating condylar fractures in children with conservative therapy in order to resolve the controversial question of whether complete remodeling occurs in this age or, if not, whether it is more likely to be associated with certain types of fracture or with other factors. This study was based on a series of 11 consecutive children and adolescents, aged between 3 and 15 years, with fractures of the condylar process who had been treated with conservative therapy at the Department of Oral and Maxillofacial surgery, Inha University Hospital, Inchon, Korea. All patients underwent a clinical investigation with special emphasis on Temporomandibular joint function and facial asymmetry. The patients also underwent a radiologic investigation, focusing on fracture remodeling and symmetry of mandible. It consists of panoramic radiograph, PA and lateral cephalogram and 3-D CT. No patient described impaired temporomandibular joint(TMJ) function or pain on the affected side. 2 of 8 (25%) unilateral and 1 bilateral fractures show slight facial asymmetry. Despite apparently excellent recovery of function, there were marked remodeling changes evident on the CT scan. Such changes are not usually evident on panoramic radiograph. Radiologic investigation showed incomplete remodelling(54.5%) and asymmetry of the mandible (27.3%) in some patients. Conservative treatment of condyle fracture in children results in satisfactory long-term outcome of jaw function despite a relative high frequency of radiologically noted aberrations.
Adolescent ; Child* ; Facial Asymmetry ; Humans ; Incheon ; Jaw ; Korea ; Mandible ; Recovery of Function ; Surgery, Oral ; Temporomandibular Joint ; Tomography, X-Ray Computed

OBJECTIVE: Bipolar disorder patients often show excessive goal-directed and pleasure-seeking behavior during manic episodes and reduced hedonic capacity during depressive episodes, indicating that bipolar disorder might involve altered reward processing. As such, bipolar disorder subjects have been reported to show impaired reward learning in situations requiring integration of reinforcements over time. In this study, we examined characteristics of reward learning in euthymic patients with bipolar disorder using a probabilistic reward task. METHODS: We recruited 23 euthymic patients with bipolar disorder and 47 healthy subjects for the probabilistic reward task. This task is a reward-based paradigm to produce a response bias, in which correct identifications of two ambiguous stimuli are differently rewarded. The other dependent measures were the discriminability, hit rate and reaction time. RESULTS: Relative to comparison subjects, bipolar patients showed a reduced acquisition of response bias toward the more frequently rewarded stimulus (p<0.01). The overall reward learning was positively correlated with state and trait anxiety levels in bipolar patients (p<0.01). No significant differences of discriminability, hit rates, and reaction time were found between bipolar patients and controls. CONCLUSION: These findings suggest that euthymic patients with bipolar disorder may have deficits in reward learning related to anxiety.
Anxiety ; Bias (Epidemiology) ; Bipolar Disorder ; Humans ; Learning ; Reaction Time ; Reinforcement (Psychology) ; Reward

Heated humidifiers are used to prevent respiratory complications associated with mechanical ventilation with an endotracheal tube. One of the heated humidifiers uses an air dryer filter in order to remove humidity from air before it enters the anesthetic machine. We report a case in which the air dryer filter was unintentionally misconnected to the inspiratory limb of the circuit, which caused insufficient volatile anesthetic concentration during anesthesia induction.
Adsorption ; Anesthesia ; Extremities ; Hot Temperature ; Humidity ; Isoflurane ; Respiration, Artificial ; Silica Gel

PURPOSE: Frey's syndrome is a common complication after parotid surgery and characterized by gustatory sweating and flushing in the periauricular area during meals. Although a variety of methods were proposed to prevent this postoperative problem, they were unsatisfactory. We used botulinum toxin A to treat 9 patients with Frey's syndrome and investigated the duration effect after the injection. METHODS: Nine patients became the object of study about the effect of botulinum toxins as treatment of Frey's syndrome. Age of patients ranged from 25 to 78 years (mean, 43.7 years). Six of nine patients had both symptoms of gustatory sweating and flushing. And the others had only gustatory sweating symptom. Using Minor starch iodine test, the affected skin area was detected, and it was marked by 1 cm2 sized grid appearance. After application of EMLA cream on the gustatory sweating area, botulinum toxin A was injected intracutaneously into the affected skin area (2.5 U/cm2). Patients were followed up from six to fifteen months (mean, about 12 months) and asked about improvement of their symptoms. RESULTS: The treatment with botulinum toxin A had an effect within 2 days after the injection. Six months after injection, gustatory sweating disappeared completely in all patients, and 5 of six patients who had gustatory flushing improved in their symptom. At the last follow-up, no patients complained of recurrent gustatory sweating and flushing except one. One patient, seven months after initial injection, was retreated with botulinum toxin A because of recurrence, and the result was successful. The duration of the effect after botulinum toxin A treatment was ranged from seven to thirteen months. One patient in our series experienced the upper eyelid weakness as adverse effect, but it improved spontaneously. CONCLUSION: Local injection of botulinum toxin A is an effective, safe and long-lasting method for treatment of Frey's syndrome. Hereafter, however, additional study is required to evaluate the duration effect of botulinum toxin A as to frequency in use and dosage
Botulinum Toxins ; Eyelids ; Flushing ; Follow-Up Studies ; Humans ; Iodine ; Lidocaine ; Meals ; Prilocaine ; Recurrence ; Skin ; Starch ; Sweating, Gustatory

PURPOSE: To evaluate the parameters affecting vaulting and correlation between preoperative crystalline lens rise and vaulting after implantable collamer lense (ICL) implantation. METHODS: A total of 53 eyes of 34 patients who underwent ICL implantation were examined retrospectively. White-to-white (WTW) and anterior chamber depth (ACD) were obtained from scanning topography (ORB scan) before surgery. Preoperative crystalline lens rise (CLR) and vaulting at 6 months after ICL implantation were measured using anterior segment optic coherence tomography (AS-OCT). Multiple regression analysis was performed to evaluate the factors affecting central vaulting. RESULTS: The mean preoperative crystalline lens rise was -120 +/- 219 microm, and mean central vaulting 6 months after surgery was 544 +/- 175 microm. Preoperative SE, WTW, ACD, and CLR were significantly correlated with vaulting at 6 months after surgery. With the use of meaningful variables, multiple regression analysis showed that CLR, WTW, ACD and SE, in that order of influence, had significant effects on vaulting and the multiple regression equation was obtained as follows: Vaulting (microm) = (160.913 x ACD (mm)) + (170.134 x WTW (mm)) + (-0.338 x CLR (microm)) + (-23.783 x SE (D)) - 2250.184. CONCLUSIONS: CLR had a stronger influence on vaulting after ICL implantation than the previously proven parameters: WTW, ACD, and SE. In addition to WTW, ACD and SE, CLR should also be considered a new criterion for estimating vaulting after ICL implantation.
Anterior Chamber ; Crystallins ; Eye ; Humans ; Lens, Crystalline ; Lenses, Intraocular ; Retrospective Studies

PURPOSE: Obesity is a frequent nutritional disorder in children and adolescent and its prevalence is increasing. Bioelectrical impedance analysis is a simple, rapid, non-invasive and reproducible technique. The aim of this study was to measure percent of body fat using bioelectrical impedance in healthy children. METHODS: We measured height, weight and bioelectrical impedance in 1035 children aged 7-18 years(496 males and 539 females). RESULTS: Percent of body fat was decreased in male children, but it was increased during the pubertal period in female. 95th percentiles of percent of body fat by bioelectrical impedance was 32.9% in 7 year olds, 31.6% in 8, 34.7% in 9, 35.1% in 10, 35.8% in 11, 33.1% in 12, 36.1% in 13, 38.2% in 14, 33.3% in 15, 28.3% in 16, 32.8% in 17 and 32.2% in 18 year olds for males. 95th percentiles of percent of body fat by bioelectrical impedance was 25.1% in 7 year olds, 29.6% in 8, 30.5% in 9, 35.6% in 10, 34.5% in 11, 36.5% in 12, 39.1% in 13, 34.1% in 14, 33.7% in 15, 32.8% in 16, 34.5% in 17 and 35.1% in 18 year olds for females. Intraobserver reliability coefficient of bioelectrical impedance analysis was 0.995 and intraobserver reliability of BI(Bioelectrical impedance) analysis was significantly high. CONCLUSION: To measure body fat percentage using bioelectrical impedance analysis in healthy children provides objective data in diagnosing obesity.
Adipose Tissue* ; Adolescent ; Child* ; Electric Impedance* ; Female ; Humans ; Male ; Nutrition Disorders ; Obesity ; Pediatric Obesity ; Prevalence

PURPOSE: Papillary thyroid carcinoma (PTC) is known to have a favorable prognosis and long-term survival due to its biologic characteristics of slow growth and late distant metastasis. However, its characteristic of lymph node metastasis has resulted in a high incidence of neck recurrence and only rare lung metastasis. The objective of this study is to analyze the characteristics of recurrent or persistent thyroid cancer and to evaluate the risk factors for the development of recurrence. METHODS: We retrospectively reviewed 479 consecutive cases of PTC and these patients had undergone surgical operations from January 2004 to December 2006. We assessed age, gender, the tumor characteristics, the operative methods and the recurrence patterns, and the correlations between these factors and recurrence were analyzed. RESULTS: Of the 479 patients with PTC and who were initially treated with surgery at our hospital, 42 patients (8.8%) had recurrent disease. Univariate analysis showed that an age less than 45 years, male gender, extra-thyroidal extension, lymph node metastasis, multifocality, bilaterality and neck node dissection were related to a higher rate of recurrence. Of these, lymph node metastasis and central or lateral neck node dissection were the independent risk factors for recurrent PTC on the multivariate analysis. CONCLUSION: The significant factors influencing locoregional recurrence and distant metastasis were cervical lymph node metastasis and incomplete neck node dissection. In order to reduce the rate of recurrence of PTC, an exact preoperative evaluation of the nodal status and formal neck node dissection are recommended during the initial surgery in patients who have these factors of recurrence.
Humans ; Incidence ; Lung ; Lymph Nodes ; Male ; Multivariate Analysis ; Neck ; Neoplasm Metastasis ; Population Characteristics ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: Papillary thyroid carcinoma (PTC) is the most common malignancy that develops from the thyroid gland and its prognosis is quite excellent. One of the characteristic behaviors of PTC is that it often occurs at multiple foci. The purpose of this study was to investigate the clinicopathologic features and risk factors of multifocal papillary thyroid cancer. METHODS: A retrospective review was carried out on 624 patients with PTC and who underwent surgery from January 2005 to December 2007. Two hundred twenty-nine of them were found to have multiple tumor foci (≥2 foci). The risk factors that included gender, age at diagnosis, tumor size, capsular invasion, extrathyroidal extension (ETE), cervical lymph node (LN) involvement, the TNM classification, local recurrence and distant metastasis were comparatively analyzed between the solitary PTC and multifocal PTC groups. RESULTS: The enrolled patients were 59 male and 565 females. The mean age was 46 years (range: 15~77 years). Age (P=0.025), tumor size (P=0.027), capsular invasion (P<0.001), ETE (P<0.001) and cervical LN metastasis (P=0.002) were the significantly related factors for multifocal papillary thyroid cancer. However, gender was not significantly related with multifocality. CONCLUSION: The results of this study showed that multifocal tumors were significantly associated with age, tumors size, capsular invasion, ETE and cervical LN metastasis in patients with PTC. LN metastasis was mostly influenced by multifocality in the PTC patients. It seems certain that total thyroidectomy and formal central node dissection with postoperative adjuvant therapy are essential treatment for these patients, and closely surveying the nodal status is needed on the follow up of patients with multifocal PTC.
Classification ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

BACKGROUND: This study was performed to examine 1) whether propofol prevented the increases in intracellular calcium and radical oxygen species (ROS) induced by lysophosphatidic acid (LPA) in endothelial cell; 2) whether these two types of increases were mediated by common underlying mechanisms. METHODS: Intracellular Ca2+ ([Ca2+]i) and H2O2 were measured in endothelial cell line (ECV 304) using a laser scanning confocal microscope. The cells, cultured and serum-starved on round coverslips, were incubated with various concentrations of propofol for 30 minutes, and then stimulated with various concentrations of LPA. The samples were excited by a 488 nm argon laser and images were filtered by a 515 nm longpass emission filter. The results were expressed as relative fluorescence intensity (RFI) and fold stimulation (fold). RESULTS: LPA increased in intracellular ROS in the endothelial cell in a dose-dependent manner. In addition, LPA-induced increase in ROS were alleviated by ROS scavengers such as Aspergillus niger catalase and n-(2-mercaptopropionyl)-glycine (2-MPG). LPA also increased in [Ca2+]i in a dose-dependent fashion. Propofol prevented LPA-induced increase in ROS and [Ca2+]i whereas 2-MPG did not affect the change of calcium level induced by LPA application. CONCLUSIONS: These results suggested that propofol prevented the increases in intracellular calcium and ROS induced by LPA in endothelial cell, and these two types of increases might be mediated by different underlying mechanisms.
Argon ; Aspergillus niger ; Calcium ; Catalase ; Cells, Cultured ; Endothelial Cells* ; Fluorescence ; Oxygen ; Propofol* ; Reactive Oxygen Species*