No abstract available.
Child ; Coronary Vessels* ; Echocardiography ; Humans

No abstract available.
Electric Stimulation* ; Vocal Cords*

Osteolipoma is an ossified lipoma with distinct components of fat and bone. We present a case of interhemispheric osteolipoma associated with total agenesis of the corpus callosum. A 20-year-old man complained of severe headache, nausea and vomiting. Brain computed tomography showed a low-density mass in an interhemispheric fissure, with high T1 and T2 magnetic resonance signals compatible with fat. The mass measured 4.9 x 2.9 cm in size and showed peripheral calcifications. There was another small piece of same signal mass within the lateral ventricular choroid plexus. The interhemispheric lesion was removed by an interhemispheric approach. Osteolipoma is rare in interhemispheric region, however, it should be a differential diagnosis of lesions with fat intensity mass and calcifications.
Brain ; Choroid Plexus ; Corpus Callosum ; Diagnosis, Differential ; Headache ; Humans ; Lipoma ; Magnetic Resonance Spectroscopy ; Nausea ; Vomiting ; Young Adult

Fabella impingement syndrome after total knee arthroplasty (TKA) is a rare condition. However, the location of the inserted prosthesis and the size of the fabella are considered major causative factors. Thus far, a conventional surgical excision of the impinged fabella is recommended treatment for the impingement. A 72-year-old woman was diagnosed with degenerative arthritis of the knee. She complained of fabella impingement due to an incompletely excised bony spur behind the posterolateral femoral prosthesis after TKA. The fabella and remaining bony spur were removed using an arthroscopic procedure. The impingement has not recurred and the range of motion (ROM) of the knee was improved after a 12 months follow-up. Arthroscopic surgery might be an alternative treatment for fabella impingement after TKA.
Aged ; Arthroplasty* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular

Background. Ultimate goal for the treatment of the deformities in the lower extremities is to minimize the energy requirement and conserve the energy on walking and daily living. The normal energy saving mechanism is usually broken down in the patients with the deformities in the lower extremity, and they need more energy consumption. This is the reason why they feel fatigue frequently. It is well known that the deformity in the lower extremity cause excessive energy consumption. Objectives. There is no report that compared the energy consumption according to the deformities of the lower extremity. When we decide the priority of the treatment in cases of multiple deformities, it will be important to understand the energy demand according to each deformity. Therefore, it is the purpose of this study that assess the energy consumption according to the various types of lower extremity deformities. Method. We induced the multiple deformities in ten normal adults with the brace artificially. The induced deformities are as follows: Equinus deformity; mild (10degrees), moderate (20degrees), severe (30degrees), Knee flexion deformity; mild (10degrees), moderate (20degrees), severe (30degrees), Hip flexion deformity; mild (10degrees), moderate (20degrees), severe (30degrees). For the control group, same braces were applied without any deformity. Oxygen consumption was measured for the energy consumption with the Oxygen Consumption Meter (Morgan Oxylog II, Morgan Ltd. England). Heart rate was checked with the Telemonitor (Dynascope, Fukuda Ltd, Japan). We evaluated the inspired volume, oxygen rate, oxygen cost, and heart rate in each group and compared the data among the groups. Result. Energy consumption was higher in the hip deformity group, in the knee deformity group, and in the ankle deformity group in that order. Conclusion. When there are concomitant deformities in hip, knee and ankle, the priority of treatment may be hip, knee and ankle, in that order in terms of energy consumption.
Adult ; Ankle ; Braces ; Congenital Abnormalities* ; Equinus Deformity ; Fatigue ; Heart Rate ; Hip ; Humans ; Joints* ; Knee ; Lower Extremity* ; Oxygen ; Oxygen Consumption ; Walking

It is not uncommon that an endoscopist should differentiate metastatic or invasive cancer to the colorectum from primary colorectal cancer with its endoscopic appearances. This study reviewed the endoscopic appearances of 7 patients who were proved to have metastatic or invasive cancers to the colorectum, both clinically and pathologically. The primary cancers were uterine cervix cancers in 3 patients, advanced gastric cancers in two, and prostatic cancer in one. The endoseopic appearances of metastatic or invasive cancer showed several characteristic features with regard to those of primary colorectal cancer, as follows. 1) Multiplicity of lesions 2) Nodular lesion with unaffected mucosa or with mild degree of erosions 3) Concentric defarmities with conical extremities and the absence of shelving margins 4) Inflammatroy lesions with mucosal hyperemia, erosion, ulceration, and bleeding, but without definite mass formation.
Cervix Uteri ; Colorectal Neoplasms ; Extremities ; Female ; Hemorrhage ; Humans ; Hyperemia ; Mucous Membrane ; Prostatic Neoplasms ; Stomach Neoplasms ; Ulcer

In our hospital we studied the effects of spinal anesthesia with 0.5% isobarie bupivacaine and hyperbaric T-caine in 60 patients undergoing operation of lower abdomen or lower limbs. The following results were obtained. 1) Maximum level of sensory loss were similar in both groups, the time taken to it was significantly faster in the T-caine group but the duration was significantly longer in the bupivacaine group. 2) Onset time of motor blockade was significantly faster in the T-caine group but the duration was significantly longer in the bupivacaine. 3) The fall in blood pressure appeared faster in the T-caine group but no significant value of difference between the two groups. No significant changes were noted in the pulse rates. 4) Post spinal headache developed in 5 patients out of 60 patients (8.3%). With the results, we can assume that 0.5% isobaric bupivacaine is a good local anesthetic agent for spinal anesthesia in operations of the lower abdomen and lower limbs.
Abdomen ; Anesthesia, Spinal* ; Anesthetics ; Blood Pressure ; Bupivacaine* ; Headache ; Heart Rate ; Humans ; Lower Extremity

In our department we selected 52 patients in ASA Class I, aged from 20 to 60 years old undergoing operation of lower limbs and lower abdomen, lasting 1 to 2 hours of duration. They were divided into 2 groups, group A (30 patients) using 0.5% hyperbaric Tcaine 13 mg (2.6 ml), group B (22 patiens) using 0.25% hyperbaric bupivacaine 10 mg (4 ml), which were injected into intrathecal space. Sensory loss level was significantly higher in group A than in group B. The time taken for the block to reach maximum level was significantly faster in group B. Analgesic duration was significantly shorter in group B. In group B, onset of motor blockade was significantly slower and also, the total duration was significantly shorter. In group A, significant decrease of diastolic and systolic blood presssure were noted. Hyperbaric 0.25% bupivacaine can be used for short timed operation of lower limbs and lower abdomen without changes of cardiovascular system.
Abdomen ; Anesthesia, Spinal* ; Anesthetics ; Bupivacaine* ; Cardiovascular System ; Humans ; Lower Extremity ; Middle Aged

Enterobacteriaceae is a family of gram-negative, rod-shaped bacteria that consists of various species. Among these, members of the genus Cedecea has been reported as relatively rare causative pathogens of human infections. Commercially available automated identification systems that use biochemical reactions are known to accurately identify Enterobacteriaceae species. However, the accurate identification of some organisms with diverse biochemical profiles by these automated identification systems may be problematic. In this study, we report two cases of isolate misidentification, from patients with acute cholecystitis and deep vein thrombosis, as Cedecea davisae with VITEK II system. Both the isolates were correctly identified as Enterobacter hormaechei using gyrB gene sequence analysis. We also performed 16S rRNA sequence analyses and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry analyses; however, indeterminate results were obtained from both the assays. Therefore, the sequence analysis of alternative genes, like gyrB, might be useful for accurate identification of species that belong to the family of Enterobacteriaceae.
Bacteria ; Cholecystitis, Acute ; Enterobacter* ; Enterobacteriaceae ; Humans ; Mass Spectrometry ; Sequence Analysis ; Venous Thrombosis

Despite improvements in therapy, cases in which relapse occurs are still common in children with acute lymphoblastic leukemia (ALL). Most relapses occur in the bone marrow, and extramedullary relapse is most commonly in the central nerve system. Soft tissue mass lesion or spinal cord involvement is extremely unusual in ALL relapse. We experienced a 13-year-old boy who presented with extremity weakness and pain. He was diagnosed with ALL 4 years ago and achieved complete remission after systemic chemotherapy. Imaging study revealed a paraspinal mass which was invading the S1-2 vertebral body. Histopathologic examination revealed infiltrates composed of immature lymphoblasts with morphology identical with that of initially diagnosed bone marrow aspiration. Studies on bone marrow were negative for disease at this time. He was treated with irradiation and intrathecal chemotherapy, in addition to systemic chemotherapy. The mass has nearly disappeared, and he is planned for allogeneic bone marrow transplantation.
Adolescent ; Bone Marrow ; Bone Marrow Transplantation ; Child ; Drug Therapy ; Extremities ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence* ; Spinal Cord