Multiple myeloma is considered to be the most common primary malignant bone tumor which has the flat bone as a predilection site in old ages. We experienced a case of an unsual multiple myeloma which formed a huge tumor mass on medial end of left clavicle. The tumor mass together with medial half of the clavicle was excised completely. We have discussed the rationale for the excision of the clavicle.
Clavicle ; Multiple Myeloma

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin* ; Rabbits* ; Wound Healing* ; Wounds and Injuries*

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin* ; Rabbits* ; Wound Healing* ; Wounds and Injuries*

n the patients with epilepsy, especially in psychomotor epilepsy the epileptiform discharges occasionally has its origin from the basal structure of brain or the mesial side of temporal lobe which is not accessible to the standard surface EEG. The nasopharyngeal electrode, which was introduced by Grinker and Serota in 1938 and modified several times, is a kind of special electrodes to investigate electrical activity from the mesiobasal part of the temporal lobe, and there are several studies about clincial usefulness of the nesopharyngeal EEGs with some controversies in other countries. In this country, however, there is no reports about this topic, and in fact only a few laboratories are known to use the nasopharyngeal electrode. To determine clinical significance of nasapharyngeal EEG in patients with psychomotor seizure, the selecting records of 123 cases who had been taken both standard surface and nasopharyngeal EEG are analysed and compared with each other. Eight nine of cases are the patients with seizure disorder including 13 simple partial seizure with or without secondary generalization, 47 psychomotor seizure (or complex partial seizure) with or without secondary generalization and 29 primary generalized seizure, diagnosed by history and clincial findings. The other 34 cases are the patients with similar symptoms of psychomotor seizure but without definite convulsion. The standard surface EEG revealed 48 (56%) of epileptiform activity, 24(28%) of nonspecific dysrrhytmia and 17(19%) of normal record in 89 patients with seizure discharges. There are 38 patients who showed spike or sharp wave on nasopharyngeal generalized seizures. In nonseizure cases, however, epileptiform activity is not detected on nasopharyngeal electrodes. Five cases are technically unsatisfactory. The significances of nasopharyngeal EEG in 38 with epiletiform discharges on nasopharyngeal electrode(s) are; more definite and prominent epileptiform activity in 17 and unexpected nasopharyngeal discharges in 10 patients including 5 with normal standard surface EEGs. In 47 psychomotor seizure, 42 cases (89%) reveal epileptiform discharges on standard surface and/or nasopharyngeal EEG and the sensitivity of nasopharyngeal EEG (75%) is higher than that of standard surface.
Brain ; Electrodes ; Electroencephalography* ; Epilepsy ; Epilepsy, Complex Partial ; Generalization (Psychology) ; Humans ; Seizures* ; Temporal Lobe

We present a case of bacterial menir gitis with spontaneous cerebrospinal rhinorrhea due to bony erosion by pituitary tumor. Brain CT and RI cisternography revealed direct bony erosion of both medial walls of sphenoid sinus which were considered as a portal of entry of bacterial meningitis. He was free from his symptoms by antimicrobial treatment and sugical repair.
Brain ; Cerebrospinal Fluid Rhinorrhea ; Meningitis, Bacterial* ; Pituitary Neoplasms* ; Sphenoid Sinus

Multiple evanscent white dot syndrom(MEWDS) has the characteristic clinical, funduscopic, fluorescein angiographic and electrophysiologic findings. The etiology of MEWDS remains unknown. The authors report on two patients with MEWDS. They were young females. Funduscopic examination showed that multiple, white dots are found at the level of the retinal pigment epithelium. These dots extended from macula into mideriphery. Also, the patients had a tiny, granular gray-white dots in the fovea. Fluorescein angiography showed an early hyperfluorescence in the areas corresponding to the white dots with late staining. Two patients had spontaneous recovery of vision in four to seven weeks. They had persistent enlargement of the physiologic blind spot or paracentral scotoma in their visual field, respectively.
Female ; Fluorescein ; Fluorescein Angiography ; Humans ; Optic Disk ; Retinal Pigment Epithelium ; Scotoma ; Visual Fields

BACKGROUND: Coronary artery diseases (CAD) are increasing in recent years among Korean due to change of socioeconomic status. Even though death rates due to CAD has increased in Korea, few epidemiologic studies have been done about risk factors of CAD. We conducted a case-control study to analyze risk factors for CAD among Korean. METHODS: The case series comprised 166 patients with angiographically confirmed CAD, who were admitted to Division of Cardiology in Asan Medical Center. The controls were 137 persons composed of patients with normal coronary arteriogram or patients with normal myocardial SPECT for chest pain. We surveyed life style habits, measured anthropometric variables, and analyzed biochemical markers among CAD patients and controls. RESULTS: In univariate analysis adjusted for age and body mass index (BMI), age, obesity, abdominal obesity, hypertension, low HDL-cholesterol, low apolipoprotein A1, and high lipoprotein (a) were associated with CAD in men and women. Smoking, diabetes, and hypercholesterolemia were associated with in men only. Exercise and high HDL-cholesterol were inversely associated with CAD both in men and women. In multivariate logistic regression analysis, smoking, abdominal obesity, low apolipoprotein A1, and high lipoprotein (a) were found as independent risk factors of CAD among men. Abdominal obesity, low apolipoprotein A1, and high lipoprotein (a) were found as independent risk factors among women. CONCLUSION: These finding suggest cessation of smoking and weight control for abdominal obesity are important for prevention of CAD among Korean. The detection of low apolipoprotein A1 and high lipoprotein (a) could be useful for prevention of CAD.
Apolipoprotein A-I ; Biomarkers ; Body Mass Index ; Cardiology ; Case-Control Studies* ; Chest Pain ; Chungcheongnam-do ; Coronary Artery Disease* ; Coronary Vessels* ; Epidemiologic Studies ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Life Style ; Lipoprotein(a) ; Logistic Models ; Male ; Mortality ; Obesity ; Obesity, Abdominal ; Risk Factors* ; Smoke ; Smoking ; Social Class ; Tomography, Emission-Computed, Single-Photon

Fibroepithelial polyp is a very rare tumor mostly arising at the urogenitalia. Norris and Taylor firstly reported 12 cases of fibroepithelial polyp in 19661 and until recently under 100 cases were reported in literature. A 11-year-old girl complainted the painless bulging mass at the left labium major. The bulging tumor was measured 5x3 cm in diameter. The margin of the mass was not demarcated ever from the skin and underlying dermis and the mass was not clearly differentiated from surrounding tissues grossly but could be delineated by palpation. The mass was excised by palpation under the general anesthesia. In microscopic finding it was primarily composed of stromal portion containing fibroblast-like stromal cells, with bundles of collagen, skin appendages, and small numbers of blood vessels. We report a case of fibroepithelial polyp of the vulva in a 11-year-old female with a brief review of the literature.
Anesthesia, General ; Blood Vessels ; Child ; Collagen ; Dermis ; Female ; Humans ; Palpation ; Polyps* ; Skin ; Stromal Cells ; Vulva*

Two cases of incomplete transverse vaginal septum with a small opening in the upper third of vagina were presented. One case was a patient presenting at 31 years of age for evaluation of primary infertility and oligomenorrhea. Diagnosis was made by hysterosalpingography, tranvaginal ultrasonography, MRI, and diagnostic pelviscopy for evaluation of abnormality of endopelvic organs. The patient was treated with surgical resection of septum (simple septectomy). Examination 3 months later demonstrated narrowing of the vaginal lumen. Another case was a patient presenting intrauterine pregnancy at 8 weeks and 2 days accompanying transverse vaginal septum with small opening. She had previous septotomy history and presented postoperative scarring. She had septectomy and anastomosis of the mucosa, and presented postoperative narrowing again about a month postoperatively. In this report we describe the two cases of transverse vaginal septum. We also reviewed the literature including diagnostic and treatment guidelines. Prevention of postoperative scarring is the most important factor in management of transverse vaginal septum. For that, first of all, initial septectomy should be done with approximation of the mucosa and postoperative dilatation is necessary. Importance of the initial accurate septectomy is too important to be over-emphasized.
Cicatrix ; Constriction, Pathologic* ; Diagnosis ; Dilatation ; Female ; Humans ; Hysterosalpingography ; Infertility ; Magnetic Resonance Imaging ; Mucous Membrane ; Oligomenorrhea ; Pregnancy ; Ultrasonography ; Vagina

Subglottic stenosis is more likely to develop secondary to endotracheal intubation if one or more traumarelated risk factors are involved. Subglottic stenosis have been dealt with many medicosurgical procedures such as dilatation, stent, laryngofissure with or without skin of mucosal graff, and segmental resection. We report longterm failure of expandable metallic stent in the treatment of subglottic tracheal steno$is in 4 cases which had been presented with respiration difficulty due to framework problem of subglottic trachea after surgical operation.
Constriction, Pathologic ; Dilatation ; Intubation, Intratracheal ; Respiration ; Risk Factors ; Skin ; Stents* ; Trachea ; Tracheal Stenosis*