Between 1980 and 1989, our experience of surgical management with 21 adrenal diseases was presented. There were 3 cases of Cushing's syndrome, 3 of primary aldosteronism, 6 of pheochromo cytoma, 5 of neuroblastoma, 2 of extraadrenal paraganglioma, 1 of adrenocortical carcinoma and 1 of adrenal cyst. The use of advanced radiographic and laboratory procedures resulted in the refinement of diagnosis and localization of tumors, enabling better surgical management of adrenal disorders. Among those, 19 cases underwent unilateral adrenalectomy and 2 cases of Cushing's disease underwent bilateral adrenalectomy. Surgical approaches to the adrenal gland were transperitoneal in 16 cases and extraperitoneal in 5 cases. Operative complications occurred in 11 cases. The incidence, however, of complications related to the operative approach was not significant except in 2 cases of postoperative ileus.
Adrenal Glands ; Adrenalectomy ; Adrenocortical Carcinoma ; Cushing Syndrome ; Diagnosis ; Hyperaldosteronism ; Ileus ; Incidence ; Neuroblastoma ; Paraganglioma

No abstract available.
Brain* ; Child* ; Epilepsy* ; Humans ; Seizures*

Ultrasonograms and thyroglobulin measurements have high sensitivity for evaluation of recurrent thyroid cancer and they allow early detection of recurrent or residual thyroid tumors. Patients treated for thyroid cancer can show recurrent or residual tumors in 5-40% of cases. Radioiodine therapy and surgical excision are effective for recurrent or residual thyroid tumors, but up to 30% of tumors will not reveal iodine uptake, and need further observation or surgical excision. Clinically, patients choose surgical excision rather than observation. During reoperation, the risk of surgical complications is increased because of fibrosis, neovascularization, and modified anatomical relationships. In the past, surgeons have occasionally used methylene blue during reoperation but it tends to spread into the surrounding tissues. Recently, charcoal injection has been used for recurrent thyroid microcarcinoma. The authors successfully used charcoal injection for the removal of tumor in two cases of recurrent microcarcinoma of the thyroid bed after total thyroidectomy.
Charcoal ; Fibrosis ; Humans ; Iodine ; Methylene Blue ; Neoplasm, Residual ; Reoperation ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

The aim of this study was to investigate behavioral and psychological symptoms of dementia (BPSD) measured by caregiver-administered neuropsychiatric inventory (CGA-NPI) as a function of dementia severity in early onset (EOAD) versus late onset Alzheimer's disease (LOAD). A total of 113 patients with AD consisting of 49 patients with EOAD and 64 patients with LOAD were enrolled consecutively. General cognitive function and severity of dementia were assessed by the Korean version of mini-mental status examination and clinical dementia rating (CDR), respectively. In the mild stage (CDR 0.5-1), LOAD patients had a significantly higher total CGA-NPI score than EOAD patients. Subgroup analysis demonstrated that disinhibition and night-time behavior were more common and severe in the LOAD group than the EOAD group. However, in the moderate to severe stage (CDR 2-3), EOAD patients had a significantly higher total CGA-NPI score with higher subscores in hallucination, agitation/aggression, irritability/lability, aberrant motor behavior, and appetite/eating change. This study suggested that the heterogeneity of BPSD in AD might be accounted for by dementia severity as well as age at symptoms onset.
Alzheimer Disease* ; Dementia* ; Hallucinations ; Humans ; Population Characteristics

The development of balloon catheters and advances in percutaneous endourology have made transluminal dilatation a safe and effective procedure for the treatment of benign ureteral strictures. Herein we introduce a case of our successful experience of percutaneous antegrade balloon dilatation of the allograft ureteral stenosis.
Allografts ; Catheters ; Constriction, Pathologic* ; Dilatation* ; Humans ; Ureter*

In the 1980s ultrasound and CT gradually replaced angiography as the primary diagnostic modalities for renal masses. From 1983 to 1988, a comparative diagnostic study was carried out on 24 patients with pathologically proven renal cell carcinoma which were staged by various methods. Staging was correct with computerized tomography in 75 per cent of the lesions (15 of 20), with ultrasound in 68.2 per cent (15 of 22) and angiography in 53.8 per cent (7 of 13). We conclude that at the present time CT is the optimal technique to stage renal cell carcinoma. Angiography should be used selected cases not adequately evaluated by CT or ultrasound.
Angiography* ; Carcinoma, Renal Cell* ; Humans ; Ultrasonography*

Amyloidosis, which refers to amyloid deposits accumulated in various organs, belongs to the same category as multiple myeloma; it can be accompanied by pathologic fracture. It is important to find out the exact cause of amyloidosis in order to decide treatment options and to predict prognosis. The authors described an amyloidosis case with multiple musculoskeletal involvements presented with pathologic fracture and arthrosis, and also reviewed the related articles.
Amyloidosis ; Fractures, Spontaneous ; Multiple Myeloma ; Plaque, Amyloid ; Prognosis

BACKGROUND/OBJECTIVES: Vascular inflammation is an important feature in the atherosclerotic process. Recent studies report that leaves and branches of Carpinus turczaninowii (C. turczaninowii) have antioxidant capacity and exert anti-inflammatory effects. However, no study has reported the regulatory effect of C. turczaninowii extract on the arterial inflammatory response. This study therefore investigated modulation of the arterial inflammatory response after exposure to C. turczaninowii extract, using human aortic vascular smooth muscle cells (HAoSMCs). MATERIALS/METHODS: Scavenging activity of free radicals, total phenolic content (TPC), cell viability, mRNA expressions, and secreted levels of cytokines were measured in LPS-stimulated (10 ng/mL) HAoSMCs treated with the C. turczaninowii extract. RESULTS: C. turczaninowii extract contains high amounts of TPC (225.6 ± 21.0 mg of gallic acid equivalents/g of the extract), as well as exerts time-and dose-dependent increases in strongly scavenged free radicals (average 14.8 ± 1.97 µg/mL IC50 at 40 min). Cell viabilities after exposure to the extracts (1 and 10 µg/mL) were similar to the viability of non-treated cells. Cytokine mRNA expressions were significantly suppressed by the extracts (1 and 10 µg/mL) at 6 hours (h) after exposure. Interleukin-6 secretion was dose-dependently suppressed 2 h after incubation with the extract, at 1–10 µg/mL in non-stimulated cells, and at 5 and 10 µg/mL in LPS-stimulated cells. Similar patterns were also observed at 24 h after incubation with the extract (at 1–10 µg/mL in non-stimulated cells, and at 10 µg/mL in the LPS-stimulated cells). Soluble intracellular vascular adhesion molecules (sICAM-1) secreted from non-stimulated cells and LPS-stimulated cells were similarly suppressed in a dose-dependent manner after 24 h exposure to the extracts, but not after 2 h. In addition, sICAM-1 concentration after 24 h treatment was positively related to IL-6 levels after 2 h and 24 h exposure (r = 0.418, P = 0.003, and r = 0.524, P < 0.001, respectively). CONCLUSIONS: This study demonstrates that C. turczaninowii modulates the arterial inflammatory response, and indicates the potential to be applied as a therapeutic use for atherosclerosis.
Antioxidants ; Arteries ; Atherosclerosis ; Betulaceae ; Cell Survival ; Cytokines ; Free Radicals ; Gallic Acid ; Humans ; Inflammation ; Inhibitory Concentration 50 ; Interleukin-6 ; Muscle, Smooth, Vascular ; Phenol ; RNA, Messenger

PURPOSE: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. MATERIALS AND METHODS: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. RESULTS: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. CONCLUSION: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options
Activities of Daily Living ; Clavicle ; Humans ; Range of Motion, Articular

OBJECTIVE: To evaluate the morphometry of the anterior thalamoperforating arteries (ATPA). METHODS: A microanatomical study was performed in 79 specimens from 42 formalin-fixed adult cadaver brains. The origins of the ATPAs were divided into anterior, middle, and posterior segments according to the crowding pattern. The morphometry of the ATPAs, including the premammillary artery (PMA), were examined under a surgical microscope. RESULTS: The anterior and middle segments of the ATPAs arose at mean intervals of 1.75+/-1.62 mm and 5.86+/-2.05 mm from the internal carotid artery (ICA), and the interval between these segments was a mean of 3.17+/-1.64 mm. The posterior segment arose at a mean interval of 2.43+/-1.46 mm from the posterior cerebral artery (PCA), and the interval between the middle and posterior segments was a mean of 3.45+/-1.39 mm. The mean numbers of perforators were 2.66+/-1.19, 3.03+/-1.84, and 1.67+/-0.98 in the anterior, middle, and posterior segments, respectively. The PMA originated from the middle segment in 66% of cases. A perforator-free zone was located >2 mm from the ICA in 30.4% and >2 mm from the PCA in 67.1% of cases. CONCLUSION: Most perforators arose from the anterior and middle segments, within the anterior two-thirds of the posterior communicating artery (PCoA). The safest perforator-free zone was located closest to the PCA. These anatomical findings may be helpful to verify safety when treating lesions around the PCoA and in the interpeduncular fossa.
Adult ; Arteries* ; Brain ; Cadaver ; Carotid Artery, Internal ; Crowding ; Humans ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery