Primary amenorrhea due to intrasella arachnoid cyst is a very rare disease and require careful and frequent evaluation because may produce intracranial hemorrhage, elevated intracranial pressure and rapid expansion. Surgical intervention is needed only when visual disturbance, hypopituitarism or enlarging lesion is shown. Thus, we present a case of primary amenorrhea due to intrasella arachnoid cyst which was resected through the transsphenoidal approach.
Amenorrhea ; Arachnoid* ; Female ; Hypogonadism* ; Hypopituitarism ; Intracranial Hemorrhages ; Intracranial Hypertension ; Rare Diseases

PURPOSE: This study was to evaluate the casual relationship between the factors in the Pender's model and to explain health promoting behaviors among middle-aged women in order to facilitate nursing interventions for this population group. METHOD: 116 women between 40~60 years old living in Incheon were asked to complete a questionnaire about their health. The data was collected between March and November, 2003. The data was analyzed by descriptive statistics and the correctional analysis SPSSWIN 11.5 program. The LISREL 8.12 program was used to find the best fit model which explained a causal relationship of the variables. RESULTS: The climacteric symptoms of middle-aged women negatively correlated with health promoting behaviors. However, marital satisfaction positively correlated with health promoting behaviors. CONCLUSION: Marital satisfaction and climacteric symptoms had an effect on health promoting behaviors. Therefore, based on this study, we plan to develop a health education program to decrease climacteric symptoms and to promote marital satisfaction for health promotion.
Socioeconomic Factors ; Middle Aged ; Korea ; Humans ; *Health Behavior ; Female ; Climacteric ; Body Mass Index ; Attitude to Health ; Adult

Neurofibroma, one of the peripheral nerve tumor, is a complex benign tumor arising from skin, deep soft tissue, nerve tissue and bone. The incidence of peripheral nerve tumor is relatively low and it may occur either solitarily or diffusely. Plexiform neurofibroma, a type of neurofibroma, develops characteristically in the patients with von Recklinghausen's disease and its exact incidence is unknown. The case reports of solitary plexiform neurofibroma not associated with von Recklinghausen's disease were extremely rare. We reported a case of solitary plexiform neurofibroma on the median nerve.
Humans ; Incidence ; Median Nerve* ; Nerve Tissue ; Neurofibroma ; Neurofibroma, Plexiform* ; Neurofibromatosis 1 ; Peripheral Nervous System Neoplasms ; Skin

Open fractures of the tibial shaft have a high incidence of complication and often result in poor outcomes. The most common method of stabilization is the external fixation by way of the Ilizarov method but the small diameter interlocking intramedullary nailing has also been introduced. The purpose of this study is to analyze the result of Ilizarov method and to compare its results with those of delayed intramedullary nailing used in the treatment of open tibial shaft fractures. We analyzed 81 patients with open tibial shaft fractures, treated using Ilizarov external fixator, or by delayed locked intramedullary nailing between January 1987 and December 1994. The follow-up period was an average 14.5 months. Out of the 81 patients, 58 patients were treated by nails and 23 patients by Ilizarov external fixators. Both groups were given the same initial management but the operation of the nailing group was delayed until proper soft tissue coverage and healing of the wound were evident. In the Ilizarov method group, 58 fractures obtained union within 26 to 53 weeks (average of 32.8 weeks) and in the nailing group, 23 fractures showed union within 14 to 51 weeks (average of 21.2 weeks). There was a significant difference between the two groups (P<0.05). Complications in the Ilizarov group included 4 nonunions, 12 delayed unions, 3 malalignments, 14 wound infections and 13 stiff ankles. There were no nonunion, 10 delayed unions, 8 malalignments, 6 wound infections and 11 stiff ankles in the nailing group. In this study, the Ilizarov group had more delayed unions and nonunions took a longer period of time to obtain the union, and had a more limited range of motion in the ankle, than the nailing group. The nailing group was easier to manage, especially in the soft tis-sue procedure, and it did not require a high level of compliance while having a relatively low risk of malunion.
Ankle ; Compliance ; External Fixators* ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Open ; Humans ; Ilizarov Technique ; Incidence ; Range of Motion, Articular ; Wound Infection ; Wounds and Injuries

Retroperitoneal fibrosis (RPF) is a rare disease characterized by marked fibro-inflammatory tissue in the retroperitoneum. Approximately 70% of cases of RPF are idiopathic, while the rest can be secondary to several other causes. The diagnosis is mainly obtained by imaging modalities such as computed tomography (CT). However, histological examination should be considered when the clinical manifestations and imaging studies suggest malignancy. In particular, in malignant diseases with retroperitoneal metastases, abnormal collagen plaques are formed from an exuberant desmoplastic response, which may not be distinguishable from RPF on CT scans. Therefore, even if CT suggests RPF, biopsy is essential to identify malignant disease because it typically results in a fatal prognosis. Here, we report a case of metastatic adenocarcinoma of unknown primary site that developed only in the retroperitoneum and was initially diagnosed as RPF based on CT findings.
Adenocarcinoma ; Biopsy ; Collagen ; Diagnosis ; Neoplasm Metastasis ; Neoplasms, Unknown Primary ; Prognosis ; Rare Diseases ; Retroperitoneal Fibrosis* ; Tomography, X-Ray Computed

Primary erythromelalgia is a rare condition that's characterized by erythema, an increased skin temperature and burning pain in the extremities. The pain is often very severe, and treating erythromelalgia is frustrating and difficult. We report here on the case of a 12-year old girl with primary erythromelalgia in both lower extremities. The pain was refractory to medical treatment, but a bilateral sympathetic block with lidocaine and triamcinolone resulted in relief from the pain. Our experience with this disease demonstrates that sympathetic blocks are effective in improving the symptoms and they may be attempted on erythromelalgia patients who do not respond to other treatments, including medication and epidural blocks.
Burns ; Erythema ; Erythromelalgia ; Extremities ; Humans ; Lidocaine ; Lower Extremity ; Skin Temperature ; Triamcinolone

OBJECTIVE: To determine the effect of the addition of Vit. D3 (1,25-Dihydroxychole calciferol D3) to the conventional postmenopausal hormone replacement therapy on bone mineral density(BMD) DESIGN: A 2-year retrospective , randomized study Setting : Department of Obstetrics and Gynecology of Catholic university hospital Patients : 388 postmenopausal women were recruited and divided into 5 groups according to treatment regimen; A: conjugated estrogens only treated group(n=146), B : conjugated estrogens and progesterone treated group(n=103), C : conjugated estrogens and Vit.D3 treated group (n=36), D : conjugated estrogens, progesterone and Vit.D3 treated group (n=41), E : control group (n=60). METHODS: The bone mineral density of the lumbar spines and femoral neck were determined by dual-energy X-ray absorptiometry(DEXA) every 2 years. STATISTICS: The difference between before and after treatment was determined by paired t-test. The comparison among the groups were determined by one way ANOVA test and student's t-test. RESULTS: The addition of progesterone to estrogen showed insignificant increase in the lumbar and femoral neck BMD. The addition of Vit. D3 compared with conventional hormone replacement therapy insignificantly influened bone density in women with initially normal BMD, but definitely increase in women with initially osteopenic and osteoporotic BMD of femoral neck rather than lumar spine(p<0.05). CONCLUSIONS: The use of Vit. D3 combined with postmenopausal estrogen replacement effects the increase of BMD in low bone density than normal bone density, especially femoral neck.
Bone Density* ; Estrogen Replacement Therapy ; Estrogens ; Estrogens, Conjugated (USP) ; Female ; Femur Neck ; Gynecology ; Hormone Replacement Therapy ; Humans ; Obstetrics ; Progesterone ; Retrospective Studies ; Spine ; Vitamins*

BACKGROUND: To identify the prevalence and risk factors of poststroke depression(PSD) in patients admitted to department of rehabilitation medicine after stroke, to compare functional recovery of depressed patients and that of non-depressed patients, and to recognize the most useful depression scale that can predict functional recovery. METHOD: Of the hospitalized stroke patients in the department of Rehabilitation Medicine, 24 patients who were communicable were included in this study. To evaluate PSD, Beck depression inventory(BDI) and Korean form of Geriatric depression scale(KGDS) were used as self-rating scales. Hamilton depression scale(HAM-D) was used as an objective scale. Functional Independence measure(FIM) was measured at admission and discharge to evaluate functional recovery. RESULTS: In the 24 subjects, 17 patients(70.8%) and 9 patients(37.5%) were depressive by BDI and HAM-D. Of the 19 elderly patients, 16(84.2%) were depressive by KGDS. Factors such as age, level of education, religion, etiology or location of stroke were not significantly associated with PSD. And FIMscores were not significantly different in the depressed patients and non-depressed patients. The correlation coefficients of BDI, KGDS, HAM-D and FIMgain or efficiency were not statistically significant. CONCLUSION: The prevalence of PSDwas high in our study, but no association was found between PSD and functional recovery.
Aged ; Depression* ; Education ; Hip* ; Humans ; Inpatients* ; Prevalence ; Rehabilitation* ; Risk Factors ; Stroke ; Weights and Measures

BACKGROUND: After the resurgence of endemic malaria case in 1993, the number of malaria cases is increasing in succeeding years and most of patients were soldiers who served in the northern parts of Kyeonggi-do and Kangwon-do. Because group donations of blood from soldiers are frequent in these area, it is possible that donated blood from these area cause malaria. So we examined blood donation history of malaria patients to know their donation behavior. METHODS: The subject was 1,671 malaria patients who were diagnosed in 1997 and referred to blood transfusion research institute and their past donation history, time and frequency of donation were examined. The database consisted of malaria patients and blood donors who are known to be related with transfusion-transmitted malaria has been retrieved at each red cross blood center for every blood donors. The results were analyzed from January to December, 1998. RESULTS: About 60% (1,017) of 1,691 malaria patients in 1997 had donated their blood before diagnosis. The number of one time donation was 268; two time 289; more than three time was 460. Two hundred thirty six donors were checked by malaria registry file. In 236 donors, 92 cases were diagnosed with malaria, 96 cases were suspected to have malaria, 48 cases were namesakes. Conclusion: Because some malaria patients donate their blood after their diagnosis, it would be necessary to operate 'the computerized retrieving programme'to detect their donation after the diagnosis. Also, an education for malaria patients for their risk of transmitting malaria and strict history taking from donors for malaria will be required.
Academies and Institutes ; Blood Donors* ; Blood Transfusion ; Diagnosis ; Education ; Gangwon-do ; Gyeonggi-do ; Humans ; Malaria* ; Military Personnel ; Red Cross ; Tissue Donors

We report a 57-year-old man with bilateral cranial nerve IX and X palsies who presented with severe dysphagia. After a mild head injury, the patient complained of difficult swallowing. Physical examination revealed normal tongue motion and no uvular deviation. Cervical X-ray findings were negative, but a brain computed tomography revealed a skull fracture involving bilateral jugular foramen. Laryngoscopy indicated bilateral vocal cord palsy. In a videofluoroscopic swallowing study, food residue remained in the vallecula and pyriform sinus, and there was reduced motion of the pharynx and larynx. Electromyography confirmed bilateral superior and recurrent laryngeal neuropathy.
Brain ; Brain Injuries* ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Deglutition ; Deglutition Disorders ; Electromyography ; Glossopharyngeal Nerve ; Humans ; Laryngoscopy ; Larynx ; Middle Aged ; Paralysis* ; Pharynx ; Physical Examination ; Pyriform Sinus ; Skull Fracture, Basilar ; Skull Fractures ; Tongue ; Vocal Cord Paralysis