We report a case of arteriovenous fistula involving the external ear in a 27- year-old male patient, who presented with pruritic erythematous scaly patch with multiple pulsating nodules on the thickened and hypertrophied left auricle.The blood flow, measured by laser Doppler velocimetry, was increased markedly on the affected site comparing with the other (710.33mV vs 8.4mV, 663.33mV vs 107. 33mV). We suggest that macrotia must be considered as the one of the clinical manifestations of cutaneous arteriovenous fistula.
Arteriovenous Fistula* ; Ear, External ; Humans ; Laser-Doppler Flowmetry ; Male

PURPOSE: To evaluate morphological differences in proprioceptors in extraocular muscles between congenital exotropia, acquired exotropia and congenital nystagmus. METHODS: Nine medial recti including the myotendinous junction were resected using medial rectus resection in three congenital and five acquired exotropia patients. Two medial recti and two lateral recti were resected using the modified Kestenbaum procedure in two congenital nystagmus patients. The muscle tissues were examined under a light microscope following examination with a transmission electron microscope. RESULTS: In the congenital exotropia group, the electron microscopic findings showed degenerative changes in proprioceptors, such as decreased microtubules, axonal shrinkage and decreased myelin thickness. In the acquired exotropia group, the neural structures in the myotendinous junction were well maintained. There were no neural structures in the myotendinous junction in the congenital nystagmus group. CONCLUSIONS: Depending on the type of strabismus, there may be morphological differences in proprioceptors of extraocular muscles.
Axons ; Exotropia* ; Humans ; Microtubules ; Muscles* ; Myelin Sheath ; Nystagmus, Congenital* ; Strabismus

A umbilical omphalomesenteric duct polyp is the result of incomplete closure of the omphalomesenteric duct, which connects the midgut with the yolk sac of the embryo. It may be associated with underlying embryologic anomalies such as Meckels diverticulum and umbilical enteric fistula, the complications of which may at times be fatal. This rare malformation should be clinically discerned from persistent granulation tissue or pyogenic granuloma. Histologically, it shows a polypoid lesion consisting of ectopic gastrointestinal epithelium with the appearance of gastric, intestinal, or colonic mucosa. We report a case of an umbilical omphalomesenteric duct polyp in an 8-year-old male patient, who had had a bright-red polyp on the umbilicus from the age of 1 month and had not had any other types of underlying abnormalities.
Child ; Colon ; Diverticulum ; Embryonic Structures ; Epithelium ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Umbilicus ; Vitelline Duct* ; Yolk Sac

Leiomyomas of vagina and vulva are rare solid tumors, but most common mesenchymal tumors in adult woman. Most of the reported cases have been benign. The tumors were firm, well-defined submucosal masses in a majority of patients. We experienced two cases of vulvar and vaginal leiomyoma, thus it is presented with a brief review of the cases and its literatures.
Adult ; Female ; Humans ; Leiomyoma* ; Vagina* ; Vulva*

With the industrial development, vehicle, wars, and natural disasters, there are increasing chsnces of mass casuaities, it is very important to classify the injured patients by their severity, to give them immediate emergency care and to transfer them to the other medical facilities effectively. And it is more essential in the army. But in practice, there is no objective and comprehensive scale for injury severity yet. So we devised a method of comprehensive description for the injuredpatients. It is based on Abbreviated Injury Scale and Injury Severity Score and is composed of five parts of the body (General, Head & Neck, Chest, Abdomen, Extremities) and five degrees of severity (Grade I, Il, III, IV, V). For example, a description of a patient with multiple injuries such as generalized abrasion and cotusion, semicomatose mentality with skull fracture, hemoperitoneum, and fracture of right femoral shaft is very diffcult to understand quickly. But, with our method of description, the above is described as follows ; G(I)+(IV)+A (IV)+E(III), ISS =4+4+3 =41. And the high score is described as ISS makes it clear that the patient is very dangerous, even to death, so intensive care is immediately needed. Using this method, we reviewed 1,256 cases of passenger acidents of vehicles treated at our hospital during the last 2 years. The results were as follows ;1. The average ISS of 56 cases of dead is 33. 2. There are only 2 cases of death below 16 of ISS, and 84% mortality above 40 of ISS. 3. The average ISS of passengers in vehicles such as motocycles is 12, taxies 11, bongo 9, and buses 8. 4. We recommend our method of description for mass casualties, especially in the army. Because it is very useful to the injured patients by their severity, to give them immediate emergency care, to transfer them to the other medical facilities and to comprehend the whole condition of all patients.
Abbreviated Injury Scale ; Abdomen ; Critical Care ; Disasters ; Emergency Medical Services ; Head ; Hemoperitoneum ; Humans ; Industrial Development ; Injury Severity Score ; Mass Casualty Incidents ; Methods ; Mortality ; Motor Vehicles ; Multiple Trauma ; Neck ; Skull Fractures ; Thorax

A 51-year-old Korean woman presented with a non-tender, well-demarcated, reddish, edematous patch on the right anterior chest where a previous mastectomy and radiation therapy had been performed. She had been diagnosed as having infiltrating ductal carcinoma of the right breast about 1 year ago. Histopathological findings of the skin lesions were consistent with inflammatory metastatic carcinoma of the breast. Inflammatory carcinoma or carcinoma erysipeloides is a well-established entity most frequently associated with carcinoma of the breast. It is characterized by dermal lymphatic invasion by malignancy and clinically should be distinguished from erysipelas or cellulitis. We describe a case of inflammatory metastatic carcinoma derived from an infiltrating ductal carcinoma of the breast which can be clinically confused with radiation dermatitis.
Breast* ; Carcinoma, Ductal ; Cellulitis ; Dermatitis ; Erysipelas ; Erysipeloid ; Female ; Humans ; Mastectomy ; Middle Aged ; Skin ; Thorax

OBJECTIVE: To compare physiological cost index of the two manual wheel chair propulsion methods: pushing the handrim forward and reversely, and to find out whether the reverse propulsion method will help prevention of the carpal tunnel syndrome in manual wheelchair users. METHOD: The subjects were thirty healthy men in their twenties. All of them performed two manual wheelchair propulsion methods for two days, foreward propulsion on the first day and reverse propulsion the next day. Duration of the wheelchair propulsion was ten minutes. Electromyography (EMG) of wrist extensor groups, biceps brachii, pectoralis major, trapezius, and triceps brachii, and heart rates were recorded. The EMG activity of each individual was transformed to root mean square (RMS), EMG activity appearance time (%), and EMG activity continuance time (%). RESULTS: EMG activity of the wrist extensors in reverse propulsion of the wheelchair was less active compared to forward propulsion. In reverse propulsion method, energy efficiency was not significantly increased, but RMS of wrist extensor groups was significantly reduced. Contractions of trapezius and biceps brachii muscles appeared in earlier phase of propulsion. CONCLUSION: We concluded that reverse propulsion of the wheelchair will be more effective method of wheelchair propulsion compared to forward propulsion in preventing carpal tunnel syndrome in long-term wheelchair users. The reverse propulsion method in this study uses wrist extensor less, which can reduce the wrist extension movement during wheelchair propulsion. It can possibly contribute on the prevention of carpal tunnel syndrome in long-term wheelchair users.
Carpal Tunnel Syndrome ; Electromyography ; Heart Rate ; Humans ; Male ; Muscles ; Superficial Back Muscles ; Upper Extremity* ; Wheelchairs* ; Wrist

BACKGROUND: The purpose of our study is to evaluate the clinical results of arthroscopic suture bridge repair for patients with rotator cuff tears. METHODS: Between January 2007 and July 2007, fifty-one shoulders underwent arthroscopic suture bridge repair for full thickness rotator cuff tears. The average age at the time of surgery was 57.1 years old, and the mean follow-up period was 15.4 months. RESULTS: At the last follow-up, the pain at rest improved from 2.2 preoperatively to 0.23 postoperatively and the pain during motion improved from 6.3 preoperatively to 1.8 postoperatively (p < 0.001 and p < 0.001, respectively). The range of active forward flexion improved from 138.4degrees to 154.6degrees, and the muscle power improved from 4.9 kg to 6.0 kg (p = 0.04 and 0.019, respectively). The clinical results showed no significant difference according to the preoperative tear size and the extent of fatty degeneration, but imaging study showed a statistical relation between retear and fatty degeneration. The average Constant score improved from 73.2 to 83.79, and the average University of California at Los Angeles score changed from 18.2 to 29.6 with 7 excellent, 41 good and 3 poor results (p < 0.001 and p = 0.003, respectively). CONCLUSIONS: The arthroscopic suture bridge repair technique for rotator cuff tears may be an operative method for which a patient can expect to achieve clinical improvement regardless of the preoperative tear size and the extent of fatty degeneration.
Adult ; Aged ; Arthroscopy/*methods ; Female ; Humans ; Male ; Middle Aged ; Muscle Strength ; Pain, Postoperative ; Range of Motion, Articular ; Rotator Cuff/*injuries/*surgery ; Shoulder Joint/physiopathology ; *Suture Techniques

No abstract available.
Humans ; Paraquat* ; Poisoning*

An exercise-induced idiopathic Brugada electrocardiographic pattern during the effort phase is very rare. A 42-year-old male visited our cardiology clinic for chest discomfort. He has been treated for myocardial infarction 2 months ago. He underwent a treadmill test according to the Bruce protocol. Typical coved-type ST-segment elevation was found during the effort phase, and it gradually recovered after the exercise. The ST-segment elevation appeared to be unrelated to hypervagotonia. This elevation was not induced by a pharmacological test with flecainide. A significant ventricular arrhythmia was not induced by programmed ventricular stimulation. Hence, we discharged the patient without implantation of an implantable cardioverter defibrillator.
Adult ; Arrhythmias, Cardiac ; Cardiology ; Defibrillators ; Electrocardiography* ; Exercise Test ; Flecainide ; Humans ; Male ; Myocardial Infarction ; Thorax ; Vagus Nerve