No abstract available.
Biopsy, Fine-Needle* ; Breast*

Interlocking medullary nails have been widely used in the treatment of long bone fractures especially in tibia and femur. But with increasing use of nails, many preoperative, intra-operative and post-operative complications have been reported. We have experienced 3 cases of very rare complication, fracture of tibia shaft which occurred during removal of interlocking medullary nail after complete healing of original tibial fracture. We report these rare complications with literature review.
Femur ; Fractures, Bone ; Tibia* ; Tibial Fractures

In orthopedic practice, patients sometimes ask certain kinds of medical documents certifying their disability grading. But many orthopedic surgeons are not accustomed to issue such medical certificates. So we want to review the way of evaluation and grading of disabilities for such different kinds of medical certificates(for examples: disability grading certificate for use in traffic accident, industrial accident, liability of national compensation, private insurance, the handicapped, military service and others) and compare the differences between them.
Accidents, Occupational ; Accidents, Traffic ; Compensation and Redress ; Disability Evaluation ; Disabled Persons ; Humans ; Insurance ; Military Personnel ; Orthopedics*

The benign mesenchymoma, in which fibrous tissue is accompanied by two or more mesencymal components, occurs very rarely in the head and neck area. The majority appear in patients under 25 years of age, most commonly in the subcutaneous scalp, cheek, or tongue. There is a 20% recurrence rate. Wide surgical excision is the treatment of choice. We report a case of mesenchymoma in the nasopharynx which was removed by transpalatine approach with a brief review of literature.
Cheek ; Head ; Humans ; Mesenchymoma* ; Nasopharynx ; Neck ; Recurrence ; Scalp ; Tongue

PURPOSE: This study was performed to evaluate the changes in tear film and ocular surface after dacryocystorhinostomy (DCR) in patients with primary acquired nasolacrimal duct obstruction. METHODS: Forty subjects who showed successful results at three months after endoscopic DCR were investigated. The changes in tear breakup time (BUT), basal secretion test (BST), corneal sensitivity test (CST), tear clearance rate (TCR) and keratoepitheliopathy (KEP) were evaluated. RESULTS: The mean age was 57.4+/-13.2 years (29~77 years). Preoperative BST and BUT in eyes which underwent DCR were 13.21+/-3.79 mm and 8.20+/-2.30 seconds, respectively. Three months after the operation, the respective values were 9.13+/-3.77 mm (p=0.01) and 6.27+/-2.20 seconds (p=0.03). Preoperative CST, TCR and KEP in eyes which underwent DCR were 57.89+/-4.18 mm, 3.26+/-0.91 and 0.12+/-0.53, respectively. Three months after the operation, the respective values were 57.75+/-3.55 mm (p=0.32), 3.04+/-0.87 (p=0.08) and 0.13+/-0.54 (p=0.08). No changes were observed between the preoperative and postoperative tear parameters in fellow eyes. CONCLUSIONS: The changes in tear film parameters including BST and BUT should be considered in patients who receive endoscopic DCR.
Dacryocystorhinostomy ; Eye ; Humans ; Nasolacrimal Duct ; Tears

PURPOSE: The prevalence of female bladder outlet obstruction(BOO) is not well known and the diagnostic criteria is uncertain. We attempted to find out the features of urodynamic and clinical findings of bladder outlet obstruction in female patients with lower urinary tract symptom. MATERIALS AND METHODS: A total of 251 patients who were referred to urodynamic study for lower urinary tract symptom was available for analysis. Patients who had previous pelvic surgery history or neurologic causes were excluded. History taking, physical examination, voiding diary, urodynamic study were performed. Urodynamic study consisted of free uroflow, urethral pressure profile, cystometry, and pressure flow studies. The criteria of bladder outlet obstruction was peak flow rate at free uroflow less than 12ml/s and detrusor pressure at a maximum flow rate of more than 20cmH2O. Among the patients who were revealed as stress urinary incontinence, but with no other abnormalities at urodynamic study, 30 served as the controls. RESULTS: In 251 patients, 42(16.7%) were BOO patients. There were no significant differences in the clinical features of the two groups, such as age, parity, surgical history. In the urodynamic study, the first voiding sense and maximal bladder capacity were similar in the two groups. Peak flow rate was 24.0+/-10.9ml/s in the control and 7.9+/-1.7ml/s in BOO, the detrusor pressure of maximum flow was 25.8+/-10.4cmH2O and 62.6+/-33.1cmH2O, maximal urethral closing pressure was 55.3+/-20.3cmH2O and 79.5+/-46.8cmH2O, voiding volume was 377.2+/-85.0ml/s and 281.0+/-104.3ml/s, and residual volume was 19.3+/-76.9ml/s and 48.7+/-80.0ml/s, respectively. CONCLUSIONS: Among the female patients who had low urinary tract symptoms, numerous patients were revealed as BOO. BOO must be considered for female patients who have low urinary tract symptoms, and urodynamic studies may play an important role for the diagnosis and treatment of BOO.
Diagnosis ; Female* ; Humans ; Parity ; Physical Examination ; Prevalence ; Residual Volume ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urinary Incontinence ; Urinary Tract* ; Urodynamics

OBJECTIVE: The effect of induced hypothermia on severe acute carbon monoxide (CO) poisoning remains to be addressed further. We investigated the effect of induced hypothermia on severe acute CO poisoning. METHODS: Retrospective chart review was conducted for patients who diagnosed as severe acute CO poisoning in emergency department and underwent induced hypothermia from May 2013 to May 2014. Hospital courses with critical medication and major laboratory results were investigated through the chart review. RESULTS: Among total 227 patients with acute CO poisoning during the period of study, patients with severe acute CO poisoning were 15. All patients underwent induced hypothermia with a temperature goal 33°C. Initial and follow-up levels of S100B protein after induced hypothermia were 0.47 μg/L (interquartile range, 0.11 to 0.71) and 0.10 μg/L (interquartile range, 0.06 to 0.37), respectively (P = 0.01). The mean Glasgow Coma Scales at emergency department admission was 6.87 ± 3.36. Except 1 patient who expired after cardiopulmonary resuscitation, Glasgow Coma Scales at 30-day of hospital discharge were 15 in 10 patients (71.4%), 14 in 1 patient (7.1%), 13 in 1 patient (7.1%), and 6 in 2 patients (14.2%). Seven patients (46.7%) developed delayed neurologic sequelae. Four patients showed mild types of delayed neurologic sequelae and 3 showed moderate to severe types of delayed neurologic sequelae. CONCLUSION: Most of patients underwent induced hypothermia had a good recovery from severe acute CO poisoning. Therefore, induced hypothermia may be considered as a possible treatment in severe acute CO poisoning.
Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Cardiopulmonary Resuscitation ; Coma ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Hypothermia, Induced* ; Poisoning ; Retrospective Studies ; Weights and Measures

Suction-assisted lipectomy has become an increasingly popular procedure, being one of the most frequently performed aesthetic procedures in Korea. Serious complications of suction-assisted lipectomy are uncommon but aesthetic problems are often troublesome. Here we report a patient with multiple abdominal masses composed of fat necrosis with fibrosis after suction- assisted lipectomy that was treated with excision. We also discussed and deduced the cause of its complication because plastic surgeons are liable to overlook this rare complication.
Fat Necrosis ; Fibrosis ; Humans ; Korea ; Lipectomy*

INTRODUCTION: In the lateral window approach for a maxillary sinus bone graft, there has been considerable controversy regarding the placement of a barrier membrane over the osteotomy site. In particular, when there is no damage to the Schneiderian membrane, clinicians should decide whether to use a barrier membrane or not, considering the benefits and costs. This study presents the clinical cases to demonstrate that only repositioning the detached window can lead to satisfactory bony healing of the grafted material without using a barrier membrane in the lateral approach for a maxillary sinus bone graft. MATERIALS AND METHODS: Five consecutive patients were treated with the same surgical procedures. After performing the antrostomy on the lateral maxillary wall using a round carbide bur and diamond bur, the bony window was detached by a gentle levering action. After confirming no perforation of the Schneiderian membrane, the grafting procedure was carried out the detached window of the lateral maxillary wall was repositioned over the grafted material without using a barrier membrane. A gross examination was carried out at the postoperative 6 month re-entry, and the the preoperative and postoperative dental computed tomography (CT) at re-entry were compared. RESULTS: All the procedures in the 5 patients went on to uneventful healing with no complications associated with the bone graft. Satisfactory bone regeneration without the interference of fibrous tissue on the gap between the repositioned window and lateral wall of the maxillary sinus was observed in the postoperative 6 month re-entry. The CT findings at re-entry revealed the, reconstruction of the external cortical plate including repositioned bony window. In addition, the loss of the discontinuity of the lateral maxillary wall was confirmed. CONCLUSION: This preliminary report showed that the detached window, which was just repositioned on the grafted material, could function as a barrier membrane in the lateral approach for a maxillary sinus bone graft. Therefore additional morphometric and histologic studies will be needed.
Bone Regeneration ; Cost-Benefit Analysis ; Dental Implants ; Diamond ; Humans ; Maxillary Sinus ; Membranes ; Nasal Mucosa ; Osteotomy ; Transplants

OBJECTIVE: Outcome of gamma knife radiosurgery (GKS) in the consecutive 100 cases with cerebral arteriovenous malformations (AVMs) was analyzed. METHODS: Data from initial 100 patients treated with GKS in the authors' institute were reviewed retrospectively. Spetzler-Martin grade at diagnosis were I in 18 patients, II in 27, III in 36, IV in 11, and V in 8. Thirty-five patients had experienced previous bleeding, 27 patients presented with seizure, and 31 patients presented with headache. The mean volume of the lesion was 4.3 cm3 (0.1-29.3 cm3). The median radiation dose delivered to the margin was 20.0 Gy (13-32 Gy). Mean follow-up period was 37.5 months (5-63 months). RESULTS: Angiographic follow-up was performed in 48 patients at least 2 years after GKS. Sixteen patients were lost in follow up following 2 years from GKS. Twenty-eight of 48 patients (58%) showed complete obliteration and 20 patients (42%) showed partial obliteration. Seven patients presented with post-GKS hemorrhage. Adverse radiation effect (ARE) was observed at follow-up MRI in 25 of 76 patients, and it was symptomatic in 5 patients. Complete obliteration was confirmed in 24 of 31 (77%) patients with volume less than 4 cm3, meanwhile only 4 of 17 (24%) patients with volume of 4 cm3 or more showed complete obliteration. Complete obliteration rate was 67% with 20 Gy or higher marginal dose, 63% with 15-20 Gy, and 17% with less than 15 Gy. CONCLUSION: GKS can provide high rates of obliteration with acceptable risk of morbidity in a subgroup of small AVMs. However, overall outcome in whole spectrum of AVMs, in which large proportion of cases have unfavorable characteristics for radiosurgery, is much worse. More effective therapeutic strategy needs to be developed for large AVMs that are difficult to be managed with current available treatment modalities.
Arteriovenous Malformations ; Follow-Up Studies ; Headache ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations ; Radiosurgery ; Retrospective Studies ; Seizures