Cutis laxa is a rarely discussed entity which manifests itself primarily as loose redundant skin and may be accompanied by internal anomalies. Localized cutis laxa is involved to the ear lobules, eyelids an lips in 34 years old male was described. Diagnosis of localized cutis laxa was established by clinical characteristic manifestations and histopathological studies.
Adult ; Cutis Laxa* ; Diagnosis ; Ear ; Eyelids ; Humans ; Lip ; Male ; Skin

Authors analysed 19 cases with Cavernous Hemangiomas of Skeletal Muscles in Extremities. Those were confirmed clinicopathologically for the period of 2 years from October 1976 to September 1978, and following results were obtained. 1. The age of initial visit varied from 6 months to 42 years of age with the average of 17.7 years. Seventeen patients(89.5%) were under 30 years of age. 2. The age of initial onset of symptoms varied from birth to 36 years of age with the average of 13.1 years. Seventeen patients(89.5%) were under 20 years of age. 3. The duration of disease varied from 6 months to 17 years with the average of 4.6 years. 4. The ratio of male and female was 9:10. 5. Chief complaints were a swelling or mass in 17 cases(89.5%), pain in 13 cases(68.4%), tenderness in 6 cases(31.6%), and impairment of function in 5 cases(26.3%). 6 The size of a mass varied from a nut size to an adult fist one, and its shape appeared oval with the average 8.1 by 4.6 cm in 12 cases, and round with the average 5.5 cm in 7 cases. 7. The site of involvement distributed to lower extremities in 10 cases(52.7%), upper ones in 9 cases(47.4%). Among extremities(thigh, leg, arm and forearm) the most common site was forearm. 8. Considering the number of involed muscles, most frequently they developed in a single muscle with 11 cases(57.9%). 9. By history, The symptoms were initiated or aggravated by trauma in 3 cases(15.8%). 10. Plain roentgenograms showed the swelling of soft tissue in 9 cases(47.4%) and phleboliths in 8 cases(42.1%). 11. Considering the methods of treatment, complete resection was possible in 17 cases(85.7%), in the remaining 2 cases only incomplete resection could be done.
Adult ; Arm ; Clinical Study ; Extremities ; Female ; Forearm ; Hemangioma, Cavernous ; Humans ; Leg ; Lower Extremity ; Male ; Muscle, Skeletal ; Muscles ; Nuts ; Parturition

The authors report the experience of twenty patients of transpedicular Zielke instrumentation after anatomical reduction of the spondylolisthesis. Anstomical reduction was done with the aid of temporary application of Harrington distraction rod, and the reduced segment was fixed with transpedicular Zielke instrumentation. And, anterior interbody fusion was supplemented in a single stage operation. Follow up period was between 13 to 25 months after operation with the average of 19 months. 1. The age of the patients was 38 years in average ranging from 11 to 61 years. 2. Types of the spondylolisthesis were spondylolytic type in 11 cases, degenerative type in 6 cases, dysplastic type in 1 case and pathologic type in 2 cases. 3. The level of the lesion were L5-Sl in 12 cases, L4-5 in 7 cases and L3-4 in 1 case. 4. Pre-operative clinical feature included low back pain in 95%, radiating pain in 65%, and neurological claudication in 45%. 5. The average percentage of slippage was changed from 24% preoperatively to 6% postoperatively and to 8% at the final follow up. The initial correction rate was 75% and the amount of correction loss during the follow up period was 11% in average. 6. Slip angle was changed from 3°preoperatively to −3°poetoperatively and to 0°at the end of follow up. In the 12 cases with local kyphosis, average slip angle of 14°preoperatively was improved to 2°postoperatively, and to 7°at the end of follow up. 7. Bony fusion was obtained in 19 cases within 4 to 6 months. 8. There were 2 cases of metal failure with considerable loss of reduction ; one patient with pathologic spondylolisthesie due to active tuberculous spondylitis required re-operation and another patient showed fusion eventually in the redisplaced position. Other complication included 1 transient dysuria, 1 ileus and 2 meralgia paresthetics. 9. Clinical symptoms were improved in 95%. Follow up result of the operation according to Gill's criteria were excellent 65%, good 25%, fair 5%, and poor 5%.
Dysuria ; Follow-Up Studies ; Humans ; Ileus ; Kyphosis ; Low Back Pain ; Spondylitis ; Spondylolisthesis

Granulosa cell tumor of the testis is extremly rare in adult males and granulosa cell tumor occurring in the paratesticular area has not been reported. We report a paratesticular granulosa cell tumor in a 34-year-old man who presented with a 5.5 cm sized scrotal mass. The tumor was present in the paratesticular area near the head of epididymis. It was located in the tunica and completely separated from the testis by thick fibrous tissue. Microscopically, the tumor exhibited solid, microfollicular, and trabecular patterns. The tumor cells had ovoid to elongated nuclei with longitudinal intranuclear grooves and one or two nucleoli and scanty cytoplasm. Mitoses were relatively frequent with an average number of 9/10 HPFs. The tumor extended into the visceral tunica vaginalis and showed multiple lymphatic tumor emboli. Immunohisto chemical stains revealed diffuse strong positivity for inhibin, vimentin, and keratin and diffuse weak positivity for estrogen and progesteron receptor. Placental alkaline phosphatase (PLAP) and epithelial membrane antigen (EMA) were negative. On electron microscopic examination, tumor cells were polygonal and had large indented nuclei. The cytoplasm contained a moderate number of small round mitochondria, abundant rough and smooth endoplasmic reticula, and a few lipid droplets. Small aggregates of intermediate filaments and intercellular junctions were observed. The patient was alive and well 5 months after orchiectomy. This is the first case of adult granulosa cell tumor arising in the paratesticular area.
Adult ; Alkaline Phosphatase ; Coloring Agents ; Cytoplasm ; Epididymis ; Estrogens ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Head ; Humans ; Inhibins ; Intercellular Junctions ; Intermediate Filaments ; Male ; Mitochondria ; Mitosis ; Mucin-1 ; Orchiectomy ; Testis ; Vimentin

The arteriovenous malformations(AVMs) of the corpus callosum are distinct anatomical and surgical entities. The AVMs of the corpus callosum are supplied by the pericallosal arteries if the malformations are located in the anterior and middle portion of the callosum and the AVMs of the splenium are usually fed by the pericallosal and posterior cerebral arteries. Radical excision of the callosal AVMs became successful with microsurgical techniques since a few years ago. The authors report a case of the callosal AVM, who had subarachnoid hemorrhage twice prior to this admission, and the studies with angiography and computed tomography revealed an AVM involing the middle portions of the corpus callosum. Radical excision of the AVM was accomplished by microsurgical techniques without neurologic sequela.
Angiography ; Arteries ; Corpus Callosum* ; Posterior Cerebral Artery ; Subarachnoid Hemorrhage

BACKGROUND: Generalized aggressive periodontitis (GAP) is a destructive periodontal disease that can develop in young age. Only a few cases of full mouth rehabilitation, using dental implants, have been reported in a patient with aggressive periodontitis. CASE DESCRIPTION: This clinical report describes the treatment procedures and results of full mouth rehabilitation in a patient with aggressive periodontitis. After all teeth were extracted, 6 implants were placed in the maxilla and mandible, respectively. Fixed detachable implant prostheses were made. The patient was satisfied with the final results. She was followed for 10 months postloading. CLINICAL IMPLICATION: For a long-term success, continuous maintenance care is critical, as the contributing factors of the disease (such as immune factors or periodontal pathogens) may not be controlled adequately.
Aggressive Periodontitis ; Dental Implants ; Humans ; Immunologic Factors ; Mandible ; Maxilla ; Mouth ; Mouth Rehabilitation ; Periodontal Diseases ; Prostheses and Implants ; Tooth

BACKGROUND: Patients with sinus rhythm, the left atrial appendage(LAA) appeared as a vigorously contracting structure and the blood flow patterns of LAA showed biphasic configuration. However, patients with AF rhythm the blood flow showed irregular or no configuration in doppler echocardiographic study. The purpose of this study is to evaluate relationship between the blood flow patterns of LAA with the presence of spontaneous contrast(SC) and thrombi in LAA. METHODS: We performed TEE and TTE simultaneously to 58 consecutive patients who had native mitral valve disease or mitral prosthesis. Spontaneous contrast(SC) and the presence and location of LAA thrombi were evaluated during TEE and left atrial dimension(LAD) & ejection fraction(EF) were evaluated during TTE. We divided the whole subjects into three groups according to the blood flow patterns ; regular pattern(Group 1), irregular pattern(Group 2), no flow pattern(Group 3). RESULTS: 1) Blood flow within the left atrial appendage is divided with three groups among of them, atrial fibrillation have two blood flow patterns. 2) Peak prositive & negative flow velocity within LAA in AF rhythm groups were slower than normal sinus rhythm group.(p<0.01) 3) Left atrial dimension in group 3 is significantly larger than others groups.(p<0.01) 4) Spontaneous contrast(SC) with LAA could be detected in 2(6.8%) of the 29 patients of group 1, 6(31.5%) of the 19 patients of group 2, 10(100%) of the 10 patients of group 3. Incidence of SC within LAA in group 3 is significantly higher than others groups. 5) LAA thrombi could be detected in 1(3.4%) of the 29 patients of group 1, 1(5.2%) of the 19 patients of group 2, 3(30%) of the 10 patients of group 3. Incidence of LAA thrombi is significangly higher than other groups. CONCLUSIONS: We can suggest that blood flow within LAA is divided into three groups according to the blood flow patterns, and spontaneous contrast and thrombi in LAA were closely related with the blood flow pattern.
Atrial Appendage ; Atrial Fibrillation ; Echocardiography ; Humans ; Incidence ; Mitral Valve ; Prostheses and Implants

PURPOSE: We describe clinical assessment of visual internal urethrotomy (VIU) as primary treatment modality in 69 men who presented with complete or partial obstructed urethral stricture. MATERIALS AND METHODS: The 63 patients with partial obstructed urethral stricture were treated by typical VIU. The 6 men with complete obstructed urethral stricture were treated by VIU using sound passed through previously placed suprapubic tract as guide. RESULTS: The procedure was completed successfully in 57 of the 63 men with partial obstructed (90.5%) and 3 of 6 patients with complete obstructed urethral stricture (50%). CONCLUSIONS: VIU is a safe and effective as primary treatment plan when urethral stricture is partial obstructed and the impassable urethral segment is shorter than 1.0cm.
Humans ; Male ; Urethral Stricture*

OBJECTIVES: Radiofrequency(RF) ablation is an effective and low risk curative treatment for supraventricular arrhythmias. Catheter ablation produced cardiac lesions primarily through formation of coagulation necrosis. We evaluated the degree of myocardial injury after RF catheter ablation by means of serial measurement of myocardial enzyme. METHODS: Fifty-one patients with symptomatic supraventricular tachycardia were included. There were 32 men and 19 women(mean age. 39.5+/-15.4 years)All patients underwent electrophysiologic study to detect accessary pathway and ablation with radiofreguency current. A mean of 18.3+/-14.2 radiofrequency pulses were delivered. The pulses were at a power of 50 to 60 Volts for a duration of 20 to 30 seconds. Unipolar method and a 6F or 7F catheter with a 4 mm tip electrode was used. LDH, CPK and Ck-MB as a kind of cardiac enzyme were measured before and after ablation. RESULTS: 1) The concentration of LDH and CPK were elecated at 8 hours and 16 hours after ablation (p<0.05). 2) The concentration of CK-MB was elevated at 8 hours, 16 hours, 24 hours and 72 hours after ablation(p<0.05). 3) There was no correlation between the number of applications and amounts of radiofrequency current and rise in LDH, CPK, CK-MB concentration. CONCLUSION: The concentration of LDH, CPK and CK-MB were elevated after ablation but they were within normal limits. RF catheter ablation produced myocardial damage inevitably but were within normal limits. RF catheter ablation produced myocardial damage inevitably but minimally, then RF ablation is an effective and safe therapeutic modality for patients with symptomatic tachyarrhythmias.
Arrhythmias, Cardiac ; Catheter Ablation* ; Catheters ; Electrodes ; Humans ; Male ; Necrosis ; Tachycardia ; Tachycardia, Supraventricular*

The use of recombinant DNA technology to produce human growth hormone has resulted in a marked increase in availability of Growth Hormone(GH) to treat short stature due to GH deficiency and other conditions, such as Turner syndrome, familial short stature, chronic renal insufficiency and intrauterine growth retardation (IUGR). But, the GH therapy may result in the adverse events such as sodium and water retention, pseudotumor cerebri, slipped capital femoral epiphysis, growth of nevi, recurrence of tumor. We experienced a case of severe hypertension associated with GH therapy in a 14-year-old male who presented high blood pressure up to 190/100 mmHg and normalized at 2-3 weeks after discontinuation of GH. Therefore, we think that the blood pressure should be carefully monitored during GH therapy.
Adolescent ; Blood Pressure ; DNA, Recombinant ; Fetal Growth Retardation ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hypertension* ; Male ; Nevus ; Noonan Syndrome ; Pseudotumor Cerebri ; Recurrence ; Renal Insufficiency, Chronic ; Slipped Capital Femoral Epiphyses ; Sodium