Leiomyomas of the vagina is a rare tumor, with 300 cases reported in the world literature. We experienced a case of leiomyoma of the vagina, and present it with a brief review of the literatures.
Leiomyoma* ; Vagina*

Fibrous dysplasia in the orbit and cranial base may involve the optic canal. Although fibrous dysplasia is benign, it may produce a mass effect along the course of the optic nerve which can then induce visual disturbance as well as contour deformities of the skull and facial bone. The treatment of fibrous dysplasia in the orbit and cranial base is to resect the lesion as much as possible and then reconstruct immediately. As well, if there is any evidence of optic canal involvement and disease progression, the treatment of fibrous dysplasia may include optic nerve decompression. It is generally understood that some patients experience improvement of visual function after optic nerve decompression. We performed radical excision and reconstruction by means of autogenous calvarial bone graft and methylmethacrylate in 7 cases. The autogenous calvarial bone was used to reconstruct the orbit. The methylmethacrylate was used to reconstruct bony defect in the temporal area. The orbit was reconstruced into one block which was made of autogenous calvarial bone with a microplate and screw. This method is superior compared to the previous multifragment wiring method with regard to stability, operation time, and appearance. The patients in our series showed satisfactory appearance. In 6 cases, we performed optic nerve decompression. Therapeutic optic nerve decompression was done in 3 cases and prophylatic optic nerve decompression was done in the others. Following therapeutic optic nerve decompression, visual acuity was improved in 2 cases while the others showed a decrease in visual acuity. There was no change of visual acuity and visual field in 1 case after prophylactic optic nerve decompression. However, the others showed decrements in visual acuity or visual field. Therefore, we believe that more attention should be paid during optic nerve decompression procedure and strict indications to that procedure should be applied.
Congenital Abnormalities ; Decompression* ; Disease Progression ; Facial Bones ; Humans ; Methylmethacrylate ; Optic Nerve ; Orbit* ; Skull ; Skull Base* ; Transplants ; Visual Acuity ; Visual Fields

No abstract available.
Child* ; Humans ; Seizures, Febrile*

OBJECTIVE: Although anterior cervical discectomy and fusion (ACDF) is the standard treatment for degenerative cervical disc disease, concerns regarding adjacent level degeneration and loss of motion have suggested that arthroplasty may be a better alternative. We have compared clinical and radiological results in patients with cervical disc herniations treated with arthroplasty and ACDF. METHODS: We evaluated 53 patients treated for cervical disc herniations with radiculopathy, 21 of whom underwent arthroplasty and 32 of whom underwent ACDF. Clinical results included the Visual Analogue Scale (VAS) score for upper extremity radiculopathy, neck disability index (NDI), duration of hospital stay and convalescence time. All patients were assessed radiologically by measuring cervical lordosis, segmental lordosis and segmental range-of-movement (ROM) of operated and adjacent disc levels. RESULTS: Mean hospital stay (5.62 vs. 6.26 days, p<0.05) and interval between surgery and return to work (1.10 vs. 2.92 weeks, p<0.05) were significantly shorter in the arthroplasty than in the fusion group. Mean NDI and extremity VAS score improved after 12 months in both groups. Although it was not significant, segmental ROM of adjacent levels was higher in the fusion group than in the arthroplasty group. And, segmental motion of operated levels in arthroplasty group maintained more than preoperative value at last follow up. CONCLUSION: Although clinical results were similar in the two groups, postoperative recovery was significantly shorter in the arthroplasty group. Although it was not significant, ROM of adjacent segments was less in the arthroplasty group. Motion of operated levels in arthroplasty group was preserved at last follow up.
Animals ; Arthroplasty ; Convalescence ; Diskectomy ; Extremities ; Follow-Up Studies ; Humans ; Length of Stay ; Lordosis ; Neck ; Radiculopathy ; Return to Work ; Upper Extremity

A retrospective study of 29 cases of brain-stem gliomas(BSG's) from 1989 to 1993, was performed to determine prognostic factors. Our study also analyzed clinical features, growth patterns, pathologic findings and modalities of treatment in patients with brain-stem gliomas. The patients ranged in age from 6 to 65 years, most commonly in the first decade. The symptom duration prior to diagnosis was 1/2 to 6 months(mean 1 1/2 months). The most common symptom and sign were cranial nerve palsies, especially 6th or 7th cranial nerve. The growth patterns of BSG's were classified into diffuse tumors(7 patients), exophytic(9 patients), focal(2 patients) and cervicomedullary(1 patient). Twenty three of 29 patients were diagnosed pathologically by means of stereotactic biopsy(13 patients) and ope surgery(10 patients). The Pathologic findings were low grade astrocytoma in 9 patients, oligodendroglioma(3 patients), malignant astrocytoma(7 patients), and glioblastoma mulitiforme(4 patients). A significant correlation between diffuse growth pattern and malignant pathologic finding could be obtained(P=0.05). The methods of radiation therapy for BSG's were conventional(10 patients), hyperfractionated(13 patients), and Gamma knife radiosurgery(6 patients). The median survival time was 12 months. The Poor prognostic factors determined in our study were 1) short symptom duration prior to diagnosis(< or = 2 months), 2) diffuse growth pattern, 3) malignant pathologic finding, 4) tumor without cystic portion, and 5) tumor without hydrocephalus.
Astrocytoma ; Cranial Nerve Diseases ; Cranial Nerves ; Diagnosis ; Glioblastoma ; Glioma ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Pathology* ; Prognosis* ; Retrospective Studies

OBJECTIVES: With the elderly population rising sharply, there is a rising interest in dementia, and recently researches on risk factors for dementia, particularly of Alzheimer's disease have been actively conducted. The purpose of this research is to examine the effect of the late-onset depression as a risk factor for Alzheimer's disease. METHODS: The subjects were divided into the group of the patients who were diagnosed with depression in the National Health Insurance Corporation Ilsan Hospital from March 1, 2000 to December 31, 2009 and the corresponding control group, which was the group of the patients who were diagnosed with osteoarthritis for the same period. Of the above patients, the following cases were excluded from the final analysis. The excluded cases were those who were first diagnosed with either of the two diseases at the age of less than 50, and those who were diagnosed with major psychiatric disorder or neurologic disorder. As a result, a total of 5,347 people, made up of 1,697 depression patients and 3,650 osteoarthritis patients, were selected. Two groups were compared through survival analysis. RESULTS: Form the Log-Rank tests, it could be confirmed that there were significant differences (p<0.01) among the two groups. Even when many confounding factors including age and gender were controlled, the degree of occurrence of Alzheimer's disease was found to be higher in the group of late-onset depression patients than in the group of osteoarthritis patients (HR : 2.53-2.80). CONCLUSION: The late-onset depression can become independently the risk factor for Alzheimer's disease. Therefore it can be expected that the rate of occurrence of Alzheimer's disease may be reduced through active medical treatment of depression.
Aged ; Alzheimer Disease ; Dementia ; Depression ; Humans ; National Health Programs ; Nervous System Diseases ; Osteoarthritis ; Risk Factors

PURPOSE: To investigate the trend of refractive change in hyperopic patients according to increases in age. METHODS: Eighty-eight children who had hyperopia of more than +1.50 diopters (D) and could be followed up for at least 5 years were included in this study. We divided the patients into two groups according to the level of initial hyperopia and retrospectively analyzed hyperopic refractive changes over a 5-year period according to age at initial diagnosis, presence of esotropia, amblyopia, astigmatism and anisometropia. RESULTS: We gained the following formula about the aspect of hyperopic reduction in 88 patients over a period of 5 years: Diopter (D)=7.99-2.14 Ln (age). The presence of anisometropia and amblyopia did not affect hyperopic reduction. Hyperopic reduction amounts in the group with a hyperopic eye of more than +5D at initial diagnosis were greater than in the group with a hyperopic eye less than +5D, and greater in the group with an astigmatic eye of more than 1D. The presence of esotropia and the age at initial diagnosis did not affect hyperopic reduction. CONCLUSIONS: We show that emmetropization in hyperopic children occurs according to the following formula: Diopter (D)=7.99-2.14 Ln (age). Both the initial level of hyperopia and the concurrent presence of astigmatism affected hyperopic reduction. However, the presence of anisometropia, amblyopia, esotropia and the age at initial diagnosis did not significantly affect hyperopic reduction.
Amblyopia ; Anisometropia ; Astigmatism ; Child ; Diagnosis ; Esotropia ; Follow-Up Studies* ; Humans ; Hyperopia ; Retrospective Studies

BACKGROUND AND OBJECTIVES: The Tinnitus Handicap Inventory (THI) often requires patients to devote their time to complete the questionnaire than they expect. Given that it limits the effectiveness of THI in a busy clinical practice that desires a quick and easy assessment of tinnitus handicap, this study evaluated clinical usefulness of a Simplified version of Tinnitus Handicap Inventory (THI-S) in measuring the severity of tinnitus handicap as well as predicting the psychological distress associated with tinnitus. SUBJECTS AND METHODS: A total of 129 outpatients suffering from tinnitus (61 with normal hearing and 68 with hearing loss) participated in this study. The responses of THI-S (10 items) and THI (25 items) were evaluated to quantify the subjective handicap of tinnitus. The self-perceived level of stress, anxiety, and depression of all participants was measured with a series of self-report questionnaires such as Korean version of Brief Encounter Psychosocial Instrument (BEPSI), State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively. All the questionnaire responses were analyzed using non-parametric analyses to examine the convergence, comparability, internal consistency reliability and validity of THI-S. RESULTS: The severity of tinnitus handicap and the relevant psychological distress greatly varied across individuals. The THI-S responses were comparable to original THI responses, regardless of hearing status of patients. The internal consistency of THI-S responses was found to be good for total score (Cronbach's alpha=0.83-0.91), with moderately high consistency for the emotional, functional, and catastrophic subscales. Significant (p<0.01) correlations of the THI-S with the THI (r(s)=0.95) as well as with the BEPSI, STAI, BDI questionnaires (r(s)=0.40-0.45) suggest that the THI-S questionnaire appeared to be useful to provide objective data of subjective tinnitus handicap as well as predict psychological distress. Three factors were extracted through factor analysis, which explained 73% of the total variance. CONCLUSIONS: Despite reducing the length of 25 items of THI to 10 items, the THI-S can be used as s a simple but reliable and valid tool for evaluating severity of tinnitus handicap as well as detecting its negative impact on psychological functioning.
Anxiety ; Depression ; Hearing ; Humans ; Outpatients ; Reproducibility of Results ; Tinnitus*

No abstract available.
Ependymoma*

The purpose of this study was comparing the serial change of serum creatinine and Resistive Index (RI) after renal transplantation. From Jul. 1995 to Feb. 1997, we examined Doppler sonography for 32 out of 99 patients, who were undertaken renal transplantation, whose resistive index were taken at POD #1 and POD #5 and named initial resistive index. The late resistive index were examined when they discharged or when the acute rejection was suspicious. The RI rejection group, which was consist of 22 out of 32 patients, were selected whose late resistive index were increased more 0.05 than inital resistive index. The RI control group, which was consist of 10 out of 32 patients, was selected whose late resistive index were not more 0.05 than initial resistive index. The group which was consist of 21 patient, had over 1.8 mg/dL of serum creatinine. The rest, 11 patients, had not more than 1.8 mg/dL of serum creatinine. The Student's T-test was used for the statistical analysis. In the RI rejection group, late RI value (0.77+/-0.04) was significantly higher than initial RI (p<0.05) and the increase of RI in the acute rejection group were significantly greater than that in the control group (p<0.05). With the serial changes of late RI more 0.05 than initial RI, we obtained 85.0% of sensitivity and 58.3% of specificity for the prediction of the acute rejection. In the patients with the serum creatinine over 1.8 mg/dL, the sensitivity was 85.0% and the specificity was 66.7%. In the patients with the serum creatinine over 1.8 mg/dL and increased RI over 0.05, the sensitivity was 94.1% and specificity was 66.7%. The result shows that serial changes of duplex Doppler scan and the level of serum creatinine after renal transplantation were not enough to predict acute rejection. But the correlation of the result show more higher sensitivity. We suggest to be able to use the Doppler sonography and serial changes of serum creatinine level with the other clinical findings to predict the acute rejection after renal transplantation.
Creatinine* ; Humans ; Kidney Transplantation* ; Sensitivity and Specificity