To evaluate the efficacy of anthelmintic treatment of Enterobius vermicularis in highly endemic population, total 82 children in two orphanage institutes were divided into 4 groups and treated with placebo, 5 mg/kg of pyrvinium pamoate, 100 mg of mebendazole and 10 mg/kg of pyrantel pamoate respectively. Total 4 anal swabs were taken from each child before treatment and the even distributions of positive rate and consecutive results between groups were considered. Follow-up swabs were taken 8 times up to the 40th day after treatment. After remarkable and significant reduction of positive rates up to 19-27th day after treatment in respective groups, the remarkable egg positive conversions were observed 3-4 weeks after treatment. The positive conversion was the earliest and the most remarkable in pyrantel-treated children and the slowest and the least remarkable in mebendazole-treated cases. Also found was that the figures of negative conversion were different with statistical significance between two categories of cases, consecutively positive and alternately positive cases of pre-treatment swabs. This means that the conventional indices of cure rate in E. vermicularis infection may be variable by the selection of subjected cases. Above results mean that the spectrum of susceptible pinworms according to the developmental stages are different between currently available drugs, and the ability to remove pinworms completely in certain developmental stage are also different between chemotherapeutics. These results suggest the need of interval chemotherapy of Enterobius vermicularis infection in heavily infected cases of in highly endemic population to achieve the complete eradication of whole range of pinworms in intestine.
parasitology-helminth-nematoda ; Enterobius vermicularis ; chemotherapy- mebendazole ; pyrantel pamoate ; enterobiasis

A 17-year-old man was referred for aborted sudden cardiac death. Ventricular fibrillation (VF) was recorded by automated external defibrillator. Post-resuscitation electrocardiograms showed frequent monomorphic premature ventricular complexes (PVCs), with left bundle branch block configuration and inferior axis. Cardiac arrest due to VF recurred twice within the initial 42 hours. Rhythm monitoring revealed multiple episodes of sustained VF triggered by a triplet of monomorphic PVCs having similar morphology with isolated PVCs. Comprehensive cardiologic workup revealed no structural heart disease and ion-channelopathies. With the impression of idiopathic VF triggered by unifocal PVCs of right ventricular outflow tract (RVOT) origin, radiofrequency catheter ablation was performed to prevent frequent VF recurrence before implantable cardioverter-defibrillator (ICD) implantation. After successful ablation of the origin of unifocal PVCs at anterolateral wall of RVOT, the burden of PVCs decreased remarkably and VF did not recur. The patient was discharged after ICD implantation.
Adolescent ; Axis, Cervical Vertebra ; Bundle-Branch Block ; Catheter Ablation ; Death, Sudden, Cardiac ; Defibrillators ; Defibrillators, Implantable ; Electrocardiography ; Heart ; Heart Arrest ; Heart Diseases ; Humans ; Recurrence ; Triplets ; Ventricular Fibrillation ; Ventricular Premature Complexes

A papillary adeno-carcinoma of the renal pelvis is very rare tumor and mostly diagnosed by histopathologic findings. A 10-years-old female was admitted to Fatima Hospital with Rt. flank pain and intermittent gross hematuria.Herein, we report a case of papillary adeno-carcinoma of the renal pelvis.
Adenocarcinoma ; Female ; Flank Pain ; Humans ; Kidney Pelvis*

As the use of free tissue reconstruction becomes more routine, attention is being focused not only on flap survival, but also on functional refinements in these flaps. One of the more important aspects of improving the outcome of these reconstruction may relate to the return of sensation. The anterolateral thigh free flap is based on the descending branch of the lateral circumflex femoral artery. This fasciocutaneous flap is indicated whenever a relatively thin flap is required in reconstruction. A neurosensory flap can be employed based on the anterior branched of the lateral femoral cutaneous nerve of the thigh. Since 1996, 15 patients with soft tissue defect on various regious were treated by using the anterolateral thigh sensate free falp. All flaps survived without total loss. Anastomosis of the sensible nerve on the recipient site with the anterior branch of the lateral femoral cutaneous nerve of the thigh was performed. All patients showed recovery of sensation in the anterolateral thigh sensate free falp beginning between the 4th and 6th month postoperatively. Follow-up periods ranged from 8 to 34 months and the results of sensory recovery were satisfactory. Therefore, resensitization of an anterolateral thigh free flap should be attempted by a nerve anastomosis in this transplant. The longterm success in this study suggests the benefits of microsurgical neurotization in free tissue transplantation.
Femoral Artery ; Follow-Up Studies ; Free Tissue Flaps* ; Humans ; Nerve Transfer ; Sensation ; Thigh* ; Tissue Transplantation ; Transplants

Basal cell carcinoma(BCC) and squamous cell carcinoma (SCC) are very prevalent neoplasms of the human skin. Ultraviolet radiation in sunlight is a well-established mutagen of the p53 gene and is one of basal cell carcinoma and squamous cell carcinoma. The newly-formed vascular network is important for neoplasms to grow beyond a size of about 1 mm2. Recent reports have suggested the hypothesis that a mutant p53 protein is closely related with capillary density. Immumohistochemistry for p53 protein and CD34 was performed in 20 cases of BCCs and 14 SCCs to evaluated the relationship between p53 protein and capillary density. The results were as follows:1. The microvessels stained by CD34 were mainly located in the interface of tumor cells and stroma. 2. There was no difference in the microvessel density according to the histologic types and age of the patients, but a higher microvessel density was noted in male patients. 3. The aggressive BCCs and the less-differentiated SCCs showed higher p53 immunostaining. 4. The mean microvessel density of cases showing strong positive immunostaining of the p53 gene(54.73+/-17.75) was higher than that of others(39.75+/-18.30). These results suggested that p53 protein expression and microvessel density are not related to the histologic types and age of the patients, but that differentiation and biologic behavior such as the infiltrating property of tumors and the microvessel density are closely related to p53 protein expression.
Capillaries ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Genes, p53 ; Humans ; Male ; Microvessels* ; Skin* ; Sunlight

The mesenchymal chondrosarcoma of the orbit is so rare that only a few cases have been reported in Korea and world-wide. We experienced that a patient whose complaints were proptosis and diplopia caused by orbital tumor. After tumor removal, it was histologically diagnosed as mesenchymal chondrosarcoma. So we report a case of mesenchymal chonrosarcoma of the orbit with a review of the literature.
Chondrosarcoma, Mesenchymal* ; Diplopia ; Exophthalmos ; Humans ; Korea ; Orbit*

PURPOSE: To evaluate the results of surgical treatment of posterior wall fractures of the acetabulum and to determine the factors affecting the results. MATERIALS AND METHODS: Thirty-one posterior wall fractures were reviewed; 7 type A1-1, 19 type A1-2 and 5 type A1-3 by AO classification. Postoperatively, the accuracy of the reduction was evaluated. At the final follow-up, clinical and radiographic results were evaluated with medical records and radiographs. The factors affecting the results were determined. RESULTS: The reduction was graded as anatomical in 22 patients, imperfect in seven and poor in two. The clinical result was excellent in 21 hips, good in six, fair in three and poor in one. The quality of the reduction was strongly associated with the clinical result. The radiographic result was excellent in 22 hips, good in five, fair in two and poor in two. The clinical result was related closely to the radiographic result. Complications were osteoarthritis in three patients, osteonecrosis of the femoral head in one, heterotopic ossification in one, penetration of a screw into the joint in one and iatrogenic sciatic nerve injury in one. The factors affecting the clinical results were fracture patterns, the surgeon's experience, the accuracy of the reduction and late complications. CONCLUSION: In this present series of posterior wall fractures, as their prognosis depends on the severity of the injury and the accuracy of the reduction, satisfactory result can be obtained by anatomical reduction with thorough preoperative planning and the surgeon's experience.
Acetabulum* ; Classification ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Medical Records ; Ossification, Heterotopic ; Osteoarthritis ; Osteonecrosis ; Prognosis ; Sciatic Nerve

PURPOSE: To understand the structure and character of the right retroperitoneal space by analysis of the extension of retroperitoneal hematoma in patients with traumatic right renal injuries. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 13 patients with right retroperitoneal hematomas caused by right renal injury. At the renal level, we analyzed the relation of a hematoma contacting psoas muscle with other retroperitoneal compartmental hematomas. At the suprarenal level, a perirenal hematoma and a hematoma contacting the diaphragm were analyzed according to their relation with intrahepatic IVC and pericaval hematoma. RESULTS: Below renal hilar level, all hematomas contacting psoas muscle, observed in eight cases, were connected with retrorenal extension of anterior pararenal hematoma. At the suprarenal level, intrahepatic pericaval hematomas were not, in all 13 cases, connected with a hematoma contacting the diaphragm, but with a perirenal hematoma. At the upper suprarenal level, the only pericaval hematomas containing a medial component of perirenal hematoma extended superiorly to the upper one third of the tenth thoracic vertebral body. CONCLUSION: The anterior renal fascia envelops perirenal space except in its medial aspect. In the upper suprarenal region, the anterior and posterior planes of the anterior renal fascia unite to fuse with diaphragmatic fascia, but along the medial aspect they fuse with intrahepatic pericaval connective tissue and posteromedial diaphragm, respectively.
Connective Tissue ; Diaphragm ; Fascia ; Hematoma* ; Humans ; Psoas Muscles ; Retroperitoneal Space* ; Retrospective Studies ; Tomography, X-Ray Computed

We reported a case of huge cystic trigeminal neurinoma. The patient was 35 year old female with trigeminal nerve dysfunction and hemiparesis. The computed tomography disclosed a huge cystic low density mass at the temporal base and suprasellar cistern that extended to cerebellopontine cistern through the tentorium, and enlargement of Meckel's cave on coronal scan. Through the infratemporal and retromastoid suboccipital approach, the cystic content was aspirated and cyst wall was removed. The cystic change of neurinoma may be due to mucoid degeneration and liquifaction.
Adult ; Female ; Humans ; Neurilemmoma* ; Paresis ; Trigeminal Nerve

Lately, surgical treatment for lumbar disc herniations has advanced markedly with new improvements of neurosurgical procedures using microscope and microinstruments. The following is the authors' report of the surgical outcomes of 3,913 consecutive patients with lumbar disc herniations treated during a 230year period. These patients received treatments of laminectomy, hemilaminectomy or partial laminectomy with or without discectomy. After 1987, we also performed microdiscectomies using microscopes and microinstruments. The ratio of male to female was 71% to 29% and the fourth and fifth decades were most common with respect to age distribution. The causes of herniated discs include lifting, traffic accidents, falls or slipping, and sports Almost all patients had complained of low back pain and leg pain(99%), and 81% had radicular pain or sensory abnormality in a dermatomal distribution. The diagnosis was made by lumbar myelogram, CT scan and/or MRI. Complications were developed in 6.2% of the surgical cases. Several conclusions can be drawn from the above indicated results of this series: 1) male patients predominate in the lumbar disc herniation which are most common the fourth and fifth decades; 2) the incomplete herniation of disc was common; 3) MRI had the highest specificity as a single diagnostic tool, while the combination of myelogram, CT scan and MRI seems to e the best diagnostic method; 4) almost all patients had low back pain and leg pain and 90% of the patients were positive in Laseque test; 5) microdiscectomy is the most recommended treatment for lumbar disc herniations ; 6) The complication rate was 6.2% and the failed back surgery syndrome was most common.
Accidents, Traffic ; Age Distribution ; Diagnosis ; Diskectomy ; Failed Back Surgery Syndrome ; Female ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Leg ; Lifting ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Neurosurgical Procedures ; Sensitivity and Specificity ; Sports ; Tomography, X-Ray Computed