Nasopharyngeal angiofibroma is a relatively rare, but is a well known tumor that occurs almost in male, most frequently during the adolescent stage. Its character is histologically benign but clinically malignant because of locally invasive character to the adjascent structures, massive bleeding tendency during surgical procedure and high recurrence rate after treatment. Recently many advancements diagnostic method and surgical technique has reached satisfactory result in treating this difficult tumor. The authors present a case of nasopharyngeal angiofibroma in 16 years old male patient, who was received surgical removal of the tumor through the transpalatal approach after full diagnostic evaluation and preoperative hormonal therapy.
Adolescent ; Angiofibroma* ; Hemorrhage ; Humans ; Male ; Methods ; Recurrence

No abstract available.
Diagnosis* ; Ossification, Heterotopic* ; Risk Factors* ; Spinal Cord Injuries* ; Spinal Cord*

No abstract available.
Adenoma*

PURPOSE: To determine the plain film findings of acute neuropathic joint in diabetic foot. MATERIALS AND METHODS: Acute neuropathic joint in diabetic foot was considered when fragmentation of the articular ends of bone and subluxation of the affected joint developed within eight weeks after clinical onset of diabetic gangrene. Eight toes of six diabetics were satisfactory to our criteria. We analyzed plain radiographic findings of the affected joint and soft tissue, interval changes in follow-up radiographs, and deformities after healing. RESULTS: The time interval between clinical onset of gangrene and bone destruction ranged from 2 weeks to 4 weeks(mean 2.6 weeks). Plain radiographs showed fragmentation of the articular ends, subluxation, and soft tissue swelling of the metatarsophalangeal joint or interphalangeal joint. The significant feature of these patients was rapid progression of the lesions. Clinically, all patients had diabetic gangrene in affected toes, however, there was no evidence of osteomyelitis in our series. Amputation was done in 2 cases, and lesions in 3 of the remaining 4 cases were repaired spontaneously with regression of gangrene, leaving radiological residua such as pointed-end, tapered-end, and ball and socket deformity. CONCLUSION: Rapid disorganization of the joint with associated evidence of soft tissue gangrene in plain radiograph is believed to be valuable for the diagnosis of diabetic osteoarthropathy.
Amputation ; Congenital Abnormalities ; Diabetic Foot* ; Diagnosis ; Follow-Up Studies ; Gangrene ; Humans ; Joints* ; Metatarsophalangeal Joint ; Osteomyelitis ; Toes

No abstract available.
Diagnosis* ; Humans

BACKGROUND: Since percutaneous mitral valvuloplasty(PMV) using balloon was introduced by Inoue in 1984, this procedure has been accepted as a new non-surgical therapeutic modality for the treatment of selected patients with mitral stenosis. Pregnant women with mitral stenosis has suffered from life threatening complication due to altered hemodynamic changes and heart failure. Surgical valvotomy has been performed after failure of medical therapy with high risk of fetal mortality and teratogenicity. PMV can be an adequate alternative to surgical valvotomy in pregnant women. METHODS: After precise echocardiographic examination of mitral valve and its surrounding structures including thrombi in left artrium was performed, antegrade transseptal procedure was done in all 3 cases with abdominal shield using Inoue balloon technique. RESULTS: Mitral valve area increased over 1.5cm2 and hemodynamic variables improved immediately after PMV. Symptoms subsided soon after PMV in all 3 cases. Healthy normal babies were delivered transvaginally without difficulties in all 3 patients. CONCLUSIONS: Percutaneous mitral valvuloplasty is a safe and effective therapeuteic alternative to surgical valvotomy in a pregnant women with mitral stenosis who failed medical therapy, in a high risk or symptomatic pregnant women.
Echocardiography ; Female ; Fetal Mortality ; Heart Failure ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Pregnancy* ; Pregnant Women

No abstract available.
Biopsy* ; Cytoplasm* ; Follow-Up Studies* ; Glomerulonephritis* ; Kidney Transplantation*

BACKGROUND: To evaluate the efficacy of transesophageal echocardiography(TEE) to detect left atrial thrombi(LAT) and to investigate the clinical and echocardiography parameters which related with LAT. METHOD: We performed TEE and TTE simultaneously to 98 consecutive patients who had native mital valve disease or mital prosthesis as usual method. We examined the presence and location of LAT and spontaneous contrast(SC) in TEE and measured left atrial dimension(LAD), ejection fraction(EF), mital valve area(MVA) in TTE. Cardiac rhythm, history of anticoagulation and systemic embolization were also reviewed. We compared such parameters in LAT positive/negative groups and SC positive/negative groups. RESULTS: 1) In TEE, we detected 26 cases of LAT, among them seventeen cases : left atrial appendage(LAA) thrombi, 3 cases : combined LA and LAA thrombi, 6 cases : LA thrombi. In TTE, six cases showed LAT but we couldn't detect LAA thrombi. The difference between two methods was statistically significant(p<0.05). 2) LAT positive group showed larger LAD, lower EF, and higher prevalence of AF, systemic embolization, and LAT than negative groups(p<0.01). 3) SC positive group showed larger LAD, lower EF, higher prevalence of AF, systemic embolization LAT than SC negative groups(p<0.05). 4) In multiple discriminant analysis, the history of systemic embolization was most important factor which can suspect LAT(Wilk's Lambda:0.77152. p<0.0001). SC, EF, presence of AF, LAD, anticoagulation therapy. MVR were also statistically valuable factors in order. The hit ratio of this analysis was 86.84%. CONCLUSION: We can suggest that TEE is very useful method to detect LAT than TTE, and the spontaneous contrast was very important factor which can suggest LAT and systemic embolization in mitral valve disease.
Echocardiography ; Echocardiography, Transesophageal* ; Humans ; Mitral Valve ; Prevalence ; Prostheses and Implants

Hypospadias can be repaired in the majority cases in 1-stage with a high success rate. We reviewed clinical experience of 50 patients who underwent primary hypospadias repair by 1 surgeon using 1-stage repairs except 3 cases in a 30-month period. The results were 1). The half of patients were younger than 5 years (48%). 2). A total of 34 cases (68.0%) had an associated ventral curvature. The dorsal tunica albuginea plication to correct intrinsic curvature was done in 21 cases (61.8%) and dividing the urethral plate in only 3 cases (8.8%). 3). Associated anomalies were cryptorchidism in 7, hydrocele in 3 and severe penoscrotal transposition in 8 cases. 4). 19 cases of anterior hypospadias were repaired by meatoplasty using Heineke-Mikulicz tissue rearrangement (9 cases), MAGPI (3 cases), pyramid procedure (4 cases), Mathieu urethroplasty (2 cases) and onlay island flap (1 case). Of the 31 cases of middle and posterior hypospadias onlay island flap repair was performed in 24 cases (77.4%). 5). The success rates in anterior, middle and posterior hypospadias were 94.7, 64.7 and 42.9%, respectively. The overall success rate was 70%. 6). The most commonly used procedure was onlay island flap urethroplasty. Only 14 of 25 cases (56.0%) were successful with this method but the last 8 cases were repaired with no complications. 7). The most common complications were urethrocutaneous fistula (11 cases) and meatal retraction (3 cases). The complications were managed by rotational advancement flap (11 cases), meatal based flap (2 cases) and urethral advancement (1 case) and the success rate was 73.3%. In conclusion, to achieve more satisfactory results the choice of operation depends on the configuration of either glans or meatus, presence or absence of chordee and status of ventral penile skin in anterior hypospadias. Although the 2-stage repair remains a safe and reliable alternatives for severe hypospadias 1-stage repair was more useful except severe hypospadias combined with penoscrotal transposition."
Cryptorchidism ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays ; Male ; Skin

To investigate the usefulness of large relaxing retinectomies in the management of selected complicated retinal detachments. The charts of 25 consecutive patients who underwent large relaxing retinectomy during vitrectomy were reviewed. Penetrating injury(10 eyes) and chronic retinal detachment(11 eyes) were the leading etiologic diagnoses. 22 eyes showed extensive PVR, 14 of them had a PVR Grade C P 12 and 3 eyes had extensive vitreoretinal incarceration. Most eyes (22 eyes) had undergone one or more previous ocular procedures and four eyes were early phthisical preoperatively. Extended tamponade was achieved with either silicone oil(23 eyes) or C3F8 gas (2 eyes). Retinectomy size was larger than 180 degrees in 20 eyes, ranging from 90 degrees to 360 degrees. Total retinal reattachment was achieved in 15 eyes(60%) and subtotal attachment including the macula in 6 eyes(24%). 10 eyes(40%) achieved 5/200 or better. The size of retinectomy or etiologic diagnosis did not influence the anatomic results. Hypotony was seen in 3 eyes and corneal decompensation in 8 eyes. Large retinectomy in selected cases of vitreoretinal surgery seemed to be an effective procedure in eyes otherwise unsuccessful.
Diagnosis ; Humans ; Retinal Detachment* ; Retinaldehyde* ; Silicone Oils ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative