BACKGROUND AND OBJECTIVES: The aim of this study was to analyse the radiological anatomic dimensions of the inferior turbinate in patients without deviated nasal septum and compare it to those in the patients with deviated nasal septum using computed tomography. SUBJECTS AND METHOD: The OMU CTs of 98 patients, 196 nostrils with or without deviated nasal septum were evaluated (control group: 42 patients, deviated septum group: 56 patients). The analysis of the CT scans contained the mucosal and bony length, mucosal width of the turbinate and the anterior and posterior mucosal overlay. And also evaluated the cross-sectional area and the type of inferior turbinate bone. RESULTS: All subjects were divided into three groups: the concave, convex, and control groups. The correlations of fifteen measuring points such as anterior, middle and posterior medial mucosal thickness, total width, bone width, medial mucosa width of inferior turbinate, and area of inferior turbinate bone were significantly different among the groups (concave side>con-trol group>convex side). Of the demographic factors, age was negatively correlated with mucosa and bone length. Types of inferior turbinate bone were as follows: lamella type (38%), combined type (37%), compact type (25%). CONCLUSION: There were statistical differences in some measured anatomical points among the concave, convex, and control groups. Greater septum deviation was correlated with greater degree of hypertrophysm of the inferior turbinate. The age of patients showed negative correlation with inferior turbinate length. Most frequent type of inferior turbinate was lamella type. The results of this study may provide important information when considering turbinate surgery.
Demography ; Humans ; Mucous Membrane ; Nasal Septum* ; Tomography, X-Ray Computed ; Turbinates*

Malignant mesothelioma is a rare aggressive tumor and arises from mesothelial cells in the pleural, peritoneal and pericardial cavities. Median survival is -1 year and the incidence is approximately 0.7 per million persons, and is increasing annually in Korea. It is difficult to diagnose malignant mesothelioma because of nonspecific symptoms, signs and laboratory findings. It needs to be confirmed by histological examination and immunohistochemistry. There is no case report of malignant mesothelioma of the peritoneum and pleura in Korea. We report a rare case of malignant mesothelioma with simultaneous involvement of the peritoneum and pleura in a 75-year-old man without evidence of asbestos exposure.
Aged ; Asbestos ; Humans ; Immunohistochemistry ; Incidence ; Korea ; Mesothelioma* ; Peritoneum* ; Pleura*

PURPOSE: Breast reconstruction in patients who have undergone a mastectomy is performed less frequently in Korea than in Western countries. The aim of this study was to investigate the psychosocial problems related to a mastectomy and awareness of reconstruction after a mastectomy in breast cancer survivors. METHODS: From March to April 2010, 252 patients who underwent a mastectomy were recruited for this survey. The questionnaire included sociodemographic characteristics of patients, psychosocial problems related to mastectomy, and reasons not to receive breast reconstruction. RESULTS: Patients had difficulty going to a public bath (70.3%) or going to a swimming pool or the beach (74.6%). More than half of patients answered that their physical activity had decreased due to persistent shoulder or arm pain after the mastectomy. The most common psychological problem that patients experienced was distress over the loss of charm as a woman (66.8%), followed by considering themselves disabled (62.0%), and worries about recurrence (59.4%). The most common reason not to receive a breast reconstruction was the high cost of the operation (59.4%), followed by anxiety about complications (46.7%). Only 16.2% of patients reported that they did not receive enough information about reconstruction from their doctor. Of 229 patients, 43.7% would consider undergoing breast reconstruction in the future. CONCLUSION: Breast cancer survivors who underwent a mastectomy suffered from various psychosocial problems, and high cost was a major reason for not undergoing breast reconstruction. Broader health insurance coverage should be provided for breast reconstruction in breast cancer survivors.
Female ; Humans ; Breast Neoplasms

Myasthenia gravis and autoimmune thyroid disorders often overlap. It is known that hyperthyroidism occurs in 2~17.5% of patients with myasthenia gravis. Thyrotoxicosis may influence the clinical course of myasthenia gravis. Overlapping clinical features may cause diagnostic confusion when Graves' disease and myasthenia gravis co-exist. Thus, various tests may be needed to distinguish these two diseases. It is clinically important to screen patients with myasthenia gravis for the co-existence of autoimmune thyroid disorders and vice versa. We cared for a patient with Graves' disease associated with ocular myasthenia gravis who presented with fluctuating double vision and ptosis. Ocular myasthenia gravis was diagnosed by electrophysiologic study and presence of acetylcholine receptor antibody. The patient had a favorable clinical and laboratory response to treatment with an anticholinesterase (pyridostigmine) and an antithyroid drug (propylthiouracil), and he had minimal symptoms at the 9-month follow-up examination.
Acetylcholine ; Diplopia ; Follow-Up Studies ; Graves Disease ; Humans ; Hyperthyroidism ; Myasthenia Gravis ; Thyroid Gland ; Thyrotoxicosis

The purpose of this study was to measure the skin dose using the glass dosimeter and diode and to compare those measurements to the planned skin dose from the treatment planning system. For the reproducibility of the glass dosimeter (ASAHI TECHNO GLASS CIRPORATION, Japan), the same dose was irradiated to 40 glass dosimeters three times, among which 28 with the reproducibility within 3% were selected for the use of this study. For each of 27 breast cancer patients, the glass dosimeters and diodes were attached to 4 different locations on the skin to measure the dose during treatment. All the patients received one fraction of 180 cGy each. The maximum difference of measurements between the glass dosimeter and diode at the same location was 3.2%. Comparing with the planned skin dose from the treatment planning system (Eclipse v6.5, Varian, USA), the dose measured by the glass dosimeter and the diodeshowed on an average 3.4% and 2.3% difference, respectively. The measured doses were always less than the planned skin dose. This may be due to the specific errors of both detectors. Also, the difference may be caused by the fact that since the skin where the detectors were attached is pretty moveable, it was not fix the detectors on the skin.
Breast ; Breast Neoplasms ; Glass ; Humans ; Skin

PURPOSE: The purpose of this study was to evaluate the factors that are associated with the accuracy of magnetic resonance (MR) imaging for predicting myometrial invasion and lymph node metastasis in women with endometrial carcinoma. MATERIALS AND METHODS: We retrospectively reviewed the medical records and preoperative MR imaging reports of 128 women who had pathologically proven endometrial carcinoma. We compared the MR imaging and the histopathology findings. RESULTS: The sensitivity, specificity and accuracy for identifing any myometrial invasion (superficial or deep) were 0.81, 0.61 and 0.74, respectively; these values for deep myometrial invasion were 0.60, 0.94 and 0.86, respectively. The sensitivity, specificity and accuracy of MR imaging for detecting lymph node metastasis were 50.0%, 96.6% and 93.0%, respectively. The patients who were older, had more deliveries and a larger tumor size more frequently had incorrect prediction of deep myometrial invasion (p=0.034, p=0.044, p=0.061, respectively). A higher tumor grade, a histology other than the endometrioid type, myometrial invasion on MR findings and a larger tumor size were associated with a more frequent false-negative prediction of lymph node metastasis (p=0.018, p=0.017, p=0.002, p=0.047, respectively). A larger tumor size was also associated with more frequent false-positive results (p=0.009). CONCLUSIONS: There are several factors that make accurate assessment of myometrial invasion or lymph node metastasis difficult with using MRI; therefore, the patients with these factors should have their MR findings cautiously interpreted.
Endometrial Neoplasms* ; Female ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging* ; Medical Records ; Neoplasm Metastasis* ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE:The study was carried out to characterized the clinical and the laboratorial features of children with mitochondrial respiratoy chain disorders in Korea. METHODS:We retrospectively analyzed the clinical and the loboratorial data of 28 children with significantly low activities in respiratory chain complexes of muscle using spectrophotometry. RESULTS:The mean age was 6.67+/-4.44 years and the ratio males to female was 1.15:1. Eighteen patients (64.3%) showed defects in Complex I, 8 (28.6%) in Complex VI, 1 (3.6%) in Complex II, and 1 in Complex I and IV. Eight cases (28.6%) were diagnosed with Leigh disease, one with MELAS, Kearns-Sayre syndrome, and Alpers disease retrospectively, but the predominant clinical presentations were a nonspecific encephalopathy (17/28, 60.7%). Epilepsy was seen in 21 (75.0%) patients, while developmental delay in 27 (96.4%) patients. Fifteen out of 28 children (53.6%), clinical symptoms mostly appeared below age of 1 year. The brain MRI showed diffuse cortical atrophy in 18 (64.3%) patients and basal ganglia signal changes in 12 (42.9%) patients. CONCLUSION:The defects in mitochondrial respiratory chain complexes should be considered in any children with an unexplained neurological condition including even epilepsy.
Atrophy ; Basal Ganglia ; Brain ; Child* ; Diffuse Cerebral Sclerosis of Schilder ; Electron Transport* ; Epilepsy ; Female ; Humans ; Kearns-Sayre Syndrome ; Korea ; Leigh Disease ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome ; Mitochondrial Diseases ; Retrospective Studies ; Spectrophotometry

A 5-year-old girl was admitted because of an acute onset of weakness in her extremities. She had experienced a similar episode before but had recovered spontaneously. She had previously been diagnosed with distal renal tubular acidosis(RTA) at the age of 2 months. During the period of acute paralysis, her serum potassium level was 1.8 mmol/L and the muscle enzymes were markedly raised suggesting massive rhabdomyolysis. Although hypokalemia is common in renal tubular acidosis, acute paralytic presentation is uncommon and is rarely described in children. We report a case of distal RTA complicated with hypokalemic paralysis with a brief review of related literatures.
Acidosis, Renal Tubular* ; Child ; Child, Preschool ; Extremities ; Female ; Humans ; Hypokalemia ; Paralysis* ; Potassium ; Rhabdomyolysis

OBJECTIVE: This study was performed to evaluate the clinicopathologic characteristics and prognostic factors of uterine endometrial cancer affecting survival of the patients. METHODS: Form Jan. 1995 to Dec. 2001, medical records including operation record and pathologic reports of 111 patients with histologically proven endometrial cancer at Samsung Medical Center were reviewed. The survival of patients was determined by description of last follow up date in medical records or phone calls. RESULTS: The median age of all patients was 52 years and the most common presenting symptom was abnormal vaginal bleeding (74.0%). Histologic type of endometrioid adenocarcinoma was the most common (90%) type of all endometrial cancers. The grades were classified into G1 (65.7%), G2 (17.1%), G3 (12.6%) and unknown (4.5%). The FIGO surgical stage was also classified into stage I(75.7%), stage II (14.4%), stage III (9.0%), and stage IV (0.9%). All patients were treated by primary surgery and postoperative adjuvant therapy including radiation therapy (54.1%), chemotherapy (4.5%) was applied. The overall 5-year disease free survival rate (DFSR) was 86.5% and overall 5-year survival rate was 87.8%. The age (p=0.04), grade (p=0.04), myometrial invasion (p=0.047), FIGO surgical stage (p=0.0067), lymph node metastasis (p=0.0001), lymphovascular space invasion (p=0.01) and C-erb B2 (p=0.04) were significant prognostic factors by univariate analysis. CONCLUSION: The age, grade, myometrial invasion, FIGO surgical stage, lymph node metastasis, lymphovascular space invasion and C-erb B2 were significant prognostic factors of uterine endometrial cancer affecting survival of the patients.
Carcinoma, Endometrioid ; Disease-Free Survival ; Drug Therapy ; Endometrial Neoplasms* ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Survival Rate ; Uterine Hemorrhage

PURPOSE: The purpose was trying to clarify utility of allogenous bone graft on open type high tibial osteotomy, among the method of treatment of osteoarthritis with genu varum deformity. MATERIALS AND METHODS: Working with eight patients who have osteoarthritis with genu varum deformity, performed the open type high tibial osteotomy. and after transplanting allogenous bone graft, fixed using L-shaped plate. Before and after the operation, measured the degree of correction of genu varum through radiography of anterior and posterior of weigh load, understudied degree of union by testing bone histology during removal of implant, and evaluated functional factor as well as improvement of patients using Lysholm's knee score and HSS knee score. RESULTS: According to radiography of anterior and posterior of weigh load, the average of varus angle was 5.3 +/- 3.2 degrees before operation, the average of correction angle was 16.1 +/- 4.1 degrees after operation and the average of valgus angle was 10.7 +/- 4.3 degrees. By radiography of anterior and posterior of weigh load and lateral taken during the continual observation, complete bone union was seen. It got result that bone histology of transplanted part was composed of osteologic tissue and ratio of live bone and dead bone was 3.3:1, which live bone was 76.7 +/- 8% by image analyzer (Pro Plus(R) system) during the implant removal. The average of correction loss angle was 1.5 +/- 1.0 degrees After 15.3 months, average period of observation, average of Lysholm's score and HSS knee score were increased from 66.2 +/- 8.3 to 75.7 +/- 9.1 and from 55.2 +/- 9.0 to 79.0 +/- 7.5 respectively. CONCLUSION: The method that using a transplantation of allogenous bone graft on open type high tibial osteotomy, can be a fine surgical technique because it gains a perfect union, has an inconsiderable loss of correction angle and precision of correction angle, and can be contributed to the improvement of functional knee joint.
Congenital Abnormalities ; Genu Varum ; Humans ; Knee ; Knee Joint ; Osteoarthritis ; Osteotomy* ; Radiography ; Transplants*