Traumatic diaphragmatic hernia may show a delayed presentation and it rarely simulates pleural effusion. We report here on two asymptomatic cases that were diagnosed by performing chest CT.
Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Omentum ; Pleural Effusion* ; Tomography, X-Ray Computed

OBJECTIVES: To evaluate characteristic computed tomography (CT) and magnetic resonance (MR) imaging findings of granulocytic sarcomas of the head and neck. METHODS: The CT (n=11) and MR (n=1) images obtained from 11 patients (7 males and 4 females; mean age, 23.5 yr; age range, 1 to 69 yr) with histologically-proven granulocytic sarcomas of the head and neck were retrospectively reviewed. Histological confirmation was done by bone marrow biopsy in 9 patients, and/or local biopsy in 4 patients. The imaging findings were analyzed with particular attention to location, size, shape, margin, bone destruction, internal architecture, pattern and degree of enhancement, and multiplicity of the lesions. RESULTS: The masses were most commonly located in the orbital cavity (n=8); other locations included lymph nodes (n=5) and palatine/pharyngeal/lingual tonsils (n=3). The mass sizes varied from a mean diameter of 1.3 to 5.8 cm (average, 2.6 cm). Multiple lesions were found in 6 patients. The shapes of the tumors were ovoid in 12 patients and irregular in 4 patients. Most lesions had poorly-defined margins (13/16) and invaded adjacent bony structures (5/16). On the pre-contrast CT images, the masses were iso- (5/8) or low-density (3/8) in comparison with muscle. The MRI, which was obtained in one patient in this study, showed that the mass was iso-signal intensity on T1-weighted images and iso-signal intensity on T2-weighted images compared to the gray matter of the brain. On the post-contrast CT images, there was homogenesous (n=12) or heterogeneous (n=4) enhancement, with mild (n=10), moderate (n=4), and marked (n=2) enhancement in the solid portions of the lesions. CONCLUSION: Although rare, granulocytic sarcomas arise in various locations in the head and neck area (most commonly in the orbit) in the form of well-demarcated, and mildly- and homogenously-enhancing masses with adjacent bony invasion.
Biopsy ; Bone Marrow ; Brain ; Head ; Humans ; Lymph Nodes ; Magnetic Resonance Spectroscopy ; Male ; Muscles ; Neck ; Orbit ; Palatine Tonsil ; Retrospective Studies ; Sarcoma, Myeloid

OBJECTIVE: Living donor liver transplantation is a surgical treatment which could impose a heavy burden on both the recipient and the potential donor. Preoperative psychological evaluation of the potential donor is essential in protecting one's psychosocial well-being, as well as one's autonomy. In this research, we examined the correlation between the preoperative psychological profile of the potential donor and one's postoperative pain and opioid analgesic usage. METHODS: Retrospective review of the medical records of all living donors who had completed preoperative psychological evaluation in our transplantation center from January, 2010 to December, 2011 was done. Preoperative psychological evaluation included Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Sentence Complete Test and an interview with a psychiatrist. Mean postoperative pain within 7 days after the surgery was evaluated. Dosages of all opioid analgesics were converted to equivalent dosage of morphine. RESULTS: Depression T-score showed a significant correlation with the duration of opioid analgesics usage (R2=0.306, F=12.363). Also, F score and dosage of opioid analgesics (R2=0.360, F=15.766), as well as Psychasthenia T- score and postoperative mean pain score (R2=0.137, F=4.448) showed significant correlation. CONCLUSION: Depression T-score, F score and Psychastenia T-score from MMPI-2 are well known to reflect one's depression, discontent, psychological instability and chronic anxiety. Such personalized and specified psychiatric intervention could help the donor to cope with post-surgical pain better.
Analgesics, Opioid ; Anxiety ; Depression ; Humans ; Liver ; Liver Transplantation ; Living Donors ; Medical Records ; Minnesota ; MMPI ; Pain, Postoperative ; Phosphatidylethanolamines ; Psychiatry ; Retrospective Studies ; Tissue Donors ; Transplants

Primary localized amyloidosis of the ureter and bladder is a very rare condition. CT and cystoscopic findings are indistinguishable from malignant neoplasm or inflammatory lesions. We report a case of unilateral distal ureteral thickening caused by primary localized amyloidosis. MR image features of hypointensity on T2-weighted images and mural enhancing pattern on contrast enhanced T1-weighted images can be helpful for diagnosis of ureteral amyloidosis.
Amyloidosis ; Ureter ; Urinary Bladder

BACKGROUND: Depression is common in chronic renal failure patients and usually associated with poor appetite. Malnutrition with poor appetite is known to be associated with increased mortality in chronic hemodialysis (HD) patients. So we evaluated the prevalence, risk factors of depression and effects of depression to nutritional status in chronic HD patients. METHODS: Sixty two HD patients (age 48.8+/-11.1 years, diabetes 29%) were investigated. Each patients were interviewed and completed the Beck depression inventory (BDI, 21 items, 0-3 point). To exclude the possible confounding effects of illness and treatment symptoms, cognitive depression index (CDI, a cognitive subset of 15 items selected from BDI) was used as a measure of depression. KT/V and nutritional parameters such as serum albumin, normalized protein catabolic rate (nPCR), subjective global assesment (SGA), body mass index (BMI), triceps skinfold thickness (TSF) and midarm muscle circumference (MAMC) were also measured. RESULTS: Corrected BDI score (CDI score multiplied by 21/15) was 24.9+/-12.7 and the prevalence of depression (corrected BDI score > or = 21) was 64.5%. DM patients had higher CDI score than non DM patient (22.9+/-7.2 vs 15.6+/-9.0). In univariate analysis, CDI score was correlated with age (r=0.39, p<0.01), serum albumin (r=-0.37, p<0.005), nPCR (r=-0.30, p<0.05), SGA (r=-0.42, p<0.05), BMI (r=-0.28, p<0.05), TSF (r=-0.41, p<0.05) and MAMC (r=-0.50, p<0.01). In multivariate analysis, CDI score was the strongest correlate of nPCR, SGA, BMI, TSF and MAMC. But KT/V, hematocrit, erythropoietin usage, plasma bicarbonate, serum parathyroid hormone, c-reactive protein concentration and HD duration had no relationship with CDI score. CONCLUSION: The prevalence of depression in chronic HD patients was high. Diabetes and old agewere important risk factors for depression. It was also concluded that severity of depression was correlated with markers of malnutrition and depression could be a independent risk factor of malnutrition in chronic HD patients.
Appetite ; Body Mass Index ; C-Reactive Protein ; Depression* ; Equidae ; Erythropoietin ; Hematocrit ; Humans ; Kidney Failure, Chronic ; Malnutrition ; Mortality ; Multivariate Analysis ; Neurobehavioral Manifestations ; Nutritional Status ; Parathyroid Hormone ; Plasma ; Prevalence ; Renal Dialysis* ; Risk Factors* ; Serum Albumin ; Skinfold Thickness