No abstract available.
Down Syndrome* ; Humans ; Mothers*

Cavernous hemangioma in the gastrointestinal tract is a rare benign vascular lesion, which can produce massive or persistent blood loss. Herein, we present two cases of gastrointestinal hemangiomas that could not be resected completely and were treated with estrogen because of multiple involvement of the gastrointestinal tract and viscera, including the anal canal. A 49-year-old male presented with unknown chronic melena and anemia. Preoperative work-up could not reveal the definite cause of bleeding. During exploration, hemangioma scattered in whole small bowel was identified and feeding vessel ligation was performed. Postoperative recurrent bleedings were controlled by additional estrogen therapy. A 25-year-old young woman had suffered from painless anal bleeding with subsequent anemia since her youth. She had diffuse carvernous hemangioma in the large intestine involving the anal canal and uterus. Total proctocolectomy and ileal-pouch anal anastomosis was performed, however the uterine hemangioma was left intact because the patient wanted to be pregnant. She was also treated with estrogen, postoperatively. It is suggested that estrogen may be a good alternative treatment modality for gastrointestinal hemangioma that can not be removed completely.
Adolescent ; Adult ; Anal Canal ; Anemia ; Estrogens ; Female ; Gastrointestinal Tract ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Intestine, Large ; Ligation ; Male ; Melena ; Middle Aged ; Uterus ; Viscera

Objectives : 201Tl - chloride, 99mTc - MIBI, 99mTc(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we performed three consecutive SPECT using 201Tl, 99mTc - MIBI, 99mTc(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods : SPECT was carried out at 10min and 3hr for 201Tl after injection of 2 mCi, and 2hr for 99mTc - MIBI and 99mTc(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - bakground(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for 201Tl. Results : The diagnostic sensitivity of 201Tl, 99mTc - MIBI and 99mTc(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer Conclusion : 201Tl and 99mTc - MIBI showed higher sensitivity than 99mTc(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.
Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Succimer* ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis, Pulmonary

Objectives : 201Tl - chloride, 99mTc - MIBI, 99mTc(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we performed three consecutive SPECT using 201Tl, 99mTc - MIBI, 99mTc(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods : SPECT was carried out at 10min and 3hr for 201Tl after injection of 2 mCi, and 2hr for 99mTc - MIBI and 99mTc(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - bakground(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for 201Tl. Results : The diagnostic sensitivity of 201Tl, 99mTc - MIBI and 99mTc(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer Conclusion : 201Tl and 99mTc - MIBI showed higher sensitivity than 99mTc(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.
Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Succimer* ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis, Pulmonary

Brain tumors represent a diverse spectrum of histology, biology, prognosis, and treatment options. Although MRI remains the gold standard for morphological tumor characterization, positron emission tomography (PET) can play a critical role in evaluating disease status. This article focuses on the use of PET with radiolabeled glucose and amino acid analogs to aid in the diagnosis of tumors and differentiate between recurrent tumors and radiation necrosis. The most widely used tracer is ¹⁸F-fluorodeoxyglucose (FDG). Although the intensity of FDG uptake is clearly associated with tumor grade, the exact role of FDG PET imaging remains debatable. Additionally, high uptake of FDG in normal grey matter limits its use in some low-grade tumors that may not be visualized. Because of their potential to overcome the limitation of FDG PET of brain tumors, 11C-methionine and ¹⁸F-3,4-dihydroxyphenylalanine (FDOPA) have been proposed. Low accumulation of amino acid tracers in normal brains allows the detection of low-grade gliomas and facilitates more precise tumor delineation. These amino acid tracers have higher sensitivity and specificity for detecting brain tumors and differentiating recurrent tumors from post-therapeutic changes. FDG and amino acid tracers may be complementary, and both may be required for assessment of an individual patient. Additional tracers for brain tumor imaging are currently under development. Combinations of different tracers might provide more in-depth information about tumor characteristics, and current limitations may thus be overcome in the near future. PET with various tracers including FDG, ¹¹C-methionine, and FDOPA has improved the management of patients with brain tumors. To evaluate the exact value of PET, however, additional prospective large sample studies are needed.
Biology ; Brain Neoplasms* ; Brain* ; Diagnosis ; Electrons* ; Glioma ; Glucose ; Gray Matter ; Humans ; Magnetic Resonance Imaging ; Necrosis ; Positron-Emission Tomography* ; Prognosis ; Prospective Studies ; Radiopharmaceuticals* ; Sensitivity and Specificity

Postoperative gas-forming bacterial infection is very rare. However, it can be a life threatening problem if not properly addressed. Authors treated a patient who was infected with gas forming Escherichia coli after both knee arthroplasty with incision and drainage, as well as arthroscopic synovectomy and antibiotics. Herein, we report a case of postoperative gas-forming bacterial infection with literature review.
Anti-Bacterial Agents ; Arthroplasty, Replacement, Knee* ; Bacterial Infections* ; Drainage ; Escherichia coli ; Humans

BACKGROUND: There is no accepted landmark for the mechanical axis of the femoral axis in sagittal plane in conventional total knee arthroplasty. METHODS: As palpable anatomic landmarks of the femur, lateral epicondyle, and anterior margin of the greater trochanter were identified. The line connecting these two landmarks was defined as the "palpable sagittal axis". The mechanical axis of the femur was compared with the palpable sagittal axis and the distal femoral anterior cortex axis. These axes were also compared with sagittal bowing of the femur. RESULTS: The distal femoral anterior cortex axis and the palpable sagittal axis were flexed by 4.1degrees and 2.4degrees more than the sagittal mechanical axes, respectively (p < 0.05). However, the palpable sagittal axis was not correlated with sagittal bowing of the femur (Spearman's rs, 0.17; p = 0.14). CONCLUSIONS: The palpable sagittal axis showed a consistent relationship with the sagittal mechanical femoral axes regardless of the severity of the sagittal bowing of the femur.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*methods ; Biomechanics ; Female ; Femur/anatomy & histology/*surgery ; Humans ; Knee Joint/anatomy & histology/surgery ; Male ; Middle Aged

While it is reasonably well known that certain dental procedures increase the temperature of the tooth's surface, of greater interest is their potential damaging effect on the pulp and tooth-supporting tissues. Previous studies have investigated the responses of the pulp, periodontal ligament, and alveolar bone to thermal irritation and the temperature at which thermal damage is initiated. There are also many in vitro studies that have measured the temperature increase of the pulp and tooth-supporting tissues during restorative and endodontic procedures. This review article provides an overview of studies measuring temperature increases in tooth structures during several restorative and endodontic procedures, and proposes clinical guidelines for reducing potential thermal hazards to the pulp and supporting tissues.
Periodontal Ligament ; Root Canal Obturation ; Tooth ; Tooth Preparation ; Ultrasonics

Familial adenomatous polyposis (FAP) is an inherited autosomal dominant syndrome caused by germ-line mutations of the adenomatous polyposis coli (APC) gene. Clinical diagnosis of familial adenomatous polyposis is usually based on the presence of >100 colonic adenomas, which, if left untreated, progress to colorectal cancer, typically at age under 40 years. Attenuated adenomatous polyposis coli is a variant of familial adenomatous polyposis and also has been described as "hereditary flat adenoma syndrome". Attenuated adenomatous polyposis coli is recognized by the occurrence of <100 (> or =5 or > or =10) colonic adenomas. It is tend to be located proximal to splenic flexure and a later onset of colorectal carcinoma than familial adenomatous polyposis. PURPOSE: This study was performed to analyze the clinicopathologic features of suspicious attenuated adenomatous polyposis coli, to document the occurrence of colorectal carcinoma, and to assess the definition of attenuated adenomatous polyposis coli. METHODS: From June 1989 to June 1998, we reviewed 773 cases of colonic adenomas and compared with three groups (Group I, II, III) at Asan Medical Center. Median follow-up period was 16.4 months (range, 1 to 102 months). RESULTS: The incidence of suspicious attenuated adenomatous polyposis coli (Group II) was 4.9%. The most common symptom was anal bleeding (36.9%). Median size and number of adenomas were 1.0 cm (0.2 to 7.5 cm), 2 (1 to 43), respectively.Location of adenoma was prevalent at right colon in Group II (P<0.05). In respect to the occurrence of carcinoma in situ (CIS), it was more frequently presented in Group II (13.5%) and Group III (13.6%) whereas 4.1% in Group I (P<0.05). Recurrence rates within 12 months after polypectomy or surgery in Group II was 13.5% whereas 5.6% in Group I (P<0.05). CONCLUSIONS: Histopathology revealed suspicious attenuated adenomatous polyposis coli with villous component to be relatively correlated with occurrence of colorectal carcinoma. In suspicious attenuated adenomatous polyposis coli (Group II), the interval of the recurrence of the polyps was shorter than the control group with right colonic predominancy. These findings might be associated with genetic codominance of APC gene or other mutator genes.
Adenoma ; Adenomatous Polyposis Coli* ; Carcinoma in Situ ; Chungcheongnam-do ; Colon ; Colon, Transverse ; Colorectal Neoplasms ; Diagnosis ; Follow-Up Studies ; Genes, APC ; Germ-Line Mutation ; Hemorrhage ; Incidence ; Polyps ; Recurrence

Calves can be easily seen in daily life and are an important part of the body contour. Asymmetric calves can develop from unbalanced distribution and deposition of fat and muscles between the legs. Calf asymmetry may be due to congenital factors, disease (e.g., poliomyelitis, cerebral palsy, or infection), spinal cord injury, or the effects of surgical treatment and may have severe adverse psychological and social implications. Generally, an asymmetric calf is diagnosed when the difference of the longest circumference between both calves is more than 2 cm. Several surgical methods have been introduced for the correction of an asymmetric calf. Implant insertion or fat injection is used to augment a hypotrophic calf. Selective neurectomy, liposuction, muscle resection, radiofrequency, and botulinum toxin injection are used to treat a hypertrophic calf. With the development of microsurgery, the authors planned to use a latissimus dorsi musculocutaneous free flap (LDMC free flap) with silicone implant to add calf volume to obtain natural calf contour. The authors present the first successful case of correction of a severely asymmetric calf using an LDMC free flap and customized silicone implant.
Botulinum Toxins ; Cerebral Palsy ; Free Tissue Flaps* ; Leg ; Lipectomy ; Lower Extremity ; Microsurgery ; Muscles ; Poliomyelitis ; Silicones* ; Spinal Cord Injuries ; Superficial Back Muscles*