PURPOSE: To analyze the variable MRI features and clinical significance of intracranial cavernous realformation. MATERIALS AND METHODS: Forty patients(mean age 35.4) with cavernous malformation were evaluated by MRI. Eleven patients were surgically confirmed. Cavernous malformations were divided into four categories on the basis of the MR imaging characteristics, especially on T2-weighted image. Type I lesion was defined as an extralesional subacute hemorrhage outside the low signal rim, type II as an intralesional hemorrhage surrounded by low signal rim, type III lesion as an intralesional thrombosis with variegated central core surrounded by low signal rim, and type IV lesion as a focal old hemorrhagic core with small low signal intensity. Type IV was further divided into IVa and IVb, whether the lesion has small iso- or hypersignal central core (IVa) or not (IVb). Follow-up MRI was evaluated in 12 patients who were managed conservatively. Follow-up intervals ranged from 2 weeks to 29 months (mean 6months). RESULTS: Total 80 lesions were detected in 40 patients. Multiple lesions were noted in 10 patients. The topography of the cavernous malformations was supratentorial in 75% and infratentorial in 23%. There were 10 lesions in type I, 15 in type 11, 21 in type III, 14 in type IVa, and 20 in type IVb. Type I lesions mainly showed mass effect and edema. Type III lesions showed minimal contrast enhancements in 7 lesions on delayed images. Type II lesions showed the characteristics of both type I and type III lesions. On follow up images, decrease in size in 5, change of type in 7, rebleeding in 2 and no change in 12 lesions were demonstrated. Hemorrhage, edema and mass effect were combined in the cases of rebleeding. On follow-up study, the estimated risk of bleeding was 32.3%/person-year and 13.7%/lesion-year. CONCLUSION: Cavernous realformations show as variable appearance, on MR imaging suggesting variable stages of evolution. The MR morphologic classification and evaluation of secondary findings are helpful to predict natural course and possibility of rebleeding of the lesion.
Classification ; Edema ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Thrombosis

It is well known that metastatic bone tumor is very rare below knee and elbow joint. Recently, we experienced two cases of metastatic tumor from kidney and lung to the tibia at Koryo General Hospital.
Elbow Joint ; Hospitals, General ; Kidney ; Knee ; Lung ; Tibia

No abstract available.
Ectromelia*

The effect of a secretory proteinase from the pathogenic amoebae Acanthamoeba castellanii on hosts defense-oriented or regulatory proteins such as immunoglobulins, interleukin-1, and protease inhibitors was investigated. The enzyme was found to degrade secretory immunoglobulin A (sIgA), IgG, and IgM. It also degraded interleukin-1alpha (IL-1alpha) and IL-1beta. Its activity was not inhibited by endogenous protease inhibitors, such as alpha2-macroglobulin, alpha1-trypsin inhibitor, and alpha2-antiplasmin. Furthermore, the enzyme rapidly degraded those endogenous protease inhibitors as well. The degradation of hosts defense-oriented or regulatory proteins by the Acanthamoeba proteinase suggested that the enzyme might be an important virulence factor in the pathogenesis of Acanthamoeba infection.
Acanthamoeba/*enzymology/pathogenicity ; Animals ; Endopeptidases/*physiology ; Immunoglobulins/*metabolism ; Interleukin-1/*metabolism ; Protease Inhibitors/*metabolism ; Support, Non-U.S. Gov't ; Virulence

The acromioclavicular and coracoclavicular ligament are usually injured by traffic accident or during sports. So, various methods of treatment has been introduced. Fourty four cases of acromioclaviclar and coracoclavicular ligament injuries were admitted and treated at Koryo General Hospital from March 1985 to February 1989. 26 cases were treated by operative method, 18 cases by conservative method in Grade 1, 2 and 3 injuries. The following results were obtained. 1. These injuries were more prevalent in male and more in left side. 2. The most common cause of injuries was traffic accident. 3. Among 44 cases, 13 cases were Grade 1, 9 cases Grade 2 and 22 cases Grade 3 by Allman's classification. 4. 18 cases were treated conservatively and 26 cases operatively. Conservatively treated 18 cases include 15 cases by Kenny-Howard sling and 3 cases by skillful neglect. And operatively treated 25 cases include 12 cases by modified Phemister method(46.2%), 2 cases by modified Bosworth method(7.7%), 2 cases by acromioclavicular plate method(7.7%), 2 cases by Stewart method(7.7%) and one case by Mumford method(3.8%). 5. There were good functional results with the K-wire fixation method after the acurate diagnosis by operative method in the Grade 2 injury. And in the Grade 3 injury we could get the functional results with the modified Phemister method.
Accidents, Traffic ; Classification ; Diagnosis ; Hospitals, General ; Humans ; Ligaments ; Male ; Methods ; Sports

No abstract available.

Toxocariasis is a zoonotic disease caused by ingesting eggs from soil contaminated with Toxocara canis and Fasciola hepatica, commonly found in feces of infected dogs and cats, leading to a range of clinical symptoms including fever, abdominal pain and gastrointestinal manifestations. Fascioliasis is also a zoonotic disease caused by liver flukes Fasciola hepatica and Fasciola gigantica, which can be contracted through consumption of contaminated water or aquatic plants, leading to various clinical features. Here, we report a case of a 39-yearold woman diagnosed with a liver abscess caused by co-infection of T. canis and F. hepatica, as confirmed by serological tests. Although the existence of a pet dog and an experience of eating raw water dropwort are potential clues for diagnosis, it cannot be determined as the source of infection because the source of infection has not been clearly identified. After administrating albendazole and triclabendazole sequentially, the patient showed improvement in blood test and imaging findings. Clinicians should be aware of parasitic coinfection and take appropriate management.

No abstract available.
Adult* ; Humans ; Liver* ; Rhabdoid Tumor*

BACKGROUND/AIMS: Intrahepatic cholangiocarcinoma, which has been defined as a primary adenocarcinoma from the intrahepatic bile ducts distal to the second-order branch of the main hepatic ducts, has a poor prognosis against various treatment modalities. We analyzed the clinical characteristics of intrahepatic cholangiocarcinomas and evaluated the outcomes of surgical treatment. METHODS: Forty five cases of microscopically-proven intrahepatic cholangiocarcinoma during 8 and a half year period from January 1993 to june 2001 were reviewed. RESULTS: They comprised 29 men and 16 women with an average age of 54.3 years (range: 34 to 76 years). The overall incidence of intrahepatic cholangiocarcinoma in association with hepatolithiasis was 4~% and in this sutdy 17 out of 45 cases (37.8%) of intrahepatic cholangiocarcinoma was combined with intrahepatic stones. The incidence of accurate preoperative diagnosis was 56% due to low index of suspicion. The growth pattern of intrahepatic cholangiocarcinoma was mass-forming type in 32 cases, periductal infiltrative type in 9 cases, and intraductal growth type in 4 cases. CONCLUSION: Careful preoperative evaluation using computed tomography, ultrasonography, and angiography and a study of tumor markers for the possibility of a intrahepatic cholangiocarcinoma is necessary in risk groups with hepatolithiasis or clonorchiasis. Hepatric resection should be used in hepatolithiasis patients to improve the chance of survival.
Adenocarcinoma ; Angiography ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma* ; Clonorchiasis ; Diagnosis ; Female ; Hepatic Duct, Common ; Humans ; Incidence ; Male ; Prognosis ; Biomarkers, Tumor ; Ultrasonography

To date, there are limited data and little consensus on treatment strategies for huge hepatocellular carcinoma (HCC). Surgical resection provides significantly better survival than other modalities for single large HCC regardless of tumor stage. Recently, with technological advances in radiation therapy, stereotactic body radiation therapy (SBRT) is considered an alternative treatment option for HCC. Herein, we present a case of huge HCC that was successfully managed by SBRT. Transarterial embolization, previously performed in Russia, was incomplete. It was also not suitable for resection and transarterial chemoembolization. Although the rationale for radiotherapy in huge HCC was insufficient, SBRT was performed because no other treatment options were available. Additional radiofrequency ablation was performed for small HCC in a different segment, and radiological complete response (CR) was achieved. The CR was maintained over 4 years. Therefore, SBRT may be an alternative treatment option for large HCC that is not suitable for curative treatment.