The authors experienced a case of orbital granular cell myoblastoma in a 22 year old female, which is extreamely rare. The tumor mass had grown since 6 years ago in her right orbit. On ocular examination, the right eye was proptosed and displaced out and upward. Extraocular movements showed slight limitation of adduction of the right eye. The computed tomographic scanning revealed well defined hypervascular mass density in the right orbit. The mass was removed by modifiedkronlein approach and histopathologic examination revealed it to have features typical of granular cell myoblastoma.
Female ; Granular Cell Tumor* ; Humans ; Orbit* ; Young Adult

The fibrovascular tissues surrounding a glaucoma implant have been found to play a major role for the orbital absorption of aqueous humor following a glaucoma implant surgery. An ultrasonographic study was performed to investigate the ultrasonographic, characteristics of the tissues and its relationship with the postoperative intraocular pressure(IOP) control. Twenty-three eyes of 23 patients had undergone the e-PTFE membrane-silicone tube implantation and had been followed up for at least 6-month(mean +/- SD, 17 +/- 8.8 months). An ultrasonographic study for these eyes included such paramneters as presence of an aqueous reservoir surrounding the implant, size(height) of the aqueous reservoir and echoreHectivity from the reservoir wall tissues. The aqueous reservoir was identified in 22(96%) of 23 eyes and had a height varying from 1.0 mm to 5.5 mm. In eyes with an aqueons reservoir. 3 mm high or more, the IOPs were all 21 mmHg or less without further glaucoma medications(p=0.040, chi-square). In one eye with an obliterated reservoir on ultrasonography, the opening of the silicone tube was found to be occluded toward the extrascleral portion of the implant when reoperation was performed. The echo reflections from reservoir wall tissues were denser and higher comparing with those from the sclera of the respective eye in 7 eyes with a complete failure of postoperative lOP control(>or=30 mmHg on maximum medical theraph). These eyes also had and irregular echoreflections within the aqueous reservoir, which reflect an invasion of proliferating tissues into the reservoir.
Absorption ; Aqueous Humor ; Glaucoma* ; Humans ; Orbit ; Reoperation ; Sclera ; Silicones ; Ultrasonography

The diagnosis of insulinoma is made primarily by the detection of an inappropriately elevated serum insulin level in the presence of a low blood glucose level. The successful resection of insulin-secreting islet cell turnors is greatly facilitated by accurate preoperative localization. But, the modalities of ultrasonography, computer tomography, magnetic resonance imaging and selective arteriography often fail to detect insulinoma smaller than 1.5 cm in diameter. In this report, we describe a patient with an insulinoma successfully localized by percutaneous transhepatic portal vein sampling but not by abdominal ultrasonography, computer tomography and selective arteriography. Percutaneous transhepatic portal vein catheterization with insulin sampling showed sudden step-up of insulin concentrations near 6 cm from distal splenic vein. During operation, a 1×1.3cm sized tumor was found at the junction of body and tail of pancreas, so distal pancreatectomy was performed, We propose that preoperative percutaneous transhepatic portal vein catheterization with measurement of radioimmunoactive insulin concentration is a safe and reliable method and plays an important role to localize insulinoma that are considered occult after conventional diagnostic studies have been negative.
Angiography ; Blood Glucose ; Catheterization ; Catheters ; Diagnosis ; Humans ; Insulin ; Insulinoma ; Islets of Langerhans ; Magnetic Resonance Imaging ; Methods ; Pancreas ; Pancreatectomy ; Portal Vein ; Splenic Vein ; Tail ; Ultrasonography

No abstract available.

The bronchopulmonary sequestration is a term used to describe an area of embryonic lung tissue supplied by an anomalous systemic artery. Two forms are recognised -extralobar and intralobar- with different clinical presentations. We have experienced a case of aspergillosis within an intralobar sequestration. The patient was 32 year-old female and had no specific complaints. The lung mass containing cystic lesion was found incidentally and confirmed to be intralobar sequestration on the operative field which showed aberrant artery in the inferior pulmonary ligament. The right lower lobectomy was done.
Adult ; Arteries ; Aspergillosis* ; Bronchopulmonary Sequestration ; Female ; Humans ; Ligaments ; Lung

Leber's hereditary optic atrophy is characterized by sudden loss of central vision occuringin the second and third decade of life and nondirect transmission with male preponderance, Leber disease affecting both eyes in different degree and not simultaneouly, showing in its. early stage hyperemia of optic disc followes by a secondary atrophy, which involves a serious permanent impairment of central vision. Recently, the auther have been experienced Leber hereditary optic atrophy in 30 years old mother and 12 years old son, with severe impaiarment of visual acuity and central scotoma in both eyes and had pallor on the discs. Clinical ophthalmoscopic, perimetric, color vision test and neurologic examination were performed in two persons.
Adult ; Atrophy ; Child ; Color Vision ; Humans ; Hyperemia ; Male ; Mothers* ; Neurologic Examination ; Optic Atrophy, Hereditary, Leber* ; Pallor ; Scotoma ; Visual Acuity

No abstract available.
Brain* ; Neoplasm Metastasis*

The deceased was a 6-month-old male infant who was transferred to the hospital due to jaundice and vomiting. During admission, subdural hemorrhage and retinal hemorrhage were observed; additionally, a rib fracture was identified on the previous radiography images, which had eventually healed by the time of the follow-up study. This case was reported to the police, alleging child abuse, which led to a medicolegal dispute between the hospital and the deceased's parents. In addition, bleeding tendency and coagulopathy related to vitamin K deficiency were also found. The past history revealed that the deceased had diarrhea, jaundice, and experienced several episodes of acholic stools, and low levels of vitamin D at birth. On postmortem examination, the brain already revealed liquefactive necrosis, but subdural hemorrhage was still observed. The optic nerves of both eyes revealed hemorrhage with focal retinal hemorrhage.No definite fracture was identified; however, osteopenia was observed in the long bones. The liver showed septal fibrosis and cholestasis which is nearly biliary cirrhosis, and mild dilation of the intrahepatic and extrahepatic bile ducts, suggesting a choledochal cyst. This case illustrates that subdural hemorrhage related to vitamin K deficiency could occur in an infant with a choledochal cyst.When subdural hemorrhage is encountered in a child with what is considered an intentional head injury, the possibility of spontaneous hemorrhage should be excluded.

No abstract available.
Spondylolysis*

Arthroscopic synovectomy has some limitations for adequate posterior visualization, and it is difficult to establish the posterior portal because of potential damage to neurovascular structures. The purpose of this study is to introduce a newly designed arthroscopic technique passing through posterior septum and to review the arthroscopic synovectomy using transposterior septal portal in the knee. Routine arthroscopic examination of the knee joint is performed using standard anterolateral and anteromedial portals. Posterior arthroscopic technique is divided into four steps. The first step is to make a posteromedial portal. The second step is to make a posterolateral portal. The third step is to make a hole at the posterior septum and to examine the posterolateral compartment. The fourth step is to examine the posteromedial compartment by switching the arthroscope to the posterolateral portal in the same manner. This technique provides complete visualization of the posterior compartment of the knee joint including the posterior aspect of the medial and lateral femoral condyles, posterior horn of both menisci, the posterior cruciate ligament(PCL), the meniscofemoral ligament, posterior aspect of the popliteal tendon, and the posterior capsule. We reviewed 47 cases(of 43 patients) of arthroscopic synovectomy using anterolateral, anteromedial and transposterior septal portal. The results were assessed with follow up of at least 1 year using the criteria of pain, synovitis, effusion, and range of motion. In 15 case rheumatoid arthritis, we had good result in 14 cases, but 1 case of recurrence was noted at 2 months after surgery. Non specific synovitis, 11 cases, had the similar result of rheumatoid arthritis. In 9 cases with hemophilic arthritis, pain and effusion were improved, but range of motion was improved minimally. In 2 cases with gouty arthritis, 2 cases with tuberculous arthritis, and I case with pigmented villonodular synovitis(PVNS), range of motion was rather reduced. It is considered that arthroscopic technique using transposterior septal portal is safe procedure without damaging the PCL, posterior capsule, neurovascular structures, and very efficient method in removing hypertrophied synovium or debris of persistent synovitis or arthritis of the knee joint and helpful in removing encapsulated loose bodies located behind the PCL.
Animals ; Arthritis ; Arthritis, Gouty ; Arthritis, Rheumatoid ; Arthroscopes ; Arthroscopy ; Follow-Up Studies ; Horns ; Knee ; Knee Joint ; Ligaments ; Range of Motion, Articular ; Recurrence ; Synovial Membrane ; Synovitis ; Tendons