The pancreatic pseudocyst as a sequela of pancreatitis or pancreatic trauma can occur at any site in the abdomen. Its detection seems to be increasing with modern imaging tools such as abdominal ultrasound or abdominal CT scanning. But recently, we experienced a case of a pseudocyst due to a ruptured pancreatic pseudocyst which was misdiagnosed as a simple hepatic cyst by abdominal ultrasonography or abdominal CT scan. A 12-year-old male presented with recurrent epigastric pain during the past 4 years. On the abdominal ultrasound and abdominal CT scan, there was an 8x7.5 cm sized sharply defined thin-walled cyst in the left lobe of the liver. First, percutaneous (cather) drainage guided by ultrasonography was done. An exploratory laparotomy was performed because of signs of hemoperitoneum. A 8x7.5 cm sized cyst was found at the left subhepatic space, which communicated with another smaller cystic lesion in the pancreatic head. Microscopic finding of the cyst showed infiltration of inflammatory cells and granulation tissue without ephithelial lined cells which is compatible to a pseudocyst. So we report this case with a review of literatures.
Abdomen ; Child ; Diagnostic Errors* ; Drainage ; Granulation Tissue ; Head ; Hemoperitoneum ; Humans ; Laparotomy ; Liver ; Male ; Pancreatic Pseudocyst* ; Pancreatitis ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Muscular Atrophy, Spinal* ; Spinal Muscular Atrophies of Childhood*

Various reconstructive surgery have been performed for repair of the patellar tendon defect due to direct trauma or infected open wound. But most surgical procedure need wide skin incision and soft tissue dissection, that result in joint stiffness or muscle weakness. We carried out two-stage reconstructive surgery used bone-patellar tendon-bone allograft and bioabsorbable interference screw for skin and patellar tendon defect due to repetitive debridment for infected wound management. The result was satisfactroy and the patient achieved nearly full return of knee motion and quadriceps strength.
Allografts* ; Humans ; Joints ; Knee ; Muscle Weakness ; Patellar Ligament* ; Skin* ; Wounds and Injuries

The pipeline(TM) embolization device (PED) is a braided, tubular, bimetallic endoluminal implant used for occlusion of intracranial aneurysms through flow disruption along the aneurysm neck. The authors report on two cases of giant internal carotid artery aneurysm treated with the PED. In the first case, an aneurysm measuring 26.4 mm was observed at the C3-C4 portion of the left internal carotid artery in a 64-year-old woman who underwent magnetic resonance imaging (MRI) for dizziness and diplopia. In the second case, MRI showed an aneurysm measuring 25 mm at the C4-C5 portion of the right internal carotid artery in a 39-year-old woman with right ptosis and diplopia. Each giant aneurysm was treated with deployment of a PED (3.75 mm diameter/20 mm length and 4.5 mm diameter/25 mm length, respectively). Nine months later, both cases showed complete radiological occlusion of the giant intracranial aneurysm and sac shrinkage. We suggest that use of the PED can be a therapeutic option for giant intracranial aneurysms.
Adult ; Aneurysm* ; Carotid Artery, Internal* ; Diplopia ; Dizziness ; Female ; Follow-Up Studies* ; Humans ; Intracranial Aneurysm ; Magnetic Resonance Imaging ; Middle Aged ; Neck

A 57-year-old man presented with weakness in both legs upon awakening after drinking. Magnetic resonance imaging (MRI) of the lumbar spine did not reveal any intraspinal abnormalities but MRI of the pelvis revealed lesions with abnormal intensities with heterogeneous contrast enhancement in both gluteal muscles. Serum creatine phosphokinase was markedly elevated. A diagnosis of lumbosacral plexopathy, complicating rhabdomyolysis was made. With supportive care he recovered well but mild weakness of the right ankle remained at 6 month-follow-up. Pelvic MRI is a helpful diagnostic tool in localizing rhabdomyolysis. Lumbosacral plexopathy should be included in the differential diagnosis of the such cases, presenting with sudden weakness of legs.
Ankle ; Creatine Kinase ; Diagnosis ; Diagnosis, Differential ; Drinking ; Humans ; Leg* ; Magnetic Resonance Imaging ; Middle Aged* ; Muscles ; Pelvis ; Rhabdomyolysis* ; Spine

Although the incidence of intracranial multiple aneurysms are not low, the occurrence of multiple aneurysms more than three developing on the ipsilateral carotid artery is quite rare. We present a patient with five aneurysms on the left internal carotid artery. Four aneurysms arising from the left internal carotid artery underwent microsurgical clipping and wrapping, and remnant superior hypophyseal artery aneurysm was treated by using coil embolization. Incidence and risk factors for management of multiple aneurysms were investigated with the literature review.
Aneurysm ; Arteries ; Carotid Arteries ; Carotid Artery, Internal ; Humans ; Incidence ; Risk Factors

BACKGROUND: It can be difficult to select an appropriate flap for various defects on the hand. Although defects of the hand usually must be covered with a skin flap, some defects require a flap with rich blood supply and adequate additive soft tissue volume. The authors present their experience with the anconeus muscle free flap in the reconstruction of various defects and the release of scar contractures of the hand. METHODS: Ten patients underwent reconstruction of the finger or release of the first web space using the anconeus muscle free flap from May 1998 to October 2013. Adequate bed preparations with thorough debridement or contracture release were performed. The entire anconeus muscle, located at the elbow superficially, was harvested, with the posterior recurrent interosseous artery as a pedicle. The defects were covered with a uniformly trimmed anconeus muscle free flap. Additional debulking of the flap and skin coverage using a split-thickness skin graft were performed 3 weeks after the first operation. RESULTS: The average flap size was 18.7 cm² (range, 13.5–30 cm²). All flaps survived without significant complications. Vein grafts for overcoming a short pedicle were necessary in 4 cases. CONCLUSIONS: The anconeus muscle free flap can be considered a reliable reconstructive option for small defects on the hand or contracture release of the web space, because it has relatively consistent anatomy, provides robust blood supply within the same operative field, and leads to no functional loss at the donor site.
Arteries ; Cicatrix ; Contracture ; Debridement ; Elbow ; Fingers ; Free Tissue Flaps* ; Hand* ; Humans ; Muscle, Skeletal ; Osteomyelitis ; Skin ; Tissue Donors ; Transplants ; Veins

BACKGROUND: It can be difficult to select an appropriate flap for various defects on the hand. Although defects of the hand usually must be covered with a skin flap, some defects require a flap with rich blood supply and adequate additive soft tissue volume. The authors present their experience with the anconeus muscle free flap in the reconstruction of various defects and the release of scar contractures of the hand. METHODS: Ten patients underwent reconstruction of the finger or release of the first web space using the anconeus muscle free flap from May 1998 to October 2013. Adequate bed preparations with thorough debridement or contracture release were performed. The entire anconeus muscle, located at the elbow superficially, was harvested, with the posterior recurrent interosseous artery as a pedicle. The defects were covered with a uniformly trimmed anconeus muscle free flap. Additional debulking of the flap and skin coverage using a split-thickness skin graft were performed 3 weeks after the first operation. RESULTS: The average flap size was 18.7 cm² (range, 13.5–30 cm²). All flaps survived without significant complications. Vein grafts for overcoming a short pedicle were necessary in 4 cases. CONCLUSIONS: The anconeus muscle free flap can be considered a reliable reconstructive option for small defects on the hand or contracture release of the web space, because it has relatively consistent anatomy, provides robust blood supply within the same operative field, and leads to no functional loss at the donor site.
Arteries ; Cicatrix ; Contracture ; Debridement ; Elbow ; Fingers ; Free Tissue Flaps* ; Hand* ; Humans ; Muscle, Skeletal ; Osteomyelitis ; Skin ; Tissue Donors ; Transplants ; Veins

Myxofibrosarcoma is also known as a myxoid variant of malignant fibrous histiocytoma, and this is one of the most common sarcomas in the extremities of elderly people; it is characterized by a high frequency of local recurrence. We herein report on a case of myxofibrosarcoma of the bladder. A 58-year-old man was referred to our hospital because of microscopic hematuria. Computed tomography(CT) and intravenous pyelography(IVP) showed a 12x7cm sized bladder mass in the pelvic cavity. The cystoscopic finding shows a protruding mass at the dome and posterior wall of the bladder. After exploratory laparotomy and tissue frozen biopsy were done, radical cystectomy and uretero-ileo-cutaneous anastomosis were then carried out. The diagnosis of the tumor was confirmed by histopathological examination. The myxofibrosarcoma of the bladder was completely excised, and there was no evidence of recurrence after 10 months of follow-up.
Male ; Humans ; Biopsy

BACKGROUND AND OBJECTIVES: The purposes of this study was to investigate the characteristics of gentamicin-induced vestibulotoxicity of s otolith organs by assessing the results of earth vertical and the off-vertical axis rotation tests with a morphologic study. MATERIALS AND METHODS: Rabbits were grouped into two groups, ototoxic and ototoxic prevention group. Vestibulotoxicity was induced by injecting gentamicin (GM) into the peritoneum. Prevention of the vestibulotoxicity was studied by injecting NMDA receptor inhibitors (MK-801), iron chelating agents (deferoxamine) peritonially, and osmotic pumps filled with neurotrophic factors (GDNF, BDNF), respectively. The animal rotation system was designed to rotate the animal sinusoidally or in velocity step (constant velocity) rotation. Off-vertical rotation was applied to evaluate the otolithic function. Scanning electron microscopy were examined for the structural changes of the otolithic organs. RESULTS AND CONCLUSIONS: GM-induced vestibulotoxicity was confirmed by gain decreasing in the earth vertical SHA rotation test and bias decreasing in the off-vertical rotation test. However, changes in modulation was not definite. Bilateral prevention of GM-induced vestibulotoxicity was confirmed by systemic injection of deferoxamine and MK-801, and characteristics of unilateral prevention was confirmed by local application of the neurotrophic factors using osmotic pumps. In the SEM study, the GM-induced hair cell damages of the vestibule were identified, which was prevented by the preventive drugs. The reduction of bias value without change of modulation was comparable with the reduction of gain in the earth vertical axis rotation after GM-induced vestibulotoxicity.
Rabbits ; Animals ; Drug Toxicity