Persistent sciatic artery (PSA) is a continuation of the internal iliac artery into the popliteal-tibial vessels and this structure provides the major blood supply to the lower limb bud during early embyrologic development, Its remnants participate in the formation of the inferior gluteal, deep femoral, popliteal, peroneal and pedal vessels. When the femoral artery develops, the PSA then involutes. In rare circumstances it persists and so provides the only major blood supply to the lower limb. The PSA was first reported by Green in 1832 and until now, only about 100 cases have been reported in the world literatures. This rare vascular anomaly is associated with aneurysmal formation in 15% to 46% of cases and it has a bilateral location in 22% of PSA cases. In more than 40% of cases, PSA is asymptomatic. When present, such non-specific symptoms as gluteal pain and painful buttock mass are presented. However, the most frequent clinical finding is lower limb ischemia because in 25% of such cases, the presented symptoms are limb threatening. We describe here the case of a 54 year-old female affected with PSA occlusion, and she was treated with a combination of thrombolysis and thromboembolectomy.
Aneurysm ; Arteries* ; Buttocks ; Extremities ; Female ; Femoral Artery ; Humans ; Iliac Artery ; Ischemia ; Lower Extremity ; Middle Aged

Alveolar Process ; Alveolar Ridge Augmentation ; Bone Regeneration ; Latency Period (Psychology) ; Osteogenesis, Distraction ; Osteotomy ; Prosthodontics

Takayasu's arteritis(TA) is a nonspecific areritis of unknown etiology affecting segmentally the aorta and its main branches, which result in stenosis, occlusion or aneurysm of involved arteries. The clinical manifestations present with a variety of symptoms such as headache, dyspnea on exertion, pain and weakness of extremities, pulse deficit, and hypertension according to involves arteries. Usually it can be managed by medical or surgical treatment, and recently by percutaneous transluminal balloon angioplasty. The type III classified by Lupi-Herrena and associates is the most frequent variety of TA. However the case of type III involving both subclavin arteries and both renal arteries has rarely been reported. We experienced a case of TA involving both subcalvian arteries, and both renal arteries presented with paroxysmal hypertension and right flank pain, in which the stenosis of both subclavian arteries were managed by percutaneous transluminal balloon angioplasty and the stenosis and occlusion of both renal arteries were successfully managed by aorto-renal bypass surgery with autogenous right iliac artery and synthetic vessel(Gortex). The patient was discharged uneventfully.
Aneurysm ; Angioplasty, Balloon ; Aorta ; Arteries* ; Constriction, Pathologic* ; Dyspnea ; Extremities ; Flank Pain ; Headache ; Humans ; Hypertension ; Iliac Artery ; Renal Artery* ; Subclavian Artery ; Takayasu Arteritis*

Castleman's disease is a benign disorder characterized by hypervascular lymphoid hyperplasia. The etiology of the disease is still unknown. Although it may occur at the various sites such as peritoneum, retroperitoneum, pelvic lymph node, muscle and lung, it occurs most commonly at the mediastinum. Even though specific pathophysiologic relations are still not clearly determined between two different histologic types -hyaline vascular type and plasma cell type-, there were several previous reports dealing with the plasma cell type transformed or progressed into different types of malignancies such as malignant lymphoma, Kaposi's sarcoma and Hodgkin's disease. We experienced a case of plasma cell type Castleman's disease that transformed into a malignant lymphoma and report this case with review of literatures.
Giant Lymph Node Hyperplasia* ; Hodgkin Disease ; Hyperplasia ; Lung ; Lymph Nodes ; Lymphoma* ; Mediastinum ; Peritoneum ; Plasma Cells* ; Plasma* ; Sarcoma, Kaposi

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

Recurrent bacterial meningitis can be caused by acquired or congenital anatomic defects, infection, or alterations in immune mechanism. Intracranial anatomical defects possibly combined with trauma can be the major cause of recurrent bacterial meningitis. Mucocele is a chronic, expansile and cyst-like lesion of the paranasal sinuses, most frequently found in the frontal sinus containing sterile mucoid secretions. Secondary infection of a mucocele may create a pyocele. Although pathogenesis of a primary mucoceles remains uncertain, causatives factors of secondary mucoceles have been suggested to include chronic inflammation, trauma, allergy and obstructing tumors. We experienced a case of recurrent bacterial meningitis with frontal sinus mucocele, which might be secondary to cranial trauma.
Coinfection ; Frontal Sinus ; Hypersensitivity ; Inflammation ; Meningitis, Bacterial* ; Mucocele* ; Paranasal Sinuses

BACKGROUND: Means to measure death anxiety, death depression and sense of symbolic immortality with approved validity and reliability does not yet exist in Korea. METHODS: Existing English questionnaires such as Templer Death Anxiety Scale (TDAS), Death Depression Scale (DDS), Sense of Symbolic Immortaligy Scale (SSIS) were translated into Korean by 5 translators, and then reviewed by 3 non-participants of translation for collegial summary and this summary was counter-translated again by another 2 non-participants. Another 3 non-participants of translation and counter-translation were chosen to examine the two sentences of each item. Then reexamination was done by retranslating and counter-translating the parts with errors. Aftr pretest on ordinary people. the completed questionnaires were given to medical students, residents and nurses of a university hospital. Pastors and missionaries were selected as comparison group. RESULTS: Kuder-Richardson or Cronbach-alpha that represent internal consistency of TDAS, DDS and SSIs was 0.69, 0.84 and 0.78. The three sentences that lowered internal consistency of SSIS was deleted. BDI and DDS showed a positive correlation (0.32, P=0.02), suggesting proved construct validity. Correlation coefficient that proves construct validity of TDAS and DDS was 0.54 (P<0.01), of SSIS and TDAS -0.23(P=0.04), of SSIS and DDS -0.29(P=0.01). The TDAS and DDS(P<0.01), DDS and BDI(P=0.02) have shown a positive correlation were shown. There was significant difference in the score of SSIS(P<0.01). The same results in cases where the 3 sentences was deleted. CONCLUSION: Korean versions of TDAS, DDS and SSIS were reliable and valid.
Anxiety* ; Attitude to Death ; Depression* ; Humans ; Korea ; Missions and Missionaries ; Reproducibility of Results* ; Students, Medical ; Surveys and Questionnaires

PURPOSE: To evaluate tear eosinophil cationic protein (ECP) as a severity marker for atopic keratoconjunctivitis (AKC) and seasonal/perennial allergic conjunctivitis (SAC/PAC). METHODS: Tear ECP levels were measured by chemiluminescent immunometric assay in 7 eyes of 7 patients with AKC, 13 eyes of 13 patients with SAC/PAC, and 10 eyes of 10 healthy control subjects. All AKC and SAC/PAC patients underwent conjunctival injection and papillary formation grading. Tear ECP levels were investigated with reference to the clinical parameters of allergic conjunctivitis (papillary formation and conjunctival injection scoring). RESULTS: Tear ECP levels in patients with AKC were significantly higher than those in patients with SAC/PAC and in control subjects (p = 0.012 and p = 0.003, respectively). The number of patients with papillary formation scores of 2-3 was significantly higher in the AKC group than in the SAC/PAC group (p = 0.016). The number of patients with conjunctival injection scores of 2-3 did not significantly differ between the AKC and SAC/PAC groups (p = 0.128). All AKC patients obtained papillary formation scores of 2-3, and tear ECP levels in patients with conjunctival injection scores of 2-3 were significantly higher than in patients with scores of 0-1 in the AKC group (p < 0.001). In the SAC/PAC group, tear ECP levels in patients with papillary formation scores of 2-3 were significantly higher than in patients with scores of 0-1 (p = 0.046). CONCLUSIONS: This study suggests that tear ECP was a useful marker to diagnose and assess the severity of disease in patients with AKC as well as SAC/PAC. It would be useful to monitor therapeutic outcome in allergic conjunctivitis.
Conjunctivitis, Allergic ; Eosinophil Cationic Protein* ; Humans ; Keratoconjunctivitis*

Abdominal Pain ; Acidosis ; Child ; Child, Preschool ; Diagnosis ; Diethylpropion ; Humans ; Hyperammonemia ; Inpatients ; Metabolic Diseases ; Methylmalonyl-CoA Decarboxylase ; Molecular Biology ; Muscle Hypotonia ; Pancreatitis ; Parenteral Nutrition, Total ; Propionic Acidemia ; Seizures ; Shock ; Vomiting

Adult ; Air Pressure ; Humans ; Nasal Cavity ; Velopharyngeal Insufficiency