Descending necrotizing mediastinitis (DNM) is one of the most lethal form of mediastinitis originating from an oropharyngeal infection. It requires an early and aggressive sugical treatment, but the operative approach and optimal form of mediastinal drainage remains controversial. We report a case of DNM in a 45-year-old male who underwent right cervicomediastinotomy to drain the deep neck space, upper mediastinum and anterior mediastinal drainage was accomplished through a subxiphoid approach. After this procedure, he steadily improved and was dischrged on hospital day 36. We report this case with a brief review of the literature.
Drainage ; Humans ; Male ; Mediastinitis* ; Mediastinum ; Middle Aged ; Neck

BACKGROUND: Our study aimed to make a comparative analysis of clinical outcomes of arthroscopic decompression for rotator cuff calcific tendinitis by location of calcific deposits and by its size. METHODS: We enrolled a total of 38 patients, comprising 39 affected shoulders, who underwent arthroscopic decompression for calcific tendinitis. As our clinical scores, we evaluated the UCLA, the ASES, and the VAS scores and analyzed them by calcific location, by calcific deposit size, by the presence or absence of calcific remnants, and by whether concomitant cuff repair was performed. RESULTS: The clinical scores of those whose calcific deposit had an area greater than 77.0 mm2 and of those whose calcific deposit had an area smaller than 77.0 mm2 did not significantly differ (p=0.21 in ASES; p=0.19 in UCLA; p=0.17 in VAS). Nor did the clinical scores significantly differ with respect to the location of calcification (p=0.23). Further, the clinical scores did not significantly differ between those who had calcific remnants and those who did not and between those who received additional cuff repair and those who did not. CONCLUSIONS: We found that the clinical outcomes after arthroscopic decompression of calcific tendinitis were not significantly associated with the cuff tendon in which the calcium deposits are found; the location of the calcium deposits in the supraspinatus tendon (if found in this tendon); the size of calcific deposits; the presence of calcific remnants; and concomitant cuff repairs.
Calcium ; Decompression ; Humans ; Rotator Cuff ; Shoulder* ; Tendinopathy* ; Tendons

Necrotizing colitis associated with carcinoma of the colon, Known also as obstructive colitis, is a disordercharacterized by anulceration and inflammation of the colon proximal to an obstructive lesion, especiallycarcinoma of the rectosigmoid colon, and in rare instances, leads to actual gangrene of the colon. The authorsanalysed radiologic findings in four cases of necrotizing colitis associated with carcinoma of the colon. Bariumenema disclosed mucosal edema, nodular filling defects, irregularity of the colonic controur and typicalthumbprinting appearance of involved colon proximal to an obstructing carcinoma of the colon. The mechanism ofnecrotizing colitis was briefly reviewed.
Colitis ; Colon ; Edema ; Gangrene ; Inflammation

The advent of computerized cranial tomography made a greater advance in the diagnosis of very wide variety of intracranial lesions. Authors analyzed 58 pathologically proven sellar and parasellar tumors examined at Kyung Hee Un-iversity Hospital from Oct. 1977 to Jun. 1981 and the results were as follows; 1. The distribution of the tumors is 28 pituitary adenomas, 18 craniopharyngiomas, 5 meningiomas, 4 germinomas, 2 astrocytomas, and 1 sphenoid mucocele. 2. In pituitary adenoma, the precontrast CT scan of tumors appeared as isodensity in 11 cases, mixed density in 8 cases, high density in 6 cases, and low density in 3 cases, and associated with destruction of sellar turcica in 15 cases, calcification in 3 cases, and hydrocephalus in 2 cases. The postcontrast CT scan study revealed 24 cases of contrast enhancement, including 17 cases of homogenous and 7 cases of ring or rim enhancement. 3. In craniopharyngioma, the precontrast CT scan of tumors appeared as low density in 12 cases, isodensity in 4 cases and high density in 2 cases and associated with calcification in 16 cases, hydrocephalus in 15 cases and destruction of sellar turcica in 2 cases. The postcontrast CT scan study revealed no enhancement in 10 cases and contrast enhancement in 8 cases including 6 of ring enhancement and 2 heterogenous enhancement.
Astrocytoma ; Craniopharyngioma ; Diagnosis ; Germinoma ; Hydrocephalus ; Meningioma ; Mucocele ; Pituitary Neoplasms ; Tomography, X-Ray Computed

Condyloma acuminatum, a benign disease caused by a filtrable virus, occurs predominantly in the perianal andgenital areas. The lesions are noninvasive but are subject to recurrence. In rare instances, a more aggresive formof this disease, known as "giant condlyloma acuminatum" or "Buschke-Lownestein tumor", occures. In this form,infiltration of the lesion into surrounding structures takes place. This tumor has been reported to occurprincipally in the genitourinary tract. The authors experienced a cases of giant condyloma acuminatum originatingfrom rectum in 67 years old male patient which recurred 3 months after electrofulguration.
Buschke-Lowenstein Tumor ; Humans ; Male ; Rectum ; Recurrence

Small hepatoma is defined as hepatocellular carcinoma less than 3cm in maximum diameter and fewer than 3 innumber. To assess the ability of ultrasound to detect small hepatomas, a prospectively study was done in a groupof patients with HBsAg-positive chronic hepatitis and liver cirrhosis. Herein, we present 4 hypoechoic smallhepatomas detected on ultrasound and emphasize the role of real-time ultrasonography as a practical test formonitoring hepatoma high-risk, subjects.
Carcinoma, Hepatocellular ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Mass Screening ; Prospective Studies ; Ultrasonography

The aim of this study was to evaluate the postoperative outcomes of anterior cruciate ligament (ACL) reconstructionuction using 2 additional fixation technique on tibial side. Between October 2008 and February 2012, sixty consecutive patients who underwent ACL reconstruction with allograft for ACL injuries were retrospectively enrolled. All patients were reconstructed with fresh frozen achilles tendon or posterior tibialis tendon allograft. Fixation on tibial side with bioabsorbable suture anchor (BSA) was in 30 patients (group A) and metal screw fixation was in 30 patients (group B). The data was collected at preoperatively and at least 1 years postoperatively, which included KT-2000 arthrometer objectively, and Tegner score, Lysholm score, and International Knee Documentation Committee (IKDC) scores subjectively. At the final follow up, the KT-2000 arthrometer improved significantly with an average of 3.28 mm anterior translation in the group A, 3.56 mm in group B. The preoperative mean Lysholm, Tegner and IKDC score was 46.14, 4.86, 63.17 in the group A, and 45.30, 4.40, 54.07 in the group B. The postoperative mean Lysholm, Tegner and IKDC score was 83.80, 8.14, 75.57 in the group A, and 88.75, 7.62, 65.10 in the group B. All functional outcomes were improved significantly (p=0.004) in both groups, but no differences were noted between the 2 groups (p>0.05). Both additional fixation techniques using BSA or metal screw fixation on tibial side in ACL reconstruction improved functional outcomes significantly. BSA technique seems to provide adequate strength suitable for early rehabilitation after ACL reconstruction.
Achilles Tendon ; Allografts ; Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction* ; Follow-Up Studies ; Humans ; Knee ; Rehabilitation ; Retrospective Studies ; Suture Anchors* ; Tendons

Acquired adult flatfoot deformity is characterized by flattening of the medial longitudinal arch and dysfunction of the posteromedial soft tissues, including the posterior tibial tendon. When the non-operative treatment fails to result in improvement of symptoms, surgery should be considered. Operative techniques include flexor digitorum longus tendon transfer, calcaneal medial slide osteotomy, lateral column lengthening, and arthrodesis of the hindfoot. The principle of correcting the deformity while avoiding overcorrection and excessive stiffness is important in achievement of good outcomes in these patients.
Adult* ; Arthrodesis ; Congenital Abnormalities ; Flatfoot* ; Humans ; Osteotomy ; Tendon Transfer ; Tendons

PURPOSE: Intrahepatic cholangiocellular carcinoma (ICC) is the second most common malignant tumor in the liver, and it arises from epithelial cells in the intrahepatic bile duct. While the reported risk factors include liver fluke infection, hepatolithiasis and sclerosing cholangitis, the genetic mechanisms involved in the development of ICC are not well understood, and only a few cytogenetic studies of ICC have been published. We recently found genetic imbalance on chromosome 20q in ICC with using Comparative Genomic Hybridization. So, we tried to find gene loci on chromosome 20q. (ED note: what kind of loci were you looking for) METHODS: We used 16 fresh frozen ICC tumor tissues and the paired normal liver tissues for DNA extraction. A set of primers for 10 microsatellite loci on chromosome 20q13-qter, based on an updated GeneMap99 and Ensemble, was purchased from Research Genetics. The markers selected for testing exhibited high levels of heterozygosity and relatively uniform distributions. Loss of heterozygosity (LOH) was analyzed by an automatic DNA analyzer. Using the Ensemble Web site, mining of putative tumor suppressor genes were developed between microsatellite markers that showed LOH. RESULTS: In one case, microsatellite instability (MSI) was found in all the markers except D20S196, and MSI was found in only one marker, d20S196, in another case. (Ed note: check this and it wasn't clear.) The most frequent region which have LOH on chromosome 20q13-qter was on D20S109 and D20S196, and their invidence was 12.5%. (ED note: the last part of the sentence makes no sense at all. You have to rewrite it.) D20S174, D20S107, D20S170, D20S96 and D20S119 were 6.3% and D20S836, D20S886 and D20S were 0%. (ED note: this sentence also makes no sense. They were 6% and 0% of what?) We found eight genes between D20S109 and D20S196: PTPN1, QSNf41 HUMAN, CT175 HUMAN, PARD6B, BCAS4, TMSL6, ADNP and DPM1. Among these, PTPN1, PARD6B and BCAS4 are well known oncogenes, so the other five genes are thought to be putative tumor suppressor genes. CONCLUSION: Using this approach, we identified two distinctive allelic losses defined by microsatellite markers as follows; D20S109 and D20S196. We identified five genes which can make contribution to the development or progression of intrahepatic cholangiocellular carcinoma. Further study will be carried out to confirm these genes have a critical role in the development or progression of intrahepatic cholangiocellular carcinoma using immunohistochemical study or other molecular biology work.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma* ; Cholangitis, Sclerosing ; Comparative Genomic Hybridization ; Cytogenetics ; DNA ; Epithelial Cells ; Fasciola hepatica ; Genes, Tumor Suppressor* ; Genetics ; Humans ; Liver ; Loss of Heterozygosity ; Microsatellite Instability ; Microsatellite Repeats* ; Mining ; Molecular Biology ; Oncogenes ; Risk Factors

No abstract available.
Neural Tube Defects* ; Spinal Canal*