Occurrence of a retroperitoneal duplication cyst associated with a heterotopic pancreas is rare. We report a case of a retroperitoneal duplication cyst associated with a heterotopic pancreas. A 35-year-old male was admitted, presenting with back pain. A pelvic computed tomographic scan disclosed a 10 cm-sized cystic mass filling the lower pelvis and displacing the rectosigmoid colon anteriorly. Histologically, the cyst wall was lined partly by mucin-secreting columnar epithelium, showing atypical hyperplasia and partly by a gastric fundic-type and a colonic-like mucosa. Beneath the epithelium, organized bundles of smooth muscle were arranged in two layers analogous to smooth muscles layers of the bowel and a small piece of pancreatic tissue were present in the smooth muscle wall of the cyst.
Adult ; Back Pain ; Colon ; Epithelium ; Humans ; Hyperplasia ; Male ; Mucous Membrane ; Muscle, Smooth ; Pancreas* ; Pelvis

From Mar. 1985 to Dec. 1992, 170 cases of osteosarcoma, which were proved histologically were admitted in our department at least one time. Among them we analysed 89 cases of Ennekings stage IIB who took limb-salvage(54) or amputation(35) and followed our protocol, with non-randomized retrospective study. The average age of the 89 patiens was 17.0 years(7 to 57). Fifty-four cases of salvage group took neoadjuvant chemotherapy, 35 cases of amputation group took neoadjuvant or adjuvant chemotherapy. The result revealed prevalences of 2/54, 0/35 as to local recurrence; 15 of 54, 17 of 35 as to metastasis; 14 of 54, 15 of 35 as to death. Of the 2 patients who had a local recurrence, one died of metastasis and the other was lost follow up. According to Kaplan-Meier's plot 5-year continuously disease free survival rate for whole 89 cases of stage IIB was 43.1%, for salvage group 56.4%, for amputation group 34.0%. There were no signifcant difference in survival rate between salvage and amputation groups(p>0.05, by log-rank test). This result means the limb-salvage operation for Enneking's stage IIB osteosarcoma does not hinder patients survival.
Amputation ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteosarcoma ; Prevalence ; Recurrence ; Retrospective Studies ; Survival Rate

BACKGROUND: Though its cause has not been well established, premature ejaculation is the most prevalent form of male sexual dysfunction. Some recent studies suggest that penile hypersensitivity and hyperexcitability, earlier excitation of the sacral reflex arc, and abnormality with peripheral and central afferent nerve conduction pathways, are related to premature ejaculation. METHODS: The bulbocavernous reflex latency (BCRL) test and dorsal nerve somatosensory evoked potential (DNSEP) test were done in 15 normal subjects (mean age: 38.2 years) and 30 premature ejaculation patients (mean age: 40.2 years) without history of neurological disorders nor history of medication which influences the nervous system. RESULTS: The mean latency of BCR was shortened significantly in patients with premature ejaculation (33.1+/-3.08 msec) than in the control group (37.2+/-3.95 msec)(P<0.01). However, there were no significant differences in latency and amplitude of DNSEP tests between the two groups. CONCLUSIONS: Based on our results, the earlier excitation of the sacral reflex arc might be related to premature ejaculation. (J Korean Neurol Assoc 19(5):494~497, 2001)
Evoked Potentials, Somatosensory* ; Humans ; Hypersensitivity ; Male ; Nervous System ; Nervous System Diseases ; Neural Conduction ; Premature Ejaculation* ; Reflex*

BACKGROUND: Cortical hyperexcitability is proposed to be the putative basis for the physiological disturbances in migraine. Recent studies have demonstrated that divalproex sodium effectively prevents migraine. The cortical silent period (CSP) elicited by transcranial magnetic stimulation (TMS) reflects the cortical inhibition of the central motor pathway. METHODS: We studied the CSP of both first dorsal interossei muscles evoked by TMS in 15 migraine patients and 15 normal subjects. As a prophylactic therapy, 15 migraine patients were treated with divalproex sodium 500~750 mg/day. After 3 months, we studied the CSP in migraine patients for the purpose of comparing with results before medication. RESULTS: The CSP was shorter in migraine patients than in controls (135.8+/-27.8 msec vs 203.7+/-32.2 msec, p<0.001). After treatment with divalproex sodium, the CSP was significantly prolonged in migraine patients (196.9+/-31.0msec, p=0.001). CONCLUSIONS: The shortened CSP in migraine patients suggests increased excitability of the cortical neuron in migraine. The prolonged CSP after medication in migraine patients suggests that the divalproex sodium may play a role in the prophylaxis of migraine by decreasing cortical neuronal hyperexcitability. (J Korean Neurol Assoc 19(5):489~493, 2001)
Humans ; Migraine Disorders* ; Muscles ; Neurons ; Transcranial Magnetic Stimulation ; Valproic Acid*

In the metastatic CNS lymphoma, parenchymal involvement, especially in both temporal lobes, is rare. A 54-year-old man complained of memory impairment and personality changes that began two weeks prior. He had ulcerated skin lesions and multiple subcutaneous nodules. Brain MRI revealed a diffuse low in T1WI, high in T2WI, and contrast-enhancement in both temporal lobes. Treatment was done with acyclovir and dexamethasone, and symptoms were improved. One week later, symptoms were aggravated and a brain biopsy was performed. The result was a peripheral T-cell lymphoma. (J Korean Neurol Assoc 19(4):417~422, 2001)
Acyclovir ; Biopsy ; Brain ; Dexamethasone ; Humans ; Lymphoma ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Peripheral ; Magnetic Resonance Imaging ; Memory ; Middle Aged ; Skin ; T-Lymphocytes* ; Temporal Lobe* ; Ulcer

No abstract available.
Appendicitis* ; Purpura, Schoenlein-Henoch*

Among several diagnostic tests, a Helicobacter pylori stool antigen (HpSA) test may offer a useful noninvasive method for diagnosing infection without sacrificing animals. In this study, male C57BL/6 mice (n=6) were infected with H. pylori ATCC 49503 (1x10(8) CFU/mouse) by intragastric inoculation three times at 2-day intervals, and H. pylori infected stool specimens were collected 1, 3, 5, 7, 14, 21 days after infection to assess reliability of the HpSA test. Five of six specimens were positive at 5-21 days after infection, and the sensitivity of the HpSA test was 83.33%. The presence of H. pylori infection was confirmed by the rapid urease test and genomic DNA polymerase chain reaction (PCR), and showed the same results as the HpSA. However, the rapid urease test and genomic DNA PCR are invasive tests and require animal sacrifice to detect H. pylori in gastric biopsy samples. We suggest that an HpSA test kit would be useful and effective for monitoring H. pylori in various laboratory animals, as H. pylori can be easily monitored without sacrificing animals.
Animals ; Animals, Laboratory ; Biopsy ; Diagnostic Tests, Routine ; DNA ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Mice ; Polymerase Chain Reaction ; Urease

BACKGROUND/AIMS: To compare the diagnostic accuracy of endoscopic ultrasound-guided core needle aspiration with that of standard fine-needle aspiration by systematic review and meta-analysis. METHODS: Studies using 22/25-gauge core needles, irrespective of comparison with standard fine needles, were comprehensively reviewed. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic curves for the diagnosis of malignancy were used to estimate the overall diagnostic efficiency. RESULTS: The pooled sensitivity, specificity, and DOR of the core needle for the diagnosis of malignancy were 0.88 (95% confidence interval [CI], 0.84 to 0.90), 0.99 (95% CI, 0.96 to 1), and 167.37 (95% CI, 65.77 to 425.91), respectively. The pooled sensitivity, specificity, and DOR of the standard needle were 0.84 (95% CI, 0.79 to 0.88), 1 (95% CI, 0.97 to 1), and 130.14 (95% CI, 34.00 to 495.35), respectively. The area under the curve of core and standard needle in the diagnosis of malignancy was 0.974 and 0.955, respectively. The core and standard needle were comparable in terms of pancreatic malignancy diagnosis. There was no significant difference in procurement of optimal histologic cores between core and standard needles (risk ratio [RR], 0.545; 95% CI, 0.187 to 1.589). The number of needle passes for diagnosis was significantly lower with the core needle (standardized mean difference, -0.72; 95% CI, -1.02 to -0.41). There were no significant differences in overall complications (RR, 1.26; 95% CI, 0.34 to 4.62) and technical failure (RR, 5.07; 95% CI, 0.68 to 37.64). CONCLUSIONS: Core and standard needles were comparable in terms of diagnostic accuracy, technical performance, and safety profile.
Biopsy, Fine-Needle ; Diagnosis ; Needles* ; Odds Ratio ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Microembolic signals (MES) have been implicated as an important mechanism of acute ischemic stroke in middle cerebral artery (MCA) stenosis. We conducted a prospective study to correlate MES and patterns of diffusion-weighted MR images (DWI). METHODS: A total of 211 consecutive patients with MCA territory ischemic symptoms within 24 hours of symptom onset were monitored for MES. Among them patients with acute ischemic lesion in MCA territory on DWI were included. MCA velocities on transcranial Doppler (TCD) examination, patterns and multiplicity of DWI lesions, and the degree of stenosis on MR angiography (MRA) were compared between MES positive and negative groups. RESULTS: MES were detected in 9 patients (17.3%) among 52 patients who fulfilled our inclusion criteria. The mean number of MES per 30 minutes was 9.11+/-5.94 (range, 1-19). Mean flow velocity of insonated ipsilateral MCA in MES positive group was higher than that of MES negative group (115.67+/-81.9 cm/s vs 58.07+/-23.5 cm/s, p= 0.032). The degree of MCA stenosis on MRA and the presence of MES had significant relationship (p=0.039), but there was no significant relationship between lesion multiplicity on DWI and the presence of MES (p=0.431). The frequency of symptom recurrence in the corresponding MCA territory during 90 days from the index stroke did not show statistical significance between two groups (p=0.681). CONCLUSIONS: Our results do not support the idea of direct causal relationship between MES and the mechanism of atherothrombotic MCA stroke. Further study is needed to identify whether the appearance of MES implicates a predictor for further ischemic events or a sign of recanalization.
Angiography ; Constriction, Pathologic ; Humans ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Prospective Studies ; Recurrence ; Stroke*

PURPOSE: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities. MATERIALS AND METHODS: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters. RESULTS: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12~49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from 27.5degrees to 46.7degrees. In radiographic measurements, calcaneal pitch angle improved from 19.1degrees to 15.8degrees, Meary angle from 13.0degrees to 9.3degrees, Hibb's angle from 44.3degrees to 37.0degrees, and tibio-calcaneal axis angle from varus 17.5degrees to varus 1.5degrees. CONCLUSION: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.
Achilles Tendon ; Ankle ; Arthrodesis ; Axis, Cervical Vertebra ; Charcot-Marie-Tooth Disease ; Congenital Abnormalities ; Fascia ; Follow-Up Studies ; Foot ; Foot Deformities* ; Guillain-Barre Syndrome ; Hemiplegia ; Humans ; Metatarsal Bones ; Osteotomy ; Patient Satisfaction ; Poliomyelitis ; Range of Motion, Articular ; Stroke ; Tendon Transfer