Eosinophilic granuloma of bone well-documented in the literature. This lytic bone disease most commonly occurs in children, but a fraction of the cases does occurs in adult. When the disease occurs in adults, the bone most often affected include the skull, ribs, mandible, clavicle, pelvis, and long bone of the extremities. We report the case of a 31-year old woman with isolated eosinophilic granuloma of the thoracic spine. She had a 1-month history of progressive back pain that radiated to the right anterior chest. Authors performed resection of vertebral body lesion and soft tissue lesion and anterior fusion from T7 to T9. Immunochemical staining showed a positive S100 protein stain. EM demonstrated characteristic Birbeck granule. Postoperatively, the patient underwent a 5-day course of RT to the T6-T10 spine with 200cGY fractions (total dose 1000cGY). Postoperatively, the patient's back and chest pain had disappeared. There is no evidence of local recurrence or distant metastasis at 18 months follow-up. Though rare, eosinophilic granuloma of the adult spine could be considered in the differential diagnosis of osteolytic lesions.
Adult* ; Back Pain ; Bone Diseases ; Chest Pain ; Child ; Clavicle ; Diagnosis, Differential ; Eosinophilic Granuloma* ; Eosinophils* ; Extremities ; Female ; Follow-Up Studies ; Humans ; Mandible ; Neoplasm Metastasis ; Pelvis ; Recurrence ; Ribs ; Skull ; Spine* ; Thorax

No abstract available.
Animals ; Cricetinae* ; Cryopreservation* ; Oocytes*

Percutaneous biliary drainage is an effective new nonsurgical method for combined external/internal catheterdecompression of obstructed extrahepatic bile ducts. Molnar and Stockum, and more recently others, have reportedsucdess utilizing this approach to establish biliary drainage in patients with obstructive jaundice. Percutaneousbiliary drainage was performed in 9 patients with obstructive jaundice. Internal drainage was accomplished in 4patients (44.4%), and external drainage in 5 patients (55.6%). Major complications occurred in 2 patients; bileleakage, one; sepsis, one. Minor complications occurred in 7 patients; mild or high fever, 5 cases; transienthemobilia, 2 cases. The catheter management problems encoutered including pain, catheter dislodgement ormigration, lumen occulusion, and external bile leakage.
Bile ; Bile Ducts, Extrahepatic ; Catheters ; Drainage ; Fever ; Humans ; Jaundice, Obstructive ; Methods ; Sepsis

PURPOSE: This study was undertaken to increase the knowledge of the intra- and extra-spinal alignments and to help recovery of sagittal alignment in operation by measuring the normal values of the spinal alignment in relation to hip axis as well as those of the thoracic, thoracolumbar junction, lumbar and lumbosacral junction of sagittal alignment and their correlation. MATERIALS AND METHODS: Whole spine standing lateral radiographs were taken in young 100 adults without spinal abnormalities clinically and radiographically. Intraspinal alignment was measured with angles of thoracic kyphosis, lumbar lordosis, maximum thoracic kyphosis, maximum lumbar lordosis, angle of the thoracolumbar junction, sacral inclination, segmental angles and disc angles respectively with special emphasis on lumbar lordosis. Extraspinal alignment was measured with sacropelvic angle, spinopelvic balance and spinal balance in relation to hip axis. Correlations among these parameters were analyzed. RESULTS: Lumbar lordosis and thoracic kyphosis were measured -49 degree(-22 - -79 degree) and 32 degree(6 degree-56 degree), respectively. Slight amount of kyphosis in thoracolumbar junctional area was considered normal. Lumbar lordosis had significant correlation with thoracic kyphosis and sacral inclination. However, there was no correlation between thoracic kyphosis and sacral inclination. Lowest two lumbar segments comprised 71% of total lordosis. Lumbar lordosis usually started at L1-2 and gradually increased at each level caudally to the sacrum. Sacropelvic angle, spinopevlic balance and spinal balance were measured -11 degree(-6 degree - 24 degree), -4 cm (-10 - 2 cm), and -2 cm (-7 - 4 cm) respectively with C7 positioned posterior to hip axis mostly. CONCLUSIONS: There was a wide range of normal sagittal alignment of the thoracic and lumbar spines, and normal values of these alignments were not easily defined. Therefore, normal patterns of sagittal curvature and sagittal balance should be more emphasized.
Adult ; Animals ; Axis, Cervical Vertebra ; Hip ; Humans ; Kyphosis ; Lordosis ; Reference Values ; Sacrum ; Spine*

Acoustics ; Child ; Cleft Palate ; Humans ; Korea

OBJECT: This cross-sectional study was performed in order to evaluate the prevalence of tardive dyskinesia among the hospitalized schizophrenic patients. METHODS: Four hundred nineteen hospitalized schizophrenic patients(male=263, female=156) were recruited for this study. They were treated with antipsychotics for more than 3 months. The prevalence of tardive dyskinesia was assessed by the Abnormal Involuntary Movement Scale. RESULTS: The prevalence of tardive dyskinesia was 35.6%(Male=36.9%, Female 33.3%). There were no significant differences in the prevalence of tardive dyskinesia among male and female schizophrenic patients. The prevalence of tardive dyskinesia among the patients over 30years old was much higher than those below 30years old. There were no significant correlations between the prevalence of tardive dyskinesia and the duration of hospitalization, the total amount of antipsychotics. The frequently involved parts of the body in the schizophrenic patients who have tardive dyskinesia were tongue, upper extremity, lips and perioral area, jaw, lower extremity, muscles of facial expression trunk, respectively. CONCLUSIONS: There was significant correlation between the age and the prevalence of tardive dyskinesia in the antipsychotic-treated schizophrenic patients.
Antipsychotic Agents ; Cross-Sectional Studies ; Dyskinesias ; Facial Expression ; Female ; Hospitalization ; Humans ; Jaw ; Lip ; Lower Extremity ; Male ; Movement Disorders* ; Muscles ; Prevalence* ; Schizophrenia ; Tongue ; Upper Extremity

PURPOSE: To assess the accuracy of preoperative CT staging of RCC and to compare the relationship between T stage and the incidence of metastasis on the basis of the old (1992) and the new (1997) UICC & AJCC tumor classification system. MATERIALS AND METHODS: In 112 cases of surgically resected RCC, the stagings of preoperative CT scans were de-termined retrospectively by two radiologists and were compared with the results of pathologic examinations. In 70 cases which had been followed up over three years after surgery, the incidence of metastasis at initial diagnosis and during the follow-up period was assessed. All cases were reconsidered, and using the old and the new TNM classification, the incidence of metastasis was compared. RESULTS: According to the old TNM classification, 5 cases (4%) were staged at T1, 73(65%) at T2, 21(19%) at T3a, 9(8%) at T3b, 0 at T3c, and 4(4%) at T4. Using the new TNM classification, we also staged 54 cases (48%) at T1 and 24(21%) at T2. Overall, using this new classification, CT correctly staged 79% of patients (88/112) overstaged 15%(17/112) and understaged 6%(7/112) . CT had a sensitivity of 84% and specificity of 91% in new T1 tumors, 71% and 95%, respectively, in new T2 tumors, 69% and 88% in T3a tumors, 78% and 98% in T3b tumors, and 75% and 99% in T4 tumors. CT had a sensitivity of 44% and a specificity of 99% in old T1 tumors, and 82% and 71%, respectively, in old T2 tumors. The incidence of metastasis in CT-staged (cT) tumors was 0% (0/4) in old cT1, 8% (3/39) in new cT1, 29% (4/14) in new cT2, 67% (6/9) in cT3a, and 75% (6/8) in cT3b. CONCLUSION: In the staging of T1 tumors, CT is more sensitive when the new TNM classification is used. Even though the cut off point between T1 and T2 tumors had been in creased from 2.5 to 7.0 cm, T1 tumors staged according to the new system did not show a significantly higher incidence of metastasis than those staged according to the old.
Carcinoma, Renal Cell* ; Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Neoplasm Metastasis ; Neoplasm Staging* ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: To evaluate the patterns of pseudo-lesions present on spiral CT hepatic arteriography (CTHA). MATERIALS AND METHODS: One hundred and seventy five patients (161 men and 14 women, aged 15-70 years [mean, 52 years]) who underwent spiral CTHA for the detection of hepatic lesions were retrospectively reviewed.Pseudo-lesion type was determined by comparing hyperattenuating lesions on CTHA with the findings of ultrasonography, conventional or multi-phase CT, Lipiodol CT, angiography, CT arterial portography(CTAP), and follow-up of spiral CTHA. Pseudo-lesions were classified according to site, size and shape. RESULTS: A total of 77 pseudo-lesions were found in 56 of the 175 patients(32.6%), and were classified into the following types :peritumoral(n=18), segment I(n=3), segment IV(n=3), gallbladder fossa (n=13), subsegmental (n=3), subcapsular(n=13), straight line sign (n=10), arterioportal shunt (n=13), and technical error (n=1). Fifteen of 77 pseudo-lesions(19.5%) showed hyperattenuation on CTHA and iso attenuation on CTAP, in contrast to adjacent liverparenchyma. CONCLUSION: In patients with hepatic mass, it is very important to understand the characteristicsite, shape and size of pseudo-lesions for the correct interpretation of CT and subsequent management of thepatient.
Angiography* ; Ethiodized Oil ; Female ; Gallbladder ; Humans ; Male ; Retrospective Studies ; Tomography, Spiral Computed*

The pseudoaneurysms are resulted from complication of vascular catheterization, trauma, etc. and recently, the reports on pseudoaneurysms have been increasing. Successful treatment of pseudoaneurysms have been described usingdirect compression guided by color doppler ultrasound, instead of invasive surgical treatment. Authors experienced three cases of pseudoaneurysm ; two resulted from post-catheterization and one from trauma. We successfully treated two post-catheterization cases using C-clamp compression under the color doppler US-guidance. The traumatic case was treated by embolization instead of US-guided compression. We suggest that the compression of pseudoaneurysm using C-clamp under the US-guidance is more useful than hand or probe compression method.
Aneurysm, False* ; Arteries* ; Hand ; Ultrasonography ; Vascular Access Devices

Sparganosis is a rare tissue-parasitic infestation caused by a plerocercoid tapeworm larva(sparganum), genus Spirometra. The most common clinical presentation of sparganosis is a palpable subcutaneous mass or masses. Fifteen simple radiographs and 10 ultrasonograms of 17 patients with operatively verified subcutaneous sparganosis were retrospectively analyzed to find its radiologic characteristics for preoperative diagnosis of sparganosis. The locations of the subcutaneous sparganosis were lower extremity, abdominal wall, breast, inguinal region and scrotum in order of frequency. The simple radiographs showed linear or elongated calcification with or without nodular elongated shaped soft tissue mass shadows in 8 patients, soft tissue mass shadow only in 2 patients and lateral abdominal wall thickening in 1 patient. But no specific findings was noted in 4 patients with small abdominal and inguinal masses. We could classify the subcutaneous sparganosis by ultrasound into 2 types: one is long band-like hypoechoic structures, corresponding to the subcutaneous tunnel-like tracks formed by migration of sparganum larva and the other is elongated or ovoid hypoechoic nodules, representing granulomas. Long band-like hypoechoic structures within or associated with mixed echoic granulomatous masses were noted in 6 patients and elongated or ovoid hypoechoic mass or masses were noted in 4 patients. In conclusion, sparganosis should be considered when these radiologic findings-irregular linear calcifications on simple radiograph and long ban-like hypoechoic structures on ultrasonography, corresponding to the subcutaneous tunnel-like tracks formed by migration of sparganum larva-are noted in the patients who have subcutaneous palpable mass or masses. And radiologic examination especially ultrasonography is very helpful to diagnose sparganosis.
Abdominal Wall ; Breast ; Cestoda ; Diagnosis ; Granuloma ; Humans ; Larva ; Lower Extremity ; Retrospective Studies ; Scrotum ; Sparganosis* ; Sparganum ; Spirometra ; Ultrasonography