Mucocele is commonly found in frontal sinus. Mucocele of sphenoid sinus is rare and only 100 cases have been reported since Burg's description in 1889. Their etiology is still conjectural. These lesions are potentially more serious and are often misdiagnosed as pituitary tumor. The author experienced a case of sphenoid sinus mucocele develped headache, fever and CSF rhinorrhea. Plain skull, cisternography brain CT scan help the diagnosis of sphenoid sinus mucocele. A transnasal approach is considered best for case with extensive sphenoid sinus mucocele with bone destruction in the floor of sella turcica. The headache, fever and CSF rhinorrhea improved after surgery.
Brain ; Diagnosis ; Fever ; Frontal Sinus ; Headache ; Mucocele* ; Pituitary Neoplasms ; Sella Turcica ; Skull ; Sphenoid Sinus* ; Tomography, X-Ray Computed

No abstract available.
Animals ; Nitric Oxide Synthase* ; Nitric Oxide* ; Rats* ; Spermatic Cord Torsion* ; Testis*

Coronary artery dissection after blunt chest trauma is very rare conditon, and this can result in a serious acute myocardial infarction. We report a case of a 54-year old male who was presented with an anterior myocardial infarction after traffic accident, with steering wheel injury. His coronary angiography revealed a discrete eccentric 85% stenosis of proximal left anterior descending coronary artery with dissection and intravascular ultrasound showed a dissecting flap from the distal left main coronary artery to proximal left anterior descending coronary artery. He was successfully treated by percutaneous transluminal coronary angioplasty with stent.
Accidents, Traffic ; Angioplasty, Balloon, Coronary ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels* ; Humans ; Male ; Middle Aged ; Myocardial Infarction* ; Stents ; Thorax* ; Ultrasonography

The presence of severe pulmonary arterial hypertension (PAH) in patients with atrial septal defect (ASD) is still thought to preclude shunt closure, although there are several reports of good clinical outcomes after vasodilator therapy. We report the case of a young woman with ASD and severe PAH who was able to successfully undergo percutaneous shunt closure following 1 year use of the oral endothelin receptor antagonist, bosentan.
Female ; Heart Septal Defects, Atrial* ; Humans ; Hypertension, Pulmonary* ; Receptors, Endothelin* ; Sulfonamides

BACKGROUND: This study was to determine whether coronary flow reserve (CFR) of infarct related artery is related to the microvascular perfusion status in the infarct zone determined by myocardial contrast echocardiography (MCE) immediately after successful revascularization in patients with acute myocardial infarction and to the presence of non-contractile myocardium at follow-up. METHODS: CFR was measured immediately after successful revascularization in 21 patients 5+/-2 days after acute myocardial infarction. Then, myocardial perfusion status was evaluated by MCE. Myocardial opacification index (MOI) was calculated as the ratio of sum of reperfusion area to total risk area of infarct-related artery. Follow-up transthoracic echocardiography was performed 1 month after infarction. RESULTS: CFR was correlated with myocardial opacification index immediately after successful revascularization (r=0.79, p<0.001). CFR was significantly higher in patients with MOI score of 1 than in patients with MOI score smaller than 1 (2.15+/-0.29 vs 1.52+/-0.27, p<0.05), and higher but insignificantly in patients without non-contractile segments than in patients with (1.83+/-0.46 vs 1.63+/-0.4, p>0.05). CONCLUSION: CFR may be used to determine the microvascular perfusion status of the myocardium in the infarct zone. CFR immediately after successful revascularization seems to be associated more closely with myocardial perfusion status determined by MCE at that time than whether the non-contractile myocardium is presence or not after 1 month.
Arteries* ; Echocardiography ; Follow-Up Studies ; Humans ; Infarction ; Myocardial Infarction* ; Myocardium ; Perfusion* ; Reperfusion*

BACKGROUND: During ophthalmologic surgery, various intravenous anesthetic induction agents are used to prevent an intraocular pressure (IOP) increase. This study was designed to compare the effects of vecuronium and rocuronium on IOP in patients who were intubated. METHODS: Thirty-two patients undergoing elective strabismus surgery, aged 4 to 12 years, were randomized to receive rocuronium 0.6 mg/kg (Group 1, n = 16), or vecuronium 1.0 mg/kg (Group 2, n = 16).IOP, mean arterial pressure (MAP), and heart rate (HR) were measured at the following time points: prior to induction (B); after the administration of the induction agents; before intubation (T0); and at 1, 3 and 5 mins after intubation (T1, T3 and T5). RESULTS: The IOP after T0 in Group 1 was significantly lower than B (P < 0.05) in Group 2.The IOP at T1 in the Group 1 and 2 was not different from B, respectively.The IOP, MAP, and HR at T1 in the Groups 1 and 2 were significantly higher than at T0 (P < 0.05).No significant differences were observed between the groups in term of IOP. CONCLUSIONS: We concluded that vecuronium and rocuronium are both useful as muscle relaxants for use in general anesthesia in ophthalmologic surgery, because both agents caused similar decreases in intraocular pressure.
Aged ; Androstanols ; Anesthesia, General ; Arterial Pressure ; Heart Rate ; Humans ; Intraocular Pressure ; Intubation ; Muscles ; Strabismus ; Vecuronium Bromide

No abstract available.

STUDY DESIGN: This is a retrospective, case-controlled study. OBJECTIVE: We wanted to evaluate the efficacy of lower-pressure percutaneous vertebroplasty (LP-PVP) using larger-diameter cement fillers for treating osteoporotic vertebral compression fracture (VCF). SUMMARY OF THE LITERATURE REVIEW: Despite the popularity of conventional PVP(C-PVP), critical complications associated with cement leakage have been widely reported due to the inadequate viscosity of flabby cement. MATERIALS AND METHODS: With excluding Kummell's disease, 23 VCF's were treated with LP-PVP using 2.8mm-diameter cement fillers, 51 VCF's were treated with kyphoplasty(KP) using the same size of cement fillers and 19 VCF's were treated with C-PVP using 1.4mm-diameter biopsy needles. The clinical and radiographic results along with the complications were investigated for more than one year. RESULTS: The visual analogue scale (VAS) was improved in all the groups. The infused cement volume was 5.9+/-1.6ml for the LP-PVP, 5.9+/-1.9ml for the KP and 3.5+/-1.0ml for the C-PVP (p=0.000). The collapsed vertebral height was restored by 10.8+/-10.3%, 13.0+/-12.7% and 4.7+/-7.6%, respectively, in each group (p=0.000) with a reduction loss of 2.1+/-1.8%, 1.1+/-1.4% and 5.9+/-4.2%. respectively, in each group (p=0.000) at follow-up. These was a reduction of the vertebral kyphotic angle by 3.0+/-4.0degrees, 3.7+/-4.4degrees and 4.2+/-4.4degrees, respectively, in each group (p=0.528) with reduction loss of 1.0+/-0.9degrees, 0.1+/-1.7degrees and 3.5+/-2.8degrees, respectively, in each group (p=0.000). There was a reduction of the regional Cobb's angle by 4.3+/-2.6degrees, 3.1+/-4.7degrees and 2.9+/-3.8degrees, respectively, in each group (p=0.184) with a reduction loss of 3.6+/-4.5degrees, 0.1+/-1.5degrees and 1.0+/-4.1degrees, respectively, in each group (p=0.000). Extravasation of cement was noticed in 6 cases (26.1%) of LP-PVP, in 14 cases (27.5%) of KP and 4 cases (26.1%) of C-PVP (p=0.689). No cases of additional VCF happened for the LP-PVP, eight cases of additional VCF happened (15.7%) for the KP and one case of additional VCF happened (5.3%) for the C-PVP (p=0.030). CONCLUSION: The LP-PVP showed clinically and radiologically results that were similar to those of KP with a higher amount of infused cement volume compared to that of C-PVP. LP-PVP is thought to be effective for the clinical and radiolographic aspects and to have fewer complications for the treatment of osteoporotic VCF.
Biopsy ; Case-Control Studies ; Follow-Up Studies ; Fractures, Compression ; Needles ; Retrospective Studies ; Vertebroplasty ; Viscosity

Basaloid squamous cell carcinoma occurs in various organs including the upper respiratory tract, the base of the tongue, pharynx, larynx, breast, uterine cervix and anus. It is a rare tumor, but it must be distinguished from other malignancies because of its aggressive clinical behavior. Many cases present in the advanced stage at the time of diagnosis. We present here a case of esophageal basaloid squamous cancer that was diagnosed in 75-year-old male patient who had dysphagia and throat pain, and this was accompanied by squamous cell cancer of the tongue base, as was determined by laryngoscopic and esophagogastroscopic examination.
Aged ; Anal Canal ; Breast ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Deglutition Disorders ; Diagnosis ; Esophagus ; Female ; Head and Neck Neoplasms ; Humans ; Larynx ; Male ; Neoplasms, Squamous Cell ; Pharynx ; Respiratory System ; Tongue*

STUDY DESIGN: This is a retrospective study. OBJECTIVE: We wanted to evaluate the efficacy of kyphoplasty for treating osteoporotic VCF and we wanted to determine the risk factors for additional VCF. SUMMARY OF THE LITERATURE REVIEW: Successful pain relief with performing kyphoplasty for VCF has been well documented. However, unsatisfactory reduction and additional VCF are remained problems for kyphoplasty. MATERIALS AND METHODS: Sixty-three patients who underwent kyphoplasty were followed up for more than 1 year. The degree of reduction of the collapsed vertebral height, the vertebral kyphotic angle, the regional Cobb's angle and the overall sagittal alignment, the visual analogue scale (VAS), the fracture configuration, the bone mineral density (BMD), the presence of intradiscal cement leakage and additional VCF were investigated. The risk factors for additional VCF were analyzed. RESULTS: In terms of deformity correction, the collapsed vertebral height were restored (67.3+/-15.6% to 82.5+/-11.8%), the vertebral kyphotic angle was improved (12.1+/-6.9degrees to 8.1+/-5.3degrees ), the degree of the regional Cobb's angle was reduced (3.1+/-4.5degrees ) and the overall sagittal balance was improved (1.7+/-5.3 cm to 0.5+/-3.9 cm) with clinical satisfaction (VAS: 6.9+/-1.3 points to 2.3+/-0.9 points). But less than 40% of the patients reached the expected reduction criteria (the vertebral height > 90%, the vertebral kyphotic angle and regional Cobb's angle reduction > 5degrees ). Additional VCF occurred in 10 patients (15.9%). The average BMD in the additional VCF group was T-score of -3.8 and that for the no-additional VCF group was T-score of -3.0 (p=0.025). The degree of reduction under general anesthesia was twice more than that under local anesthesia. Eleven cases (17.5%) of intradiscal cement leakages were noticed, but this showed no relevance to the fracture configurations and additional VCF. The overall sagittal alignment and cement volume showed no relevance to additional VCF. CONCLUSION: Kyphoplasty was excellent for pain reduction, but it was unsatisfactory for correcting deformity. Vertebral height correction was more effectively performed under general anesthesia. Additional VCF was caused by severe osteoporosis.
Anesthesia, General ; Anesthesia, Local ; Bone Density ; Congenital Abnormalities ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphoplasty ; Osteoporosis ; Retrospective Studies ; Risk Factors