PURPOSE: Differential diagnosis of solitary pulmonary nodule with cavity includes lung abscess, tuberculoma, bronchogenic carcinoma, metastasis and trauma, etc. We analyzed the CT appearance of tubercuioma presenting as a solitary pulmonary nodule with cavity and describe the findings which suggest tuberculoma in the differential dignosis of soliary pulmonary nodule with cavity. MATERIALS AND METHODS: 25 patients with solitary pulmonary nodule(diameter less than 4 cm) without surrounding parenchymal consolidation on chest radiograph, who had a cavity within the nodule on CT, were included in our study. Density of the nodule, maximal wall thickness, the character of inner and outer wall margin, location of cavity within the nodule, location of the nodule, presence or absence of satellite lesions and calcification were analyzed. RESULTS: Solitary tuberculoma with cavity showed maximal wall thickness more than 15 mm in 40%(10/25) and 5-14 mm in 56%(14/25), eccentric cavitation in 84%(21/25) and concentric cavitation in 16%(4/25), spiculated outer wall margin in 56%(14/15) and Iobulated margin in 32%(8/25), smooth inner wall margin in 60%(15/25) and nodular margin in 40%(10/25). CT density of the cavity wall compared with the chest wall muscle was low in 84%(21/25) and isodense in 16%(4/25). Accompanying satellite lesions were seen in 84% (21/25) and calcification was visible in 28%(7/25). CONCLUSION: The CT findings of solitary tuberculoma with cavity are relative peripheral location, eccentric cavitation, finely spiculated outer wall margin, and mean maximal wall thickness of 13.2 mm, which are also the common features of malignant nodule. However, relative low density of the nodule compared to the chest wall muscle and surrounding satellite lesions can be additional clues favoring solitary tuberculoma with cavity on CT.
Carcinoma, Bronchogenic ; Diagnosis, Differential ; Humans ; Lung Abscess ; Neoplasm Metastasis ; Radiography, Thoracic ; Solitary Pulmonary Nodule ; Thoracic Wall ; Tuberculoma*

Polydactyly is one of the most common congenital anomalies of the limb, however its surgical treatment varies from simple excision to reconstruction. The purpose of this study is to present out classification of polydactyly in which the type of surgery was concerned primarily. Two hundred and thirty five digits(134 fingers and 101 toes) in 188 patients were operated from 1980 to 1992. We divided the polydactyly into two types-the simple type, in which the extradigit arises from only one digit, and the complex type in which the extradigit connects more than two adjacent main digits. The simple type was subdivided into joint type(type I), in that the extradigit has its own joint in its origine; epiphyseal type(type II), the extradigit share common epiphysis with main digit; and hypoplastic type(type III), the extradigit is connected only by soft tissue to the main digit. The epiphyseal type(type II) was further divided into subtype A(type IIA), in that the origin seems to be directly derived from the epiphysis; and subtype B(type IIB), which resemble an osteochondroma. Type III and type IIB can be treated by simple excision, however the type I and type IIB can be treated by arthroplasty with or without osteotomy as well as excision of extradigit. Result of surgical treatment in 1 digit of the simple form, which siginifies the extradigit arising from only one digit, are good in 193 digits(91%), fair 14(6.6%), and poor 5(2.4%) after an average follow-up period of 20 months. Our principles in the surgical treatment of polydactyly was treatment according to the type, and early treatment.
Arthroplasty ; Classification ; Epiphyses ; Extremities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Osteochondroma ; Osteotomy ; Polydactyly

Horseshoe adrenal gland is a rare congenital abnormality associated with multiple congenital anomalies that may involve the cardiovascular, central nervous, and genitourinary systems. In this report, we describe the sonographic findings of horseshoe adrenal gland in a newborn with right isomerism a frequently associated cardiovascular anomaly.
Adrenal Glands* ; Congenital Abnormalities ; Humans ; Infant, Newborn* ; Isomerism* ; Ultrasonography ; Urogenital System

No abstract available.
Thyroid Gland* ; Thyroiditis*

No abstract available.
Neoplasm Metastasis* ; Neuroblastoma*

Generalized lymphangiomatosis is a rare disease that is characterized by widespread bony and soft tissue involvement of lymphangioma. Radiological evaluation is crucial because the site and extent of the lymphangioma are important prognostic factors. We reported here on three cases of generalized lymphangiomatosis and all three cases showed similar radiologic findings, but a different clinical course. The CT, US and MR images showed sharply defined, non-enhanced cystic lesions involving the mediastinum, bones, spleen, lung and lower neck. The whole body MR imaging with the short tau inversion recovery (STIR) sequence showed good capability for evaluating the extent of disease.
Tomography, X-Ray Computed ; Male ; Magnetic Resonance Imaging ; Lymphangioma/*diagnosis/radiography/ultrasonography ; Humans ; Diagnosis, Differential ; Contrast Media ; Child, Preschool ; Child

No Abstract Available.
Carpal Tunnel Syndrome* ; Collagen* ; Humans ; Ligaments*

PURPOSE: The purpose of this study was to evaluate the validity of the cutoff size for a localized renal cell carcinoma (RCC) by assessing the survival of RCC patients according to a series of alternative size cutoff values. MATERIALS AND METHODS: The outcomes of 147 patients with localized RCC, treated by radical nephrectomy at our institution, between 1984 and 2004, were retrospectively evaluated. The mean follow-up period was 54.9+/-32.5 months. The survival of patients with tumors smaller than a specified size cutoff was compared with that of tumors larger than the cutoff, and the most discriminating cutoff identified. RESULTS: 114 and 33 patients were pT1 (77.6%) and pT2 (22.4%), respectively. There were 10 recurrences (8.8%) and 6 deaths (5.3%) in the pT1 group, and 8 recurrences (24.2%) and 8 deaths (24.2%) in the pT2 group. The differences in survival were maximized when the tumor size cutoff point was 7cm (cancer-specific survival rate: 92.0% vs. 71.5% p=0.0003, diseasefree survival rate: 88.5% vs. 69.1% p=0.0092). The next significant difference was observed with a cutoff of 4cm (cancer-specific survival rate: 96.0% vs. 83.7% p=0.0467, disease-free survival rate: 96.0% vs. 78.8% p=0.0121). CONCLUSIONS: Tumor size is an important prognostic factor in patients with an organ confined RCC. The established cutoff point of 7cm provided reasonable prognostic differences. A 4cm cutoff point is also feasible for separating groups with different survivals after a nephrectomy. Hence, the T1a/1b/T2 classification system is practical for the division of localized RCC.
Carcinoma, Renal Cell* ; Classification ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Neoplasm Staging ; Nephrectomy ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: To evaluate the usefulness of transjugular liver biopsy (TJLB), and possible complications. MATERIALS AND METHODS: During a three-year period, TJLB was performed in 21 patients. Through the right internal jugular vein, a 9F sheath was introduced into the right hepatic vein, and using Mansfield forceps, biopsy was then performed. RESULTS: Reasons for TJLB included massive ascites in six patients, coagulopathy in nine, thrombocytopenia in five, and other causes in one. In 20 cases, we obtained liver tissue, and pathologic diagnosis was possible in 17 ; in three cases, the amount of biopsy tissue obtained was insufficient for pathologic diagnosis. In one patient with Budd-Chiari syndrome, we were unable to catheterize the right hepatic vein and failed to obtain liver tissue. Complications occurred in five patients, as follows: hematoma formation at the puncture site in one patient, and pain at the puncture site, lasting 24 hours, in four. CONCLUSION: TJLB may be a safe and useful method in patients in whom percutaneous liver biopsy is contraindicated.
Ascites ; Biopsy* ; Budd-Chiari Syndrome ; Catheters ; Diagnosis ; Hematoma ; Hepatic Veins ; Humans ; Jugular Veins ; Liver* ; Punctures ; Surgical Instruments ; Thrombocytopenia

Even the antituberculous drugs could cure the disease itself, it might not prevent progressive kyphosis and its sequelae. Therefore, radical curettage and anterior arthrodesis with autogenous strut bone graft has been used to prevent this deformity. From May 1982 to May 1989, twenty four cases of spinal tuberculosis treated with anterior arthrodesis were analysed about the progression of postoperative kyphosis. These cases were followed up for more than 1 year at least, and the following results were obtained; 1. Lumbar spine was most commonly involved. There was involvement of one disc space in 12 cases, only narrowing of disc space in 7 cases, and two disc spaces in 5 cases. 2. The degree of vertebral loss was under 1 in 15 cases, 0 (disc space narrowing only) in 7 cases, and over 1 in 2 cases. 3. Compared with immediate postoperative kyphotic angle, there was increase of kyphotic angle in 15 cases but most of them were under 10 degress. 4. Preoperative degree of vertebral loss of 15 incerased cases was 0.5 and that of 9 decreased of maintained cases was 0.2 in average. 5. Preoperative vertebral involvement of 15 increased cases was 1.3 and that of 9 decreased or maintained cases was 1.2 in average.
Arthrodesis ; Clinical Study ; Congenital Abnormalities ; Curettage ; Kyphosis ; Spine ; Transplants ; Tuberculosis, Spinal