An inflammatory myofibroblastic tumor (IMT) is a rare tumor that is currently classified as an intermediate cancer according to the World Health Organization classification system. The pathophysiology of its occurrence is still unknown. Imaging tests, such as CT or MRI, can be helpful in diagnosis, but the final diagnosis is confirmed by a pathological examination through a biopsy and immunohistochemistry stain. The patient, in this case, presented an asymptomatic intrahepatic mass discovered incidentally on an imaging examination. Initially, intrahepatic cholangiocarcinoma was suspected, but she was finally diagnosed with IMT through a histological examination after a liver resection.

No abstract available.
Female ; Humans ; Persistent Fetal Circulation Syndrome*

The authors underwent the serum lipid study, involving the lipoprotein fraction, and the HDL-cholesterol mean values in normal Korean adults visited to Hanyang University Hospital, and also compared with the previously reported serum lipid studies. The results are as follows; 1) The mean values of triglyceride, total cholesterol, and phospholipid were 103.3+/-17.1mg%, 188.9+/-18.2mg%, and 196.7+/-19.8mg%, respectively. 2) Compared with the past 7 years triglyceride showed increasing tendency with significance, and cholesterol and phospholipid showed slightly increasing tendency. 3) In the serum lipoprotein fraction, the mean values of alpha-lipoprotein, pre-beta-lipoprotein, and beta-lipoprotein were 37.2+/-5.9%, 16.0+/-4.2%, and 48.6+/-5.2%, respectively. 4) Compared with the past 10 years, the alpha-, and pre-beta-lipoprotein showed increasing tendency, meanwhile, beta-lipoprotein revealed decreasing tendency. 5) The mean value of HDL-cholesterol was 52.3+/-14.6mg%, and the ratio of HDL-cholesterol to total cholesterol(HDL-cholesterol/total cholesterol) was 28.2+/-7.9. 6) Compared with the past 2 years, HDL-cholesterol level showed slightly increasing tendency.
Adult ; Cholesterol ; Humans ; Lipoproteins ; Triglycerides

Bilateral coronary artery fistula is very uncommon congenital anomaly which occupy small percentage of all congenital coronary artery fistula. About 20% of the cases associated with additional congenital heart disease. And it may cause congestive heart failure, especially severely in neonate. We experienced a case of neonate who was 1 day-old-male with bilateral coronary artery-right ventricular fistula associated with atrial septal defect and congestive heart failure. The Patient was admitted because dyspnea, cyanosis since birth. 2D ecgicardiogram and cardiac catheterization revealed that a fistulous communicating ; forming a large aneurysm, was noted from bilateral coronary artery emptied into the right ventricle, and there was oxygen step-up in right ventricle.
Aneurysm ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Cyanosis ; Dyspnea ; Fistula* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Infant, Newborn* ; Oxygen ; Parturition

PURPOSE: To evaluate the usefulness of CT for the diagnosis and treatment planning of mechanical intestinal obstruction. MATERIALS AND METHODS: We retrospectively reviewed 38 patients who were clinically suspected of mechanical intestinal obstruction and had undergone abdominal CT. The CT scans were evaluated for the absence or presence, severity, cause and site of intestinal obstruction. CT findings were compared with the results of laparotomy, barium study and clinical course. The absence or presence and severity of intestinal obstruction were classified into no obstruction, partial obstruction, complete obstruction. Diagnosis was estabilished by means of laparotomy in 20 cases, barium study in 9 cases and clinical course in 9 cases. RESULTS: Of 38 cases, 7(18.4%) showed no obstruction, 22(57.9%) showed partial obstruction, and 9(23.7%) showed complete obstruction. The presence or absence and severity on CT scans were corretly predicted in 36 of 38 cases (sensitivity 95%, specificity 97%, accuracy 96%) (in case of no obstruction:sensitivity 100%, specificity 94%, accuracy 95%;in case of partial obstruction:sensitivity 91%, specificity 100%, accuracy 95%;in case of complete obstruction:sensitivity 100%, specificity 100%, accuracy 100%). All 9 cases with complete obstruction underwent prompt and immediate laparotomy. 13 cases, excluding those with mass around the site of transition and adhesion with strangulation, with partial obstruction improved with conservative treatment without laparotomy. The causes of obstruction were adhesion in 13, hernia in 6, primary cancer in 5, metastatic cancer in 3, abscess in 2, intestinal tbc in 1, and Crohn's disease in 1. The cause of obstruction on CT scans were correctly predicted in 27 of 31 cases (87.1%). The sites of obstruction on CT scans were correctly predicted in 22 of 26 cases (84.6%). CONCLUSION: CT is valuable in the evaluation of absence or presence, severity, cause and site of intestinal obstruction, and is considered to be helpful in treatment planning for the patients with intestinal obstruction.
Abscess ; Barium ; Crohn Disease ; Diagnosis ; Hernia ; Humans ; Intestinal Obstruction* ; Laparotomy ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: We report two cases of uveo-meningeal syndrome involving the retina, uvea, and optic disc in both eyes after viral meningitis. CASE SUMMARY: A 16-year-old female was referred to our department with blurred vision in both eyes. She was hospitalized in the pediatric ward with viral meningitis. She showed a norma best-corrected visual acuity (BCVA) and normal intraocular pressure in both eyes, but had severe inflammation in the anterior chamber on slit lamp examination, and optic disc edema and multiple whitish lesions on fundus examination. She was treated with intravenous antibiotic injections and steroid eye drops. After close observation, inflammation in the anterior chamber, optic disc edema, and the multiple whitish lesions in the retina were improved. A 27-year-old male who was treated for viral meningitis at the neurology department was referred to us with blurred vision in both eyes. His BCVAs were 0.7 (right eye) and 0.6 (left eye). The intraocular pressure was normal in both eyes. Slit lamp examination revealed inflammation in the anterior chamber and optic disc edema, and a fundus examination revealed multiple infiltrations. He received treatment for presumed herpes virus infection. After close observation, inflammation in the anterior chamber, optic disc edema, and multiple infiltrations with hemorrhage in the retina were improved. CONCLUSIONS: Clinicians should consider the possibility of uveo-meningeal syndrome, which can cause inflammation in the uvea,retina, and optic disc simultaneous with viral meningitis accompanying blurred vision.
Adolescent ; Adult ; Anterior Chamber ; Edema ; Female ; Hemorrhage ; Humans ; Inflammation ; Intraocular Pressure ; Male ; Meningitis ; Meningitis, Viral ; Neurology ; Ophthalmic Solutions ; Retina ; Slit Lamp ; Uvea ; Vision Disorders ; Visual Acuity

Purpose: To investigate risk factors of age-related macular degeneration (AMD) with routine health check-up data. Methods: Among 9,019 patients older than 40 years who underwent a routine health checkup at a single institution of South Korea from January to December 2017, 7,018 patients were enrolled in this retrospective study. An additional 2,001 patients were accepted, due to the absence of a fundus photo or having a fundus photo of poor quality. Results: Among 7,018 patients, 183 patients were diagnosed with AMD. We diagnosed 104 patients with early-phase, 75 patients with intermediate-phase, and 4 patients with late-phase AMD. The AMD groups were compared to a control group using one-way analysis of variance. The control, early, and intermediate groups showed meaningful differences with respect to age. In propensity score matching for age and sex, no differences were observed with respect to blood pressure, body mass index, or weight; however, significant differences were evident for the parameters of hepatitis B surface antigen, alkaline phosphatase, platelet, erythrocyte sedimentation rate, gamma glutamyl transferase, high density lipoprotein (HDL), carcinoembryonic antigen (CEA), C-reactive protein (CRP), status of exercise, drinking, and smoking between the control and AMD groups. In multiple logistic regression analyses with relevant factors, a strong positive relationship was established for hepatitis B surface antigen, HDL, CRP and CEA elevation, absence of exercise, and current smoking in AMD patients. Conclusions Risk for AMD was strongly correlated with hepatitis B surface antigen, elevation of HDL, CEA and CRP in blood tests, the absence of exercise, and a history of smoking.

Ramsay Hunt syndrome(RHS or herpes zoster oticus) is caused by reactivation of latent varicella-zoster virus(VZV) in the geniculate ganglion of the seventh cranial nerve. Unilateral facial paralysis is accompanied by herpetic vesicles on the external auditory canal or in the mouth. The prognosis is not good as that of idiopathic facial palsy. Aggressive treatment with acyclovir, in combination with steroids, is recommended. RHS is thought to affect adults primarily, but a few cases of children with RHS have been reported. We present a case of RHS combined with aseptic meningitis in a previously healthy 10-year-8-month-old boy. He showed a complete peripheral facial palsy on the right side with CSF pleocytosis. Eight days after the onset of the facial palsy, the characteristic herpetic vesicles appeared on the pinna of the right side. The analysis of sera confirmed the clinical diagnosis of RHS with a positive IgG and IgM-ELISA antibody titer of VZV. Although we administered acyclovir and prednisolone adequately to the patient, he has shown an incomplete recovery of the facial palsy on a follow-up visit. The physicians should be prudent in the diagnosis of idiopathic facial palsy or RHS, and must watch for the appearance of vesicles in children with facial palsy.
Acyclovir ; Adult ; Child ; Diagnosis ; Ear Canal ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Geniculate Ganglion ; Herpes Zoster ; Herpes Zoster Oticus* ; Herpesvirus 3, Human ; Humans ; Immunoglobulin G ; Leukocytosis ; Male ; Meningitis, Aseptic* ; Mouth ; Prednisolone ; Prognosis ; Steroids

BACKGROUND: Increased BMD after treatment means that the treatment regimen was effective to prevent fracture associated with osteoporosis. But changes of BMD reflected at least after 1 year. Now we use markers of bone turnover more easily, and they reflects bone metabolism faster than BMD within 3 4 months. Some data showed that changes of bone markers after 3 months could predict the changes of the BMD after 1 year. METHODS: 126 postmenopausal Korean women with osteoporosis were evaluated who visited Samsung Cheil hospital from Aug. 1997 to July 2000, with respect to markers of bone turnover and BMD at lumbar spine. Subjects were classified into 3 groups, HRT only group, HRT with alendronate group and HRT with calcitonin group. To evaluate the effectiveness of treatment regimen, we compared changes of markers after 3 months and changes of spinal BMD after 1 year treatment among 3 groups. And also evaluate the predictability of the changes of markers of bone turnover after 3 months about the changes of spinal BMD, multiple regression analysis were made. RESULTS: Our results showed those findings 1. Percent changes of markers of bone turnover decreased significantly compared with baseline(osteocalcin 30.4 53.4%, total alkaline phosphtase 26.7 20.0%, deoxypyridinoline 19.0 30.1%, and mean percent changes of markers among three groups showed no significant differences. 2. No significant relationships were noted between percent changes of spinal BMD and percent changes of markers of bone turnover. 3. Percent changes of BMD at lumbar spine were increased significantly after 1 year treatment(HRT only 5.6 3.6%, HRT with calcitonin 7.8 4.5%, HRT with alendronate 9.8% 4.7%). CONCLUSION: These results made conclusion that changes of markers of bone trunover after 3 months couldn't predict the changes of spinal BMD after 1 year treatment. But, HRT with antiresorptive agents may be effective in treating postmenopausal osteoporotic Korean women.
Alendronate ; Bone Density Conservation Agents ; Calcitonin ; Female ; Humans ; Metabolism ; Osteoporosis* ; Postmenopause ; Spine

To dtermine the optimal timing for Aortic Valve Replacement in patients of aortic insufficiency is very important, because irreversible myocardial damage can result before symtoms such as dyspnea, syncope and chest pain, appear for the first time. Henry suggested that the echocardiographic index of left ventricular end systolic dimension 55mm could be useful as an indicator of whether to operate or not. But Fioretti, et al., insisted that there was no significant difference postoperatively between those below 55mm and those over 55mm. To determine whether a left ventricular end systolic dimension greater than 55mm is one of the risk factors for AVR in patients with aortic insufficiency, we analyzed the serial echocardiographic examinations of 23 patients who underwent AVR for isolated AI. Group I patients (n=17) had a preoperative left ventricular end systolic dimension less than or equal to 55mm and Group II patients (n=6) had a preoperative left ventricular end systolic dimension greater than than 55mm. 1) left ventricular end systolic dimension decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 modths after operation. 2) Left ventricular end diastolic dimension also decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 months after operation. 3) Ejection Fraction was decreased markedly just postoperatively, but it was recovered soon in both groups, and there was no statistically significant differences of the ejection fractions between the two groups postoperatively. 4) SV1+/-RV6 in EKG, as an indicator of LV mass, was also analzed and it revealed significant reduction in both groups postoperatively, but we could not observe statistically significant differences between the two groups from 6 months after the operation. We concluded that the preoperative left ventricular end systolic dimension 55mm could be useful as an index to predict postoperative prognosis and to determine the timing of aortic valve replacement.
Aortic Valve* ; Chest Pain ; Dyspnea ; Echocardiography* ; Electrocardiography ; Humans ; Prognosis ; Risk Factors ; Syncope