PURPOSE: The aim of this study is to evaluate the T2 value of the articular cartilage of the glenohumeral joint in rotator cuff disease displayed on 3.0T MRI and to apply it in clinical practice. MATERIALS AND METHODS: This study involved sixty-two patients who underwent shoulder MRI containing T2 mapping. The mean T2 value was measured by placing a free hand ROI over the glenoid or humeral cartilage from the bone-cartilage interface to the articular surface on three consecutive, oblique coronal images. The drawn ROI was subsequently divided into superior and inferior segments. The assessed mean T2 values of the articular cartilage of the glenohumeral joint were compared and evaluated based on the degree of rotator cuff tear, the degree of fatty atrophy of the rotator cuff, and the acromiohumeral distance. RESULTS: ICC values between two readers indicated moderate or good reproducibility. The mean T2 value for the articular cartilage of the glenoid and humeral head cartilage failed to show any significant difference based on the degree of rotator cuff tear. However, the mean T2 values of articular cartilage, based on fatty atrophy, tended to be higher in fatty atrophy 3 or fatty atrophy 4 groups while some sub-regions displayed significantly higher mean T2 values. There was no correlation between the acromiohumeral distance and the mean T2 values of the articular cartilage of the glenoid and humeral head. CONCLUSION: T2 mapping of the glenohumeral joint failed to show any significant difference in quantitative analysis of the degenerative change of the articular cartilage based on the degree of rotator cuff tear. However, it also offers quantitative information on the degenerative change of cartilage of the glenohumeral joint in patients with rotator cuff tear and severe fatty atrophy of the rotator cuff.
Atrophy ; Cartilage ; Cartilage, Articular ; Hand ; Humans ; Humeral Head ; Magnetic Resonance Imaging ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Tears

OBJECTIVE: To assess the feasibility of balloon-occluded retrograde transvenous obliteration (BRTO) in active gastric variceal bleeding, and to compare the findings with those of transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: Twenty-one patients with active gastric variceal bleeding due to liver cirrhosis were referred for radiological intervention. In 15 patients, contrast-enhanced CT scans demonstrated gastrorenal shunt, and the remaining six (Group 1) underwent TIPS. Seven of the 15 with gastrorenal shunt (Group 2) were also treated with TIPS, and the other eight (Group 3) underwent BRTO. All patients were followed up for 6 to 21 (mean, 14.4) months. For statistical inter-group comparison of immediate hemostasis, rebleeding and encephalopathy, Fisher's exact test was used. Changes in the Child-Pugh score before and after each procedure in each group were statistically analyzed by means of Wilcoxon's signed rank test. RESULTS: One patient in Group 1 died of sepsis, acute respiratory distress syndrome, and persistent bleeding three days after TIPS, while the remaining 20 survived the procedure with immediate hemostasis. Hepatic encephalopathy developed in four patients (one in Group 1, three in Group 2, and none in Group 3) ; one, in Group 2, died while in an hepatic coma 19 months after TIPS. Rebleeding occurred in one patient, also in Group 2. Except for transient fever in two Group-3 patients, no procedure-related complication occurred. In terms of immediate hemostasis, rebleeding and encephalopathy, there were no statistically significant differences between the groups (p > 0.05). In Group 3, the Child-Pugh score showed a significant decrease after the procedure (p = 0.02). CONCLUSION: BRTO can effectively control active gastric variceal bleeding, and because of immediate hemostasis, the absence of rebleeding, and improved liver function, is a good alternative to TIPS in patients in whom such bleeding, accompanied by gastrorenal shunt, occurs.

PURPOSE: Laparoscopic totally extraperitoneal herniorrhaphy (TEP) was developed as an alternative treatment of inguinal hernias to open hernia repair. This study evaluated 92 cases of laparoscopic surgery to determine the effectiveness and safety of laparoscopic TEP. METHODS: Laparoscopic TEP was performed on 92 patients with inguinal hernias from January 2008 to December 2010. Through a retrospective study of these patients, information om TEP repair was collected including the patients' characteristics, operation time, hospital stay, analgesic use and related complications. RESULTS: Laparoscopic herniorrhaphy were performed on a total of 92 patients (85 men and 7 women, age ranging from 16 to 83 years, with a mean of 56 years). The mean operation time for a unilateral inguinal hernia and bilateral inguinal hernia was 58.7 and 84.2 min, respectively. The mean postoperative hospital stay was 4.0 days (range, 2~9 days). Thirty nine patients were discharged without an analgesic injection, whereas 36 patients were injected with analgesic on the day of surgery. Of these 92 procedures, 10 complications were recorded; one granuloma complication, two patients with operation site discomfort, five with urinary retention issues, one patient with a scrotal seroma, and one patient with scrotal edema. CONCLUSION: TEP repairs have minimal morbidity and are more effective with less pain than the open procedure. TEP repair can be considered a favorable procedure for patients who request minimally invasive procedures for inguinal hernia repairs.
Female ; Granuloma ; Hernia ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Laparoscopy ; Length of Stay ; Male ; Pyrazines ; Retrospective Studies ; Seroma ; Urinary Retention

Collagenous colitis is an uncommon condition charaeterized clinically by diarrhea and weight loss and histologically by thickening of the subepithelial collagen band with chromic inflammation. Laboratory tests of blood, urine and stool, and colonscopic findings are usually normal. The etiology of collagenous colitis is unknown. We report a case of collagenous colitis improved after treatment with sulfasalazine with review of literatures.
Colitis, Collagenous* ; Collagen* ; Diarrhea ; Inflammation ; Sulfasalazine ; Weight Loss

We present the methods of analysis of left ventricular wall motion by 2-dimensional echocardiography using computerized system. Quantiative analysis of left ventricular wall motion abnormalities depents on the used reference method, because the heart shifts and rotates within thorax during the cardiac cycle. To access left ventricular wall motion abnormalities, we studied 60 subjects(normal; 30 subjects, abnormal; 30 subjects)with 5 different floating reference methods correcting for traslation and/or rotation in two echocardiographic views. (apical 4-chamber view and apical 2-chamber view) In the first the endocardial tracings of enddiastole and endsystole in 30 normal subjects were stored in VAX-11-780 main computer and the data of these 30 normal subjects were plotted to obtain a 95% confidence interval for measured normal fractional change every five degree according to 5 reference methods. In the second, 30 patients with abnormal left ventricular wall motion analyzed and the results were compared with a 95% confidence interval. We assessed that left ventricular wall motion by visual and computerized quantitative anlysis were in close relationship according to optimal reference method. We suggested that computerized quantitative analysis of left ventricular wall motion by 2-dimensional echocardiography was clinically useful method and translation of the midpoint of mitral anulus with rotation according to center of mass was the most specific and sensitive new method of evaluating left ventricular wall motion abnormalities.
Echocardiography* ; Heart ; Humans ; Thorax

Nephrotic syndrome has been considered a hypercoagulable state because thromboembolic events of the venous or the arterial circulations occur on occasion. There are various risk factors for thromboembolism in patients with nephrotic syndrome (membranous nephropathy, severe hypoalbuminemia, hemoconcentration and medications such as steroid and diuretics). As thromboembolism is often fatal, early detection and proper management are important. Although anticoagulation is the preferred therapy, thrombolysis may be considered for an extensive thrombosis, for inferior vena cava (IVC) thrombosis, for recurrent pulmonary thromboembolism and for bilateral renal vein thrombosis in conjunction with acute renal failure. We report here on a case of renal vein and IVC thrombosis in a 24-year-old male with nephrotic syndrome, and this patient was treated with intravenous thrombolytics rather than anticoagulation and local thrombolytic infusion. He complained of left flank pain and his CT scan revealed left renal vein thrombosis and IVC thrombosis. After urokinase infusion, his thrombi were resolved successfully without bleeding complications.
Acute Kidney Injury ; Flank Pain ; Hemorrhage ; Humans ; Hypoalbuminemia ; Male ; Nephrotic Syndrome* ; Pulmonary Embolism ; Renal Veins* ; Risk Factors ; Thromboembolism ; Thrombosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator ; Vena Cava, Inferior* ; Young Adult

Melorheostosis usually affects long bones of the lower limbs, and the hand is a relatively uncommon site of presentation. This disease is diagnosed by its characteristic X-ray finding and is confirmed by histololgic examination. Recently, Magnetic Resonance (MR) images have been used to evaluate disease activity and to understand soft tissue pathoanatomy in melorheostosis. The authors evaluated the activity of the melorheostosis indirectly with MR imaging and achieved a good symptomatic result with conservative treatments.
Hand* ; Lower Extremity ; Magnetic Resonance Imaging ; Melorheostosis*

Both intrathyroidal parathyroid adenoma and acute pancreatitis from hyperparathyroidism are rare disorders. We report a case of acute pancreatitis from hyperfunctioning intrathyroidal parathyroid adenoma in a 40-year-old man with severe abdominal pain. Serum chemistry values show-ed high amylase, lipase, calcium and intact parathyroid hormone level, and abdominal CT revealed acute pancreatitis. A 7 mm lesion was detected inside the left upper pole of thyroid on neck ultrasonography and confirmed to be a parathyroid lesion based on fine needle aspiration cytology. After exploratory parathyroidectomy, symptoms subsided. In patients who present with acute pancreatitis, hyperparathyroidism should also be considered if risk factors such as alcohol ingestion, gallstone, previous endoscopic retrograde cholangiopancreatography, and abdominal trauma do not exist. Exploratory parathyroidectomy should be performed in a case of acute pancreatitis from primary hyperparathyroidism.
Abdominal Pain ; Adult ; Amylases ; Biopsy, Fine-Needle ; Calcium ; Chemistry ; Cholangiopancreatography, Endoscopic Retrograde ; Eating ; Gallstones ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Lipase ; Neck ; Pancreatitis* ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Parathyroidectomy ; Risk Factors ; Thyroid Gland ; Tomography, X-Ray Computed ; Ultrasonography

Angioleiomyoma is a solid benign tumor, which is often painful. It can be found in the dermis, subcutaneous fat and fascia. Peak incidence is during the fourth to sixth decades of life. Angioleiomyoma in the hand can be treated with simple excision, and is relatively rare in the hand. So far, there has been no report of angioleiomyoma in the hand in South Korea. The authors experienced two cases of angioleiomyoma in the hand; one in the second web space and the other in the fifth metacarpal region. Both patients were treated by simple excision. There was no evidence of recurrence at one-year follow up.
Angiomyoma* ; Dermis ; Fascia ; Follow-Up Studies ; Hand* ; Humans ; Incidence ; Korea ; Recurrence ; Subcutaneous Fat

Carcinoma of the parathyroid gland has been reported as a rare disease occurring in 0.5 to 4% of patients with the primary hyperparathyroidism. Brown tumor is characterized as the terminal stage of remodeling processes during the primary or secondary hyperparathyroidism. Brown tumor induced by the primary hyperparathyroidism can commonly occur in the ribs, clavicle, and pelvic bone. We experienced a case of a 29-year old female patient, who had parathyroid carcinoma leading to primary hyperparathyroidism, followed by multiple Brown tumor. We present this case of parathyroid carcinoma with Brown tumors with a brief review of literature.
Clavicle ; Female ; Humans ; Hyperparathyroidism, Primary ; Hyperparathyroidism, Secondary ; Osteitis Fibrosa Cystica ; Parathyroid Glands ; Parathyroid Neoplasms* ; Pelvic Bones ; Rare Diseases ; Ribs