PURPOSE: To evaluate the characteristics of CT findings in differential diagnosis of cervical lymphadenopathy. MATERIALS AND METHODS: We evaluated CT findings of histopathologically proved 32 cases of tuberculous lymphadenitis, 12 cases of nodal lymphoma, 29 cases of metastasis from March 1986 to Dec. 1992, retrospectively. We analyzed age and sex distribution, location of lymphadenopathy, internal nodal density, feature of contrast enhancement, extracapsular spread and nodal calcification. RESULTS: Tuberculous lymphadenitis was more preponderant in young female (mean;32) and CT showed internal low density(91%) with irregular thick marginal enhancement(46.9%), predilection for spinal accessory node(71.9%), and nodal calcification(5/32). Nodal lymphoma showed predilection for internal jugular chain (100%) and had conglomerated homogeneous internal node structures(83%). Metastasis showed old male preponderance (mean :52 years), predilected at internal jugular chain(89.7%),internal low density(93.3%) with regular thin marginal enhancement(44.8%), extracapsular spread(41.4%), and nodal calcification(2 cases of nodal metastasis of papillary type thyroid cancer). CONCLUSION: We concluded that CT evaluation of the chracteristics of lymphadenopathy is helpful for differential diagnosis of cervical lymphadenopathy.
Diagnosis, Differential* ; Female ; Humans ; Lymphatic Diseases* ; Lymphoma ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Sex Distribution ; Thyroid Gland ; Tuberculosis, Lymph Node

PURPOSE: To analyze the clinical and radiologic results after total knee arthroplasties using down-sizing femoral prosthesis for tight fitting in patients over 75 years old. SUBJECTS AND METHODS: The study tracked the histories of 99 elderly patients aged 75 and over who underwent total knee arthroplasties with at least five years of follow-up from January 1st, 2005 to December 31st, 2007. The average age of the 99 patients was 78.58 years, and 17 women an 82 men patients underwent 78 cases of total knee arthroplasties on the right and 77 cases of total knee arthroplasties on the left. The HSS score and VAS scoring systems were introduced for clinical analysis. We compared the results of the width of the radiolucent line in 7 sections around the femoral component, 7 sections around the tibia component and 5 sections in the patella component using the American Knee Society Radiographic Evaluation and Scoring system respectively. RESULT: The average period of postoperative follow-up study was 6.2 years. The average femoral prosthesis size in preoperative measurement was 2.41 while the size selected in surgery was 1.89. The average VAS score decreased from 8.15 in preoperative measurement to 2.85 in postoperative measurement. Clinical significant loosening or dislocation of femoral prosthesis was not observed. Although the radiolucent line was observed in 5 cases, the score was less than 4. CONCLUSION: Total knee arthroplasties using down-sizing femoral prosthesis does not increase osteolysis and dislocation of femoral prosthesis but does reduce pain and help patients return to normal activities. Therefore this study showed that total knee arthroplasties using down-sizing femoral prosthesis helped elderly patients aged 75 and over.
Aged* ; Arthroplasty ; Dislocations ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteolysis ; Patella ; Prostheses and Implants ; Tibia

“Thrombus-in-transit” in pulmonary embolism is associated with high mortality and refers to a free-floating clot in the right atrium or right ventricle, indicating that deep vein thrombosis is present en route to the pulmonary artery. Thrombus entrapped in a patent foramen ovale (PFO) is a rare condition and is associated with paradoxical systemic embolism. Here, we report a case of acute pulmonary embolism with thrombus-in-transit through a PFO in a 68-year-old woman with a diagnosis of metastatic pancreatic cancer undergoing palliative chemotherapy. She presented with syncope after acute onset of exertional dyspnea and was diagnosed with cardiogenic shock due to massive pulmonary embolism with thrombus-in-transit on admission to the emergency room. We treated her with systemic thrombolysis and anticoagulation therapy instead of surgical thrombectomy. We show that hemodynamically unstable pulmonary embolism with thrombus-in-transit entrapped by a PFO may be successfully treated with systemic thrombolysis without paradoxical embolism.
Aged ; Diagnosis ; Drug Therapy ; Dyspnea ; Embolism ; Embolism, Paradoxical ; Emergency Service, Hospital ; Female ; Foramen Ovale ; Foramen Ovale, Patent ; Heart Atria ; Heart Ventricles ; Humans ; Mortality ; Pancreatic Neoplasms ; Pulmonary Artery ; Pulmonary Embolism ; Shock, Cardiogenic ; Syncope ; Thrombectomy ; Thrombolytic Therapy ; Thrombosis ; Venous Thrombosis

PURPOSE: Synovial sarcoma is an uncommon malignant soft tissue tumor mostly prevalent in young adults. Previous studies analyzing the prognostic factors have been limited due to the inclusion of heterogenous cohorts of patients with nonextremity and recurrent tumors. The purpose of this study was to determine the independent prognostic factors for the treatment methods associated with local recurrence and metastasis of primary synovial sarcoma localized to the extremities. MATERIALS AND METHODS: Between April 1999 and June 2014, a total of 79 patients were diagnosed with synovial sarcoma, of which 73 underwent wide excision at Kosin University Gospel Hospital and were followed-up for 60 months (24-72 months). The analyzed prognostic factors were treatment methods for local recurrence and metastasis during the postoperative follow-up period. The Cox regression model was used for multivariate analysis. RESULTS: For local recurrence according to the treatment methods, 9 recurrences occurred in 9 surgical treatments, 8 in 20 chemotherapy added surgical treatments, 13 in 20 radiotherapy added surgical treatments, and 4 in 24 chemotherapy with radiotherapy added surgical treatments. For metastasis according to the treatment methods, 9, 5, 12, and 2 metastases occurred respectively. Chemotherapy had statistical significance in multivariate analysis (p<0.0001). CONCLUSION: Adjuvant chemotherapy can be useful for the treatment of synovial sarcoma.
Chemotherapy, Adjuvant ; Cohort Studies ; Drug Therapy ; Extremities* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Radiotherapy ; Recurrence ; Sarcoma, Synovial* ; Survival Rate ; Young Adult

Chondromyxoid fibroma is a rare bone tumor of cartilaginous origin, representing less than 1% of all bone tumors. It preferentially arises in the eccentric location of the metaphysis of a long tubular bone. Juxtacortical locations are reported infrequently in the long bones and even more rarely in short tubular bones, with only three cases documented. Here we present two new cases of juxtacortical chondromyxoid fibroma in the small bones. One was an intracortical osteolytic lesion of the metatarsal bone of the foot with degenerative atypia that histologically should be differentiated from chondrosarcoma. The other was a phalangeal mass protruding into the interphalangeal joint of the hand, which had been labeled mistakenly as a soft tissue mass preoperatively. These cases illustrated that chondromyxoid fibromas have various the manifestations and should be included in the differential diagnosis of an osteolytic lesion or an exophytic mass in the small bones.

“Thrombus-in-transit” in pulmonary embolism is associated with high mortality and refers to a free-floating clot in the right atrium or right ventricle, indicating that deep vein thrombosis is present en route to the pulmonary artery. Thrombus entrapped in a patent foramen ovale (PFO) is a rare condition and is associated with paradoxical systemic embolism. Here, we report a case of acute pulmonary embolism with thrombus-in-transit through a PFO in a 68-year-old woman with a diagnosis of metastatic pancreatic cancer undergoing palliative chemotherapy. She presented with syncope after acute onset of exertional dyspnea and was diagnosed with cardiogenic shock due to massive pulmonary embolism with thrombus-in-transit on admission to the emergency room. We treated her with systemic thrombolysis and anticoagulation therapy instead of surgical thrombectomy. We show that hemodynamically unstable pulmonary embolism with thrombus-in-transit entrapped by a PFO may be successfully treated with systemic thrombolysis without paradoxical embolism.

A spermatic cord leiomyoma is an uncommon disease. A leiomyoma can originate anywhere, including the genitourinary system, where smooth muscle is present. 70 and 30% of spermatic cord leiomyomas are benign and malignant, respectively. The preoperative diagnosis of a leiomyoma is difficult; the only definite diagnostic method is histological confirmation. A retroperitoneal lipoma probably constitutes the largest group of solid abdominal tumors. However, their etiology is unknown and the symptoms insidious, and recurrences and sarcomatous changes frequently occur. The clinical diagnostic methods are the clinical symptoms, a physical examination and radiological evaluations, such as intravenous urography, computed tomography and angiography, and so on, but an abdominal CT scan provides the most useful information. A fifty-six-old man presented with a five-month history of a suddenly enlarging right inguinal mass. He had undergone a right inguinal hernia operation, with medication for hypertension. Herein, a rare case of a huge retroperitoneal lipoma, with a spermatic cord leiomyoma, is reported.
Angiography ; Diagnosis ; Hernia, Inguinal ; Hypertension ; Leiomyoma* ; Lipoma ; Muscle, Smooth ; Physical Examination ; Recurrence ; Retroperitoneal Space ; Spermatic Cord* ; Tomography, X-Ray Computed ; Urogenital System ; Urography

GMH/IVH(Germinal martrix-Intraventricular hemorrhage ) is an inportant factor that influences on the mortality rate of low-birth-weight infants. The real-time high resolution sonography with a mechanical sector scanner is a convenient and useful method for the detection and follow-up study of intracranial hemorrhage in low-birth-weight infants. Authors analysed 112 cases of neurosonographic findings in low-birth-weight infants, weighing less than 2,500gm. The incidence of GMH/IVH was 54.5%. The severity of GMH/IVH was classified into 4 grades(I-IV) and their percentages were 41%, 41% 8.1%, and 9.9%, respectively. The onset of GMH/IVH was within the first week after birth in 75.4% of cases. The overall mortality rate of low-birth-weight infants with GMH/IVH was 18% (4% for grade I, 12% for grade II, 40% for grade III and 83% for grade IV). In the follow-up study of 61 cases, complete absorption was seen in 25 cases, rebleeding in 5 cases, cystic change in 24 cases, ventriculomegaly in 9 cases and hydrocephalus in 7 cases. The incidence of GMH/IVH in neonates with pathologic lung conditions was 82.5% and that with normal lung conditions was 39%. In conclusion, sonography is very useful in the diagnosis and follow-up of GMH/IVH in low-birth-weight infants. Our study is the first step in the further study of the relationship between GMH/IVH and neuromotor outcome.
Absorption ; Diagnosis ; Follow-Up Studies* ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Intracranial Hemorrhages ; Lung ; Methods ; Mortality ; Parturition

No abstract available.
Magnetic Resonance Imaging* ; Subacute Combined Degeneration*

Hibernoma is a rare benign tumor of a brown fat origin with hypervascularity. Although the magnetic resonance imaging features resemble a liposarcoma, its malignant potential is unknown. A complete local excision with meticulous hemostasis is the treatment of choice. We present a case of hibernoma in the psoas muscle with a review of the relevant literature.
Adipose Tissue, Brown ; Hemostasis ; Lipoma* ; Liposarcoma ; Magnetic Resonance Imaging ; Psoas Muscles*