PURPOSE: To evaluate the radiologic findings of intraspinal epidural arachnoid cyst. MATERIALS AND METHODS: Six pateuts with surgically proven intraspinal epidural arachnoid cyst were included in this study. Four were freeof specific past history, but two had a history of trauma. All underwent examination by plain radiography,CT-myelography and MRI, and the following aspects were retrospectively analysed : vertebral pressure erosion,interpedicular distance, enlargement of neural foramina, as seen on plain radiograph, contrast-filling and lateralbulging of lesions through neural foramina on CT-myelograph, and signal intensity, size and shape of margin andepidural fat pattern, as seen on MRI. RESULTS: Three of four congenital intraspinal epidural arachnoid cysts weresingle in the thoracolumbar region, while in the other case, there were multiple cysts in the mid- and lowerthoracic regions. Cysts were equivaleut in size to between four and six vertebral bodies. Plain radiographicfindings of pedicular pressure erosion, widened interpedicular distance, and bilateral neural foraminalenlargement of several contiguous vertebrae were observed in all four cases. One showed posterior vertebralscalloping. On CT-myelograph, a contrast-filled cystic lesion occupying the posterior epidural space, with lateralbulging through neural foramina and anterior displacement of the contrast-filled thecal sac, was seen. On MRI,longitudinally elongated, well-demarcated cysts were seen to be present in the posterior epidural space; theirsignal intensity was the same as in CSF. An epidural fat cap pattern enveloping the upper and lower ends of thecysts was apparent in all cases. In two cases, traumatic intraspinal epidural arachnoid cysts were situated in thethoracolumbar and lumbosacral region, respectively, near a previously injured region and were smaller (equivalentto the height of three vertebral bodies). CT-myelograph and MRI showed that their effect on the thecal sac wascompressive only. CONCLUSION: When pressure erosion of vertebral odies and pedicles of contiguous severalvertebrae in the thoracic or thoracolumbar region is recognized on plain radiograph, intraspinal epiduralarachnoid cyst should be included in differential diagnosis, and for accurate evaluation, CT-myelograph and/or MRIare needed.
Arachnoid Cysts ; Arachnoid* ; Diagnosis, Differential ; Epidural Space ; Lumbosacral Region ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine

Anomalous systemic arterial supply to the lung is a rare congenital anomaly. The lung supplied by the anomalus systemic artery has a normal bronchial tree, which is usually in the basal segment of the lung, especially in the left lung. Most of patients are asymptomatic, but the main clinical symptoms of this disease are hemoptysis and exertional dyspnea. CT is useful for the diagnosis and showed a retrocardiac nodular shadow connected to the descending aorta branching into the basal segments of the relatively normal lower lobe. Surgery is indicated for all patients. Here we report a case of anomalous systemic arterial supply to normal basal segments of left lower lobe in a patient with hemoptysis with a review of the relevant literature.
Aorta, Thoracic ; Arteries ; Diagnosis ; Dyspnea ; Hemoptysis ; Humans ; Lung

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

Following gastric surgery, 25~50% of patients experience dumping symptoms. Early dumping usually involves both gastro-intestinal and vasomotor complaints, while late dumping involves mainly the latter. Management is mainly achieved by dietary modification. Drug therapy has been investigated without consistent success. However, the somatostatin analogue octreotide alleviates dumping by slowing gastric emptying, inhibiting insulin release, decreasing enteric peptide secretion and intestinal absorption of water and sodium, slowing monosaccharide absorption, increasing gut transit time and preventing hemodynamic changes. We report a case with the place of octreotide in the medical management of the dumping syndrome. The patient was 71-year-old male who had taken total gastrectomy for gastric cancer in 1987. He had been well except intermittent abdominal pain for 8 years after total gastrectomy. But he had suffered from sudden symptoms such as hypoglycemic shock and fainting, which start 2~3 hours after ingesting of a meal for recent 5 years. Studies for diagnosing insulinoma were all negative. We start diet modification and medication such as acarbose to him with impression of dumping syndrome, but there were no improvement of his symptoms. Then we start octreotide, 50 g, given subcutaneously, three-times per day, 30 min prior to each meal. His symptom was dramatically improved.
Abdominal Pain ; Absorption ; Acarbose ; Aged ; Drug Therapy ; Dumping Syndrome* ; Food Habits ; Gastrectomy ; Gastric Emptying ; Hemodynamics ; Humans ; Hypoglycemia ; Insulin ; Insulinoma ; Intestinal Absorption ; Male ; Meals ; Octreotide* ; Shock* ; Sodium ; Somatostatin ; Stomach Neoplasms ; Syncope ; Water

PURPOSE: To evaluate the therapeutic effect of gamma knife radiosurgery in cerebral vascular malformationusing a radiologic imaging method such as MRI or angiography. MATERIALS AND METHODS: We retrospectively reviewedMRIs, Ct scans and angiograms of 29 cases of arteriovenous malformation and 15 of cavernous malformation beforeand after gamma knife radiosurgery. The patients underwent follow-up radiologic studies for between 6 and 35months after radiosurgery. No patient underwent ofter surgery of embolization. Radiological imaging analysisfocused on changes in the volume of the nidus or central core. Other findings of edema, cystic change, hemorrhage,signal intensity, enhancement and distributional vascular markings were also studied. The volume of the AVM niduswas measured and assigned ot one of four groups : <1cc, 1-4cc,> 4-10cc and> 10cc. RESULTS: In arteriovenousmalformation cases, the volume of the nidus decreased by mean 60.2%; reduction was greatest(68.1%) in the 1-4ccgroup. Three cases showed complete loss of the nidus at 9, 12 and 25 months after radiosurgery, respectively. Innine cases, dereased caliber or loss of draining vein was noted. High signal intensity on T2-weighted MR images,suggesting either edema or demyelination, was observed in four cases. In cavernous angioma cases, core volume wasreduced by 36.8%. Transient cerebral edema and presumed radiation necrosis were observed in two cases and one,respectively. CONCLUSION: Gamma knife suregery was effective in nearly all cases of arteriovenous malformationand some cases of cavernous malformation. More than two years follow-up involving radiologic imaging such as MRIis needed for the evaluation of therapeutic effect and diagnosis of complications.
Angiography ; Arteriovenous Malformations ; Brain Edema ; Demyelinating Diseases ; Diagnosis ; Edema ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Intracranial Arteriovenous Malformations ; Magnetic Resonance Imaging ; Necrosis ; Radiosurgery* ; Retrospective Studies ; Tomography, X-Ray Computed ; Veins

Large bowel metastasis from a primary lung cancer is rare and is hard to be asymptomatic. We report a case of intussusception without any symptoms caused by cecal metastasis of primary small cell lung cancer. A 70-year-old woman was admitted to hospital with cough and sputum of 3 weeks' duration. She was diagnosed with small cell lung cancer based on percutaneous needle biopsy of a lung mass identified by chest CT. In abdominal CT, multiple metastatic lesions were detected in the left adrenal gland and cecum with intussusception. After further colonoscopy and biopsy evaluations, the pathology results showed metastatic cancer originating from small cell cancer of the lung.
Adrenal Glands ; Biopsy ; Biopsy, Needle ; Cecum ; Colonoscopy ; Cough ; Female ; Humans ; Intussusception ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Small Cell Lung Carcinoma ; Sputum ; Thorax

A fracture of the anterior process of the calcaneus has been considered unusual injury. A clinically missed diagnosis is often, that had gone on to non united fragment. Particularly if the patient has calcaneocuboid pain and disability, and that early excision of the fragment is usually advisable. There were 12 cases with performing the simple excision. The fracture characteristics were analyzed by Degan's classification; type 1 was 1case (8.3%), type 2 was 6 cases (50.0%) and type 3 was 5 cases (41.7%); and their morphology; elongation was 3 cases (50.0%) and fragmentation 3 cases (50.0%). And, the pre and post operative American Orthopedic Foot and Ankle Society midfoot score and visual analog scale was evaluated; 66.0 and 5.8 was significantly improved to 90.1 (p=0.007) and 2.2 (p=0.003), respectively. Postoperative Excellent and good satisfaction with possible return to previous sports activity was 10 cases (83.3%). Conclusively, simple excision of non united fragment of anterior process of the calcaneus is a successful clinical option.
Animals ; Ankle ; Calcaneus ; Foot ; Humans ; Orthopedics ; Sports

BACKGROUND: The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. However, the cheek flap is cosmetically superior as it uses the adjacent large flap. Thus, the study aims to demonstrate its versatility with clinical practices. METHODS: This is retrospective case study on 38 patients who removed facial masses and reconstructed by the cheek rotation flap from 2008 to 2015. It consists of defects on cheek (16), lower eyelid (12), nose (3), medial canthus (3), lateral canthus (2), and preauricle (2). Buccal mucosa was used for the reconstruction of eyelid conjunctiva, and skin graft was processed for nasal mucosa reconstruction. RESULTS: The average defect size was 6.4 cm², and the average flap size was 47.3 cm². Every flap recovered without complications such as abnormal slant, entropion or ectropion in lower eyelid, but revision surgery required in three cases of nasal side wall reconstruction due to the occurrence of dog ear on nasolabial sulcus. CONCLUSION: The cheek rotation flap can be applicable instead of paramedian forehead flap for the large nasal sidewall defect reconstruction as well as former medial and lateral canthal defect reconstruction.
Animals ; Cheek* ; Cicatrix ; Conjunctiva ; Dogs ; Ear ; Ectropion ; Entropion ; Eyelids ; Forehead ; Humans ; Lacrimal Apparatus ; Mouth Mucosa ; Nasal Mucosa ; Nose ; Retrospective Studies ; Skin ; Skin Pigmentation ; Transplants

Behcet's disease is multi-systemic vasculitis affecting all sizes of arteries and veins. The prevalence of coronary involvement in Behcet's disease is extremely rare. A 35-year-old woman with one-year history of Behcet's disease was in hospitalized with pseudoaneurysm of left anterior descending coronary artery, which was detected by echocardiography. The patient was successfully treated by implantation of an endovascular graft-stent.
Adult ; Aneurysm, False* ; Arteries ; Coronary Vessels* ; Echocardiography ; Female ; Humans ; Prevalence ; Vasculitis ; Veins

Among 136 patients having undergone mitral valve surgery from September of 1994 through August of 1995 in Sejong Heart Institute, forty four patients(18 males, 26 females) underwent mitral valve reconstruction using prosthetic rings and their clinical results were evaluated. Patients' ages ranged from 5 to 63 years(mean age 38.2 years). Mitral valvular diseases were due to rheumatic origin in 30 patients(68 %), degenerative in 13(30%), and congenital in one patient(2%). Mitral regurgitation(MR) was in 33 patients(76%), mitral stenosis 2(5%), and mitral stenoinsufficiency 9 patients(19%). The patients were divided into Carpentier's functional groups : type I, 5 patients(11%) ; type II, 24 patients(55%) ; type III, 4 patients (9%) ; and mixed(II + III), 11 patients(25%). Average number of anatomic lesions of mitral valve per patient was 3.7. The techniques included prosthetic ring annuloplasty(44 patients, 32 Carpentier ring and 12 Duran ring), leaflet mobilization(24, 55%), chordae shortening(23, 52%), chordae trans- position(23, 52%), commissurotomy(16, 35%), leaflet resection(9, 20%), papillary muscle splitting(8, 18%), and chordae reimplantation(1, 2%). Average 3.4 surgical procedures were applied on mitral valve per patient. There were two hospital mortality and one reoperation due to development of MR(grade III) after 2 weeks. During the mean follow up of 12 months, patients improved in terms of functional class of the New York Heart Association, which was mean 3.0 preoperatively and 1.3 postoperatively. Doppler echocardiographic studies showed adequate valve area(2.07 +/- 0.11 cm2, mean +/- standard error), improved ventricular contractility in 41 patients(93%), absence of MR in 23(53%), trace MR in 18(42%), and grade II MR in 2 patients(5%).
Echocardiography ; Follow-Up Studies ; Heart ; Heart Valve Diseases* ; Hospital Mortality ; Humans ; Male ; Mitral Valve ; Mitral Valve Annuloplasty ; Mitral Valve Stenosis ; Papillary Muscles ; Reoperation