We report a case of calcific bursitis of the shoulder in four-year-old boy who had severe pain and limitation of motion of the left shoulder joint for three days. Radiographs revealed the oval radiopaque lesion in the subacormial space, and the MR signal intensity of the mass was moderate on T2WI. Histological examination of the mass showed acute necrotizing inflammation with calcification.
Bursitis ; Humans ; Inflammation ; Male ; Shoulder ; Shoulder Joint

Since the advent of volar locking plate, volar approach for internal fixation has become a major trend in the treatment for unstable distal radius fracture. However, dorsal approach is preferred for certain fracture pattern include AO type C3, dorsal Barton's fractures and concomitant intercarpal ligament injury, because it can afford excellent exposure of the articular surface. Although dorsal approach and plating technique has inherent disadvantages include extensor tendon irritation and rupture, improvements in implant design lead to decrease complication rate. Here, we provide overview of the pros and cons through historic perspective, indications, and surgical technique of the dorsal approach for the distal radius fracture.
Ligaments ; Radius Fractures* ; Rupture ; Tendons ; Palmar Plate

Annular pustular psoriasis(APP) is a rare variant of the generalized pustular psoriasis characterized by subacute onset of annular lesion with peripheral advancing pustules. Histologically, it is characterized by spongiform and/or subcorneal pustules which are also found in subcorneal pustular dermatosis(SPD). SPD is very difficult to differentiate from APP, although SPD is thought to be a separate and distinctive entity because of its clinical appearance, characteristic histology, and response to dapsone. We herein report a case of APP showing clinical and histologic features of SPD developed in a patient who had a history of generalized pustular psoriasis.
Dapsone ; Humans ; Psoriasis* ; Skin Diseases, Vesiculobullous*

BACKGROUND: Although a magnetic resonance imaging (MRI) is highly sensitive for changes associated with ischemic stroke, the detection of an acute ischemic lesion is usually impossible within 6 hours of the stroke onset on a conventional MRI. The perfusion MRI is a new imaging technique for diagnosing acute ischemic stroke. We evaluate the clinical usefulness of the perfusion MRI in predicting the final infarct extent in 18 patients with acute middle cerebral artery (MCA) territory ischemic stroke. METHOD: The perfusion MRI was performed within 6 hours after the stroke onset in all patients with a single-section dynamic contrast-enhanced T2*-weighted imaging in conjunction with a conventional routine MRI and MR angiography. Time-concentration curves and cerebral blood volume (CBV) maps were calculated from the dynamic MR imaging data by using numerical integration techniques. We compared findings of CBV maps with infarction on a follow-up CT or MRI. RESULTS: In 14 of 18 patients, the CBV in the occluded MCA territory were decreased. In the remaining 4 patients with a reversible ischemic neurologic deficit (RIND) or transient ischemic attack (TIA), the CBV were increased in 3 and normal in 1. Out of 14 patients with a decreased CBV, two had focal regions of increased CBV within the affected territory, indicating reperfusion hyperemia. The regions of increased or decreased CBV were eventually converted to infarction on follow-up images in all 14 patients. Out of 4 patients with RIND or TIA, one showed focal infarction in centrum semiovale on a follow-up image. CONCLUSIONS: The perfusion MRI was useful for the assessment of hemodynamic change about cerebral perfusion and may predict the extent of final infarction in acute MCA territory ischemic stroke. These results suggest that the perfusion MRI may play an important role in the diagnosis and management of acute ischemic stroke.
Angiography ; Blood Volume ; Diagnosis ; Follow-Up Studies ; Hemodynamics ; Humans ; Hyperemia ; Infarction ; Ischemic Attack, Transient ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Neurologic Manifestations ; Perfusion* ; Reperfusion ; Stroke*

The vast majority of discoid menisci are lateral. A medial discoid meniscus is very rare. A 33-year-old and a 15-year-old male patient were diagnosed as having a complete medial discoid meniscus by means of magnetic resonance imaging and arthroscopic procedures. The first patient had a peripheral tear along with cystic degeneration, and the second had a horizontal tear. One was treated successfully by an arthroscopic partial meniscectomy with a peripheral repair, and the other by an arthroscopic partial meniscectomy. We report two cases of medial discoid meniscus with a brief review of literature.
Adolescent ; Adult ; Arthroscopy ; Humans ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial*

Background/Aims: Because hepatitis B virus (HBV) replication has been known to play animportant role in cancer recurrence after curative treatment of HBV-related hepatocellularcarcinoma (HCC), we examined whether treatment based on nucleos(t)ide analogues (NAs)might decrease the recurrence rate and improve patient survival. Methods: The retrospective cohort study enrolled 73 patients with chronic hepatitis B whowere treated with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA)with curative intent for HCC. Among those, 30 and 43 patients were treated with tenofovirdisoproxil fumarate (TDF) and entecavir (ETV), respectively. Results: Of the 73 patients, 51 experienced HCC recurrence, and 14 patients were deadduring a follow-up of 73±34 months. Multivariate analyses showed that tumor size (hazardratio [HR], 1.590; 95% confidence-interval [CI], 1.106-2.285; P=0.012) and Child-Pugh class B(vs. class Aon cirrhosis; HR, 5.794; 95% CI, 2.311-14.523; P=0.001) was significantly associatedwith HCC recurrence, and Child-Pugh class B (HR, 7.357; 95% CI, 2.100-25.777; P=0.002) was anindependent unfavorable prognostic factor for survival. During NAs therapy, TDF was superiorto ETV for complete viral response at 1 year after the date of combination of TACE and RFA(P=0.016). However, the risks of HCC recurrence and survival were not significantly differentbetween those treated with TDF versus ETV. Conclusions TDF was superior to ETV for achieving complete viral response. However, therecurrence and mortality after TACE and RFA for HBV-related HCC were not significantlydifferent between patients treated with TDF versus ETV.

Background/Aims: Because hepatitis B virus (HBV) replication has been known to play animportant role in cancer recurrence after curative treatment of HBV-related hepatocellularcarcinoma (HCC), we examined whether treatment based on nucleos(t)ide analogues (NAs)might decrease the recurrence rate and improve patient survival. Methods: The retrospective cohort study enrolled 73 patients with chronic hepatitis B whowere treated with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA)with curative intent for HCC. Among those, 30 and 43 patients were treated with tenofovirdisoproxil fumarate (TDF) and entecavir (ETV), respectively. Results: Of the 73 patients, 51 experienced HCC recurrence, and 14 patients were deadduring a follow-up of 73±34 months. Multivariate analyses showed that tumor size (hazardratio [HR], 1.590; 95% confidence-interval [CI], 1.106-2.285; P=0.012) and Child-Pugh class B(vs. class Aon cirrhosis; HR, 5.794; 95% CI, 2.311-14.523; P=0.001) was significantly associatedwith HCC recurrence, and Child-Pugh class B (HR, 7.357; 95% CI, 2.100-25.777; P=0.002) was anindependent unfavorable prognostic factor for survival. During NAs therapy, TDF was superiorto ETV for complete viral response at 1 year after the date of combination of TACE and RFA(P=0.016). However, the risks of HCC recurrence and survival were not significantly differentbetween those treated with TDF versus ETV. Conclusions TDF was superior to ETV for achieving complete viral response. However, therecurrence and mortality after TACE and RFA for HBV-related HCC were not significantlydifferent between patients treated with TDF versus ETV.

Primary hepatic leiomyosarcoma is a very rare tumor of the liver and primary hepatic leiomyosarcoma with Behcet's disease has not been reported previously. Behcet's disease is a multisystem disorder presenting with recurrent oral and genital ulcerations as well as ocular lesions; it has rarely been reported in association with malignant disease. We report a case of primary hepatic leiomyosarcoma with intrahepatic and abdominal subcutaneous metastasis in a patient with Behcet's disease; this is the first report of these findings in Korea.
Abdominal Neoplasms/diagnosis/*secondary ; *Abdominal Wall ; Adult ; Behcet Syndrome/*complications ; Female ; Humans ; Leiomyosarcoma/*complications/diagnosis/*secondary ; Liver Neoplasms/*complications/diagnosis/*secondary ; *Subcutaneous Tissue

BACKGROUND AND OBJECTIVES: Corticosteroids have been used for therapeutic management of sudden sensorineural hearing loss (SSNHL). Because the levels of steroid within inner ear after systemic administration is very low, high-dose steroid regimens have been used. The purpose of this study is to compare the effect of high-dose (HD) steroid therapy with that of super-highdose (SHD) steroid therapy in SSNHL. SUBJECTS AND METHOD: The study group consisted of 97 patients diagnosed as SSNHL. They were divided into two groups : those who were administered 60 mg prednisolone as the initial high dose (HD group) and those who were administered 1,200 mg hydrocortisone (about 300 mg prednisone) as the super high dose (SHD group). RESULTS: Hearing improvement was observed in 76.8% of HD group and in 67.9% of SHD group and there was no statistically significant difference in the rate of hearing improvement between HD group and SHD group. CONCLUSION: Super-high-dose steroid regimen is not superior to high-dose steroid regimen in the treatment of SSNHL.
Adrenal Cortex Hormones ; Ear, Inner ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Hydrocortisone ; Prednisolone ; Steroids

PURPOSE: The purpose of this study was to analyze the factors affecting the survival rate and the marginal bone level of dental implants that have functioned over 7-years. MATERIALS AND METHODS: In 92 patients, 178 dental implants were included. Implant-related factors (diameter, length, prosthetic splint), patient-related factors (gender, smoking, plaque index, compliance to supportive periodontal therapy) and surgery-related factors (proficiency of surgeon, bone graft) were evaluated via clinical and radiographic examination. The marginal bone level was determined by intraoral standard radiography at the mesial and distal aspects of each implant using an image analysis software program. RESULTS: The survival rate of all the implants was 94.94% and the marginal bone level was 0.89 ± 1.05 mm, these results are consistent with other studies that present long-term good clinical results. Implant length and plaque index among several factors were statistically significant for implant survival rate (P < 0.05). Smoking and the presence of regeneration surgery were statistically significant for the marginal bone level (P < 0.05). CONCLUSION: Dental implant that have functioned over 7-years showed favorable long-term survival rates and marginal bone level. Implant length and plaque control should be considered for improving the long-term clinical results. It is needed that careful application of bone regeneration technique and smoking control for maintaining of marginal bone level.
Bone Regeneration ; Compliance ; Dental Implants ; Humans ; Radiography ; Regeneration ; Smoke ; Smoking ; Survival Rate