PURPOSE: To evaluate changes in the spinal canal in cases of L5 spondylolysis, as seen on sagittal MR images. MATERIALS AND METHODS: We retrospectively analysed the MR findings of 27 patients suffering from L5 spondylolysis without spondylolisthesis and compared them with 100 control subjects. Spondylolysis had been confirmed by conventional radiography. On midsagittal MR images, sagittal canal ratio (SCR) was defined as midsagittal canal diameter at L5 devided by that at L1. We analysed the frequency of posterior epidural fat deposition (posterior epidural fat between the posterior margin of the dural sac and the anterior cortical margin of the spinous process on the midsagittal line), and compared this with the frequency in 100 control subjects. RESULTS: Mean SCR value in 27 patients with L5 spondylolysis (1.22) was significantly greater than 100 control subjects (0.96, p<0.001). Mean SCR value in 17 patients with L5 spondylolysis and posterior epidural fat deposition (1.27) was significantly higher than in nine control subjects with posterior epidural fat deposition (0.97). Posterior epidural fat deposition was more frequently indentified in patients with L5 spondylolysis (63%) than in control subjects (9%). CONCLUSION: The possibility of L5 spondylolysis is suggested when on midsaggital MR imaging, the anteroposterior diameter of the L5 spinal canal is seen to be widened and posterior epidural fat deposition is noted.
Humans ; Magnetic Resonance Imaging ; Radiography ; Retrospective Studies ; Spinal Canal* ; Spondylolisthesis ; Spondylolysis*

PURPOSE: The purpose of this study is to investigate the impact of the vascular endothelial growth factor (VEGF) and the hypoxia-inducible factor-1 (HIF-1) expression on clinicopathologic factors in osteosarcomas and chondrosarcomas. MATERIALS AND METHODS: Thirty-five osteosarcomas and 9 chondrosarcomas were assessed for HIF-1 and VEGF expressions with monoclonal antibodies using immunohistochemistry. The pathologic tumor grades are followed the WHO classification. RESULTS: Nineteen out of 35 osteosarcomas (54.3%) and 8 out of 9 chondrosarcomas (88.9%) showed HIF-1 expressions. The HIF-1 expressions increased with the pulmonary metastasis (p=0.020) and the tumor grades (p=0.016) in only osteosarcomas. Twenty-four out of 35 osteosarcomas (68.6%) and 6 out of 9 chondrosarcomas (66.7%) showed VEGF expressions. The extents of VEGF expression in only osteosarcomas showed positive correlation with the pulmonary metastasis (p=0.024). CONCLUSION: The HIF-1 and VEGF appear to be an important role for the development and progression of these two tumors. The HIF-1 expression in osteosarcomas seems to be poor prognostic value including aggressive tumor grades and pulmonary metastasis. The extents of VEGF immunostaining might indicate the possibility of pulmonary metastasis in osteosarcomas. However, the two gene expressions could not indicate the significant prognostic value in chondrosarcomas.
Antibodies, Monoclonal ; Chondrosarcoma* ; Classification ; Gene Expression ; Immunohistochemistry ; Neoplasm Metastasis ; Osteosarcoma* ; Vascular Endothelial Growth Factor A*

OBJECTIVE: The purpose of this study was to analyze the transverse dental compensation in reference to the maxillary and mandibular basal bones using cone-beam computed tomography (CBCT) and evaluate the correlations between transverse dental compensation and skeletal asymmetry variables in patients with skeletal Class III malocclusion and facial asymmetry. METHODS: Thirty patients with skeletal Class I (control group; 15 men, 15 women) and 30 patients with skeletal Class III with menton deviation (asymmetry group; 16 men, 14 women) were included. Skeletal and dental measurements were acquired from reconstructed CBCT images using OnDemand3D 1.0 software. All measurements were compared between groups and between the deviated and nondeviated sides of the asymmetry group. Correlation coefficients for the association between skeletal and dental measurements were calculated. RESULTS: Differences in the ramus inclination (p < 0.001), maxillary canine and first molar inclinations (p < 0.001), and distances from the canine and first molar cusp tips to the midmaxillary or midmandibular planes (p < 0.01) between the right and left sides were significantly greater in the asymmetry group than in the control group. In the asymmetry group, the ramus inclination difference (p < 0.05) and mandibular canting (p < 0.05) were correlated with the amount of menton deviation. In addition, dental measurements were positively correlated with the amount of menton deviation (p < 0.05). CONCLUSIONS: Transverse dental compensation was correlated with the maxillary and mandibular asymmetry patterns. These results would be helpful in understanding the pattern of transverse dental compensation and planning surgical procedure for patients with skeletal Class III malocclusion and facial asymmetry.
Compensation and Redress* ; Cone-Beam Computed Tomography* ; Facial Asymmetry* ; Humans ; Male ; Malocclusion* ; Molar

Objective: We investigated the proportions of and reclassified BRCA1/2 variants of unknown significance (VUS) in Korean patients with epithelial ovarian, tubal, and primary peritoneal cancers. Methods: Data from 805 patients who underwent genetic testing for BRCA1/2 from January 1, 2006 to August 31, 2018 were included. The VUS in BRCA1/2 were reclassified using the 2015 American College of Medical Genetics and Genomics and the Association for Molecular Pathology standards and guidelines. Results: A BRCA1 pathogenic variant was found in 17.0% (137/805) of the patients, and BRCA1 VUS were found in 15.9% (128/805) of the patients. Further, 8.7% (69/805) of the patients possessed a BRCA2 pathogenic variant and 18.4% (148/805) of the patients possessed BRCA2 VUS. Fifty-three specific BRCA1 VUS were found and 20 were further reclassified as benign (n=11), likely benign (n=5), likely pathogenic (n=3), and pathogenic (n=1). The remaining 33 remained classified as VUS. For BRCA2, 55 specific VUS were detected; among these, 14 were reclassified as benign or likely benign, and 2 were reclassified as likely pathogenic. Among the 805 patients, 195 were found to have only VUS and no pathogenic variants (PV), and 41.5% (81/195) were reclassified as benign or likely benign, and 10.3% (20/195) as pathogenic or likely pathogenic variants. Conclusions Approximately 33.3% (36/108) of the specific BRCA1/2 variants analyzed in this study that were initially classified as VUS over a 13-year period were reclassified. Among these, 5.6% (6/108) were reclassified as pathogenic or likely pathogenic variants.

PURPOSE: To compare and assess factors influencing the detection of an inflamed appendix by both ultrasonography (US) and CT. MATERIALS AND METHODS: We retrospectively analyzed US and CT findings of 58 patients with confirmed acute appendicitis (42 patients with perforation and 16 patients without perforation), in which both preoperative US and CT scans were performed. We compared the use of US and CT for the diagnostic accuracy of acute appendicitis, and determined the detection rate for an inflamed appendix. According to the location of the appendix, the amount of mesenteric fat content in lower abdominal cavity, the presence of cecal wall thickening, and the presence of pericecal fluid or an abscess, the use of US and CT were compared for the determination of the detection rate of an inflamed appendix. RESULTS: The diagnostic accuracies for US and CT for acute appendicitis in our study group were both 93.1%, and there was no difference between the use of the two modalities. Although the detection rate of an inflamed appendix was slightly higher for US (93.1%) than for CT (84.5%), the difference between the use of the two modalities was not significant (p > 0.05). There was no significant difference in the detection rate of an inflamed appendix between the use of US and CT according to location of appendix, the amount of mesenteric fat content and the presence of cecal wall thickening. A pelvic location of the inflamed appendix and the presence of pericecal fluid or an abscess, were factors that significantly increased the detection rate for US than for CT (p < 0.05). CONCLUSION: The use of US for diagnosis of acute appendicitis is as useful as the use of CT. US is especially useful to detect an inflamed appendix more effectively than CT in cases where the appendix is in a pelvic location and presents with pericecal fluid or an abscess.
Abdominal Cavity ; Abscess ; Appendicitis ; Appendix* ; Diagnosis ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography*

Hemosuccus pancreaticus is an unusual gastrointestinal hemorrhage through the main pancreatic duct. We report a rare case of hemosuccus pancreaticus due to a simple mucinous cyst of the pancreas. A 52-year-old man who had been followed-up for a suspected branch duct intraductal papillary mucinous neoplasm (IPMN) visited the emergency room due to hematochezia. Endoscopy showed active bleeding from the ampulla. Computed tomography revealed hemorrhage in a 2.0-cm cystic mass in the pancreatic body. The patient was diagnosed with hemosuccus pancreaticus caused by bleeding into the main pancreatic duct from suspected IPMN. Elective laparoscopic distal pancreatectomy was performed. The histopathological diagnosis was a simple mucinous cyst with squamous metaplasia based upon the pathological finding involving the absence of ovarian-type stroma. In conclusion, it should be recognized that a pancreatic cyst including simple mucinous cyst may cause hemosuccus pancreaticus, and these cysts should be viewed as neoplastic and approached similarly as other mucinous pancreatic neoplasms.
Diagnosis ; Emergency Service, Hospital ; Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Metaplasia ; Middle Aged ; Mucins* ; Pancreas* ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Ducts ; Pancreatic Neoplasms

BACKGROUND/AIMS: Benign esophageal stricture after esophagectomy is not an infrequent complication. Anastomotic esophageal stricture requires frequent multiple dilations. We aimed to evaluate the clinical outcomes of dilation therapies using an endoscopic balloon or bougie dilator and analyzed the risk factors associated with refractory stricture. METHODS: Between January 2009 and May 2016, the medical records of 21 patients treated with endoscopic balloon dilation or bougie dilation for esophageal anastomotic strictures were retrospectively reviewed. RESULTS: During the study periods, a total of 21 patients were diagnosed with esophageal anastomotic stricture and included for analysis (17 male; mean age, 68.2±7.2 years at the first procedure). The mean stricture length was 6.4±8.1 mm. The refractory stricture was found in 28.6% of patients, and successful relief of dysphagia was achieved in 71.4% of patients. The major complication associated with dilations was absent. Factors associated with refractory stricture were stricture length (> 10 mm, p<0.049) and diabetes mellitus (p=0.035). Additive bougie dilations achieved clinical success in 4 out of 7 patients. CONCLUSIONS: Dilation with endoscopic balloon or bougie dilator was an effective and safe procedure for benign anastomotic esophageal strictures of less than 10 mm in length.
Constriction, Pathologic ; Deglutition Disorders ; Diabetes Mellitus ; Esophageal Stenosis* ; Esophagectomy ; Esophagus ; Humans ; Male ; Medical Records ; Retrospective Studies ; Risk Factors

Clear cell odontogenic carcinoma (CCOC), a rare tumor in the head and neck region, displays comparable properties with other tumors clinically and pathologically. In consequence, an incorrect diagnosis may be established. A 51-year-old male patient who was admitted to the Department of Oral and Maxillofacial Surgery at Pusan National University Dental Hospital was initially diagnosed with ameloblastoma via incisional biopsy. However, the excised mass of the patient was observed to manifest histopathological characteristics of ameloblastic carcinoma. The lesion was ultimately diagnosed as clear cell odontogenic carcinoma by the Department of Oral Pathology of Pusan National Dental University. Therefore, segmental mandibulectomy and bilateral neck dissection were performed, followed by reconstruction with fibula free flap and reconstruction plate. Concomitant chemotherapy radiotherapy was not necessary. The patient has been followed up, and no recurrence has occurred 6 months after surgery.

Clear cell odontogenic carcinoma (CCOC), a rare tumor in the head and neck region, displays comparable properties with other tumors clinically and pathologically. In consequence, an incorrect diagnosis may be established. A 51-year-old male patient who was admitted to the Department of Oral and Maxillofacial Surgery at Pusan National University Dental Hospital was initially diagnosed with ameloblastoma via incisional biopsy. However, the excised mass of the patient was observed to manifest histopathological characteristics of ameloblastic carcinoma. The lesion was ultimately diagnosed as clear cell odontogenic carcinoma by the Department of Oral Pathology of Pusan National Dental University. Therefore, segmental mandibulectomy and bilateral neck dissection were performed, followed by reconstruction with fibula free flap and reconstruction plate. Concomitant chemotherapy radiotherapy was not necessary. The patient has been followed up, and no recurrence has occurred 6 months after surgery.
Ameloblastoma ; Ameloblasts ; Biopsy ; Busan ; Diagnosis ; Diagnostic Errors ; Drug Therapy ; Fibula ; Free Tissue Flaps ; Head ; Humans ; Male ; Mandibular Osteotomy ; Middle Aged ; Neck ; Neck Dissection ; Pathology, Oral ; Radiotherapy ; Recurrence ; Surgery, Oral