PURPOSE: To evaluate the value and the radiologic findings of CT discography in the diagnosis of the far lateral disk herniation. MATERIALS AND METHODS: We retrospectively reviewed 7 cases of surgically proven far lateral lumbar disc herniation. CT discography was performed for all cases. Four cases underwent conventional CT and three cases MRI as a primary diagnostic imaging method. Far lateral diac herniation was divided into 3 groups by location;Intraforaminal herniation, extraforaminal herniation, and mixed type. We analyzed the findings of CT discography including location and extent of far lateral disc herniation. RESULTS: In all 7 cases, CT discography clearly demonstrated the filling of contrast media in laterally-protruded disc material. Intraforaminal and extraforminal types were seen in 2 cases each, and mixed type in 3 cases. Subligamentous herniated nucleus pulposus was present in 6 cases and extruded disc in 1 case. Far lateral disc herniation was located at L4-5 in 5 cases and L5-S1 in 2 cases. CONCLUSION: CT discography can help establishing accurate preoperative diagnosis for far lateral disc herniation.
Contrast Media ; Diagnosis ; Diagnostic Imaging ; Magnetic Resonance Imaging ; Retrospective Studies

Gastric type mucinous endocervical adenocarcinomas of the uterine cervix (GAC) are a newly classified mucinous subtype with morphologically in 2014, WHO. They have a much more aggressiveness and show unusual metastatic patterns compared to usual type endocervical adenocarcinoma. They tend to present at higher stage and even in stage I, they have worse survival. Therefore, differential diagnosis of GAC from the usual type of endocervical adenocarcinoma is very important because they are related to a significant risk of recurrence and decreased 5-year disease-specific survival. Besides, GACs are mostly not associated with human papillomavirus (HPV) infection and p16 immunohistochemistry is also typically negative in GAC that is HPV-unassociated tumor. We report a very rare and interesting case of stage IB1 GAC with negative HPV DNA and p16.
Adenocarcinoma ; Cervix Uteri ; Diagnosis, Differential ; DNA ; Female ; Humans ; Immunohistochemistry ; Mucins ; Recurrence

Objective: : The goal of this study was to analyze the clinical outcomes of endoscopic third ventriculostomy (ETV) and endoscopic septostomy when shunt malfunction occurs in a patient who has previously undergone placement of a ventriculoperitoneal shunt. Methods: : From 2001 to 2020 at Seoul National University Children's Hospital, patients who underwent ETV or endoscopic septostomy for shunt malfunction were retrospectively analyzed. Initial diagnosis (etiology of hydrocephalus), age at first shunt insertion, age at endoscopic procedure, magnetic resonance or computed tomography image, subsequent shunting data, and follow-up period were included. Results: : Thirty-six patients were included in this retrospective study. Twenty-nine patients, 18 males and 11 females, with shunt malfunction underwent ETV. At the time of shunting, the age ranged from 1 day to 15.4 years (mean, 2.4 years). The mean age at the time of ETV was 13.1 years (range, 0.7 to 29.6 years). Nineteen patients remained shunt revision free. The 5-year shunt revisionfree survival rate was 69% (95% confidence interval [CI], 0.54–0.88). Seven patients, three males and four females, with shunt malfunction underwent endoscopic septostomy. At the time of shunting, the age ranged from 0.2 to 12 years (mean, 3.9 years). The mean age at the time of endoscopic septostomy was 11.9 years (range, 0.5 to 29.5 years). Four patients remained free of shunt revision or addition. The 5-year shunt revision-free survival rate was 57% (95% CI, 0.3–1.0). There were no complications associated with the endoscopic procedures. Conclusion : The results of our study demonstrate that ETV or endoscopic septostomy can be effective and safe in patients with shunt malfunction.

Coccidioidomycosis is a fungal infection acquired by inhalation of the arthrospore of Coccidioides immitis, and endemic disease in specific geographic areas, such as south central California, south Arizona, Nevada, and New Mexico. Approximately 60 percent of infected people is asymptomatic and the remainders mostly exhibit respiratory complaints, from flu-like coughing to overt pneumonia. Usually the infection due to Coccidioides immitis is self-limited. Symptoms resolve within several weeks but radiographic abnormalities could be resolved more slowly. If the radiographic abnormalities persist more than 8 weeks, the term 'chronic pulmonary coccidioidomycosis'is designated. They take forms of nodules, cavities or progressive pneumonia. When manifested as nodule(s), lung malignancy is suspected as a possible diagnosis and histologic confirmation is needed. Here, we report a case of chronic pulmonary coccidioidomycosis manifested as solitary pulmonary nodule in a Korean woman who has traveled in Arizona, which is diagnosed fianlly by lobectomy and histologic examination.
Arizona ; California ; Coccidioides ; Coccidioidomycosis* ; Cough ; Diagnosis ; Endemic Diseases ; Female ; Humans ; Inhalation ; Lung ; Nevada ; New Mexico ; Pneumonia ; Solitary Pulmonary Nodule*

Rice bodies are numerous small fibrinous, cartilaginous-like materials which were first described in tuberculous joints. Rice bodies are common findings in joints afflicted with rheumatoid arthritis or other seronegative arthropathy. But less commonly, those can be seen in periarticular bursae or at the sites of tendon or ligament insertion. Rice bodies, thought to be a nonspecific response to synovial inflammation, probably evolve from ischemia in a proliferative synovium. Some of these bodies contain a core of collagen with a mantle of fibrin, others contain only fibrin. Subacromial bursa are sometimes involved in the patients with rheumatoid arthritis and can reach impressive dimensions before becoming clinically detectable because significant constrain is lacking. Subacromial arthrography or magnetic resonance imaging accurately delineated the existence of cartilaginous loose bodies before surgical exision. We experienced a man with rheumatoid arthritis who had massive subacromial bursitis with rice bodies. His shoulder had been swollen since 5 years ago. He felt no pain and had only mild limitation of motion. Subacromial arthrography or magnetic resonance imaging of right shoulder showed multiple rice bodies in enlarged subacromial bursa. Operation finding showed a large encapsulated mass in the subacromial bursa, and hundreds of fibrinous rice bodies were revealed, which were resected. We report this patient with a review of literatures.
Arthritis, Rheumatoid* ; Arthrography ; Bursitis* ; Collagen ; Fibrin ; Humans ; Inflammation ; Ischemia ; Joints ; Ligaments ; Magnetic Resonance Imaging ; Shoulder ; Synovial Membrane ; Tendons

Hemangioendothelioma is the most common tumor of liver in infancy characterized by heart failure due to arteriovenous shunt and thrombocytopenia. Recently with the advance of technology, this tumor can be diagnosed with antenatal ultrasonography. We report a case of hemangioendothelioma that demonstrates huge abdominal mass with increased blood flow in liver detected by ultrasonography.
Heart Failure ; Hemangioendothelioma* ; Liver ; Thrombocytopenia ; Ultrasonography*

BACKGROUND: Osteoporosis in men is an important public health problem. Because of the incremental tendency of elderly population and age-specific incidence of fracture, it is inevitable that the health burden of fracture will increase. Also, the mortality of fracture in men is higher than in women. Alcohol consumption is a risk factor for osteoporosis based on the frequent finding of a low bone mass decreased bone formation rate and increased fracture incidence in alcoholics. Chronic alcohol consumption may reduce bone density but also increase bone density. It has been well established that liver cirrhosis also induces bone density changes and thus it is difficult to distinguish the role of liver disease from that of alcohol itself in bone alterations occurring in patients with chronic alcohol consumption. So we studied male chronic alcoholics which did not have liver cirrhosis to assess the effect of chronic alcohol consumption on bone mineral density. METHODS: We studied 18 chronic heavy drinkers of more than 40 g/day for at least 5 years and age-matched 18 control groups who had drunk alcohol less than 20 g/day. Serum and urinary parameters of bone and mineral metabolism were determined. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at four axial sites (lumbar spine, femoral neck, ward's triangle and trochanter). RESULTS: Alcoholic patients drank alcohol 97.7 g/day. Osteocalcin, a marker of bone formation, was slight decreased in alcoholic patients and deoxypyridinoline, a marker of bone resorption, was slight increased but not statistically significant (p > 0.05). The levels of 25-(OH)-vit D, parathyroid hormone, free testosterone, estradiol were not different between the two groups. Ward's triangle and trochanter BMD of femur were significantly lower than controls and L-spine BMD decreased parallel with total alcohol intake amount in the alcoholics (r=-0.62, p < 0.05). CONCLUSION: We suggest that chronic alcohol consumption induced low bone density on femur ward and trochanter. And there was significant inverse correlation between L-spine BMD and total alcohol consumption amount. The large scaled randomized and prospective studies are needed to clarify the pathogenesis of alcohol-induced male osteoporosis.
Absorptiometry, Photon ; Aged ; Alcohol Drinking ; Alcoholics ; Alcoholism ; Bone Density* ; Bone Resorption ; Eating* ; Estradiol ; Female ; Femur ; Femur Neck ; Humans ; Incidence ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Male* ; Metabolism ; Mortality ; Multiple Endocrine Neoplasia Type 1 ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Parathyroid Hormone ; Public Health ; Risk Factors ; Spine ; Testosterone

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced diffuse trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin (androgenesis). Partial hydatidiform moles appear to be focal trophoblastic hyperplasia, a fetus or indications of previous fetal existence, 69 chromosomes. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies and associated with a risk of persistent gestational trophoblastic tumor. Recently, hydatidiform moles with a fetus have become more common due to use of assisted reproductive technology. Most patients with hydatidiform mole and coexisting normal fetus must cautioned about the potential for risks of malignant change and severe medical complications, such as preeclampsia, hyperthyroidism and antepartum hemorrhage, that may necessitate prompt pregnancy termination. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 15 gestational weeks. A brief reviews of related literature was done.
Classification ; Female ; Fetus* ; Hemorrhage ; Humans ; Hydatidiform Mole* ; Hyperplasia ; Hyperthyroidism ; Incidence ; Pre-Eclampsia ; Pregnancy ; Reproductive Techniques, Assisted ; Trophoblastic Neoplasms ; Trophoblasts ; Ultrasonography

PURPOSE: Methemoglobinemia is a disorder caused by over accumulation of methemoglobin in the red blood cells of circulating blood, prohibiting adequate supply of oxygen to organs. The seriousness of its clinical symptoms and its treatment methods are determined by the blood methemoglobin level. Therefore, we revealed the clinical relation between the blood methemoglobin level and oxygen saturation on a pulse oximeter. Then we tried to indirectly measure the blood methemoglobin level by using their relation, instead of checking its level through blood sampling. METHODS: The medical records of 39 patients who were admitted to the Chonnam University Hospital Emergency Medical Center due to acute methemoglobinemia between January 1, 2001, and June 30, 2005, underwent a prospective analysis. RESULTS: Among the total of 39 cases, there were 25 males (64.1%) and 14 females (35.9%). There were 15 cases (38.5%) of dapsone overdosage, 18 cases (46.1%) of aniline- type pesticide intoxication, and 6 cases (15.4%) of aniline gas inhalation. As for the main symptoms for admission to the emergency center, there were 8 cases involving on altered mental state, 7 involving dizziness, 3 involving cyanosis, 7 involving dyspnea; and 14 cases were nonsymptomatic. Relational analyses of arterial blood gas analysis results, pulse oximetry saturation levels, and blood methemoglobin levels of the admitted patients revealed that only the pulse oximetry saturation level was related to the blood methemoglobin level (p<0.001). CONCLUSION: When in doubt about the possibility of acute methemoglobinemia, differences in the oxygen saturation level on the pulse oximeter level can be used instead of repeated co-oximetry examinations, can be used to judge treatment responses.
Blood Gas Analysis ; Cyanosis ; Dapsone ; Dizziness ; Dyspnea ; Emergencies ; Erythrocytes ; Female ; Humans ; Inhalation ; Jeollanam-do ; Male ; Medical Records ; Methemoglobin* ; Methemoglobinemia* ; Oximetry ; Oxygen* ; Prospective Studies

Parathyroid carcinoma is a very rare disease which comprising 0.1~5% of hyperparathyroidism, and it usually presents with marked hypercalcemia. Clinically, it shows hypercalcemia due to the effect of excessive secretion of parathyroid hormone, bone disease, renal involvement and palpable neck mass. It is known that hyperparathyroidism is induced mostly by parathyroid adenoma but it can be seen in parathyroid hyperplasia, hyperparathyroid carcinoma, rarely associated with familial or multiple endocrine neoplasia. Parathyroid carcinoma can be diagnosed with distant metastasis or local invasion. Treatment is complete resection of primary cancerous lesion and local tissue. Since recurrence or distant metastases are frequent, radiological studies should be done when hypercalcemia is recurred. Sometimes, other tumors can causes hypercalcemia. There are several reports of parathyroid cancer associated with multiple endocrine neoplasia, but has never been reported of parathyroid carcinoma associated with meningioma. We experienced a parathyroid carcinoma with meningioma in 68 year old woman and report the case with the review of literatures.
Aged ; Bone Diseases ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperplasia ; Meningioma* ; Multiple Endocrine Neoplasia ; Neck ; Neoplasm Metastasis ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Rare Diseases ; Recurrence