The reports of the association of cerebral aneurysm and brain tumor are rare. Recently, we experienced five cases of association of cerebral aneurysm and bain tumor and available literature were reviewed. Of five cases of brain tumor, there were two cases of meningioma, two cases of pituitary adenoma and a case of malignant glioma. Vascular clips were used for aneurysm obliteration in three cases, coating was in a case and four cases of them had favorable outcome. The association of cerebral aneurysm and brain tumor had difficult problems in treatment such as brain swelling and hemorrhage from the aneurysm after removal of tumor.
Aneurysm ; Brain Edema ; Brain Neoplasms* ; Brain* ; Glioma ; Hemorrhage ; Intracranial Aneurysm* ; Meningioma ; Pituitary Neoplasms

BACKGROUND: Due to its anatomical location and vague symptom, early diagnosis of traumatic pacreatic injury is difficult. Furthermore it is very difficult to carry out appropriate management for the injury, so morbidity and mortality rates of traumatic pancreatic injuries remain high. Patients and METHODS: We reviewed medical records of 35 cases of patients who had been diagnosed as pancreatic injury and operated at Department of Surgery, Busan National University College of Medicine between January 1995 and December 2000. RESULT: 1) The male to female ratio was 2.5:1 and the highest incidence occurred in the 4th decade(31.3%). 2) Thirty two cases(91.4%) were injured by blunt trauma and 3 cases(8.6%) were injured by penetrating trauma. 3) The most common clinical manifestation was abdominal pain. 4) Twenty two patients(62.9%) were operated within 24hours after injury, and the mean time interval between injury and operation was 26.4 hours. 5) The serum amylase levels higher than 150 somogi unit were recorded in 20 cases(57.1%) of the patients. 6) Twenty seven patients(77.1%) had another associated injury with an average of 2 associated intraabdominal injuries. The most frequently injured intraabdominal organ was mesentery. 7) Complications occurred in 20 of 35 patients(57.1%) and the most common complication was pancreas-related complications, such as fistula, pseudocyst, abscess, pancreatitis. 8) Six patients(17.1%) were died due to hypovolemic shock, sepsis, respiratory failure and renal failure. CONCLUSION: Early diagnosis and appropriate operative methods may reduce morbidity and mortality from traumatic pancreatic injury
Abdominal Pain ; Abscess ; Amylases ; Busan ; Early Diagnosis ; Female ; Fistula ; Humans ; Incidence ; Male ; Medical Records ; Mesentery ; Mortality ; Pancreatitis ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis ; Shock

PURPOSE: To evaluate the usefulness of preoperative MRI in the patient with recurrent anorectal fistula. MATERIALS AND METHODS: Fourteen patients with recurrent anorectal fistula underwent non-contrast MRI. In eight patients, T1-, T2- and proton-weighted images were taken in the axial, coronal and sagittal planes, and T1- andT2-weighted images taken in the axial and coronal planes were obtained from the other six. RESULTS: Fourteen cases of anorectal fistula and eight cases in which there was a combined abscess were detected. Preoperative MRI clearly showed the exact anatomical relationship with the anal sphincter, levator ani and surrounding soft tissue. In two cases in which there was fibrous scarring of the fistula tract, low signal intensities were seen on all MRI sequences. Preoperative information in the group in which only axial and coronal T1- and T2-weighted images were obtained was sufficient. CONCLUSION: Preoperative MRI in patients with recurrent anorectal fistula or suspected multiple fistulous tracts provide objective information concerning the anatomical location and extension of a fistula and combined abscess and could thus reduce the reoperation rate. An understanding of pathologic state through MRI signal intensity can help decide the most appropriate course of treatment.
Abscess ; Anal Canal ; Cicatrix ; Fistula* ; Humans ; Magnetic Resonance Imaging* ; Reoperation

Many longitudinal studies have reported the successful osseointegration of dental implants, with survival rates approaching 90-95%. However, implants regarded as a "success" may have also failed to undergo osseointegration. A variety of complications and failures have been observed, including implant fracture - a rare and delayed biomechanical complication with serious clinical outcomes. Given the increasing popularity of dental implants, an increase in the number of failures due to late fractures is expected. This study sought to determine the rate of implant fractures and factors associated with its development. This retrospective evaluation analyzed implants placed at Wonkwang Dental Hospital (from 1996 to the present). In our study we found that the frequency of dental implant fractures was very low (0.23%, 8 implant fractures out of 3,500 implants placed). All observed fractures were associated with hybrid-surface threaded implants (with diameter of 4.0 or 3.75 mm). Prosthetic or abutment screw loosening preceded implant fracture in a majority of these cases.
Dental Implants ; Electrons ; Osseointegration ; Retrospective Studies ; Survival Rate

OBJECTIVE: There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. METHODS: Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. RESULTS: There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. CONCLUSION: In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.
Aspirin ; Cerebral Infarction ; Hemorrhage ; Humans ; Infarction ; Methacrylates ; Prevalence ; Risk Factors ; Sodium ; Stroke ; Thromboxane A2 ; Thromboxane-A Synthase ; Tissue Plasminogen Activator

Evaluation of postpneumonectomy space (PPS) by CT in patients with lung cancer for operation-related complication or tumor recurrence is critical, but often difficult. We retrospectively analysed CT scans of 38 patients who underwent pneumonectomy for lung cancer. CT scans were obtained on 7-10th post-operative day for baseline image and at varying intervals of 2 to 24 months thereafter. Usual postoperative findings in patients without complication included mediastinal shifting, changes in subpleural space, changes in parietal pleura, and herniation of contralateral lung. Four patients had postoperative complications including empyema(n=3) and bronchopleural fistula(n=2). Twelve patients showed findings of tumor recurrence such as lymph node metastasis, local recurrence, and pericardial and contralateral pleural effusion. By comparing follow-up CT with baseline CT, we were able to detect early cancer recurrence and postoperative complications. Our results indicate that serial chest CT play an important role in the evaluation of the patients who underwent pneumonectomy for lung cancer.
Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Pleura ; Pleural Effusion ; Pneumonectomy* ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed*

BACKGROUND: Dexmedetomidine is a useful sedative drug with various uses. We designed this study to investigate the clinical effects and complications of different loading doses, 0.5 and 1.0 microg/kg. METHODS: Forty six patients, of American Society of Anesthesiologists physical status I and II, who required elective and emergency operation under spinal anesthesia were randomly assigned to group L or group H. Group L received a loading dose of 0.5 microg/kg for 10 minutes while group H received 1.0 microg/kg. Bispectral index (BIS), systolic blood pressure, heart rate, and Ramsay score were recorded at T0 (before loading), TL (just after loading) and T10, 20, 30 (10, 20, 30 minutes after TL). Complications, drug use, lowest BIS and time to reach BIS 80 after termination of dexmedetomidine were recorded during this study. RESULTS: In group H, BIS value decreased significantly after TL compared to the baseline (T0), while in group L after T10. Between two groups, BIS values showed a significant differences only at T10, BIS of group H was lower than that of group L. Ramsay score showed no significant differences except in TL; the score of group L was significantly lower than that of group H. Other vital signs and complications showed a minimal differences between two groups. CONCLUSIONS: Higher loading dose (1.0 microg/kg) of dexmedetomidine can lead to faster sedation without any severe complications.
Anesthesia, Spinal ; Blood Pressure ; Conscious Sedation ; Dexmedetomidine* ; Emergencies ; Heart Rate ; Humans ; Vital Signs

OBJECTIVES: This study sought to provide guidelines in order to decrease the incidence of nerve injury during mandibular ramus bone harvesting, and to improve understanding of the anatomical structure of the inferior alveolar canal (IAC) to include its distance from the exterior buccal cortex. MATERIALS AND METHODS: In January and February 2009, 20 patients who visited the Wonkwang University Department of Oral and Maxillofacial Surgery reporting various conditions underwent cone beam computed tomography and were included in this study. Patients with missing left or right mandibular first molars or incisors, or who had jaw fracture or bone pathologies, were excluded. The reference point (R point) was defined as the point where the occlusal plane reached the anterior ramus of the mandible. The position of the IAC in relation to the R point, the buccal bone width (BW), the alveolar crest distance (ACD), the distance from the alveolar crest to the occlusal plane (COD), and the distance from the IAC to the sagittal plane (CS) were determined using proprietary image analysis software which produced cross-sectional coronal and axial images. RESULTS: The distance medially from the R point to the IAC along the axial plane was 6.19+/-1.21 mm. The HD from the R point, posteriorly to IAC, in the lateral view was 13.07+/-2.45 mm, the VD from the R point was 14.24+/-2.41 mm, and the ND from the R point was 10.12+/-1.76 mm. The pathway of the IAC was positioned almost in a straight line along a sagittal plane within 0.56+/-0.70 mm. The distance from the buccal bone surface to the IAC increased anteriorly from the R point. CONCLUSION: Marking osteotomy lines in the retromolar area in procedures involving bone harvesting should be discouraged due to the risk of damage to IAC structures. Our measurements indicated that the area from the R point in the ramus of the mandible to 10 mm anterior can be safely harvested for bone grafting purposes.
Bone Transplantation ; Cone-Beam Computed Tomography ; Dental Occlusion ; Humans ; Incidence ; Incisor ; Jaw Fractures ; Mandible ; Mandibular Nerve ; Molar ; Osteotomy ; Surgery, Oral

Ectopic thyroid is an uncommon status characterized by the presence of thyroid tissue in a site other than in its usual region. It is rare for dual ectopic thyroid to have two ectopic foci simultaneously. Three cases of dual ectopic thyroid have been reported in the Korean literature. Clinically, most cases in ectopic thyroid were noted at adolescence or postpartum due to increased physiologic hormonal demands. Clinical manifestation, thyroid function test, and radiologic imaging should be employed to make a diagnosis and therapeutic plan of this disease. We present a patient with dual ectopic thyroid tissue in the suprahyoid and infrahyoid area without thyroid tissue in its normal thyroid bed.
Adolescent ; Diagnosis ; Humans ; Postpartum Period ; Thyroid Dysgenesis* ; Thyroid Function Tests ; Thyroid Gland

In malignant bone and soft tissue tumors, lung is the most predilection site of metastasis and multiple pulmonary metastases is a poor prognostic factor. Aggressive treatment of pulmonary metastases may offer a chance of long term survival in selected patients whose primary tumors were controlled. We wanted to know the feasibility of pulmonary metastasectomy, whether it can prolong the survival. From Apr. 1989 to Dec. 1993, pulmonary metastasectomies were carried out for 20 patients, and followed up to Sept. 1994, with average follow-up period of 18.7(2-65) months. The primary malignant tumors were 8 in bone and 12 in soft tissues. Mean age was 27.5(12-70) years. Fifteen cases showed late metastasis after control of primary tumor(late metastasis group), and 5 cases showed pulmonary metastasis at first visit(initial stage III group). As a control we analyzed the survival of 24 cases of no treatment after pulmonary metastasis from bone or soft tissue sarcoma, during the same period of investigation. At final follow-up, in late metastasis group, 4 cases were in no evidence of disease (NED), 4 alive with disease (AWD) and 7 dead of disease (DOD). Tumor free interval (TFI) of NED and AWD was averaged 30 months, and for DOD 9.8 months. Five among 11 cases (45%) of multiple lung metastases and 3 among 4 cases (75%) of single metastasis were alive. In initial stage III group, 1 case was in NED, 1 AWD and 3 DOD. For late metastasis group, Kaplan-Meier's 5-year estimated survival rate from the first metastasectomy was 37.4%. The median survival period of 15 cases was 44 months. For initial stage III group, Kaplan-Meier's 9 months estimated survival rate was 40%. Median survival period was 8 months. Twenty four cases of no treatment cases died within 14 months from diagnosis of pulmonary metastasis. Their median survival period was 6 months. Pulmonary metastasectomy appears to prolong survival and occupies an important mode of treatment for late pulmonary metastases in malignant bone and soft tissue tumor patients. In the cases of initial stage III, more cases and follow up period are needed to have a conclusion.
Diagnosis ; Follow-Up Studies ; Humans ; Lung ; Metastasectomy ; Neoplasm Metastasis ; Sarcoma ; Survival Rate