No abstract available.
Muscles*

Spontaneous testicular hemorrhagic necrosis is a rare disease usually associated with testicular torsion. Partially involved and suspicious testis tumor cases are also defined from orchiectomy specimens. Herein, a spontaneous hemorrhagic necrosis, without any testicular torsion, but with involvement of the whole testicle and epididymis, is reported. A 21 year old patient, who presented with a painless left testicular enlargement of several days duration was believed, based on physical examination, ultrasonography and elevation of serum LDH, to have a testicular tumor. Diagnosis was made only after radical orchiectomy and histopathological examination.
Diagnosis ; Epididymis ; Hemorrhage ; Humans ; Male ; Necrosis* ; Orchiectomy ; Physical Examination ; Rare Diseases ; Spermatic Cord Torsion ; Testis* ; Ultrasonography ; Young Adult

No abstract available.
Zygoma*

A clinical decision on the treatment of asymptomatic carotid stenosis is challenging, unlike symptomatic carotid stenosis. Carotid artery stenting (CAS) has been recommended as an alternative to carotid endarterectomy (CEA) based on the finding that the efficacy and safety of CAS were comparable to CEA in randomized trials. However, in some countries, CAS is often performed more frequently than CEA for asymptomatic carotid stenosis. Moreover, it has been recently reported that CAS is not superior to the best medical treatment in asymptomatic carotid stenosis. Due to these recent changes, the role of CAS in asymptomatic carotid stenosis should be revisited. When determining the treatment for asymptomatic carotid stenosis, one should consider several clinical factors including stenosis degree, patient life expectancy, stroke risk by medical treatment, availability of a vascular surgeon, high risk for CEA or CAS, and insurance coverage. This review aimed to present and pragmatically organize the information that is necessary for a clinical decision on CAS in asymptomatic carotid stenosis. In conclusion, although the traditional benefit of CAS is being revisited recently, it seems too early to conclude that CAS is no longer beneficial under intense and systemic medical treatment. Instead, a treatment strategy with CAS should evolve to select eligible or medically high-risk patients more precisely.

Endovascular thrombectomy is the primary treatment for acute intracranial vessel occlusion and significantly improves recanalization success rate. However, achieving optimal recanalization remains a challenge. The histopathological components of thrombus composition play a crucial role in determining endovascular outcomes. This review aimed to consolidate the recent evidence on the impact of thrombus composition on mechanical properties and endovascular outcomes. The relationship between thrombus composition and mechanical properties was significant, with fibrin and/or platelet-rich thrombi being stiff, tough, elastic, and less deformable; fibrin-rich thrombi were sticky and had higher friction with the vessel wall. Erythrocyte composition was positively associated with successful recanalization, whereas lower platelet composition was associated with specific outcomes, such as the first-pass effect and complete recanalization. The number of thrombectomy device passes was possibly related to erythrocyte, platelet, and fibrin composition, with a smaller number of passes associated with erythrocyte-rich thrombi. Procedural time was consistently related to thrombus composition, with shorter times observed for erythrocyte-rich thrombi. The relationship between thrombus composition and secondary embolism remains inconclusive. Understanding the role of thrombus composition in endovascular outcomes is crucial to optimize stroke treatment. Although evidence suggests a link between thrombus composition and mechanical properties, further research is needed to establish stronger correlations and to reduce study variations. Exploring non-traditional thrombus components such as leukocytes and neutrophil extracellular traps is vital. Thrombus imaging could provide a practical solution for predicting thrombus composition before endovascular procedures. This review highlights the importance of thrombus composition for enhancing endovascular stroke treatment strategies.

The management of malignant left colon obstruction remains a difficult problem. Conventional surgical treatment is muti-staged and each stage carries its own morbidity and mortality. The purpose of this study is to identify the feasibility and safety of one stage operation in patients presenting with acute obstruction of the left colon. From January 1991 to June 1996, 29 patients received one stage resection for acutely obstructed carcinoma of the left colon at Soonchunhyang University Chunan Hospital. Subtotal colectomies were performed in 9 patients(31.0%), left hemicolectomies in 6(20.7%), low anterior resection in 6(20.7%), sigmoid colectomy in 4(13.8%), anterior resection in 4 patients(13.8%). Subtotal colectomy was performed in patients with massively distended colon of dubious viability and to contain ischemic lesions at proximal colon. Total operative mortality was 6.9%: 5% in the immediate resection with anastomosis group, 11.1% in subtotal colectomy group. Complications included wound infection(4), fecal incontinence(2), intestinal obstruction(2), anastomotic leakage(1), upper G-I bleeding(1), postoperative bleeding(1), pulmonary complication(1). Our results suggest that resection and primary anastomosis can be performed with acceptable morbidity and mortality in patients with acute malignant obstruction of the left colon.
Chungcheongnam-do ; Colectomy ; Colon* ; Colon, Sigmoid ; Humans ; Mortality ; Wounds and Injuries

PURPOSE: To report the relative frequency and clinical characteristics of patients with benign eyelid tumors. METHODS: A retrospective study of 192 consecutive patients admitted to Korea University Ansan Hospital with benign eyelid tumor between January 2009 and December 2014 was undertaken, and clinical records including age, sex, involved site, and pathology of tumors were reviewed retrospectively. All eyelid tumors were confirmed histopathologically. RESULTS: The sexual distribution revealed 87 males and 105 females with benign eyelid tumors. The mean age at diagnosis was 42.6 +/- 19.2 years. Molluscum contagiosum (5.5 +/- 3.5 years) and pilomatrixoma (14.0 +/- 15.6 years) were generally found in younger individuals, while seborrheic keratosis (60.2 +/- 15.8 years) and squamous cell papilloma (50.5 +/- 13.4 years) occurred predominantly in elderly patients. Tumors were most common on the upper lid (63.0%). The four most frequent subtypes were melanocytic nevus (37.5%), epidermal cyst (8.3%), squamous cell papilloma (5.7%), and seborrheic keratosis (5.2%). CONCLUSIONS: The most common histopathological diagnosis of benign eyelid tumors was melanocytic nevus. The results of this study provide epidemiological information that will be useful for diagnosis and therapy of such tumors.
Aged ; Diagnosis ; Epidermal Cyst ; Eyelids* ; Female ; Gyeonggi-do ; Humans ; Keratosis, Seborrheic ; Korea ; Male ; Molluscum Contagiosum ; Nevus, Pigmented ; Papilloma ; Pathology ; Pilomatrixoma ; Retrospective Studies

Symptomatic vertebral artery (VA) stenosis associated with bilateral carotid rete mirabile (CRM) has not been reported. We report the long-term clinical and angiographic outcome after stenting for symptomatic VA stenosis in the patient with bilateral CRM. This report is the first case that symptomatic VA stenosis associated with bilateral CRM was treated with stenting.
Adult ; Angioplasty, Balloon ; Carotid Arteries/pathology/*radiography/*surgery ; Cerebral Angiography ; Female ; Humans ; *Stents ; Syncope/etiology ; Treatment Outcome ; Vertebrobasilar Insufficiency/*radiography/*surgery ; Young Adult

A 16-year-old girl was transferred to the department of thoracic and cardiovascular surgery because of a spontaneous pneumothorax with prolonged air leakage. Chest computed tomography demonstrated a cystic lesion measuring 2×3 cm and involving the left upper lobe. Left upper lobectomy was performed via video-assisted thoracoscopic surgery. A pathologic examination of the specimen revealed a mesenchymal cystic hamartoma. Despite the rarity of pulmonary mesenchymal cystic hamartoma, it should be considered a potential cause of pneumothorax for patients with a large pulmonary cyst. Further, surgical resection must be considered because serious complications such as hemothorax, hemoptysis, and malignant transformation have been reported.
Adolescent ; Female ; Hamartoma* ; Hemoptysis ; Hemothorax ; Humans ; Lung* ; Pneumothorax ; Thoracic Surgery, Video-Assisted ; Thorax