MR images of seven patients with histologically documented synovial sarcoma were reviewed to find the suggestive or pathognomonic findings of the disease. MR appearance of the tumor was inhomogeneous, multiseptated mass with various degree of internal septation and infiltrative tumor margin. The signal intensity of the mass was slightly hyperintense relative to muscle on T1-weighted image and hyperintense relative to subcutaneous fatty tissue on T2-weighted image.
Adipose Tissue ; Humans ; Magnetic Resonance Imaging* ; Sarcoma, Synovial*

No abstract available.
Parenteral Nutrition, Total

Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.
Angiography ; Femoral Artery* ; Fractures, Bone ; Groin ; Humans ; Leg ; Transplants ; Vascular System Injuries

Cavovarus deformity is considered an anatomical risk factor for chronic lateral ankle instability (CLAI). However, subtle deformity can be difficult to detect, and its correction is controversial. The current study aimed to evaluate clinical and radiographic outcomes of a modified Broström procedure (MBP) with additional procedures for CLAI with subtle cavovarus deformity and a positive peek-a-boo heel sign. We reviewed the records of 15 patients who underwent MBP with additional procedures for CLAI with a positive peek-a-boo heel sign between August 2009 and April 2015. Consecutive physical and radiographic examinations were performed. The visual analog scale (VAS) for pain, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the Karlsson-Peterson (KP) ankle score were applied to assess clinical outcomes. Weight bearing radiographs, hindfoot alignment view, and ankle stress radiographs were also examined. The mean follow-up period was 58.5 months. Calcaneal lateral closing wedge osteotomy was performed in seven patients to correct fixed hindfoot varus, and first metatarsal dorsiflexion osteotomy was performed in 11 patients to correct plantarflexion of the first ray. Three patients underwent both procedures. Mean VAS, AOFAS, and KP ankle scores improved significantly (p=0.001), and instability did not recur. Radiographically, all stress parameters improved significantly (p=0.007). Simultaneous correction of a positive peek-a-boo heel sign and cavovarus deformity with MBP for CLAI improves clinical outcomes and prevents recurrent instability. A comprehensive evaluation and cautious approach for subtle cavovarus deformity should be followed when treating patients with CLAI. This trial is registered on Clinical Research Information Service (CRiS, KCT0003287).

PURPOSE: To analyze early postoperative complications of calcaneal fractures operated by a lateral extensile approach and to identify risk factors for wound complications. MATERIALS AND METHODS: From July 1990 to February 2003, 116 calcaneal fractures in 104 patients were treated by open reduction and internal fixation through a lateral extensile approach. The patient's records were reviewed for early postoperative complications. Statistical analysis was performed to determine significant relationships between predicted variables and the development of wound complications. RESULTS: Fourteen fractures (12.0%) developed infection. Ten of them were superficial infection and four were deep infection that required surgical treatment. Eight fractures (6.9%) developed skin necrosis. Six of them were marginal skin necrosis and two were flap necrosis that required surgical treatment. Seven fractures (6.0%) developed sural nerve injury, but their symptoms were improved without additional treatment. Open fracture (p=0.003) and prolonged operating time (p=0.049) increased significantly the rate of wound complications. CONCLUSION: The rate of early postoperative complications of calcaneal fractures operated by a lateral extensile approach is high. These complications can be reduced by meticulous treatment of an open wound, reduced operating time within 90 minutes through preoperative planning and skillful technique, and correct incision to avoid damage of the sural nerve.
Fractures, Open ; Humans ; Necrosis ; Postoperative Complications* ; Risk Factors ; Skin ; Sural Nerve ; Wounds and Injuries

Gastric volvulus can either present as an acute or chronic symptoms according to the degree of gastric rotation and subsequent obstruction. The diagnosis of gastric volvulus is often difficult and is mainly based on imaging studies. We describe a case of mesenteroaxial gastric volvulus associated with paraesophageal hernia, well demonstrated on upper gastrointestinal (UGI) series and coronal reconstructed CT image.
Diagnosis ; Hernia, Hiatal* ; Intestinal Volvulus* ; Stomach Volvulus ; Stomach*

A 59-year old female was admitted to Yongdong Severance Hospital due to diarrhea and lower abdominal pain lasting for 2 months. She had a previous history of admission for stomach cancer on September 1995. At that time, she underwent total gastrectomy and gastroduodenostomy. The pathology of the specimen revealed a signet ring cell carcinoma of stomach. On admission, computerized tomography revealed rectal wall thickness and no evidence of lymph node enlargement in abdomen and pelvic cavity. Barium enema study showed stricture of rectum. After sigmoidoscopic biopsy, she was diagnosed as a rectal metastasis resulted in rectal stricture and underwent sigmoid loop colostomy. Hence we present a case of gastric cancer with rectal metastasis resulted in rectal stricture.
Abdomen ; Abdominal Pain ; Barium ; Biopsy ; Carcinoma, Signet Ring Cell ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic* ; Diarrhea ; Enema ; Female ; Gastrectomy ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Pathology ; Rectum ; Stomach ; Stomach Neoplasms*

OBJECTIVE: Cerebrovascular and cardiovacular diseases are the main causes of death in patients with chronic renal failure (CRF) and who are undergoing hemodialysis. We investigated the risk factors for the development of intracerbral hemorrhage (ICH) in this population. METHODS: We retrospectively reviewed a total of 53 patients who underwent hemodialysis for CRF and who developed ICH. The patients' demographics, including gender and age, the duration of the hemodialysis, the initial Glasgow Coma Scale (GCS) score, the underlying causes of CRF, the past medication history, the location and amount of hemorrhage and the therapeutic modality for ICH were analyzed. RESULTS: The development of ICH significantly increased in the old age patients (> or = 65 years), the patients with a prolonged history of hemodialysis (> or = 5 years) and the patients with hypertension (p < 0.05). However, gender, anemia (hemoglobin < or = 8.0 g/dl) and the initial systolic blood pressure (> or = 180 mmHg) were not significantly correlated with the occurrence of intracerebral hemorrhage in the hemodialyzed patients. CONCLUSION: The present study suggests that the development of ICH in patients with CRF is increased in the old age patients, the patients with a prolonged history of hemodialysis and the medically co-morbid patients. To avoid this disastrous complication, we should try to minimize the modifiable risk factors of hemorrhagic stroke in CRF patients.
Anemia ; Blood Pressure ; Cause of Death ; Cerebral Hemorrhage ; Demography ; Glasgow Coma Scale ; Hemorrhage ; Humans ; Hypertension ; Kidney Failure, Chronic ; Renal Dialysis ; Retrospective Studies ; Risk Factors ; Stroke

Angiosarcoma is a rare malignant vascular tumor of endothelial origin. It can involve any organ, including the skin, soft tissue, liver, bone, spleen, and orbit. Skin is the most frequent site of primary angiosarcoma, however, metastatic skin involvement of angiosarcoma is exceptional. Wolf's isotopic response implies that the new disease appeared at the site of an already healed skin disease. Several types of cutaneous lesions have been described, occurring within cleared cutaneous herpes zoster, or herpes simplex lesions. These lesions include comedones, granulomatous diseases, tinea, furunculosis, wart, psoriasis, pseudolymphoma, leukemia, lymphoma, basal cell carcinoma, squamous cell carcinoma and cutaneous metastases, from internal carcinoma. Herein, we report a case of cutaneous angiosarcoma of unknown origin that has developed at the site of a scar, after herpes zoster in a 79-year-old man as isotopic response.
Aged ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cicatrix ; Furunculosis ; Hemangiosarcoma ; Herpes Simplex ; Herpes Zoster ; Humans ; Leukemia ; Liver ; Lymphoma ; Methylmethacrylates ; Neoplasm Metastasis ; Orbit ; Polystyrenes ; Pseudolymphoma ; Psoriasis ; Skin ; Skin Diseases ; Spleen ; Tinea ; Warts

OBJECTIVE: To suggest a new useful diagnostic technique, principles of the selective excitation technique-magnetic resonance images (Proset-MRI), and to know the precise radiologic findings that can prove symptomatic foraminal and extraforaminal stenosis at L5-S1. METHODS: Nineteen patients with symptomatic L5-S1 stenosis were checked by Proset-MRI. Four patients were performed decompressive surgery and 15 patients were performed selective nerve root block (SNRB) at L5. The pain scale of patients was checked by Visual Analogue Scale (VAS) scores at the pre- and post-treatment state. RESULTS: Proset-MRI findings of patients with symptomatic stenosis are root swelling (RS) and indentation. The comparisons with VAS scores had a meaningful statistical result at each RS (p<0.01) and indentation (p<0.01). However, the findings of RS combined with indentation lacked statistical significance (p=0.0249). In addition, according to a comparison with the treatment modalities, reducing of VAS scores had statistical meaningful significance in decompressive surgery cases (p<0.01), and also in SNRB cases (p<0.01) after a 3-month follow-up period. CONCLUSION: The three dimensional Proset-MRI is very useful and sensitive technique to diagnose the symptomatic foraminal and extraforaminal stenosis at L5-S1.
Constriction, Pathologic ; Humans ; Magnetic Resonance Imaging