PURPOSE: Struma ovarii is ovarian tumor composed solely or predominantly of thyroid tissue or tumor in which hyperthyroidism results from ovarian thyroid tissue, and usually occurs in tandem with cystic teratoma. Ovarian cystic teratoma is radiologically easily diagnosed due to calcification or fat, for example, but the preoperative diagnosis of struma ovarii is often difficult due to rare characteristic features of thyroid tissue. Our purpose was to determine whether there were specific findings of struma ovarii which distinguished it from other ovarian tumors, and this involved analysis of its radiologic findings. MATERIALS AND METHODS: Using ultrasonography, computed tomography, and magnetic resonance imaging, preoperative radiologic findings of pathologically-proven struma ovarii in eleven patients were retrospectively evaluated for site, margin, nature (cystic, solid, mixed), contrast enhancement, septa, mural nodule, calcification, fat, and metastasis. These findings were compared with pathologic findings. RESULTS: All eleven tumors were unilateral, ten had smooth tumor margins, seven were mixed cystic and solid tumors (more than 70% of solid components in one tumor), and nine had regular septa. Three of four cystic masses (one unilocular, one bilocular and two multilocular cysts) had mural nodules. Calcifications were found in two tumors, and fat in one. Malignant change or metastasis was not found in any tumor. In one patient with hyperthyroidism due to struma ovarii, symptoms and signs of this subsided after removal of the tumor on salpingo-oophorectomy. CONCLUSION: Most cases of struma ovarii occurred unilaterally within ovarian teratomas in premenopausal women, and were mixed cystic and solid masses with smooth margins that are commonly enhanced on contrast enhanced scans. In one patient, hyperthyroidism was caused by struma ovarii. There were, however, no specific radiologic findings that were sufficiently typical to suggest the correct preoperative diagnosis of struma ovarii.
Diagnosis ; Female ; Humans ; Hyperthyroidism ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Ovarian Cysts ; Retrospective Studies ; Struma Ovarii* ; Teratoma ; Thyroid Gland ; Ultrasonography

PURPOSE: The purpose of this study was to evaluate the CT findings of renal parenchyma infiltrated by pelvocalyceal transitional cell carcinoma. MATERIALS AND METHODS: This study included 28 patients in whom transitional cell carcinoma was dignosed after nephrectomy. CT findings were analyzed for the presence or absence of renal parenchymal infiltration; diagnostic criteria for this included parenchymal inhomogeneous low attenuation, ill-defined margin between the mass and renal parenchyma, or focal calyceal dilatation. To detect renal parenchymal infiltration by transitional cell carcinoma, we evaluated the frequency, sensitivity and specificity of each CT finding. RESULTS: Pathologic reports showed that renal parenchymal infiltration had occurred in 17 of 28 patients, (60.7%) ; on CT scans, renal parenchymal infiltration was seen in 15 of these 28 (53.6%). It two patients who did not show CT findings of renal parenchymal infiltration, pathologic examination revealed parenchymal invasion. All 15 patients who showed renal infiltration on CT had parenchymal inhomogeneous low attenuation (sensitivity: 88.2%, specificity : 100%), 13 showed ill-defined margin of the mass (sensitivity : 76.5%, specificity : 100%), and six showed focal dilatation of the calyx (sensitivity : 35.3%, specificity : 100%). CONCLUSION: In patients with pelvocalyceal transitional cell carcinoma, CT findings of parenchymal inhomogeneous low attenuation, ill-defined margin of mass, and focal calyceal dilatation suggest renal parenchymal infiltration, and these findings may be helpful in preoperative prognosis.
Carcinoma, Transitional Cell* ; Dilatation ; Humans ; Nephrectomy ; Prognosis ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Native coronary artery spasm after coronary artery bypass grafting (CABG) is scarce. It frequently causes disastrous circulatory collapse. We report a 72-yr-old male, who experienced native coronary artery spasm and grafted artery spasm following CABG, which was successfully treated with coronary angiography and intracoronary injection of nitroglycerine.
Aged ; Coronary Angiography ; Coronary Artery Bypass/*adverse effects ; Coronary Vasospasm/drug therapy/*etiology ; *Coronary Vessels/drug effects/physiopathology/surgery ; Humans ; Male ; Nitroglycerin/therapeutic use ; Treatment Outcome ; Vasodilator Agents/therapeutic use

Uterine cervical carcinoma is one of the most common malignant tumors occur-ring in females. After primary treatment, patients are usually followed up with CT or MRI and the findings of these modalities may be the first sign of recurrent disease. Because earlier additional treatment by chemotherapy or radiation therapy may improve the prognosis, the early detection of recurrent cervical carcinoma is clinically important. In this article, we review the CT and MR imaging findings of recurrent uterine cervical carcinoma, and assign them to one of four groups: a)recurrence at the primary site, involving the intrapelvic organs, b) extension to the pelvic side-wall, c) metastases to pelvic and extrapelvic lymph nodes, or d)metastases to distant organs. A further contribution of CT and MR imaging is the detection of hydronephrosis due to ureteral obstruction. The cases in each group are illustrated and discussed, and since an awareness of the spectrum of imaging findings of recurrent cervical carcinoma is likely to lead to its early detection, radi-ologists should be familiar with the information presented.
Adult ; Aged ; Case-Control Studies ; Cervix Neoplasms/*diagnosis/radiography ; Cervix Uteri/pathology ; Female ; Human ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Middle Age ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/*diagnosis/radiography ; Tomography, X-Ray Computed

PURPOSE: To investigate the results of intravitreal injection of triamcinolone acetonide (TA) for the treatment of chronic uveitic cystoid macular edema (CME). METHODS: Six patients, 8 eyes with refractory uveitic CME were included in the study. Four milligrams of TA was injected into the vitreous cavity. The clinical outcome and complication were reviewed, retrospectively. RESULTS: Ten intravitreal injections of TA were performed, and the mean follow-up duration was 10.4 months (6~19 months). Foveal retinal thickness diminished and CME improved anatomically in 7 (88%) eyes. Visual acuity improved by 1.75 lines of the Snellen chart in 6 (75%) eyes, and the time to improvement varied from 1 week to 8 months. Inflammation decreased in all eyes and there was symptomatic improvement in 6 (75%) eyes. CME recurred in 3 (38%) eyes at 4 to 16 weeks and re-treatments were performed in 2 eyes. Intraocular pressure increased in 3 eyes and one eye needed additional filtration surgery. Cataract worsened in one eye. CONCLUSIONS: Intravitreal triamcinolone injection effectively induced anatomic and symptomatic resolution, and decreased inflammation in uveitic CME patients. Nevertheless, the visual improvement was modest, and consideration for recurrence and complication is necessary.
Cataract ; Filtering Surgery ; Follow-Up Studies ; Humans ; Inflammation ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema* ; Recurrence ; Retinaldehyde ; Retrospective Studies ; Triamcinolone Acetonide ; Triamcinolone* ; Uveitis ; Visual Acuity

PURPOSE: To compare the incidence of posterior capsular opacification (PCO) based on low and high fluid-dynamic parameters during cataract surgery and evaluate the importance of these findings. METHODS: This retrospective study included 125 eyes in 73 patients with senile cataract who received a cataract surgery between September 2013 and March 2014. Patients were divided into 2 groups: those with low (vacuum: 180 mm Hg, aspiration flow: 18 mL/min, bottle height: 55 cm) and high (vacuum: 400 mm Hg, aspiration flow: 22 mL/min, bottle height: 90 cm) fluidic parameters during the nucleus was removal. We measured the total surgery time, ultrasound time, and balanced salt solution consumption during phacoemulsification. Best corrected visual acuity (BCVA), PCO score, PCO percentage and severity were measured at 3, 6 and 12 months postoperatively. Endothelial cell density (ECD) was measured preoperatively and 12 months postoperatively. RESULTS: The study included 20 eyes of 13 patients with low parameters and 20 eyes of 15 patients with high parameters. There was no statistically significant difference in the mean total surgery time, ultrasound time or fluid consumption between the two groups. BCVA and ECD were not significantly different between the two groups during the postoperative follow-up. PCO score, percentage and severity were higher in the low parameter group at 3, 6 and 12 months postoperatively. CONCLUSIONS: Surgery with low fluid-dynamic parameters is equally effective as with high parameters in terms of surgical time and postoperative BCVA. However, the incidence of PCO was higher in the low fluid-dynamic parameter group up to 12 months. Surgical efforts to reduce remnant lens epithelial cells are needed during low fluidic-dynamic parameter surgery.
Cataract ; Endothelial Cells ; Epithelial Cells ; Follow-Up Studies ; Humans ; Incidence* ; Operative Time ; Phacoemulsification ; Retrospective Studies ; Ultrasonography ; Visual Acuity

BACKGROUND: Sternal wound infection (SWI) is an important complication after cardiac surgery. The aim of this study was to investigate the predictors affecting sternal wound infection and preventive factors including short term Vancomycin therapy in patients who underwent coronary artery bypass grafting (CABG). MATERIAL AND METHOD: A retrospective study was done using data collected from January 2001 through December 2007. This included 219 patients who had isolated CABG. The definition of SWI was documentation from a microbiological study and a requirement for simple closure or other surgical revision. RESULT: The overall incidence of SWI was 7.8% (n=17). The causative organisms were methicillin resistant Staphylococcus aureus (MRSA, n=13), methicillin resistant Staphylococcus epidermidis (n=2), Pseudomonas aeruginosa (n=1), and Candida albicans (n=1). Ten cases had deep sternal wound infection with mediastinitis; 7 cases had a superficial wound infection. Infection-related mortality was low (1/17; 6%). Diabetes mellitus (p=0.006) and smoking history (p=0.020) were factors that predicted high risk. Short term use of vancomycin decreased the incidence of MRSA-associated SWI (p=0.009). For treatment, curettage and rewiring or flap were needed in most cases (88%, n=14). CONCLUSION: Patients who had diabetes mellitus and a smoking history need careful management. Short term use of vancomycin is effective for prevention of SWI with MRSA.
Candida albicans ; Coronary Artery Bypass ; Coronary Vessels ; Curettage ; Diabetes Mellitus ; Humans ; Incidence ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas aeruginosa ; Reoperation ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Staphylococcus aureus ; Staphylococcus epidermidis ; Sternum ; Thoracic Surgery ; Vancomycin ; Wound Infection

Severe protein-calorie malnutrition, common in patients with advanced liver disease, can seriously undermine the capacity for regeneration and functional restoration of liver. Nutritional supplementation for these patients can improve biochemical and hormonal abnormalities. However, these effects were not identified in patient with nonalcoholic liver cirrhosis. To determine effects of nutritional supplementation in patients with nonalcoholic liver cirrhosis, 77 subjects aged 29 to 69 years participated in this study for 12 weeks and were subdivided into three groups; normal diet group (Control group, n=16), branched-chain amino acid supplementation group (BCAA group, n=31), nutritional supplementation group (NS group, n=30). Anthropometric parameters, hemoglobin, hematocrit, blood cell counts, serum levels of lipids, vitamins, minerals and fatty acid composition, and plasma amino acids were examined. The mean values of age and height, and the initial values of weight and body mass index (BMI) were not different among all groups. After 12 weeks, there were no significant changes in these values in Control group. Only NS group showed significant increases in weight, lean body mass, midarm circumference, triceps skinfold thickness. Serum transferrins were increased both in BCAA and NS groups. Plasma levels of branched-chain amino acids, urea amino acids and glutamic acid were also significantly increased in these groups, but plasma levels of ammonia, serum LDL cholesterol and atherogenic index were decreased. However, there were no significant changes in serum levels of vitamin and mineral and composition of fatty acids in phospholipids in these groups. These results showed that the nutritional supplementation for patients with nonalcoholic liver cirrhosis can more improve nutritional status in these people together with increases of weight, body fat and lean body mass, compared to only BCAA supplementation. To ascertain and investigate the appropriate nutritional supplementation for patients with nonalcoholic liver cirrhosis, further studies are necessary.
Amino Acids ; Amino Acids, Branched-Chain ; Ammonia ; Blood Cell Count ; Body Mass Index ; Body Weight ; Cholesterol, LDL ; Diet ; Fatty Acids ; Glutamic Acid ; Hematocrit ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Minerals ; Nutritional Status ; Phospholipids ; Plasma ; Protein-Energy Malnutrition ; Regeneration ; Skinfold Thickness ; Transferrin ; Transferrins ; Urea ; Vitamins

We reviewed 15 cases of necrotizing fascitis of the male genitalia. The clinical courses could be divided into two different types. In about one half of the patients the symptoms and signs progressed slowly within 122 weeks and in the remained they progressed rapidly. In the former, the prodromal signs were noted, usually low abdominal and inguinal pain. In 8 of fifteen patients, the locations of infectious focus were difficult to determine. The diagnosis were made after the development of scrotal necrosis in all of the cases. There were no differences in the causative pathogens comparing to 1hose of previous reports. The common underlying diseases were liver cirrhosis and diabetes. Hypoalbuminemia and leukocytosis were found in all. Of course, the strategy of treatment is same between two types, we would like to propose to use the term Fourier`s gangrene, a specific form of necrotizing fascitis, only to whose clinical course in acute and the location of primary infecious foci are obscure.
Diagnosis ; Fasciitis, Necrotizing* ; Gangrene ; Genitalia, Male* ; Humans ; Hypoalbuminemia ; Leukocytosis ; Liver Cirrhosis ; Male ; Male* ; Necrosis ; Prodromal Symptoms

We reviewed 15 cases of necrotizing fascitis of the male genitalia. The clinical courses could be divided into two different types. In about one half of the patients the symptoms and signs progressed slowly within 122 weeks and in the remained they progressed rapidly. In the former, the prodromal signs were noted, usually low abdominal and inguinal pain. In 8 of fifteen patients, the locations of infectious focus were difficult to determine. The diagnosis were made after the development of scrotal necrosis in all of the cases. There were no differences in the causative pathogens comparing to 1hose of previous reports. The common underlying diseases were liver cirrhosis and diabetes. Hypoalbuminemia and leukocytosis were found in all. Of course, the strategy of treatment is same between two types, we would like to propose to use the term Fourier`s gangrene, a specific form of necrotizing fascitis, only to whose clinical course in acute and the location of primary infecious foci are obscure.
Diagnosis ; Fasciitis, Necrotizing* ; Gangrene ; Genitalia, Male* ; Humans ; Hypoalbuminemia ; Leukocytosis ; Liver Cirrhosis ; Male ; Male* ; Necrosis ; Prodromal Symptoms