No abstract available.
Brain Abscess* ; Brain* ; Catheters*

Epiphrenic diverticulum is a relatively rare condition resulting from mucosal herniation through the muscular wall of the esophagus. This pulsion diverticulum is often associated with abnormal esophageal motility such as esophageal achalasia. Although pneumatic dilatation is recommended as the initial treatment for patients with esophageal achalasia, some authors caution against the use of pneumatic dilatation when esophageal achalasia is complicated by epiphrenic diverticulum. A 49-year old female patient was admitted due to progressive dysphagia for both solid and liquid foods, and weight loss and frequent vomiting. She suffered from Heller's myotomy due to esophageal achalasia 8 years prior. She was diagnosed as having recurrent esophageal achalasia with epiphrenic diverticulum due to incomplete myotomy, using esophagography, esophagogastrodudenoscopy, esophageal manometry, and esopahgeal transit scan. The patient was successfully treated with pneumatic balloon dilatation, and her symptoms markedly improved.
Deglutition Disorders ; Dilatation ; Diverticulum* ; Esophageal Achalasia* ; Esophagus ; Female ; Humans ; Manometry ; Middle Aged ; Vomiting ; Weight Loss

Epiphrenic diverticulum is a relatively rare condition resulting from mucosal herniation through the muscular wall of the esophagus. This pulsion diverticulum is often associated with abnormal esophageal motility such as esophageal achalasia. Although pneumatic dilatation is recommended as the initial treatment for patients with esophageal achalasia, some authors caution against the use of pneumatic dilatation when esophageal achalasia is complicated by epiphrenic diverticulum. A 49-year old female patient was admitted due to progressive dysphagia for both solid and liquid foods, and weight loss and frequent vomiting. She suffered from Heller's myotomy due to esophageal achalasia 8 years prior. She was diagnosed as having recurrent esophageal achalasia with epiphrenic diverticulum due to incomplete myotomy, using esophagography, esophagogastrodudenoscopy, esophageal manometry, and esopahgeal transit scan. The patient was successfully treated with pneumatic balloon dilatation, and her symptoms markedly improved.
Deglutition Disorders ; Dilatation ; Diverticulum* ; Esophageal Achalasia* ; Esophagus ; Female ; Humans ; Manometry ; Middle Aged ; Vomiting ; Weight Loss

PURPOSE: To characterize the MR findings for a differential diagnosis and to make a plan for treatment by interventional technique of the vascular masses with/without hypertrophic feeding vessels of the head and neck. SUBJCETS AND METHODS: Seven patients with vascular masses of the head and neck proved by pathology, angiography, clinical findings were included. Vascular masses included 4 venous malformations, a capillary hemangioma, and a hemangiopericytoma, a hemangioma combined with arteriovenous malformation. 7 patients had MR studies with 1.0T and 1.5T using routine TI-, T2- weighted spin echo sequences, and contrast enhancement. 4 MR angiography, 3 inversion recovery, and 6 contrast angiography were studied from 7 patients RESULTS: All vascular masses demonstrated higher than muscle signal intensity on Tl-weighted images, bright signal intensity on T2-weighted images, and prominent enhancement, except AV hemangioma combined with prominent arteriovenous malformation on postcontrast scan. Three hemangiomas demonstrated distinct serpiginous signal voids. Venous malformations demonstrated venous lakes seen as homogenous regions of high signal intensity and phleboliths seen as low signal foci on images. Inversion recovery was the best pulse sequence for evaluation of the extent of lesion. CONCLUSION: MR findings of the vascular masses of the head and neck are useful in delineating the extent of the disease, differentiating venous malformation or cavernous hemangioma from other hemangiomatous lesions including hypertrophic feeding vessels, and making a plan for treatment by interventional technique also.
Angiography ; Arteriovenous Malformations ; Diagnosis, Differential* ; Head* ; Hemangioma ; Hemangioma, Capillary ; Hemangioma, Cavernous ; Hemangiopericytoma ; Humans ; Lakes ; Neck* ; Pathology

Hypoglycemia due to non-islet cell tumor is usually associated with hypersecretion of big insulin-like growth factor II (IGF-II). This big IGF-II cannot form ternary IGF complex, and is biologically more active in peripheral tissue, inducing increased glucose utilization and hypoglycemia. A 57-year-old man developed severe hypoglycemia due to hepatocellular carcinoma. To control hypoglycemia, the patient required continuous glucose infusion. The circulating levels of cortisol and free T4 were in the normal range. The plasma levels of insulin, C-peptide, IGF-I, IGF binding protein-3 (IGFBP-3), and total IGF-II levels were decreased. Radioimmunoassay of IGF-II revealed that big IGF-II immunoreactivity markedly increased compared to that of normal control. In this patient, it was strongly suggested that big IGF-II might be a cause of severe intractable hypoglycemia.
C-Peptide ; Carcinoma, Hepatocellular ; Glucose ; Humans ; Hydrocortisone ; Hypoglycemia* ; Insulin ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II* ; Middle Aged ; Plasma ; Radioimmunoassay ; Reference Values

PURPOSE: We conducted a retrospective analysis to determine if adjuvant chemotherapy prolongs overall survival in patients with pathologic stage IB lung adenocarcinoma who had undergone complete resection and were defined as high-risk by a newly developed recurrence risk scoring model. MATERIALS AND METHODS: Patients who underwent curative resection for stage IB lung adenocarcinoma were analyzed with a newly developed recurrence risk scoring model and divided into a low-risk group and a high-risk group. The patients in the high-risk group were retrospectively divided into two groups based on whether they underwent adjuvant chemotherapy or observation. Recurrence-free survival and overall survival were compared between these two groups. RESULTS: A total of 328 patients who underwent curative resection between 2000 and 2009 were included in this study, of whom 110 (34%) received adjuvant chemotherapy and 218 (67%) underwent observation without additional treatment. According to our risk model, 167 patients (51%) were high-risk and 161 (49%) were low-risk. The 5-year recurrence-free survival rates and overall survival were 84.4% and 91.5% in low-risk patients and 53.9% and 74.7% in high-risk patients (p < 0.001). In high-risk patients, the 5-year overall survival rates were 77% among patients who underwent observation and 87% among those who underwent adjuvant chemotherapy (p=0.019). CONCLUSION: Adjuvant chemotherapy prolonged overall survival among high-risk patients who had undergone complete resection for stage IB lung adenocarcinoma.
Adenocarcinoma* ; Chemotherapy, Adjuvant* ; Humans ; Lung* ; Recurrence* ; Retrospective Studies ; Survival Rate

PURPOSE: Many patients with benign prostatic hyperplasia (BPH) have storage symptoms. The aim of this study was to evaluate the effects of treatment with a 5-alpha reductase inhibitor (5ARI) on storage symptoms in patients with BPH. METHODS: This study was conducted in 738 patients with lower urinary tract symptoms secondary to BPH. Patients with a prostate volume of higher than 30 mL on the transrectal ultrasound were classified into two groups: group A, in which an alpha blocker was solely administered for at least 12 months, and group B, in which a combination treatment regimen of an alpha blocker plus 5ARI was used. This was followed by an analysis of the changes in parameters such as the total International Prostate Symptom Score (IPSS), voiding symptom subscore, and storage symptom subscore between the two groups. In addition, we examined whether there was a significant difference between the two groups in the degree of change in storage symptoms between before and after the pharmacological treatment. RESULTS: Of the 738 men, 331 had a prostate volume > or =30 mL, including 150 patients in group A and 181 patients in group B. Total IPSS, the voiding symptom subscore, and the storage symptom subscore were significantly lower after treatment than before treatment in both groups (P<0.05). A comparison of the degree of change between before and after treatment, however, showed no significant differences in the storage symptom subscore between the two groups (P>0.05). CONCLUSIONS: Alpha blocker and 5ARI combination treatment is effective for patients with BPH including storage symptoms. However, 5ARI does not exert a significant effect on storage symptoms in BPH patients.
5-alpha Reductase Inhibitors ; Humans ; Lower Urinary Tract Symptoms ; Male ; Oxidoreductases ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder, Overactive

BACKGROUND: Androgenetic alopecia (AGA) is one of the most common type of alopecia among all men and women after puberty. The number of patients with AGA appears to be gradually increasing. OBJECTIVES: The purpose of this study was to investigate the clinical status such as age, family history, and type of patients with AGA and to review recent Korean literature. METHODS: 1500 patients with AGA who had visited the Department of Dermatology, Busan Paik Hospital, Inje University School of Medicine during the last 7 years (from May 1997 through December 2003) were examined through the clinical records. RESULTS: 1) There were 1162 male and 338 female patients being most prevalent in the third decade in both sexes. 2) In males AGA, Norwood-Hamilton's type II was the most common. 3) In females AGA, Ludwig's type I was the most common. 4) There was a family history of baldness in 62.9% of relatives in male patients and 48.8% in female patients. 5) The largest number of patients with AGA first visited our department when they had had 1-5 year's history of AGA in both sexes. 6) In the management of male AGA, oral finasteride only or with topical medications was the most common (72.4%) treatment modality. 7) In the management of female AGA, topical minoxidil solution only or with other topical medications was the most common (78.7%) treatment modality. CONCLUSIONS: The proportion of young patients with mild types appears to be high among AGA patients. It might be largely due to psychological stress in social situations.
Adolescent ; Alopecia* ; Busan ; Dermatology ; Female ; Finasteride ; Humans ; Male ; Minoxidil ; Puberty ; Stress, Psychological

We performed a thermographic study to observe any possible interaction between the esophageal acid perfusion and the temperature changes of skin surface in patients with gastroesophageal reflux disease (GERD). Twenty-seven patients with GERD were categorized as group I(globus symptoms with posterior laryngitis) and group II (heartburn and/or regurgitation symptoms). Patients and 6 healthy volunteers underwent Bernstein test (BT) and digital infrared thermographic imaging (DITI) simultaneously. The positive rate for BT in group I and group II was 22.2% and 55.6%, respectively, and the DITI positive rate was 55.6% for group I and 50.0% for group II. None of healthy control were positive in BT or DITI. All subjects with DITI positive were hypothermic. The overall accordance rate between DITI and BT was 69.7%. All group I patients showed a diffuse type, while in group 11, 4 patients showed diffuse type and 5 patients showed localized type (p<0.05). In patients with DITI (+)/BT (-), 83.3% showed diffuse type, whereas equal numbers of diffuse and localized type were noted in patients with DITI (+)/BT (+). In conclusion, add contact with a sensitive mucosa leads to an activation of the sympathetic nervous system in some patients with GERD, inducing skin surface hypothermia.
Adult ; Female ; Gastroesophageal Reflux/physiopathology* ; Human ; Hydrochloric Acid/administration & dosage ; Image Processing, Computer-Assisted/methods ; Male ; Perfusion ; Skin Temperature/physiology* ; Thermography/methods

While intussusception can occur at any age, the disease is most often seen in children and no etiologic factor can be seen in most cases of childhood intussusception. In contrast, the adult intussusception is rare and usually has an identifiable causes such as benign tumor, malignant tumor, sarcoma, Meckel's diverticulum and congenital anomaly. Especially, adult intussusception due to primary malignant lymphoma of small intestine is rare clinical condition. Here, we describe the case of a 49-year-old male patient with ileo-ileo-colic intussusception due to primary malignant lymphoma of the small intestine. The clinical, radiographic and pathologic findings are described with brief review of the literature.
Adult* ; Child ; Humans ; Intestine, Small* ; Intussusception* ; Lymphoma* ; Male ; Meckel Diverticulum ; Middle Aged ; Sarcoma