PURPOSE: To assess the role and efficacy of radiologic intervention in the adult patients with esophagobronchial fistula. MATERIALS AND METHODS: Radiologic intervertion was performed in 4 patients with esophagobronchial fistula. We tried direct occlusion of fistula tract by glue(histoacylate 0.4cc + lipiodol 0.3cc) and coil in 2 patients and performed presurgical wire insertion by using 8F curved catheter via esophageal opening of fistula tract. The latter procedure was carled out to detect the fistula tract easily at operation. RESULTS: Direct occlusions of fistula tract by glue and coil were performed only to fail in 2 patients. Pre-surgical wire incertion by using 8F curred catheter under guidance of fluroscopy in 3 patients were helpful in detecting fistula tract at operation. CONCLUSION: Direct occlusion of the fistulous tract in esophagobronchial fistulas was ineffective. However, presur- gical wire insertion by using cured catheter under fluroscopy guidance is helpful to detect the fistula tract easily at operation.
Adhesives ; Adult* ; Catheters ; Ethiodized Oil ; Fistula* ; Humans

PURPOSE: To evaluate the MR image in the differentiation of benign and malignant lesion in compression of the vertebral body. MATERIALS AND METHODS: MR images of 47 benign(acute traumatic within one month:19, chronic traumatic longer than one month or nontraumatic:28) and 21 metastatic compression fractures were respectively reviewed in terms of margin of lesions, signal intensity, paraspinal mass formation, soft tissue change, and involvement of posterior element of vertebra. MR images of TI-(T1WI) and T2*-weighted gradient echo (GE T2WI) sequences were obtained on 0.5T unit in sagittal and axial orientation with 5mm section thickness. RESULTS: The margin of benign compression fracture was usually indistinct (acute fracture:90% (17/19), chronic fracture:68% (19/28)), whereas it was sharply delineated in metastatic compression fracture (92%, (12/13) (p<0.001). Paraspinal mass was seen in both acute traumatic and metastatic compression fractures (acute fracture :26% (5/19), metastatic fracture: 52% (11/21). Soft tissue change was seen only in acute cornpression fractures (58%, 11/19). Involvement of posterior element of vertebra was noted in metastatic fracture (71%, 15/21), acute fracture (32%, 6/19) and chronic fracture (7%, 2/28) CONCLUSION: On MR imaging, involvement of entire portion of a given vertebral body, sharp margin between normal and abnormal areas in partially involved cases, paraspinal mass formation, and posterior element involvement are more frequently seen in metastatic compression fractures, which are considered to be useful in differentiation between benign and malignant causes of compression fracture.
Fractures, Compression* ; Magnetic Resonance Imaging* ; Spine

The improved survival rate of premature infants requiring intensive care, shows an increased risk for nosocomial infections such as disseminated fungal infection. Renal candidasis usually occurs secondary to systemic disease, and can Iead to obstructive uropathy by fungus ball. A male neonate was born in week 28 of the gestational period. His birth weight was 1200gm. He required mechanical ventilation and surfactant for respiratory distress syndrome, umbilical artery and vein catheterization, percutaneous central veneous catheterization(PCVC) for parenteral nutrition, steroid, aminophylline and broad spectrum anibiotics. Hypertension developed on the 29th hospital day, but was not controlled by diuretics and antihypertensive drugs. on the 40th hospital day, he had abdominal distension, anuria, and azotemia. A Renal ultrasonogram showed that the ureteropelvic junction of the left kidney was completely obstructed with fungus balls. A percutaneous nephrostorny tube, made in a pigtail shape by hand, was inserted under fluoroscopy guidance, and the obstruction of the pelvis was resolved by wire manipulation. Parenteral amphotericin B and oral flucytocine were started, and the left renal pelvis was directly drained and irrigated by percutaneous nephrostomy tube. Candida albicans(C. albicuns) was cultured from urine and a percutaneous central venous catheter tip. His general condition improved, and follow up urine culture revealed no fungus. On follow-up renal ultrasonogram, renal cortex echogenicity and fungus ball had disappeared except for mild left renal calyectasis and pelvic thickening. This report describes a case of obstructive uropathy by fungus ball in systemic candidiasis of prematurity, and reviews the related literature.
Aminophylline ; Amphotericin B ; Antihypertensive Agents ; Anuria ; Azotemia ; Birth Weight ; Candida ; Candidiasis ; Catheterization ; Catheters ; Central Venous Catheters ; Cross Infection ; Diuretics ; Fluoroscopy ; Follow-Up Studies ; Fungi ; Hand ; Humans ; Hypertension ; Infant, Newborn ; Infant, Premature ; Critical Care ; Kidney ; Kidney Pelvis ; Male ; Nephrostomy, Percutaneous* ; Parenteral Nutrition ; Pelvis ; Respiration, Artificial ; Survival Rate ; Ultrasonography ; Umbilical Arteries ; Veins

Candidiasis of the central nervous system (CNS) is a rare condition and like other opportunistic fungal infections, most commonly occurs in immune-compromised patients. Because of the increasing use of antibiotics and the improving survival rate of premature infants requiring intensive care, the incidence of fungal infections in the brain has increased. We report the findings of ultrasonography and MR imaging in two cases of candidiasis of the CNS in premature infants.
Anti-Bacterial Agents ; Brain ; Candidiasis* ; Central Nervous System ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Critical Care ; Magnetic Resonance Imaging* ; Nervous System* ; Survival Rate ; Ultrasonography

BACKGROUND: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a “knot-ache”. This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. METHODS: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. RESULTS: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. CONCLUSIONS: The knots of suture anchor maybe a possible etiology of the pain, which we termed a “knot-ache”. Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, “knot-ache”. Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

Lichen planus (LP) commonly involves the flexor aspects of the wrists, legs, and oral and genital mucous membranes. But it rarely occurs on the palms and/or soles. It mainly affects people in the age range 30~60 years. Childhood LP is reported to constitute only 1~4% of total cases of LP. In the literature, a few cases of LP on the palms and soles of pediatric patients have been reported. Here we report an interesting case of childhood LP with palmoplantar involvement. The patient was a 7-year-old boy who for 6 months had variously sized and shaped, pruritic, violaceous, polygonal papules and plaques on the whole body. The skin biopsy specimens taken from four sites of the patient (dorsum of the hand and foot, sole and chest) showed typical features of LP on histopathology. A diagnosis of generalized LP with palmoplantar involvement was made.
Biopsy ; Child ; Foot ; Hand ; Humans ; Leg ; Lichen Planus ; Lichens ; Mucous Membrane ; Skin ; Wrist

Lymphoma is the third most common childhood malignancy after leukemia and brain tumor. In contrast to adult non-Hodgkin's lymphoma, that occurring in children is usually found extranodally. The most common site is the abdomen, including the gastrointestinal tract, kidney and pancreas, and the next most common is the extranodal head and neck. Gastrointestinal non-Hodgkin's lymphoma in adults is usually considered to be MALT lymphoma, a distinct B-cell type, but the occurrence of this variety in the small bowel of children is relatively rare. We report a case of high-grade MALT lymphoma occurring in a nine-year-old boy who presented with ileoileal intussusception.
Abdomen ; Adult ; B-Lymphocytes ; Brain Neoplasms ; Child* ; Gastrointestinal Tract ; Head ; Humans ; Ileum* ; Intussusception* ; Kidney ; Leukemia ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Male ; Neck ; Pancreas

BACKGROUND: In large clinical series, noise induced hearing loss (NIHL) following middle ear surgery has been demonstrated in 1.2% to 4.5% of patients and it is associated with a lower incidence than expected. The aim of the present work was to analyze the effect of halothane anesthesia on NIHL and hair cell morphological change. METHODS: We used 40 BALB/c mice with normal Preyer's reflex to investigate the effect of halothane on the NIHL. Control (n = 20) and halothane group (n = 20, respectively) were exposed to 120 dB SPL (sound pressure level), broad band white noise 3 hours daily for 3 consecutive days. The halothane group was anesthetized with halothane while exposed to noise. Hearing thresholds were determined with the auditory brainstem response (ABR). On day 7 post-noise, mice were sacrificed and the cochlea were collected for the histological study. RESULTS: ABR thresholds in the halothane group were less elevated after noise exposure than in the control group and then gradually recovered. In control group, the damage to the outer hair cell and supporting cell was noticeable, but not in halothane group. The expression of Bcl-2 protein was detected in halothane group, the expression of Bax protein was seen in control group. As a result in TUNEL stain, the result is positive in the control group but negative in the halothane group. CONCLUSIONS: The occurrence of NIHL decreased and the tissue damage was suppressed while anesthetized by halothane. And the noise-induced cell death of hair cell was also suppressed during anesthesia.
Anesthesia ; Animals ; Apoptosis* ; bcl-2-Associated X Protein ; Cell Death ; Cochlea ; Ear, Middle ; Evoked Potentials, Auditory, Brain Stem ; Hair ; Halothane* ; Hearing Loss* ; Hearing* ; Humans ; In Situ Nick-End Labeling ; Incidence ; Mice* ; Noise* ; Reflex

Lung cancer metastases can occur in almost any organ. However, metastasis of small cell lung cancer to the pancreas is rare. Moreover, not all cases present with clinically diagnosed pancreatitis. We recently treated a patient with small cell lung carcinoma that invaded the pancreatic duct causing acute pancreatitis. Generally, the treatment for tumor-induced acute pancreatitis is initially supportive followed by aggressive chemotherapy or surgery. If the patient can tolerate the insertion of an endoscopic intrapancreatic stent, this is performed in addition to chemotherapy and surgery; this approach offers a safe and effective treatment modality for such patients.
Tomography, X-Ray Computed ; *Stents ; Prosthesis Implantation/*methods ; Pneumonectomy ; Pancreatitis/diagnosis/etiology/*surgery ; Pancreatic Neoplasms/*complications/secondary/therapy ; Pancreatic Ducts/radiography/*surgery/ultrasonography ; Middle Aged ; Lung Neoplasms/*pathology/therapy ; Humans ; Follow-Up Studies ; Female ; Endosonography ; Cholangiopancreatography, Endoscopic Retrograde ; Carcinoma, Small Cell/*complications/secondary/therapy ; Antineoplastic Agents/therapeutic use

Crohn's disease is a condition of chronic inflammation that potentially involves any location the in gastrointestinal tract; however, Crohn's disease with the primary lesion confined to just the appendix is very rare through out the world. Physicians may not be able the clinically differentiate Crohn's disease confined to the appendix from acute appendicitis, and it may not be distinguishable from granulomatous appendicitis of other causes, according to the histopathology. Therefore, clinical follow-up for assessing additional manifestations and sometimes further investigations are the only means of differentiating between granulomatous appendicitis of other causes and early Crohn's disease of the appendix. We experienced 26-year-old man who underwent ileocecectomy for a presumed diagnosis of an acute appendicitis, which pathologically resulted in a granulomatous appendicitis. The cause of the granulomatous appendicitis might have been Crohn's disease because the patient subsequently developed other manifestations of Crohn's disease, according to the follow-up colonoscopy findings.
Adult ; Appendicitis ; Appendix ; Colonoscopy ; Crohn Disease ; Follow-Up Studies ; Granuloma ; Humans ; Inflammation