Primary intimal sarcoma of the pulmonary artery is a rare disease and there has been no report of any case originating from the pulmonary valve. Recently we experienced a 62 year-old female patient who had a primary intimal sarcoma of the pulmonary valve with distal metastasis. She was brought to medical attention due to exertional dyspnea facial edema productive coughing and general weakness for 1 month. Chest CT and echocardi-ography suggest an acute pulmonary thromboembolism or tumor. Exploration showed a large polypoid mass arising from the pulmonary leaflets and multiple masses on distal pulmonary arteries. We replaced the pulmonary valve and reconstructed the pulmonary artery. She received radiotherapy 1 month postoperatively and now 4 months after surgery she has begun receiving chemotherapy.
Cough ; Drug Therapy ; Dyspnea ; Edema ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Radiotherapy ; Rare Diseases ; Sarcoma* ; Tomography, X-Ray Computed

No abstract available.
Pregnancy*

PURPOSE: The aim of this study was to examine the relationship between tooth loss and sub-clinical atherosclerosis in Korean adults. MATERIALS AND METHODS: The subjects were part of a cohort study conducted in Ansan city by the Korea University medical school as part of the Korean Genome project. 749 subjects over than 40 years old were evaluated. After taking panoramic radiography, the amount of tooth loss was calculated. The intima-media thickness (IMT) was assessed by using ultrasonography at the common carotid artery. Traditional cardiovascular risk factors for atherosclerosis were also evaluated. The relationship between tooth loss and the IMT was evaluated using ANOVA with Scheffe's multiple comparison method in univariate analysis. Multiple regression analysis was also performed to determine the significance between the IMT and tooth loss. RESULTS: With age, tooth loss increased, but there was no significant increase in other traditional cardiovascular risk factors. Univariate analysis revealed the IMT to be positively related with the amount of tooth loss. Regression analysis of the IMT in the anterior and posterior tooth loss revealed that only the posterior tooth loss was significantly related with the IMT at all sites of the common carotid artery (right far wall, P = .015; left far wall, P = .008; right near wall, P < .001; left near wall, P = .001). CONCLUSION: This study verified the positive relationship between the increased tooth loss at the posterior area and the accumulation of atheroma in arteries.
Adult ; Arteries ; Atherosclerosis ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Cohort Studies ; Genome ; Humans ; Korea ; Plaque, Atherosclerotic ; Radiography, Panoramic ; Risk Factors ; Schools, Medical ; Tooth ; Tooth Loss

PURPOSE: To evaluate the efficacy of the combination therapy of intravitreal bevacizumab injection and photodynamic therapy in neovascular age-related macular degeneration associated with large retinal pigment epithelial detachment. METHODS: A total of 13 eyes were reviewed, with 9 eyes diagnosed with definite choroidal neovascularization (CNV) and 4 eyes diagnosed with CNV or polypoidal choroidal vasculopathy (PCV) becausethe exact type could not be determined. Photodynamic therapy was performed within 1 week after bevacizumab injection according to indocyanine green angiography (ICGA). Additional bevacizumab injections were performed within a 4 to 6 week interval. Additional photodynamic therapy was performed within 4 months. RESULTS: The visual acuity on final examination had improved in 3 eyes (23.1%), was maintained in 7 eyes (53.8%), and decreased in 3 eyes (23.1%). The change of the PED before and after treatment showed regression in 5 eyes (38.5%), recurrence after regression in 2 eyes (15.4%), persistence in 4 eyes (30.8%), and retinal pigment epithelial tear in 2 eyes (15.4%). The maintained or improved visual acuity rate was 66.7% (6/9) and 100% (4/4) in the CNV and CNV or PCV group, respectively. CONCLUSIONS: The combination therapy in neovascular age-related macular degenerationassociated with large retinal pigment epithelial detachment is a viable alternative treatment in the stabilization and improvement of vision. However, further studies with long-term follow up and controlled studies with anti-vascular endothelial growth factor antibody monotherapy are required.
Angiography ; Antibodies, Monoclonal, Humanized ; Choroid ; Choroidal Neovascularization ; Endothelial Growth Factors ; Eye ; Follow-Up Studies ; Indocyanine Green ; Macular Degeneration ; Photochemotherapy ; Recurrence ; Retinal Detachment ; Retinaldehyde ; Vision, Ocular ; Visual Acuity ; Bevacizumab

PURPOSE: To review the radiological findings of retroanastomotic hernia and to derive the useful US and CT criteria to assist in the diagnosis of the condition in patients who had previously undergone gastrojejunostomy. METHODS: During a recent period, 8 consecutive cases of retroanastomotic hernia were encountered. Of the patients involved, seven underwent US and CT imaging. The US and CT scans were reviewed retrospectively to determine the abnormal findings. Surgical confirmation was available in all cases. RESULTS: The efferent loop was herniated through the defect created behind the anastomosis in seven cases, and the afferent loop in one case. Retroanastomotic hernia was suggested prospectively in all cases. Among the seven cases of efferent loop herniation, the US and CT signs of retroanastomotic hernia included whirling of the mesenteric vessels, jejunal loops, and mesentery in the periumbilical abdomen (7/7); mural thickening of the herniated bowel loops (5/7); dilatation of the herniated bowel loops (2/7); and US showed decreased peristalsis of the herniated bowel loops (2/6). In one case, the US and CT signs of retroanastomotic hernia of the afferent loop included dilatation and whirling of a short length of the afferent loop behind the anastomosis. One out of the eight patients had reVersible bowel ischemia, and one had bowel necrosis. CONCLUSION: Retroanastomoic hernia is an important condition, and the US and CT findings might be used for its diagnosis.
Abdomen ; Diagnosis ; Dilatation ; Gastric Bypass* ; Hernia* ; Humans ; Intestines ; Ischemia ; Mesentery ; Necrosis ; Peristalsis ; Retrospective Studies ; Tomography, X-Ray Computed

A 42 year-old male with a history of multidrug-resistant pulmonary tuberculosis suddenly developed massive hemoptysis. Embolization of a bronchial artery branch and the collateral systemic arteries did not resolve the recurrent bleeding. Spiral computerized tomography(spiral CT) of the chest showed contrast enhanced nodules within a large cavity at the left lower lobe in the arterial phase suggesting a Rasmussen aneurysm. A pulmonary angiogram showed abnormal vascular nodules at that site. Coils were deployed at both the proximal and distal vessels of this aneurysmal sac for embolization. Transcatheter arterial embolization is a safe and effective means of controlling bleeding from this pulmonary arterial pseudoaneurysm. Here we report a case of a Rasmussen aneurysm diagnosed by spiral CT, which was successfully treated by pulmonary arterial embolization with a coil.
Aneurysm* ; Aneurysm, False ; Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis ; Hemorrhage ; Humans ; Male ; Respiratory Insufficiency ; Thorax ; Tomography, Spiral Computed ; Tuberculosis, Pulmonary

No abstract available.
Adenoma* ; Hyperaldosteronism*

PURPOSE: To report a 38-year-old woman who showed esotropia and diplopia after LASEK surgery. METHODS: A 38-year-old mildly myopic woman, who didn't ordinarily need glasses or contact lenses, visited our clinic complaining of sudden onset of esotropia and diplopia following LASEK. Although she had had rarely intermittent esotropia in the past, her orthophoria had been maintained usually. The refractive error, -2.00 Dsph=-0.75 Dcyl x 172 A in the right eye and -2.50 Dsph=-0.75 Dcyl x 27 A in the left eye before LASEK. was improved to -0.50 Dsph -0.25 Dcyl x 48 A in the right eye and -0.25 Dsph in the left eye after LASEK. However, she showed acute esotropia of 40 prism diopters (PD) at near and 30 PD at distance and diplopia. The Worth 4 dot test and Bagolini striated lens test indicated left suppression. In the Titmus stereo test, she exhibited loss of stereoacuity. RESULTS: Her esotropia persisted for two months after first visiting our clinic, so we performed surgery of unilateral lateral rectus muscle resection and medial rectus muscle recession. After strabismus surgery, she showed orthophoria and the diplopia disappeared, while fusion and stereoacuity were regained. CONCLUSIONS: The clinical course of this patient suggested that recovery of accommodative need convert esophoria to esotropia. Therefore we recommend meticulous preoperative evaluation of strabismus in all candidates for refractive surgery.
Adult ; Contact Lenses ; Diplopia ; Esotropia* ; Eyeglasses ; Female ; Glass ; Humans ; Keratectomy, Subepithelial, Laser-Assisted* ; Refractive Errors ; Refractive Surgical Procedures ; Strabismus

Amidarone is one of the most commonly prescribed anti-arrythmic agents for almost all arrythmias, whether atrial or ventricular in origin. There are several side effects associated with amiodarone therapy. These include corneal deposits, abnormal liver function tests, hyper and hypothyroidism, bluish discolorations of the skin, bone marrow suppression, coagulopathies, peripheral neuropathies, and pulmonary toxicity. Amiodarone-induced pulmonary toxicity(APT), which was first described in 1980, is potentially serious side effects that are believed to develop in 5% of patients. Doctors often assume that APT occurs only when high amiodarone doses are used for a long time, but in practice a low maintenance dose of amiodarone may also be toxic. In this report, a case of amiodarone-induced pulmonary toxicity after a long course of a low dose therapy for refractory supraventricular arrythmia is described.
Amiodarone ; Arrhythmias, Cardiac ; Bone Marrow ; Humans ; Hypothyroidism ; Liver Function Tests ; Peripheral Nervous System Diseases ; Skin

Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. We present a case of traumatic neuroma around the celiac trunk after gastrectomy in a 56-year-old man, which was confirmed by pathology. CT demonstrated the presence of a lobulated, homogeneous, hypoattenuating mass around the celiac trunk, mimicking a nodal metastasis.
Celiac Plexus/*pathology/surgery ; Diagnosis, Differential ; Gastrectomy ; Gastric Bypass ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasms, Post-Traumatic/*diagnosis/surgery ; Neuroma/*diagnosis/surgery ; Peripheral Nervous System Neoplasms/*diagnosis/surgery ; Positron-Emission Tomography ; Tomography, X-Ray Computed