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

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

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

No abstract available.
Adenoma* ; Hyperaldosteronism*

We report a case of posttraumatic intestinal stenosis (PIS), an uncommon sequela of blunt abdominal trauma, in which injury to the mesentery and bowel wall results in later focal ischemic stricture of that segment. We present CT images at the time of trauma and 3 weeks later when clinical signs of intestinal obstruction occurred. At surgery, a stenotic small bowel loop was found adjacent to a healed defect in the mesentery. Histologic examination of the resected segment showed mucosal and submucosal ischemia with mucosal ulceration, mural inflammation, and fibrosis. PIS subsequent to a mesenteric tear should be included in the differential diagnosis for a patient with a history of blunt abdominal trauma and signs of intestinal obstruction.
Constriction, Pathologic* ; Diagnosis, Differential ; Fibrosis ; Humans ; Inflammation ; Intestinal Obstruction ; Ischemia ; Mesentery ; Ulcer

Sparganosis is a parasitic infectious disease by sparganum which is a plerocercoid larva of spirometra, a kind of cestode. We experienced a case of intramural sparganosis of cecum presenting as chronic intermittent abdominal pain. A 39 year old man was hospitalized due to intermittent abdominal pain for 6 months and the operation was done under the impreesion of the intestinal tuberculosis or submucosal tumor of cecum after diagnostic work-up. Resected cecum revealed diffuse wall thickening and luminal narrowing. The microscopic findings showed a degenerated larva in the muscle layer with typical tissue reaction which was basically noncaseating cavitary granulomatous inflammation and many calcareous corpuscles which were pathognomonic features of cestode were prominent within the degenerated worm.
Abdominal Pain ; Adult ; Cecum ; Cestoda ; Communicable Diseases ; Humans ; Inflammation ; Intestinal Obstruction* ; Intestines ; Larva ; Phenobarbital ; Sparganosis* ; Sparganum ; Spirometra ; Tuberculosis

PURPOSE: Study by result analysis the proper recession amount according to the deviation angle after unilateral lateral rectus recession in exodeviation. METHODS: A retrospective analysis data from 139 patients who underwent unilateral lateral rectus recession with 15~24PD exodeviation and monitored for 12 months or longer was performed. The analyzed patients were divided into 7.5 mm, 8 mm, 8.5 mm, 9 mm, 9.5 mm groups according to the surgical amount of recession and 15~18PD, 19~20PD, 21~24PD groups according to the deviation angle. The strabismus surgery and results analyses were based on distance deviation. Alignment within 4PD of esodeviation and 10PD of exodeviation was considered a surgical success. RESULTS: The success rates were 53.8% for the 15~18PD group and 40% for the 19~20PD group in the 7.5 mm recession group, 77.7% for the 15~18PD group and 66.7% for the 19~20PD group and 63.6% for the 21~24PD group in the 8 mm recession group, 100% for the 15~18PD group and 81.2% for the 19~20PD group and 72.7% for the 21~24PD group in the 8.5 mm recession group, 83.3% for the 15~18PD group and 85.7% for the 19~20PD group and 83.3% for the 21~24PD group in the 9 mm recession group, 100% for the 19~20PD group and 76.9% for the 21~24PD group in the 9.5 mm recession group at 1 year postoperative. The rates of -1 abduction limitation were respectively 3.1%, 12% and 21.4% in the 8.5 mm, 9 mm and 9.5 mm recession groups and the rate of -2 abduction limitation was 14.3% in the 9.5 mm recession group at 1 year postoperative. CONCLUSIONS: Considering the success state and abduction limitaions, the proper surgical amount of recession is 8.5 mm in the 15~18PD group and 9 mm in the 19~20PD and 21~24PD groups.
Esotropia ; Exotropia* ; Humans ; Retrospective Studies ; Strabismus