No abstract available.
Polyps*

High output heart failure due to congenital arteriovenous fistula is a rare disease and is difficult to treat. A 27 year old man, suffering from dyspnea, palpitation, lower extremity edema, and abdominal distension admitted May, 1987. At admission there were continuous thrill and bruit at left supraclavicular and infraclavicular area. The heart sound was irregular and rapid, and grade IV/VI pansystolic murmur was audible at the apex. Chest PA showed marked cardiomegaly with pleural effusion and notching at superior aspect of left 2nd rib. Selective left subclavian artery angiogram showed extensive congenital arteriovenous fistula at the area of left subclavian artery and its branches. After setrial feeding artery embolization and palliative operation, the fistula size decreased much with clinical improvement.
Adult ; Arteries ; Arteriovenous Fistula* ; Cardiomegaly ; Dyspnea ; Edema ; Fistula ; Heart Failure ; Heart Sounds ; Humans ; Lower Extremity ; Pleural Effusion ; Rare Diseases ; Ribs* ; Subclavian Artery* ; Thorax

This is a case report of the familial olivo-ponto-cerebellar atrophy (Menzel type OPCA, OPCA III with retinal degeneration). The patient is a 37 year-old male with 5 years history of slowly progressive cerebellar ataxia, dysarthria, visual change, horizontal nystagmus and signs of pyramidal dysfunction. The CT brain scan shows significant atrophy of brain stem and cerebellum with dilatation of cisterns. His younger sister, also, has similar clinical manifestations and radiological abnormalities, but mild. By history, his mother who died at 47 years of her age looked like to have same kind of chronic disease.
Adult ; Atrophy ; Brain ; Brain Stem ; Cerebellar Ataxia ; Cerebellum ; Chronic Disease ; Dilatation ; Dysarthria ; Humans ; Male ; Mothers ; Nystagmus, Pathologic ; Olivopontocerebellar Atrophies* ; Retinaldehyde* ; Siblings

No abstract available.
Tuberculosis, Meningeal*

No abstract available.
Esophageal and Gastric Varices* ; Gastrectomy*

PURPOSE: To evaluate the usefulness of 3 dimensional-volume MR imaging technique for demonstrating the facial nerves and to describe MR findings in facial palsy patients and evaluate the significance of facial nerve enhancement. MATERIALS AND METHODS: We reviewed the MR images of facial nerves obtained with 3 Dimensional-volume imaging technique before and after intravenous administration of Gadopentetate dimeglumine in 13 cases who had facial paralysis and 33 cases who had no facial palsy. And we analyzed the detectabilty of anatomical segments of intratemporal facial nerves and facial nerve enhancement. RESULTS: When the 3 Dimensional-volume MR images of 46 nerves were analyzed subjectively, the nerve courses of 43(93%) of 46 nerves were effectively demonstrated on 3 Dimensional-volume MR images. Internal acoustic canal portions and geniculate ganglion of facial nerve were well visualized on axial images and tympanic and mastold segments were well depicted on oblique sagittal images. 10 of 13 patients(77%) were visibly enhanced along at least one segment of the facial nerve with swelling or thickening, and nerves of 8 of normal 33 cases(24%) were enhanced without thickening or swelling. CONCLUSION: MR findings of facial nerve paralysis is asymmetrical thickening of facial nerve with contrast enhancement. The 3 Dimensional-volume MR imaging technique should be a useful study for the evaluation of intratemporal facial nerve disease.
Acoustics ; Administration, Intravenous ; Facial Nerve Diseases ; Facial Nerve* ; Facial Paralysis ; Gadolinium DTPA ; Geniculate Ganglion ; Humans ; Magnetic Resonance Imaging* ; Paralysis

Hip fractures are common among elderly individuals. Internal fixation with the intramedullary system has been widely used to treat intertrochanteric femur fractures. The Gamma 3 nail is a useful device for fixating trochanteric fractures of the proximal femur. We report a rare complication of medial pelvic penetration of the lag screw of a Gamma 3 nail two months after surgery. There was a complete separation between the nail body and lag screw, and the lag screw penetrated through the acetabulum into the pelvis. We report a case of unstable intertrochanteric fracture with intrapelvic penetration after surgical treatment with proximal femoral nailing and a case followed by fatal results.
Acetabulum ; Aged ; Femur ; Hip Fractures ; Humans ; Pelvis

PURPOSE: The purpose of this study was to analyze the results of an immediate and mid-term angiographic and clinical follow-up of endovascular treatment for paraclinoid aneurysms. MATERIALS AND METHODS: From January 2002 to December 2012, a total of 113 consecutive patients (mean age: 56.2 years) with 116 paraclinoid saccular aneurysms (ruptured or unruptured) were treated with endovascular coiling procedures. Clinical and angiographic outcomes were retrospectively evaluated. RESULTS: Ninety-three patients (82.3%) were female. The mean size of the aneurysm was 5.5 mm, and 101 aneurysms (87.1%) had a wide neck. Immediate catheter angiography showed complete occlusion in 40 aneurysms (34.5%), remnant sac in 51 (43.9%), and remnant neck in 25 (21.6%). Follow-up angiographic studies were performed on 80 aneurysms (69%) at a mean period of 20.4 months. Compared with immediate angiographic results, follow-up angiograms showed no change in 38 aneurysms, improvement in 37 (Fig. 2), and recanalization in 5. There were 6 procedure-related complications (5.2%), with permanent morbidity in one patient. CONCLUSION: Out study suggests that properly selected patients with paraclinoid aneurysms can be successfully treated by endovascular means.
Aneurysm* ; Angiography ; Catheters ; Female ; Follow-Up Studies ; Humans ; Neck ; Retrospective Studies

BACKGROUND: Anesthesia and surgery may exacerbate liver function in patients with pre-existing liver disease so it is important to choose less hepatotoxic anesthetics in patients with chronic liver disease. METHODS: This study was designed to examine the postoperative liver function test in 150 patients after hepatectomy with portal triad clamping through retrospective chart review. Patients were divided into an isoflurane group (group I, n = 56) and a propofol group (group P, n = 57) by used anesthetics for maintaining anesthesia. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase, alkaline phosphatase, total bilirubin, albumin, and prothrombin time were checked at preoperation, and postoperatively at 1, 3, 7 and 14 days in the two groups. Indocyanine retention rate (ICG-R15) was measured at preoperation, and postoperatively at 1 and 7 days. RESULTS: AST values increased postoperatively at 1, 3, 7, and 14 days compared with preoperation. ALT values increased postoperatively at 1, 3 and 7 days compared with preoperation and there was difference between group I (443.8 +/- 52.1 U/L) and group P (202.7 +/- 24.7 U/L) at postoperative 1 day. Other values had no significant difference between the two groups. CONCLUSIONS: Though it might need a well controlled study to find the differences in effect between isoflurane and propofol on the postoperative liver function test, we concluded that total intravenous anesthesia using propofol is also one of the safest anesthetic methods for hepatic resection with minimal hepatotoxicity.
Alanine Transaminase ; Alkaline Phosphatase ; Anesthesia ; Anesthesia, Intravenous ; Anesthetics ; Aspartate Aminotransferases ; Bilirubin ; Constriction* ; Hepatectomy ; Humans ; Isoflurane* ; L-Lactate Dehydrogenase ; Liver Diseases ; Liver Function Tests* ; Liver* ; Propofol* ; Prothrombin Time ; Retrospective Studies

BACKGROUND: Postoperative nausea and vomiting (PONV) is a distressing adverse effect of anesthesia. This study was designed to evaluate antiemetic effects of metoclopramide, ondansetron and granisetron in middle ear surgery. METHODS: We compared the antiemetic activity of prophylactic administration of metoclopramide, ondansetron and granisetron in 103 patients undergoing middle ear surgery (tympanomastoidectomy and tympanoplasty). All Study drugs were given as a short intravenous infusion 30 minutes before the end of anesthesia. The incidence of PONV were assessed by direct questioning of patients at 6, 12, 24 and 48 hr after recovery from anesthesia. RESULTS: For the first 6 hr recovery period after surgery, the percentages of emesis in patients were 46.7%, 16%, 12% and 16% in the control, metoclopramide, ondansetron and granisetron groups respectively. After 6 hr, the percentage of emesis in patients significantly decreased in the control, ondansetron and granisetron groups when compared with the first 6 hr, but in the metoclopramide group there was no changes after 6 hr. CONCLUSIONS: The antiemetic drugs, metoclopramide, ondansetron and granisetron, were all effective in controling PONV in middle ear surgery.
Anesthesia ; Antiemetics* ; Ear, Middle* ; Granisetron* ; Humans ; Incidence ; Infusions, Intravenous ; Metoclopramide* ; Ondansetron* ; Postoperative Nausea and Vomiting ; Vomiting