Sebaceous carcinoma is a particularly common malignant tumor of the eyelid. Therefore, this lesion is important to ophthalmologist. Recently, there appears to have been an increased incidence or recognition of sebaceous carcinomas of the eyelid, which had been previously believed to be very rare. Frequently mistaken for a recurrent chalazion, invasion by sebaceous carcinoma is frequently enhanced by repeat curettage and forms of therapy that obscure the true diagnosis. This tumor is difficult to completely resect due to intraepithelial widespread, so its prognosis is poor. The authors experienced two cases of sebaceous carcinoma of the eyelid. One was a 57 year old female patient who was treated with surgical resection and the other was a 71 year old male with cervical lymph node metastasis. He was treated with surgical resection, but he rejected radiotherapy.
Aged ; Chalazion ; Curettage ; Diagnosis ; Eyelids* ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Radiotherapy

No abstract available.
Humans ; Intracranial Aneurysm* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.

Two patients were presented with painful unilateral oculomotor nerve palsy and one of them was combined with trochlear nerve palsy. First case was initially thought to have diabetic opthalmoplegia, and second case was thought to have posterior communicating or distal internal carotid aneurysms. But both had, in fact dural carotid cavernous fistula, draining posteriorly into inferior petrosal sinus. Embolization was done in these two cases, which was followed by clinical improvement in one case.
Aneurysm ; Fistula* ; Humans ; Oculomotor Nerve Diseases* ; Oculomotor Nerve* ; Trochlear Nerve Diseases

PURPOSE: To assess the usefulness of 0.5 %-methylcellulose as oral contrast agent in spiral CT examinationsfor the evaluation of anastomotic site and remnant stomach in patients who have undergone subtotal gastrectomy dueto stomach cancer. MATERIALS AND METHODS: Twenty-seven patients who underwent subtotal gastrectomy for stomachcancer and were referred for the evaluation of anastomosis recurrence and lymph node metastasis wereprosepectively analyzed by spiral CT. They were divided into two groups: before scanning, group A patients drank0.5 %-methylcellulous 500ml as oral contrast agent, while those in group B drank diluted gastrografin 500ml. Threepatients were examined twice. Anatomic delineation of the anastomosis site was graded by two radiologists asexcellent (3), good (2), fair (1), or poor (0). To evaluate the degree of distension, maximal transverse andanterior-posterior diameter of remnant stomach and anastomotic sites were measured. RESULTS: In Group A, anatomicdelineation of the anastomotic site was very much better than in group B (mean score: 2.93 vs 1.80, p<0.05). Inaddition, the maximum diameters of remnant stomach and anastomotic site were significantly larger in group A thanin group B (transverse A-P remnant stomach and anastomosis site: 87.5 +/-14.7mm, 103.3 +/-20.1mm, 17.6 +/-2.9mm vs57.6 +/-20.1mm, 69.9 +/-3 5 . 0 m m , 10.7 +/-7 . 2 m m ) CONCLUSION: In patients who had undergone subtotalgastrectomy, the use of 0.5 %-methylcellulose as oral contrast agent for spiral CT showed excellent anatomicdelineation of the anastomotic site and distension of remnant stomach.
Contrast Media ; Diatrizoate Meglumine ; Gastrectomy* ; Gastric Stump ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms ; Tomography, Spiral Computed

BACKGROUND: Although a magnetic resonance imaging (MRI) is highly sensitive for changes associated with ischemic stroke, the detection of an acute ischemic lesion is usually impossible within 6 hours of the stroke onset on a conventional MRI. The perfusion MRI is a new imaging technique for diagnosing acute ischemic stroke. We evaluate the clinical usefulness of the perfusion MRI in predicting the final infarct extent in 18 patients with acute middle cerebral artery (MCA) territory ischemic stroke. METHOD: The perfusion MRI was performed within 6 hours after the stroke onset in all patients with a single-section dynamic contrast-enhanced T2*-weighted imaging in conjunction with a conventional routine MRI and MR angiography. Time-concentration curves and cerebral blood volume (CBV) maps were calculated from the dynamic MR imaging data by using numerical integration techniques. We compared findings of CBV maps with infarction on a follow-up CT or MRI. RESULTS: In 14 of 18 patients, the CBV in the occluded MCA territory were decreased. In the remaining 4 patients with a reversible ischemic neurologic deficit (RIND) or transient ischemic attack (TIA), the CBV were increased in 3 and normal in 1. Out of 14 patients with a decreased CBV, two had focal regions of increased CBV within the affected territory, indicating reperfusion hyperemia. The regions of increased or decreased CBV were eventually converted to infarction on follow-up images in all 14 patients. Out of 4 patients with RIND or TIA, one showed focal infarction in centrum semiovale on a follow-up image. CONCLUSIONS: The perfusion MRI was useful for the assessment of hemodynamic change about cerebral perfusion and may predict the extent of final infarction in acute MCA territory ischemic stroke. These results suggest that the perfusion MRI may play an important role in the diagnosis and management of acute ischemic stroke.
Angiography ; Blood Volume ; Diagnosis ; Follow-Up Studies ; Hemodynamics ; Humans ; Hyperemia ; Infarction ; Ischemic Attack, Transient ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Neurologic Manifestations ; Perfusion* ; Reperfusion ; Stroke*

Salmonellosis is one of communicable disease and still occur in sporadic in Korea frequently. They are four main clinical manifestations in salmonellosis. They are gastroenteritis, typhoidal or septisemia syndrome, focal manifestation and carrier state. Among them, focal manifestation is rarely seen. Saphra, et al. reported that localized salmonella infection is about 5%. Localized salmonella infection frequently occur during salmonella bacteremia, but may also occur with enteric fever or gastroenteritis. Gray, et al reported 3390 cases of minor gunshot wound infection that bacterial isolates from infected wounds consisted of Staphylococcus aureus(90%), Streptococcus sp.(6%), and mixed organisms(4%). Incresed host susceptibility to infection secondary to lowered resistance due to debilitating disease is an important determinant of Salmonella infection. Since salmonella is seldom suspected as a cause of soft tissue infections,there is usually a dangerous delay in the institution of appropriate antimicrobial therapy and isolation procedure. We experienced one case of subcutaneous salmonella abscess developed on gunshot wound area in lung cancer patient, which was confirmed by pus culture.
Abscess* ; Bacteremia ; Carrier State ; Communicable Diseases ; Gastroenteritis ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Salmonella Infections ; Salmonella* ; Staphylococcus ; Streptococcus ; Suppuration ; Typhoid Fever ; Wounds and Injuries* ; Wounds, Gunshot

BACKGROUND: Catheter-related infection is one of the most important causes of technical failure in peritoneal dialysis patients. We have examined the incidence and etiology of exit-site infection (ESI) at Keimyung University Dongsan medical center. METHODS: Between January 2001 and December 2003, 292 new patients received peritoneal dialysis using double cuffed straight Tenckhoff catheter and were reviewed retrospectively. RESULTS: In 292 patients, 81 (27.7%) patients experienced ESI and a total of 97 episodes of ESI has occurred during study period. The overall incidence of peritonitis during peritoneal dialysis was 0.27 episodes/patient-year. According to Twardowski's classification, equivocal infection in 14.4%, acute infection in 68.1% and chronic infection in 17.5% were noted. Staphylococcus aureus was the most frequently isolated organism, followed by Staphylococcus epidermidis, and Pseudomonas aeruginosa. The duration of treatment was significantly longer in chronic infection group than acute infection group (44.6 days vs. 18.5 days, p<0.05). The rates of Pseudomonas infection (p<0.05) and catheter replacement (p<0.05) were significantly higher in the chronic infection group than in the acute infection group. There was one catheter loss due to refractory peritonitis and three deaths unassociated with ESI during mean follow-up of 20.3 months. CONCLUSIONS: Exit-stie infection is still a major causes of peritonitis and catheter failure. Because of suboptimal quality of practice guideline, additional studies on the definition, prevention and treatment of ESI are required.
Catheter-Related Infections ; Catheters ; Classification ; Focal Infection ; Follow-Up Studies ; Humans ; Incidence ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Pseudomonas aeruginosa ; Pseudomonas Infections ; Retrospective Studies ; Staphylococcus aureus ; Staphylococcus epidermidis

BACKGROUND: This study was designed to evaluate the hemodynamic effects of vecuronium, pancuronium and rocuronium in patients with coronary artery disease (CABG) or valvular heart disease (VHD). METHODS: With IRB approval, 121 patients (61 patients with CABG and 60 patients with VHD) were randomly divided into a vecuronium, pancuronium and rocuronium group, respectively. Midazolam and fentanyl were administered and then 3 times of ED95 of a muscle relaxant (vecuronium, 0.12 mg/kg; pancuronium, 0.12 mg/kg; or rocuronium, 0.9 mg/kg) was injected. Additional dose of fentanyl was given and the patient was intubated. Hemodynamic variables were measured before the induction of anesthesia, just prior and 1 min after the administration of the muscle relaxant, just before intubation, 5 and 10 min after intubation. RESULTS: The number of patients enrolled in the CABG-vecuronium, CABG-pancuronium, CABG- rocuronium, VHD-vecuronium, VHD-pancuronium, and VHD-rocuronium was 20, 20, 21, 19, 20, and 21 respectively. Each of 10, 4, 4, 5, 1, and 1, respectively, were treated for hypotension or bradycardia during the induction of anesthesia. The heart rate (HR) changed significantly only in the CABG- vecuronium group compared with the control value. All three muscle relaxants decreased mean systemic artery pressure (MAP) significantly in both CABG and VHD patients. The decrease in HR and MAP were significantly greater in CABG-vecuronium and VHD-vecuronium than in CABG-pancuronium and VHD-pancuronium, respectively. The decrease in HR was also greater in VHD-vecuronium than in VHD-rocuronium. Cardiac index (CI) decreased in CABG-vecuronium and all VHD patients. The decrease in CI was greater in CABG-vecuronium than in CABG-pancuronium but it was not significantly different among the three muscle relaxants in VHD patients. CONCLUSIONS: While pancuronium and rocuronium exerted minimal hemodynamic effects, vecuronium reduced HR and MAP more significantly than pancuronium in both CABG and VHD patients, and CI also decreased more significantly with vecuronium in CABG patients.
Anesthesia* ; Arteries ; Bradycardia ; Coronary Artery Disease* ; Coronary Vessels* ; Ethics Committees, Research ; Fentanyl ; Heart Rate ; Heart Valve Diseases* ; Hemodynamics* ; Humans ; Hypotension ; Intubation ; Midazolam ; Pancuronium* ; Vecuronium Bromide*

Transcatheter aortic valve implantation (TAVI) has shown favorable outcomes in patients with severe symptomatic aortic valve stenosis who are at high surgical risk or are unsuitable candidates for open heart surgery. However, concerns exist over treating patients who have previously undergone mitral valve surgery due to the potential interference between the mitral prosthetic valve or ring and the TAVI device. In this case report, we present a patient with symptomatic severe aortic stenosis and previous mechanical mitral valve replacement who was successfully treated with TAVI using a CoreValve.
Aortic Valve Stenosis ; Aortic Valve* ; Catheters ; Heart Valve Prosthesis ; Humans ; Mitral Valve* ; Prosthesis Implantation ; Thoracic Surgery