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.

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*

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

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

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

PURPOSE: Since 2001, breast cancer has been the most common type of cancer observed in Korean women. Due to improved screening and treatment, multiple primary cancer (MPC) in association with breast cancer has been more prevalent. However, there is a lack of information regarding MPC in Korea. Therefore, this study was conducted to provide an overview of the clinical characteristics of MPC that occurs in association with breast cancer. METHODS: We retrospectively investigated 149 patients with MPC, including breast cancer patients, who were treated between July 1989 and December 2005 at the Breast clinic in Asan Medical Center. Patients with contra-lateral breast cancer as well as patients that experienced a recurrence of breast cancer were excluded from this study. We studied the clinical characteristics of patients including the mean age, stage of disease, hormone receptor status, cause of death, common cancers that were combined with breast cancer, the time interval between the onset of breast cancer and other cancers, and mean survival. We considered the cancer to be synchronous if a second cancer has been diagnosed at least six months before the diagnosis of an initial primary cancer, however, other forms of cancer were considered to be metachronous. RESULTS: Of 149 patients, 146 patients were female (98.0%) and 3 were male (2.0%). The mean age of the study group was 51.5, which is higher than the mean age of 47.3 that was observed in breast cancer patients at our hospital during the same period (p<0.001). Forty-four of the patients evaluated in this study had synchronous cases of cancer, whereas the remaining 88 patients had metachronous MPC. In metachronous cancers, the average time between diagnosis with the primary cancer and the secondary cancer was 5.2 yr. The most common cancer found to be combined with breast cancer included cancer of the thyroid (45, 29.2%), cervix and uterus (28, 18.2%), stomach (19, 12.3%), colon and rectum (15, 9.7%), ovary (11, 7.1%) and lung (9, 5.8%). CONCLUSION: Thyroid cancer is the cancer most commonly associated with breast cancer, and the mean age of MPC patients was higher than that of patients who only had breast cancer. Due to the improved survival length and treatment, MPC associated with breast cancer is now a greater concern.
Breast Neoplasms* ; Breast* ; Cause of Death ; Cervix Uteri ; Chungcheongnam-do ; Colon ; Diagnosis ; Female ; Humans ; Korea ; Lung ; Male ; Mass Screening ; Neoplasms, Second Primary ; Ovary ; Rectum ; Recurrence ; Retrospective Studies ; Stomach ; Thyroid Neoplasms ; Uterus

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

Transcatheter aortic valve implantation (TAVI) is an alternative treatment modality for surgical aortic valve replacement in patients at high surgical risk. Transfemoral access is not feasible in many cases with unfavorable iliofemoral anatomy or severe peripheral arterial disease (PAD). Elderly patients with severe aortic valve stenosis have a higher prevalence of PAD due to atherosclerotic degenerative changes in the large and small vessels. Transsubclavian, transapical, and direct access to the ascending aorta by thoracotomy are alternative routes for the TAVI procedure. In this case, we describe a patient with a previous coronary artery bypass graft and bilateral iliac artery stenosis who successfully underwent TAVI using a CoreValve(R) by transfemoral approach after balloon angioplasty of iliac artery stenosis.
Aged ; Angioplasty, Balloon ; Aorta ; Aortic Valve ; Aortic Valve Stenosis ; Constriction, Pathologic ; Coronary Artery Bypass ; Heart Valve Prosthesis ; Humans ; Iliac Artery ; Peripheral Arterial Disease ; Prevalence ; Thoracotomy ; Transplants