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

Corneal thickness is not only a major indicator of corneal diseases but an important parameter for the safety and the prevention of complications in various refractive surgeries widely performed nowadays.Therefore, we tried to acquire the basic data of corneal thickness in normal Koreans through this study. Central corneal thickness was measured using ultrasonic pachymeter in 460 eyes of 238 normal Koreans and analyzed according to the difference in age, sex, left &right, refractive error, and mean keratometry.Mean CCT was 529.67+/-32.18 micrometer.There is no statistically significant difference in CCT according to the difference in age, sex, left and right, refractive error, and mean keratometry in normal Koreans.
Corneal Diseases ; Refractive Errors ; Refractive Surgical Procedures ; Ultrasonics*

The adrenal gland is the second most common site of metastasis from a hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) for these tumors has been reported to be a potentially effective alternative to an adrenalectomy, especially for inoperable patients. However, for intermediate or large adrenal tumors, combination therapy of transarterial chemoembolization (TACE) and RFA can be attempted as it may reduce the heat sink effect. A 74-year-old patient presented with abdominal discomfort. Abdominal CT images revealed a 5.0 cm sized right adrenal mass. A percutaneous biopsy of the adrenal mass revealed a metastatic hepatocellular carcinoma. TACE was performed on the adrenal mass. However, a one-month follow-up CT image revealed a residual viable tumor. RFA was performed for the adrenal tumor six weeks after the TACE. No procedure-related major complications were noted. The serum alpha-fetoprotein level had also been normalized after the treatment, and 10-month follow-up CT images showed no definite evidence of viable adrenal tumor.
Adrenal Glands ; Adrenalectomy ; Aged ; alpha-Fetoproteins ; Biopsy ; Carcinoma, Hepatocellular* ; Catheter Ablation* ; Follow-Up Studies ; Hot Temperature ; Humans ; Neoplasm Metastasis ; Tomography, X-Ray Computed

Elastofibroma dorsi is a rare, slow-growing, ill defined soft tissue tumor that's typically found between the inferior scapula and chest wall. The characteristic findings on ultrasonography, MRI and CT usually allow the correct diagnosis and so prevent unnecessary surgical procedure. We experienced a case of bilateral elastofibroma dorsi in an 87-year-old man, and we report on this case along with a review of the literature.
Aged, 80 and over ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Scapula ; Thoracic Wall ; Ultrasonography

Self-expanding metallic stent insertion has been widely applied for the palliative treatment of malignant esophageal strictures. Although it is known as an easy, safe, and effective procedure, complications are well known and include things such as stent migration and esophageal stent occlusion caused by tumor ingrowth. However, metallic stent fractures have been rarely reported in the esophagus, especially for nitinol stents. We report a case of a stent fracture associated with migration in a patient with a malignant esophageal stricture near the gastroesophageal junction. It is highly probable that the stent fracture was due to chemical erosion of the stent caused by gastric juice.
Alloys ; Constriction, Pathologic ; Esophageal Stenosis ; Esophagogastric Junction ; Esophagus ; Gastric Juice ; Humans ; Palliative Care ; Stents

No abstract available.
Cord Blood Stem Cell Transplantation* ; Fetal Blood* ; Humans ; Leukemia* ; Siblings*

No abstract available.
Herpes Simplex ; Herpes Zoster ; Humans ; Methylmethacrylates ; Polystyrenes

It is known that humidity in the laser room might affect the outcomes of excimer laser refractive surgery. This study evaluated the outcomes of laser in situ keratomileusis (LASIK)according to humidity changes in laser room. Hinged flap was made by SCMD turbokeratome and photoablation was performed by utilizing VISX 20/20 excimer laser system. The differences between targeted refraction and actual refractive error, namely, refractive correction errors (defined by authors)were calculated. We have divided LASIK patients into two groups. Group A consisting of 61 eyes of 31 patients underwent LASIK when laser room humidity was over 70% (average 73%) and Group B includes 49 eyes of 28 patients when laser room humidity was under 40% (average 35%). Each group was broken into two subgroups, that is high myopia (> or= -6 D)and mild to moderate myopia (< -6 D). The mean refractive correction errors in the high myopia (> or= -6 D)was 1.28+/-1.42 D in the group A (n=46 eyes)and 1.99 +/-1.38 D in the group B (n= 26 eyes). In both groups, the difference between two subgroups was statistically significant and high myopes group B was overcorrected compared with ones in group A (t-test, p<0.05). The mean refractive correction errors in the low to moderate myopia (< -6 D)was 0.38 +/-0.49 D in the group A (n=15 eyes)and 0.4 +/-0.38 D in the group B (n=23 eyes). In both subgroups, there was no statistically significant difference in mean refractive correction errors (t-test, p>0.05). The proper room humidity is critical for LASIK results, particularly in the high myopia (> or= -6 D)because humidity can affect outcomes of LASIK. Therefore, the humidity should be maintained properly for enhancement of surgical outcome predictability in the high myopia.
Humans ; Humidity* ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Refractive Errors ; Refractive Surgical Procedures

Eight cases of chondroblastoma were studied by analyzing the clinical and pathologic findings. The age of eight cases ranged from 17 to 38 years old(median age, 22.7 years old). The tumors developed in the femur (3 cases), patella (2 cases), tibia( 1 case), fibula (1 case), and ulna (1 case). The mean diameter of tumors was 4.0 cm (range, 1.5 to 8.0 cm). Grossly, tumors showed grayish brown solid area with foci of secondary aneurysmal bone cyst. Histologically, the tumor cells were round or polygonal in shape with nuclear groove. And there were chondroid differentiation(7 cases), mitosis(3 cases), calcific deposits(3 cases), secondary aneurysmal bone cyst(4 cases), hemosiderin deposits(4 cases), necrosis(3 cases), vascular invasion(1 caes) and foamy histiocytes and cholesterol cleft(1 cases). All cases showed no metastasis to lymph node and distant organ. Seven cases (87.5 %) were immunoreactive for S-100 protein. None were immunoreactive for cytokeratin.
Aneurysm ; Bone Cysts ; Cholesterol ; Chondroblastoma* ; Femur ; Fibula ; Hemosiderin ; Histiocytes ; Keratins ; Lymph Nodes ; Neoplasm Metastasis ; Patella ; S100 Proteins ; Ulna

PURPOSE: To evaluate whether the Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon could reflect the genomic information of breast cancers and to suggest intuitive imaging features as biomarkers. METHODS: Matched breast MRI data from The Cancer Imaging Archive and gene expression profile from The Cancer Genome Atlas of 70 invasive breast cancers were analyzed. Magnetic resonance images were reviewed according to the BI-RADS MRI lexicon of mass morphology. The cancers were divided into 2 groups of gene clustering by gene set enrichment an alysis. Clinicopathologic and imaging characteristics were compared between the 2 groups. RESULTS: The luminal subtype was predominant in the group 1 gene set and the triple-negative subtype was predominant in the group 2 gene set (55 of 56, 98.2% vs. 9 of 14, 64.3%). Internal enhancement descriptors were different between the 2 groups; heterogeneity was most frequent in group 1 (27 of 56, 48.2%) and rim enhancement was dominant in group 2 (10 of 14, 71.4%). In group 1, the gene sets related to mammary gland development were overexpressed whereas the gene sets related to mitotic cell division were overexpressed in group 2. CONCLUSION: We identified intuitive imaging features of breast MRI associated with distinct gene expression profiles using the standard imaging variables of BI-RADS. The internal enhancement pattern on MRI might reflect specific gene expression profiles of breast cancers, which can be recognized by visual distinction.