The authors analyse the ultrasonographic findings of 10 cases of appendiceal mucocele retrospectively. In atotal of 10 cases, 6 cases showed only cystic masses with posterior reinforcement. The remaining 4 cases showedinternal echoes in the cystic masses. Differential diagnosis of mucocele from periappendiceal abscess is notpossible in ultrasound. The possibility of mucocele shold be considered if cystic mass in right lower quadrantabdomen is observed in ultrasound.
Abscess ; Diagnosis, Differential ; Mucocele ; Retrospective Studies ; Ultrasonography

OBJECTIVE: Terson's syndrome, a complication of visual function, has occasionally been reported in patients with aneurysmal subarachnoid hemorrhage (SAH), however the factors responsible for Terson's syndrome in aneurysmal SAH patients have not yet been fully clarified. In this study, we report on potential risk factors for prediction and diagnosis of Terson's syndrome in the earlier stage of the disease course in patients with aneurysmal SAH. MATERIALS AND METHODS: The authors retrospectively analyzed the data of 322 consecutive patients who suffered from aneurysmal SAH in a single institution between Jan. 2007 and Dec. 2013. Medical records including demographics, neurologic examination, and radiologic images were collected to clarify the risk factors of Terson's syndrome. Patients with visual problem were consulted to the Department of Ophthalmology. RESULTS: Among 332 patients with aneurysmal SAH, 34 patients were diagnosed as Terson's syndrome. Four individual factors, including World Federation of Neurosurgical Societies (WFNS) grade at admission, aneurysm size, method of operation, and Glasgow outcome scale showed statistically significant association with occurrence of Terson's syndrome. Of these, WFNS grade at admission, aneurysm size, and method of operation showed strong association with Terson's syndrome in multivariate analysis. Terson's syndrome accompanied by papilledema due to increased intracranial pressure led to permanent visual complication. CONCLUSION: In patients with aneurysmal SAH, the patients' WFNS grade at admission, the size of the aneurysms, particularly the diameter of the aneurysm dome, and the method of operation might influence development of Terson's syndrome.
Aneurysm* ; Demography ; Diagnosis ; Glasgow Outcome Scale ; Humans ; Incidence* ; Intracranial Pressure ; Medical Records ; Multivariate Analysis ; Neurologic Examination ; Ophthalmology ; Papilledema ; Retrospective Studies* ; Risk Factors* ; Subarachnoid Hemorrhage* ; Vitreous Hemorrhage

OBJECTIVE: Terson's syndrome, a complication of visual function, has occasionally been reported in patients with aneurysmal subarachnoid hemorrhage (SAH), however the factors responsible for Terson's syndrome in aneurysmal SAH patients have not yet been fully clarified. In this study, we report on potential risk factors for prediction and diagnosis of Terson's syndrome in the earlier stage of the disease course in patients with aneurysmal SAH. MATERIALS AND METHODS: The authors retrospectively analyzed the data of 322 consecutive patients who suffered from aneurysmal SAH in a single institution between Jan. 2007 and Dec. 2013. Medical records including demographics, neurologic examination, and radiologic images were collected to clarify the risk factors of Terson's syndrome. Patients with visual problem were consulted to the Department of Ophthalmology. RESULTS: Among 332 patients with aneurysmal SAH, 34 patients were diagnosed as Terson's syndrome. Four individual factors, including World Federation of Neurosurgical Societies (WFNS) grade at admission, aneurysm size, method of operation, and Glasgow outcome scale showed statistically significant association with occurrence of Terson's syndrome. Of these, WFNS grade at admission, aneurysm size, and method of operation showed strong association with Terson's syndrome in multivariate analysis. Terson's syndrome accompanied by papilledema due to increased intracranial pressure led to permanent visual complication. CONCLUSION: In patients with aneurysmal SAH, the patients' WFNS grade at admission, the size of the aneurysms, particularly the diameter of the aneurysm dome, and the method of operation might influence development of Terson's syndrome.
Aneurysm* ; Demography ; Diagnosis ; Glasgow Outcome Scale ; Humans ; Incidence* ; Intracranial Pressure ; Medical Records ; Multivariate Analysis ; Neurologic Examination ; Ophthalmology ; Papilledema ; Retrospective Studies* ; Risk Factors* ; Subarachnoid Hemorrhage* ; Vitreous Hemorrhage

Hemangioblastomas in the pituitary stalk are especially rare. Most pituitary stalk hemangioblastomas reported in the literature were associated with von Hippel-Lindau (VHL) disease. Here, we report only the 3rd case of sporadic pituitary stalk hemangioblastoma diagnosed in a 60-year-old woman. Despite the danger of potential complications due to excessive vascularity or proximity to important neural structures, the tumor in our case was successfully removed while preserving pituitary function. In this case, complete surgical excision was shown to be an effective treatment option for symptomatic pituitary stalk hemangioblastoma, and we suggest careful evaluation of any highly enhancing mass with a signal void in the pituitary stalk preoperatively, even if no VHL disease is evident.
Female ; Hemangioblastoma* ; Humans ; Middle Aged ; Pituitary Gland*

OBJECTIVE: This study was to evaluate the association of the G1691A mutation of factor V gene with preeclamptic patients in Korea. METHODS: Factor V genotype were determined in 113 preeclamptic patients and 100 normotensive pregnant women. A 267 base-pair DNA fragment of the factor V gene that includes nucleotide 1691 was amplified by PCR. PCR product was digested with MnlI restriction enzyme and the fragments were analysed by electrophoresis using 2% agarose gel. RESULTS: The difference of genetic and allelic frequencies between two groups could not be mentioned because all women were G1691G homozygotes. There was no individuals with mutant allele among preeclamptic patients and control women. CONCLUSION: There was no evidence of association between preeclampsia and factor V gene polymor- phism in Korean population.
Alleles ; DNA ; Electrophoresis ; Factor V* ; Female ; Genotype ; Homozygote ; Humans ; Korea* ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnant Women ; Sepharose

OBJECTIVE: We conducted this study to report the efficacy of local application of vancomycin powder in the setting of surgical site infection (SSI) of posterior lumbar surgical procedures and to figure out risk factors of SSIs. METHODS: From February 2013 to December 2013, SSI rates following 275 posterior lumbar surgeries of which intrawound vancomycin powder was used in combination with intravenous antibiotics (Vanco group) were assessed. Compared with 296 posterior lumbar procedures with intravenous antibiotic only group from February 2012 to December 2012 (non-Vanco group), various infection rates were assessed. Univariate and multivariate analysis to figure out risk factors of infection among Vanco group were done. RESULTS: Statistically significant reduction of SSI in Vanco group (5.5%) from non-Vanco group (10.5%) was confirmed (p=0.028). Mean follow-up period was 8 months. Rate of acute staphylococcal SSIs reduced statistically significantly to 4% compared to 7.4% of non-Vanco group (p=0.041). Deep staphylococcal infection decreased to 2 compared to 8 and deep methicillin-resistant Staphylococcus aureus infection also decreased to 1 compared to 5 in non-Vanco group. No systemic complication was observed. Statistically significant risk factors associated with SSI were diabetes mellitus, history of cardiovascular disease, length of hospital stay, number of instrumented level and history of previous surgery. CONCLUSION: In this series of 571 patients, intrawound vancomycin powder usage resulted in significant decrease in SSI rates in our posterior lumbar surgical procedures. Patients at high risk of infection are highly recommended as a candidate for this technique.
Administration, Topical ; Anti-Bacterial Agents* ; Cardiovascular Diseases ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Length of Stay ; Methicillin-Resistant Staphylococcus aureus ; Multivariate Analysis ; Risk Factors ; Staphylococcal Infections ; Surgical Wound Infection ; Vancomycin*

BACKGROUND: In postmenopausal women, progestogen should be added to protect the endometrium from hyperplasia or carcinoma induced by the unopposed estrogen. However, the effects of progestogen on bone mineral densities and serum lipodproteins have not been precisely evaluated in Korean postmenopausal women. METHODS: To evaluate the effects of progestogen on bane mineral densities and serum lipoprotein in estrogen rephcement therapy, we canducted a 2-year trial of long conjugated equine estrogen(conjugated estrogen 0.625mg/day) with or without cyclic progestogen(MPA 5mg/day for 12 days) in 120 postmenopausal women. In all subjects, bone mineral density was measured in lumbar vertebra(L2-L4) and femur neck using dual energy X-ray absorptiometry(DEXA) and serum lipoprotein was measured from the beginning of the treatment, 12 manths, and 24 manths later, respectively. RESULTS: BMD of femur neck in both groups increased but not significantly compared to basal level at 12 months and/or 24 months of treatment. As for BMD of lumbar spine, it increased significantly in both groups. Both groups showed a significant decrease in the levels LDL cholesterol, but there was no statistical significance in serum triglycerids. Conjugated estrogen plus MPA group in constrast to conjugated estrogen only group showed a significant decrease in total cholesterol levels. CONCLUSIONS: These results suggest that the addition of MPA of the daily of 5mg for 12 days cyclically in estrogen replacement treatment appear to be effective in postmenopausal women with protection on bone mineral density and maintenance of long-term favorable effects on serum lipoprotein.
Bone Density* ; Cholesterol ; Cholesterol, LDL ; Endometrium ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Femur Neck ; Humans ; Hyperplasia ; Lipid Metabolism* ; Lipoproteins ; Postmenopause ; Spine

PURPOSE: Extremely elderly patients who present with complicated gallstone disease are less likely to undergo definitive treatment. The use of laparoscopic cholecystectomy (LC) in older patients is complicated by comorbid conditions that are concomitant with advanced age and may increase postoperative complications and the frequency of conversion to open surgery. We aimed to evaluate the results of LC in patients (older than 80 years). METHODS: We retrospectively analyzed 302 patients who underwent LC for acute cholecystitis between January 2011 and December 2013. Total patients were divided into three groups: group 1 patients were younger than 65 years, group 2 patients were between 65 and 79 years, and group 3 patients were older than 80 years. Patient characteristics were compared between the different groups. RESULTS: The conversion rate was significantly higher in group 3 compared to that in the other groups. Hematoma in gallbladder fossa and intraoperative bleeding were higher in group 3, the difference was not significant. Wound infection was not different between the three groups. Operating time and postoperative hospital stay were significantly higher in group 3 compared to those in the other groups. There was no reported bile leakage and operative mortality. Preoperative percutaneous transhepatic gallbladder drainage and endoscopic retrograde cholangiopancreatography were performed more frequently in group 3 than in the other groups. CONCLUSION: LC is safe and feasible. It should be the gold-standard approach for extremely elderly patients with acute cholecystitis.
Aged* ; Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Conversion to Open Surgery ; Drainage ; Gallbladder ; Gallstones ; Hematoma ; Hemorrhage ; Humans ; Length of Stay ; Mortality ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Wound Infection

Papillary thyroid cancer (PTC) has a good prognosis and a low incidence of distant metastases. It is extremely rare for PTC to metastasize to the pancreas. Only five cases have been previously reported worldwide. Most cases are discovered incidentally by abdominal computed tomography (CT) or positron emission tomography-CT (PET-CT) during follow-up studies after thyroidectomies. Pancreatic metastasis of PTC is usually unidentifiable by a whole-body I131 scan, a common follow-up modality. When a pancreatic mass is found in patients with PTC, it must be differentiated from pancreatic cancer. In previous reports, patients with pancreatic metastases of PTC underwent operations for therapeutic diagnosis or underwent fine needle aspiration biopsies (FNAB). However, it is unclear whether the benefit of an operation outweighs the risk. We experienced a case of PTC with pancreatic metastasis that was found on PET-CT. Contrast-enhanced endoscopic ultrasonography (EUS) was performed to evaluate the characteristics of the pancreatic mass and pathological confirmation was obtained cytologically via EUS-FNA.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Electrons ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Follow-Up Studies ; Humans ; Incidence ; Neoplasm Metastasis* ; Pancreas ; Pancreatic Neoplasms* ; Prognosis ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. METHODS: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. RESULTS: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn't be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. CONCLUSION: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn't be found on CXR to be verified, which helped us to could accurately evaluate patients.
Contusions ; Early Diagnosis ; Emergencies ; Hemothorax ; Humans ; Lacerations ; Medical Records ; Pneumothorax ; Retrospective Studies ; Rib Fractures ; Subcutaneous Emphysema ; Thoracic Injuries ; Thoracic Wall ; Thorax ; Tomography, X-Ray ; Vital Signs