No abstract available.
Echocardiography* ; Mass Screening*

PURPOSE: To present initial and follow-up HRCT findings of lymphangitic carcinomatosis of the lung. MATERIALS AND METHODS: Both initial and follow-up HRCT scans were obtained in 18 patients with lymphangitic carcinomatosis of the lung. After dividing the patients into two groups (with anticancer chemotherapy (n=12) and without chemotherapy (n=6), changes of pulmonary parenchymal abnormalities (percentile increase or decrease in the extent of each pattern) were assessed and compared on initial and follow-up HRCTs. RESULTS: Findings on initial CT were interlobular septal thickening (n=18) (smooth in 15 and mixed smooth and nodular in three), thickening of bronchovascular bundles (n=17), areas of ground-glass opacity (n=15), polygonal lines (n=15), and nodules (n=10). With chemotherapy, the finding of polygonal lines decreased by 20/3%, while findings of ground-glass opacity, bronchovascular bundle thickening, septal thickening, and nodules remained stable. Without chemotherapy, all CT patterns of abnormalities except nodules increased by 45-88%. In three patients who did not undergo chemotherapy, smooth interlobular septal thickening changed to nodular thickening. CONCLUSION: Lymphangitic carcinomatosis of the lung manifests initially as smooth thickening of the interlobular septae, bronchovascular bundle thickening,areas of ground-glass opacity, and polygonal lines, as seen on HRCT. Without chemotherapy, the extent of CT findings increases and there is a tendency for smooth septal thickening to change to nodular thickening. Chemotherapy induces improvement or cessation of the progression of CT findings.
Carcinoma* ; Drug Therapy ; Follow-Up Studies ; Humans ; Lung*

Alveolar Bone Loss ; Animals ; Bone Lengthening ; Cicatrix ; Congenital Abnormalities ; Electric Stimulation ; Electromagnetic Fields ; Hand ; Humans ; Magnets ; Mandible ; Mastication ; Osteogenesis ; Osteogenesis, Distraction ; Osteotomy ; Recurrence

BACKGROUND: The purpose of our study was to evaluate the usefulness of hip arthroscopy including extensive capsulectomy for synovial chondromatosis of the hip. METHODS: From 2008 to 2016, 13 patients with synovial chondromatosis of the hip were treated with arthroscopic removal of loose bodies and synovectomy using three arthroscopic portals. An extensive capsulectomy was performed to allow the remaining loose bodies to be out of the extracapsular space, and the excised capsule was not repaired. All patients were assessed by clinical scores and the radiographs were reviewed to determine whether the remaining loose bodies disappeared at the last follow-up. RESULTS: Eight men and two women were followed up for a minimum of 1 year (mean, 3.8 years; range, 1 to 6.8 years) after hip arthroscopy. Clinical outcomes such as modified Harris hip score, University of California Los Angeles score, and Western Ontario and McMaster Universities Osteoarthritis Index score improved at the last follow-up. Although seven hips had remaining loose bodies after arthroscopic surgery, the remaining loose bodies disappeared in five hips (71.4%) at the last follow-up. CONCLUSIONS: Arthroscopic surgery was useful to treat synovial chondromatosis of the hip. In spite of limited removal of loose bodies, arthroscopic procedures including extensive capsulectomy could be effective for the treatment of synovial chondromatosis of the hip.
Arthroscopy* ; California ; Chondromatosis, Synovial* ; Female ; Follow-Up Studies ; Hip* ; Humans ; Male ; Ontario ; Osteoarthritis

INTRODUCTION: The authors present a retrospective analysis of the clinical features and prognostic factors of long-term survival in gliomatosis cerebri. METHODS: The authors reviewed the clinical features of 27 cases of gliomatosis cerebri treated between August 1988 and January 2001. Age at diagnosis ranged from 19 to 62(median 41) years and the male to female ratio was 18:9. Most cases presented as a headache or seizure and the mean duration of symptoms was 9.6 months. An ill defined, diffuse high signal intensity lesion extending two lobes or more, without a central necrotic center in T2-weighted magnetic resonance(MR) imaging was characteristic. All patients underwent histological confirmation by craniotomy(12 cases), stereotactic biopsy(14 cases) and stereotactic biopsy followed by craniotomy(1 case). External beam radiation therapy was administered in every case except two, one of which expired within a month of surgery and the other refused treatment. RESULTS: Mean survival time after diagnosis was 41.1 months. By univariate analysis, the symptom duration(lower than 12 months) and the Karnofsky performance scale at discharge(lower than 70), focal enhancement on preoperative MR imaging, postoperative increased intracranial pressure sign, pathologic grade(high grade) and p53(>5%) were correlated with the length of survival(p-values were 0.07, 0.00, 0.007, 0.001, 0.04, and 0.02 respectively). CONCLUSION: We suggest that:1) gliomatosis cerebri can be diagnosed by a combination of MR imaging and histopathological examination:2) confusion with extensive glioma is possible due to vague diagnostic criteria, and so survival might be better than expected had discrete diagnosis been made. 3) Initial active management for increased ICP and further radiation therapy might be an important therapy.
Biopsy ; Diagnosis ; Female ; Glioma ; Headache ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Male ; Neoplasms, Neuroepithelial ; Retrospective Studies ; Seizures ; Survival Rate

Diffuse myalgia is common in transient systemic viral infections but overt myositis, with weakness and signs of muscle inflammation, rarely accompanies viral infection in chidren. We describe a 8-year-old boy with severe myalgia and tenderness in both lower extremities, whose unusual skeletal muscle uptake on Technetium-methylene diphosphate bone scan helped to diagnosis of myositis. Clinical course, muscle-derived enzyme studies(AST, ALT, LD, CK), electromyogram findings, histopathologic findings obtained from left gastrocnemius muscle biopsy and serologic studies for enteroviral antibodies (enterovirus type 71 and Coxsackie B4 neutralization antibody titer 1:128 respectively) were all compatible with acute viral myositis.
Antibodies ; Biopsy ; Child ; Diagnosis ; Humans ; Inflammation ; Lower Extremity ; Male ; Muscle, Skeletal ; Myalgia ; Myositis*

It is now well established that acute subarachnoid hemorrhage secondary to rupture of a cerebral aneurysm can precipitate life-threatening cardiac arrhythmia. We experienced a 60 year old patient with a subarachnoid hemorrhage (neurologic grade III) due to rupture of anterior communicating artery aneurysm who presented with such intraoperative electrocardiographic changes as ST segment elevation and T wave inversion which are hallmark of acute myocardial infarction. The operation was uneventfully ended. On the postoperative laboratory examination about suspected acute myocardial infarction, the patient was found to have normal triple enzyme study and echocardiographic finding. The electrocardiogram three days after subarachnoid hemorrhage due to cerebral aneurysm returned to normal sinus rhythm. This case suggests that this patient's electrocardiographic change simulating acute myocardial infarction is transient change due to subarachnoid hemorrhage.
Arrhythmias, Cardiac ; Echocardiography ; Electrocardiography* ; Humans ; Intracranial Aneurysm ; Middle Aged ; Myocardial Infarction* ; Rupture ; Subarachnoid Hemorrhage*

BACKGROUND: Etomidate is short-acting non-barbiturate intravenous anesthetic with minimal cardiovascular depression. As a small change in venous capacitance significantly alters venous return and thus cardiac output, it is important to know the effects of intravenous anesthetics on venous capacitance. The purpose of this study was to examine the effect of etomidate or pentobarbital (control agent) on venous capacitance. METHOD: All twenty rats (etomidate group: 10, pentobarbital group: 10), weighing 350-450 gram, were anesthetized with pentobarbital 50 mg/kg given intraperitoneally for surgical preparation. Mean arterial pressure (MAP), heart rate (HR), and mean circulatory filling pressure (MCFP) were measured in the awake state(recovered from pentobarbital anesthesia for surgical preparation) as well as during anesthesia with etomidate or pentobarbital. Venous capacitance was assessed before and during anesthesia with etomidate or pentobarbital by measuring MCFP. MCFP was measured during a brief period of circulatory arrest produced by inflating a balloon inserted in right atrium. RESULTS: As compared with MCFP in the corresponding awake state, MCFP was not significantly altered by etomidate but significantly decreased by pentobarbital. As compared with MAP in the corresponding awake state, MAP was not significantly altered by etomidate but significantly decreased by pentobarbital. CONCLUSION: The results suggest that unaltered venous capacitance by etomidate may contribute to a maintained MAP but increased venous capacitance by pentobarbital decrease in MAP of the normovolemic rat.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Arterial Pressure ; Cardiac Output ; Depression ; Etomidate* ; Heart Atria ; Heart Rate ; Pentobarbital ; Rats*

Multiple coronary arteries to communicating with the left ventricular fistulae is a very rare congenital anomaly in adults. This anomaly involves three major coronary arteries that have a direct communication between these arteries and the left ventricle. Hemodynamically, it induces myocardial ischemia due to coronary steal syndrome and diastolic volume overload from a left-to-left shunt. A 70-year-old woman with essential hypertension was admitted to our clinic to evaluate complaints of exertional dyspnea. Clinical examination revealed a diastolic murmur at the apex. A coronary angiogram showed a common fistular channel connecting the right coronary artery, the left circumflex coronary artery, and the first large diagonal branch of the left anterior descending coronary artery with the left ventricular chamber. The patient's symptoms were relieved by the administration of calcium channel blocker and angiotensin II receptor blocker. We report a very rare case of three major coronary arteries communicating to the left ventricular fistulae via a common channel.
Adult ; Aged ; Arteries ; Calcium Channels ; Coronary Vessel Anomalies ; Coronary Vessels* ; Dyspnea ; Female ; Fistula* ; Heart Murmurs ; Heart Ventricles ; Humans ; Hypertension ; Myocardial Ischemia ; Receptors, Angiotensin

PURPOSE: The pathophysiology of hypogammaglobulinemia in nephrotic syndrome (NS) remains unknown. We evaluated the differences in the distribution of anti-bacterial antibodies and anti-viral antibodies, and those of immune antibodies and natural antibodies in steroid-sensitive NS. MATERIALS AND METHODS: We examined the antibody status of 18 children who had routine vaccinations. The levels of immnunoglobulin G (IgG), the IgG subclasses, and the antibodies induced by vaccinations such as diphtheria-pertussis-tetanus and measles-mumpsrubella were analyzed in children with steroid-sensitive NS. RESULTS: There was a positive correlation between the albumin and IgG values (r = 0.6, p < 0.01), and the four IgG subclasses were all evenly depressed in the nephrotic children during the acute stage of the disease. The antibodies induced by bacterial antigens were depressed and the seropositivity of anti-viral antibodies tended to be lower than those of age-matched control children during the acute stage. The depressed immune antibody status recovered rapidly in the remission stage of NS, despite corticosteroid treatment. CONCLUSIONS: IgG levels correlated positively with albumin levels, and all antibodies, including immune and natural antibodies, were depressed in the acute stage of NS. Our results suggest that hypogammaglobulinaemia in NS may be associated with intravascular homeostasis of oncotic pressure.
Adolescent ; Antibodies, Bacterial/immunology ; Antibodies, Viral/immunology ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin G/immunology ; Male ; Nephrotic Syndrome/*drug therapy/*immunology ; Steroids/*therapeutic use