Thallium-201 brain SPECT is utilized in the diagnosis of brain tumor especially in cases where CT or MRI findings alone cannot differentiate malignant lesion from benign. Recently we came across two cases of positive T1-201 brain SPECT in clinically suspected brain tumor patients that turned out to be hemorrhagic cerebral infarction instead on biopsy. The findings in these cases demonstrate that thallium-201 accumulation may occur by the breakdown of the blood-brain barrier and phagocytic cell infiltration in the liquefaction stage of infarction.
Biopsy ; Blood-Brain Barrier ; Brain ; Brain Neoplasms ; Cerebral Infarction* ; Diagnosis ; Humans ; Infarction ; Magnetic Resonance Imaging ; Phagocytes ; Tomography, Emission-Computed, Single-Photon

A total of 212 cases of gastric carcinoma resected at Kang-Dong Sacred Heart Hospital during the period of 4 years from December 1986 to December 1990 were examined according to Borrmann, Mulligan-Rember, Ming and WHO methods based on histopathological investigations. In Mulligan-Rember (M-R) classification, intestinal cell type (IC) was frequently seen in Borrmann type I and II; pyloro-cardiac gland cell type (PC) in II and III, and mucous cell type (MC) in IV and III. Expanding growth pattern was more frequent in IC, infiltrative growth pattern in MC, and PC showed less infiltrative growth than MC. In gross type, the most expanding growth pattern was seen in Advanced gastric carcinoma type (AGC) I and the next one was in AGC II; the ratio of infiltrative versus expanding type was highest in AGC IV and next in AGC resembling early gastric carcinoma (EGC) and AGC III in order. On WHO classification except squamous type, all the papillary type showed expanding growth and infiltrative growth was frequently seen in signet-ring cell, undifferentiated, tubular and mucinous types in order. Lymphoid stroma was more frequently found in expanding type than infiltrative type. The frequency of angioinvasion of tumor cells observed was high in AGC resembling EGC, AGC II, III, IV, I and EGC in order. In WHO classification excluding squamous type, undifferentiated and signet-ring cell types occurred more frequently under the age of 60 and papillary type were more frequnetly seen over the age of 60. But tubular type had no difference between the two age groups. In Ming's classification, expanding type was more frequently seen than infiltrative type over the age of 60.

For comminuted shaft fracture of clavicle, the operative goal, aside from sound bone healing without complications of direct reduction, is maintenance of the original length in order to maintain the normal biomechanics of adjacent joint. Our bridge plating technique utilizing distraction through a lumbar spreader was expected to be effective for restoring clavicular length with soft tissue preservation. However, there are two disadvantages. First, there is more exposure to radiation compared to conventional plating; and second, it is difficult to control the rotational alignment. Despite these disadvantages, our technique has important benefits, in particular, the ability to preserve clavicular length without soft tissue injury around the fracture site.
Adult ; Aged ; Clavicle/injuries/radiography/*surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal/*instrumentation/*methods ; Fractures, Comminuted/radiography/*surgery ; Humans ; Male ; Middle Aged ; Prospective Studies ; Range of Motion, Articular ; Young Adult

We reviewed 46 hips of the 36 patients treated with free vascularized fibular graft for avascular necrosis of femoral head with a mean follow-up of 39.9 months (ranging from 2 years to 6 years 4 months). There were thirty-four men and two women. The mean age of patients at the time of operation was 36.6 years (ranging from seventeen to fifty-seven years). The procedure was performed on both hips in ten patients. Of the 46 hips, twenty-nine were idiopathic, ten alcoholic, six steroid induced, and one traumatic. According to Ficats stage, there were eighteen in Stage 2A, fifteen in Stage 2B and thirteen in Stage 3. According to Ohzonos classification, there were four in Type 1B, forty in Type 1C and one in Type 3B. Clinical assessments according to the cause and severity of the disease were evaluated using Harris hip scoring system. Thirty-two hips(69.6%) were excellent, 9 hips(19.6%) were good, 2 hips(4.3%) were fair, and 3 hips(6.5%) were poor. Therefore clinically satisfactory results, including excellent and good, were obtained in 41 hips(89.2%). Radiographic assessments according to healing of avascular necrosis lesion and collapsing the femoral head postoperatively were performed. Thirty hips(65.2%) were excellent, 9 hips(19.6%) were good, 4 hips(8.7%) were fair, and 3 hips(6.5%) were poor. Therefore radiographic satisfactory results were obtained in 39 hips(84.8%). Clinical and radiographic assessments according to Ohzonos classification were also evaluated. Clinically satisfactory result were obtained in 6 hips(100%) of Type 1A and 3B in 33 hips(82.5%) of Type 1C. The etiological factors didn t affect the results. There were two cases of peroneal nerve palsy in which one was irreversible and one case of clawing of great toe as complications. In conclusion, free vascularized fibular graft appears to be a very effective method for Ficats stage 2A, 2B, and early stage 3 of symptomatic avascular necrosis of femoral head, in Ohzonos Type 1C which have a high incidence of collapse.
Alcoholics ; Animals ; Classification ; Female ; Follow-Up Studies ; Head* ; Hip ; Hoof and Claw ; Humans ; Incidence ; Male ; Necrosis* ; Paralysis ; Peroneal Nerve ; Toes ; Transplants*

Intramuscular lipomas are benign adipose tumors of the soft tissues that may resemble liposarcomas because of their size, deep location, and occasionally infiltrative growth. An awareness of their existence is fundamental to treating them correctly, and their differential diagnosis from liposarcoma is essential. Magnetic resonance imaging (MRI) is a useful diagnostic tool to differentiate benign adipose tumors from liposarcoma. Marginal excision and biopsy are required for the definite diagnosis and the treatment of symptomatic intramuscular lipomas. To the best of the authors’ knowledge, this is the first report in South Korea regarding the treatment of an intramuscular giant lipoma of the ankle.

Osteoblastoma is rare, benign, bone-forming tumor that often occur in the spine. There are few reports of osteoblastomas resulting in pathologic fractures involving long bones. Authos report a unique case of a pathologic fracture due to an osteoblastoma of the humerus shaft. The tumor was treated successfully by curettage, intramedullary nailing and bone allograft.
Curettage ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Humerus ; Osteoblastoma ; Spine ; Transplantation, Homologous

No abstract available.
Adenocarcinoma* ; Immunohistochemistry*

Purpose: The aim of this study was to compare the discrepancy of alignment categorization in total knee arthroplasty (TKA) between the anatomical femorotibial angle (aFTA) measured on short knee radiographs and the mechanical hip– knee–ankle axis angle (mHKA) measured on full-length radiographs in knees with and without bowing. Methods: From January 2014 to June 2017, 107 of 526 osteoarthritic knees at our hospital were found to have femoral or tibial bowing. Bowing was defined as a femoral bowing angle (FBA) > 3° or < − 3° or a tibial bowing angle (TBA) > 2° or < − 2° in full-length preoperative radiographs. Among 419 knees without bowing, we selected 107 knees as a control group using propensity-score matching. Postoperative alignments were categorized by aFTA in short knee radiographs and mHKA in full-length radiographs into neutral (2° ≤ aFTA≤7° , − 3° ≤ mHKA≤3° ), varus (aFTA< 2° , mHKA< − 3° ), and valgus (aFTA> 7° , mHKA> 3°) alignments. We compared the categorization of alignments between knees with and without bowing using the McNemar test and used logistic regression to find factors for the alignment discordance. Results: Coronal alignment was discordant in 26.2% of the knees with bowing and 13.1% of the knees without bowing (p < 0.001). FBAs were a significant factor affecting the discordance of alignment categorization (OR = 1.152, 95%CI 1.038– 1.279, p = 0.008). Conclusion Short knee radiographs are insufficient for estimating coronal alignment after TKA, particularly in knees with femoral bowing.Level of evidence: III: Retrospective comparative study.

Actinomycosis is a rare form of disease caused by Actinomyces such as A. israelii and A. bovis, which may take the form of an acute or a subacute disease progression. Clinically, it is categorized into cervicofacial, thoraxic, abdomen, pelvis, and systemic infections, of which cervicofacial infection accounts for 50%. It presents as a challenging clinical diagnostic dilemma because of variable presentations in the head and neck. Actinomycosis of the hypopharynx is rare. We report a case of actinomycosis in the posterior hypopharyngeal wall presenting as a dysphagia in a 72-year-old woman with a review of the literature.
Abdomen ; Actinomyces ; Actinomycosis ; Aged ; Deglutition Disorders ; Disease Progression ; Female ; Head ; Humans ; Hypopharynx ; Neck ; Pelvis ; Thorax