OBJECTIVE: Our goal was to evaluate the usefulness of CT perfusion (CTP) in early detection of the post operative cerebral ischemia, alteration of treatment modality and patient prognosis in cerebral aneurysm patients. METHODS: 24 patients who underwent either surgical operation or endovascular coiling for ruptured aneurysms were selected. All patients undertook an angiogram, conventional CT, and CTP scan immediately following surgical operation or endovascular coiling. All patients performed a CT 2 weeks after treatment to evaluate possible development of a cerebral infarction. Postoperative CT results of patients with abnormal postoperative CTP scan findings were compared, and these results were compared with the CT results and clinical symptoms of patients who developed infarction or not. RESULTS: Of the 24 patients evaluated, 11 patients showed abnormal findings on CTP. 9 patients were diagnosed with cerebral infarction through a CT scan done 2 weeks after treatment; all exhibited abnormal CTP results immediately after treatment. Abnormal CTP findings were divided into two groups; patients with abnormal CBF and MTT maps, but with normal CBV maps, and patients with abnormal CBF, CBV and MTT maps. A correlation was seen between abnormality on CBV maps and cerebral infarction. Patients with abnormal CTP findings also exhibited poorer prognostic value. CONCLUSION: Postoperative CTP in ruptured aneurysm patients is a very useful and objective tool in evaluating abnormal cerebral hemodynamics. The CBV map of CTP is the most precisely predictable value of postoperative patient's status and alteration of treatement modality.
Aneurysm, Ruptured* ; Brain Ischemia ; Cerebral Infarction ; Cytidine Triphosphate ; Hemodynamics ; Humans ; Infarction ; Intracranial Aneurysm ; Perfusion* ; Prognosis ; Tomography, X-Ray Computed

BACKGROUND: Bronchogenic carcinoma is generally considered as a disease that predominantly affects middle-aged and elderly men. A small percentage of patients with lung cancer are diagnosed in the third or fourth decade of life or earlier. The current study was performed to review the clinical characteristics of bronchogenic carcinoma in patients younger than 40 years of age at Chungnam National University Hospital. METHOD: To determine the clinicopathologic characteristics including survival rates of lung cancer patients younger than 40 years of age and to compare them with those of patients older than 40 years of age at diagnosis, data of 905 patients diagnosed as lung cancer from January 1990 to March 1997 were analyzed. RESULT: Twenty-three of 805 patients(2.5%) belonged to the young age group (less than 40 years). Male to female ratios of young age group and control group were 2.8 : 1 and 5.3 : 1, respectively. The mean duration of symptoms from onset to the definite diagnosis was 3.2 months in the young age group. The most common initial symptoms in the young age group were cough(52.2%) and dyspnea(43.5%). Adenocarcinoma(43.5%) was more frequent in the young age group than in the control group(20.1%). Stage III and IV(70%) tumors were more frequent in the young age group than in the control group(52.3%). Distant metastasis rae of the young age group(56.6%) was higher than that of the control group(22.3%). CONCLUSION: The predominance of adenocarcinoma, the lower male-female ratio, and the high incidence of advanced stage tumor at diagnosis are the characteristics of lung cancer in patients younger than 40 years of age.
Adenocarcinoma ; Aged ; Carcinoma, Bronchogenic ; Chungcheongnam-do ; Diagnosis ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Neoplasm Metastasis ; Survival Rate

PURPOSE: To investigate the teratogenic effect of gamma-ray on the heart of chick embryo. METHODS: 50 rad, 100 rad, 150 rad, 200 rad, 250 rad, and 300 rad of gamma-ray were used to irradiate three days old chick embryos. The control group was not irradiated. After three weeks, the embryos were sacrificed and examined for cardiovascular malformation. RESULTS: The survival rate of the gamma-ray irradiated group was significantly lower than that of the control group(33.3-63.3% vs 76.4%, P=0.001). The cardiac malformation rate of the experimental group was 11.0%. In the control group, no congenital cardiac malformations were observed. The experimental groups had a significantly higher malformation rate(P=0.001). The types of malformation were ventricular septal defect, tricuspid atresia, Ebstein anomaly and aortic arch anomaly. In the gamma-ray irradiated group, the cardiac malformations were : 14 small ventricular septal defects (VSDs), five large VSDs, two tricuspid atresias, and one Ebstein anomaly. The higher the dose of radiation applied, the higher the incidence of cardiac malformation was noted. CONCLUSION: Gamma-ray irradiation of 3 days old chick embryos increased the rate of death and the rate of cardiac malformation significantly.
Animals ; Aorta, Thoracic ; Chick Embryo* ; Ebstein Anomaly ; Embryonic Structures ; Heart Septal Defects, Ventricular ; Heart* ; Incidence ; Survival Rate ; Tricuspid Atresia

Teratomas are tumors composed of derivatives of all three germinal cell layers. They have been described in a variety of organs in both children and adults, most commonly in the gonads. Extragonadal intraperitoneal teratomas are very rare. We here report a case of a large mature teratoma of the gastrohepatic ligament in a 20-year-old woman. To the best of our knowledge, a teratoma of the gastrohepatic ligament has never before been described, although there are a few reports of teratomas arising from the greater and lesser omentum.
Adult ; Child ; Female ; Gonads ; Humans ; Ligaments* ; Omentum ; Teratoma* ; Young Adult

Mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland is a very rare malignant tumor. Primary squamous cell carcinoma of the thyroid may develop from squamous metaplasia of the follicular epithelium in a variety of pathologic conditions, such as other differentiated carcinomas of the thyroid. A 70-year-old man presented with a palpable mass on the right side of the thyroid gland. The patient underwent a right lobectomy without neck lymph node dissection. Histopathological findings revealed primary squamous carcinoma mixed papillary thyroid carcinoma. He underwent a completion thyroidectomy and radioactive iodine therapy. Adjuvant radiotherapy and chemotherapy were not performed.
Aged ; Carcinoma ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Epithelium ; Humans ; Iodine ; Lymph Node Excision ; Metaplasia ; Neck ; Radiotherapy, Adjuvant ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

We report a case in which an intramural and intraluminal hematoma of the jejunum served as the lead point of intussusception in a 77-year-old man with warfarinization. The patient presented with cramping abdominal pain and vomiting. Palpation of the abdomen revealed periumbilical tenderness. Abdominal computed tomography revealed a circular mass with a concentric ring, consistent with an intussuscepted jejunum. Because of warfarinization, which was due to atrial fibrillation and lacunar infarction, the patient's prothrombin time was prolonged. Laparotomy revealed reducible jejuno-jejunal intussusception, and we performed a segmental resection of the intussuscepted jejunum. We identified an intramural and intraluminal jejunal hematoma as the lead point. Upon histopathological examination, angiodysplasia of the intussuscepted jejunum was found to be the bleeding focus. No similar case was found in the literature.
Abdomen ; Abdominal Pain ; Adult ; Aged ; Angiodysplasia ; Atrial Fibrillation ; Hematoma ; Hemorrhage ; Humans ; Intussusception ; Jejunum ; Laparotomy ; Muscle Cramp ; Palpation ; Prothrombin Time ; Stroke, Lacunar ; Vomiting ; Warfarin

Head and neck surgeons see many congenital cysts of the neck. Most of these cysts are thyroglossal duct cysts and branchial cleft cysts. Bronchogenic cysts are rare congenital malformations of the ventral foregut development. They are usually located in the mediastinum and intrapulmonary regions. Cervical bronchogenic cysts are unusual. Only 70 cases of bronchogenic cysts in the head and neck regions have been reported on and the majority of cases have been found in the pediatric population. We describe here a 61-year-old female who presented a palpable left neck mass. The preoperative diagnostic studies included chest X-ray and sonography-guided fine needle aspiration. The neck sonography showed the mass, but it could not rule out a pathologic lymph node. Aspirated material contained no cellular content. The mass was excised. The neck mass of the patient was diagnosed as a bronchogenic cyst. We suggest that the clinical observation of a lateral neck mass in an adult includes the possibility of a bronchogenic cyst in the differential diagnosis.
Adult ; Biopsy, Fine-Needle ; Branchioma ; Bronchogenic Cyst* ; Diagnosis, Differential ; Female ; Head ; Humans ; Lymph Nodes ; Mediastinum ; Middle Aged ; Neck ; Thorax ; Thyroglossal Cyst