Menetrier's disease is a rare disease characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss and edema due to gastric protein loss. The 48-year-old male patient was admitted to the Hangang Sacred Heart Hospital with cheif complaints of indigestion and epigastric pain. The diagnosis of Menetriers disease is established by radiologic, endoscopic, and pathologic examination. He was treated with soft diet, antacid, H2- receptor antagonist, and IV albumin. We report a case of Menetriers disease with brief review of literatures.
Diagnosis ; Diet ; Dyspepsia ; Edema ; Gastritis, Hypertrophic* ; Heart ; Humans ; Male ; Middle Aged ; Rare Diseases ; Stomach ; Weight Loss

The close vicinity of the optic nerve to the sphenoid sinus may cause visual loss in the sphenoid fungus ball. We present a case of blindness secondary to sphenoid fungus ball without any evidence of orbital invasion in imaging studies. A 61-year-old man, suffering from uncomplicated diabetes, was referred for right visual loss that developed 1 day ago. He perceived hand motion on the right. CT and MRI revealed a fungus ball in the right sphenoid sinus. However, there was no evidence of orbital invasion. Endoscopic sphenoethmoidectomy was performed to remove the fungus ball. Systemic mega-dose steroid and amphotericin B were started because he lost the light perception 3 days after surgery. Biopsy revealed aspergillus fungus ball and no evidence of mucosal invasion. However, blindness was not reversed. Evidence of orbital invasion in imaging diagnosis is elusive in sphenoid fungus ball; therefore, systemic antifungal treatment should be initiated and early endoscopic sphenoidotomy should be performed in case of rapidly progressing visual loss, especially in diabetic or immunocompromised patients. Mega-dose steroid therapy for optic neuropathy should be selective because it may aggravate underlying systemic diseases to cause early termination of systemic antifungal treatment.
Amphotericin B ; Aspergillus ; Biopsy ; Blindness ; Fungi ; Hand ; Humans ; Immunocompromised Host ; Light ; Middle Aged ; Optic Nerve ; Optic Nerve Diseases ; Orbit ; Sphenoid Sinus ; Stress, Psychological

Organized hematoma of the maxillary sinus is a rare clinical disease. We report a case of organized hematoma of the maxillary sinus presenting with acute sinusitis. This is the first article describing such a case. Included is a review of the literatures, highlighting the diagnostic signs of organized hematoma of the maxillary sinus.
Hematoma ; Maxillary Sinus ; Sinusitis

BACKGROUND: Investigation of the change of ventricular function and mitral regurgitation after surgical repair of patient with anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is key issue for the better surgical outcome. MATERIAL AND METHOD: From April 1986 to July 2002, 12 patients presented with ALCAPA. The median age at repair was 4 months. Surgical methods included left coronary artery transfer to the aorta (10), Takeuchi procedure (1), saphenous vein free graft bypass (1). Mitral valve was repaired in 1. RESULT: There were 2 hospital death (16.7%). The mean follow-up period was 7.1+/-4.1 years (range, 7 months to 13 years). Four patients required postoperative circulatory assist for 2.2+/-1.1 days and one needed left ventricular assist device (LVAD) for 1day. Postoperative echocardiography demonstrated significant improvements in mean fractional shortening (33.4+/-9.1% vs 17.7+/-9.6%, n=10, p<0.05); left ventricular end diastolic dimension (33.1+/-7.3 mm vs 41.8+/-7.0 mm, n=10, p<0.05) and systolic dimension (22.2+/-7.5 mm vs 33.4+/-7.9 mm, n=10, p<0.05). Severities of mitral regurgitation decreased in all survivors at 1st and 4th year follow-up echocardiography. There were 2 reoperation due to residual MR and right ventricular outflow obstruction (Takeuchi case). CONCLUSION: Anatomic repair of anomalous left coronary artery from the pulmonary artery offered an excellent surgical results, especially in terms of the recovery of left ventricle function and mitral regurgitation. However, preoperative indications for mitral procedure is to be evaluated.
Aorta ; Bland White Garland Syndrome ; Coronary Vessels* ; Echocardiography ; Follow-Up Studies ; Heart Defects, Congenital ; Heart Ventricles ; Heart-Assist Devices ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Pulmonary Artery* ; Reoperation ; Saphenous Vein ; Survivors ; Transplants ; Ventricular Function* ; Ventricular Outflow Obstruction

BACKGROUND AND OBJECTIVES: Because of the close vicinity of the orbit to the sphenoid sinus, invasive fungal sphenoiditis is a difficult disorder to correctly diagnose and treat. The aims of this study were to examine clinical characteristics of invasive sphenoidal aspergillosis and to discuss diagnostic and therapeutic priorities. MATERIALS AND METHODS: Eleven patients who presented with sphenoidal aspergillosis in our department since 1997 were reviewed retrospectively. These patients were classified into two groups:a clinically invasive group who experienced aggravation even after endoscopic surgery and required further treatments, including antifungal agent, and a non-invasive group who were cured after surgery. The presenting symptoms, age, underlying systemic diseases, CT and MRI findings, treatment modality, and prognosis were reviewed between the clinically-invasive fungal and non invasive groups. RESULT: Only the clinically invasive group presented with visual disturbance. Visual disturbance developed rapidly within several days. Age over 50 years and diabetes may be associated with visual disturbance. Bony erosion and expanding lesions upon CT or MRI were observed more frequently in the clinically invasive group than in the non-invasive group. Enhancement outside the sphenoid sinus was demonstrated only in the clinically invasive group. Endoscopic sinus surgery was performed with additional amphoterichin B and/or mega-dose steroid therapy. Recovery from visual disturbance was poor. Moreover, mega-dose steroid therapy had no effect on symptoms and caused two complications, uncontrolled diabetes and pneumonia. CONCLUSION: Aged diabetic patients, rapidly progressing eye symptoms, bony erosion, and expanding sphenoid lesions upon imaging incur high suspicion of invasiveness in a sphenoid fungus ball. Endoscopic sinus surgery to remove sphenoid fungus balls, as well as systemic antifungal treatment, should be started as early as possible in patients with these clinical features.
Aged ; Aspergillosis ; Aspergillus ; Eye ; Fungi ; Humans ; Orbit ; Pneumonia ; Prognosis ; Retrospective Studies ; Sphenoid Sinus

BACKGROUND AND OBJECTIVES: The intimate relationship of vertigo and anxiety has been previously recognized. Anxiety may have an important influence on recovery of symptoms in vestibular neuritis (VN). The aim of study was to evaluate subjective anxiety of the pre-VN, at the time of onset of VN, and just after vestibular rehabilitation therapy (VRT) using Beck Anxiety Inventory (BAI) questionnaire, respectively. MATERIALS AND METHODS: Twenty-eight patients with VN were asked to complete the BAI and dizziness handicap inventory (DHI). Each of the BAI and DHI was scored. We also evaluated the relationship between the DHI and BAI scores. RESULTS: The VN patients at the time of attack had significantly more anxiety with vertigo and related symptoms (p<0.05). In most patients, anxiety level decreased following VRT. CONCLUSION: These findings indicate that almost every VN patients can recovery from anxiety as vertigo regressed. However, the emotional support as well as physical and/or functional rehabilitation may be required to provide a more rapid and complete return to normal daily lives for these patients.
Anxiety ; Dizziness ; Humans ; Surveys and Questionnaires ; Vertigo ; Vestibular Neuronitis

Berry syndrome (interrupted aortic arch, aortopulmonary window, and aortic origin of right pulmonary artery with intact interventricular septum) is a very rare and complex cardiac malformation. We report a successful one-stage repair in a 14-day-old neonate without circulatory arrest.
Aorta, Thoracic ; Fruit* ; Heart Defects, Congenital ; Humans ; Infant, Newborn* ; Pulmonary Artery

Berry syndrome (interrupted aortic arch, aortopulmonary window, and aortic origin of right pulmonary artery with intact interventricular septum) is a very rare and complex cardiac malformation. We report a successful one-stage repair in a 14-day-old neonate without circulatory arrest.
Aorta, Thoracic ; Fruit* ; Heart Defects, Congenital ; Humans ; Infant, Newborn* ; Pulmonary Artery

PURPOSE: A pooled analysis of multi-institutional trials was performed to analyze the effect of surgical timing on tumor response by comparing short course concurrent chemoradiotherapy (CCRT) with long course CCRT followed by delayed surgery in locally advanced rectal cancer. MATERIALS AND METHODS: Three hundred patients with cT3-4N0-2 rectal adenocarcinoma were included. Long course patients from KROG 14-12 (n=150) were matched 1:1 to 150 short course patients from KROG 10-01 (NCT01129700) and KROG 11-02 (NCT01431599) according to stage, age, and other risk factors. The primary endpoint was to determine the interval between surgery and the last day of neoadjuvant CCRT which yields the best tumor response after the short course and long course CCRT. Downstaging was defined as ypT0-2N0M0 and pathologic complete response (ypCR) was defined as ypT0N0M0, respectively. RESULTS: Both the long and short course groups achieved lowest downstaging rates at < 6 weeks (long 20% vs. short 8%) and highest downstaging rates at 6-7 weeks (long 44% vs. short 40%). The ypCR rates were lowest at < 6 weeks (both long and short 0%) and highest at 6-7 weeks (long 21% vs. short 11%) in both the short and long course arms. The downstaging and ypCR rates of long course group gradually declined after the peak at 6-7 weeks and those of the short course group trend to constantly increase afterwards. CONCLUSION: It is optimal to perform surgery at least 6 weeks after both the short course and long course CCRT to obtain maximal tumor regression in locally advanced rectal adenocarcinoma.
Adenocarcinoma* ; Arm ; Chemoradiotherapy ; Humans ; Rectal Neoplasms ; Risk Factors

Modified Norwood procedure with maintaining cardiac beat was done in a 30-day-old neonate. Procedure was done with regional perfusion of innominate and coronary artery. Postoperative course was uneventful. Second-stage operation (bi-directional cavopulmonary shunt) was done 4 months later. The diameter of ascending aorta was more than 5 mm, Norwood procedure can be done in beating hearts.
Aorta ; Coronary Vessels ; Heart Defects, Congenital ; Heart* ; Humans ; Infant, Newborn ; Norwood Procedures* ; Perfusion