PURPOSE: We analyzed the clinical outcome of osteosarcoma developed in distal radius and the effect of delayed treatment on prognosis. MATERIALS AND METHODS: Twelve patients with distal radius osteosarcoma were analysed. We categorized patients into two groups of standard treatment or non-standard treatment. The patients of standard treatment group are all stage IIB and non-standard treatment group includes five stage IIB and one stage III. RESULTS: Five-year overall survival and disease-free survival rates of standard treatment group were 100% and 83%. Five-year overall survival rate of non-standard treatment group was 44%. Between two group, there are differences in age, tumor size, surgery type, symptom duration. CONCLUSION: Distal radius osteosarcoma have good prognosis than other extremity osteosarcoma. Survival rate of non-standard treatment group were lower than standard treatment group. Although the prognosis of non standard treatment group is poorer, the duration till death was longer than that of other sites with similar condition. Further multi-institutional study should be needed.
Disease-Free Survival ; Extremities ; Humans ; Osteosarcoma ; Prognosis ; Radius ; Survival Rate

PURPOSE: To describe CT findings and differential points of cystic thymic lesions. MATERIAL AND METHOD: We evaluated retrospectively total 19 masses with well marginated cystic lesions at thymic area on CT scans. They were 10 teratomas, 3 congenital thymic cysts, 2 multilocular thymic cysts(associated with thymoma and myasthenia gravis in each), 2 cysts Assciated with thymic Hodgkin's lymphomas an ectopic parathyroid cyst, and an infected thymic cyst. The radiological abnormalities evaluated were thickness of the wall, presence or abscene of septa, mural nodule, solid component, calcification and fat component. RESULTS: All three cases of congenital thymic cysts and an ectopic parathyroid cyst appeared as thin-walled unilocular cyst with homogeneous internal density and without identifiable solid component. In multilocular thymic cyst, there were thick wall and solid components(n=2), thick internal septa and calcifications(n=l). The cysts of teratomas manifested thick walls(n=9), internal septa(n=4), calcifications(n=6), fat components(n=4), and solid components(n=4). Cysts in Hodgkin's diseases appeared as multilocular or unilocular and had thick wall and septa without calcification. infected thymic cyst presented with multilocular cystic mass with identifiable wall and septa, calcification, and solid components. CONCLUSION: The thymic diseases with cystic lesion include teratomas, congenital thymic cysts, multilocular thymic cysts, parathyroid cyst, .and Hodgkin's disease. Congenital thymic cyst and ectopic parathyroid cyst are thin-walled unilocular cystic lesions. Cystic lesions associated with teratoma, Hodgkin's disease, and multilocular thymic cyst are thick-walled cystic lesions with or without solid component.
Hodgkin Disease ; Mediastinal Cyst ; Myasthenia Gravis ; Retrospective Studies ; Teratoma ; Thymoma ; Tomography, X-Ray Computed

A 21-year-old woman presented with productive cough and hemoptysis. Chest radiograph shows a large thin-walled cystic lesion with an air-fluid level in medial portion of the left lower lung zone and opacity in paravertebral area of the right lower lung zone. Chest CT scan shows a thin-walled cavitary lesion in the posterior basal segment of left lower lobe with an air-fluid level. Area of consolidation containing air-filled cysts was also observed in medial aspect of right lower lobe. Selective angiogram obtained from aberrant artery arising from descending abdominal aorta showed two main branches of the artery supplying bilateral pulmonary lesions.
Aorta, Abdominal ; Arteries ; Bronchopulmonary Sequestration* ; Cough ; Female ; Hemoptysis ; Humans ; Lung ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Young Adult

PURPOSE: To evaluate effectiveness of oblique approach under biplane fluoroscopic guidance in transthoracic fine needle aspiration biopsy. MATERIALS AND METHODS: Fourteen consecutive patients underwent transthoracic fine needle aspiration biopsy for subcarinal lesions. Subcarina was the only accessible biopsy site in 13 patients. Subcarinal biopsy was performed to determine the presence of metastasis in an enlarged subcarinal lymph node in the remaining one patient. Before biopsy, we evaluated the size and location of the lesion on preliminary plain chest X-ray film and CT scan. Under dual projection fluoroscopic guidence, biopsy was performed through right posterior intercostal space with the patient prone by using oblique approach. On 15 degree LAO projection the needle was directed to the area anterior to the spine and advanced to the line extending through the posterior wall of the main bronchus. RESULTS: Cytologic diagnosis was made in 12 out of 14 patients(accuracy 85.7%). The final diagnosis consisted of 5 squamous cell carcinoma, 5 small cell carcinoma, 1 adenocarcinoma and 1 adenosquamous carcinoma. Pneumothorax developed in 2 patients(14%) and was managed by chest tube drainage. Mild hemoptysis was observed in 2. CONCLUSION: Transthoracic fine needle aspiration biopsy using oblique approach under biplane fluoroscopic guidance is a relatively safe and sensitive method for the histologic diagnosis of subcarinal lesion.
Adenocarcinoma ; Biopsy* ; Biopsy, Fine-Needle* ; Bronchi ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Chest Tubes ; Diagnosis ; Drainage ; Hemoptysis ; Humans ; Lymph Nodes ; Needles ; Neoplasm Metastasis ; Pneumothorax ; Spine ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

Ganglioneruroblastoma and neuroblastoma are among commonest types of childhood malignancy and a number of unique paraneoplastic syndromes have associated with both localized and disseminated neuroblastoma. The coincidence of neuroblastoma and myoclonic encephalopathy or other paraneoplastic syndromes occurs relatively rare, and therefore, failure to recognize this association could result in delays in both diagnosis and treatment, and the result could prove to be unfortunately fatal. The mechanism which underlies the remote damaging effect of neural crest tumor, especially neuroblastoma, on the nervous system resulting in myoclonic encephalopathy is by no means clear. In addition the nature and the extent of the pathologic lesion are inconsistent. We experienced a case of myoclonic encephalopathy associated with an occult mediastinal ganglioneuroblastoma in a 22-month-old girl who was hospitalized for inability to walk without support and tilting of the head to the left side. She became increasingly ataxic, and during the hospitalization myoclonic jerks of upper extremities and head along with chaotic, rapidly flickering, multidirectional spontaneous eye movements, were noted. Laboratory data included normal complete blood count, urinalysis, BUN and creatinine, electrolytes and bone marrow. Chest X-ray and chest CT revealed a relatively well marginated right posterior mediastinal mass. In a 24 hours urine excretion test, VMA and catecholamines were increased. Over the next 2 weeks, a surgical exploration revealed a right posterior mediastinal mass. Microscopically the mass proved to be a ganglioneuroblastoma, extending to right innominate artery and right axillary lymph nodes. Within 2 weeks after the surgery, radiotherapy (2,400 rads) and chemotherapy (CTX, DTIC, VCR) were started, but corticosteroid was not used. She has been free of tumor and abnormal neurological systemic symptoms and signs for 1 1/2 year since the completion of chemotherapy. In the 3 1/2 years follow-up period, her neurologic symptoms has completely resolved by the completion of 2 years chemotherapy. We report a case of mycoclonic encephalopathy associated with hidden ganglioneuroblastoma in 22-month-old girl.
Blood Cell Count ; Bone Marrow ; Brachiocephalic Trunk ; Catecholamines ; Creatinine ; Dacarbazine ; Diagnosis ; Drug Therapy ; Electrolytes ; Epilepsies, Myoclonic* ; Eye Movements ; Female ; Follow-Up Studies ; Ganglioneuroblastoma* ; Head ; Hospitalization ; Humans ; Infant ; Lymph Nodes ; Myoclonus ; Nervous System ; Neural Crest ; Neuroblastoma ; Neurologic Manifestations ; Paraneoplastic Syndromes* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed ; Upper Extremity ; Urinalysis

PURPOSE: We analysed the role of modified Gianturco self-expandable stents in the treatment of tracheobronchial stenosis in 13 patients. MATERIALS AND METHODS: We inserted modified Gianturco self-expandable stents under the fluoroscopic and bronchoscopic guidance. There were stenosis in the trachea(n--2), the right main bronchus(n=2), and the left main bronchus(n=9). The causes of the stenosis were endobronchial tuberculosis(n=10), intubation granuloma (n=l), restenosis after surgical reconstruction(n=2). RESULTS: Dyspnea or wheezing was improved within 1 or 2 days following the procedure. There were 32% and 22% respective increase in average FEV1 and FVC. Lung perfusion scan showed 9.6% increase of perfusion in the involved lung. No complications related to the procedure were encountered. During follow-up period of up to 31 months, 2 patients showed tracheal or bronchial restenosis, at 3 and 6 months, retrospectively. There was a distal migration of the stents in one case. CONCLUSION: During the follow up period after stent insertion, improvement of the obstructive changes and dyspnea persisted in 10 out of 13 patients. The modified Gianturco self-expandable metallic stents may be a good choice for the treatment of tracheobronchial stenosis, either as a primary treatment, or when the reconstruction failed.
Constriction, Pathologic* ; Dyspnea ; Follow-Up Studies ; Granuloma ; Humans ; Intubation ; Lung ; Perfusion ; Respiratory Sounds ; Retrospective Studies ; Stents*

Intraductal variant of peripheral cholangiocarcinoma is extremely rare. This variant shows intraductal growth and intraluminal extension without any infiltrative growth. The mode of intraductal growth is not known. The prognosis of this variant is better than that of usual cholangiocarcinoma. We report three cases, one of which is associated with Clonorchis sinensis (CS) infection. The tumors were entirely confined within the dilated peripheral tributaries of the intrahepatic bile duct. Microscopically, the tumors were well to moderately well differentiated, with a papillary or a micropapillary growth pattern. Focal clear cytoplasmic change and mucin production were noted. The tumors showed intraductal spreading without any invasion to the liver parenchyme. Mucosal hyperplasia and dysplasia were noted in the adjacent ducts. The authors assume that intraductal cholangiocarcinoma is a distinct subtype, and persistent irritation, such as, CS infection may undergo a malignant transformation through mucosal dysplasia.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma* ; Clonorchis sinensis ; Cytoplasm ; Hyperplasia ; Liver* ; Mucins ; Prognosis

No abstract available.

PURPOSE: The purpose of this study was to determine the following:the safety of fine needle aspiration biopsy in immunocompromized children with radiographic features of Pneumocystis car/nil pneumonia, its diagnostic rate in those groups and the appropriate radiographic stage for fine needle aspiration biopsy to prove the etiologic agent. METHODS AND MATERIALS: We retrospectively reviewed the patient records of 16 children with immune compromizing diseases who had undergone fine needle aspiration biopsy of the lung. They showed the infectious sign of the lung along with the radiographic pattern of diffuse pulmonary disease, suggesting Pneumocystis carlnil pneumonia. All patients had underlying lymphoreticular malignancies including 14 acute lymphocytic leukemia and 2 non Hodgkin's lymphoma. According to the radiographic pattern of biopsy site, parenchymal disease was categorized as fine reticulonodular density(n=4), ground-glass opacity(n=9) and compact consolidation(n=3). We assessed the diagnostic rate of Pneumocystis carinii pneumonia and complications in each of the three groups. RESULTS: A diagnosis of Pneumocystis carinii pneumonia was established by fine needle aspiration biopsy in 9 patients(56%) including 2 of 4 patients with fine reticulonodular density, 4 of 9 patients with ground-glass opacity, and all 3 patients with compact consolidation. Four patients(25%) developed pneumothorax, and three of them required tube insertion. There was no patient who developed hemoptysis. CONCLUSION: Fine needle aspiration biopsy is a safe and easy method that can yield Pneumocystis carinii organism at a relatively high rate in immunocompromized children with diffuse pulmonary lesions suopicions of Pneumocystis carinii pneumonia. We recommend performing fine needle aspiration biopsy regardlesss of radiographic patterns when Pneumocystis carinii pneumonia is suggested.
Biopsy* ; Biopsy, Fine-Needle* ; Child* ; Diagnosis ; Hemoptysis ; Humans ; Lung Diseases ; Lung* ; Lymphoma, Non-Hodgkin ; Pneumocystis ; Pneumocystis carinii ; Pneumonia* ; Pneumonia, Pneumocystis ; Pneumothorax ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies

Purpose: To report the outcomes of extensively porous-coated femoral stems based on diaphyseal fixation caused by extensive bone loss and osteoporosis of the proximal femur in revision total hip arthroplasty. Materials and Methods: 14 cementless femoral revision procedures performed between Aug, 2000 and Apr, 2003 were reviewed retrospectively. The follow up period ranged from 24 to 53 months, with an average of 33 months. The average age at surgery was 52.3 years, there were 10 males and 4 females. The reasons for the revision surgery were aseptic loosening in 11(78.7%) hips, progressive osteolysis in 1(7.1%), septic loosening in 1(7.1%) and periprosthetic fracture in 1(7.1%). Results: The Harris hip score improved from 50.4 points preoperatively to 88.5 points postoperatively. The complications encountered were a greater trochanteric fracture in 2 hips (14.3%), periprosthetic fracture in 1(7.1%), dislocation of the hip in 2(14.3%), and minimal thigh pain in 2(14.3%). Radiographic evidence of a bone ingrown stem was found in 11 hips (78.6%), and 3 hips (21.4%) showed stable fibrous fixation. Stem subsidence > 5mm was noticed in 1 hip (7.1%) and > 10mm in 2 (14.3%) but there was no further progression after 1 year. Moderate stress-shielding was noticed in 4 hips(28.6%). To date, no significant wear or osteolysis has been observed. Conclusion: An extensively porous-coated revision stem appears to be a reasonable choice in the presence of proximal femoral bone loss as a short term follow up. However, the concerns related to the postoperative complications will require a longer term follow up.
Arthroplasty, Replacement, Hip* ; Dislocations ; Female ; Femur ; Follow-Up Studies ; Hip ; Humans ; Male ; Osteolysis ; Osteoporosis ; Periprosthetic Fractures ; Postoperative Complications ; Retrospective Studies ; Thigh