Differential diagnosis of vertebral lesion by simple radiography is not so easy whether the lesion is benign or malignant. The purpose of this study is to evaluate that the magnetic resonance imaging characteristics can differentiate benign or malignant vertebral lesions. In this study, thirty-nine cases of signal change within the vertebral body by MRI was reviewed retrospectively and the followings are the summary of the results. It is difficult to differenciate benign or malignant lesions, only based on MRI signal changes or vertebral lesion patterns. But those cases of pedicle involvement, complete replacement of bone marrow in T1image and associated soft tissue mass or cord compression are strongly suggest the possibility of malignancy and need further study.
Bone Marrow ; Diagnosis, Differential* ; Magnetic Resonance Imaging* ; Radiography ; Retrospective Studies ; Spine

The concealed penis is caused by a prominent suprapubic fat pad in addition to the restrictive fibrous bands of the dartos fascia fixing the shaft of the penis proximally. Anchoring of the skin of the base of the penis to the periosteum of the pubis only does not satisfy the obese patients with concealed penis because the suprapubic fat concealed the penis. We treated 4 obese patients with concealed penis by removing the suprapubic fat and anchoring the skin of the base of the penis to the pubic symphysis. All penes project adequately, and the patient's socialization status and self-image are improved. One patient felt moderate pain in the suprapubic area for 3 months after operation. Other complications such as infection, hemorrhage, and lymphorrhea have not been seen in our practice. We consider that excision of suprapubic fat with sectioning of the tethering dartos bands should be added to anchoring of the skin of the base of the penis to the periosteum of the pubis. Suprapubic lipectomy to excise suprapubic fat seems simple and satisfying. Additional liposuction may be valuable in contouring the adjacent abdominal fat.
Abdominal Fat ; Adipose Tissue ; Fascia ; Hemorrhage ; Humans ; Lipectomy* ; Male ; Penis* ; Periosteum ; Pubic Symphysis ; Skin ; Socialization

Pyrimethamine(PYR) produces reversible infertility in mice. The antifertility effect of PYR is due to its antifolate action. PYR causes male infertility in Balb C mice in a dose dependent manner. The present study was performed to determine DNA synthesis of germ cell in mice treated with PYR. For 6-8 weeks adult Balb C mice were administered a PYR dose of 100mg- 200mg/ kg/day suspended in vegetable oil.10 control mice received only vegetable oil without PYR. After 7 weeks administration 28.6% of mice(4/14) administered a PYR dosage of 100mg/kg were infertility, whereas all of those(4/4), 200mg/kg/day were infertile. Morphologic changes of the testis induced by orally administered PYR were spermatogenic arrest and depopulation of germ cell. The incorporation of thymidine into DNA of germ cells was studied by using autoradiography after intraperitoneal injection of 15 Ci of methyl-3H-thymidine. Synthesis of DNA takes place in interphase and early prophase of mitotic phase of germ cell. The synthesis of DNA in spermatogonia reduced in all stage of spermatogenesis in mice treated with PYR due to spermatogenic arrest, compared with that of control mice. These results suggest that reduced synthesis of DNA in spermatogonia by PYR administration caused hypospermatogenesis. PYR represents further approach toward development of male contraceptive.
Adult ; Animals ; Autoradiography ; DNA* ; Germ Cells* ; Humans ; Infertility ; Infertility, Male ; Injections, Intraperitoneal ; Interphase ; Male ; Mice* ; Mice, Inbred BALB C ; Oligospermia ; Prophase ; Pyrimethamine* ; Spermatogenesis ; Spermatogonia ; Testis* ; Thymidine ; Vegetables

Primary pulmonary Hodgkin's lymphoma is a rare but distinct entity to be distinguished from nodal Hodgkin's lymphoma and from lymphomas involving lung secondarily. This lymphoma affects women more frequently than men, and typically involves superior portions of the lung. This case is reported to illustrate the clinical, radiographic and anatomic characteristics of the primary pulmonary Hodgkin's lymphoma. A 34-year-old woman presented for the evaluation of hemoptysis. A chest CT revealed a large poorly defined mass in the medial aspect of the right upper lobe, extending to the right mediastinum and trachea. The microscopic examination of the biopsied lesion revealed fibroblastic stroma infiltrated by a mixture of lymphocytes, histiocytes, and eosinophils. The clinical impression was inflammatory pseudotumor, presumably due to slightly favorable response to corticosteroid therapy. Two months later the patient's symptoms worsened despite the steroid therapy and a lobectomy was done. The specimen showed a soft to firm, pale yellow, ill defined mass, 10.0 8.0 cm, involving the visceral pleura. A few satellite nodules around the main mass were noted. The histologic findings were consistent with Hodgkin's lymphoma, nodular sclerosis type.
Adult ; Eosinophils ; Female ; Fibroblasts ; Granuloma, Plasma Cell ; Hemoptysis ; Histiocytes ; Hodgkin Disease* ; Humans ; Lung ; Lymphocytes ; Lymphoma ; Male ; Mediastinum ; Pleura ; Sclerosis ; Tomography, X-Ray Computed ; Trachea

No abstract available.
Musculocutaneous Nerve ; Paralysis

A laryngocele is an uncommon, air-filled dilatation of the laryngeal saccule or appendix of the laryngeal ventricle with an unclear etiology. This abnormality is generally classified into internal, external, or mixed type depending on their relationship to the thyrohyoid membrane. Many laryngoceles are asymptomatic and are discovered incidentally when radiographs of the neck or endolaryngeal examinations are performed for unrelated symptoms. We have experienced a case of bilateral mixed type laryngocele.
Appendix ; Dilatation ; Laryngocele* ; Membranes ; Neck ; Saccule and Utricle

Background: Many studies have assessed the risk factors for adverse drug reactions (ADRs) in elderly patients. However, most of these studies have focused on risk factors for ADRs, not serious ADRs (s-ADRs). s-ADRs are commonly found in hospitalized patients. s-ADRs warrant imminent but thorough investigations, given their critical impact on patient health. Therefore, this retrospective study aimed to assess the associated risk factors for s-ADRs in elderly hospitalized patients. Methods: In-patients aged >65 years having ADRs during hospitalization at a university hospital in Korea between 2010 and 2012 were included. Medical professionals spontaneously reported ADRs using an electronic submission system at the study hospital. Further, all descriptions of ADRs were characterized and categorized through the screening of electronic medical records. We compared the characteristics of patients having s-ADRs with those of patients not having s-ADRs. Results: There were 353 cases of ADRs, 67 of which were s-ADRs. Patients taking more than eight concomitant drugs showed the highest odds ratio (OR, 11.99; 95% confidence interval [CI], 3.42–42.03). The ratio of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) was also significantly related to s-ADRs (OR, 2.78; 95% CI, 1.33–5.81). The use of antibiotics (OR, 2.39; 95% CI, 1.13–5.02) and antineoplastics (OR, 4.17; 95% CI, 1.09–15.94) were significant risk factors. Conclusion Our findings highlight the importance of polypharmacy. Liver function tests (AST/ALT ratio) must be monitored carefully within high-risk groups for ADRs.

Generalized syringoma is a rare variant of syringoma, whose incidence peaks during childhood and adolescence, with no difference seen in either sex. It frequently affects the chest, neck, abdomen and axilla, and occasionally shows spontaneous regression. A 34-year-old woman presented with pruritic, multiple, 1~3 mm sized, lightbrownish papules on the chest, abdomen, and back. One year before, she had been diagnosed as having verruca plana at a private dermatologic clinic and had received immunotherapy, but experienced disappointing results. Histologically, the disorder showed numerous dilated eccrine ducts lined by two rows of epithelial cells. We herein report a case of generalized syringoma misdiagnosed as verruca plana, plus a review of the literature.
Abdomen ; Adolescent ; Adult ; Axilla ; Diagnostic Errors ; Epithelial Cells ; Female ; Humans ; Immunotherapy ; Incidence ; Neck ; Syringoma* ; Thorax ; Warts*

PURPOSE: The aim of this study was to evaluate the diagnostic value of the MR Imaging findings with provoked discography used as the standard for painful lumbar disc derangement. MATERIALS AND METHODS: Two hundred patients (412 discs), (age range: 21-77 years), with chronic low back pain underwent MRI and provoked discography. We evaluated the MRI T2-WI findings such as disc degeneration, high-Intensity zones and endplate abnormalities. Subsequently, provocative discography was independently performed with using MR imaging, and a painful disc was defined when moderate to severe and concordant pain was provoked. We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the MRI findings with using provoked discography as the standard. RESULTS: 400 discs showed abnormal findings such as disc degeneration, HIZ and endplate abnormalities on the T2-WI images. 12 discs showed normal findings. HIZ or endplate abnormalities were always combined with disc degeneration. The prevalence of each findings were disc degeneration (400 discs: 97.1%), HIZ (111 discs: 26.9%), type I endplate abnormalities (34 discs: 8.3%), type II endplate abnormalities (75 discs: 18.2%), the combined findings of HIZ and type I endplate abnormalities (2 discs: 0.5%) and the combined findings of HIZ and type II endplate abnormalities (7 discs: 1.7%). The disc degeneration showed high sensitivity (99.5%) and low specificity (5.0%), so only the NPV (91.7%) was significant, and not the PPV (47.8%). Each findings of HIZ (sensitivity, 36.5%; specificity, 81.4%; PPV, 63.18%; NPV, 59.5%), type I endplate abnormalities (11.0%, 94.1%, 61.8% and 54.8%, respectively), type II endplate abnormalities (19.8%, 83.2%, 50.7% and 54.3%, respectively), the combined findings of HIZ and type I endplate abnormalities (0.5%, 99.6%, 50.0% and 53.4%, respectively) and the combined findings of HIZ and type II endplate abnormalities (26.0%, 99.1%, 71.4% and 53.8%, respectively) show high specificity, but low sensitivity, so the PPV and NPV were also not significant. CONCLUSION: For diagnosing painful lumbar disc derangement, the MR imaging findings seem to be inadequate as predictive factors when provoked discography was used as the standard.
Humans ; Intervertebral Disc Degeneration ; Low Back Pain* ; Magnetic Resonance Imaging* ; Prevalence ; Sensitivity and Specificity

Spasticity is common stroke in patients, and its management has been considered as one of the major problems in stroke rehabilitation. The goal of this study was to determine if transcutaneous electrical nerve stimulation(TENS) and acupuncture would reduce the muscle spasticity. To estimate the efficacy of electrical stimulation for the treatment of spasticity TENS(100 Hz, asymmetric bipolar pulse current) was applied to the skin over the extensor muscles of spastic limbs for 20 minutes, once a day in six stroke patients. In addition, acupuncture was also applied to the acupoints of extensor muscles of all extremities and face for 20 minutes twice a day to determine the efficacy of acupuncture for the treatment of spasticity in six stroke patients. As controls subjects, six stroke patients were examined without TENS or acupuncture treatment. In experimental groups, the efficacy of treatment was measured 1, 5, 10, 15 days and 20 days after treatment with either TENS or acupuncture using the spasticity measurement methods (modified Ashworth scale, ankle clonus score, and H/M ratio). Based on the results from the present study, we have concluded that the H/M ratios of affected spastic limbs were significantly higher than those of unaffected limbs (p<0.05). TENS and acupuncture therapies lessened the spasticity of affected limbs of stroke patients when measured with the modified Ashworth scale however not with the H/M ratios nor with the ankle clonus scores.
Acupuncture Points ; Acupuncture* ; Ankle ; Electric Stimulation ; Extremities ; Humans ; Muscle Spasticity ; Muscles ; Rehabilitation ; Skin ; Stroke* ; Transcutaneous Electric Nerve Stimulation*