No abstract available.
Fistula* ; Humans ; Infant*

STUDY DESIGN: A retrospective study. OBJECTIVES: To assess the relationship between surgical outcomes and preoperative MRI findings, a retrospective review was conducted on the surgical outcomes depending on the preoperative MRI findings including type of herniation and Modic changes. SUMMARY OF LITERATURE REVIEW: In most reports, the patients that have large disc herniation were expected to have improved surgical outcomes. However, there have been controversies regarding the outcomes and Modic changes. MATERIALS AND METHODS: The retrospective review was conducted in 82 patients who underwent a discectomy for single level lumbar disc herniation. The average follow-up period was 34.2 months. Among their preoperative baseline MRI measurements, the stage of disc herniation, degree of nerve root compression, degree of dural sac compression, and Modic change of vertebral endplate were evaluated for the subsequent comparison between the preoperative and postoperative changes and ODI score. RESULTS: Patients with extrusion or sequestration type showed significant improvements compared to the patients with protrusion type disc herniation. By degree of nerve root compression, patients with root compression showed significant improvements compared to the patients who had contact type. The degree of dural sac compression revealed no correlation with changes in the ODI score. 23 of the 82 patients, the preoperative MRI showed a Modic change. Compared to the group who did not show such a Modic change, they turned out to be unrelated to the preoperative and postoperative changes in the ODI score. CONCLUSIONS: Patients who had extrusion or sequestration type disc herniation showed a better clinical improvement than protrusion type. Patients with compression type root lesion showed better clinical improvement than contact type root lesion. No correlation was noted regarding the outcomes of the surgical treatment and degree of dural sac compression or Modic changes.
Diskectomy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

The epidermoid cyst of the testis is a rare benign lesion with a characteristic gross and microscopic appearances. This 25 year old male who had been previously diagnosed as Klinefelter's snydrome (47/XXY) had right orchiectomy due to hard testicular nodule for a presented malignant testicular tumor. Sectioning of the testis revealed a intraparenchy matous cystic lesion, 1.5 cm in diameter, filled with cheesy white material. Histologically, stratified squamous epithelium lined the cyst. The remaining testis showed advanced tubular sclerosis and Leydig cell hyperplasia. It is necessary to submit multiple sections to rule out other histologic elements in the cyst wall or the presence of a scar. Although epidermoid cyst occurring as a solitary testicullar nodule could be regarded as a stage in the development of a teratoma, they need to be distinguished from the complex differentiated teratomas because of a distinct difference in prognosis.
Male ; Humans ; Cysts

No abstract available.

Recently, most bone cancers have shown a dismal prognosis even though they were managed with amputation. In the 1970s, anticancer drugs began to be used for bone tumor treatment as adjuvant agents, with the hope of survival improvement, while keeping the limb preserved. The 5-year survival of osteosarcoma patients increased up to 70% with anticancer chemotherapy and limb-salvage surgery. Limb salvage surgery includes all surgical procedures performed to accomplish resection of a malignant bone tumor and reconstruction of the skeletal system with an acceptable oncological and functional outcome. Currently, surgeons can choose a variety of reconstruction methods, including osteoarticular allograft, allograft-prosthesis composite, and metallic tumor endoprosthesis. However, complication rates are still high. The advancement of implant technology, adjuvant chemotherapy, and radiologic imaging modality has contributed to the evolution of limb salvage surgery. Nevertheless, there are still many barriers that have yet to be addressed to move further.

A 48-year-old woman was admitted to our hospital with a palpable mass in her lower abdomen. A left ovarian, cystic mass containing multiple mobile globules was seen on CT and MR images. The outer portion of the globules showed fat components on CT and fat-saturated T1-weighted MR images. Ultrasonography showed multiple echogenic, mobile globules with some sound attenuation and hyperechoic lines and dots within the cystic mass, which corresponded with the presence of lipid globules and hair shafts of ovarian mature cystic teratoma, respectively.
Abdomen ; Female ; Hair ; Humans ; Middle Aged ; Ovary ; Teratoma* ; Ultrasonography

PURPOSE: To determine the diagnostic performance of contrast-enhanced multidetector CT (MDCT) and the Alvarado score for acute appendicitis. MATERIALS AND METHODS: MDCT and determination of the Alvarado score were prospectively performed in 282 patients with 146 pathologically proven cases of acute appendicitis and 136 pathologically proven or clinically diagnosed cases of non-acute appendicitis. To compare the diagnostic performance of MDCT and the Alvarado score, the patients were subdivided according to age and sex, and receiver operating characteristics (ROC) analysis and Spearman rank correlation were performed. RESULTS: ROC analysis revealed that the optimal cut off value of the CT appendicitis grades was 2 in all patients, resulting in a sensitivity of 96.6% and a specificity of 94.9%. The optimal cut off values of the Alvarado score was different according to age and sex, resulting in a sensitivity of 85.6% and a specificity of 48.5%. There was a significant correlation between the CT appendicitis grades and the surgical-pathological grades (r=0.496, p<.0001). However, no significant correlation was observed between the Alvarado score and the surgical-pathological grades. CONCLUSION: Contrast-enhanced MDCT has a higher diagnostic accuracy and significant correlation with pathological findings than those of the Alvarado score in patients with acute appendicitis.
Acute Disease ; Appendicitis* ; Humans ; Prospective Studies* ; ROC Curve ; Sensitivity and Specificity

Lichen aureus is regarded as an uncommon variant of the pigmented purpuric dermatosis and resistant to treatment. Recently several authors reported the PUVA therapy to be effective in the pigmented purpuric dermatosis, but there was no report that the PUVA therapy was tried to the lichen aureus. We tried topical PUVA therapy on a 54-year-old male with bilateral lichen aureus. After 23 times of topical PUVA therapy, the lesion improved markedly. This report may provide a new method of treatment for lichen aureus.
Humans ; Lichens* ; Male ; Middle Aged ; PUVA Therapy* ; Skin Diseases

Syphilitic granulomatous pancreatitis is an extremely rare condition,and can occur in the generalized acquired syphilitic patient in tertiary or secondary phase. The most serious problem with granulomatous pancreatic lesion is clinical or radiological misdiagnosis as cancer. We experienced a case of syphilitic granulomatous pancreatitis arising in 54 year old female patient. She was treated for syphilis 20years ago. But she and her husband are still strong positive to VDRL and TPHA. On abdominal computed tomography and endoscopic pancreatico- duodenography, there was an obstructive mass of low density in the distal common bile duct or pancreatic head. Under the preoperative diagnosis of pancreatic head carcinoma, Whipple's operation was done. On gross examination, the pancreas was fibrotic, and the common bile duct was well preserved without tumor mass. Microscopically, numerous intralobular noncaseating epithelioid cell granulomas with multinucleated giant cells are identified. They surround thick-walled, small to medium sized arteries and involve vascular wall with luminal narrowing or obliteration, which are characteristic findings of the syphilitic granuloma. The remaining parenchyme shows fibrosis, acinar atrophy or destruction with dense infiltration of lymphohistiocytes, plasma cells with granuloma formation. Although the Warthin-Starry stain reveals no spirochetes, the serologic result and pathologic findings are compatible with syphilitic granulomatous pancreatitis.
Female ; Humans

The maintenance of corneal endothelial cells is essential for success of corneal transplantation. Endothelial cell count by specular microscope and measurement of donor corneal thickness is useful in measuring the function of cornea. We studied difference of corneal thickness in central and peripheral corneal region in enucleated eye. We measured corneal thickness of 48 eyes(48 persons) with ultrasound pachymetry that were presented to The Eye Bank of Catholic University Medical College. Average age was 61.42+/-16.12 years and average time was 163.02+/-102.52 minutes until measurement of corneal thickness after death. Increased amount of corneal thickness was 136.73+/-101.44micrometer in center and 61.37+/135.46micrometer in periphery compared with normal average corneal thickness. According to these results, corneal edema due to functional loss of endothelial cells after death lead to increased corneal thickness, especially in central region being more statistically significant than peripheral region (p=0.002).
Cornea ; Corneal Edema ; Corneal Transplantation ; Endothelial Cells ; Eye Banks ; Humans ; Tissue Donors ; Ultrasonography