In the unusual manifestation of right upper lobe collapse confusing with mediastinal or parenchymal mass, both alteration of the pulmonary vessels and shifting pattern of the collapsed lobe to the periphery on supine positionare the key to the diagnosis of it rather than mediastinal or parenchymal mass. The mechanisms of these unusual manifestation s are obscure, however lobar torsion and gravity factor are considered to be a main process. Authors have experienced 2 cases of unusual manifestations of right upper lobe collapse due to bronchogenic carcinomaduring resent 2 years in Kyung Hee University hospital, and prsent radiologic findings.
Carcinoma, Bronchogenic ; Diagnosis ; Gravitation

PURPOSE: To correlate SOhographic and pathologic findings of gallbladder adenoma, and to evaluate the clinical significance of sonographic findings. MATERIALS AND METHODS: Ultrasound findings of twenty gallbladder adenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and was correlated with the pathological finding. RESULTS: Among 14 patients, 11 patients had single lesion and 3 patients had multiple lesions. Three patients showed 2, 3 and 4 adenomas, respectively. Nine of 20 lesions showed focal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerous change. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the mean diameter of adenomas without dysplasia was 8.7 mm (3-13mm). The echogenicity of adenoma with focal dysplasia were hyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoic in 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) and stalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showed histological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, the diameter more than 14 mm on sonography was statistically significant (p<0. 005). Also age of patient was significantly different between the two groups (p<0.01), while echogenicity and associated stone were not statistically significant. CONCLUSION: As gallbladder adenoma more than 14ram in diameter on US is suggestive of dysplasia on pathology, so, close follow up US or surgery is recommended.
Adenoma* ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography

BACKGROUND: The minimally invasive plate osteosynthesis (MIPO) technique using periarticular locking plates may be a good option for the repair of displaced proximal humeral fractures. However, axillary nerve complications related to this technique may be underestimated. The purpose of this study is to evaluate the outcomes of the minimally invasive plating, focusing on the complications. METHODS: The records of 21 consecutive patients treated for proximal humerus fractures using the MIPO technique with locking plates were retrospectively reviewed. These patients were treated between March 2009 and March 2011 with a minimum one-year follow-up. The clinical function, complications, and radiological bony union were evaluated. RESULTS: All of the patients, with one exception, showed at least 90 degrees of flexion and abduction at the shoulder joint six months postoperatively. The average Constant scores at three months, six months, and one year follow-ups were 74.0 (range, 62 to 90), 79.4 (range, 64 to 91), and 82.7 (range, 66 to 92), respectively. All of the patients achieved bony union within the average of 3.2 months (range, 2 to 6 months). There was one case of delayed union, one case of intra-articular screw penetration, and one case of axillary nerve paresis (incomplete injury), which did not completely recover during the one year of follow-up. CONCLUSIONS: The MIPO technique using periarticular locking plates is a useful option for the treatment of selected cases of displaced proximal humeral fractures. However, nerve complications such as axillary nerve paresis should be considered along with implant-related complications when choosing patients for minimally invasive plating.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fracture Fixation, Internal/*adverse effects ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/adverse effects ; Peripheral Nerve Injuries/etiology ; Retrospective Studies ; Shoulder Fractures/*surgery ; Young Adult

No abstract available.
Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Submandibular Gland*

PURPOSE: The purpose of this study is to determine correlation between femoral tunnel angle in the coronal plane on a simple radiograph and femoral tunnel location in the sagittal plane on three-dimensional computed tomography (3D-CT). MATERIALS AND METHODS: The subjects included 42 patients who underwent 3D-CT after the operation out of 70 cases of anterior cruciate ligament reconstruction using quadriceps tendon-patelllar bone autograft from April, 2009 to June, 2011. Measurement of the femoral tunnel angle was based on the anatomical axis of the femur in antero-posterior (AP) and Rosenberg views; femoral tunnel location was described as a proportional percentage on the medial surface of the lateral femoral condyle in the 3D-CT image; then the correlation between femoral tunnel angle and femoral tunnel location was analyzed retrospectively. RESULTS: Femoral tunnel angle was 41.5degrees+/-6.8degrees (range: 29.7degrees-53.9degrees) on AP radiographs, and 34.9degrees+/-6.9degrees (range: 23.8degrees-46.5degrees) on Rosenberg views. The femoral tunnel was located 36.9%+/-11.3% from posterior, and 38.1%+/-6.5% from proximal on the 3D-CT image. On plain AP radiographs, femoral tunnel angle and femoral tunnel location showed negative correlation (p<0.001, rho=-0.498), and, in comparison with Rosenberg view, they showed negative correlation (p=0.006, rho=-0.416). Twenty three patients (53.5%) had femoral tunnel in the anatomical location. Their femoral tunnel angle on AP radiographs was 43.3degrees+/-6.1degrees, while the femoral tunnel angle of patients who had femoral tunnel in non-anatomical locations was 38.4degrees+/-6.4degrees (p=0.004). In the Rosenberg picture, similar difference was observed between the two groups (p=0.012). CONCLUSION: On AP radiographs and Rosenberg views, femoral tunnel angle showed significant correlation with the femoral tunnel location on the 3D-CT image, and the group who had femoral tunnel location in the anatomical range showed a relatively higher femoral tunnel angle.
Anterior Cruciate Ligament Reconstruction ; Autografts ; Axis, Cervical Vertebra ; Femur ; Humans ; Retrospective Studies

Although stent fracture after implantation of a drug-eluting stent (DES) is a rare complication, it has been suggested to be a cause of restenosis. To date, most DES fractures have been associated with sirolimus-eluting stents. We describe here a case of a zotarolimus-eluting stent fracture after 8 months of stent placement in a calcified left anterior descending artery lesion in a patient undergoing hemodialysis.
Arteries ; Drug-Eluting Stents ; Humans ; Renal Dialysis ; Stents

Although stent entrapment is a rare event during percutaneous coronary intervention, stent entrapment can cause stent breakage or loss, which results in fatal complications such as stent embolism or acute myocardial infarction. We report one case of stent entrapment that was successfully treated by a snare via a contralateral transfemoral approach.
Angioplasty ; Embolism ; Myocardial Infarction ; Percutaneous Coronary Intervention ; SNARE Proteins ; Stents

BACKGROUND: Chromosomal translocation t (15 ; 17), the breakpoints of which are in the PML gene on chromosome 15 and RARA gene on chromosome 17, is specifically found in acute promyelocytic leukemia (APL). According to the site of breakpoint on PML gene, two major isoforms (Long or Short) of PML-RARA mRNA are produced. METHODS: To detect long (L) and short (S) isoforms, we extracted RNA and amplified PML-RARA mRNA by RT-PCR from leukemic cells of 20 cases of APL. We compared the result of cytogenetic study and the clinical response after chemotherapy or ATRA therapy for remission induction with the isoforms of PML-RARA mRNA. RESULTS: In 19 cases (94%) among 20 cases with APL, PML-RARA mRNA was positive, and negative in a case who showed only i (17q) without t (15;17). In 12 cases (63.2%), L isoform of PML-RARA mRNA was detected, and S isoform (36.8%) in 7 cases of APL. All the cases with t (15;17) were positive for PML-RARA mRNA. In a case of trisomy 8 without t (15;17), PML-RARA mRNA of L isoform was detected. There was no significant difference between L and S isoform in laboratory findings and clinical response after chemotherapy or ATRA treatment. Excluding 6 cases with death before or within 10 days of ATRA treatment or chemotherapy, among 13 patients of positive PML-RARA mRNA, 11 cases (84.6%) reached to complete remission, but a case of negative PML-RARA mRNAwas resistent to ATRA treatment. CONCLUSION: This study suggests that detection of PML-RARA mRNA with two major isofroms using RT-PCR is more sensitive to diagnose APL and to detect minimal residual disease than cytogenetic study and that further study with more cases may be substantiated the types of PML-RARA mRNA isoform as a prognostic marker.
Chromosomes, Human, Pair 15 ; Chromosomes, Human, Pair 17 ; Cytogenetics ; Drug Therapy ; Humans ; Leukemia, Promyelocytic, Acute* ; Neoplasm, Residual ; Protein Isoforms* ; Remission Induction ; RNA ; RNA, Messenger* ; Translocation, Genetic ; Trisomy

Despite its low incidence, stent thrombosis (ST) is one of the most dreaded complications of percutaneous coronary intervention. Endeavor (Medtronics Europe SA) is a new zotarolimus-eluting stent (ZES) with a favorable safety profile that was reported in early and ongoing trials. However, few lethal stent thromboses related to this new drug eluting stent (DES) have been reported. We experienced a case of simultaneous subacute ZES thromboses, 6 days after stent implantations in the proximal left anterior descending artery and the proximal right coronary artery (RCA).
Arteries ; Coronary Vessels ; Drug-Eluting Stents ; Europe ; Incidence ; Percutaneous Coronary Intervention ; Sirolimus ; Stents ; Thrombosis

In this study, the effect of particle size of genistein-loaded solid lipid particulate systems on drug dissolution behavior and oral bioavailability was investigated. Genistein-loaded solid lipid microparticles and nanoparticles were prepared with glyceryl palmitostearate. Except for the particle size, other properties of genistein-loaded solid lipid microparticles and nanoparticles such as particle composition and drug loading efficiency and amount were similarly controlled to mainly evaluate the effect of different particle sizes of the solid lipid particulate systems on drug dissolution behavior and oral bioavailability. The results showed that genistein-loaded solid lipid microparticles and nanoparticles exhibited a considerably increased drug dissolution rate compared to that of genistein bulk powder and suspension. The microparticles gradually released genistein as a function of time while the nanoparticles exhibited a biphasic drug release pattern, showing an initial burst drug release, followed by a sustained release. The oral bioavailability of genistein loaded in solid lipid microparticles and nanoparticles in rats was also significantly enhanced compared to that in bulk powders and the suspension. However, the bioavailability from the microparticles increased more than that from the nanoparticles mainly because the rapid drug dissolution rate and rapid absorption of genistein because of the large surface area of the genistein-solid lipid nanoparticles cleared the drug to a greater extent than the genistein-solid lipid microparticles did. Therefore, the findings of this study suggest that controlling the particle size of solid-lipid particulate systems at a micro-scale would be a promising strategy to increase the oral bioavailability of genistein.
Absorption* ; Animals ; Biological Availability* ; Drug Liberation ; Genistein* ; Nanoparticles* ; Particle Size* ; Powders ; Rats