Agressive osteoblastoma is a very rare primary bone tumor having locally aggressive and destructive natures.But distant metastasis is not well occurred. Aggressive osteoblastoma may be similar to osteoblastomaradiologically, but has different pathological featurs. We experienced one case of aggressive osteoblastomaarising from left ilium and report this case with review of the literatures.
Ilium ; Neoplasm Metastasis ; Osteoblastoma

Diffuse tremendous thickening of gastric wall caused by excessive proliferation of the mucosa of unknown causewas first decribed by Menetrier in 1888. The disease is highly uncommon, but the exact preoperative diagnosis iscrucial because of the more excellent prognosis than other malignant lesions including gastric lymphoma andinfiltrative gastric carcinoma. The authors recently experienced a case of Menetrier's disease which had beendiagnosed as gastric lymphoma preoperatively. Radiologic differentiation is not impossible between this extermelyrare disease and other mimicking malignant lesions, that is the reason why we introduce radiographic findings ofthe case by comparison with gastric lymphoma of giant rugal type and infiltrative gastric carcinoma. Typical upperG-I series findings of the case are: 1) Enlarged tortuous proximal gastric rugal folds only along the greatercurvature, 2) Perpendicular lines of barium spicules trapped by apposed folds with clubbed or forked appearance,3) Abrupt transition of transion to normal stomach, 4) No luminal narrowing and retained but sluggish peristalsis.Thus radiologists can diagnose Menetrier's disease scrupulously based on critical application of enlarged foldspattern and extent of the lesion in association with other radiologic features and clinial history of fairly longduration. Brief review of clinical and pathologic features about Menetrier's disease is included.
Barium ; Diagnosis ; Diagnosis, Differential ; Gastritis, Hypertrophic ; Hypertrophy ; Lymphoma ; Mucous Membrane ; Phenobarbital ; Prognosis ; Stomach

Kasabach-Merritt phenomenon does not occur with common hemangioma, rather it is associated with the more aggressive Kaposiform hemangioendothelioma and rarely with other vascular neoplasm. We report the case of an adult who was diagnosed as Kaposiform hemangioendothelioma complicated by Kasabach-Memtt phenomenon. This is the first report in Korea of an adult with Kasabach-Merritt phenomenon who has osteolytic changes of femur, pelvic bone, and lumbar spine.
Adult* ; Femur ; Hemangioendothelioma* ; Hemangioma ; Humans ; Kasabach-Merritt Syndrome ; Korea ; Pelvic Bones ; Spine ; Vascular Neoplasms

An intravaginal foreign body of long duration can lead to infection and ulceration. Foul-smelling, bloody vaginal discharge, and pelvic pain may indicate the presence of an intravaginal foreign body and symptoms may be referred to the bladder or rectum. But these clinical features are nonspecific and a number of diagnostic modalities may fail to detect the presence of the foreign body. Moreover, long-standing intravaginal foreign body may be difficult to distinguish from an advanced cervical cancer especially in uninformed cases. We present a case of a 41-year-old female who suffered from an aggravating chronic pelvic pain and malodorous dirty vaginal discharge. Initially the advanced cervix cancer complicated with recto-vaginal fistula was suspected. But results of repeated biopsies were benign and symptoms were improved by intravenous antibiotics. Finally the embedded foreign body in the posterior fornix was detected and successfully removed. It was proved as the grip of an umbrella. We concluded that a high index of suspicion is very important for the correct diagnosis of long-standing vaginal foreign body especially in uninformed cases.
Adult ; Anti-Bacterial Agents ; Biopsy ; Diagnosis ; Female ; Fistula ; Foreign Bodies ; Hand Strength ; Humans ; Pelvic Pain ; Rectum ; Ulcer ; Urinary Bladder ; Uterine Cervical Neoplasms* ; Vagina ; Vaginal Discharge

STUDY DESIGN: This is a retrospective study. OBJECTIVE: We wanted to evaluate the efficacy of epidural steroid injection (ESI) for treating lumbar spinal stenosis (LSS) SUMMARY OF LITERATURE REVIEW: Treatment for lumbar spinal stenosis has generally consisted of some form of conservative treatment or surgery. Surgery may be contraindicated in many stenotic patients because of their significant comorbidities. Therefore, conservative management is necessary for those who cannot or do not want to undergo surgery. MATERIALS AND METHODS: From January 2002 to June 2003, we retrospectively analyzed 128 patients, 55 years or older, who received ESI (s). The average age of the men and women was 47 and 81, respectively. Their mean age was 76 (age range: 55~84). The injection materials were 2 ml methylprodnisolone acetate (40 mg/cc) in combination with 3 cc normal saline and 3 cc lidocaine. The follow up period was 12 months to 30 months. We measured the outcomes by the duration and amount of pain relief, the change in functional status and the rate of performing surgery; patient satisfaction was assessed by a 5-item questionnaire. RESULT: Of the 128 participants, 31% reported more than 2 months of pain relief, 41% reported less than 2 months of pain relief and 27% reported no relief from the injection (s). Sixteen percent subsequently had surgery. Sixty-nine percent reported improvement in their functional abilities. Seventy-two percent were at least somewhat satisfied with ESI as a form of treatment. CONCLUSION: ESI is a reasonable treatment for LSS as it provided one third of our patient population with sustained relief and more than half with sustained improvement in function.
Comorbidity ; Female ; Follow-Up Studies ; Humans ; Lidocaine ; Male ; Patient Satisfaction ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Stenosis* ; Spine

BACKGROUND: The catheter ablation usin radiofrequency(RF) energy in patients with atrioventricular nodal reentrant tachycardia(AVNRT) and atrioventricular reentrant tachycardia(AVRT) ahs been proved as a safe and effective nonpharmacologic therapeutic modality. The purpose of our study was to evaluate the success rate and complications of the initial experience and to determine the extent of myocardial damage of RF catheter ablation. METHODS: Electrophysiologic study was performed with the standard technique. Twenty five patinents(M:F=16:9, mean age:42 years old) underwent RF catheter ablation in St. May's Hospital from April to December in 1994. The RF generator in this study was RFG-3D model and catheters were 6F or 7F steerable catheters with 4mm kistal tip. In order to evaluate the extent of myocardial damage the WBC count, LDH, CK, and CK-MB fraction were checked before and after RF catheter ablation and the Tc99m myocardial scintigraphy was performed within 72 hours of the porcedure. RESULTS: Six of twenty five patients had AVNRT, in which the success rate of selective ablation of the slow pathway was 83.8%. Nineteen patients with AVRT had one accessory pathway. The ablation success rate of 14 accessory pathways in left free wall location was 85.7%, and that of 3 in left posteroseptal location was 66.6%. Two right sided accessory pathways were not ablated successfully. The level of CK-MB fraction after ablation was within normal limit. Only one case revealed grade 2 of hot spot in Tc99m myocardial scintigraphy. CONCLUSION: The RF catheter ablation in patients with AVNRT and AVRT is a safe and effective nonpharmacologic therapeutic modality. But right sided accessory pathways are more difficult to ablate than left sided accessory pathways, requiring more experiences and better technique. The extent of myocardial damage after RF catheter ablation reveals relatively minimal by cardiac enzyme study and Tc99mmyocardial scintigraphy.
Catheter Ablation* ; Catheters ; Humans ; Myocardial Perfusion Imaging ; Radionuclide Imaging ; Tachycardia, Supraventricular*

OBJECTIVE: Vascular endothelial growth factor (VEGF) increases angiogenesis. It is known that one of angiogenetic factors, angiopoietin-1 (Ang-1) stabilizes maturity of normal vessels and angiopoietin-2 (Ang-2) antagonizes the action of angiopoietin-1 by binding Tie-2 that is their receptor. Recently those factors are known to be involved in carcinogenesis. The aim was to investigate the mRNA expression of those factors in epithelial ovarian cancer including normal ovary and ovarian cyst and to evaluate their role in ovarian carcinogenesis. METHODS: The tissue samples of 16 ovarian cyst, and 29 epithelial ovarian cancer patients who were diagnosed at Ewha Woman's University MokDong Hospital from 1997 to 2003, and 18 normal ovary subjects who had hysterectomy and salpingoophorectomy due to uterine myoma and confirmed as normal controls, were obtained. The mRNA expressions of Angiopoietin-1, Angiopoietin-2, Tie-2 and Vascular endothelial growth factor were measured by Quantitative Competitive polymerase chain reaction (PCR). Their expressions were analyzed with ANOVA test and Spearman correlation test. RESULTS: The expressions of Ang-1 mRNA were higher in normal ovary than those of ovarian cyst and ovarian cancer (p<0.05). The expressions of Tie-2 mRNA were higher in ovarian cyst than those of normal ovary and ovarian cancer (p<0.05). The expressions of VEGF mRNA were higher in ovarian cancer than those of normal ovary and ovarian cyst (p<0.05). The expression of Ang-2 mRNA in ovarian cancer was related with the expression of VEGF and Tie-2 mRNA. CONCLUSION: The lower expression of Ang-1 mRNA and higher expression of VEGF mRNA might be a role in ovarian carcinogenesis. The expression of Ang-1, Tie-2 and VEGF might be related to ovarian carcinogenesis, together. However, this study is based on limited number of cases and short-term period of follow up, further prospective studies on a larger population should be done.
Angiopoietin-1* ; Angiopoietin-2* ; Carcinogenesis ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Leiomyoma ; Ovarian Cysts* ; Ovarian Neoplasms* ; Ovary* ; Polymerase Chain Reaction ; RNA, Messenger* ; Vascular Endothelial Growth Factor A*

Hydrogen peroxide solution is commonly used for irrigating and cleaning wounds. When it is applied to tissues, catalase causes its rapid molecular degeneration with the release of oxygen bubbles. We present case report illustrating two hazards ; chemical colitis and oxygen embolus. A 29-year-old previously healthy woman presented to the bloody diarrhea and anal pain after hydrogen peroxide enema. In the colonoscopic examination, severe mucosal edema and ulceration with bleeding was noted from anus to sigmoid colon. With use of anal endosonography, multiple high level echo were noted in the internal and external anal sphincter of the upper anal canal. Microscopically, mononuclear cells were infiltrated in lamina propria and congestion. She had treatment with IV fluid, IV antibiotics and NPO. At 3rd hospital day, anal pain was disappeared. Bloody stool was disappeared next day. At 8th hospital day, mucosal edema and ulceration were disappeared on colonoscopic examination. Recovery was full and the patient was discharged at nine days after the episode.
Adult ; Anal Canal ; Anti-Bacterial Agents ; Catalase ; Colitis* ; Colon, Sigmoid ; Diarrhea ; Edema ; Embolism ; Endosonography ; Enema* ; Estrogens, Conjugated (USP) ; Female ; Hemorrhage ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Mucous Membrane ; Oxygen ; Ulcer ; Wounds and Injuries

Multiple extradural arachnoid cysts of the spine are extremely uncommon in children with only a few cases reported. The authors report a case of multiple extradural spinal arachnoid cysts in children with a review of the relevant literature.
Arachnoid ; Arachnoid Cysts ; Child ; Humans ; Spine

Endovascular treatment of ethmoidal dural arteriovenous fistula (DAVF) has not been widely performed because of the technical difficulty of the procedure and the potential risk of central retinal artery occlusion. We report the case of a patient who underwent Onyx embolization through the ophthalmic artery in bilateral ethmoidal DAVF; to our best knowledge this is the first report.
Central Nervous System Vascular Malformations ; Humans ; Ophthalmic Artery ; Retinal Artery Occlusion