No abstract available.
Breast Neoplasms* ; Breast*

Cerebral white matter changes (WMCs) and silent brain infarcts (SBIs) are common radiologic findings in neurologically asymptomatic elderly people, but are associated with an increased risk of subsequent stroke. We investigated the prevalence and risk factors for these cerebral changes on brain computed tomography (CT) in 480 community-dwelling healthy Korean adults without stroke or dementia, who were recruited for an early health program. Cerebral WMCs were defined as the presence of approximately 5 mm wide ill-defined and moderately hypodense lesions, and SBIs were defined as the presence of >2 mm wide well-defined hypodense lesions. Of the 480 patients, 49 (10.2%) had cerebral WMCs and SBIs findings on brain CT. The prevalence of WMCs and SBIs increased with age: the prevalence was 2.4%, 9%, and 32% for subjects in their 50, 60s, and 70s, respectively. In addition, hypertension, abdominal obesity, increased levels of homocysteine and high sensitivity C-reactive protein were significantly associated with cerebral WMCs and SBIs. Our study suggests that regular monitoring of risk factors is required to prevent cerebral WMCs and SBIs and decrease the incidence of stroke and dementia in healthy individuals.

In this report, a case of a 70-year-old man with a large ganglion cyst formed after anterior transposition of the left ulnar nerve is presented. Three months after the index surgery, the patient presented with a painless superficial ovoid, soft mass measuring 5x4x2 cm in size located at the posteromedial aspect of the left elbow, the previously operated site. Magnetic resonance imaging showed a well demarcated cystic mass with a stalk connecting to the elbow joint. Excisional biopsy was performed and pathologic findings showed that the cystic wall had no definite lining cells with myxoid degeneration compatible with findings of ganglion cyst.
Aged ; Biopsy ; Cubital Tunnel Syndrome ; Elbow ; Elbow Joint ; Ganglion Cysts* ; Humans ; Magnetic Resonance Imaging ; Ulnar Nerve*

PURPOSE: This study aimed to find out whether there are relationships among anatomic characteristics of inferior oblique muscle insertion, corneal diameter, axial length and inferior oblique recession landmark. METHODS: Thirty-one Korean cadaver orbits were dissected to expose the full length of extraocular muscles and sclera, and then we measured the length from the recession landmark of inferior oblique to the lateral edge of insertion of inferior rectus and to the inferior edge of insertion of lateral rectus. RESULTS: The mean of angles between the inferior oblique muscle insertion and lateral rectus direction is 27.9+/-9.0degrees and the range is from 15 degrees to 50 degrees . There is a statistically significant correlation between cord length of 8 mm recession landmark of inferior oblique and angles of inferior oblique insertion with lateral rectus direction. We divided the shapes of inferior oblique insertion into straight and convexed curves. Twelve insertions are straight and thirteen insertions are curved. There is no statistically significant correlation between shape of inferior oblique insertion and cord length from recession landmark. In corneal diameter and axial length, we found correlations with cord length of 8 mm and 10 mm recession landmark of inferior oblique. CONCLUSIONS: We conclud that there are some correlations among anatomic characteristics, axial length and corneal diameter with recession landmark of inferior oblique.
Cadaver ; Muscles ; Orbit ; Sclera

No abstract available.
Hydrocephalus*

No abstract available.
Humans ; Hydronephrosis* ; Radioisotope Renography*

BACKGROUND: With the recent development in arterial reconstructive procedure such as percutaneous transluminal coronary angioplasty or atherectomy, the incidence of vascular complications involving femoral artery is increasing due to greater use of larger percutaneous instruments(including arterial sheath) and periprocedural anticoagulant therapy. Femoral pseudoaneurysm requires rapid diagnosis and management to prevent limb ischemia, worsening of the arterial injury or repair of the arterial defect. Recently, accurate diagnosis of these injuries can be made nonivasively with duplex sonography and Doppler color flow imaging, and nonsurgical treatment may be possible by using external compression guided by ultrasound even in patients requiring prolonged anticoagulant therapy. METHOD: Three patients, one undergoing coronary angiography and two undergoing percutaneous transluminal coronary angioplasty, developed expansile groin masses at the vascular access sites diagnosed as femoral artery pseudoaneurysm s by Doppler ultrasound. All patients were hypertensives, taking aspirin and two patients who underwent PTCA received intravenous heparin after procedure. After diagnosis of femoral pseudoaneurysm, all patients underwent mechanical(C-clamp) external compression guided by ultrasound for 3 hours. RESULT: Follow up color flow scans were obtained after 24 hours and in one patients, blood flow in the tract was eliminated but persistent blood flow was observed in two patients who underwent PTCA. Before closure of pseudoaneurysm, one patient needed another 6 hours of ultrasound guided compression and the other needed more 12 hours. All patients were discharged without complication or recurrence of pseudoaneurysm. CONCLUSION: These cases suggest that nonsurgical closure of femoral pseudoaneurysms is feasible even in patients requiring prolonged antiplatelet and anticoagulant therapy.
Aneurysm, False* ; Angioplasty, Balloon, Coronary ; Aspirin ; Atherectomy ; Cardiac Catheterization* ; Cardiac Catheters* ; Coronary Angiography ; Diagnosis ; Extremities ; Femoral Artery ; Follow-Up Studies ; Groin ; Heparin ; Humans ; Incidence ; Ischemia ; Recurrence ; Ultrasonography

PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Dislocations ; Female ; Femur* ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Limb Salvage* ; Lung Neoplasms ; Male ; Multiple Myeloma ; Osteosarcoma ; Periprosthetic Fractures ; Prostatic Neoplasms ; Prostheses and Implants* ; Recurrence ; Thyroid Neoplasms ; Walking ; Weights and Measures

Lichen planopilaris is believed to be a variant of lichen planus which is occasionally accompanied by classical lichen planus. A 68-year old male had asymptomatic skin colored or light violet colored papules and nodules on the occipital area followed by hair loss for 2 months. He had also violaceous pea to bean sized whitish scaly papules on the right lower extremity. Histopathological examination revealed the dilated follicles to be filled with horny material. There were also intense infiltrations of monocytes which were most prominent at the lower pole of the hair follicles on the scalp lesion. There was also hyperkeratosis, focal hypergranulosis and band-like infiltrations of lymphocytes at the dermo-epidermal junction on the lesion of the lower extremity. Direct immunofluorescence examination showed linear deposition of fibrin at the dermo-epidermal junction in the hair follicles. We had an opportunity to observe a man with lichen planopilaris who had loss of scalp hair which was accompanied by classical lichen planus on the lower extremity.
Aged ; Fibrin ; Fluorescent Antibody Technique, Direct ; Hair ; Hair Follicle ; Humans ; Lichen Planus ; Lichens* ; Lower Extremity ; Lymphocytes ; Male ; Monocytes ; Peas ; Scalp ; Skin ; Viola

To investigate the relationship between insulin response and morphometric changes of the mitochondria of pancreatic beta-cell, this study was performed using hyperglycemia and streptozotocin as oxidative stresses. Adult and neonatal rats were used. Intravenous glucose tolerance test (IVGTT) and morphologic examination of pancreas using immunohistochemical stain, in situ end-labeling method and electron microscopic study were performed. Various mitochondrial parameters were measured by image analyzer. Immunohistochemical stain revealed a markedly reduced islet size and decreased number of beta-cells and the increased number of non-beta-cell in adult and neonatoal streptozotocin group, and the appearance of insulin positive cells throughout the exocrine parenchyma in neonatal streptozotocin group. Three days after injection of streptozotocin in adult streptozotocin group, TUNEL stain showed increased apoptotic cells in islets. Ultrastructurally, beta-cells in adult streptozotocin group showed increase in number and size of mitochondria, and disruption of mitochondrial structures. Hyperglycemic group and neonatal streptozotocin group showed preserved mitochondrial ultrastructure. Ultrastructural morphometric study revealed increase in size and number of mitochondria and decrease in mitochondrial contour index in adult streptozotocin-treated rats, which suggested mitochondrial degeneration. Hyperglycemic group showed mild increase in size of mitochondria. Increased number of mitochondria was also observed in neonatal streptozotocin group. IVGTT revealed marked decrease in insulin response in adult streptozotocin group, and non-insulin-dependent diabetes mellitus pattern in glucose and insulin response in neonatal streptozotocin group. Hyperglycemic group showed a glucose and insulin response similar to control group. The above results suggest that a severe oxidative injury may cause degeneration and disruption of mitochondria of pancreatic beta-cell, and may be associated with substantial apoptotic cell death. The changes in the morphology and the number of mitochondria may result from streptozotocin treatment within neonatal period and hyperglycemia treatment, which may be associated with changes in insulin response.
Adult ; Animals ; Cell Death ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; In Situ Nick-End Labeling ; Insulin* ; Mitochondria ; Oxidative Stress ; Pancreas ; Rats ; Streptozocin