Percutaneous endoscopic gastrostomy tube placement is often performed in patients with a ventriculoperitoneal shunt and it has been accepted as a safe procedure. The authors report a case of a 50-year-old male who developed acute exacerbation of the hydrocephalus immediately after the percutaneous endoscopic gastrostomy tube placement without any signs of shunt infection, which has not been reported until now. After revision of the intraperitoneal shunt catheter, the sizes of the intracranial ventricles were normalized.
Catheters ; Gastrostomy* ; Humans ; Hydrocephalus ; Male ; Middle Aged ; Ventriculoperitoneal Shunt

No abstract available.
Osteoblastoma* ; Spine*

Hallux valgus has been defined as a static subluxation of the first metatarsophalangeal joint with lateral deviation of the proximal phalanx on the first metatarsal head from the longitudinal axis of the first metatarsal with medial deviation of the first metatarsal. And first-second metatarsal angle is increased as well as bursal hypertrophy over the medial eminence of the first metatarsal head. Many procedures have been reported for the treatment of the hallux valgus ranging from resection arthroplasty to distal first metatarsal or basal first metatarsal osteotomy. Of these, Johnson and Corless have required sufficiently good results in the modifying Mitchell osteotomy into Chevron osteotomy. The Chevron procedure is an osteotomy involving the distal portion of the first metatarsal, lateral displacement of the metatarsal head with exostosectomy, and tightening of the medial capsular structures. Authors studied 17 cases in 10 patients with the hallux valgus deformity treated by Chevron osteotomy at the Department of Orthopedic Surgery, Capital Armed Forced General Hospital from September 1987 to September 1989. The results were as follows; 1. Seven patients (12 cases) were male and three patients (5 cases) were female. All patients had bilateral hallux valgus deformity. 2. The average first-second intermetatarsal angle was 11 degrees and average valgus angle was 32 degrees, preoperatively. They were corrected to 9 degrees and 14 degrees respectively. 3. The metatarsalgia of the great toe was subsided in all cases and they were satisfied with the result of their operations in respect to cosmetically and functionally. Avascular necrosis of capital fragment, nonunion, and dorsal angulation were not developed in any case. But, one case had marginal skin necrosis, presumably due to excessive compressive dressing. 4. Chevron osteotomy is a technically easy procedure and it can be obtained early bone healing with less complication.
Arm ; Arthroplasty ; Bandages ; Congenital Abnormalities ; Female ; Hallux Valgus ; Hallux ; Head ; Hospitals, General ; Humans ; Hypertrophy ; Male ; Median Eminence ; Metatarsal Bones ; Metatarsalgia ; Metatarsophalangeal Joint ; Necrosis ; Orthopedics ; Osteotomy ; Skin ; Toes

No abstract available.
Small Cell Lung Carcinoma*

Lymphangioma of the spleen is an extremely rare disease in adults, and performing splenectomy has been considered necessary for its diagnosis and treatment, but the diagnosis of an isolated splenic mass lesion without performing splenectomy is a challenging problem. Herein, we report on a case of multiple splenic lymphangiomas that were found incidentally in a 56-year-old female; these lesions were diagnosed by percutaneous splenic biopsy without splenectomy. We suggest that this approach is a reasonable option for benign looking-appearing splenic tumors because splenectomy and its postsplenectomy complications can be avoided.
Adult ; Biopsy ; Biopsy, Needle* ; Diagnosis ; Female ; Humans ; Lymphangioma* ; Middle Aged ; Needles* ; Rare Diseases ; Spleen ; Splenectomy

5-Fluorouracil (5-FU) is a commonly used chemotherapeutic agent. However, its neurotoxicity is rare and not well recognized. We report a case of 5-FU neurotoxicity with organic brain syndrome and progression to multifocal leukoencephalopathy in a 44-year-old male patient having malignant gast- rointestinal stromal tumor. 5-FU-induced neurotoxicity should, therefore, be considered as an important differential diagnosis in cancer patients with neurological abnormality and history of chemotherapy.
Adult ; Brain/*pathology ; Case Report ; Electroencephalography ; Fluorouracil/*adverse effects/therapeutic use ; Gastrointestinal Neoplasms/drug therapy ; Human ; Leukoencephalopathy, Progressive Multifocal/diagnosis/etiology ; Magnetic Resonance Imaging ; Male ; Neurotoxicity Syndromes/diagnosis/*etiology

An anomalous origin of the left coronary artery (LCA )from the pulmonary artery (ALCAPA syndrome )or Bland-White-Garland syndrome is a rare congenital cardiac anomaly. We report a 65-year old female patient who presented with atypical chest discomfort. Coronary angiography and three-dimensional multidetector computed tomography coronary angiography demonstrated the ectatic right coronary artery (RCA )arising from the aorta, rich collaterals from the RCA to LCA and the ectatic tortuous LCA that originated from the pulmonary trunk.
Aged* ; Aorta ; Bland White Garland Syndrome ; Collateral Circulation ; Coronary Angiography* ; Coronary Vessel Anomalies ; Coronary Vessels* ; Female ; Humans ; Multidetector Computed Tomography ; Pulmonary Artery* ; Thorax

The aim of this study was to establish reference data for the quantitative ultrasound (QUS) of the calcaneus and for the bone mineral densities (BMD) of the calcaneus and distal forearm, and to evaluate the correlation between QUS parameters and BMD in a Korean population. We performed a cross-sectional study involving 3,053 subjects (1,225 men and 1,828 women). QUS was conducted on the calcaneus and was quantified as speed of sound (SOS, m/sec), broadband ultrasound attenuation (BUA, dB/MHz), and stiffness index. The BMD of the calcaneus and distal forearm were measured using dual X-ray absorptiometry. The peak mean values for the QUS parameters occurred in the 20 to 29-yr-old subjects of both sexes, with the exception of the BUA, which reached the highest values in women of 30-39 yr. For both sexes, the mean BMD of the calcaneus was highest in those 20-29 yr old and that of the distal forearm was highest in those 40-49 yr old. The correlations between the QUS and BMD results were found to be 0.41 to 0.73 in men and 0.51 to 0.76 in women. Theses data can serve as a reference values for both sexes in Korea.
Adult ; Aged ; *Bone Density ; Calcaneus/*metabolism/*ultrasonography ; Cross-Sectional Studies ; Densitometry, X-Ray ; Female ; Forearm ; Humans ; Korea ; Male ; Middle Aged ; Osteoporosis/etiology/metabolism/ultrasonography ; Reference Values ; Risk Factors

BACKGROUND AND OBJECTIVES: Osteoprotegerin (OPG) is a decoy receptor for receptor nuclear factor-kB ligand (RANKL). We sought to evaluate the association between the serum OPG level and the target lesion calcium (TLC) in those patients suffering with coronary artery disease (CAD). SUBJECTS AND METHODS: We assayed the serum OPG levels in 65 CAD patients (mean age: 62+/-10 yrs, M : F=46 : 19) with using enzyme immunoassay, and these patient underwent intravascular ultrasound (IVUS) examinations of their target lesions. The degree of TLC was estimated by the maximum arc of calcium and also the calcified plaque surface area that was calculated from the serial cross-section IVUS images. RESULTS: The median serum OPG levels were greater in the subjects with TLC than in the subjects without TLC (1.36 vs 0.95 ng/mL, respectively, p<0.05). Significant correlation was noted between the serum OPG levels and the maximum arc of calcium (r=0.274, p=0.027). The median serum OPG levels were significantly increased more in the subjects who had a maximum arc of calcium ranging from 90 to 180 degrees than in those subjects who had a maximum arc of calcium less than 90 degrees (1.63 vs 1.14 ng/mL, respectively, p<0.05) and the median serum OPG levels were also increased more in the subjects who fell within the second tertile of the calcified plaque surface area than that in those subjects who fell within the first and third tertile (0.96, 1.53, 1.40 ng/mL for the first, second, third tertile, respectively, p<0.05). On the stepwise multivariate logistic regression analysis, the serum OPG level remained a risk factor for TLC after adjustment was made for the other risk factors such as age, diabetes mellitus, HbA1C and a smoking history (p=0.019, odds ratio 5.208 [95% confidence interval: 1.308-20.744]). CONCLUSION: In patients with CAD, an increased serum OPG level is associated with target lesion calcification.
Calcium* ; Coronary Artery Disease* ; Coronary Vessels* ; Diabetes Mellitus ; Humans ; Immunoenzyme Techniques ; Logistic Models ; Odds Ratio ; Osteoprotegerin* ; Risk Factors ; Smoke ; Smoking ; Ultrasonography

No abstract available.
Aneurysm* ; Coronary Vessels* ; Stents*