Although epidural fibrosis after laminectomy is considered to be the cause of pain in a number of patients, the exact relationship of postoperative scar tissue and symptoms remains controversial. However it is generally accepted that epidural fibrosis after surgical decompression of neural tissue has to be avoided. To diminish the likelihooa that such a scar will form, fat grafts have been used to create an interpositional membrane. Compression of a nerve after the use of a fat graft is rare; postoperative cauda equina syndrome, resulting from compression by a grafted fat. We report the case of a patient who had this complication.
Cauda Equina* ; Cicatrix ; Decompression, Surgical ; Fibrosis ; Humans ; Laminectomy* ; Membranes ; Polyradiculopathy* ; Spine* ; Transplants*

The minor fissure is an important anatomical landmark in the localization of the pulmonary diseases. For the evaluation of the normal feature of the minor fissure, we analyzed the high-resolution computed tomography (CT) scans in 51 normal patients. The purposes of this study are to evaluate the normal appearance of the minor fissure on high-resolution CT scans and to compare it with that on the coventional CT and chest radiographs. We analysed the morphologic feature of the minor fissure on the high-resolution CT scans in 51 normal patients, and compared it with that on the conventional CT scans. On the high-resolution CT scans, we particularly paid attention to the completeness and types according to Berkmen classification. And finally, we compared the types determined by the high-resolution CT scans with those by the plain radiographs. In most patients (n=47), the minor fissure was seen as a hyperattenuating line or hand on the high-resolution CT scans. In contrast, it was mostly seen as a lucent zone on the conventional CT scans (n=44). Of 47 patients having a hyperattenuating line or band on the high resolution CT scans, the minor fissure was considered to be complete in 17 patients (36%), and incomplete in 30 patients (64%), who had defect at medial portion of the minor fissure. The most common type of the minor fissure seen on the high-resolution CT scans was type I variety (n=23), followed by type IIa (n=10) and type II (n=8). We could not determine the type in six patients. The type determined by the high resolution CT scans was highly well correlated with that determined by the plain radiographs (p<0.05). In conclusion, the minor fissure was seen on CT studies as variable appearances and high-resolution CT scans were superior to the conventional CT scans in the evaluation of the minor fissure. The type of the minor fissure determined by the high-resolution CT scans were well correlated with those seen on the radiographs.
Classification ; Hand ; Humans ; Lung Diseases ; Radiography, Thoracic ; Tomography, X-Ray Computed

The minor fissure is an important anatomical landmark in the localization of the pulmonary diseases. For the evaluation of the normal feature of the minor fissure, we analyzed the high-resolution computed tomography (CT) scans in 51 normal patients. The purposes of this study are to evaluate the normal appearance of the minor fissure on high-resolution CT scans and to compare it with that on the coventional CT and chest radiographs. We analysed the morphologic feature of the minor fissure on the high-resolution CT scans in 51 normal patients, and compared it with that on the conventional CT scans. On the high-resolution CT scans, we particularly paid attention to the completeness and types according to Berkmen classification. And finally, we compared the types determined by the high-resolution CT scans with those by the plain radiographs. In most patients (n=47), the minor fissure was seen as a hyperattenuating line or hand on the high-resolution CT scans. In contrast, it was mostly seen as a lucent zone on the conventional CT scans (n=44). Of 47 patients having a hyperattenuating line or band on the high resolution CT scans, the minor fissure was considered to be complete in 17 patients (36%), and incomplete in 30 patients (64%), who had defect at medial portion of the minor fissure. The most common type of the minor fissure seen on the high-resolution CT scans was type I variety (n=23), followed by type IIa (n=10) and type II (n=8). We could not determine the type in six patients. The type determined by the high resolution CT scans was highly well correlated with that determined by the plain radiographs (p<0.05). In conclusion, the minor fissure was seen on CT studies as variable appearances and high-resolution CT scans were superior to the conventional CT scans in the evaluation of the minor fissure. The type of the minor fissure determined by the high-resolution CT scans were well correlated with those seen on the radiographs.
Classification ; Hand ; Humans ; Lung Diseases ; Radiography, Thoracic ; Tomography, X-Ray Computed

The bicuspid aortic valve (BAV) is the most common congenital cardiovascular malformation. Patients with BAV are at higher risk of other congenital cardiovascular malformations and valvular dysfunction, including aortic stenosis/regurgitation and infective endocarditis. BAV may also be related to aortic wall abnormalities such as aortic dilatation, aneurysm, and dissection. The morphology of the BAV varies with the presence and position of the raphe and is associated with the type of valvular dysfunction and aortopathy. Therefore, accurate diagnosis and effective treatment at an early stage are essential to prevent complications in patients with BAV. This pictorial essay highlights the characteristics of BAV and its related congenital cardiovascular malformations, valvular dysfunction, aortopathy, and other rare cardiac complications using multimodal imaging.

PURPOSE: To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). METHODS: This study is a case report detailing clinical follow-up and an aqueous humor test by PCR-RFLP. RESULTS: The deep, white retinal lesions coalesced and progressively expanded in a circumferential manner, with sparing of the perivascular retina. However, retinal and vitreous hemorrhages, unusual findings for PORN, could be noted around the optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR. CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, concurrent or combined etiologic agents can include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral therapy with acyclovir and ganciclovir could be more reasonable as an initial therapy.
Vitreous Hemorrhage/*complications ; Retinitis/*complications/pathology/*virology ; Necrosis ; Humans ; *Herpes Zoster ; Female ; Disease Progression ; Adult ; Acquired Immunodeficiency Syndrome/*complications

The displacement of an entire tooth into the adjacent anatomical area is an uncommon complication of a tooth extraction. We encountered a 23-year-old woman who had previously undergone surgery under local anesthesia to remove the lower third molar about 12 weeks prior and the upper third molar was extracted 2 days prior to visiting this hospital. Upon admission, she complained of a swallowing discomfort and a mouth opening limitation. Panoramic radiograph and a CT scan revealed a displacement of the entire tooth into the lateral pharyngeal space. The tooth was retrieved via the transoral approach under general anesthesia. The removed tooth had an indentation formed by a dental bur. Therefore, it was concluded that the tooth displaced into the lateral pharyngeal space was the lower third molar. This report describes an unusual case of a third molar that was displaced into the lateral pharyngeal space with a review of the relevant literature.
Anesthesia, General ; Anesthesia, Local ; Deglutition ; Female ; Humans ; Molar, Third* ; Mouth ; Tomography, X-Ray Computed ; Tooth ; Tooth Extraction ; Young Adult

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

Percutaneous catheter drainage (PCD) of pancreatic pseudocyst has been reported to have good therapeutic results, low complications, and short hospital course. To find the clinical and radiological findings which can predict the treatment period for PCD, we retrospectively correlated the clinical data (presence of invection, initial and 1 week follow-up serum and aspirate amylase level, daily drainage amount) and radiological findings (evidence of fistula, PCD route, inital size of pseudocyst) with the treatment period in each case. The age ranged from 20 to 64 years(mean:39.8 years) and male to female ratio was nine to one. When the cavity was obliterated after PCD and did not recur after tube removal without a surgical treatment, we regarded the patient to be cured. Mean treatment period was 20.2 days and nine patients(90%) were cured. We think that the factors shortening treatment period are the presence of superimposed infection and the abrupt decrease of the amount of daily drainage for the first week. But the presence of fistula to the pancreatic duct may prolong the treatment period. In conclusion, PCD is safe and effective in the treatment of pancreatic pseudocyst, and the clinical ad radiological findings are expected to be able to predict the treatment period of PCD.
Amylases ; Catheters* ; Drainage* ; Female ; Fistula ; Follow-Up Studies ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Retrospective Studies

Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic

Since Kappis described percutaneous celiac plexus block in 1914, variations and refinements of his technic have been proposed. Recently, computed tomography (CT) guided nerve block has improved results of the block and made it safer, particularly when neurolytic drugs are injected for the relief of intractable abdominal pain caused by malignancy or chronic pancreatitis. We report a case of CT-guided alcohol block of the celiac plexus with the anterior approach in a patient with a common bile duct carcinoma.
Abdominal Pain ; Celiac Plexus* ; Common Bile Duct ; Humans ; Nerve Block ; Pancreatitis, Chronic