No abstract available.
Aneurysm* ; Angiography* ; Circle of Willis*

No abstract available.
Arteriovenous Fistula*

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

Primary non-Hodgkin's lymphoma of the cranial vault is very rare. A 55-year-old woman presented with a right parietal subcutaneous scalp lump. Computed tomography(CT) scan showed a right parietal cranial vault lesion with scalp swelling and extradural and intradural involvement. Tumor removal, including portion of involved skull, followed by c ranioplasty with resin were performed. Histologic study revealed the features of a T-cell non-Hodgkin's lymphoma(high grade, large cell, diffuse, immunoblastic type) and there was no systemic involvement. The chemotherapy and radiotherapy were instituted after surgery.
Drug Therapy ; Female ; Humans ; Lymphoma, Non-Hodgkin* ; Middle Aged ; Rabeprazole ; Radiotherapy ; Scalp ; Skull ; T-Lymphocytes

Lymphangioma is a rare benign developmental vascular tumor that may be found in orbit, skull and elsewhere in head and neck. Few cases of extension of this benign but insidious tumor posteriorly out of the bony orbital cavity have been reported. The patient was 40-year-old man complaining of proptosis of right eye for one month. Physical examination revealed severe right exophthalmus, impairment of eyeball movement in all directions. Visual acuity was much impaired and he could percept only light with right eye. CT and MRI scans showed intraconal and extraconal involvement of ill-defined, heterogenous mass with extension of the tumor posteriorly beyond the orbital cavity involving right frontal and temporal lobe, skull and subcutaneous tissue. The tumor was subtotally removed via orbito-frontal approach without damaging vital neural and orbital component. Then, orbital roof reconstruction and cranioplasty were done with resin. Successful surgical removal of lymphangioma is very difficult due to its severe infiltration to surrounding tissue and tendency to bleed during debulking. We report a rare case of orbital cavernous lymphangioma with intracranial extension treated with surgical decompression, with review of literatures.
Adult ; Decompression, Surgical ; Exophthalmos ; Head ; Humans ; Lymphangioma* ; Magnetic Resonance Imaging ; Neck ; Orbit* ; Physical Examination ; Skull ; Subcutaneous Tissue ; Temporal Lobe ; Visual Acuity

Anterior cervical interbody fusion(ACIF) is an effective method for the treatment of various cervical diseases, but complications from such procedure include non-union, absorption, collapse and displacement of graft bone, kyphosis and pseudoarthrosis. A retrospective study of 67 cases with ACIF with versus without plating system in degenerative cervical disease was performed to compare the arthrodesis level, average admission period, average ambulation period, fusion rate, complications, clinical outcome and reoperation rate for complications and to provide a efficacy and role of internal fixation(IF) after ACIF. Forty-five patients were operated through ACIF without IF and twenty-two patients were operated through ACIF with IF. In the group of ACIF without IF, the average admission period was 20.31 days, postoperative average ambulation period was 6.48 days, fusion rate was 97.7%, the rate of graft related complication was 31.1%, reoperation rate for graft related complications was 8.9%. In the group of ACIF with IF, the average admission period was 17.64 days, postoperative average ambulation period was 3.19 days, fusion rate was 100%, the rate of graft and plate related complications was 13.6%, reoperation rate for plate related complications was 9.1%. There was no reoperation for graft related complication in group of ACIF with IF. In conclusion, ACIF with IF had less chance of serious graft related complications and reoperation for graft related complications.
Absorption ; Arthrodesis ; Humans ; Kyphosis ; Pseudarthrosis ; Reoperation ; Retrospective Studies ; Transplants ; Walking

Cytomegalovirus(CMV) is one of the leading cause of intrauterine infections of man with an incidence ranging from 0.48% to 2.2% of all live births. Although the majority of CMV-infected newborns are clinically asymptomatic at birth, some will have signs of congenital infection : Intrauterine growth retardation, petechial or purpuric rash, microcephaly, anemia, thrombocytopenia, jaundice, hepatosplenomegaly and intracranial calcification. We experienced a case of symptomatic congenital CMV infection in a 1-day-old male who presented generalized petechiae, hepatosplenomegaly, anemia, thrombocytopenia. Urine PCR and viral culture for CMV were positive, and a brain CT revealed ventriculomegaly and periventricular calcification. And auditory evoked potential revealed left sensorineural hearing loss. He received ganciclovir treatment for 6 weeks, was discharged in good health, and continued conunder follow-up at the outpatient department.
Anemia ; Brain ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Evoked Potentials, Auditory ; Exanthema ; Fetal Growth Retardation ; Follow-Up Studies ; Ganciclovir ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing* ; Humans ; Incidence ; Infant, Newborn ; Jaundice ; Live Birth ; Male ; Microcephaly ; Outpatients ; Parturition ; Polymerase Chain Reaction ; Purpura ; Thrombocytopenia

Between January 1995 and May 1998, 177 patients with proven lumbar disc herniation were treated by microdiscectomy or by percutaneous endoscopic discectomy(PED). Among them, 43(24.2%) patients underwent PED and were followed for long term outcome. We included only those patients who were followed up more than 13 months. Three patients who did not improved immediately after PED and underwent microdiscectomy were excluded for this study. Of remaining 40 patients, there were 22 men and 18 women who ranged in age from 23 to 68 years (mean 38.1 years). The disc herniations were located at L1-2(1), L2-3(1), L3-4(1), L4-5(26) and L5-S1(11). Three patients were treated by biportal approach. The mean follow up period was 34.7 months(range 13-47 months). Overall, excellent and good results were achieved in 12(30%) and 19(47.5%) patients, and fair and poor results in 7(17.5%) and 2(5%) patients, respectively. Thirty-eight(95%) patients returned to their previous works and the mean duration was 5.7 months. Thirty-three(82.5%) patients answered that they would recommend this procedure to others. There was no complication except for one patient who suffered from discitis. The indication of PED is restricted to contained or small subligamentous lumbar disc herniation without stenosis, spondylolisthesis and sequestration. PED can be performed under local anesthesia and tissue trauma, risk of epidural scarring, hospitalization time and postoperative morbidity are minimal. The result of the present study justify the assumption that PED can be a surgical alternative for patients suitable for its indications.
Anesthesia, Local ; Cicatrix ; Constriction, Pathologic ; Discitis ; Diskectomy* ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Male ; Spondylolisthesis

Supratentorial hemangioblastomas are rare tumors. The first documented case of congenital cystic supratentorial hemangiblastoma associated with intracystic hemorrhage is presented; it occurred in a 38-day-old male infant.
Hemangioblastoma* ; Hemorrhage* ; Humans ; Infant ; Male