Renal inflammatory pseudotumor is a very rare benign condition of unknown etiology characterized by proliferative myofibroblasts, fibroblasts, histiocytes, and plasma cells. In the case we report, the lesion appeared on contrast-enhanced power Doppler US images as a well-defined hypoechoic mass with intratumoral vascularity, and on CT as a low-attenuated mass. Differentiation from malignant renal neoplasms was not possible.
Case Report ; Contrast Media ; Granuloma, Plasma Cell/*radiography/*ultrasonography ; Human ; Kidney Diseases/*radiography/*ultrasonography ; Male ; Middle Age ; Polysaccharides/diagnostic use ; Ultrasonography, Doppler

PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

It is well known that troponin T (below TnT) is present in the myocardial cells and released during myocardial damage, so it`s very specific enzyme to myocardium. Availability of cardiac specific TnT in assessing perioperatively myocardial damage was evaluated from 34 open heart surgery patients. They consisted of 11 ischemic heart, 13 acquired valvular heart and 10 congenital heart cases. Patients were divided into two groups, group A (patients with myocardial damage) and group B (patients without myocardial damage), according to the symptom of chest pain suspecting angina and the ECG findings of ST segment and T wave changes which show myocardial ischemia and injury. Serum TnT levels were measured by enzyme immunoassay method preoperatively, immediately postoperatively, postoperative day 1, day 2, day 3, and day 7. We observed and analyzed the changes of serum TnT levels in two groups and compared the serum TnT levels with CK-MB levels measured at the same time. In group A, serum TnT levels showed 1.37+/-0.26microgram/L, 3.16+/-0.66microgram/L, 2.39+/-0.74microgram/L, 2.49+/-0.76microgram/L, and 1.23+/-0.60microgram/L, immediate postoperatively, postoperatively day1, day2, day3, and day7, respectively. It was observed there were significant differences compared with those of group B (0.38+/-0.04microgram/L, 0.34+/-0.05microgram/L, 0.25+/-0.03microgram/L, 0.24+/-0.04microgram/L, and 0.11+/-0.03microgram/L) during identical periods (p<0.01). Serum CK-MB level in group A significantly elevated to 145.04+/-35.08 IU/L on the postoperative day 1 compared to group B (31.28+/-5.87 IU/L, p<0.05), However, it stiffly decreased from day 2 and returned to preoperative level at day 3. When serum TnT level more than 1.0microgram/L is thought to reflect myocardial damage, serum TnT had 100% of sensitivity and 87% of specificity in diagnosing the postoperative myocardial damage (p<0.01). I conclusion, serum TnT levels increased significantly at very early stage of myocardial damage and persisted much longer period than CK-MB. This suggests that serum TnT has more advantage and availability in assessing the perioperatively myocardial damage than any other tests.
Chest Pain ; Electrocardiography ; Heart* ; Humans ; Immunoenzyme Techniques ; Myocardial Infarction ; Myocardial Ischemia ; Myocardium ; Sensitivity and Specificity ; Thoracic Surgery* ; Trinitrotoluene ; Troponin T* ; Troponin*

PURPOSE: To report the first case of lattice corneal dystrophy, gelsolin type in Korea. CASE SUMMARY: A 61-year-old man visited our clinic with severe dry eye symptom in both eyes. Clinical examination revealed in both eyes a visual acuity of 0.7 without correction and intraocular pressure of 18 mm Hg. On slit-lamp examination, both corneas had scattered lattice lines at various depths within the stroma with punctate epithelial erosions. The patient had characteristic features of Meretoja syndrome, including cranial neuropathy characterized by dermatochalasis and facial weakness, and was positive for the gelsolin mutation according to DNA analysis. This is the first description of a patient with lattice corneal dystrophy, gelsolin type in Korea. CONCLUSIONS: This is the first description of a patient with lattice corneal dystrophy, gelsolin type in Korea and demonstrates the importance of recognizing the systemic and ophthalmic features for appropriate management of the condition.
Amyloidosis ; Cornea ; Corneal Dystrophies, Hereditary ; Cranial Nerve Diseases ; DNA ; Eye ; Gelsolin ; Humans ; Intraocular Pressure ; Korea ; Visual Acuity

A clinical evaluation was performed on 11 cases of the cardiac rupture by blunt chest trauma at the department of thoracic and cardiovascular surgery, Yeungnam University Hospital during the period from July, 1993 to May, 1995. The results were as follows ; The sex distribution was 8 mem and one women, and mean age was 41 years old. The causes of accident was traffic accident in most cases. And then one case was cultivator accident and another one was fall down. The average times from trauma to admission was 139 minutes and the patients that transferred via other hospitals have relatively long average times to 227 minutes. The average times from admission to operation was 117 minutes and we consumed 25 minutes for the preoperative preparation. The sites of injury were 7 cases in the right heart and 3 cases in the left heart. There were symptoms and signs of the cardiac tamponade (dyspnea, chest pain, nausea/vomitus, neck vein distention & hypovolemic shock) at admission and in most of them typical symptoms and signs of a tamponade appeared. Surgical approach was performed with median sternotomy in 10 cases. Subxiphoid pericardial window was created in one case. Another case which was very difficult in surgical procedure was operated under cardiopulmonary bypass and the result was good.
Accidents, Traffic ; Adult ; Cardiac Tamponade ; Cardiopulmonary Bypass ; Chest Pain ; Female ; Heart ; Heart Rupture* ; Humans ; Hypovolemia ; Neck ; Sex Distribution ; Sternotomy ; Thorax* ; Veins

OBJECTIVE: To retrospectively assess conventional magnetic resonance imaging (MRI) features that differentiate malignant pure mesenchymal uterine tumors (MPMUT); endometrial stromal sarcoma (ESS) and leiomyosarcoma (LMS) from uterine leiomyoma with cystic degeneration (ULCD). METHODS: We retrospectively reviewed magnetic resonance (MR) images of 30 patients with ULCD, 18 with ESS, and 15 with LMS, to assess tumor location, margin, T2 signal intensity (SI), speckled appearance, and peripheral band using univariate and multivariate analyses. RESULTS: ULCD more frequently showed subserosal location (53.3%), well-defined margin (96.7%), and speckled appearance (90.0%) compared with ESS (0%, 33.3%, and 33.3%, respectively) or LMS (20.0%, 33.3%, and 60.0%, respectively). In quantitative T2 SI comparisons, the T2 SI ratio of the main solid tumor portion to gluteus maximus muscle differed significantly among the three groups, with ULCD showing a lower SI ratio (0.62) compared with ESS (2.44) and LMS (1.13). On multivariate analysis, an ill-defined margin (odds ratio [OR]=44.885; p=0.003) and high T2 SI (OR=4.396; p=0.046) were the significant MR differentiators. CONCLUSION: An ill-defined tumor margin and high T2 SI ratio of the main solid tumor-to-gluteus maximus muscle were useful MRI features in the differentiation of MPMUT from ULCD.
Humans ; Leiomyoma* ; Leiomyosarcoma ; Magnetic Resonance Imaging* ; Multivariate Analysis ; Retrospective Studies ; Sarcoma, Endometrial Stromal

The outbreak of Coronavirus Disease 2019 (COVID-19) caused a worldwide pandemic. Less than 6 weeks after the first confirmed cases in Korea, the patient number exceeded 5,000, which overcrowded limited hospital resources and forced confirmed patients to stay at home. To allocate medical resources efficiently, Korea implemented a novel institution for the purpose of treating patients with cohort isolation out of hospital, namely the Community Treatment Center (CTC). Herein, we report results of the initial management of patients at one of the largest CTC in Korea. A total of 309 patients were admitted to our CTC. During the first two weeks, 7 patients were transferred to the hospital because of symptom aggravation and 107 patients were discharged without any complication. Although it is a novel concept and may have some limitations, CTC may be a very cost-effective and resource-saving strategy in managing massive cases of COVID-19 or other emerging infectious diseases.

A 32-year-old man with blurred vision in the right eye and headache presented with anterior uveitis, an intraocular pressure (IOP) of 60 mmHg, an open angle, no visual field defects, and normal optic nerve. He had a history of five previous similar attacks. In each of the previous instances, his anterior uveitis and high IOP were controlled with antiglaucoma medications and topical steroids. However, at the fifth attack, his optic disc was pale and a superior paracentral visual field defect was shown. Brain magnetic resonance image studies were normal. This case represents that a recurrent Posner-Schlossman syndrome (PSS)-induced optic disc atrophy likely due to ocular ischemia caused by a recurrent, high IOP. Although PSS is a self-limiting syndrome, we should manage high IOP and prevent ischemia of the optic nerve head by treating with ocular antihypertensive medications.
Atrophy/diagnosis/etiology ; Diagnosis, Differential ; Glaucoma, Open-Angle/*complications/diagnosis/physiopathology ; Humans ; *Intraocular Pressure ; Male ; Optic Disk/*pathology ; Optic Nerve Diseases/diagnosis/*etiology/physiopathology ; Syndrome ; Young Adult

PURPOSE: To evaluate the accuracy of spiral CT angiography(CTA) in the demonstration of accessory or multiplerenal arteries and renal artery stenosis. MATERIALS AND METHODS: We prospectively performed CTA in 50 patients(24 males and 26 females) between nine and 77 years old (mean 39.3) in whom renovascular hypertension was suspected (n=32), or who were potential renal donors (n=18). Within two days of CTA, intraarterial digital subtraction angiography (IA-DSA) was performed. Both spiral CTA and IA-DSA images were blindly compared by two radiologists with respect to the number of accessory renal arteries and the location and severity of renal arterystenosis. The severity of renal arterial stenosis was graded with a five-point scale (grades 0-4). RESULTS: CTA demonstrated 26 of total 27 accessory renal arteries (detection rate = 96.5 %). For the diagnosis of grade 2-4stenosis (> or = 50% stenosis) (n=40 of a total of 127 renal arteries), the sensitivity, specificity, and accuracy of CTA were 90%, 96.5%, and 94.5%, respectively. For the detection of grade 3-4 stenoses (> or = 75% stenosis) (n=33), the sensitivity, specificity, and accuracy of CTA were 87.9%, 98.9%, and 96.1%, respectively. For the detection ofgrade 3-4 stenoses in the main renal artery (n=27), the sensitivity, specificity, and accuracy of CTA were 96.3%,100%, and 99.0%, respectively. CONCLUSION: Spiral CTA is a reliable and accurate screening modality for the evaluation of renal artery in patients suspected to be suffering from renovascular hypertension, or who arepotential renal donors.
Aged ; Angiography ; Arteries ; Constriction, Pathologic ; Diagnosis* ; Humans ; Hypertension, Renovascular ; Male ; Mass Screening ; Prospective Studies ; Renal Artery Obstruction* ; Renal Artery* ; Sensitivity and Specificity ; Tissue Donors ; Tomography, Spiral Computed

The recent advances in interventional radiology have made balloon catheter dilation the alternative treatment modality for ureteral stricture. However, it has not been widely accepted despite proven success in some case reports. Herein we analyzed the effect of antegrade balloon dilation on the 19 patients with various ureteral strictures. Twelve iatrogenic, 4 tuberculosis, 1 retroperitoneal fibrosis, 1 primary UPJ obstruction and 1 patient with unknown cause were included. The mean follow up period was 18.5 months. Symptomatic and radiologic success rate, factors influencing the outcome such as etiology. duration, length and site of stricture were evaluated. The overall success rates were 68% symptomatically and 63% radiologically. The success rate was not different between iatrogenic and non-iatrogenic strictures significantly. Most favorable results were obtained in the patients with tuberculosis and postsurgical strictures of less than 6 months in duration. Significant complications were not observed in all patients. Conclusively, balloon catheter dilation seems to be effective alternatives in the treatment of ureteral strictures of various etiology without severe complication. To improve the success rate, more experiences, development of equipment and method, and establishment of indications should be necessary.
Catheters ; Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Humans ; Radiology, Interventional ; Retroperitoneal Fibrosis ; Tuberculosis ; Ureter*