The authors report a case of brain abscess associated with pulmonary arteriovenous malformation(AVM). As right to left shunt in systemic circulation can precipitate brain abscess in congenital cyanotic heart disease, arteriovenous fistula in pulmonary AVM is an etiologic factor of brain abscess. Brain abscess associated with pulmonary AVM is very rare and has so far been lacking in previous report in Korea. The pertinent literatures of brain abscess associated with pulmonary AVM are also reviewed.
Arteriovenous Fistula ; Arteriovenous Malformations* ; Brain Abscess* ; Brain* ; Heart Diseases ; Korea

A 7-year-old Thoroughbred gelding was admitted to Equine Hospital, Korea Racing Association for evaluation and treatment of colic. Based on the size and duration of the large colonic and cecal impaction, a routine ventral midline celiotomy and large colon enterotomy were performed to relieve the impaction. Six days following surgery the gelding exhibited signs of lethargy, fever, inappetence and diarrhea. Eleven days following surgery, the jugular veins showed a marked thrombophlebitis. On the sixteenth day of hospitalization the gelding died suddenly. Upon physical examination, the horse was febrile, tachycardic and tachypnoeic. Thoracic excursion appeared to be increased; however, no abnormal lung sounds were detected. No cough or nasal discharge was present. Hematology revealed neutrophilic leukocytosis. Serum biochemistry was normal but plasma fibrinogen increased. In necropsy, fibrinopurulent fluid was present in the thoracic cavity. There were firm adhesions between visceral pleura and thoracic wall. White, mixed and red thrombi were formed in both jugular veins from the insertion point of IV catheter. Histopathological examination showed fibrinopurulent inflammation and vascular thrombosis in the lung. The pleura showed edematous thickening and severe congestion. The clinicopathological and pathological findings suggest that septic thrombi associated with septic thrombophlebitis metastasized into the pulmonary circulation and were entrapped in the pulmonary parenchyma and provoked pleuropneumonia.
Animals ; Colic/*surgery ; Fatal Outcome ; Histocytochemistry ; Horse Diseases/*pathology ; Horses ; Male ; Pleuropneumonia/complications/pathology/*veterinary ; Postoperative Complications/pathology/*veterinary ; Sepsis/complications/pathology/veterinary ; Thrombophlebitis/complications/pathology/*veterinary

No abstract available.
Carcinoma, Hepatocellular*

A three-dimensional (3D) intraoral scanner, which is one of the major developments in digital dentistry, is widely used in fixed prosthodontics. The application of intraoral scanner is now increasing in removable prosthodontics. Sclerotic change induced by scleroderma causes the limitation of mouth opening and multiple loss of the teeth. Conventional prosthodontic procedures are challenging for patients with this disease. This study showed a case of digital approach to the removable prosthodontic treatment of a patient who had the scleroderma and the consequent microstomia. At the provisional stage, the optical impression of patient’s oral structures was digitally obtained. Using a 3D printer, the provisional dentures were fabricated. After extraction of hopeless tooth, the definitive digital impression was taken and the metal frameworks were fabricated, based on the data acquired from the impression. The definitive removable partial dentures were completed and delivered to the patient, who was satisfied with the prostheses.

Background: Toe symphalangism is characterized by a fusion of the interphalangeal joint between the middle and distal phalanges. While typical lesser toe fractures heal well with conservative treatment, in our clinical experience, we encountered patients with symphalangeal toe fractures who experienced long-lasting pain and delayed radiographic union. Therefore, this study aimed to report radiographic outcomes following conservative treatment of symphalangeal fractures of the lesser toes. Methods: We retrospectively reviewed 14 patients with symphalangeal lesser toe fractures who were treated conservatively. We investigated the mechanism of injury and measured the time from the initial injury date to the complete radiographic union. The fracture gap distance was measured on an initial lateral radiograph. Results: Symphalangeal fractures involved the fourth toe in 4 patients (28.5%) and the fifth toe in 10 patients (71.4%). Regarding the mechanism of injury, 6 patients (42.9%) were injured by stubbing or bumping into the door, 5 patients (35.7%) were injured by tripping, 2 patients (14.3%) were injured by heavy objects falling directly on their toes, and 1 patient (2.3%) complained of pain after wearing pointed shoes for half a day. The mean time to complete union was 9.1 months, and the median period was 5.5 months (range, 0.8–29 months). The initial gap of the fracture was 0.60 mm (range, 0.30–1.04 mm). Conclusions The results of our case series may help counsel patients in the outpatient clinic that prolonged healing time may be required for the union of symphalangeal toe fractures.

Colonoscopy is a safe and standard procedure for diagnosis and therapy of colonic disorders. Iatrogenic colonic perforation during diagnostic colonoscopy, a rare abdominal emergency, has an 0.3~0.8% incidence rate. The choice of treatment for this complication remains controversial. Prompt operative intervention is preferred to minimize morbidity and mortality. However, operative intervention is invasive and needs a long-term recovery period. Conservative treatment is less invasive but can lead to more extensive surgery in case of treatment failure. Very important point on the treatment of iatrogenic perforation of the colon during diagnostic colonoscopy is to avoid the leaking of intestinal contents into the intraperitoneal cavity. We report here a case in which an iatrogenic perforation of the colon during diagnostic colonoscopy was successfully treated by endoscopic clip therapy.
Colon* ; Colonoscopy* ; Diagnosis ; Emergencies ; Gastrointestinal Contents ; Incidence ; Mortality ; Treatment Failure

BACKGROUND: False tendons(FT), also referred to as pseudotendons or bands, are fibrous strings that pass from two papillary muscles and insert elsewhere except mitral valve leaflets. They can be classified into six types according to sites of attachment to the left ventricular wall and thickness. FT have been generally considered to be common normal structural variants with no clinical significance. But, these may be misinterpreted echocardiographically as left ventricular endocardium of the ventricular septum or mural thrornbus, since the echo from the tendon might mimic these structures. Moreover they have been reported to be a cause of functional ejection murmur. Some investigators have suggested that FT rnight be an etiologic factor in the genesis of ventricular arrhythmias in the autopsy and the clinical studies. METHODS: We evaluated the prevalence of the false tendons in consecutive 263 patients for 2 month period in routine echocardiographic method. In cases with FT, we examined their attachment and thickness accurately by tilting and rotating the echo probe, and classified them. In possible 9 cases, 24 hour ambulatory ECG monitoring was performed and evaluated the existence of ventricular arrhythmias. RESULTS: FT were found in routine echocardiographic views in 15 patients(male 11, female 4) out of 263 patients(prevalence 5.7%). The pye of FT were longitudinal type 7 cases(thin 3 cases, thick 4 cases) most commonly, diagonal type 3 cases(thin 2 cases, thick 1 cases), transverse thin type 4 cases and apical thin type 1 case. In 24 hour ambulatory ECG monitoring, ventricular premature contractions were detected in all 9 patients. Interestingly in one patient(case 5) visited with dyspnea and repetitive long period of palpitation, suggestive ILVT(idiopathic left ventricular tachycardia) and FT(longitudinal thick type) were coexisted. CONCLUSION: FT are common normal variants, but may be confused with other normal structures. Clinically in apparently healthy subjects with symptomatic idiopathic ventricular arrhythmias(ventricular premature contractions, ILVT and so on), the echocardiography would be performed carefully for the existence of FT and could be helpful for the evaluation of etiologies.
Arrhythmias, Cardiac ; Autopsy ; Dyspnea ; Echocardiography* ; Electrocardiography ; Endocardium ; Female ; Humans ; Mitral Valve ; Papillary Muscles ; Prevalence ; Research Personnel ; Systolic Murmurs ; Tendons* ; Ventricular Septum

Anisakiasis of the gastrointestinal tract is caused by the ingestion of raw fish or uncooked foods infested with Anisakis larvae belonging to the subfamily Anisakidae. With the increasing popularity of Japanese cuisine such as sashimi in Korea, the incidence of anisakiasis is expected to increase. The entire gastrointestinal tract from the esophagus to the rectum can be involved. Colonic anisakiasis is rare in comparison with gastric involvement. We report the anisakiasis concurrently invading the stomach, ileocecal valve and transverse colon treated by endoscopy with a brief review of the relevant literature.
Anisakiasis* ; Anisakis ; Asian Continental Ancestry Group ; Colon ; Colon, Transverse* ; Eating ; Endoscopy ; Esophagus ; Gastrointestinal Tract ; Humans ; Ileocecal Valve* ; Incidence ; Korea ; Larva ; Rectum ; Stomach*

The authors treated 26 cases of extramedullary tumors around foramen magnum and craniocervical junction by various surgical approaches between 1982 and February 1993. They are 12 meningiomas, 9 neurinomas, 3 chordomas, 1 teratoma and 1 capillary lymphangioma. Among them, 7 cases are located at anterior portion of foramen magnum, 6 cases at anterolateral portion, 2 cases at lateral portion, 7 cases at posterolateral portion, and 4 cases are posteriorly located. These tumors were attacked via various surgical approaches. 19 cases were treated by conventional suboccipital approach, 5 cases by far lateral suboccipital approach and 2 cases of chordoma by transoral approach which was combined with far lateral suboccipital approach. So, 19 cases of tumors were removed completely, but 7 cases were subtotally removed. There was 1 case of operative mortality and in 2 cases of meningioma there was permanent lower cranial nerve palsy. Pyogenic meningitis due to CSF leakage developed in 2 cases of chordoma which were treated by transoral approach.
Capillaries ; Chordoma ; Cranial Nerve Diseases ; Foramen Magnum* ; Lymphangioma ; Meningioma ; Meningitis ; Mortality ; Neurilemmoma ; Teratoma

BACKGROUND: Smoking and high-risk occupation have been known to be the risk factors of lung cancer. The carcinogen-metabolizing enzymes in human body such as glutathione S-transferase M1, T1 and N-acetyltransferase 1 have also been regarded as risk factors in many cancers, because the activities of those enzymes play a role in metabolizing the carcinogen. A case-control study was conducted to evaluate the genetic polymorphism of GSTM1, T1 and NAT1 in lung carcinogenesis in Korean men. METHODS: The histologically proven lung cancer cases were recruited from Seoul National University Hospital. The patients of more than 40-year-old with the nonmalignant urinary tract diseases were recruited as controls from the same hospitals. The informations of demographical characteristics and smoking were obtained by interview or chart review and the genetic polymorphisms of GSTM1, T1 and NAT1 were determined by PCR-based assay. The statistical analyses were performed by linear logistic regression. RESULTS: The number of case-control was 118 and 150, respectively. The smoking history was significantly higher in the lung cancer patients than the controls. The prevalence of GSTM1 null-type was statistically higher(OR=2.25 ; 95% C I=1.12-4.51) in squamous cell carcinoma than other genotypes, but other histologic types were not. The prevalence of GSTT1 null-type were not statistically higher than other genotypes in all histologic types. The fast acetylator of NAT1 was more prevalent than normal(OR-2.13 ; 95% C I=1.04-4.40) in all lung cancer patients. CONCLUSION: The null-type of GSTM1 and fast acetylator of NAT1 are associated with development of lung cancer in Korean men.
Adult ; Carcinogenesis ; Carcinoma, Squamous Cell ; Case-Control Studies ; Genotype ; Glutathione Transferase* ; Glutathione* ; Human Body ; Humans ; Logistic Models ; Lung Neoplasms* ; Lung* ; Male ; Occupations ; Polymorphism, Genetic* ; Prevalence ; Risk Factors ; Seoul ; Smoke ; Smoking ; Urologic Diseases