Arteriovenous malformation (AVM) is a lesion involving a high-flow vascular malformation, which is one of the causes of massive gastrointestinal bleeding. In the pediatric population, AVM is quite rare in the gastrointestinal tract, and the most common primary site is the colon. A small bowel is a rare primary site of AVM, and only 1 case has been reported in Korea. Here, we report on a case of AVM found in the distal ileum of a 14-year-old girl who complained about recurrent lower abdominal pain only without a gastrointestinal hemorrhage. In the previous research literature, a small bowel AVM can be diagnosed through detecting the existence of an enhancing nidus of the intestinal wall at the arterial phase, accompanied by an early draining vein as it appeared on a dynamic contrast-enhanced abdominal computed tomography. In our case, the pathologically confirmed AVM of the distal ileum showed a dot-like enhancement within the thick low-attenuating submucosal layer of the terminal ileum.

Zinner's syndrome is a rare congenital abnormality of the mesonephric duct. Unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction are the triad of maldevelopment of the mesonephric duct which comprises Zinner's syndrome. It is an extremely rare case, in that approximately 100 cases only have been reported worldwide. We discovered a rare developmental anomaly with other mesonephric duct-associated abnormalities, Zinner's syndrome with a presumed ectopic prostate and triorchidism and do report here.

Solid pseudopapillary tumor (SPT) is a low grade malignant tumor in the pancreas, and extrapancreatic SPT is extremely rare. We report a case of a 61-year-old woman who complained abdominal pain with diffuse tenderness. She was diagnosed with extrapancreatic SPT with extensive peritoneal dissemination and hepatic metastases. Although a few cases have reported imaging findings of extrapancreatic SPT, there have been no reports of extrapancreatic SPT with aggressive tumor behavior and dismal prognosis. Although imaging features closely resembled those of classical pancreatic SPTs, malignant transformation of extrapancreatic SPT should be considered when focal discontinuity of the tumor capsule with ill-defined margin and invasion of adjacent structures were identified.
Abdominal Pain ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Prognosis ; Ultrasonography

BACKGROUND: There has been increasing interest in facial contouring procedures throughout Asian countries. As such, botulinum toxin A injections for masseteric hypertrophy have become a common procedure provided to patients who desire non-surgical correction of a square-angled mandible. We published a retrospective review of our initial results and our technique and treatment protocol in 2005. We also completed a long-term follow-up of the results (average follow-up period of 4.28 years) and the efficacy of repeated injections in 2010. The purpose of the current study is to systematically evaluate the changes to the masseter muscle at weekly intervals to determine the physiologic effects of botulinum toxin A injection. METHODS: Eight patients were prospectively followed on a weekly basis after botulinum toxin A injection for masseteric hypertrophy. Eight patients were followed for 15 weeks and four patients were followed for 25 weeks. Changes in the thickness of the muscle were recorded and analyzed. RESULTS: A reduction in the muscle thickness was found during the clenching phase of the muscle in the first week followed by a reduction in thickness during the resting phase in the second week. The reduction in muscle thickness continued until the eleventh week after which there was a gradual, but incomplete, return of muscle thickness over the study period. CONCLUSIONS: There is a predictable, phasic reduction in muscle thickness after botulinum toxin A injection for masseteric hypertrophy. This reduction first occurs during the clenching phase followed by a concomitant reduction during the resting phase. Maximal size reduction occurs at 11 weeks followed by gradual muscle size recovery.
Asian Continental Ancestry Group ; Botulinum Toxins* ; Botulinum Toxins, Type A* ; Clinical Protocols ; Follow-Up Studies ; G0 Phase ; Humans ; Hypertrophy* ; Mandible ; Masseter Muscle* ; Nerve Block ; Prospective Studies ; Retrospective Studies

BACKGROUND: Combining blepharoptosis correction with double eyelid blepharoplasty is common in East Asian countries where larger eyes are viewed as attractive. This trend has made understanding the relationship between brow position and height of the palpebral fissure all the more important in understanding post-operative results. In this study, authors attempt to quantify this relationship in order to assess whether the expected postoperative brow descent should be taken into consideration when determining the amount of ptosis to correct. METHODS: Photographs of ten healthy female study participants were taken with brow at rest, with light elevation and with forceful elevation. These photographs were then viewed at 2 x magnification on a computer monitor and caliper was used to measure the amount of pull on the eyebrow in relation to the actual increase in vertical fissure of the eye. RESULTS: There was a positive, linear correlation between amount of eyebrow elevation and height of the palpebral fissure, which was statistically significant. Brow elevation increased vertical fissure, and thereby aperture of the eye, by 18%. CONCLUSIONS: Although the eye-opening strength as well as height of the palpebral fissure is improved with ptosis repair, the true effectiveness of ptosis surgery is diminished by the associated descent of the brow from relief of the involuntary frontalis muscle action and this should be taken into account prior to surgical intervention. Regardless, the combination of frontalis muscle relaxation and the increased eye-opening strength from ptosis repair gives the eye and the periorbital region a more natural look.
Asian Continental Ancestry Group ; Blepharoplasty ; Blepharoptosis* ; Eyebrows* ; Eyelids ; Female ; Humans ; Muscle Relaxation ; Muscles

Anteromedial force to the knee in an extended position can cause an avulsion fracture of the proximal fibula with combined injuries to the posterolateral ligaments. Avulsion fractures of the proximal fibula are rare and current management of these fractures is based on few descriptions in literature. Various surgical methods of fixation for these fractures have been reported, but there is still no standard treatment modality. Anatomic reduction of these fractures is technically difficult, and failure of reduction may cause posterolateral instability, secondary arthritis and other complications. We present our experience with two such cases of comminuted avulsion fractures of the proximal fibular with posterolateral ligament ruptures surgically fixated with a locking compression hook plate and non absorbable sutures.
Arthritis ; Collateral Ligaments ; Fibula ; Knee ; Ligaments ; Rupture ; Sutures

PURPOSE: To retrospectively evaluate the effect of post-prostate-biopsy hemorrhage on the interpretation of magnetic resonance diffusion-weighted (MRDW) and magnetic resonance spectroscopic (MRS) imaging in the detection of prostate cancer. We also investigated the optimal timing for magnetic resonance examination after prostate biopsy. MATERIALS AND METHODS: We reviewed the records of 135 men. All patients underwent prostate magnetic resonance imaging (MRI). The prostate was divided into eight regions according to the biopsy site. Subsequently, we measured hemorrhage on apparent diffusion coefficient (ADC) values and (choline+creatinine)/citrate ([Cho+Cr]/Cit) ratios in the same regions on the MRI. We investigated the effect of hemorrhage at ADC values and (Cho+Cr)/Cit ratios on MRI and the relationship between prostate biopsy results and MRI findings. RESULTS: The mean patient age was 68.7 years and the mean time between biopsy and MRI was 23.5 days. The total hemorrhagic score demonstrated no significant associations with intervals from biopsy to MRI. Higher hemorrhagic scores were associated with higher ADC values, prostate cancer, and noncancer groups, respectively (p<0.001). ADC values were lower in tumors than in normal tissue (p<0.001), and ADC values were inversely correlated with tumor Gleason score in biopsy cores (p<0.001). However, (Cho+Cr)/Cit ratios did not exhibit any association with prostate biopsy results and hemorrhage. CONCLUSIONS: Hemorrhage had no significant associations with the interval from biopsy to MRI. ADC values may help to detect prostate cancer and predict the aggressiveness of cancer; however, it is important to consider the bias effect of hemorrhage on the interpretation of MRDW imaging given that hemorrhage affects ADC values.
Bias (Epidemiology) ; Biopsy ; Diffusion ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Male ; Neoplasm Grading ; Prostate ; Prostatic Neoplasms ; Retrospective Studies

Intussusception is a common surgical disorder in infancy. Intussusception in preterm infant is very rare and about 40 cases have been reported. Furthermore, double intussusception is extremely rare in children and there seems to be no such a case reported in preterm infant. We report a case of idiopathic double intussusception in the preterm infant, who was born at 25 weeks' gestation, underwent an explolaparotomy for bowel perforation on 39 days of life, and during the operation, an ileo-ileo-colic intussusception was found without a leading point.
Child ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intussusception ; Pregnancy

PURPOSE: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. MATERIALS AND METHODS: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. RESULTS: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. CONCLUSION: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.
Arthritis ; Clavicle ; Debridement ; Edema ; Follow-Up Studies ; Humans ; Osteomyelitis ; Recurrence ; Retention (Psychology) ; Sternoclavicular Joint ; Sternum

Solitary necrotic nodule (SNN) of the liver is a very uncommon benign lesion, and it is detected incidentally as a rule. It is important to differentiate SNN radiologically from various single hepatic nodules because SNN mimics hepatic metastasis, especially in staging work up of known primary malignancy. The reported imaging findings of SNN are well-defined nodule without enhancement or with subtle peripheral enhancement. There has been no report about the target-like SNN of the liver and about the imaging finding of 3T magnetic resonance imaging and positron emission tomography. We report a case of targetlike SNN of the liver, mimicking hepatic metastasis, with findings of various imaging modalities and try to find a cause of this nodule according to the pathologic and literature review.
Humans ; Liver ; Liver Neoplasms ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Positron-Emission Tomography