• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.98-102
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• 2004

The terrible triad of the shoulder, a combination of anterior shoulder dislocation, massive rotator cuff tear and neurologic injury, is rare. We experienced 4 patients with this condition who were treated with a rotator cuff repair. The mean age was 65 years. Follow-up averaged 27 months. All patients had a history of redislocation after initial traumatic shoulder dislocation and were evaluated with electromyography and magnetic resonance imaging. At the operation, massive rotator cuff tear and hypertrophy of the long head of the biceps were found in all patients. Clinically, 3 patients achieved recovery of their nerve injury by 3 months postoperatively and the final results were fair. In one patient, there was no recovery of deltoid function and this case was rated as a failure. For this injury pattern, the prognosis appears to be dependent on eventual nerve recovery when the rotator cuff has been repaired early.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.92-99
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• 2007

The posterior reversible encephalopathy syndrome(PRES) is characterized clinically by a combination of acute or subacute confusion, lethargy, visual disturbance, and seizures. PRES has been described in various clinical settings, including severe hypertension, chemotherapy, eclampsia, and seizure. We report a case of a 7-year-old girl who had taken cyclosporine for steroid resistant nephrotic syndrome. Twenty one days after the cyclosporine therapy, she was admitted due to generalized tonic clonic seizure and headache. Her blood pressure was 170/90 mmHg. Magnetic resonance(MR) imaging showed necrotic/cystic lesions involving the bilateral parieto-occipital region. After discontinuation of cyclosporine, and control of blood pressure, she had no more seizure and headache. The follow-up MR examination which was performed 6 months later showed the decreased extent of the lesion.

• Archives of Plastic Surgery
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• v.40 no.6
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• pp.687-696
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• 2013

Background Ischemic preconditioning has been shown to improve the outcomes of hypoxic tolerance of the heart, brain, lung, liver, jejunum, skin, and muscle tissues. However, to date, no report of ischemic preconditioning on vascularized bone grafts has been published. Methods Sixteen rabbits were divided into four groups with ischemic times of 2, 6, 14, and 18 hours. Half of the rabbits in each group underwent ischemic preconditioning. The osteomyocutaneous flaps consisted of the tibia bone, from which the overlying muscle and skin were raised. The technique of ischemic preconditioning involved applying a vascular clamp to the pedicle for 3 cycles of 10 minutes each. The rabbits then underwent serial plain radiography and computed tomography imaging on the first, second, fourth, and sixth postoperative weeks. Following this, all of the rabbits were sacrificed and histological examinations were performed. Results The results showed that for clinical analysis of the skin flaps and bone grafts, the preconditioned groups showed better survivability. In the plain radiographs, except for two non-preconditioned rabbits with intraoperative ischemic times of 6 hours, all began to show early callus formation at the fourth week. The computed tomography findings showed more callus formation in the preconditioned groups for all of the ischemic times except for the 18- hour group. The histological findings correlated with the radiological findings. There was no statistical significance in the difference between the two groups. Conclusions In conclusion, ischemic preconditioning improved the survivability of skin flaps and increased callus formation during the healing process of vascularized bone grafts.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.193-197
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• 2008

Recent studies suggest that sphincter of Oddi dysfunction (SOD) is one of the possible causes of unexplained recurrent acute pancreatitis in children. A 14-year-old boy who had suffered from idiopathic recurrent acute pancreatitis was diagnosed with SOD. Abdominal ultrasonography, computerized tomography, and magnetic resonance cholangiopancreatography revealed no evidence of stone, tumor, or pancreatic ductal anomaly. Endoscopic retrograde cholangiopancreatography (ERCP) and sphincter of Oddi manometry (SOM) revealed elevated basal pressure and tachyoddia consistent with SOD. Hence, an endoscopic pancreatic sphincterotomy was performed. We report a case of recurrent acute pancreatitis associated with SOD in a child. ERCP and SOM may be considered in patients with multiple unexplained attacks of pancreatic pain and negative abdominal imaging.

• Journal of Veterinary Clinics
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• v.29 no.3
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• pp.250-254
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• 2012

An eight-year-old, castrated male, a Schnauzer dog was presented with dysuria, hematuria and intermittent vomiting. Retrograde positive contrast urethrography was performed under fluoroscope. On the contrast examination, the leakage was observed in the prostatic urethra region and irregular filling defect was also shown from the prostatic urethra and the level of the trigon of the bladder. Surgical treatment was selected because of partial urethral obstruction and dysuria. The metastasis at the time of surgery was suspected, and the owner decided euthanasia. We detected lymph metastasis with immunohistochemical staining for pan-cytokeratins (CK) AE1/AE3, confirming their epithelial origin. This report described typical clinical findings, diagnostic imaging and histopathological examination of a prostatic adenocarcinoma.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.289-293
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• 2015

A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.540-544
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• 2007

The patient is a 62-year-old man with known diabetes mellitus who presented with a two-weeks-history of dyspnea, cough, and fever. He was diagnosed with a lung abscess in the right upper lobe and was treated with intravenous antibiotics. The patient's clinical and radiological findings improved within seven days after medical treatment. However, newly developed ground-glass opacity and infiltrations were observed in the right lower lung. Fourteen days after admission, the patient's symptoms and imaging finding became aggravated despite trestment with susceptible antibiotics for lung abscess. Trans-bronchial lung biopsy (TBLB) was performed in the lateral basal segment of the right lower lobe of the lung. A histologic photomicrograph showed organizing pneumonia, also called bronchiolitis obliterans with organizing pneumonia(BOOP), that became more definite as the terminal bronchioles and alveoli became occluded with masses of inflammatory cells and fibrotic tissue. The clinical symptoms and radiograph findings resolved quickly with prednisone treatment. We report a case of secondary organizing pneumonia diagnosed after TBLB following lung abscess treatment and provide a review of the literature.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.105-109
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• 2005

This journal reports three cases diagnosed with schwannomatosis in which no clinical symptoms of type 2 neurofibromatosis. The chief complain was pain. In adolescence and adult group, all masses were found. The locations were brachial plexus, popliteal fossa and hand. No hearing impairment, vertigo, tinnitus and visual disturbance was observed in any of the case. Family history was negative. In all cases, there was no evidence of vestibular schwannoma on cranial MRI imaging study. In all cases, Tinel sign was positive. Pathologic diagnosis was positive for schwannoma. Further study and case collection is needed to idenity the clinical manifestation, clinical course and genetic characteristic of schwannomatosis.

• Archives of Craniofacial Surgery
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• v.16 no.2
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• pp.67-72
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• 2015

Background: A schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. In this study, we retrospectively review orbital schwannomas and characterize clinical, radiologic, and histologic features of this rare entity. Methods: A retrospective review was performed to identify patients with histologically confirmed orbital schwannoma, among a list of 437 patients who had visited our hospital with soft tissue masses within the orbit as the primary presentation between 2010 and 2014. Patient charts and medical records were reviewed for demographic information, relevant medical and family history, physical examination findings relating to ocular and extraocular sensorimotor function, operative details, postoperative complications, pathologic report, and recurrence. Results: Five patients (5/437, 1.1%) were identified as having histologically confirmed orbital schwannoma and underwent complete excision. Both computed tomography (CT) and magnetic resonance imaging (MRI) studies were not consistent in predicting histologic diagnosis. There were no complications, and none of the patients experienced significant scar formation. In two cases, patients exhibited a mild postoperative numbness of the forehead, but the patients demonstrated full recovery of sensation within 3 months after the operation. None of the five patients have experienced recurrence. Conclusion: Orbital schwannomas are relatively rare tumors. Preoperative diagnosis is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumors by CT or MRI and prompt management is warranted to prevent the development of severe complications. Therefore, orbital schwannomas should be considered in the differential diagnosis of slow-growing orbital masses.

• Journal of Yeungnam Medical Science
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• v.31 no.1
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• pp.13-16
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• 2014

Congenital abnormalities of the coronary arteries are found in 0.6% to 1.3% of patients in coronary angiography. Dual left anterior descending coronary artery (LAD) is a rare coronary anomaly and is incidentally detected during coronary angiography. We report a case of a 65-year-old female with a rare coronary anomaly who was diagnosed with dual LAD via coronary computed tomography and coronary angiography. The imaging studies revealed dual LAD originating from the left main stem and right coronary sinus. These angiographic findings were considered to be consistent with the type IV variety of dual LAD by Spindola-Franco classification. Recognition of dual LAD is important to prevent errors of interpretation of the coronary angiogram and for optimal surgery.