Osteoradionecrosis of the Anterior Thoracic Wall after Radiation Therapy for Breast Cancer

Although osteoradionecrosis of the thoracic wall is rare, severe complications following radiation therapy for breast cancer can occur. The authors report the case of a 65-year-old woman who developed osteoradionecrosis in the left thoracic wall 17 years after undergoing radiation therapy for breast cancer. Chest CT revealed fractures in the left third and fourth ribs as well as in the sternal body, with severe sclerotic and lytic changes and cortical irregularity. Ultrasonography of the left chest wall revealed diffuse edematous changes in the overlying skin layer. Radiologists should be familiar with the imaging findings of osteoradionecrosis to differentiate osteoradionecrosis from bony metastasis.

Hepatocellular Carcinoma with Vascular Central Scar / 대한소화기학회지

No abstract available.

Ultrasonographic diagnosis of round ligament varicosities mimicking inguinal hernia: report of two cases with literature review

Round ligament varicosities are rare, and the mass mimics an inguinal hernia. Round ligament varicosities should be considered in the differential diagnosis of a groin swelling in a female, especially during pregnancy. The diagnosis of round ligament varicosities can be established on grayscale and color Doppler ultrasonography. We report two cases of round ligament varicosities in a 33-year-old non pregnant woman and a 28-year-old pregnant woman, and these patients were diagnosed using ultrasonography. We also reviewed the literature on round ligament varicosities including the present cases. Ultrasonography is diagnostic and can prevent unnecessary surgical intervention and associated morbidity.

Metastatic lipid-rich mammary carcinoma in a dog / 대한수의학회지

An adult female dog was presented for evaluation of mammary gland masses. Complete blood count and serum chemistry data were within normal limits. Fine-needle aspiration cytology of the mammary masses revealed clusters of malignant epithelial cells with clear cytoplasmic vacuoles. Based on histopathological findings, a diagnosis of lipid-rich mammary carcinoma was made. Approximately 5 weeks after surgical removal, the tumor recurred at the surgery site and metastasis to the tibia was detected. Due to the poor prognosis and deterioration of the condition, the dog was euthanized.

Computed Tomography and Magnetic Resonance Images of Adrenocortical Oncocytoma Cases

We present two cases of adrenocortical oncocytomas that were well-delineated on multi-detector computed tomography and magnetic resonance imaging. The images showed a well-enhanced large mass with multiple stippled calcifications in a 10-yr-old girl who was consulted due to precocious puberty. A well-enhanced solid mass with necrotic components was incidentally noticed in a 54-yr-old man. These lesions were resected and diagnosed as adrenocortical oncocytomas through immunohistochemical studies and electron microscopy. Adrenocortical oncocytomas are rare disease entities, therefore, we report these interesting, rare adrenocortical oncocytomas here with radiologic findings, and discuss differential diagnosis.

A Posterior Petrous Meningioma with Recurrent Vertigo

Meningioma's account for around 15% of all primary brain tumors with some 10% of meningiomas arising in the posterior fossa. In rare cases, a meningioma can form around the endolymphatic sac. When formed in the posterior fossa, meningioma tumors can produce vague, non-specific vertiginous symptoms. Research has observed that a subset of these lesions could produce symptoms indistinguishable from those of Meniere's disease. Therefore, we described the clinical features of a case of posterior petrous meningioma with recurrent vertigo as well as the substantial resolution of symptoms after tumor removal via transmastoid approach.

Cerebellar maturation ratio of forebrain and brainstem at magnetic resonance imaging in the micropig / 대한수의학회지

The study of pigs as a human disease model has been conducted in neuroscience. But the morphological development of pig brain by using MRI is rare. The purpose of this study is to determine whether cerebellum maintains consistent proportion to other brain regions in aging. Clinically healthy sixteen micropigs, 1, 2, 4, and 8 months were studied. The micropigs were anesthetized with isoflorane. MRI was acquired using a 0.3T system. To figure out development of ratio that allowed identification of normal cerebellum size, we measured the area of the cerebellum, brainstem, and forebrain from the mid-sagittal brain images on T1W. Mid-sagittal cross-sectional area (CSA) of total brain, forebrain, brainstem, and cerebellum were expressed as absolute values and also as percentages which were compared between the four age groups of micropigs for the purpose to define the effect of age on brain morphometry. It was found that there was not a significant difference in the percentage of the brain occupied by an individual region between groups although the absolute CSA differed significantly among age groups. There was no effect of age on the ratio between the cerebellum and total brain in 4 age groups. The normal size of cerebellum changes during brain development maintained a consistent ratio to other brain regions in normal micropigs. The ratio of CSA quantified on the mid-sagittal MR images offers a suitable method to detect presence of cerebellar anomalies in micropigs.

A Case of Superficial Giant Basal Cell Carcinoma with Satellite Lesions on Scalp

Giant basal cell carcinoma (BCC), defined as a lesion greater than 5 cm at its largest diameter, is a rare variant of BCC. In contrast to small BCC, giant BCC develops on skin that is not exposed to sunlight, including the back, shoulder, groin and thigh. Most of the histopathologic subtypes of giant BCC are micronodular, morpheaform and nodular, but the superficial subtype is rare. Giant superficial BCC arising on the scalp is extremely rare. We report the case of giant superficial BCC with four satellite lesions on the scalp in a 53-year-old male without predisposing factors.

Syringocystadenoma Papilliferum in Co-existence with Tubular Apocrine Adenoma on the Calf

Syringocystadenoma papilliferum (SCAP) occurs singly or in association with other tumors. Although it is rare, the association of tubular apocrine adenoma (TAA) with SCAP in the background of nevus sebaceous (NS) on the scalp is well documented. However, the co-existence of these two tumors without background of NS has not been reported on the extremities. We report a case of SCAP associated with TAA on the calf without pre-existing NS in an adult.

Real time observation of mouse fetal skeleton using a high resolution X-ray synchrotron

The X-ray synchrotron is quite different from conventional radiation sources. This technique may expand the capabilities of conventional radiology and be applied in novel manners for special cases. To evaluate the usefulness of X-ray synchrotron radiation systems for real time observations, mouse fetal skeleton development was monitored with a high resolution X-ray synchrotron. A non-monochromatized X-ray synchrotron (white beam, 5C1 beamline) was employed to observe the skeleton of mice under anesthesia at embryonic day (E)12, E14, E15, and E18. At the same time, conventional radiography and mammography were used to compare with X-ray synchrotron. After synchrotron radiation, each mouse was sacrificed and stained with Alizarin red S and Alcian blue to observe bony structures. Synchrotron radiation enabled us to view the mouse fetal skeleton beginning at gestation. Synchrotron radiation systems facilitate real time observations of the fetal skeleton with greater accuracy and magnification compared to mammography and conventional radiography. Our results show that X-ray synchrotron systems can be used to observe the fine structures of internal organs at high magnification.

Assessment of experimental saccular aneurysm using selective angiography in common carotid artery of rabbits / 대한해부학회지

In order to study the treatment of aneurysms, the technique of making experimental aneurysms in laboratory animals must be established. In our study, to examine the feasibility of making experimental aneurysm and selective angiography on the common carotid artery in rabbits and to determine the size of experimental aneurysm after surgery, saccular aneurysms were fashioned on the right common carotid artery in 17 rabbits using a vein pouch technique. Selective angiography of the common carotid artery was performed immediately after surgery, and at 1 week, 4 weeks, and 8 weeks after surgery. Also, histological changes in the aneurysms were observed. In 16 rabbits with established successful experimental aneurysm, no differences were found in diet intake and behavior before and after surgery. The patency of the carotid artery was confirmed by selective angiography. The average size of the aneurysm immediately after surgery was similar to that of 1 week postoperatively in selective angiography, however it increased with time at 4weeks and 8 weeks. Histologically, infiltration of inflammatory cells and hemorrhage were found at the junction of the carotid artery and the vein pouch at 1 week, which disappeared at 4 weeks and 8 weeks. This study suggests experimental saccular aneurysm using the vein pouch technique might form aneurysms similar to that of the human in its properties such as increment of size, and selective angiography might be suitable for assessment of experimental aneurysm. Therefore, this animal model may be suitable for investigating new treatment methodologies for human aneurysms.

The Study of pH in Nasal Secretion in Normal and Chronic Rhinosinusitis

BACKGROUND AND OBJECTIVES: Nasal mucosal pH have a direct effect on the alteration of the physio-chemical characteristics of the nasal mucosa. Previous studies have reported the normal mucosal pH to be within the range of 5.3-7.0, mucosal pH with sinusitis to be within 6.8-7.6 and mucosal pH with rhinitis to be within 7.2-8.3. However, no consideration was paid to the conditions that influence the pH and there were no measured pH value by different methods. This study was therefore designed with the latest trend method in pH measurement with the purpose of evaluating pH in nasal secretion and creating an objective parameter for a beneficial manifestation of mucosa. MATERIALS AND METHODS: We measured the pH values from 30 normal control group (group 1), 30 patients with chronic sinusitis (group 2), and 30 patients with allergic rhinitis (group 3). Nasal secretion was obtained through filter paper absorption method and, using a micro pH electrode with pH meter, pH was measured in nasal secretion. RESULTS: pH in nasal secretion in this study was higher than the nasal mucosal pH from previously reported studies. pH values in nasal secretion showed a significant difference between three groups (group 1:7.86, group2:8.06, group 3:8.24) in this study (p<0.01). CONCLUSION: The measurement of pH in nasal secretion seems to be a useful parameter for monitoring and assessing the state of nasal mucosa. And we recommend this study as a method for obtaining an objective parameter for pH measurement in nasal cavity.

An Airway Tube for Minimizing Nasal Obstruction Following Intranasal Packing

BACKGROUND AND OBJECTIVES: Nasal packing after nasal surgery is commonly practiced for various purposes including hemostasis, stabilization of nasal structure, and synechia prevention. However, the use of nasal packing has led to the development of uncomfortable symptoms such as nasal obstruction. In this study, therefore, we have devised a new method of nasal packing involving the use of an airway tube for reducing nasal obstruction and discomforts in association with post-surgical nasal obstruction. Materials and METHODS: An airway tube was made by cutting the distal end of a 1cc syringe. It was inserted between the nasal septum and the packing material. Nasal cavities of 20 patients (Group 1) who underwent nasal surgery were packed using packing materials and the devised airway tubes following nasal surgery. We evaluated the symptoms of nasal obstruction after the postoperative nasal packing in this study group and compared them with those of the 20 patients (Group 2) who received packing with existing merocel nasal stents and 20 patients (Group 3) who were given packing with only merocel without airway tubes after nasal surgery. RESULT: In this study, nasal obstruction and discomforts in association with post-surgical nasal obstruction were significantly improved among patients given packing material and devised airway tubes (Group 1) comparative to other patient groups. CONCLUSION: Devised airway tube is useful in minimizing the symptoms of nasal obstruction and discomforts as well as in reducing surgical expense.

Cerebellar vermian hypoplasia in a Cocker Spaniel

An eight-week-old female Cocker Spaniel was presented with ataxia, dysmetria and intention tremor. At 16 weeks, the clinical signs did not progress. Investigation including imaging studies of the skull and cerebrospinal fluid analysis were performed. The computed tomography revealed a cyst-like dilation at the level of the fourth ventricle associated with vermal defect in the cerebellum. After euthanasia, a cerebellar hypoplasia with vermal defect was identified on necropsy. A polymerase chain reaction amplification of cerebellar tissue revealed the absence of an in utero parvoviral infection. Therefore, the cerebellar hypoplasia in this puppy was consistent with diagnosis of primary cerebellar malformation comparable to Dandy-Walker syndrome in humans.

Clinical Significance of Nasal Secretory Proteins in Chronic Sinonasal Diseases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Many studies report changes in the expressions of nasal secretory proteins which play important roles in the evaluation of sinonasal mucosal status. The biomarkers in nasal secretions provide valuable information on pathophysiological status of the rhinosinusitis. We have monitored the level and ratio of nasal secretion markers, especially secretory IgA (sIgA) and lactoferrin as markers of sinonasal submucosal glands to evaluate mucosal status for chronic sinonasal diseases and allergic rhinitis. SUBJECTS AND METHOD: Samples were obtained with the filter paper absorption method from 20 normal healthy controls (Group I), 20 patients with chronic rhinosinusitis (Group II), 20 patients with allergic rhinitis (Group III), 20 normalized persons of chronic rhinosinusitis patients treated with antibiotics, previously (Group IV). We estimated concentrations of sIgA and lactoferrin determined by enzyme-linked immunosorbent assay method. RESULTS: The concentration of sIgA and lactoferrin in nasal secretion showed a significant difference between the control group and other groups (p<0.05). The sIgA/lactoferrin ratio was more highly significant in the normal group and normalized in chronic rhinosinusitis patients treated with antibiotics (Group IV) than other groups (p<0.05). CONCLUSION: In this study, sIgA and lactoferrin are useful secretion markers and the levels of sIgA, lactoferrin and sIgA/lactoferrin ratios in nasal secretions seem to be very useful parameters for monitoring and assessing the conditions of the sinonasal mucosal diseases.

Erratum: Establishment of a canine spinal cord injury model induced by epidural balloon compression

The 150 microl and 50 micol was reversed in the labeled line of the insert box in above article, on page 92, Fig. 4. The correct figure is printed below. We apologize for any confusion resulting from this error.

Spontaneous Disappearance of Microcalcifications in Breast Papillary Carcinoma: Case Report

Spontaneous disappearance of breast calcification has rarely been reported. The majority of cases of spontaneously resolving calcifications have been concerned with benign processes. We report here on breast papillary carcinoma that showed spontaneously resolving microcalcifications without newly developed parenchymal changes on the follow-up mammogram.

Preoperative Assessment of Mesorectal Fascial Involvement in Patients with Rectal Cancer: The Diagnostic Value of MDCT for Measuring the Mesorectal Fascial Thickness

PURPOSE: To assess the diagnostic value of the use of multi-detector row computed tomography (MDCT) in evaluating mesorectal fascial (MRF) involvement in patients with T3 stage rectal cancer. MATERIALS AND METHODS: From September 2005 to June 2006, we enrolled 21 patients with T3 stage rectal cancer. In addition, 21 healthy patients were enrolled in a control group. Two radiologists measured the mean MRF thickness independently. We considered positive MRF involvement when the MRF thickness exceeded 4 mm, and then we measured the MRF thickness of patients with T3 rectal cancer. We analyzed interobserver agreement for the measured MRF thickness of the control group and assessed the diagnostic value of 4 mm, 5 mm and 6 mm as references in predicting MRF involvement. RESULTS: The mean MRF thickness of the control group was 3.24+/-0.50 mm (radiologist 1) and 3.04+/-0.51 mm (radiologist 2). Using 4 mm, 5 mm and 6 mm as a reference thickness in predicting MRF involvement, sensitivity was 100%, 100% and 28.57%, specificity was 71.43%, 85.71% and 92.86%, the false negative rate (FNR) was 0%, 0% and 71.43%, the false positive rate (FPR) was 28.57%, 14.29% and 7.14%, the negative predictive value (NPV) was 100%, 100% and 72.2%, the positive predictive value (PPV) was 63.64%, 77.78% and 66.7%, and the accuracy was 80.95%, 90.48% and 71.43%. CONCLUSION: Preoperative assessment of the MRF thickness on MDCT is beneficial in predicting MRF involvement in patients with advanced rectal cancer and a value of 5 mm as a reference MRF thickness was established.

Establishment of a canine spinal cord injury model induced by epidural balloon compression

A model that provides reproducible, submaximal yet sufficient spinal cord injury is needed to allow experiments leading to development of therapeutic techniques and prediction of clinical outcome to be conducted. This study describes an experimental model for spinal cord injury that uses three different volumes of balloon inflation and durations of compression to create a controlled gradation outcome in adult dogs. Twenty-seven mongrel dogs were used for this study. A 3-french embolectomy catheter was inserted into the epidural space through a left hemilaminectomy hole at the L4 vertebral arch. Balloons were then inflated with 50, 100, or 150 microliter of a contrast agent at the L1 level for 6, 12, or 24 h and spinal canal occlusion (SCO) measured using computed tomography. Olby score was used to evaluate the extent of spinal cord injury and a histopathologic examination was conducted 1 week after surgery. The SCO of the 50, 100, and 150 microliter inflations was 22-46%, 51-70%, and 75-89%, respectively (p 50% for 24 h, and > 75% for 12 h induces paraplegia up to a week after spinal cord injury.

Guided bone regeneration with beta-tricalcium phosphate and poly Llactide-co-glycolide-co-epsilon-caprolactone membrane in partial defects of canine humerus

This study was performed to evaluate the effect of betatricalcium phosphate and poly L-lactide-co-glycolide-coepsilon- caprolactone (TCP/PLGC) membrane in the repair of partial bone defects in canine proximal humerus. Three adult mixed-breed dogs were used during the experimental period. The length of the defect was quarter of the full length of humerus, and width of the defect was quarter of middle diameter of the lateral aspect of humerus. The humeri of each dog were divided into treatment (TCP/ PLGC) and control groups. The defect was covered with TCP/PLGC membrane in treatment group. To evaluate regeneration of the bone, computerized tomography (CT) and histopathologic examination were performed. The radiopaque lines were appeared at the original defect sites in TCP/PLGC group but below the original site in control at 4th week. Radiopacity and thickness of the defect sites, and radiopaque lines were more increased at 8th week than those of 4th week. Histopathologic findings revealed fibrous connective tissue migration into the defect and the migration inhibited the structure of new cortex to be placed in the original level in control whereas new cortex growth was found in the level of original line in TCP/ PLGC group. However, the new cortical bone in the TCP/ PLGC group was thinner and less organized than the adjacent intact cortex, and the amount of new cancellous bones were also scanty. The result suggested that TCP/ PLGC membrane is a good guided bone regeneration material to restore the original morphology of humerus in partial defect.