There was decreasment of the domestic animal rabies, but increasment of the sylvatic animal rabies now a days in the world. We could see stable statistics of the ministry of health and social affairs annuala report, however, only rabies we could occationally find out suggestive human rabies by domestic animal for the slight more incidence in Korea. Now, we report on the three cases of sugg. Rabies in our children and review of literature. We think the improvement should be needed for postmortem examination that isn't taking by the Korean custom.
Animals ; Animals, Domestic ; Autopsy ; Child ; Humans ; Incidence ; Korea ; Rabies*

We have reported on a case of craniopharyngioma of 11 year old korean who had diabetes insipidus and the other typical symptoms. X-ray finding. Hormonal therapeutic study and review of literature for a case were made friefly.
Child ; Craniopharyngioma* ; Diabetes Insipidus ; Humans

We reviewed MR angiograms to evaluate its efficacy for visualizing the renal arteries and detecting renovascular disease. 41 renal arteries in 19 patients were examined by MR angiography. 3-D time-of-flight technique was used as routine examination method for MR angiography and 2-D time-of-flight technique was added in some particular cases to visualize venous flow. Within two weeks after MR angiography was performed, 23 renal arteries in 10 patients were additionally examined by conventional angiography or intraarterial DSA. The success rates of vessel visualization on MR angiography in normal renal arteries were 100% in main 67.7% in segmental, and 11.8% in intrarenal arteries. As a result of comparative study in normal main renal arteries with MR angiograms and conventional angiograms, overall correspondence in the number and the shape was noted and the caliber discrepancy between two examination did not exceed 3.0 mm. one arteriovenous fistula with aneurysm, one stenotic artery and two occluded arteries were well evaluated One arteriovenous fistula with aneurysm, and two occluded arteries were well evaluated by MR angiography. However three stenotic lesions were misdiagnosed as occlusions on MR angiography. and the overall accuracy was 87%. We conclude that MR angiography has the potential to be a noninvasive and useful screening method for determining the number of renal arteries and for detection of abnormalities of main renal arteries.
Aneurysm ; Angiography* ; Arteries ; Arteriovenous Fistula ; Humans ; Mass Screening ; Methods ; Renal Artery*

We have reported on a case of hemophilia B (Christmas disease) of 6 month old Korean who was have admitted to our hospital in duration of 7 days on Aug. 1974. Clinical study review of literature for a case were made briefly.
Hemophilia B ; Humans ; Infant

PURPOSE:We report the results of image-guided percutaneous biopsies with a biopsy gun and evaluate the clinical usefullness. MATERIALS AND METHODS: One hundred and five biopsies under ultrasonographic or fiuoroscopic guidance were performed. Various anatomic sites were targeted (liver;50, chest;22, kidney;12, pancreas;8, intraperitoneum;7, retroperitoneum; ). RESULTS:Obtained tissue was diagnostic in 98 of the 105 biopsies(93%). In each instance, representative core tissue specimens were obtained. Evaluation of the core tissue by pathologist revealed consistent, uniform specimens that contained significant crush artifact in no case. Five biopsies yielded inadeguate tissues which were too small for histopathologic interpretation or were composed of necrotic debris. Two biopsies yielded adequate tissues, but tissues were not of the target. The diagnoses were malignancy in 77 biopsies and benign disease in 21 biopsies. No complications other than mild, localized discomfort were encountered except a transient hemoptysis and pneumothorax which was observed in two patients. CONCLUSION:Cutting biopsy with a biopsy gun provided sufficient amount of target tissue for an accurate diagnosis of malignant and benign disease. It was a safe and useful procedure for percutaneous biopsy.
Artifacts ; Biopsy* ; Diagnosis ; Hemoptysis ; Humans ; Pneumothorax

BACKGROUND: Intrahepatic stones are common in East Asia and pose serious complications such as biliary stricture, liver atrophy, liver abscess, sepsis and sometimes cholangiocarcinoma. The management of primary intrahepatic stones is difficult and it is also difficult to remove all stones during operation. METHODS: Eighty seven patients with hepatolithiasis were admitted to the department of surgery, Keimyung University Dongsan Medical Center during 4 year period between 1994 and 1997. We reviewed medical records retrospectively for these patients. RESULTS: The peak incidence of age was 50's and the male to female ratio was 1:1.2. Intrahepatic stones were located in the left lobe in 62.1%, right lobe 17.2% and both lobe 20.7%. Stones were found only within the liver (I type) in 34.5% and both inside and outside the liver (IE type) in 65.5%. Analysis of the composition of intrahepatic stones revealed calcium bilirubinate as the most common compound (over 75%) and E. coli was the most common organism in bile culture. We classified intrahepatic stones as four types. Type I (45.9%) is cases with liver atrophy on abdominal CT, type II (20.6%) is cases without liver atrophy as IE type, type III (16.0%) is cases with dilatation of extrahepatic bile duct as I type, and type IV (17.2%) is cases without liver atrophy nor extrahepatic bile duct dilatation. Of the 72 operated patients, liver resection was done in 43 (59.7%) and 9 patients (20.0%) had residual stones. Cholangiocarcinoma was found in 3 (7.0%) of the total 43 patients who underwent liver resection. CONCLUSION: Hepatic resection should be performed in selected patients with intrahepatic stones because of lowest presence of residual stones and no difference of postoprative complications compared with drainage procedure.
Atrophy ; Bile ; Bile Ducts, Extrahepatic ; Bilirubin ; Cholangiocarcinoma ; Constriction, Pathologic ; Dilatation ; Drainage ; Far East ; Female ; Humans ; Incidence ; Liver ; Liver Abscess ; Male ; Medical Records ; Retrospective Studies ; Sepsis ; Tomography, X-Ray Computed

OBJECTIVE: We evaluated postoperative outcomes in patients who have lumbar foraminal or extraforaminal disc herniation (FELDH) and suggested the risk factors for poor outcomes. METHODS: A total of 234 patients were selected for this study. Pre- and post-operative Visual Analogue Scale (VAS) and Korean version Oswestry Disability Index (KODI) were evaluated and the changes of both score were calculated. Outcome was defined as excellent, good, fair, and poor based on Mcnab classification. The percentage of superior facetectomy was calculated by using the Maro-view 5.4 Picture Archiving Communication System (PACS). RESULTS: Paramedian lumbar discectomy was performed in 180 patients and combined lumbar discectomy was performed in 54 patients. Paramedian lumbar discectomy group showed better outcome compared with combined discectomy group. p value of VAS change was 0.009 and KODI was 0.013. The average percentage of superior facetectomy was 33% (range, 0-79%) and it showed negative correlation with VAS and KODI changes (Pearson coefficient : -0.446 and -0.498, respectively). Excellent or good outcome cases (Group I) were 136 (58.1%) and fair or poor outcome cases (Group II) were 98 (41.9%). The percentage of superior facetectomy was 26.5% at Group I and 42.5% at Group II. There was significant difference in superior facetectomy percentage between Group I and II (p=0.000). CONCLUSION: This study demonstrated that paramedian lumbar discectomy with preservation of facet joints is an effective and good procedure for FELDH. At least 60% of facet should be preserved for excellent or good outcomes.
Classification ; Diskectomy ; Humans ; Risk Factors* ; Zygapophyseal Joint

OBJECTIVE: We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. METHODS: We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. RESULTS: PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were 3.6+/-2.9 and 5.4+/-6.4 in the unresected PARS group, 5.8+/-2.1 and 11.3+/-7.1 in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. CONCLUSION: The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.
Arthrodesis ; Body Mass Index ; Humans ; Neurologic Manifestations ; Spine

Medullary cystic disease (MCD) and familial juvenile nephronophthisis are inherited diseases characterized by development of small cysts at the cortico- medullary borders of the kidneys. Both diseases consist of microscopic or gross cysts of the renal medullae associated with atrophy of nephrons, anemia, renal insufficiency, polyuria, and salt-wasting. We report a 27-year-old pregnant female patient with MCD which caused acute renal failure progressing to end stage renal disease during the second trimester. Hypertension, oliguria, preeclampsia, placenta abruptio, and disseminated intravascular coagulation were also accompanied. Radiologically, abdominal ultrasonography and computed tomogram showed many cysts confined only to the renal medullae, which are typical findings consistent with MCD. In spite of conservative therapy, her renal function deteriorated rapidly and uremic symptoms including pulmonary edema were aggravated. She was started on hemodialysis and she has received regular hemodialysis without recovery of renal function.
Acute Kidney Injury ; Adult ; Anemia ; Atrophy ; Disseminated Intravascular Coagulation ; Female ; Humans ; Hypertension ; Kidney ; Kidney Failure, Chronic* ; Nephrons ; Oliguria ; Placenta ; Polyuria ; Pre-Eclampsia ; Pregnancy Trimester, Second ; Pregnancy* ; Pulmonary Edema ; Renal Dialysis ; Renal Insufficiency ; Ultrasonography

For a 67-year-old man with diabetes mellitus, a 9-cm liver mass was found on CT during the diagnostic work-up for weight loss and fever. Dynamic CT and MRI showed a layered pattern of contrast enhancement suggesting the imaging features of the solid inflammatory mass. After tissue diagnosis of immunoglobulin G4 (IgG4)-related disease by gun needle biopsy, steroid therapy induced partial shrinkage of the mass on the follow-up CT at 4 weeks. On the 5-month follow-up CT with the maintenance of low-dose oral steroid medication, disease progression with invasion to diaphragm brought surgical intervention of right hemihepatectomy considering the possibility of combined malignancy. In the area of diaphragmatic destruction, focal actinomycosis was complicated in the main mass of IgG4-related disease. We are the first to describe a rare case of IgG4-related inflammatory pseudotumor, complicated by actinomycosis, showing an invasive nature that mimicked malignancy during steroid therapy in a diabetic patient.