Two cases of carotico-cavernous fistula, which experienced at Dept. of Neurosurgery of Busan National University Hospital, are presented with a brief review of the literature. Because it is the very interesting disease. These were of spontaneous onset. One was 39 year-old woman who was treated with the ligations of internal and common carotid artery in the neck, another was 17 year-old boy treated with the ligations of internal and common carotid artery followed by intraluminal mascular embolization. This surgical management was successful and there was neither recurrence nor other neurologic deficit.
Adolescent ; Adult ; Busan ; Carotid Artery, Common ; Female ; Fistula* ; Humans ; Ligation ; Male ; Neck ; Neurologic Manifestations ; Neurosurgery ; Recurrence

The cystometry had been performed in 28 cases of H.L.D. and 1 case of unstable lumbar spine due to spondylolysis from January 1974 to September. Among them, 24 cases were checked cystometry again after one week of postoperative period. We obtained the results as follows: 1. Preoperative cystometrograms were revealed that 21 cases were bladder hypofunction,3 cases were bladder irritability, and 5 cases were normal. 2. The postoperative cystometrograms were revealed that were improved in 3 cases, unchanged in 19 cases, and worsened in 2 cases. 3. It is likely that the bladder hypofunction is related to the severity of radiating pain rather than the severity of myelographic findings, the direction and the level of disc herniation.
Postoperative Period ; Spine ; Spondylolysis ; Urinary Bladder*

The concept of using radiographic measurements in the diagnosis of intraspinal lesions is not new. There have been many studies for the measurements of the spinal canal and normal ranges of variation in normal human and patient with spondylosis or developments stenosis. The author measured the cervical spinal canal in 89 normal Korean adults plain X-rays(male;62 cases, female;27 cases) in order to establish a range of normal value in X-ray diagnosis. The sagittal diameters of the cervical spinal canal were measured from the middle of the posterior surface of the vertebral body to the "nearest point" on the cortical line at the point of fusion of the corresponding laminae. The transverse diameters of the cervical spinal canal were measured the interpediculate distance which represents the greatest diameter of the cervical neural canal from C3 to C7. According to the normal ranges of the sagittal and transverse diameters of the cervical spinal canal, It was concluded: 1. The sagittal diameter is progressively narrowed from C1 to C4(Mean+/-SD=C1; 21.83+/-2.43, C2; 19.30+/-2.39, C3; 17.14+/-2.65, C4; 16.41+/-2.47) thereafter it is progressively widened from C5 to C7(C5; 16.79+/-2.72, C6; 17.39+/-2.74, C7; 17.68+/-2.81). 2. The transverse diameter is progressively widened from C3 to C6(Mean+/-SD= C3; 27.10+/-2.23, C4; 28.05+/-2.30, C5; 28.95+/-2.36, C6; 29.12+/-2.25) thereafter it is narrowed in C7(C7; 27.81+/-2.28). 3. Generally, the length of the male are more longer than that of female both in sagittal and transverse diameter in cervical spinal canal(average;1.29 mm). 4. Ranges of normal values both in sagittal and transverse diameters in whole length of the cervical spinal canal were established(Fig. 5. Table 4, and 5).
Adult* ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Male ; Neural Tube ; Reference Values ; Spinal Canal* ; Spondylosis

PURPOSE: Although influenza is regarded as one of the major causes of morbidity and mortality in children with cancer, the actual vaccine coverage remains poor. We conducted evaluation of immunogenicity and safety of influenza vaccine in children with cancer. METHODS: In this study, 25 children with cancer who received influenza vaccine (SK influenza IX vaccine(R)) at the Korea Cancer Center Hospital between October and December 2009 were analyzed. Blood samples of patients were collected twice (at the beginning of this study and at 30th day after vaccination) and their antibody titers were measured using the hemagglutination-inhibition (HI) assay. Immunogenicity of the influenza vaccine was assessed by seroprotection rate on days 0 and 30, seroconversion rate on day 30, and mean fold increase (MFI) of geometric mean titer (GMT) of HI between days 0 and 30. RESULTS: Any of the subjects in our study did not experienced serious adverse events after influenza vaccination. Seroprotection rates were 68% for H1N1, 40% for H3N2, and 36% for B. Seroconversion rates were 12% for H1N1, 16% for H3N2, and 20% for B. MFIs were 0.9 for H1N1, 1.2 for H3N2, and 1.8 for B. CONCLUSION: In the study, we found a limited protective immune response to influenza vaccine, among subjects with cancer. However, some subjects showed seroconversion, and there were no severe adverse events among all subjects, supporting the recommendation of annual influenza vaccination in children with cancer.
Child ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Vaccination

We were recently encountered a cases of newborn infant with a congenital lumbar mass with associated anomalies which proved to be quite bizarre. This case if presented with review of the literatures because we were seldom able to find a cases of myelomeningocele as usual, interesting as this. A 15 day-old infant, the product of full term, was admitted to Busan National University Hospital on May 26th, 1972, because of a large pedunculated lumbar mass without any neurologic deficits. The tumor mass was translucent, flabby, infected and increased in tension when the infant cried. Chest film showed the underdeveloped with agenesis and fork rib in right upper 5 ribs and narrowed intercostal spaces between right 5,6,7 and 8th ribs. Right scapula was higher in position of axis. Total spine films showed non-fusion pattern of 3rd and 4rh thoracic vertebral bodies with cleft vertebrae, scoliosis in upper thoracic region, widening of lumbar canal, a large soft tissue mass overlying the abdominal region and hypoplasia of the spinous process at 4th lumbar vertebra. The sac of myelomeningocele was repaired successfully. He has regularly been followed up in the out-patient after discharge and has remained well. Repeated neurologic examination performed after discharge showed no neurologic deficits. We feel our present case will be of added interest.
Axis, Cervical Vertebra ; Busan ; Humans ; Infant ; Infant, Newborn ; Meningomyelocele* ; Neurologic Examination ; Neurologic Manifestations ; Outpatients ; Ribs ; Scapula ; Scoliosis ; Spine ; Thorax

Mediastinal fibrosis is pathologically characterized by chronic inflammation and fibrosis of mediastinal soft tissue. Mediastinal fibrosis is local expression of a family of systemic fibrosing syndroms. This can result in compression of adjacent mediastinal structures. Idiopathic fibrosing syndromes include retroperitoneal fibrosis, sclerosing cholangitis of the orbit and fibrosis of the thyroid gland(Riedel's struma). The cause of these disorders is obscure, in some instance there is an underlying malignancy, infection, history of drug ingestion, or trauma with retoperitoneal bleeding. Treatment of mediastinal fibrosis depends on structures involved by the fibrotic process. The disease is self limited in most case or improved by steroids uses. We experienced a case of idopathic solerosing mediastinitis with orbital fibrous dysplasia of unknown cause, which was confirmed by open lung biopsy, so reported it with a review of literature.
Biopsy ; Cholangitis, Sclerosing ; Eating ; Fibrosis* ; Hemorrhage ; Humans ; Inflammation ; Lung ; Mediastinitis ; Orbit ; Retroperitoneal Fibrosis ; Steroids ; Thyroid Gland

Neovesical-urethral anastomotic stricture is a complication of orthotopic neobladder, with a reported incidence of 2.7% to 8.8%. Strictures of the neovesico-urethral anastomotic site can be treated with regular self-dilation, but high-grade strictures require a surgical procedure involving incision by electrocautery or cold knife. Here we describe a grade III neovesical-urethral anastomotic stricture after an orthotopic bladder substitution that was successfully treated by use of a ureteral dilation balloon catheter.
Catheters ; Cold Temperature ; Constriction, Pathologic ; Electrocoagulation ; Incidence ; Ureter ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder Neoplasms ; Urinary Diversion

STUDY DESIGN: Retrospective evaluation. PURPOSE: To analyze the effect of T1 slope on degree of degeneration in patients with cervical disc degeneration. OVERVIEW OF LITERATURE: The T1 slope is well known parameter that may be very useful in evaluating sagittal balance. There are no reports on the analysis of the relationship between T1 slope and cervical disc degeneration. We hypothesized that T1 slope has an effect on the degree of cervical degeneration. METHODS: Sixty patients who had cervical spine magnetic resonance imaging (MRI) in our orthopedic clinic were enrolled. Patients were divided into two groups according to T1 slope. Radiologic parameters obtained from radiography and cervical spine MRI were compared between low T1 slope group (< or =25) and high T1 slope group (>25). RESULTS: Among low T1 slope group, average degeneration grade of each cervical segment was 2.65 in C2-3, 2.50 in C3-4, 2.62 in C4-5, 3.23 in C5-6, and 2.81 in C6-7. And that of high T1 group was 2.35 in C2-3, 2.32 in C3-4, 2.59 in C4-5, 2.79 in C5-6, and 2.32 in C6-7. Grade of degeneration of low T1 group was significantly higher, as compared with high T1 group in C5-6 (p=0.028) and C6-7 (p=0.009). Percentage of high grade degeneration of more than grand III was 65.4% in low T1 group and 32.4% in high T1 group (p=0.018). Risk of high grade degeneration of C6-7 was significantly higher in low T1 group (odds ratio, 5.63; 95% confidence interval, 1.665-19.057; p=0.005). CONCLUSIONS: Patients with low T1 slope had higher grade of degeneration regardless of age and gender. Low T1 slope is a potential risk factor of cervical spondylosis especially in the C6-7 cervical segment.
Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging ; Orthopedics ; Radiography ; Retrospective Studies ; Risk Factors ; Spine ; Spondylosis

BACKGROUND: Differentiation of viral hepatitis from acute cellular rejection (ACR) after liver transplantation can be difficult because of overlapping histological features. Here we investigated clinicopathologic characteristics of 311 liver allograft biopsies and searched for characteristic histopathological features that would facilitate the differential diagnosis between hepatitis B virus (HBV) infection and ACR. METHODS: A retrospective clinicopathologic examination of 311 liver allograft biopsies consisting of clinically proven ACR or HBV infection was performed. Immunohistochemical staining for HBcAg and HBsAg was done for 64 allograft biopsies showing HBV infection. RESULTS: Moderate to severe bile duct damage, diffuse centrilobular necrosis and centrilobular inflammation (p<0.000, for each) were more frequently observed in cases of ACR, whereas diffuse acidophilic bodies and spotty necrosis (p<0.000, for each) were more prevalent in cases of HBV infection. Immunopositivity for HBcAg (n=60, 93.8%) was higher than that for HBsAg (n=14, 21.9%) CONCLUSIONS: The presence of moderate to severe bile duct damage, diffuse centrilobular necrosis and centrilobular inflammation was a characteristic feature of ACR, whereas diffuse distribution of acidophilic bodies or spotty necrosis was the only characteristic feature of HBV infection. HBcAg was a more sensitive immunohistochemical marker than HBsAg for detecting HBV infection in liver allograft biopsies.
Bile Ducts ; Biopsy ; Diagnosis, Differential ; Graft Rejection ; Hepatitis ; Hepatitis B ; Hepatitis B Core Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Inflammation ; Liver ; Liver Transplantation ; Necrosis ; Rejection (Psychology) ; Retrospective Studies ; Transplantation, Homologous

BACKGROUND: Direct puncture by a needle is a risk factor for nerve damage. This study was designed to demonstrate nerve damage caused by a needle using the synchrotron small-angle X-ray scattering (SAXS) technique. METHODS: A 15 mm section of rat (Male Spargue-Dawley, about 250 grams) sciatic nerves were involved in this study. The nerve specimen for the experiment (N = 5) was punctured 5 times by a needle (25 G, 100 beveled) under general anesthesia with enflurane. The needle was placed perpendicular to the nerve and the needle bevel was placed parallel to the nerve. The SAXS patterns of the punctured nerves, extracted about 15 min prior to the experiment, were acquired after 1 week. The SAXS patterns of a normal sciatic nerve (N = 5), extracted about 15 min prior to the experiment, were measured in order to provide a comparison. Experiments were carried out at 4C1 beamline at Pohang Accelerator Laboratory in Korea. Incoming X-rays were monochromatized at 11 keV using a double multilayer (WB4C) monochromator; the beam size was around 0.5 (V) x 0.8 (H) mm2. The exposure time was 60 sec, and 8 to 12 images were acquired per sample with a 0.5 mm interval. RESULTS: In the punctured group, the periodic peaks of myelin sheath and collagen fiber were not changed. However, the periodic peaks of interfibrillar distance of collagen were greatly changed. CONCLUSIONS: Direct needle-nerve impalement did not cause damages in myelin sheath and collagen fibers when the needle was placed perpendicular and the needle bevel paralleled to the nerve fiber. This result can imply that the needle slipped into the interfibrillar packing of collagen fibrils.
Anesthesia, General ; Animals ; Collagen ; Enflurane ; Gyeongsangbuk-do ; Korea ; Myelin Sheath ; Needles* ; Nerve Fibers ; Peripheral Nerve Injuries* ; Punctures ; Rats* ; Risk Factors ; Sciatic Nerve* ; Synchrotrons*