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

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

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

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*

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

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

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

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 AND OBJECTIVES: Antrochoanal polyp (ACP) is a benign maxillary sinus polyp that originates from the mucosa of the maxillary sinus, passes through the sinus ostium, and extends into the choana. Surgical methods employed in the treatment of antrochoanal polyp are simple avulsion, Caldwell-Luc operation, osteoplastic maxillary sinus operation, and endonasal endoscopic removal. In this study, we evaluated the clinical presentation of ACP and compared its surgical outcomes. MATERIALS AND METHODS: We retrospectively reviewed 111 patients who were treated for ACP between January 1995 and May 2008, and analyzed clinical features, radiologic findings, and surgical results. RESULTS: The study group consisted of 111 patients (65 males, 46 females) with a mean age of 20.0 years (range, 4 to 70). Sixty-one cases were accompanied by sinusitis (20 with unilateral sinusitis, 41 with bilateral sinusitis). Endoscopic sinus surgery (ESS) was used to treat 95 cases, and the external approaches of Caldwell-Luc operation or osteoplastic maxillary sinus operation were applied in 12 and four cases, respectively. Among those who received ESS, ACP recurred in 16 cases, whereas none of the patients who received the external approach showed recurrence. CONCLUSION: Endoscopic sinus surgery is a good alternative method for the treatment of ACP. If the antral part of ACP cannot be removed completely, an external approach such as Caldwell-Luc operation or osteoplastic maxillary sinus operation for pediatric patients may be considered to prevent recurrence.
Carbamates ; Humans ; Male ; Maxillary Sinus ; Mucous Membrane ; Organometallic Compounds ; Polyps ; Recurrence ; Retrospective Studies ; Sinusitis

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