An unusual case of intraspinal peripheral neuroepithelioma arising from the cauda equina is reported. The patient, a 21-year old female, suffered from low back pain with radiation to the posterior aspect of both legs. Myelographic, computed tomographic scan and magnetic resonance imaging studies of lumbosacral spine showed the intradural extramedullary mass lesion on the L3-S1 level which was excised surgically, but recurred rapidly. It could be diagnosed by the histopathologic findings. The postoperative radiotherapy and chemotherapy were administered. We report this rare case with review of the literatures.
Cauda Equina* ; Drug Therapy ; Female ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Neuroectodermal Tumors, Primitive, Peripheral* ; Radiotherapy ; Spine ; Young Adult

Congenital hand anomalies encompass a very broad spectrum of deformity, and precise classification of these deformities has always posed a major problem. We reviewed 50 cases of congenital hand deformities in 47 patients, managed at Department of,Orthopedic Surgery, Severance Hospital from Jan. 1980. to Jun. 1984 and the following results were obtained. 1. There were 26 males and 21 females in 47 patients and the ratio between male and female was 1.2: 1. Right hands were involved in 16 patients and both hands were in 14 patients. 2. The most commomn type of anomalies were polydactylysm(48%), next were syndactylysm (24%) and the follwing anomalies were found: camptodactyly, congenital constriction band syndrome, congenital ulnar deficiency, congenital clasped thumb, clinodactyly, congenital finger deficiency, symphalangism. 3. 9 associated congenital anomalias were found in 5 patients, in which, anomalies of the foot were most common. 4. Prenatal history such as drug ingestion, preeclampsia, breech delivery, prematurity, low birth weight were found and 2 cases of family history were found. 5. Treatment was stressed upon the function of hand and the improvement of the deformity.
Classification ; Clinical Study ; Congenital Abnormalities ; Constriction ; Eating ; Female ; Fingers ; Foot ; Hand Deformities, Congenital ; Hand ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Pre-Eclampsia ; Thumb

Autograft is frequently used to restore anatomic morphology and functional properties in bone defects. Disadvantages of the autograft are related to donor site morbidity and include the risk of wound infection, increased blood loss and additional postoperative discomfort. Allograft and xenograft, which are currently employed as the most common alternative to autografts, encounter the complications such as fracture, resorption and nonunion secondary to immunologic rejection. These volumetric and immunologic concerns with biologic implants have stimulated interest in the potential for synthetic, bioinert materials as bone graft substitutes. Hydroxyapatite (HA), a calcium phosphate ceramic, is a well known biocompatible artificial bone substitite without induction of systemic toxic and foreign body reactions. Bone conduction usually occurrs by the implanted HA but biodegradation of HA is poor and the bone formation around HA is slow. Carbonate apatite has been known as that the physicochemical properties are similar of the natural bony apatite and demonstrates no toxic reactions with better biodegradation. Carbonate apatite collagen composite was reported to show more bone formation and biodegradation than hydroxyap atite. In this study, the composite (CA-C) consisted of carbonate apatite and type I collagen was implanted in rabbit tibiae to evaluate the possibility as an artificial bone substitute. Forty HA (HA group) and forty CA-C (CA-C group) were applied in 80 dissected rabbit tibiae and fixed by external fixators. For biomechanical study, the rabbits were sacrificed and the specimens were obtained in 2, 4, 6 and 8 weeks after implantation. Tensile load was applied to the prepared tibiae in Instron and biomechanical properties were investigated. The fracture at the callus occurred as transverse or short oblique fracture in the vertical direction to the axis of applied tensile load. In each group, the tensile strength at breaking point increased significantly with time and at 4 weeks more prominent increase in break strength was observed (p<0.05). HA group showed higher mean strength before 6 weeks and at 8 weeks CA-C group higher mean strength but statistical significance could not be found. There was no significant difference in extension length at breaking point between both groups and time intervals. In summary, carbonate apatite collagen composite revealed similar biomechanical properties as hydroxyapatite, suggesting its clinical usefulness as a bone substitute, but it will be necessary to improve biodegradational property, stiffness of carbonate apatite collagen composite.
Allografts ; Autografts ; Axis, Cervical Vertebra ; Bone Conduction ; Bone Substitutes ; Bony Callus ; Calcium ; Carbon* ; Ceramics ; Collagen Type I ; Collagen* ; Durapatite* ; External Fixators ; Foreign Bodies ; Heterografts ; Humans ; Osteogenesis ; Rabbits ; Tensile Strength ; Tibia* ; Tissue Donors ; Transplants ; Wound Infection

Insulinoma is a rare tumor, occurring more often in women and in the older age range. Eighty percent of patients have a single benign tumor, usually 2 cm in diameter, located with about equal frequency in body, head or tail of pancreas and amenable to surgical cure. About 10% have multiple tumors. The remaining 10% of patients have metastatic malignant insulinoma. The symptom of insulinoma is characterized by the periodic attack of hypoglycemia of blood sugar level below 50mg%, by fasting or exertion, and rapid relief of symptom by oral or intravenous administration of glucose. Symptom often lead to misdiagnosis as a neurologic or psychiatric disorder. A case described by authors was 44-year old female with the chief complaints of the loss of consciousness, epileptic seizure although she has been treated by anticonvulsants. Serum blood sugar and insulin level during fasting suggested insulinoma but abdominal computed tomography shows no definitive mass in pancreas. Celiac angiography revealed insulinoma. She transferred to the department of General Surgery and was performed enucleation. Microscopic findings shows the islet cell tumor of pancreas. A brief review of the literature was made.
Adenoma, Islet Cell ; Administration, Intravenous ; Angiography ; Anticonvulsants ; Blood Glucose ; Diagnostic Errors ; Epilepsy ; Fasting ; Female ; Glucose ; Head ; Humans ; Hypoglycemia ; Insulin ; Insulinoma* ; Pancreas ; Tail ; Unconsciousness

No abstract available.
Aneurysm*

Trichilemmal carcinoma is a rare adnexal tumor originating from outer root sheath of hair follicle. We report a case of trichilemmal carcinoma occurring on the scalp. A 71-year-old women presented with a nodule on the vertex of scalp. Histopathologically, tumor cells showed a lobular proliferation in continuity with the epidermis. The lobules showed peripheral palisading and trichilemmal keratinization. The prominent tumor cells were large cells with PAS-reactive, diastase-sensitive, clear cytoplasm. Striking cytologic atypia and high mitotic index were found. Total excision was done and the patient has been free of recurrence or metastasis for 1 year.
Aged ; Cytoplasm ; Epidermis ; Female ; Hair Follicle ; Humans ; Mitotic Index ; Neoplasm Metastasis ; Recurrence ; Scalp ; Strikes, Employee

Filler injection is an extremely popular cosmetic procedure in Korea, but surprisingly few dermatologists are aware of the package inserts in filler products. In the era of legal dispute, it is important that we fully understand the indications, contraindications, and side effects of the individual filler products. The purpose of this paper is to provide a general overview of the contents of package inserts of filler products that are commercially available in Korea, especially in terms of the contraindications of filler injection. The authors emphasize that greater improvement in the Korean package inserts of filler products can be expected. Currently, practicing physicians are usually blamed for filler complications. We also found many significant translational errors. We hope that dermatologists take more interest in filler package inserts by reading this overview.
Dissent and Disputes ; Hope ; Korea* ; Product Labeling*

Punctate palmoplantar keratoderma(PPK) is a rare disease, characterized by small, hard hyperkeratotic papules which are irregularly distributed on the palms and soles. PPK is an autosomal dominant disease with variable penetrance. We report a case of sporadic case of punctate palmoplantar keratoderma in a 26-year-old female patient.
Adult ; Female ; Humans ; Keratoderma, Palmoplantar* ; Penetrance ; Rare Diseases

The major purpose of this study was to assess the post-operative quality of life after performing a pylorus-preserving gastrectomy (PPG) in early gastric cancer patients, comparing the results with patients who underwent a conventional gastrectomy (CG). There were 48 patients with gastric cancer who underwent surgical intervention at the Department of Surgery, Taejon St. Mary's Hospital, The Catholic University of Korea School of Medicine from November 1995 through June 1996. Out of 48 gastric cancer patients, 13 patients (27.1 %) were early gastric cancers. Seven patients of these 13 patients underwent a PPG and the others underwent a CG. The indications for PPG were ; 1) a lesion at least 5 cm proximal to the pyloric ring, 2) a lesion in the middle third of the stomach, 3) a lesion less than 40 mm in maximum length, and 4) especially a lesion located at the greater curvature. Localization of the lesion was precisely performed through a gastrotomy during the operation. Dissections of the No. 7, 8, and 9 nodes (D1 +) were performed in cases of ulcerated lesions (type III) or poorly differentiated lesions. The proximal and distal portions of the stomach were anastomosed together 2-3 cm proximal to the pyloric ring to preserve the pyloric function. Gastrografin studies were performed on the sixth or the seventh day following PPG, and disclosed that the pylori were almost normal in appearance and function. Compared to a CG, the duration of nasogastric decompression was longer by one day, the start of oral feeding was delayed by two days, and the duration of the hospital stay was longer by five days after PPG. Three months following PPG, the amount of food taken in a meal was 70-90 % compared to that of the pre-operative amount, oral feedings took place three to four times a day, and the performance status was excellent (grade 0). Endoscopic examination revealed two cases of food stasis without subjective symptoms and a case of bile reflux with minimal mucosal edema after the PPG. After the CG, three out of the six cases had bile reflux with mucosal redness and erosion. In conclusion, it seemed that for early gastric cancer a pylorus-preserving gastrectomy, with selective lymphnodal dissection, was superior to the standard operation in terms of post-operative quality of life.
Bile Reflux ; Daejeon ; Decompression ; Diatrizoate Meglumine ; Edema ; Gastrectomy* ; Humans ; Korea ; Length of Stay ; Meals ; Quality of Life ; Stomach ; Stomach Neoplasms* ; Ulcer

Intercellular Adhesion Molecule-1(ICAM-1) plays an important role in a variety of inflammatory and immune-mediated mechanisms, including lymphocyte recruitment and targeting, antigen presentation and recognition, and lymphocyte cytotoxicity.In order to study the changes of soluble ICAM-1 and relationship to the immune mechanism of Graves' disease, we performed the measurement of a soluble form of ICAM-1 in sera from patients with Graves' disease before and after treatment with antithyroid drugs using a highly sensitive ELISA method.Our results were as followed.1) The serum levels of soluble ICAM-1 in patients with Graves' disease before treatment were significantly elevated than normal controls(p<0.001).2) The serum levels of soluble ICAM-1 in patients with Graves' disease after treatment significantly decreased after treatment(p<0.001) but not as low as normal controls. 3) The serum levels of soluble ICAM-1 molecule in patients with ophthalmopathy were not elevated compared to patients with no ophthalmopathy(p>0.2).4) The serum levels of soluble ICAM-1 showed no significant correlation with serum titers of anti-thyroperoxidase antibody and anti-thyroglobulin antibody, serum T_3, T_4, TSH and goiter size in patients with Graves' disease.In conclusion, the soluble ICAM-1 levels reflect the activity of autoimmune reaction and might be used as a index of efficacy of antithyroid drug treatment of Graves' disease.
Antigen Presentation ; Antithyroid Agents ; Enzyme-Linked Immunosorbent Assay ; Goiter ; Graves Disease ; Humans ; Intercellular Adhesion Molecule-1 ; Lymphocytes