Spinal cavernous hemangiomas of the cauda equina are extremely rare vascular malformations. We report a case of intradural extramedullary cavernous hemangioma of the cauda equina with it's clinical, radiologic and surgical findings. This is the twelveth case of cavernous hemangioma of the cauda equina in the literature. The pertinent literatures are reviewed.
Cauda Equina* ; Hemangioma, Cavernous* ; Vascular Malformations

PURPOSE: The purpose of this study was to compare outcomes for surgical treatment with those for medical treatment of GB dyskinesia. METHODS: Retrospective analysis of medical records and telephone interviews of 67 patients diagnosed with GB dyskinesia was done at Pohang St. Mary's Hospital between January 2004 and December 2009. Group 1 (n=18) patients received laparoscopic cholecystectomy. Group 2 (n=49) patients received medical treatment. GB dyskinesia was the diagnosis if the patient had typical biliary colic symptoms without GB stones or other GI disease, and if the ejection fraction was less than 35% on Tc-99m-DISIDA scans. RESULTS: The average age of patients diagnosed with GB dyskinesia was 45.8 years old. The sex ratio was 15:52 (male:female). The average symptom duration was 25.4 days. All had RUQ and, or epigastric pain. There were no significant between group differences in age, sex ratio, symptom duration, symptoms, follow up period, and ejection fraction. In group 1, patient symptoms improved after treatment in 16 cases (88.9%); in group 2, patient symptoms improved in 19 cases (38.8%). Surgical treatment was significantly more effective than medical treatment. The reasons for choosing medical treatment were predominantly the preference of the doctors. CONCLUSION: Surgical treatment is a more effective treatment for GB dyskinesia than medical treatment. Therefore, laparoscopic cholecystectomy should be considered as the 1st line treatment of choice for GB dyskinesia.
Biliary Dyskinesia ; Cholecystectomy, Laparoscopic ; Colic ; Dyskinesias ; Follow-Up Studies ; Gallbladder ; Humans ; Interviews as Topic ; Medical Records ; Retrospective Studies ; Sex Ratio

BACKGROUND: Legionella pneumophila has been recognized as an important cause of community-acquired pneumonia(CAP) requiring hospitalization. However, epidemiological data on the occurrence of legionella-related pneumonia is unavailable in Korea. The purpose of this study was to evaluated the etiological imprtance of legionella pneumophila serogroup 1 in patients hospitalized with CAP. METHOD: The CAP patient over 16 year-old were recruited from July 1999 to June 2000 at the Chunchon Sacred Heart Hospital. Fifty four patients (male 29, female 25, average age 63.8±15.3) were included in this study. A diagnosis of a legionella pneumophila infection was based on a urinary antigen test using the Binax Company enzyme immunoassay. The severity of pneumonia was assessed using the Fine's PORT scoring system. RESULT: The average Fine's PORT score was 99.7(±44.9). According to the risk classification proposed by the Infectious Disease Society of America, the number of patients in each class(from class I to class V) were 6(11.1%), 13(24.1%), 9(16.7%), 14(25.8%), and 12(22.2%), respectively. Thirty two patients(59.3%) were initially admitted to the intensive care unit. The mortality rate was 16.7%(9 in 54). In all patients, urinary antigens to Legionella pneumophila serogroup 1 were not detected. CONCLUSION: Legionella pneumophila may play little role in causing adult CAP in Korea. Therefore, the routine use of macrolide in the empirical treatment of the CAP patients based upon the ATS guidelines(1993) in Korea should be reevaluated.
Adult ; Americas ; Classification ; Communicable Diseases ; Diagnosis ; Female ; Gangwon-do ; Heart ; Hospitalization ; Humans ; Immunoenzyme Techniques ; Intensive Care Units ; Korea* ; Legionella pneumophila* ; Legionella* ; Legionnaires' Disease ; Mortality ; Pneumonia*

Asphyxia due to plastic bag is not common. The manner of death may be accidental, suicidal or homicidal. We report an asphyxial death using plastic bag, giving us difficulty in determining the manner of death, suicidal or homicidal. A 32-year-old female was found dead in bathroom and her head was wrapped in a supermarket shopping bag sealed with adhesive tape around the neck. Strangely she was handcuffed behind the back of the victim. Because of no evidence of violence on the body and the presence of a suicide note at the scene, the manner of death was concluded as suicide. This case emphasizes that the interpretation of postmortem examination should be incorporated with the proper investigation of circumstances at the scene of death to determine the manner of death.
Adhesives ; Adult ; Asphyxia ; Autopsy ; Female ; Head ; Humans ; Neck ; Plastics ; Suicide ; Violence

PURPOSE: We aimed to analyze the clinical results and investigate the factors that affect the range of motion (ROM) after revision total knee arthroplasty. MATERIALS AND METHODS: We measured the range of motion from 61 knees of 55 patients who underwent revision total knee arthroplasty using the Nexgen(R) LCCK and we investigated the factors affecting the postoperative ROM, including age, the body mass index (BMI), the preoperative ROM, deformity, causes of revision (septic vs. aseptic) and the type of polyethylene inserts (constrained vs. posterior-stabilized). The clinical results and radiographic findings were assessed using the American Knee Society Score and the roentgenographic method of the American Knee Society. RESULTS: The mean range of motion was improved from 113.7degrees to 127.2degrees. The preoperative ROM (p=0.000) and diagnosis (p=0.006) significantly influenced the postoperative ROM, yet age (p=0.386), BMI (p=0.054), deformity (p=0.218) and the type of polyethylene insert (p=0.195) were not related to the postoperative knee ROM. The American Knee Society Knee Score and Function Score on average was improved from 31.7 and 27.9 points to 86.7 and 64.7 points, respectively. CONCLUSION: The range of motion and clinical results were satisfactory after revision total knee arthroplasty using the Nexgen(R) LCCK, and the important factors affecting the range of motion after operation were the preoperative ROM and the causes of revision. The range of motion after arthroplasty using the constrained type polyethylene insert was not inferior to that using the posterior-stabilized insert.
Arthroplasty ; Body Mass Index ; Congenital Abnormalities ; Humans ; Knee ; Knee Joint ; Polyethylene ; Range of Motion, Articular

PURPOSE: This study was conducted to measure the length of the patellar tendon in normal adults and to analyze the effect of several anthropological variables on the patellar tendon length. MATERIALS AND METHODS: The study included 316 knees (278 males, 38 females) that were undergoing anterior cruciate ligament reconstruction with a bone-patellar-bone autograft. The patellar tendon length was measured on the middle 1/3 of the ipsilateral patellar tendon taken during the operation and we analyzed the relationships between the tendon length and age, weight, height and gender using simple correlation tests and linear regression analysis. RESULTS: The mean tendon length was 42.6 mm (range: 30~60 mm) and the mean age, mean weight and mean height was 32.7 years, 72.8 kg and 170.2 cm, respectively. There was weak negative correlation between the tendon length and age (Pearson correlation r=-0.187) and weak positive correlation between the tendon length and weight (r=0.288) but there was no significant correlation between tendon length and the body mass index (p=0.282) There was a positive correlation between tendon length and height (r=0.434). There was a significant difference between the males and females for the length of tendon (p<0.001), yet after removing the variance of height, the difference was statistically insignificant (beta=-0.041, p=0.491). The linear regression equation for the patellar tendon length (y, in centimeters) as a function of height (x, in centimeter) can be expressed as y=0.032x1.183. CONCLUSION: The length of the patellar tendon is correlated with height, and a patient's height can predict the length of the patellar tendon.
Adult ; Anterior Cruciate Ligament Reconstruction ; Body Mass Index ; Female ; Humans ; Knee ; Linear Models ; Male ; Patellar Ligament ; Tendons

Carbonic anhydrase catalizes the reversible hydration of carbonic dioxide and participate in various biological processes. There are several isozymes and differ in their kinetic properties, tissue distribution and subcellular localization. The expression of carbonic anhydrase isozymes in digestive tract vary according to animal species and region of the tract. The distribution of carbonic anhydrase (CA) isozymes I, II, IV and IX was investigated in various portions of the rat small intestine using Western blotting analysis and immunohistochemical staining. Western blotting analysis of rat small intestine revealed that CAI was found to be abundantly expressed throughout the small intestine. Expression of CAII in duodenum was much higher than that in jejunum and ileum. Expression of CAIV and IX was found to be weak throughout the small intestine. Immunohistochemical reaction revealed no staining of CAI in all parts of small intestine except blood vessels. CAII was detected at the supranuclear cytoplasm of surface epithelium, but not in intestinal gland. Staining intensity was most strong in the proximal duodenum. CAIV was detected at the apical surface of epithelial cells of villi, and showed most strong staining intensity in the terminal ileum. CAIX was detected at the surfcae epithelium, cells of intestinal gland and Brunner's gland, and the positive reaction was confined to the supranuclear cytoplasm. CAIX differed from CAII in tissue distribution, but subcellular localization of CAIX and II were the same. These results indicate that the surface epithelium of small intestine express CAII, IV and IX, intestinal gland and Brunner's gland express CAIX, and suggest that CAIX may somewhat contribute the control of acid-base balance in the small intestine.
Acid-Base Equilibrium ; Animals ; Biological Processes ; Blood Vessels ; Blotting, Western ; Carbon* ; Carbonic Anhydrases* ; Cytoplasm ; Duodenum ; Epithelial Cells ; Epithelium ; Gastrointestinal Tract ; Ileum ; Immunohistochemistry ; Intestinal Mucosa ; Intestine, Small* ; Isoenzymes* ; Jejunum ; Rats* ; Tissue Distribution

BACKGROUND AND OBJECTIVES: A left ventricular mass (LVM) can be used as a prognostic factor in patients with cardiovascular disease, and echocardiographic LVM measurements are most commonly used. We have measured LVM using quantitativel gated myocardial perfusion SPECT (QGS), and compared these results with LVM measured by echocardiography. SUBJECTS AND METHODS: One hundred and sixteen subjects (M/F=66/50, mean age: 58 yrs) underwent both rest QGS with Tc-99m MIBI and echocardiography. On visual interpretation, thirty-six subjects (31%) showed perfusion defects. The myocardial volume was obtained using the AutoQUANT program, and the LVM (LVMSPECT) was calculated by multiplying the volume by the specific gravity of the myocardium. We also measured the echocardiographic LVM (LVMEcho) by the Devereux formula, within one month of the LVMSPECT. RESULTS: The LVMSPECT and LVMEcho were well correlated (r=0.717, p<0.001), but a significant difference was noted between the two values. The mean difference between the LVMSPECT and LVMEcho was 24 g. The LVMEcho was smaller than the LVMSPECT in those subjects with a small LVMEcho, and greater than the LVMSPECT in the subjects with a large LVMEcho. The difference between the LVMEcho and LVMSPECT (LVMEcho-LVMSPECT) was positively correlated with the LVMEcho (r=0.893, p<0.001). CONCLUSION: The LVMs measured by gated myocardial perfusion SPECT and echocardiography were well correlated. But they were significantly different, especially in subjects with large LVMs.
Cardiovascular Diseases ; Echocardiography* ; Humans ; Hypertrophy, Left Ventricular ; Myocardium ; Perfusion* ; Specific Gravity ; Tomography, Emission-Computed, Single-Photon*