Plexiform schwannoma is a rare benign tumor arising from the peripheral nerve sheath and characterized by a multinodular and plexiform growth pattern. This tumor usually arises sporadically. In rare cases, plexiform schwannomas have been associated with neurofibromatosis type 2. Plexiform schwannoma should be differentiated from plexiform neurofibroma, because the latter is pathognomonic tumor of neurofibromatosis type 1 and has a potential of malignant transformation. We report a case of multiple plexiform schwannomas associated with bilateral acoustic neuromas and meningioma.
Meningioma ; Neurilemmoma* ; Neurofibroma, Plexiform ; Neurofibromatoses* ; Neurofibromatosis 1 ; Neurofibromatosis 2* ; Neuroma, Acoustic ; Peripheral Nerves

Our previous experimental work with tissue plasminogen activator (TPA) suggested the possibility of the clearance of vitreous hemorrhage by repetitive injections of low-dose TPA. We therefore investigated in rabbits the effect of both repeated injections of TPA and the change of the integrity of the vitreous body on the clearance of vitreous hemorrhage. Vitreous hemorrhage was produced by intravitreal injection of 0.05 ml of autologous whole blood in the pigmented rabbit eyes with intact vitreous or gas-compressed vitreous. Three intravitreal injections of 3-g TPA (total dose of 9 microgram), separated by 7-day intervals, were performed. The endpoint for vitreous hemorrhage clearance was defined as clear visualization of the posterior central retina of the rabbits. Regardless of whether gas compression vitrectomy was performed, repeated injections of low-dose TPA resulted in rapid clearance of fresh vitreous hemorrhage in approximately two to three weeks after the last TPA injection. No evidence of retinal toxicity was seen in all experimental groups. Repetitive injections of low-dose TPA may be effective in the treatment of fresh vitreous hemorrhage.
Animals ; Disease Models, Animal ; Injections ; Rabbits ; Tissue Plasminogen Activator/*administration & dosage/therapeutic use ; Vitreous Body/drug effects ; Vitreous Hemorrhage/*drug therapy

Chronic paranasal sinusitis is one of the most common disease in the field of otolaryngology, and endoscopic sinus surgery(ESS) is efficient and safe operative method of chronic paranasal sinusitis. We employed socalled symptom score to quantify the common sinusitis related symptoms before and after endoscopic sinus surgery which followed up to 6 months. A prospective study of 50 patients all having undergone ESS from June, 1995 to February, 1996 was performed and we analyzed the surgical results using questionaires which focused on six common sinusitis related symptoms-nasal obstruction, rhinorrhea, olfactory disturbance, postnasal drip, headache and sneezing. Postoperative symptom relief was apparent in all six common symptoms(p value<0.001) and the higher sinusitis stage, the more relief of sinusitis related symptoms(p value=0.029). It seems to be helpful to employ a symptom score in predicting and analyzing the surgical results in the treatment of chronic sinusitis.
Headache ; Humans ; Otolaryngology ; Prospective Studies* ; Sinusitis ; Sneezing

Multiple aneurysms at the same cerebral arterial branching site are rare, and have been mainly described in a few case reports in comparison with other intracranial multiple aneurysms. Most reported locations of the same artery where multiple aneurysms developed were internal carotid artery and anterior communicating artery. We experienced a very rare case of multiple aneurysms arising at the same bifurcation site of the middle cerebral artery. Only one case like this has been reported previously in the literature. We discussed the preoperative diagnosis and surgical management of such condition.
Aneurysm* ; Arteries ; Carotid Artery, Internal ; Diagnosis ; Middle Cerebral Artery*

Familial adenomatous polyposis(FAP) is a rare hereditary disorder characterized by the development of hundreds to thounds polyps throughout the colon and rectum. Moreover, several extracolonic manifestations are seen. Recently, this disease is recognized as a adenomatous polyposis syndrome which can involve the entire astrointestinal tract. Several reports have demonstrated a high incidence of gastroduodenal polyps in patients with familial adenomatous polyposis. These colon polyps can be eventually developed as colon cancer, if not be treated. So early diagnosis is needed and prophylactic surgery should be erformed. We experienced a case of familial adenomatous polyposis with a large sentinel polyp on the sigmoid colon, presenting hematochezia and mucoid diarrhea. He was early treated before progression to carcinoma by total colectomy, rectal mucosectomy and J pouch ileoanal anastomosis.
Adenomatous Polyposis Coli* ; Colectomy ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonic Pouches ; Diarrhea ; Early Diagnosis ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Polyps* ; Rectum

BACKGROUND: Minimal (subclinical) hepatic encephalopathy (mHE) currently diagnosed by psychometric tests or neurophysiological test adversely affects daily functioning. In view of its sociomedical relevance, simple and reproducible tests for routine diagnosis are required. The aims of this study are to evaluate cognitive function of patients with chronic liver disease by computerized neuropsychological test (STIM), and the difference of cognitive function according to Child classification. METHODS: Between June, 2002 and February, 2003 We enrolled 61 randomized consecutive patients diagnosed with chronic liver disease by biochemical tests, ultrasonographic finding or histology. This study used finger tapping, visual CPT, spatial memory test, Wisconsin card sorting test chosen from Neuscan and STIM system (Neurosoft company, U.S.A) and global-local processing test. RESULTS: In the present study, significant correlation was found between neurologic abnormalities and the degree of liver disease. The result of neuropsychological test showed that cognitive function was decreased according to the severity of chronic liver disease, especially liver cirrhosis. Cirrhotic patients, especially Child C group, exhibited selective deficits in complex attentional and fine motor skills, visuospatial perception, with preservation of memory. CONCLUSION: The STIM in this study is simple, objective and reproducible method because it can subdivide evaluation of cognitive function and computerize the measurement of response. We assume that STIM may be used early detection method of mHE if the study will be in a large scale. Because psychomotor deficits found in mHE could have a disadvanting influence on daily functioning of patients, e.g., driving abilty of a car or performance at work, we concluded early detection of mHE and aggressive treatment of mHE in clinically asymptomatic cirrhotic patients is necessary for improvement of their quality of life.
Child ; Classification ; Diagnosis ; Fingers ; Hepatic Encephalopathy ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Memory ; Motor Skills ; Neuropsychological Tests* ; Psychometrics ; Quality of Life ; Wisconsin

This study investigated the trabecular and cortical bone microarchitecture of tibia in 14-week-old C3H/HeN, C57BL/6J and ICR mice using micro-computed tomography (micro-CT). Defined volumes of interest were scanned at a resolution of 17 micrometer (isotropic). The X-ray tube was set at photon energy of 50 kV, current of 200 microA, exposure time 1.2 sec, and a 0.5 mm-thick aluminium filter. For quantification of bone mineral density (BMD), the bone samples were scanned by micro-CT together with 2 calibration phantoms. The image slices were reconstructed using 3-dimensional CT analyzer software. C3H/HeN mice showed significantly higher levels of bone volume fraction, trabecular number and BMD, and lower levels of trabecular separation, structure model index and degree of anisotropy compared to C57BL/6J or ICR mice in trabecular bone area. So the C3H/HeN mouse appeared to be a good model animal for the study on the changes of trabecular bone with high trabecular bone mass.
Animals ; Anisotropy ; Bone Density ; Calibration ; Mice ; Mice, Inbred ICR ; Tibia

This study investigated the trabecular and cortical bone microarchitecture of tibia in 14-week-old C3H/HeN, C57BL/6J and ICR mice using micro-computed tomography (micro-CT). Defined volumes of interest were scanned at a resolution of 17 micrometer (isotropic). The X-ray tube was set at photon energy of 50 kV, current of 200 microA, exposure time 1.2 sec, and a 0.5 mm-thick aluminium filter. For quantification of bone mineral density (BMD), the bone samples were scanned by micro-CT together with 2 calibration phantoms. The image slices were reconstructed using 3-dimensional CT analyzer software. C3H/HeN mice showed significantly higher levels of bone volume fraction, trabecular number and BMD, and lower levels of trabecular separation, structure model index and degree of anisotropy compared to C57BL/6J or ICR mice in trabecular bone area. So the C3H/HeN mouse appeared to be a good model animal for the study on the changes of trabecular bone with high trabecular bone mass.
Animals ; Anisotropy ; Bone Density ; Calibration ; Mice ; Mice, Inbred ICR ; Tibia

OBJECTIVE: The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). METHODS: A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. RESULTS: Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. CONCLUSION: The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.
Arm ; Cohort Studies* ; Diskectomy* ; Follow-Up Studies* ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Neck ; Radiography ; Range of Motion, Articular ; Retrospective Studies* ; Risk Factors* ; Spondylosis

Emery-Dreifuss muscular dystrophy is characterized by 1) early contractures of the elbows, Achilles tendons, and postcervical muscles, 2) slowly progressive muscle wasting and weakness with a humeroperoneal distribution in the early stages, and 3) cardiomyopathy with conduction defects and risk of sudden death. The inheritance is usually X-linked recessive but can be autosomal dominant and recessive. We report a case of 28-year old woman who presented with dizziness, palpitation, and progressive muscular weakness. Her ECG revealed high degree AV block and muscle biopsy demonstrated diffuse degenerative change consistent with Emery-Dreifuss muscular dystrophy. She was diagnosed as autosomal dominant Emery-Dreifuss muscular dystrophy by characteristic clinical features, and findings of ECG, nerve conduction test, electromyography and muscle biopsy findings. A VVI-type permanent pacemaker was implanted.
Achilles Tendon ; Adult ; Atrioventricular Block* ; Biopsy ; Cardiomyopathies ; Contracture ; Death, Sudden ; Dizziness ; Elbow ; Electrocardiography ; Electromyography ; Female ; Humans ; Muscle Weakness ; Muscles ; Muscular Dystrophy, Emery-Dreifuss* ; Neural Conduction ; Wills