Traumatic atlanto-occipital dislocation is usually fatal. To date, few cases have been reported in the literature because survival after traumatic atlanto-occipital dislocation is extremely rare. We present the case of a 47-year-old man with traumatic atlanto-occipital rotatory posterior dislocation combined with atlanto-axial rotatory subluxation and treated by occipito-cervical fusion using Bohlman's triple wiring technique.
Dislocations* ; Humans ; Middle Aged

No abstract available.
Humans*

Lipoprotein(a) [Lp(a)] is considered an additional, independent and largely genetically determined risk factor for the development of premature coronary heart disease. Furthermore abnormal plasma lipoprotein patterns have been associated with increased risk for developing coronary heart disease. Among these lipoproteins, an increased concentration of serum Apo B and decreased level of Apo A are considered as major risk factors. together with elevated serum cholesterol and decreased HDL cholesterol. The aim of this study is to assess serum Lp(a) levels in newborns and to observe their evolution between brith, 7 days and 1 month in 64 healthy newborns by using ELISA method, Other lipid profiles were also measured and compared with feeding formula methods. The results obtained were as follows: 1) There were no significant changes from birth to 7 days, but was increased significantly after 7 days to 1 month of serum Lp(a) concentrations. 2) There were dramatic increases between birth and 7 days for Apo B and did not change between 7 days and 1 month, while Apo A-I was already present in significant levels at birth and was changed continuously between 7 days and 1 month. 3) There were marked increases between birth and 7 days for total cholesterol and triglycerides, while after 7 days the cholesterol levels only progressively increased until month. 4) There were continuous increases between birth and 7 days and 1 month for HDL-C, while LDL-C was markedly increased between birth and 7 days. 5) There were no significant correlations between serum Lp(a)concentrations and other lipid profiles neither age, sex and feeding formulas. In conclusion, our data suggest that the adequate timing for the screening test of Lp(a) in newborns is around 1 month after birth and there are no statistically significant correlations between Lp(a) and other lipid profiles.
Apolipoprotein A-I ; Apolipoproteins B ; Cholesterol ; Cholesterol, HDL ; Coronary Disease ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant, Newborn* ; Lipoprotein(a)* ; Lipoproteins ; Mass Screening ; Parturition ; Plasma ; Risk Factors ; Triglycerides

Pheochromocytoma is a hazardous and dramatic cause of hypertension. This potentially lethal neoplasm originates in most cases in the adrenal medulla and less frequently in the cells of the extraadrenal paraganglion system which are disseminated along the paravertebral axis from the pelvis to the base of the skull. The organ of Zuckerkandl is paraganglia lying the abdominal aorta with highest incidence in the region of the inferior mesenteric artery and usually degenerate shortly after birth. In the literature, and additional one case of pheochromocytoma arising from the organ of Zuckerkandl associated with intracerebral hemorrhage which was treated recently in the Kyung Hee University Hospital is presented in this report.
Adrenal Medulla ; Aorta, Abdominal ; Axis, Cervical Vertebra ; Cerebral Hemorrhage* ; Deception ; Hypertension ; Incidence ; Mesenteric Artery, Inferior ; Para-Aortic Bodies* ; Parturition ; Pelvis ; Pheochromocytoma* ; Skull

Fibrous dysplasia is a benign bony disorder that contains trabeculae of poorly calcified primitive bone formed by osseous metaplasia. It is also characterized by replacement of normal spongiosa by abnormal fibrous tissues. We retrospectively analyzed the computed tomographic (CT) findings of 29 cases with clinically and radiologically diagnosed craniofacial fibrous dysplasia. In 2 cases, only cranial bones were involved and in 7 cases only facial bones were involved. Involvements of both cranial and facial bones were noted in the remained 20 cases. The commonly involved bones in the decreasing order of frequency were as follows: frontal, sphenoidal, ethmoidal and temporal bones in cranium and maxilla, zygoma, lacrimal bones and mandible in facial bones. Even though plain films are enough to diagnose the fibrous dysplasia, we think that CT is useful in more accurate diagnosis by demonstrating amorphous "ground-glass" appearance in the lesion and defining the exact extent of craniofacial fibrous dysplasia.
Diagnosis ; Facial Bones ; Mandible ; Maxilla ; Metaplasia ; Retrospective Studies ; Skull ; Temporal Bone ; Zygoma

The bone marrow biopsy is an integral part of the staging process in patients with malignant lymphomas. Bone marrow(BM) involvement indicates stage IV disease, but there are always a lot of cases in which clear separation is not possible when based on morphology alone. Additional difficulties are caused by morphologic discordance between the BM and the primary lymphoma. Immunohistochemical stain, mRNA in situ hybridization (ISH) for light chain restriction and polymerase chain reaction (PCR) for IgH CDR3 and TCRgamma were performed to find a minimal lesion and the clonality in formalin fixed paraffin embedded tissues of 39 primary lymphomas and corresponding BM biopsy specimens. As a result, nine morphologically negative bone marrows of 18 lymphomas were positive by PCR (Group I). Among the 6 lymphoma cases with morphologically suspicious BM involvement (Group II), one was confirmed to be positive for marrow involvement by both mRNA ISH and PCR and the other four by PCR alone. The positive bone marrows of Group I and II revealed gene rearrangement at the same site as the primary lesion, suggesting the same clonality. Thirteen of 15 lymphomas with morphologically positive BM (Group III) had the same clonality in the primary lymphomas and the BM lesion. Three cases among the Group III with morphologic discordance also revealed the same clonality by PCR. This study shows that a combination of mRNA ISH and PCR in addition to an immunohistochemical stain improves the diagnostic sensitivity in the detection of BM involvement and identification of clonality. Among the three different methods used, PCR is the most sensitive in detecting a minimal lesion.
Biopsy ; Bone Marrow ; Formaldehyde ; Gene Rearrangement ; Humans ; In Situ Hybridization ; Lymphoma* ; Paraffin ; Polymerase Chain Reaction ; RNA, Messenger

PURPOSE: Ultrasound(US) findings of hyperechoic renal medulla in gouty nephropathy were compared with clinical features such as serum uric acid level to evaluate its usefulness in determination of the treatment and prognosis. MATERIALS AND METHODS: A retrospective review of US of 36 cases of gouty arthritis was classified into four groups according to the medullary echogenicity (O:normal, grade 1 :renal medulla as isoechoic as renal cortex, grade 2'heterogeneous increased echogenicity of renal medulla than that of renal cortex, grade 3 :the echogenicity of all renal medulla higher than that of renal cortex with renal contour deformity) which were compared with the serum urate level and associated conditions. Nephrocalcinosis and nephrolithiasis were analyzed through the KUB and the RGP. RESULTS: The degree of hyperechoic renal medulla was related to the level of serum uric acid, and in group IV, six cases of obstructive uropathy (nephrocalcinosis and nephrolithiasis) showed deformed renal contour. Associated conditions such as hypertension, alcoholism, diabetes mellitus and drug abuse were distributed in relation to the degree of hyperechoic renal medullas. CONCLUSION: US findings of hyperechoic renal medulla was related with uric acid level in gouty nephropathy and thus could be valuable for treatment decision and prediction of prognosis.
Alcoholism ; Arthritis, Gouty ; Diabetes Mellitus ; Hypertension ; Nephrocalcinosis ; Nephrolithiasis ; Prognosis ; Retrospective Studies ; Substance-Related Disorders ; Ultrasonography* ; Uric Acid

PURPOSE: To evaluate the usefulness of T2-weighted oblique coronal imaging in the diagnosis of anteriorcruciate ligament (ACL) injury. MATERIALS AND METHODS: The MRI findings of 12 patients with ACL injury and a groupof 12 with normal ACL were respectively reviewed in terms of nonvisualization or focal defect, morphologic changeand increased signal intensity of ACL. Diagnostic accuracy in the conventional sagittal or coronal plane and inthe T2-weighted oblique coronal plane was also compared. T2-weighted oblique coronal scanning was performed, withthe imaging plane parallel to the direction of the intercondylar roof. RESULTS: In the ACL injury group,conventional MR imaging showed nonvisualization or focal defect (10/12), morphologic change (7/12), displacement(4/12), and increased signal intensity (9/12). T2-weighted oblique coronal imaging showed nonvisualization orfocal defect (11/12), morphologic change (5/12), and increased signal intensity(9/12). In the normal ACL group,conventional MR imaging demonstrated false-positive findings, i.e. these mimicked ACL injuries. Nonvisualizationor focal defect (2/12), and morphologic change (1/12), and increased signal intensity (5/12) were seen.T2-weighted oblique coronal imaging demonstrated normal ACL as an anteromedial and posterolateral band ; therewere no false-positive cases. On T2-weighted oblique coronal scan, no normal ACL showed increased signal intersity; compared with conventional MR imaging, this difference was statistically significant(P < 0.005). Overall, thesensitivity, specificity, and accuracy of conventional sagittal or coronal plane and T2-weighted oblique coronalplane imaging were, respectively 92% and 92%, 58% and 100%, and 75% and 96%. CONCLUSION: On T2-weighted obliquecoronal scans, the visualization of all normal anterior cruciate ligaments was better than on conventional MRimages. When ACL injury is vague on conventional MR imaging, T2-weighted oblique coronal imaging is considered tobe useful for the differentiation of ACL injury and normal ACL.
Anterior Cruciate Ligament* ; Diagnosis ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Sensitivity and Specificity

No abstract available.
Humans

PURPOSE: To evaluate the CT findings of histologically confirmed endobrnchial tuberculosis(EBTB) and to access their diagnostic value by comparing with the bronchoscopic findings. MATERIALS AND METHOD: We evaluated retrospectively the CT findings of 25 patients(male : female=5 : 20) with EBTB, and classified them into 3 types by their characteristic features, which are compared with the brochoscopic findings. The 3 types of CT features were as follows ; type 1 : central mass-like lesion with coarse calcific spots associated with atelectasis, type 2: caseous pneumonia with air-bronchogram associated with atelecatasis, type 3 : irregularly distorted and narrowed bronchovascular changes. RESULTS: Comparing the characteristic CT findings with the bronchoscopic findings, they were as follows ; type 1 showed completely occluded lumen by caseous or scar-like tissue with severely swollenmucosa, type 2 showed very thick tenacious mucous plug with anthracotic pigmentation of mucosa, type 3 showed chronic inflammatory change of mucosa with severely deviated or septated bronchial lumen by out-growing caseousgranulation tissue. A tracheal tuberculosis without parenchymal lesion was noted and the bronchoscopy showed caseous materials along the tracheal lumen to the carinal level. CONCLUSION: The characteristic CT findings ofthe bronchial wall and the changes of the adjacent tissues are related to the tracheobronchial tuberculous involvement. CT is useful for diagnosis of the endobronchial tuberculosis.
Adult* ; Bronchoscopy ; Diagnosis ; Humans ; Mucous Membrane ; Pigmentation ; Pneumonia ; Pulmonary Atelectasis ; Tuberculosis* ; Tuberculosis, Pulmonary