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*

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

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

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

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

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

Angiomyxolipoma is a rare variant of lipoma, which is described by Mai, 1996, at first. The nine cases of which have been reported to date. Microscopically, the lesion consists of adipose tissue with the paucicellular myxoid areas and fat tissue with numerous thin, dilated, and congestive blood vessels. The reported cases mostly located to the superficial layer on the scalp, subungual, extremities in adults. We report one case of angiomyxolipoma located in the submuscular and parosteal area in the distal femur around knee joint in a child.
Adipose Tissue ; Adult ; Blood Vessels ; Child ; Estrogens, Conjugated (USP) ; Extremities ; Femur ; Humans ; Knee Joint ; Lipoma ; Scalp

The causes of temporomandiublar joint(TMJ) ankylosis are classified into trauma, systemic or local infection, and systemic diseases. Recent reports have implicated taruma as the main cause, with infection being a distant one. Local infections of surrounding structures(eg, mastoiditis and otitis media) can spread to TMJ by a direct extension or a hematogenous spread. In childhood, dense barrier of bone between the middle ear and the joint cavity may not be developed to prevent the spead of the infection. Otitis media is known to be a common complication of measles in children. Therefore children are more susceptible to TMJ ankylosis secondary to otitis media caused by measles. In the present case, the patient was 21 years old. At the age of 5 years, he had been caught by measles and accompanying otitis media. Since then, he had suffered from trismus for over 15 years. He was diagnosed as bony ankylosis of the left TMJ. We reconstructed his TMJ with 1) the resection of the condylar mass, 2) ipsilateral coronoidectemy, 3) contralateral coronoidectomy, 4) recontouring of glenoid fossa, and 5) replacement with a metal prosthesis(titanium condyle). In the choice of the graft material, we preferred metal prosthesis to autogenous costochnodral rib bone because the patient was still in the state of chronic otitis media and mastoditis. His mandibular function was improved significantly postoperatively. Unitl now he gets along without any postoperative complication.
Ankylosis* ; Child ; Ear, Middle ; Humans ; Joints ; Mastoid ; Mastoiditis ; Measles ; Otitis Media* ; Otitis* ; Postoperative Complications ; Prostheses and Implants ; Ribs ; Temporomandibular Joint* ; Transplants ; Trismus ; Young Adult

Hemangioblastomas are benign tumors that most commonly occur in the posterior fossa around the 4th ventricle. Recurrent mutifocal hemangioblastomas are often found as a part of a systemic autosomal dominant disease, the Von Hippel-Lindau syndrome. Surgical removal of recurrent multifocal tumors are technically more difficult and challenging than solitary ones due to their proximity to critical structures, disturbed anatomical landmark and adehesion to the surrounding tissue, all of which may lead to high postoperative morbidity and mortality. Authors have experienced 2 cases of the multiple and recurrent hemangioblastomas with Von Hippel-Lindau syndrome. The patients of each of the cases underwent surgery for tumor removal at least 2 times. In the first patient, a 42-year-old male, a solitary cerebellar hemangioblastoma had been removed 6 years prior to recurrence. On followup MRI, more than three solid, homogenously enhanced nodules were found in the cerebellum. These tumors were operated on through the previous craniectomy site, but only two of them could be removed. This patient was discharged without additional neurologic deficit. The 2nd patient, a 40-year-old-male, had undergone three prior operations for cerebellar hemangioblastomas. On followup examination, he presented with progressive ataxia and confusion. Brain MRI showed multiple recurrent lesions of homogenously strongenhanced masses in the 4th ventricle and cerebellar vermis surrounded by cystic lesions, accompanied by obstructive hydrocephalus. No additional surgery of tumors were attempted, and only ventriculoperitoneal shunt was performed. He was discharged with improved neurological symtomes and sign.
Adult ; Ataxia ; Brain ; Cerebellum ; Follow-Up Studies ; Hemangioblastoma* ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Male ; Mortality ; Neurologic Manifestations ; Radiosurgery ; Recurrence ; Ventriculoperitoneal Shunt ; von Hippel-Lindau Disease*