Air within the spinal canal called pneumorrhachis has been seen rarely. We report a case showing multiple air pockets in the paraspinal and epidural space with vacuum disc and review pathogenesis and treatment of pneumorrhachis.
Epidural Space ; Intervertebral Disc ; Pneumorrhachis* ; Spinal Canal ; Spine ; Vacuum*

OBJECTIVE: Although gadolinium enhancement of compression fractures is well known, the enhancement pattern of the acute stage of a fracture is not completely understood. Here, we investigated the enhancement pattern of acute vertebral compression fractures (VCFs). METHODS: We conducted a retrospective study of patients with acute osteoporotic VCFs admitted to hospital between January 2004 and December 2005. The demographic details, stage of the fracture, management data, and results were analyzed. There were nine men and 22 women, and the mean age was 71 years (range, 53-92 years). According to the onset of pain, patients were divided into the following four groups : Group I (less than 3 days), Group II (4-7 days), Group III (8-14 days), and Group IV (14-30 days). RESULTS: All patients had central low-signal intensity of the nonenhancing part of vertebral bodies on T1 images. Enhancing box sign (EBS) was seen 7 days of VCF development. After 7 days of onset (Groups III and IV), patch or Kummell's enhancements occurred. EBS has been statistically correlated with stage of compression fracture (Pearson's correlation = -0.774). However, EBS had no statistically significant correlation with prognosis in our study (Pearson's correlation = 0.059). CONCLUSION: EBS represents a characteristic sign 7 days of VCF development.
Female ; Fractures, Compression ; Gadolinium ; Humans ; Magnetic Resonance Imaging ; Male ; Prognosis ; Retrospective Studies

Esophageal duplication cysts are congenital anomalies of the foregut that are rarely found in the abdomen. An accurate preoperative diagnosis is not always possible, so the definitive diagnosis can be made by histologic examination of the surgical specimen. We experienced a case of Intra-abdominal esophageal duplication cyst in a 52-year-old female, who initially presented with an esophageal submucosal tumor on upper gastrointestinal endoscopy. She did not have any gastrointestinal symptoms. Barium esophagography, chest computed tomography scan and endoscopic ultrasonography demonstrated the cystic lesion in the intra-abdominal esophagus. Transhiatal enucleation of the lesion was performed successfully via the abdominal approach with no postoperative complications. Histologic study showed that the cyst wall contained a two-layered muscle coat and the surface of the lumen was lined by pseudo-ciliated columnar epithelium. The patient has been doing well without any complaints for 3 months of follow-up period.
Tomography, X-Ray Computed ; Radiography, Abdominal ; Middle Aged ; Humans ; Female ; Esophageal Cyst/*diagnosis/pathology/*surgery ; *Abdomen

BACKGROUND AND PURPOSE: The functional outcome of traumatic brain injury (TBI) varies widely. The aim of this study was to identify the factors predicting outcome following TBI. METHODS: We prospectively enrolled acute TBI patients, and assessed them clinically and radiologically using brain magnetic resonance imaging (MRI). Functional outcome was measured using the Glasgow Outcome Scale (GOS) at 3 months after TBI. A GOS score of < or =4 was regarded as an unfavorable outcome. We performed multivariate analysis to investigate the association between clinicoradiological variables and outcome. RESULTS: Forty-two patients completed the clinical evaluation in the acute phase and outcome measurement at 3 months. Motorcycle accident was associated with unfavorable outcome [odds ratio (OR)=38.3, p=0.022]. If the patients were the victims of the accident, they were more likely to have an unfavorable outcome (OR=21.3, p=0.037). All seven patients with a low Glasgow Coma Scale (GCS) score (i.e., < or =8) at 24 or 48 h after TBI were also found to have an unfavorable outcome. The presence of diffuse axonal injury (DAI) was a significant predicting factor of an unfavorable outcome (OR=8.48, p=0.042). CONCLUSIONS: Motorcycle accident, being an accident victim, and a lower GCS score at 24 hours or more after the accident were found to be unfavorable prognostic variables. DAI was the only radiologic variable predicting an unfavorable outcome. Thus, it is important to identify DAI by applying MRI in the acute phase.
Brain ; Brain Injuries ; Diffuse Axonal Injury ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Magnetic Resonance Imaging ; Motorcycles ; Multivariate Analysis ; Neuroimaging ; Prospective Studies

Vertebral artery injury may occur following blunt trauma to the cervical spine and can produce severe neurological deficit. We report upon two patients having vertebral artery injury following blunt trauma to the cervical spine. The first one developed a cerebellar infarct and the second cervical cord ischemia. The possibility of vertebral artery injury should be considered in patients with cervical spine injury, especially in those having a subluxation or fracture of the facet joint. Early signs of vertebral artery injury may be silent. Non-invasive techniques, such as magnetic resonance angiography should be utilized in such cases.
Humans ; Ischemia ; Magnetic Resonance Angiography ; Spine* ; Vascular System Injuries ; Vertebral Artery* ; Wounds, Nonpenetrating ; Zygapophyseal Joint

Rothmund-Thomson syndrome (RTS), is a rare autosomal recessive disorder, characterized by:skin photosensitivity, poikiloderma, sparse hair, sparse eyebrows/lashes, short stature, skeletal abnormalities, cataracts, and an increased risk of malignancy. Skeletal abnormalities include:dysplasia, absent or malformed bones, such as absent radii, osteopenia, and delayed bone formation. RTS is thought to result from chromosomal instability, and children with RTS are at risk of cancer. Reported cancers in children with RTS include:basal cell carcinoma, squamous cell carcinoma of the skin and osteosarcoma of bone. We report an 11 year-old boy, who presented to our institution with poikilodermatous skin change with telangiectasia and hyperpigmentation, absence of radius and thumb, and the development of osteosarcoma of the left tibia. The patient is now receiving supportive care and is receiving maintenance chemotherapy after surgery for osteosarcoma.
Bone Diseases, Metabolic ; Carcinoma, Squamous Cell ; Cataract ; Child ; Chromosomal Instability ; Hair ; Humans ; Hyperpigmentation ; Maintenance Chemotherapy ; Male ; Osteogenesis ; Osteosarcoma ; Radius ; Rothmund-Thomson Syndrome* ; Skin ; Telangiectasis ; Thumb ; Tibia

No abstract available.
Soccer*

No abstract available.
Hyperplasia*

The outbreak of Coronavirus Disease 2019 (COVID-19) caused a worldwide pandemic. Less than 6 weeks after the first confirmed cases in Korea, the patient number exceeded 5,000, which overcrowded limited hospital resources and forced confirmed patients to stay at home. To allocate medical resources efficiently, Korea implemented a novel institution for the purpose of treating patients with cohort isolation out of hospital, namely the Community Treatment Center (CTC). Herein, we report results of the initial management of patients at one of the largest CTC in Korea. A total of 309 patients were admitted to our CTC. During the first two weeks, 7 patients were transferred to the hospital because of symptom aggravation and 107 patients were discharged without any complication. Although it is a novel concept and may have some limitations, CTC may be a very cost-effective and resource-saving strategy in managing massive cases of COVID-19 or other emerging infectious diseases.

The double pylorus is a rare condition consisting of a double communication between gastric antrum and duodenal bulb. Some investigators postulate that the doubling of the pyloric channel is a congenital phenornenon, but others believe that it is an acquired lesion. A 72 year-old-man was admitted to this hospital because of epigastric pain for 1 month. Upper G-I series revealed thickened rnucosal folds of pylorus and duodenal bulb and dilated, deformed duodenal bulb filled with barium materials. Endoscopic findings also showed two ovoid large openings of the pyloric channel divided by smooth thickened septum and multiple gastroduodenal ulcers. We thought that this case was an acquired lesion. The relevant literatures on the subject were reviewed.
Barium ; Duodenal Ulcer ; Humans ; Peptic Ulcer ; Pyloric Antrum ; Pylorus* ; Research Personnel ; Stomach Ulcer