No abstract available.
Thanatophoric Dysplasia*

A case of carcinoma of the parathyroid gland causing hyperparathyroidism was experienced at the department of orthopaedic surgery, C.A.F.G.H. This patient, a 23 years old male, had complained of a left shoulder pain during the past 3months. And weakness of the lower extremities causing walking disturbance, multiple bone pain, and polyuria had occurred sinoe one month before admission. Physical examination revealed a hard palpable mass in the right anterior region of the neck. Radiologic examination revealed subperiosteal bone resorption in phalanges of the hands and feet, generalized osteoporosis and cystic lesions, and pathologic fracture of the ribs, left humerus, and left femur. Laboratory studies demonstrated hypercalcemia, hypophosphatemia, increased alkaline phosphatase and PTH, hypercalciuria, and hyperphophaturia. Sonogram and C-T scan of the neck revealed a mass in the right inferior portion of the thyroid. Rib biopsy revealed the findings of ostitis fibrosa cystica, and parathyroid gland and regional lymph node biopsy revealed a parathyroid carcinoma with regional lymph node metastasis.
Alkaline Phosphatase ; Biopsy ; Bone Resorption ; Femur ; Foot ; Fractures, Spontaneous ; Hand ; Humans ; Humerus ; Hypercalcemia ; Hypercalciuria ; Hyperparathyroidism ; Hypophosphatemia ; Lower Extremity ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Osteoporosis ; Parathyroid Glands ; Parathyroid Neoplasms ; Physical Examination ; Polyuria ; Ribs ; Shoulder Pain ; Thyroid Gland ; Walking

No abstract available.
Arthroplasty* ; Hip*

A 41-year-old man was diagnosed with a huge symptomatic liver mass and was referred to our hospital for liver biopsy and further evaluation. He presented with right upper quadrant tenderness. Enhanced abdominal computed tomography and magnetic resonance imaging revealed a 12.5-cm relatively well-defined heterogeneous enhancing mass in the right inferior liver with a large exophytic component containing a fat component and progressive delayed enhancement. The patient underwent right inferior sectionectomy. The pathological diagnosis was confirmed as angiomyolipoma, 12.3×9.2×5.0 cm in size, with tumor necrosis in 20% of the tissue. Hepatic angiomyolipoma is known as a benign tumor, but in our case, because of the large tumor size and coagulative necrosis, this tumor had malignant potential; surgical resection was deemed to be appropriate, and close follow-up monitoring was essential postoperatively.

A 41-year-old man was diagnosed with a huge symptomatic liver mass and was referred to our hospital for liver biopsy and further evaluation. He presented with right upper quadrant tenderness. Enhanced abdominal computed tomography and magnetic resonance imaging revealed a 12.5-cm relatively well-defined heterogeneous enhancing mass in the right inferior liver with a large exophytic component containing a fat component and progressive delayed enhancement. The patient underwent right inferior sectionectomy. The pathological diagnosis was confirmed as angiomyolipoma, 12.3×9.2×5.0 cm in size, with tumor necrosis in 20% of the tissue. Hepatic angiomyolipoma is known as a benign tumor, but in our case, because of the large tumor size and coagulative necrosis, this tumor had malignant potential; surgical resection was deemed to be appropriate, and close follow-up monitoring was essential postoperatively.

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*

PURPOSE: This study was performed to determine the mechanism of contralateral testis damage after repair of testicular torsion. In addition, we investigated the effect of allopurinol pretreatment on the contralateral testis damage. MATERIALS AND METHODS: The levels of malondialdehyde (MDA) in the testes, kidneys and serum samples were determined in rats following torsion, detorsion or detorsion after allopurinol pretreatment, as were the levels of superoxide dismutase (SOD) in the testes samples. H&E staining was performed on the testes specimens and we calculated the mean numbers of spermatids per tubule in each group. RESULTS: Torsion caused a significant increase in the MDA levels in the contralateral testes, and detorsion caused a further significant increase in MDA in the contralateral testes and in the serum. Moreover, pretreatment with allopurinol prevented this further increase. The levels of SOD in the contralateral testes were not significantly different between the sham and torsion groups, whereas detorsion caused a significant reduction in SOD. In addition, pretreatment with allopurinol also prevented this decrease. The contralateral testes were histologically normal in all groups and the mean numbers of spermatids per tubule in the ipsilateral and contralateral testes were similar in all groups. CONCLUSIONS: Injury of the contralateral testis after the repair of testicular torsion seems to be caused by lipid peroxidation that is due to oxygen free radicals induced by the reperfusion of ischemic torsed testis. Toxic substances such as oxygen free radicals seem to be transferred to the contralateral testes through the blood stream, and allopurinol appears to protect the contralateral testes from the injury caused by detorsion.
Allopurinol* ; Animals ; Free Radicals ; Kidney ; Lipid Peroxidation ; Malondialdehyde ; Oxygen ; Rats* ; Reperfusion ; Reperfusion Injury ; Rivers ; Spermatic Cord Torsion* ; Spermatids ; Superoxide Dismutase ; Testis*

Posterior transarticular screw fixation is known to be one of the best surgical method for the atlanto-axial instability. Between April 1995 and February 1997, this technique was used in the treatment of 21 patients(10 men, 11 women) suffering from this condition. The average age at the time of operation was 39 years(range, 17 to 63). and mean follow-up period was 14(mean 3 to 25) months. The indication for fusion were nine cases, type II-A odontoid process fracture; three cases, type II-P odontoid process fracture; three cases, os odontoideum; three cases transverse ligament laxity due to rheumatoid disease; and three cases, transverse ligament injury without bone fracture. Eleven operations involved cases were operated with posterior C1, 2 transarticular screw fixation using a 3.5 mm cortical screw augmented th interlaminar iliac graft and sublaminar wire fixation. The other ten patients underwent the same surgery without sublaminar wire fixation. In two cases d screw were misplaced; one was placed lateromedially and the other caused widening of the joint capsule space, but there were corrected by reoperation. Patients were ambulated with Philadelphia neck collar on the first post-operation day. At the end of three months follow-up, bone union was seen in all cases, and the following conclusions may be drawn: 1) Immediately after surgery, ambulation is possible; 2) The rate of occurrence of bone union is high; 3) A halo vest is not needed; 4) Sublaminar wiring is also unnecessary.
Follow-Up Studies ; Fractures, Bone ; Humans ; Joint Capsule ; Ligaments ; Male ; Neck ; Odontoid Process ; Reoperation ; Transplants ; Walking

No abstract available.
Arthritis* ; Immunoblastic Lymphadenopathy*

Colonic atresia (CA) is the rare cause of intestinal obstruction, and diagnosis of CA is difficult. But only few research has been performed, so little information has been available. The purposes of this study was to analyze the clinical findings of CA so that help physicians make decision properly. Children with CA who were treated at the division of pediatric surgery at Asan Medical Center in the period from January 1989 to December 2011 were evaluated retrospectively. A total of 6 children were treated with CA. These accounted for 2.7% of all gastrointestinal atresias managed in Asan Medical Center. Only one child was premature and low birth weight, the others were fullterm neonates and showed normal birth weight. Vomiting and abdominal distension were common symptoms and simple X-ray and barium study were used for diagnose of CA. But only 66.7% of the babies were diagnosed as CA pre-operatively. And 2 children out of 6 underwent re-operation due to missed CA at the time of the first operation. In aspect of types of atresia, the type IIIa were two, type IV were two, type I was one case, and one child showed rectal stenosis due to rectal web. Various operations were done according to individual findings and associated diseases. The 50% (n=3) of children underwent the primary anastomosis and the others (n=3) underwent colostomy first and staged operation later for missed CA or associated disease. All of them were recovered any significant complications. Therefore, the prognosis of CA is satisfactory if diagnosis and surgical management could be made properly. But because of the low incidence of CA, delay of diagnosis and treatment may occur. To prevent delay of diagnosis, we suggest prompt evaluation of doubtful infant and careful inspection of distal patency of bowel including whole colon and rectum when operating patients with intestinal atresia at any level.
Barium ; Birth Weight ; Child ; Colon ; Colostomy ; Constriction, Pathologic ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intestinal Atresia ; Intestinal Obstruction ; Prognosis ; Rectum ; Retrospective Studies ; Vomiting