TCavernous angiomas represent 5 to 12% of spinal vascular malformations and usually are located at the vertebral body level with possible extension into the extradural space. The intradural intramedullary cavernous angioma occurs in about 3% of cases, whereas extramedullary localization is extremely rare. We report a case of intradural extramedullary cavernous angioma in which the patient presented with low back pain and both leg pain. The magnetic resonance imaging study showed intraspinal mass lesion at L1-2. It was removed totally through laminectomy of L1-2 and confirmed as cavernous angioma. The postoperative course was uneventful without any neurologic deficit. We report this unusual spinal malformation.
Hemangioma ; Hemangioma, Cavernous* ; Humans ; Laminectomy ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Vascular Malformations

PURPOSE: The insulin like growth factors (IGFs) circulate complexed to IGF-binding proteins(IGFBPs). IGFBP-3 is the major circulating IGFBP and is found primarily as a 150 kDa complex which contains an acid labile subunit(ALS), IGFBP-3, and IGF-I or IGF-II and is considered to be growth hormone(GH) dependent. In this study, we measured serum IGF-I, IGFBP-3 and 150 kDa levels in sera of growth hormone deficient children(GHD) before and after GH treatment respectively to clarify the utility of these factors as a diagnostic marker for GHD and to observe the alterations of these factors according to GH treatment. METHODS: Measurement of serum IGF-I, IGFBP-3 and 150 kDa complex were performed in 10 children with complete growth hormonr deficiency(cGHD), in 6 children with partial growth hormone deficiency(pGHD) and in 10 normal healthy subjects. Serum IGF-I was measured by radioimmunoassay (RIA). IGF-I was seperated from IGFBPs by Sephadex G-50 acid chromatography. Serum IGFBP-3 was assessed by Western ligand blot(WLB) analysis as described by Hossenlopp with minor modifications. To evaluate alterations of different molecular size classes of IGF-BP complexes according to GH treatment, WLB was done after neutral size-exclusion chromatography using Sephacryl S-200. RESULTS: 1) The serum IGF-I level in children with GHD was significantly lower than that of control subjects(96.2+/-40.1 ng/ml vs 147.5+/-37.9 ng/ml)(p<0.01). 2) The serum IGF-I level in children with cGHD was significantly lower than that of normal subjects (p<0.01). But four of the 10 children with cGHD the IGF-I levels were distributed within the range of -2 S.D.. The serum IGF-I level in children with pGHD was also lower than that of normal subjects but there was no statistical significance between two groups(P>0.05). 3) The serum IGFBP-3 level is markedly decreased in 9 of 10 children with cGHD, but only in 2 of 6 children with pGHD which was measured by WLB method. 4) The serum IGF-I level after GH treatment was increased significantly in children with GHD(138.7+/-49.2 ng/ml vs 78.7+/-23.4 ng/ml)(p<0.01). The serum IGFBP-3 level was also increased after GH treatment as similar pattern. 5) The marked decrement of serum IGFBP-3 level in children with cGHD was explained as the result of decline in the 150 kDa IGFBP complex, and after GH treatment 150 kDa complex was increased; in the 150 kDa IGFBP complex, free IGF-I binding sites were increased. CONCLUSIONS: The serum levels of IGF-I, IGFBP-3 and 150 kDa complex in children with cGHD were decreased significantly, but in children with pGHD these changes were not observed as prominant as cGHD. These findings suggest that the measurments of serum IGF-I, IGFBP-3 level may be useful not only in the diagnosis of GHD but also differentiate cGHD from pGHD and the serum IGFBP-3 level may be more sensitive for diagnosing GHD even though each test by itself has a limited diagnostic accuracy as a single test.
Binding Sites ; Child* ; Chromatography ; Diagnosis ; Growth Hormone* ; Humans ; Insulin* ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Radioimmunoassay ; Somatomedins

OBJECTIVE: The objective of this study was to validate the effects of a titanium mesh cage and dynamic plating in anterior cervical stabilization after corpectomy. METHODS: A retrospective study was performed on 31 consecutive patients, who underwent anterior cervical reconstruction with a titanium mesh cage and dynamic plating, from March 2004 to February 2006. Twenty-four patients had 1-level and 7 had 2-level corpectomies. Ten patients underwent surgery with a cage of 10-mm diameter and 21 with 13-mm diameter. Neurological status and outcomes were assessed according to Odom's criteria. Sagittal angle, coronal angle, settling ratio, sagittal displacement, and cervical lordosis were used to evaluate the radiological outcomes. RESULTS: In overall, 26 (83.9%) of 31 showed excellent or good outcomes. Thirteen percent (4 cases) of the patients developed surgical complications, such as hoarseness, transient dysphagia, or nerve root palsy. Seven (22.6%) patients had reconstruction failure : 5 (20.8%) in the 1-level corpectomy group and 2 (28.5%) in the 2-level corpectomy group. Revisions were required in 2 patients with plate pullout due to significant instability. However, none of 5 patients who demonstrated cage displacement or screw pullout, underwent a revision. Radiographs revealed bony consolidation in 96.3% of the patients, including 6 patients with implantation failure during the follow-up period. CONCLUSION: Based on our preliminary results, the titanium mesh cage and dynamic plating was effective for cervical reconstruction after corpectomy. The anterior cervical reconsrtruction performed with dynamic plates is considered to reduce stress shielding and greater graft compression that is afforded by the unique plate design.
Animals ; Deglutition Disorders ; Follow-Up Studies ; Hoarseness ; Humans ; Lordosis ; Paralysis ; Retrospective Studies ; Spine* ; Titanium* ; Transplants

PURPOSE: To evaluate the clinical and radiological results, as well as the survival rate, associated with total hip arthroplasty using a hydroxyapatite (HA)-coated anatomical femoral stem at a follow-up of > or =12 years. MATERIALS AND METHODS: From April 1992 to May 1997, 86 patients (102 hips) underwent total hip arthroplasty with a HA-coated ABG I (Anatomical Benoist Giraud; Howmedica) hip prosthesis. The average age at the time of surgery was 53.4 years and the mean duration of follow-up was 17.1 years (range, 12.1-21.0 years). The Harris hip score (HHS) and radiographic assessments of thigh pain were used to evaluate the clinical results. We observed osteointegration, cortical hypertrophy, reactive line, calcar resorption and osteolysis around the femoral stems. The survival rate of the femoral stems was evaluated by using the span of time to a revision operation for any reasons was defined as the end point. RESULTS: The mean HHS was 50.5 preoperatively and 84.2 at the time of last follow-up. Osteolysis only around the HA-coated proximal portion of the femoral stem was observed in 72 hips, cortical hypertrophy all around the distal portion of the femoral stem was observed in 38 hips, and calcar resorption was observed in 44 hips. A reactive line was observed in 13 hips, but was unrelated to component loosening. Stem revision operations were performed in 24 (23%) hips due to osteolysis (14 hips), fracture (5 hips) and infection (5 hips). The femoral stem survival rate was 75% over the mean duration of follow-up. CONCLUSION: Total hip arthroplasty using a HA-coated anatomical femoral stem showed necessitated a high rate of revision operations due to osteolysis around the femoral stem in this long term follow-up study.
Arthroplasty, Replacement, Hip* ; Durapatite* ; Follow-Up Studies ; Hip ; Hip Prosthesis ; Humans ; Hypertrophy ; Osteolysis ; Survival Rate ; Thigh

Milwaukee shoulder syndrome is a rare clinical entity that is a rapid destructive shoulder arthropathy associated with deposition of calcium hydroxyapatite crystals. It mainly affects elderly women. It is characterized by the presence of large amount of noninflammatory synovial fluid containing calcium hydroxyapatite crystals, a complete tear of the rotator cuff and progressive degenerative changes at the humeral head, leading to almost complete functional impairment. We present a case of a 65-year-old woman suffered by Milwaukee shoulder syndrome with literature view.
Aged ; Durapatite ; Female* ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder* ; Synovial Fluid

Lewy bodies (LBs) and Lewy neurites (LNs) are pathological hallmarks of Parkinson’s disease (PD) or dementia with LBs (DLB). Incidental Lewy body disease (iLBD) is defined when LBs and LNs are found in the brain of normal elderly individuals. A 65-year-old man presented with autopsy-proven Lewy body pathology (LBP). He had never complained of cognitive impairments or parkinsonian motor symptoms, and he had always maintained independence in activities of daily living. Hypopigmentations in the locus coeruleus and substantia nigra were discovered during the autopsy. The patient showed severe-to-extremely severe LBs in the neocortex and limbic areas, except in the nucleus basalis of Meynert, amygdala, and brainstem, according to microscopic findings. Hence, using several of the previously known staging systems, it was difficult to classify the patient’s LBP type. Furthermore, these findings were unique because they had never been observed before in iLBD.

PURPOSE: Growth and development of infants can be periodically assessed through health screening, but iron deficiency anemia, which is common in infants, is difficult to detect by conducting only infant health screening. This study evaluated the prevalence of iron deficiency anemia in infants who visited Chung-Ang university hospital between 9 and 12 months of age. The study also determined the difference of anemia between term and preterm infants. METHODS: The subjects of this study were infants aged 9 to 12 months who visited outpatient clinics of Chung-Ang University Hospital from January 2006 to August 2018 for the purpose of infant health screening and immunizations. We divided the subjects as the term group and the preterm group, and their medical records were retrospectively analyzed. RESULTS: One hundred and fifty-two infants were included in the study. There were 51 in the preterm infant group and 101 in the term infant group. Thirteen infants were diagnosed with iron deficiency anemia, and 12 infants of these infants were in the term group and one infant was in the preterm group, which was statistically significant (P<0.001). There are significant differences in the hemoglobin (12.0±1.1 g/dL, 12.6±1.2 g/dL), hematocrit (35.8%±2.7%, 36.7%±3.2%), serum iron (60.8±25.4 µg/dL, 73.5±40.9 µg/dL), and unsaturated iron binding capacity (279.1±67.7 µg/dL, 252.0±47.5 µg/dL) between the term infant group and the preterm infant group, respectively (P<0.05). CONCLUSION Iron deficiency anemia was significantly more often diagnosed in term infants than that in preterm infants. Preterm infants may have a lower prevalence of iron deficiency anemia than do term infants because the preterm infants are taking iron supplements prophylactically. Therefore, iron deficiency anemia should be prevented in term infants, and it is important to confirm the presence of iron deficiency anemia by conducting blood tests during the first 9 to 12 months of life.

Partial trisomy 1q is a rare chromosomal disorder characterized by ventriculomegaly with craniofacial, renal, cardiac, and finger and toe anomalies. Most reported cases of partial trisomy1q have involved stillborn or premature deaths due to cardiac or liver failure. This case report describes an 18-month-old patient with partial duplication of the 1q32-44 segments and consequent developmental delays who exhibited improvement in developmental status with rehabilitation. Prenatal ultrasonography and magnetic resonance imaging of the mother revealed ventriculomegaly and atrophic changes in the left cerebral hemisphere of the fetus. The infant was born with micrognathia, microphthalmia, macrocephaly, low-set ears, polydactyly, and long feet at 37+5 weeks of gestation. A chromosomal study revealed an abnormal male karyotype of 46,XY,rec(1)dup(1)(q32.1q44)inv(1)(p36.3q32.1)pat. In this rare case of a patient with partial trisomy, we observed improvement in developmental delays following treatment using appropriate rehabilitation techniques. Further research is required to help validate the findings of this case study and establish a standardized rehabilitation technique that can be subsequently applied to such cases.

OBJECTIVE: To evaluate the associations between clinical and laboratory parameters and antinuclear antibodies (ANA)in rheumatoid arthritis (RA). METHODS: We determined functional status,disease duration,hemoglobin,platelet count,erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor (RF),ANA,and antiperinuclear factor in 89 RA patients.ANAs were studied by indirect immunofluorescence using Hep-2 cells.The medical records of the patients were reviewed. RESULTS: ANAs were detected in 30.3%of RA patients and 66.6%of ANAs were below the titer of 1:80.Nine patients had ANAs above the titer of 1:160, five of them had additional diseases besides RA.The ANA positivity was correlated only with the presence of RF.Two of the 5 ANA-positive patients without RF had thyroid disease. CONCLUSIONS: Except for RF,no significant correlation was observed between clinical and laboratory parameters and ANA positivity,but ANA positivity appears to be associated with the general autoimmunity.It is needed to search other associated pathologic conditions for ANA positive RA patients without RF.
Antibodies, Antinuclear* ; Arthritis, Rheumatoid* ; Fluorescent Antibody Technique, Indirect ; Humans ; Medical Records ; Rheumatoid Factor ; Thyroid Diseases

A case report of lymphangiohemangioma of the mediastinum that was misdiagnosed as thymic origin mass on chest CT and MR angiography. Operative finding revealed vascular proliferation originated from innominate vein and the pathologic finding showed both lymphatic and vascular component which was diagnosed lymphangiohemangioma.
Angiography ; Brachiocephalic Veins ; Lymphangioma ; Mediastinal Neoplasms ; Mediastinum* ; Tomography, X-Ray Computed