Massive hemorrhage into an intracranial neurinoma is a rare event. A 42-year old man noticed hearing loss, nystagmus, diplopia and paresthesia on the left side of the face. A computerized tomography scan demonstrated a large high density mass in the left cerebellopontine angle. The tumor was successfully removed and postoperative course was favorable. Such a case of acoustic neurinoma which revealed itself through intratumoral hemorrhage has not been previously reported in Korea.
Adult ; Cerebellopontine Angle ; Diplopia ; Hearing Loss ; Hemorrhage* ; Humans ; Korea ; Neurilemmoma* ; Neuroma, Acoustic ; Paresthesia

6 patients underwnet CT-guided stereotactic biopsy or hematoma aspiration procedure for posterior fossa lesions. Trajectory for biopsy or aspiration was transcerebellar approach. The patients were placed under general endotracheal anesthesia and positioned prone or sitting. No complications were encountered in the postoperative period when this technique was used. Stereotaxic transcerebellar multiple biopsy can safely provide tissue conformation of the neoplastic nature of a posterior fossa lesion thought to be a tumor. In addition, hematoma aspiration has been demonstrated to be safe, reliable, and efficient.
Anesthesia ; Biopsy ; Hematoma ; Humans ; Postoperative Period

Authors experienced a case of acute myocardial infarction confirmed by analysis of LDH isoenzyme. 53-year-old male was admitted to Sacred Heat Hospital, Chung Ang University Because of severe precordial pain radiating to both arm, shoulder and back. Chest X-ray film & electrocardiogram were within normal limit and SGOT was 110 unit/ml on the day of admission. Determination of total LDH value and analysis of LDH isoenzyme by agar gel electrophoresis were made on the second hospital day. Total LDH was 315unit/ml, but there was significant increased percentage of LDH isoenzyme(LDH1). Electrocardiogram showed ST segment elevation only on the 8th hospital day.
Male ; Humans

Hip and knee replacement arthroplasty is one of the important causes of pulmonary embolism, of which the incidence was reported to be from 2 to 16% But, there are no reports about the incidence of pulmonary embolism after these operations in Korea. The authors' intention was to study the incidence and clinical manifestations of pulmonary embolism after hip and knee surgery. Lung perfusion scans and inhalation scans were done preoperatively and 7 days postoperatively for 139 hip or knee replacement arthrosplasty patients in Asan Medical Center. We studied 62 cases of avascular necrosis of the femoral head, 33 cases of femur neck fractures, 45 cases of degenerative arthritis of the hip and knee joints and 17 cases of other diseases. In this study, hip replacement arthroplasties were done in 114 cases, knee replacement arthrosplasties in 25 cases. On preoperative lung scan, high or intermediate probability findings of pulmonary embolism were shown in 18 cases and all of them were asymptomatic. 139 cases showed normal or low probability on preoperative lung scan, of which 5 cases were changed to high probability and 7 cases to intermediate probability on postoperative lung scan. Four of the 7 intermediate probability cases were confirmed to be pulmonary embolism on pulmonary angiography. Of these 9 cases, hip replacement arthroplasties were done in 6 cases and knee replacement arthroplasties in 3 cases. There were 5 cases of osteoarthritis of hip and knee, 3 cases of avascular necrosis of femoral head and 1 case of femoral neck fracture. We concluded that preoperative and postoperative incidences of pulmonary embolism in Korea were similar to those in western countires. Most of the pulmonary embolism patients were asymptomatic and so lung perfusion scans and inhalation scans were helpful in the early diagnosis of pulmonary embolism.
Angiography ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Chungcheongnam-do ; Early Diagnosis ; Femoral Neck Fractures ; Head ; Hip ; Humans ; Incidence ; Inhalation ; Intention ; Knee Joint ; Knee ; Korea ; Lung ; Necrosis ; Osteoarthritis ; Osteoarthritis, Hip ; Perfusion ; Pulmonary Embolism

A retrospective analysis of the ultrasonographic findings of 9 cases of tuberculous abscess, 5 cases of pyogenic abscess and 2 cases of hematoma of psoas and adjacent muscles was made. Fluid collection with or without internal echoes was seen in 12 cases out of total 16 cases. Other findings were 2 cases of only muscle swelling, 1 case of highly echogenic mass.like appearance and 1 case of fluid collection with septae. Ultrasonography is considered an accurate method in identifying early pathologic changes of the psoas muscle and determining its extent. and in differentiating tumor from fluid collection of the psoas muscle. Authors dare to say that ultrasound examination is a procedure of choice in the diagnosis of psoas abscess and hematoma.
Abscess ; Diagnosis ; Hematoma ; Methods ; Muscles ; Psoas Abscess ; Psoas Muscles ; Retrospective Studies ; Ultrasonography

Osteoporosis is a major health-care problem for aging communities. And postmenopausal osteoporosis is a common disorder characterized by an increase in bone resorption relative to bone formation, generally in conjunction with an increased rate of bone turnover. Twenty female rats were used as rat model of osteoporosis. They randomly were divided into two groups: a normal control group, and calcium-free diet groups treated with bilateral ovariectomy. The animals were sacrified at 12 weeks after treatment. In the rats with osteoporosis, there was significant thining and loss of trabeculae, accompanied by a disconnection of trabeculae. And acid mucopolysaccharides were decreased in osteoporotic animals. In order to setup conditions of invivo micro-CT, proper anesthetic is ketamine (50 mg/kg) /xylazine (6 mg/kg). And proper breathing rate of experimental animals is 1.3~1.6/sec. Our finding suggest that bilateral ovariectomy and calcium-free diet induce decrease in thickeness of trabecular bone and decrease in acid mucopolysaccharide, therefore cause weakness of bone. And micro-CT imaging system is useful to evaluate trabecular bone. Anesthetic time, anesthetics and respiration rate also signify much in micro-CT imaging system.
Aging ; Anesthetics ; Animals ; Bone Resorption ; Diet ; Female ; Glycosaminoglycans ; Humans ; Ketamine ; Models, Animal ; Osteogenesis ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Ovariectomy ; Rats ; Respiration ; Respiratory Rate

Eosinophilic granuloma of the cervical spine is an uncommon disease. A 20-year old male patient noticed cervical pain, restricted range of movement, torticollis and tenderness. On computed tomographic scan, myelographic imaging and plain radiographic imaging demonstated a bony destruction in the left side of the third cervical vertebral body and a part of the pedicle. Preoperative radioisotope bone scan demonstrated an hot uptake in the third cervical vertebral body. Gross total removal of the lesion and radiation therapy were performed. Postoperative course was favorable. The lesion is readily curable and should be considered in the diferential diagnosis of pain or neurological deficit in association with a lytic defect in the cervical spine. Occasionally, a solitary lesion characteristic of eosinophillic granuloma in found in cases of otherwise classic Hand-Schuller-Christian. So, close chinical and radiologic follow-up sholuld be obtained.
Diagnosis ; Eosinophilic Granuloma* ; Eosinophils* ; Follow-Up Studies ; Granuloma ; Humans ; Male ; Neck Pain ; Spine* ; Torticollis ; Young Adult

The posterolateral approaches to the spine is an effective method for the neural decompression and the spinal stabilization. This procedure has an advantages of an one-stage posterolateral decompression-stabilization. We have experienced 8 patients with burst fracture in the thoracolumbar junction. A three-quater prone position was used for patient positioning. No patient showed neurologic deterioration after surgery. Patient positioning and the operative approach are described and illustrated.
Decompression* ; Humans ; Patient Positioning ; Prone Position ; Spine*

Peripheral primitive neuroectodermal tumor (pPNET), a rare, highly aggressive neoplasm of indetermined histogenesis, occurs typically in the soft tissues of the chest wall and the paraspinal region. Comprehensive diagnostic studies including histological, ultrastructural, immunohistochemical and molecular analyses have been stressed to diagnose this entity. We report a case of primary renal PNET which was incidentally found in a 59-year-old man who presented with generalized weakness for 4 months. He was diagnosed as a non-insulin dependent diabetes mellitus 15 years ago and has been made well by oral therapy. An ill-defined mass, measuring 3.5 3 cm, located in the left kidney and perirenal fat, was incidentally found by ultrasonogram during a renal diabetic examination. The mass was resected because of the unresponsiveness against one-year chemotherapy and radiation therapy. Grossly, a homogeneously solid, gray-white mass, measuring 2.8 1.8 cm, was noted in the mid portion of renal cortex. The mass showed severe adhesion to the perirenal fatty tissue. Microscopically, tumor cells were rather uniform, small round with scanty cytoplasm and often showed rosette formation. Ultrastructurally, they showed membrane-bound dense core granules, measuring 125~150 nm, intercellular junctions and microvillous cytoplasmic projections. The tumor cells were uniformly immunoreactive for neuron-specific enolase and were focally immunoreactive for CD99 (013), chromogranin, synaptophysin and cytokeratin. They were not reactive for S-100 protein, vimentin, Leu-7, leukocyte common antigen, desmin and smooth muscle actin. To our knowledge, this is the smallest renal PNET in literature.
Actins ; Adipose Tissue ; Antigens, CD45 ; Cytoplasm ; Desmin ; Diabetes Mellitus ; Drug Therapy ; Humans ; Intercellular Junctions ; Keratins ; Kidney* ; Middle Aged ; Muscle, Smooth ; Neuroectodermal Tumors, Primitive* ; Phosphopyruvate Hydratase ; Rosette Formation ; S100 Proteins ; Sarcoma, Ewing ; Synaptophysin ; Thoracic Wall ; Ultrasonography ; Vimentin

A cornual pregnancy occurs when the conceptus implants at the cornus of the uterus which is the junction between the fallopian tube and uterine cavity. It accounts for 2 to 4% of tubal pregnancy and rupture usually occurs between 8 weeks and 16 weeks of gestation. The rich vascularity in this location makes the rupture particularly dangerous, resulting in higher maternal mortality. The presented case was unique in that the pregnancy was believed to be a normal intrauterine pregnancy till 24 week's of gestation, when it ruptured and presented as the pregnant patient with hypovolemic shock of unknown cause. We present this case with a brief review of the literature.
Cornus ; Fallopian Tubes ; Female ; Humans ; Maternal Mortality ; Pregnancy Trimester, Second ; Pregnancy* ; Pregnancy, Tubal ; Rupture ; Shock ; Uterine Rupture ; Uterus