Bone marrow pressure is neither arterial pressure nor venous pressure of extremity, that is thought the precapillary pressure of bone. It is different between long bone and flat bone, and is also different in various site of the bone. Author measured bone marrow pressure of 84 normal femoral heads of Korean adults for basic data of early diagnosis of avascular necrosis of femoral head. The results are followings : 1. The baseline bone marrow pressure of Korean healthy adults is average 22.5 ±7.2mmHg. 2. The most significant change of bone marrow pressure in stress test is observed at 5 min. after injection of 5cc normal saline. 3. The increase of bone marrow pressure at 5 min. after stress test was average 7.4 ±4.4 mmHg. 4. Sex and age factors do not influence bone marrow pressure.
Adult ; Age Factors ; Arterial Pressure ; Bone Marrow ; Early Diagnosis ; Exercise Test ; Extremities ; Head ; Humans ; Necrosis ; Venous Pressure

Cortical dysplasia is used to designate any cerebral developmental malformation, and encompass a spectrum of pathologic changes from mild cortical disruption to more severe pattern of cortical dyslamination with large bizarre neurons, balloon cells, and astrocytosis. The gross appearance of the brian reveals focal or diffuse cortical thickening with no clear cortical-white matter junction due to excessive spillover of abnormal neurons. Cerebellar cortical dysplasias are uncommon but has been reported in cases with more widespread cerebral malformations. We present two autopsy cases of cortical dysplasia, one of which involves both cerebrum and cerebellum. Case 1 was a 4-year-old boy and presented with severe intractable epilepsy of neonatal onset , cerebral palsy, microcephaly, and severe neurologic deficits. Both cerebrum and cerebellum were markedly reduced in size. Microscopic examination of cerebrum showed disorganized cortical architecture with abnormal neurons in the cortex and white matter. The cerebellum disclosed massive spillover of Purkinje cells into white matter. Case 2 was a 51-year-old woman and found in dead in her house. No previous clinical history was informed. At autopsy, no gross abnormality of the brain was observed, but microscopic examination showed giant, dysmorphic neurons throughout the cerebral cortex.
Autopsy* ; Brain* ; Cerebellum ; Cerebral Cortex ; Cerebral Palsy ; Cerebrum ; Child, Preschool ; Epilepsy ; Female ; Gliosis ; Humans ; Male ; Malformations of Cortical Development* ; Microcephaly ; Middle Aged ; Neurologic Manifestations ; Neurons ; Paralysis ; Purkinje Cells

O1igodendrocytes are known to be responsible for the synthesis and maintenance of myelin sheath in the central nervous system, and their functional disturbance leads to defect in myelination. But, the fine mechanism of myelination by oligodendrocytes is not yet known, and iron metabolism in central nervous system is suspected to be related with myelination process by oligodendrocytes. Carbonic anhydrase-II[CA-II], transfe-rrin, and ferritin are known to be present at oligodendrocytes and suspected to play a role in iron metabolism of central nervous system. In this study, demyelination and remyelination of ICR mouse brains were induced using cuprizone, the copper-chelating agent, and immunohistochemical changes of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes at corpus callosum were observed. During demyelination by cuprizone feeding, the numbers of CA-II- and transferrin-immunoreactive oligodendrocytes were decreased. Especially, the decrease ratio of CA-II-positive cells was great. In contrast, the number of ferritin-positive oligodendrocytes was increased during demyelination by cuprizone feeding. Cessation of cuprizone feeding leaded remyelination and the numbers of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes were returned to normal level. In conclusion, the derangement of iron metabolism in oligodendrocytes may be related to demyelination mechanism of central nervous system, and the CA-II is suspected to have an important role in iron metabolism of oligodenrocytes in relation to demyelination and remyelination induced with cuprizone.
Animals ; Brain ; Carbon* ; Central Nervous System ; Corpus Callosum ; Cuprizone* ; Demyelinating Diseases ; Ferritins ; Iron ; Iron-Binding Proteins* ; Metabolism ; Mice* ; Mice, Inbred ICR ; Myelin Sheath ; Oligodendroglia ; Transferrin

We experienced one case of severe pituitary dwarfism in a 10 years old female girl. Magnetic resonance image (MRI) revealed transection of the pituitary stalk stalk with the formation of high intensity ectopic posterior lobe located at the median eminence and agenesis of an anterior lobe of pituitary gland. The serum growth Hormone (GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient had responses to TRH, normal TSH and partial prolactin response, respectively. There was not response LH and FSH to GnRH. The morning cortisol concentration and serum T4 concentration were decreased below the normal range. These findings and no hyperprolactinemia suggested the presence of a vascular connection between the pituitary gland and hypothalamus, which is not visible on MRI. Sofar, the primary cause of idiopathic pituitary dwarfism in many patients is injury to hypothalamus by perinatal insults. In this patient, there was no history of perinatal insults and postnatal head trauma but transection of the pituitary stalk. We report a case of severe pituitary dwarfism due to agenesis with brief review of related litereature.
Child ; Clonidine ; Craniocerebral Trauma ; Dwarfism, Pituitary* ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Hypothalamus ; Levodopa ; Magnetic Resonance Imaging ; Median Eminence ; Pituitary Gland* ; Pituitary Gland, Anterior* ; Prolactin ; Reference Values

No abstract available.
Atrioventricular Block* ; Long QT Syndrome*

Cryptococcosis is an acute, subacute or chronic infectian caused by the encap sulated yeast Cryptococcus neoformans. The case of Cryptococcosis is a 2 5/12 year-old boy with involvement of the skin, lungs, liver, spleen, lymph node and central nervous system is reported. He has suffered from fever, nausea., vomiting and multiple skin lesions for a month. Thcre were various cutaneous lesions consisting of papules, pustules, nodules, crusts and ulcers on the scalp, face, back, buttocks and both extremities. Diagnosis was confirmed by the clinical characteristics, histopathologic findings and culture of the C. neoformans from cerebrospinal fluid and marcerated skin tissue. He was successfully treated with combination of Amphotericin B and 5-fluorocytosine.
Amphotericin B ; Buttocks ; Central Nervous System ; Cerebrospinal Fluid ; Cryptococcosis* ; Cryptococcus neoformans ; Diagnosis ; Extremities ; Fever ; Flucytosine ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Nausea ; Scalp ; Skin ; Spleen ; Ulcer ; Vomiting ; Yeasts

The pilomatricoma (calcifying epithelioma of Malherbe) is a rare, benign, asymptomatic tumor arising from the hair follicular matrix cells. It is usually a solitary lesion and it is most commonly found on the face and upper extremities. This tumor can occur in patients of any age, but about 60% of pilomatricomas are found in those patients less than twenty years old. The radiologic features of this neoplasm have rarely been described in the literature; in particular, the CT findings of pilomatricoma originating from the eyelid have not been published in Korea. We report here on a case of pilomatricoma that occurred in 69-year-old female; she had a hard subcutaneous mass on her right eyelid with overlying bluish skin.
Aged ; Carcinoma ; Eyelids* ; Female ; Hair ; Humans ; Korea ; Pilomatrixoma* ; Skin ; Upper Extremity

It is well known that fractures around the knee joint are usually combined with ligament injuries but it is easy to miss the ligament injuries during the treatment of fractures. The invention of the MRI and the development of arthroscopic techniques has made it easy to diagnose and care for ligament injuries. Authors reviewed the patients who had fractures around the knee joint to evaluate the frequencies, types, treatments and the results of combined ligaments injuries. There were 57 cases with the fracture of the proximal tibia and fibula which could be follwed up at least one year: from January 1992 to June 1995. There were 19 cases (33%) which had combined ligament injuries. The ligament injuries were diagnosed by stress X-ray & MRI evaluation and confirmed by arthroscopic examination. Single lateral rim avulsion fracture of proximal tibia was the most common type of fractures (7 cases, 37%). There were 11 cases (57%) of combined injuries of anterior cruciate ligament and medial collateral ligament. It was the most common combined ligament injury. Except for one, eleven cases that were combined with lateral rim avulsion of proximal tibia had anterior cruciate ligament injury. There were ten cases (53%) of fibula head and neck fractures which were combined with ligament injuries. The total number of the injured ligament was 35 and the common rupture sites of the injured ligaments was the attachment site of femur (13 cases) and tibia (16 cases). There were seven meniscal injury cases (37%). The interval from injury to operation averaged 14.1 days because many cases were acute injuries. Primary repairs for ruptured ligament were done in 31 cases (88%) because of their attachment site injuries. There were no instabilities except one case which was treated with posterior cruciate ligament reconstruction using semitendinosus ligament. It had a grade I posterior instability at the last follow-up. Early diagnosis and proper treatment on the ruptured ligaments and the torn meniscus combined with proximal tibia and fibular fractures seem to be important for a good prognosis.
Anterior Cruciate Ligament ; Collateral Ligaments ; Early Diagnosis ; Femur ; Fibula* ; Follow-Up Studies ; Head ; Humans ; Inventions ; Knee ; Knee Joint ; Ligaments* ; Magnetic Resonance Imaging ; Neck ; Posterior Cruciate Ligament ; Prognosis ; Rupture ; Tibia*

PURPOSE: The Remeex (Mechanical External Regulation) sling is a mid-urethral sling that allows adjustment of the sling tension in the postoperative period. We evaluated the early outcomes of the procedure in patients in whom the success rate of tension-free slings is low, such as with intrinsic sphincter deficiency (ISD). MATERIALS AND METHODS: We included 17 women with urodynamically proven stress urinary incontinence (SUI) who underwent the Remeex procedure and were followed for at least 12 months. The patients were considered to have ISD on the basis of a Valsalva leak point pressure (VLPP) <60 cmH2O or a maximum urethral closure pressure (MUCP) <20 cmH2O. We analyzed parameters including history taking, urodynamic study (UDS), and postoperative clinical outcomes. Patient's success and satisfaction rates were evaluated after the procedure. Also, we asked about lower urinary tract symptoms (LUTSs) with a questionnaire, and the severity of LUTSs was assessed with the Visual Analog Scale (VAS) before and 12 months after the operation. RESULTS: The patients' mean age was 55.6+/-9.58 years. Four (23.5%) patients had mixed incontinence. Five patients (29.4%) had undergone previous surgery for SUI. At a mean follow-up of 13.3 months (range, 12-16 months), 14 patients (82.3%) were cured and 3 patients (17.6%) were improved. Four patients (23.5%) answered very satisfied and 13 patients (76.4%) answered satisfied on the satisfaction questionnaire. Also, LUTSs were improved except voiding pain (p<0.05). CONCLUSIONS: This procedure provides high cure and satisfaction rates. Our results demonstrate that the Remeex procedure is suitable for women with SUI with ISD.
Female ; Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms ; Postoperative Period ; Suburethral Slings ; Urinary Incontinence ; Urodynamics

No abstract available.
Kidney*