Intraspinal neurenteric cysts are rare congenital lesions that results from abnormal separation of germ layers in the third week of embryonic development, which may cause spinal compression. Although, the diagnosis of neurenteric cyst was very difficult prior to operation, MRI has proven to be a useful imaging modality in detection, localization and characterization of intraspinal neurenteric cysts. We recently experienced intraspinal neurenteric cyst in two patients who presented with progerssive quadriparesis. Myelography, CT myelography and MRI were taken and complete excision was performed. The MRI findings are presented and the literature is reviewed.
Diagnosis ; Embryonic Development ; Female ; Germ Layers ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neural Tube Defects* ; Pregnancy ; Quadriplegia

PURPOSE: The purpose of this study is to describe Magnetic Resonance(MR) findings of two epidural cavernous malformations of the spine. MATERIALS AND METHODS: MR imaging was performed in 2 patients(29-year-old man and 54-year-old woman). Sagittal T1 -, T2-weighted images and Gadolinium (Gd)-enhanced axial and sagittal images were acquired. Two patients had surgery and MR findings were compared with surgical and histopathological findings. RESULTS: MR imaging showed high- and low-signal intensity components of these lesions that were characteristic of an epidural cavernous malformation in one case. The other case showed a high signal intensity on T2- and strong enhancement on Gd-enhanced T1 -weighted images. We think that the former may be due to mixed subacute and chronic hemorrhage and the latter may be due to blood within the endotheliumlined sinusolds without hemorrhage. CONCLUSION: These findings were well correlated with the surgical and histo-pathological findings of cavernous malformation.
Gadolinium ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Spine*

There is much controversy concerning the method of treatment on the tibial fracture because of frequent complications, such as non-union, delayed union and infection. Authors reviewed and analyzed 110 tibial fractures which had been treated at the Department of Orthopedic Surgery, Sung Ae General Hospital from June 1983 to March 1987 by the groups, conservative treatment, open reduction and internal fixation with compression plate and closed flexible intramedullary nailing. The results were as follows :1. In regard to the fracture location, there was no difference in the healing time among the treatment methods. The I.M. nailing group healed 1.5 weeks earlier than other groups in each location. 2. In minor and moderate severity by Ellis, the I.M. nailing group revealed better result, and in major one, the compression plate group showed better result. More complications occured in major severity. 3. Union time among the trestment methods was not affected by the fibular fractures, but most of the complications occured in the concomitant fibular fracture case. 4. In open fracture, the healing time showed no difference among the groups, and was prolonged about 2 weeks than closed fracture. In closed case, the I.M. nailing group showed good result. 5. The cases, which were reduced earlier in the conservative group, and treated within 3 days in the I.M. nailing group revesled better result. 6. The radiological union time from the definite treatment was 15.80 weeks in the conservative treatment group, 15.18 weeks in the compression plate group and 13.92 weeks in the I.M. nailing group.
Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hospitals, General ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

Congenital dislocation of the knee is very rare deformity and presents with anterior displacement of the tibia in relation to the femur. Early gentle manipulation and serial splintage or plaster cast is recommended for treatment and successful in the majority except the case of quadriceps contracture or late correction. We experienced two cases of bilateral congenital dislocation of the knee who had been treated with early gentle manipularion, immobilization with serial corrective dual splint, passive stretching and night splint. Our results are good in both cases.
Casts, Surgical ; Congenital Abnormalities ; Contracture ; Dislocations ; Femur ; Immobilization ; Knee ; Muscle Stretching Exercises ; Splints ; Tibia

No abstract available.
Leiomyoma*

PURPOSE: To evaluate the merits of this technique and to provide a standard for comparison with futuretreatment alternatives. MATERIALS AND METHODS: We retrospectively reviewed the records of 52 patients withdirect CCF treated at the Yonsei Medical Center between 1983 and 1997 by transarterial or transvenous embolizationusing detachable balloon(s) and/or coils. RESULTS: Among the 52 cases, 51 were traumatic in origin, while onlyone was the result of a ruptured aneurysm. The three most common presentations were chemosis, bruit, andpulsatile proptosis. Forty-five patients were successfully treated with detachable balloon(s) and/or coils andinternal carotid blood flow was preserved in 35. When coils were used (1993-7), the ICA preservation rate washigher than when they were not used (1983-92). To confirm statistical significance, however, more studies areneeded. Four patients who initially presented with incomplete occlusion showed spontaneous occlusion on follow upangiography. In two patients, surgical ligation was performed because embolization failed and there was incompleteocclusion of the fistula. We experienced complications such as transient 3rd and 6th cranial nerve palsy,migration of deflated balloons and coils to the lung, and loss of vision. CONCLUSION: Transarterial andtransvenous embolization with detachable balloon(s) and/or coils provides a high rate of fistula obliteration withlow morbidity. In particular, the use of coils led to an increased rate of ICA preservation, thus and isconsidered as a good treatment modality for CCF obliteration.
Aneurysm, Ruptured ; Cranial Nerves ; Exophthalmos ; Fistula* ; Humans ; Ligation ; Lung ; Retrospective Studies

Purpose: To establish age/sex-specific reference intervals for serum uric acid and to examine the associations between serum uric acid level and metabolic syndrome (MetS) and its components in Korean children and adolescents. Methods: We analyzed data for 1,349 subjects aged 10 to 19 years from the Korea National Health and Nutrition Examination Survey 2016–2017. Results: The mean uric acid levels were 5.9±1.3 mg/dL (interquartile range, 5.0–6.8 mg/dL) in males and 4.6±0.9 mg/dL (interquartile range, 3.9–5.2 mg/dL) in females. The mean uric acid level increased significantly from 10–13 years of age in males, but not in females. The overall prevalence of MetS was 5.9% (7.3% in males and 4.3% in females; P=0.022). The prevalences of MetS in the lowest, second, third, and highest quartiles of uric acid level were 4.4%, 3.3%, 6.1%, and 15.2%, respectively, in males (P for trend <0.001) and 1.9%, 0.0%, 4.1%, and 10.9%, respectively, in females (P for trend <0.001). Compared with the lowest quartile of uric acid level, the odds ratio (with 95% confidence interval) for MetS in the highest quartile was 2.897 (1.140–7.361) in males and 5.173 (1.459–18.342) in females. Subjects in the highest quartile exhibited increased risk for abdominal obesity and low high-density lipoprotein cholesterol in both sexes. Conclusion Serum uric acid level is positively associated with MetS and its components abdominal obesity and low high-density lipoprotein cholesterol.

BACKGROUND:Thoracoscpic sympathicotomy is an effective treatment for essential hyperhidrosis. Patients are generally satisfied with the surgery at the early post operative period, but they suffer from recurrence and compensatory sweating at the late post operative period. There are many sympathicotomy methods for minimizing recurrence and the compensatory sweating. We compared the outcome from between the R3 and R4 sympathicotomy methods for the symptoms, satisfaction, recurrence and compensatory sweating. MATERIAL AND METHOD: From January 1999 to July 2007, 39 cases of thoracoscopic sympathicotomy at the 3rd rib (R3) and 72 cases of thoracoscopic sympathicotomy at the 4th rib (R4) for treating palmar hyperhidrosis were compared for the early and late satisfaction, the compensatory sweating and recurrence. RESULT: There is no difference of gender and age for the 2 groups. Early satisfaction was reported by 94.9% of the R3 patients and by 98.7% of the R4 patients. 84.6% of the R3 patients reported late satisfaction and 87.5% of the R4 patients reported late satisfaction. There were no significant differences between the groups for the early and late satisfaction. But there was a difference between the groups for compensatory sweating (23.1% in the R3 group and 9.7% in the R4 group (p=0.020)). The reoperation rate due to recurrence was 5.1% in the R3 group and 4.2% in the R4 group. There was no significant difference between the groups for recurrence. CONCLUSION: R4 sympathicotomy has excellent therapeutic results for compensatory sweating as compared to R3 sympathicotomy for treating palmar hyperhidrosis.
Humans ; Hyperhidrosis ; Recurrence ; Reoperation ; Ribs ; Sweat ; Sweating

Inflammatory pseudotumor (IPT) of the liver is rare benign tumor. When the diagnosis of IPT is established with biopsy, simple observation or conservative therapy is preferred because of the possibility of regression. But IPT is unresponsive to the conservative treatment, surgical resection should be considered. We experienced a 63-year-old male, who was suspected hepatocellular carcinoma in abdominal computed tomography (CT) and magnetic resonance image (MRI) scan, presented with 2-month history of intermittent fever and weight loss. Percutaneous ultrasound guided core biopsy confirmed IPT of the liver. Non-steroidal anti-inflammatory drugs and antibiotics were administered for 8 and 4 weeks, respectively, but fever continued. So, extended right hepatectomy was performed for IPT of the liver and then fever subsided. The patient remains well during a follow-up period of 12 months.
Middle Aged ; Male ; Magnetic Resonance Imaging ; Liver Diseases/*diagnosis/pathology/*surgery ; Liver/pathology/surgery ; Humans ; *Hepatectomy ; Granuloma, Plasma Cell/*diagnosis/pathology/*surgery ; Diagnosis, Differential

PURPOSE: After curative resection for hepatocellular carcinoma (HCC), the five-year survival rate ranges between 30~50%; however, this might be different from the actual survival rate. The actual 5-year survival rate and prognostic factors following curative resection for HCC were analyzed. METHODS: A retrospective analysis was performed on 63 HCC patients, who had undergone curative resection, between 1998 and 1999. RESULTS: A total of 63 cases, including 53 men and 10 women, were reviewed. The median age was 49 years old. Pathologic T stage I, II, III and IV were observed in 1, 17, 38 and 7 cases, respectively. The actual 1-, 3- and 5-year survival rates were 85.7, 69.8 and 57.0%, respectively, with a median survival time of 58 months. The actual 1-, 3- and 5-year disease free survival rates were 68.1, 51.9 and 50.2%, respectively, with a median disease free survival time of 46 months. Thirty-one patients had recurrence, mostly within one year (65%), indicating a poor survival rate, with an actual 5-year survival rate of 5%. A satellite nodule, the pT stage, recurrence of tumor, time to recurrence (within one year), and presence of extrahepatic metastasis were found to be prognostic factors influencing the survival rate of HCC patients. However, microvessel invasion caused a difference in the survival rate, but without statistical significance (p=0.08). A satellite nodule, microvessel invasion and the pT stage were found to be factors influencing the disease free survival rate of HCC patients. No statistically related factors, with the exception of the pT stage, were found in a multivariate analysis. CONCLUSION: The actual 5-year survival and disease free survival rates were 57.0 and 50.2%, respectively. The time to recurrence and pT stage were found to be factors influencing the survival rate of patients with a hepatocellular carcinoma. Further advanced studies will have to be carried out for the active treatment of HCC cases with a pT stage III or IV to reduce recurrence.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Female ; Hepatectomy ; Humans ; Male ; Microvessels ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate*