We studied to assess the relationship between intrauterine growth retardation and theincreased nucleated red blood cell counts (NRBC) in small for gestational age (SGA) and appropriatefor gestational age (AGA) neonates with low birth weight. We also evaluated the nucleated red blood cell counts in low birth weight neonates who had either perinatal asphyzia or hyaline membrane disease (HMD) or died within 7 days after birth. The results were as follows: 1) In low birth weight neonates, the mean value for NRBC counts was 9.02/100 WBCs and the mean absolute value for NRBC counts was 0.9210E9/L. 2) The mean values for NRBC counts were 13.4/100 WBCs in SGA and 6.4/100WBCs in AGA. The mean absolute values for NRBC were 1.32x10E9/L in AGA neonates 3) In SGA neonates with low birth weight, the mean NRBC counts wers 19.6/100WBCs in asphyxiated group and 4.5/100WBCs in control group. The mean absolute NRBC counts were 1.9810E9/L in control group. 4) In AGA neonates with low birth weight, the mean NRBC countswere 9.1/100WBCs in asphyxiated group and 2.4/100WBCs in control group. The meanabsolute NRBC counts were 0.98x10E9/L in asphyxiated group and o.23x10E9/L in controlroup. 5) The mean NRBC counts were 13.8/100WBCs in neonates with HMD and 7.1/100WBCs in control group. The mean absolute NRBC counts were 1.50x10E9/L in neonates withHMD and 0.70x10E9/L in control group. 6) The mean NRBC counts were 19.9/100 WBCs in expired group and 6.8/100WBCs in suvived group. The mean absolute NRBC counts were 2.1810E9/L in expired group and 0.66x10E9/L in survived group. 7) The NRBC counts of SGA neonates were significantly higher than that of AGA neonates with low birth weight. 8) The NRBC counts of asphyxiated neonates were significantly higher than that of the control group. 9) The NABC counts of expired neonates were significantly higher than that of the control group. 10) The NRBC counts of expired neonates were significantly higher than that of the survived neonates.
Birth Weight* ; Erythrocyte Count* ; Erythrocytes* ; Fetal Growth Retardation ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Infant, Low Birth Weight ; Infant, Newborn* ; Parturition*

An inflammatory myofibroblastic tumor (IMT) is a rare tumor that is currently classified as an intermediate cancer according to the World Health Organization classification system. The pathophysiology of its occurrence is still unknown. Imaging tests, such as CT or MRI, can be helpful in diagnosis, but the final diagnosis is confirmed by a pathological examination through a biopsy and immunohistochemistry stain. The patient, in this case, presented an asymptomatic intrahepatic mass discovered incidentally on an imaging examination. Initially, intrahepatic cholangiocarcinoma was suspected, but she was finally diagnosed with IMT through a histological examination after a liver resection.

Tuberculoma of the lungs is not an uncommon finding, but an ectopic liver in the lung is extremely rare. Pulmonary tuberculosis presenting as tuberculoma can be diagnosed radiologically, but its definite diagnosis is established by confirmation of the acid-fast bacillus or the unique histology. We report here on a case of tuberculoma of the left lower lobe that was erroneously diagnosed as ectopic liver by ultrasono-guided fine needle aspiration biopsy. An understanding of the normal variants of the liver can prevent a patient from undergoing an unnecessary invasive procedure.
Bacillus ; Biopsy ; Biopsy, Fine-Needle ; Humans ; Liver ; Lung ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

Ganglioneuroma is an uncommon benign tumor and arise from neural crest cells or sympathetic and peripheral nerves. A 13-year-old boy was referred to our institute and presented with three-day history of right upper extremity weakness associated with neck pain for nearly one month. Magnetic resonance imaging showed right side dumbbell shaped extramedullary lesion at the C2-3 level extending outside through neural foramen. Paraspinal and posterior neck mass, cafe au lait spot was identified. We performed surgical decompression of the spinal cord by resection of intradural portion mass. Histopathological diagnosis was ganglioneuroma.
Adolescent ; Decompression, Surgical ; Diagnosis ; Ganglioneuroma* ; Humans ; Magnetic Resonance Imaging ; Male ; Neck ; Neck Pain ; Neural Crest ; Neurofibromatoses ; Peripheral Nerves ; Spinal Cord Compression* ; Spinal Cord* ; Upper Extremity

OBJECTIVE: The purpose of this study is to evaluate clinical and radiological outcomes analysis of the laminoplasty in the elderly patients, and to compare with the non-elderly patients. METHODS: A retrospective study of the short term result in patients who had treated with the laminoplasty for cervical spondylotic myelopathy (CSM) was performed. From January 2008 to December 2012, total 62 patients were operated with single open-door technique because of CSM; 28 patients were the elderly and 34 patients were the non-elderly. We evaluated some factors including sex, symptom duration, estimated blood loss during operation, operation time, hospitalization day, complications, pre- and postoperative modified Japanese Orthopedic Association (mJOA) score, recovery rate of mJOA score, achieved mJOA score, mean cervical canal width and expansion ratio of antero-posterior diameter in order to identify difference between the two group. Clinical outcomes were calculated with the recovery rate of mJOA score at the time of one year after operation. RESULTS: Mean age were 71.9 in the elderly group and 52.9 in the non-elderly group. Although postoperative mJOA score in the elderly group was lower than that of the non-elderly group, achieved mJOA score was statistically same between the two groups. Other clinical and radiological outcomes were also statistically same. CONCLUSION: We conclude that the laminoplasty also assures good clinical outcomes in the elderly patients with CSM, same as in the non-elderly group.
Aged* ; Asian Continental Ancestry Group ; Hospitalization ; Humans ; Orthopedics ; Retrospective Studies ; Spinal Cord Diseases*

There are few reported cases of post-operative spondylitis caused by Mycobacterium intracellulare. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were positive for acid-fast bacilli and traditional anti-tuberculous medications were started. Because the Polymerase Chain Reaction for non-tuberculous mycobacterium (NTM) was positive, the anti-tuberculous medications were changed to anti-NTM drugs. However, the neurologic deficits did not improve and persistent elevation of erythrocyte sedimentation rate and C-reactive protein were noted. Eight weeks after the revision, Mycobacterium intracellulare was detected in the specimen cultures. Despite supportive care with medication, the patient died due to multiple organ failure.
Aged ; Biopsy ; Blood Sedimentation ; C-Reactive Protein ; Epidural Abscess ; Female ; Fever ; Fractures, Compression ; Hematoma ; Humans ; Low Back Pain ; Magnetic Resonance Spectroscopy ; Multiple Organ Failure ; Mycobacterium ; Mycobacterium avium Complex ; Neurologic Manifestations ; Osteomyelitis ; Paraparesis ; Polymerase Chain Reaction ; Spinal Cord ; Spondylitis

To characterize the association between chronic kidney disease (CKD), mortality, severity of coronary artery disease (CAD), treatment modality of CAD, and type of coronary stents among patients undergoing coronary angiography (CAG), we retrospectively reviewed the electronic medical records of the patients who underwent CAG at Seoul National University Bundang Hospital in Korea between May 2003 and January 2006. CKD was staged using an estimated glomerular filtration rate (eGFR) from the creatinine value prior to CAG. There were 3,637 patients included. The presence of CAD was 48% in CKD stage 1, 61% in stage 2, 73% in stage 3, 87% in stage 4, and 81% in stage 5. Survival rate gradually diminished for patients with decreasing renal function. No significant differences in all-cause and cardiac mortality were observed by medical treatment, PCI or CABG, in CKD patients with an eGFR less than 60 mL/min/1.73 m(2). CKD patients with drug-eluting stents showed significantly lower all-cause mortality (5.4% vs. 13.3%) and incidence of myocardial infarction (1.7% vs. 10%) than those with bare metal stents. In conclusion, an eGFR is a strong independent prognostic marker among patients undergoing CAG and the severity of CAD increases progressively with worsening renal function.
Aged ; Coronary Angiography/*methods ; Coronary Artery Disease/complications/*diagnosis/mortality ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney/pathology/*physiology ; Kidney Diseases/complications/*diagnosis/mortality ; Kidney Function Tests ; Male ; Middle Aged ; Stents ; Time Factors ; Treatment Outcome

Cervicomedullary junction arteriovenous malformation(AVM) is extremely rare. The authors present a case of a cervicomedullary junction AVM in a 31-year-old woman presenting with recurrent intraventricular hemorrhage(IVH). Magnetic resonance imaging revealed the AVM(of a size of approximately 2X2.5X4cm) extending from a lower medulla to C2-3 level. Vertebral angiography demonstrated a tightly coiled vascular mass with multiple feeders (radiculomedullary arteries) and irregular-shaped aneurysm at distal part of feeder originating at right C-1 level. The patient underwent superselective embolization of upper nidus and the aneurysm. The pertinent literature is reviewed, and diagnostic and therapeutic implications are discussed.
Adult ; Aneurysm ; Angiography ; Arteriovenous Malformations ; Female ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging

Cholesterol granuloma of frontal bone is a rare disease which usually occurs at the lateral part of the supraorbital ridge. This expanding lesion grows slowly and extends into the orbit and anterior cranial fossa. The most common symptom is proptosis. This granuloma is composed of a granulomatous reaction surrounding cholesterol crystals. Surgical treatment involves aspiration of contents and stripping or curettage of the lining which is highly successful. We experienced a case of cholesterol granuloma of frontal bone with huge intracranial extension, which was cured by surgical removal. The clinical features, radiologic, and pathologic finding were discussed and the pertinent literatures were reviewed.
Cholesterol* ; Cranial Fossa, Anterior ; Curettage ; Exophthalmos ; Frontal Bone* ; Granuloma* ; Orbit ; Rare Diseases

OBJECTIVE: This study evaluated the prognostic factors that influence the surgical outcomes of elderly patients older than 65 years old with an aneurysmal subarachnoid hemorrhage. METHODS: Ninety-two patients older than 65 years old, who were operated in our hospital between 1998 and 2005, were reviewed retrospectively. The clinical outcomes were evaluated using the modified Rankin Scale three months after surgery. RESULTS: The preoperative neurological status, such as the Hunt-Hess grade (p<0.001), World Federation of Neurological Surgeons (WFNS) grade (p<0.001), and the Fisher grade (p=0.001), was significantly associated with the surgical outcomes in this series. The vasospasm (0.016) and ventriculostomy (0.039) are factors influencing the surgical outcomes. However, the other factors including hypertension (0.831), smoking (0.228), accompanying disorder (0.706), size of aneurysms (0.177), location of aneurysms (0.755), shunt operation (0.356), and timing of surgery (0.194) had no influence on the surgical outcome. CONCLUSION: In elderly patients with intracranial aneurysms, the preoperative neurological status, vasospasm, and ventriculostomy are the most significant prognostic factors.
Aged* ; Aneurysm* ; Humans ; Hypertension ; Intracranial Aneurysm ; Retrospective Studies ; Smoke ; Smoking ; Subarachnoid Hemorrhage* ; Ventriculostomy