Meningioma of unusual age of onset, location, histogenesis and histologic type is reported. The patient, 4 year-old girl, had an intradural spinal meningioma arising from lumbar nerve root with no dural attachement. The meningioma revealed glycogen-rich, clear cell type with extensive and blocky hyalinization of the stroma. The tumor shared common fibrous sheath with attached lumbar nerve, and nerve fibers were scattered within the tumor. Ultrastructurally, the tumor cells had abundant glycogen particles, intermediate filaments and intercellular desmosomes. Hyalinized material revealed large amianthoid collagen fibers.
Child ; Male ; Female ; Humans ; Meningioma

Endoscopic retrograde cholangiopancreatography(ERCP) is a new diagnostic method for pancreatic and biliarydiseases which has been made possible by the development of fiberoptic duodenoscopy. It has been thought that ERCPwell serve an important role in the early detection of pancreatic cancer, but in order to detect minor lesions ofthe pancreas and improve the diagnostic accuracy of resectable pancreatic cancer, Endoscopic RetrogradeParechymography of the pancreas (ERPP) was developed recently. The authors analyzed 117 cases of ERCP performed atthe Kwangju Christian Hospital between Jan. and Dec. 1980, and compared them with the final diagnosis. The resultswere as follows; 1. Out of 117 cases, successful visualization of the duct of concern was achieved in 105 cases.Of these, 25 cases were ERPP. 2. The ratio of males to female was 1.44:1. Most patients were in the 4th to 6thdecade. 3. The commmonest clinical manifestations were upper abdominal pain (77cases), jaundice(23 cases),indigestion, vomiting and abdominal mass, in order of frequency. 4. Out of 46 cases of suspected pancreaticdiseases, the pancreatic duct was visualized in 36 cases, and 24 cases revealed pathognomonic findings. These werediagnosed as 16 cases of pancreatic cancer, 4 cases of chronic pancreatitis, 2 cases of pancreatic pseudocyst and2 cases of periampullary cancer with pancreas invasion. In pancreatic cancer findings were; encasement, localdilatation, delayed excretion, poor filling, obstruction of pancreatic duct, accompanying C.B.D. obstruction orstenosis and so called double duct sign. The chronic pancreatitis findings included; ductal dilatation (with orwtihout) obstruction, tortuosity with dilated saccular lateral branching, stone formation and the parenchymalfilling defect. 5. Out of 71 cases of suspected biliary tract diseases, the biliary tract was visualized in 57cases, and in 31 cases abnormalities were suggested; such as 20 cases of biliary stone, 1 cases of ascariasis, 1case of clonorchiasis with cholangitis, 1 case of clonorchiasis with stone, 2 cases of C.B.D. ca. 2 cases of G.B.ca, 3 cases of intrahepatic disease, 1 case of stones in the biliary tree with ampullary ca. 6. Complications ofERCP and ERPP were extremely raare. Transient abdominal distention, abdominal discomfort and elevated serumamylase were noted, but were not clinically significant.
Abdominal Pain ; Ascariasis ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Clonorchiasis ; Diagnosis ; Dilatation ; Duodenoscopy ; Female ; Gwangju ; Humans ; Male ; Methods ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Vomiting

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

To analyze the improvement of shouder function after arthroscpic subacrominal decompression and open repair for complete rotator cuff tear, we performed a prospective study in 14 patients using self evaluation form from the American Shouder and Elbow Society(ASES). All patients were treated with arthrscopic biplanar subacromial decompression and open repair by use of bony trough and followed for more than 1 year from November 1994 to June 1996 in Dankook university hospital. All patients were assessed preoperatively and at final follow-up using the standardised method of research committee of American shoulder & elbow surgeons. Tears of the rotator cuff were divided into medium(8 shoulders), large(3 shoulders) and massive(3 shoulders). Most of the patients were heavy laborers. Average age was 56.2 years (51-73 years). There were 9 male and 5 female patients. The dominant arm was affected in 8 shoulders. Postoperative abduction brace was used in all cases and passive range of mortion exercise was started from postoperative third day. At average follow-up of 17 months, average pain scores decreased to 0.8+/-1.1 from 6.9+/-2.3. Scores of ASES evaluation form increased to 87.3+/-12.2 from 35.8+/-16.3(p<0.05). As to the range of mortion, only internal rotation improved from T12 to T8(p<0.05). Thirteen patients achieved excellent or good result. Twelve patients returned to initial occupations. Arthroscopy is helpful to define the tear size which may affect the surgical approach and open repair by use of bony trough and tunnel is useful to recovery of shoulder function.
Arm ; Arthroscopy ; Braces ; Decompression* ; Diagnostic Self Evaluation ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Occupations ; Prospective Studies ; Rotator Cuff* ; Shoulder

Endoscopic Retrograde Cholangiopancreatography(ERCP) is one of the important diagnostic methods for pancreaticcancer. It has an essential role in the early detection of pancreatic cancer. The ERCP findings of 35 cases ofpathologically proven pancreatic cancer during the period of five and a half years from April 1977 through Nov.1982 at Kwangju Christian Hospital were studied. The resuls were as follows; 1. The ratio of male of female was3.4:1, and most of the patients were over 40 years of age (88.5%). 2. The locations of the lesions were the headin 28 cases (80%), the body in 7 cases(20%), and the ail in 3 cases (8.6%). 3. The ERCP findings of pancreaticcancers were as follows; 1) Encasement or obstruction of common bile duct, 18 cases (51.4%). 2) Obstruction ofpancreatic duct, 16 cases (45.7%). 3) Irregular stenosis of pancreatic duct, 8 cases (22.3%). 4) Double duct sign,7 cases (20%). 5) Diffuse narrowing of pancreatic duct, 2 cases (5.7%).
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Constriction, Pathologic ; Female ; Gwangju ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Neoplasms

PURPOSE: Headache is a frequent symptom in pediatric practice, but the prevalence of chronic recurrent headache was estimated in several studies with wide variations, because of inadequate expression and differences in case definition in children. Headache classification of International Headache Society is usually used in adults, but the application of it to children is uncommon, so we tried to diagnosis children with headache by using International Headache Society Classification. METHODS: We analyzed the clinical pictures, physical examinations including neurologic examination, PNS series, EEG and CT or MRI in 53 children with nonprogressing recurrent headache over than one month, who visited to pediatric department of Dong-A University hospital from January, 1995 to Feburary, 1996 and diagnosed them by using International Headache Society Classification. RESULTS: 1) The sex ratio between male and female was 1:1.2. 2) Diagnosed groups consisted of children with migraines in 22 cases(41.5%), tension-type headache in 19 cases(35.9%), coexisting migraine and tension-type headaches in 5 cases(9.4%), miscellaneous headaches not associated with structual lesion in 1 case(1.9%), headache associated with vascular disorders in 2 cases(3.8%), headache associated with nonvascular intracranial disorder in 1 case(1.9%), headache due to facial pain in 3 cases(5.6%). 3) Of 22 migraine cases, 13 cases(59.1%) had migraine with aura, 8 cases(40.9%) have migraine without aura and of 19 tension-type headache cases, 8 cases(42.1%) have episodic type, 11(57.9%) cases have chronic type. 4) Of 53 cases with recurrent headache, 3 cases(6%) had abnormal findings in CT or MRI. 5) Of 53 cases with recurrent headache, 9 cases(17%) had abnormal findings in EEG. CONCLUSIONS: International Headache Society Classifications are useful, but the diagnostic criteria are too strict for children, especially in migraine and tension type headache.
Adult ; Child* ; Classification* ; Diagnosis ; Electroencephalography ; Facial Pain ; Female ; Headache* ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Neurologic Examination ; Physical Examination ; Prevalence ; Sex Ratio ; Tension-Type Headache

No abstract available.
Humans

Severe ankle sprain secondarily leads to chronic lateral ankle instability in 20-30%. Many surgical procedures have been presented for reconstruction of the lateral ankle instability, but controversy still remains for the ideal surgical option. Brostrom procedure or its modifications have been widely used but they have some limitations for the instabilities for the over-weight, physically high demanding patients and especially for significantly deficient or attenuated ligaments. Moreover the tenodesis procedures using peroneus brevis tendon are non-anatomical and sacrifice important lateral stabilizing tendon. Therefore recently, many reconstructive procedures for lateral ankle instability utilizing free allograft or autograft tendon have been introduced to anatomically stabilize the lateral ligaments to various degrees.
Animals ; Ankle ; Collateral Ligaments ; Humans ; Ligaments ; Sprains and Strains ; Tendons ; Tenodesis ; Transplantation, Homologous

OBJECTIVES: This study was conducted to investigate the executive function deficit and the lack of theory of mind in children with autistic disorder. METHODS: Forty children, aged between 11 and 15, were involved in this study: 14 autistic disordered, 12 non-autistic mentally retarded(psychiatric control), and 14 normal children(normal control). In addition to the "Sally-Ann" task to test theory of mind, three other neuropsychological tests were administered individually to assess executive function in all subjects. RESULTS: Significant group differences were found on the executive function and the theory of mind tests. Those deficits were more widespread in the autistic group than in the non-autistic mentally retarded group. The autistic group was impaired on the test requiring inhibition of prepotent responses compared to the two control groups. Both of the autistic and the non-autistic mentally retarded groups exhibited difficulties in predicting other's behavior based on their understanding of other's mental states. CONCLUSIONS: These results show that executive function and theory of mind deficits coexist in children with autistic disorder. This co-occurrence of deficits suggests the possibility that prefrontal cortex may be the neurological region responsible for causing autistic disorder.
Autistic Disorder* ; Child ; Executive Function* ; Humans ; Mentally Disabled Persons ; Neuropsychological Tests ; Prefrontal Cortex ; Theory of Mind

Accessory navicular is a congenital anomaly of the tuberosity of the navicular from a secondary ossification center. The accessory navicular is occasionally the source of pain and local tenderness over the medial side of midfoot. If conservative treatment fails for the painful accessory navicular, surgical treatment is required. There are several surgical option for accessory navicular, which vary from simple excision, percutaneous drilling, modified Kidner procedure and osteosynthesis of the accessory ossicle to the navicular body. In addition, symptomatic flatfoot deformity should be addressed concomitantly.
Congenital Abnormalities ; Flatfoot ; Mandrillus