Calcification is exceedingly rare in schwannomas. In the literatures, we found only three reports of schwannomas with calcification. We report two cases of intracranial calcified schwannomas, one in the anterior cranial fossa and the other in the middle cranial fossa.
Cranial Fossa, Anterior ; Cranial Fossa, Middle ; Neurilemmoma*

The purposes of this clinical study are to observe the clinical findings of the high lumbar disc herniation, to analyze the of the posterior approach and to define the surgical indications of the high lumbar disc herniation. We analyzed the 13 cases which were treated at the Deparment of the Orthopaedic Surgery, National Medical Center from March 1988 to December 1992(Mean follow up rate : 17. 2 months). 1. We operated 10 cases by posterior approach and 1 case by anterior approach due to marked degenerative osteophyte. 2. We evaluated the post-operative results by modified Macnab criteria, the 2 cases showed no symptomatic improvement because of respectively associated high lumbar osteophyte and lower lumbar spinal stenosis. 3. On conclusion, suspicion is important in cases of incompatible clinical symptoms and signs of the intervertebral disc herniation. MRI is the most recommended diagnostic tool, because it can provide the high lumbar levels with saggital section image and differentiate herniation from degenerative osteophyte. As for the surgical indications of high lumbar disc herniations, we suggest marked dural compression by disc or sequestered disc materials in MRI, definite neurological complications such as ankle clonus, increased DTR, weakness of quadriceps and hip flexor muscle and severe radiating pain on the anterior thigh. We recommended the posterior approach for the surgical intervention of high lumbar disc herniation except cases marked degenerative osteophytes.
Ankle ; Clinical Study ; Follow-Up Studies ; Hip ; Intervertebral Disc ; Magnetic Resonance Imaging ; Osteophyte ; Spinal Stenosis ; Thigh

Creutzfeldt-Jakob disease(CJD) is characterized clinically by rapidly progressive dementia with pyramidal, extrapyramidal, and cerebellar symptoms and signs, and histologically by spongiform change, neuronal loss and reactive gliosis. We have experienced 2 cases of CJD. Case 1 was a 36-year-old male who had suffered from myoclonus and cerebellar symptoms including sluggish speech, gait and balance disturbance. Case 2 was a 70-year-old female who had showed cognitive dysfunction, ataxic gait and disturbance of extraocular movement. Both patients, underwent brain biopsy. Case 1 revealed marked cortical atrophy, 2mm in thickness, with neuronal loss and astrocytic proliferation extending into white matter. The spongiform change, made up of many small, usually rounded or oval, vacuoles was noted mainly in the neuropil. Case 2 revealed remarkable spongiform change throughout the cortex and cytoplasmic vacuoles compressing the nuclei of neuronal cells were numerous. Neuronal loss and gliosis were also found without considerable change in the white matter. On double immunostaining against GFAP and PrP(Prion Protein), there was a weak positive reaction for PrP in the perinuclear cytoplasm in case 1, and a strongly positive reaction in case 2. The electron microscopic examination showed numerous membrane-bound vacuoles in neuropil and perikarya of neurons. The majority of the vacuoles were multiseptated by thin membranous structures. They demonstrated curled, or disrupted membrane, that had foldings and protrusions into the vacuolar clear spaces. There were neither identifiable virus-like particles nor amyloid deposition.
Female ; Male ; Humans

In the treatment of elderly hip fracture, early mobilization as a means of reducing early postoperative morbiyt and morbidity is mandatory. Even though Ender nailing have many advantages, most serious problems with use of Ender nailing method are distal migration of nails, subsequent loss of fixation and limited knee joint motion. To prevent these difficult problems, we have used distal wiring technique with Ender nailing since 1988. In operation, we performed Ender nailing as usual manner under image intensifier and for the prevention of the nail migration, we performed circumferential wiring through the each Ender nail eye and above the adducter tubercle of the distal femur. Forty six cases were available with minimum follow-up of six months which were healed radiologically and clinically (Mean follow up: 21 months). The mean age was 74 years (Range: 52 years-88 years)and showed 26 cases of famale and 20 cases of male. The radiological morphometry using Singh index showed poor bone quality: 36 cases were below Grade III and the fracture type was classified by Tronzo criteria. In results, patients who had Ender nailing with distal wiring showed no distal migration, however one case of proximal migration was observed at the beginning stage of this technique. So, in elderly trochanteric fracture, to reduce the complication of the Ender nailing, especially nail migration, the authors recommend the Ender Nailing with distal wiring technique.
Aged ; Early Ambulation ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip ; Humans ; Knee Joint ; Male ; Methods

Synovial sarcoma is comparatively uncommon and highly malignant tumor, which usually arises in proximity to a joint and may affect the adjacent bones. Occurence in finger and severe bony involvement are rare. We present a case of synovial sarcoma of the thumb, because the tumor arose in an unusual site and was characterized by severe bony destruction.
Fingers ; Joints ; Sarcoma, Synovial ; Thumb

The results of corrective surgery in strabismus patients are not always predictable. To lower the chance of reoperation, intraoperative or postoperative adjustment is performed. The authors performed intraoperative adjustment surgery in 24 patients with topical Anesthesia with 0.5% tetracaine. We evaluated the severity of pain and the strabismus angel postoperatively. Follow-up showed success rate of 95.8% immediately after surgery. 79.2% on 6 weeks after surgery and 70.8% after 1 year. Among 24 patients, 17 patients felt no pain and 7 patients had on slight pain on muscle traction. The above results suggest that we can not prevent long-term recurrence after adjustment operation using topical anesthetics, this method causes no intolerable pain and making this a useful treatment for strabismus angle.
Anesthesia* ; Anesthetics ; Follow-Up Studies ; Humans ; Recurrence ; Reoperation ; Strabismus* ; Tetracaine ; Traction

Exophthalmos after trauma may develop because of retrobulbar hemorrhage, carotid cavernous fistula and orbital roof fracture. The orbital roof is composed of two layers of strong bone that makes it the strongest among the orbital walls and reports of its case are hardly found. However, rarely strong impact such as in automobile accidents causes these fractures and exophthalmos may develop due to herniation of brain tissue through a traumatic defect in the roof of the orbit. The authors experienced gradually increasing exophthalmos in a 33-year old man who had developed a subdural hematoma, orbital roof fracture and anterior temporal skull fracture due to an automobile accident. We report a case of orbital roof fracture in which herniation of brain was shown in orbital computed tomography and exophthalmos disappeared after dural suture.
Adult ; Automobiles ; Brain ; Encephalocele* ; Exophthalmos* ; Fistula ; Hematoma, Subdural ; Humans ; Orbit* ; Retrobulbar Hemorrhage ; Skull Fractures ; Sutures

No abstract available.
Liver*

Stress fracture of the metatarsal was first described as March fracture by Breithaupt, a Prussian military surgeon in 1855, According to the classical references, the second metatarsal is the most frequently involved and radiological evidence of fracture appears as late as several weeks. The purpose of this study is to document the incidence and clinical feature of march fractures in Korean military soldiers. From may 1991 to April 1994, at one military hospital in Korea, 52 march fractures in 46 patients were detected among infantry soldiers. There are different findings of fracture site and its clinical features from the previous foreign reports. 1. By physical examination, direct point tenderness on the location of the metatarsal shaft is characteristic, with careful history taking. 2. On roentgenographic examination, cortical fissuring or break is seen one week after onset of symptoms and external callus is seen from two weeks or at the latest four weeks. 3. The third metatarsal is the most frequently involved site(34 cases, 65.4%), and the second metatarsal is less frequent(12 cases, 23.1%) 4. The discrepancy between previous reports and present findings should be emphasized and analyzed in further study.
Bony Callus ; Fractures, Stress ; Hospitals, Military ; Humans ; Incidence ; Korea ; Metatarsal Bones ; Military Personnel ; Physical Examination

PURPOSE: This study was to measure the angle between the femoral epicondylar axis and the femoral posterior condylar axis, to clarify which axis can be used as a guideline to achieve proper rotational align- ment of femoral component in total knee arthroplasty. MATERIAL AND METHODS: From Jan. 1997 to Dec. 1998, the axial images of MRI of 121 patients who sustained acute knee injury were selected to measure the posterior-epicondylar angle(the angle between the femoral epicondylar axis and the femoral posterior condylar axis). Congenital anomaly or any fracture cases were all excluded. Comparisons were made according to gender and ages and the student t-test was used to evaluate the statistical differences. RESULTS: The mean posterior-epicondylar angle was a 4.8(+- 2.0) and there was no significant statisti- cal difference between gender and ages except 3rd decade. CONCLUSION: It can induce an insufficient external rotation of the femoral component in total knee arthroplasty, if we usually do 3 of external rotation of femoral component from the posterior condylar axis.
Arthroplasty* ; Axis, Cervical Vertebra* ; Femur* ; Humans ; Knee Injuries ; Knee* ; Magnetic Resonance Imaging