Obstructive hydrocephalus caused by tectal glioma, which relived by neuroendoscopy, have been described using 3.0 Tesla magnetic resonance imaging (3T MRI) so far, we present the results obtained from 3T and 7T MRI in this patient. A 21-year-old woman presented at our hospital with gait disturbance, hormonal insufficiency, and urinary incontinence that began prior to 6 years of age. 3.0T MRI revealed a non-enhancing tectal mass along with obstructive hydrocephalus. The mass measured approximately 1.1×1.0×1.2 cm. An endoscopic third ventriculostomy was performed to relieve the hydrocephalus. We compared hydrocephalus and cerebrospinal fluid (CSF) flow findings from 3T and 7T MRI, both preoperative and postoperative at 1, 6 months. Intraventricular CSF voiding on T2-weighted images obtained with 7T MRI showed greater fluid inversion than those obtained with 3T MRI. This study shows that 7T brain MRI can provide detailed information on hydrocephalus caused by tectal glioma. Further studies are needed to develop refined 7T MRI protocols for better images of hydrocephalus.
Brain ; Brain Neoplasms ; Cerebrospinal Fluid ; Female ; Gait ; Glioma* ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging* ; Neuroendoscopy ; Urinary Incontinence ; Ventriculostomy ; Young Adult

BACKGROUND: Calcium plays a key role in vascular contraction and regulates receptor sensitivity to certain neurotransmitters. Calcium channel blockers are useful in the treatment of both clinical and experimental hypertension. The present study was designed to examine whether there is an alteration of the activity of calcium channels in association with the development of hypertension. METHODS: Deoxycorticosterone acetate(DOCA)-salt hypertension was made by subcutaneous implantation of DOCA(200mg/kg)strip plus saline drinking(1%) and 2-kidney, 1 clip(2KIC)hypertension by clipping the left renal artery with a silver clip(internal gap of 0.2mm). They were used 4 weeks later. Age-matched normal rats served as a control. Mean arterial pressure(MAP) and heart rate(HR) were continuously recorded from the right femoral artery. The drugs were administered intravenously. RESULTS: Vehicle alone was without effect on MAP or HR. In normotensive rats, nifedipine infusion(5 and 10ug/kg/min)caused a dose-dependent decrease in MAP without significant changes in HR, while Bay k 8644(Bay K, 5 and 10 ug/kg/min) increased MAP transiently. Both the depressor response to nifedipine and the pressor response to Bay k were more marked in DOCA-salt hypetensive rats than in normotensive rats. The maximal changes in MAP indced by nifedipine(5 and 50 ug/kg) or Bay K(5 and 50 ug/kg) were also enhanced in 2KIC hypertensive rats as compared with control rats. CONCLUSION: These results indicate that calcium channel inhibitors and activators can affect on the regulation of blood pressure in an opposite fashion. It is also suggested that the activity of calcium channels might be altered in the developement of experimental hypertension.
3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester* ; Animals ; Bays* ; Blood Pressure ; Calcium ; Calcium Channel Blockers ; Calcium Channels ; Desoxycorticosterone ; Femoral Artery ; Heart ; Hypertension ; Neurotransmitter Agents ; Nifedipine* ; Rats* ; Renal Artery ; Silver

A clinicostatistical analysis of 683 males with infertility who visited the Pusan National University Hospital between January 1986 and December 1995 was performed. We divided the patients into 5 groups by Shirataki classification as follows, group I, sperm concentration above 20 x 106/ml, group II, oligozoospermia with a sperm concentration above 10 x 100000/ml, but below 20 x 1000000/ml, group III,oligozoospermia with a sperm concentration below 10x 100000/ml, group IV, primary azoospermia, group V, obstructive azoospermia. The mean age was 33.1 years. The mean duration of infertility was 48.2 months. The frequency in each groups were group IV 383 cases (56.1%), group III 127 cases (18.6%), group I 111 cases (16.3%), group II 37 cases (5.4%), and group V 25 cases (3.7%), respectively. Except group V, as decreasing the sperm density, testicular volume tended to reduce (p<0.01). The semen volume in group V was significantly less than that in other groups (p<0.05). As sperm density decreased, the sperm motility tended to reduce (p<0.05). The levels of serum luteinizing hormone (LH) and follicular stimulating hormone (FSH) in group IV were significantly the higher than other groups (p<0.05). As for serum prolactin and testosterone, there were no significant differences between each 5 group. Of etiologic factors of male infertility, idiopathic was the most common cause with 489 cases (71. 6%), and followed by varicocele 71 cases (10.4%), seminal tract obstruction 44 cases (6.4%), chromosome abnormality 30 cases (4.4%), infection 20 cases (2.9%), testicular trauma 13 cases (1.9%), cryptorchidism 10 cases (1.5%), hyperprolactinemia 4 cases (0.6%) and retrograde ejaculation 2 cases (0.3%). A total of 391 cases had a management for male infertility which consisted of medical treatments 291 cases (74.4%), surgical treatments 89 cases (22.8%) and assisted reproductive technologies 11 cases (2.8%). In conclusion, We think the more clear clarification of physiology of male reproductive system, the development of new drugs for the improvement of spermatogenesis and the application of advanced assisted reproductive technique would be needed to handle properly the patients with male infertility.
Azoospermia ; Busan ; Chromosome Aberrations ; Classification ; Cryptorchidism ; Ejaculation ; Humans ; Hyperprolactinemia ; Infertility ; Infertility, Male* ; Luteinizing Hormone ; Male ; Male* ; Oligospermia ; Physiology ; Prolactin ; Reproductive Techniques, Assisted ; Semen ; Sperm Motility ; Spermatogenesis ; Spermatozoa ; Testosterone ; Varicocele

Objective: : The latest version of the Leksell Gamma Knife IconTM allows for mask- and frame-based fixation. Although mask fixation provides fractionated treatment and immobilization using a noninvasive method, it is not free from collision. The authors investigated the collision problem with a modified mask fixation method. Methods: : This study presents a case of two meningiomas in the frontal area, where a collision occurs in the occipital area. A modified mask fixation method was introduced to avoid the collision : first, the edges of the head cushion were cut off and polystyrene beads with a diameter of approximately 5 cm were removed. Next, the head cushion was sealed using a stapler. Finally, the head cushion was flattened in the adapter. We compared the shot coordinates, 3-dimensional (3D) error, clearance distance, and vertical depth of the head cushion between the initial and modified mask fixations. Results: : When comparing the initial and modified mask fixations, the difference in the shot coordinates was +10.5 mm along the y-axis, the difference in the 3D error was approximately 18 mm, and the difference in clearance was -10.2 mm. The head cushion was approximately 8 mm deeper in the modified mask fixation. Conclusion : Based on these findings, we recommend a modified mask fixation method for gamma knife radiosurgery using ICON with a collision.

PURPOSE: To evaluate effect of modified arthroscopic pull-out suture technique which used number 5-nonabsorbable suture material for tibia intercondylar eminence comminuted fractures. MATERIALS AND METHODS: There were 21 cases of tibia intercondylar emimence fracture which arthroscopic treated at our hospital between 1999 and 2004. However the study population only included 12 cases in which a number 5-nonabsorbable suture material (Ethibond No. 5) was used for tibia intercondylar eminence comminuted fractures and minimum 1-year follow-up has gone. The average follow-up period was 18.5 months (range, 12 to 42 months). Lachman test and KT-2000 athrometer test were evaluated at the pre-and post-operation. Clinical results of all patients were evaluated with the Meyers and Mckeever 's criteria. RESULTS: In all 12 cases, the normal range of motion and sports activities were recovered at the final follow-up. When tested for anterior instability with KT-2000 arthrometer, there were no different between normal knee and operated knee. Clinical results by Meyers and Mckeever's criteria were excellent in 10 patients and good in 2 patients. CONCLUSION: We obtained early mobilization and stable fixation in modified arthroscopic pullout suture technique for tibia intercondylar eminence comminuted fractures. Patients can early return to his job. This technique seems to be one of the effective operative techniques for treatment of tibia intercondylar eminence comminuted fractures.
Arthroscopy ; Early Ambulation ; Follow-Up Studies ; Fractures, Comminuted* ; Humans ; Knee ; Reference Values ; Sports ; Suture Techniques ; Sutures* ; Tibia*

Acute necrotizing pancreatitis after kidney transplantation is a rare, but serious complication. We report a case of patient who was developed acute pancreatitis after cadaveric kidney transplantation with several causative factors: viral infection (Cytomegalovirus, Varicella zoster virus), usage of immunosuppressant, gallbladder stones, and previous peritoneal dialysis history. Cytomegalovirus infection was suspected as major etiologic factor of this case, but other factors would have a complex effect on development of acute pancreatitis.
Cadaver ; Chickenpox ; Cytomegalovirus Infections ; Gallbladder ; Herpes Zoster ; Humans ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Pancreatitis ; Pancreatitis, Acute Necrotizing ; Peritoneal Dialysis

Advanced or complete atrioventricular (AV) block is frequently regarded as a cause of informed syncopal attacks even though escape rhythm is maintained. Torsades de pointes (TdP) may be a significant complication of AV block associated with QT prolongation. Maintaining ventricular rate over 70 beats/min is known to be important to normalize QT interval and to reduce the possibility of bradycardia-related TdP recurrence after pacemaker implantation. We report one case of syncopal attacks associated with TdP in a 70 year old female patient with advanced AV block and prolonged QT interval. She was referred to evaluate palpitation and syncope. Advanced AV block and QT interval prolongation were seen with electrocardiography, but junctional escape rhythm was maintained. Syncopal attacks occurred during temporary pacemaker insertion. Multiple episodes of nonsustained polymorphic ventricular tachycardia and TdP related to syncopal attacks were demonstrated by 24-hour Holter monitoring. A permanent pacemaker was implanted and ventricular rate was set over 70 beats/min resulting in no recurrence of TdP and syncope.
Atrioventricular Block* ; Electrocardiography ; Electrocardiography, Ambulatory ; Female ; Humans ; Recurrence ; Syncope* ; Tachycardia, Ventricular ; Torsades de Pointes* ; United Nations

A 59-year-old Korean man complained of a painless scrotal hard nodule and weak urine stream. The ultrasound scan revealed a 2.2-cm sized round heteroechogenic nodule located in the extratesticular area. Microscopic hematuria was detected in routine laboratory examinations. On scrotal exploration, multiple spargana were incidentally found in the mass and along the left spermatic cord. On cystoscopy, a 10-mm sized mucosal elevation was found in the right side of the bladder dome. After transurethral resection of the covered mucosa, larval tapeworms were removed from inside of the nodule by forceps. Plerocercoids of Spirometra erinacei was confirmed morphologically and also by PCR-sequencing analysis from the extracted tissue of the urinary bladder. So far as the literature is concerned, this is the first worm (PCR)-proven case of sparganosis in the urinary bladder.
Animals ; Cystoscopy ; DNA, Helminth/chemistry/genetics ; Hematuria/diagnosis ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Scrotum/*parasitology/*pathology/ultrasonography ; Sequence Analysis, DNA ; Sequence Homology, Nucleic Acid ; Sparganosis/*diagnosis/parasitology ; Spirometra/*isolation & purification ; Urinary Bladder Diseases/*parasitology/*pathology/surgery

A 39-yr-old female patient, diagnosed with tuberous sclerosis 10 years ago, presented for selective arterial embolization under general anesthesia. The symptoms of the patient were lower abdominal pain and gross hematuria. Renal arteriography showed multiple bilateral renal angiomyolipomas and ruptured aneurysms in right kidney. She had also pulmonary lymphangiomyomatosis, hepatic angiomyolipomas, and multiple subependymal nodules without mass effect in brain. We report the anesthetic management of this case with tuberous sclerosis for selective arterial embolization under general anesthesia.
Abdominal Pain ; Anesthesia ; Anesthesia, General ; Aneurysm, Ruptured ; Angiography ; Angiomyolipoma ; Brain ; Female ; Hematuria ; Humans ; Kidney ; Lymphangioleiomyomatosis ; Tuberous Sclerosis*

PURPOSE: To investigate mid-term clinical outcomes of various methods of scapholunate reconstruction for chronic scapholunate instability. METHODS: We retrospectively reviewed 11 patients diagnosed as chronic scapholunate instability, from 2005 to 2013 and followed up for more than one year after surgery. 7 patients were treated with Garcia technique of triple ligament reconstruction, 2, bone-ligamemt-bone repair, and 2, dorsal capsulodesis. Mean age was 42 years (range, 23-61 years). The right side was involved in 6 patients, and the left in 5. The follow-up period averaged 42 months (range, 13-125 months). The postoperative functional outcomes were assessed with Modified Mayo wrist score (MMWS), disability of the arm, shoulder and hand (DASH) score and range of motion. The postoperative radiologic results were analyzed with the change of scapholunate angle and distance. RESULTS: The mean MMWS score improved from 65 preoperatively to 77 postoperatively (p=0.072). The mean DASH score improved from 29.4 (range, 18.3-43.3) preoperatively to 12.7 (range, 0-38.3) postoperatively (p=0.003). The dorsiflexion increased from 67° to 78°, the volar flexion decreased from 51° to 45°, the supination increased from 69° to 88°, and the pronation increased from 62° to 66°. The SL angle changed from 55° preoperatively to 51° postoperatively, the mean SL distance changed from 3.4 mm preoperatively to 1.7 mm postoperatively. CONCLUSION: The chronic scapholunate instability is amenable to various techniques and postoperative functional outcomes improved satisfactory.
Arm ; Follow-Up Studies ; Hand ; Humans ; Ligaments* ; Pronation ; Range of Motion, Articular ; Retrospective Studies ; Shoulder ; Supination ; Wrist