No abstract available.
Cytomegalovirus Infections*

Encephalocele is a relatively rare congenital anomaly which is classified into occipital, parietal, anterior syncipital and anterior basal type regarding to the protrusion site through the bony defect of the skull. Anterior basal type of encephalocele is important in view of it's pathogenesis as well as diagnostic difficulty because of invisibility on external appearance. We have experienced a case which could be best fit to anterior basal encephalocele. This type of encephalocele is extremely rare. This report deals with a case of deadborn of 34 weeks of gestation with body weight of 2400gm and head circumference of 32 cm. There was no evidence of protrusion of brain on external examination. On autopsy the normal brain structure was compressed by abnormal mass of brain with normal consistency which was found in the petrous portion of the parietal area and covered partly by the dura. In this case, there were another associated anomalies, such as atrophy of the left optic nerve, hemihypoplasia of the left mandible, patent ductus arteriosus, bilateral hydrocele, and Meckel's diverticulum.

Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techniques. The basic disciplines of approaching skull base lesions are provide direct vision, minimizing brain retraction, excellent exposure and minimal blood loss. The focus of this report is to review the advantages of skull base approach in our cases and suggest some indications. We experienced 20 cases of skull base surgery by a team approach consisting of a neurosurgeon and plastic surgeon. The surgical approach were supraorbital osteotomy(5 case), orbitozygomatic osteotomy(8 case), orbitozygomaticoglenoid osteotomy (5 case ) and orbitozygomaticoglenoidocondylar osteotomy (2 case). In our experience, these approaches provided excellent exposure of the lesion, direct access to lesions and minimal brain retraction thereby better outcome.
Brain ; Osteotomy ; Skull Base* ; Skull* ; Surgery, Plastic*

No abstract available.

A clinical observation was performed on 13 cases of giant hydronephrosis in the Department of Urology, College of Medicine, Hanyang University from May 1972 to March 1981 The results are as follows; 1) In 13 cases of giant hydronephrosis 6 cases were male and 7 cases female, 2nd decade was most common. 2) Side of giant hydronephrosis; Rt. side: 4 cases, Lt. side: 9 cases. 3) The most common etiology of giant hydronephrosis was congenital UPJ stricture (53.8%). 4) The details of the symptoms as follows; 12 cases were flank mass, 5 fever and chillness, 4 frequency of urination, 3 hematuria, 2 abdominal distention and 1 oliguria. 5) Renal function test (B.U.N., creatinine) was normal except 1 case of solitary kidney with neurogenic bladder. 6) In 4 cases out of giant hydronephrosis were compensatory hydronephrotic change on contralateral kidney and 8 cases normal. 7) The operative procedures were as follows; 11 cases were nephrectomy, 1 case pyeloplasty and 1 case nephrostomy.
Constriction, Pathologic ; Female ; Fever ; Hematuria ; Humans ; Hydronephrosis* ; Kidney ; Male ; Nephrectomy ; Oliguria ; Surgical Procedures, Operative ; Urinary Bladder, Neurogenic ; Urination ; Urology

Purpose: To investigate the extent of bone ingrowth into the porous-coated acetabular cups as well as the factors that correlated with bone ingrowth in total hip arthroplasty. Materials and Methods: Thirty six Harris-Galante porous-coated acetabular cups that were retrieved through revision surgery were examined in this study. Acetabular cups retrieved due to infection or severely destroyed cups (ed note: severe what?) were excluded. The extent of bone ingrowth into the acetabular cups was grossly measured, and its correlation with the variables including age, gender, weight, height, the duration of fixation, size, number of screws, inclination and anteversion was statistically analyzed. Results: The mean proportion of bone ingrowth was 52.9 21.9%(2~90%) and less than 30% in three cups(8.3%). The pattern and the location of bone ingrowth were not consistent. There was no correlation between the extent of bone ingrowth and age, gender, weight, height, the duration of fixation, cup size, number of screws, size, inclination and anteversion. Conclusion: Harris-Galante porous-coated acetabular cups showed satisfactory bone ingrowth regardless of the variables associated with the demographic or surgical conditions. Surface treatments with a fiber-metal porouscoating appears to be suitable for cementless acetabular cups in terms of the long term results.
Acetabulum* ; Arthroplasty, Replacement, Hip

The present study was undertaken to investigate the influence of cardamonin on vascular smooth muscle contractility and to determine the mechanism(s) involved. Denuded aortic rings from male rats were used and isometric contractions were recorded and combined with molecular experiments. Cardamonin significantly relaxed fluoride-, phenylephrine-, and phorbol ester-induced vascular contractions, suggesting that it has an anti-hypertensive effect on agonist-induced vascular contraction regardless of endothelial nitric oxide synthesis. Furthermore, cardamonin significantly inhibited the fluoride-induced increase in pMYPT1 level and phenylephrine-induced increase in pERK1/2 level, suggesting inhibition of Rho-kinase and MEK activity and subsequent phosphorylation of MYPT1 and ERK1/2. This study provides evidence that the relaxing effect of cardamonin on agonist-induced vascular contraction regardless of endothelial function involves inhibition of Rho-kinase and MEK activity.
Animals ; Fluorides ; Humans ; Isometric Contraction ; Male ; Muscle, Smooth, Vascular ; Nitric Oxide ; Phosphorylation ; Rats ; rho-Associated Kinases*

PURPOSE: We report clinical and radiologic outcomes after metacarpal extension osteotomy for mild osteoarthritis of the thumb carpometacarpal joint. MATERIALS AND METHODS: From 1999 to 2008, 11 patients were diagnosed with mild thumb carpometacarpal arthritis (Eaton stage I, II), and extension osteotomies were performed. Of these, seven patients with at least 6 years follow-up were analyzed retrospectively. Male to female ratio was 2:5, and mean age at time of surgery was 38.9 years old. Symptom onset period was a mean of 11.2 months. Two patients were I, and five patients were II in Eaton stage. Preoperative visual analogue scale (VAS) and disabilities of the arm, shoulder and hand scale (DASH) scores were 3.7 points (3-4 points), and 40.1 points (32-51 points). Radial abduction was 38.5degrees (30degrees-45degrees), and volar abduction was 42.1degrees (40degrees-45degrees). Grip strengths and pinch powers, compared with the normal contralateral side were 82% (64%-90%) and 72% (40%-100%), respectively. RESULTS: The mean follow-up period was 8.5 years, and all patients except one maintained their occupational activity during the follow-up period. Final VAS and DASH scores were 0.7 points (0-2 points) and 11.7 points (8-16 points), respectively, and were statistically significant. Volar abduction, grip strengths, and pinch power were improved to 45degrees (40degrees-50degrees), 92.3% (73%-117%), and 94.4% (75%-117%) with statistical significances. In five patients, Eaton stages did not change, and two patients advanced to the next stage (stage I to II in one patient, stage II to III in one patient). CONCLUSION: Among the various treatment options for mild thumb carpometacarpal arthritis, metacarpal extension osteotomy may be considered as an effective treatment.
Arm ; Arthritis* ; Carpometacarpal Joints ; Female ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Male ; Osteoarthritis ; Osteotomy* ; Retrospective Studies* ; Shoulder ; Thumb*

BACKGROUND: Video assisted thoracic sympathectomy or sympathicotomy is a safe and effective therapy for the treatment of palmar hyperhidrosis with immediate symptomatic imporvement. However the degree of satisfaction may diminish with time due to cmpensatory sweating or excessive hand dryness. Therefore by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathectomy or sympathicotomy at various levels we aim to determine the optimal level of sympathetic nerve block which will result in minimal side effects and maximal benefit. MATERIAL AND METHOD: Among 194 patients having undergone video assisted thoracic sympathectomy or sympathicotomy between January 1996 and June 1999, 137 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into three groups. Group I(n=61) ; patients having undergone T2,3,4 sympathectomy group II(35) ; patients having undergone T2 sympathicotomy and group III(41) ; patients having undergone limited T2 sympathicotomy which consist of block of interganglionic neuronal fiber on the third rib. The parameters studied comprised of pre- and post-operative palmar temperature change treatment satisfaction the degree of compensatory sweating or discomfort from palmar dryness postoperative complication and changes in plantar sweating. RESULT: There was no difference in age and sex among the groups and the mean postoperative elevation in palmar temperature was 21.59degrees C without any differences among the groups. Patients expressing satisfaction were 65.6%, 62.9% and 90.24% in groups I, II and III, respectively(p<0.05) Moderate to severe compensatory sweating was present in 65.6% 51.4%, and 24.39%, in group I, II, and III, respectively (p<0.05) Slight but comfortable amount of palmar humidness was expressed in decreasing order group III(41.6%) group I(24.6%) and group II(5.7%) (p<0.05) Ineffectiveness or recurrence was present in 5patients in group I(8.2%) 1 patient in group II(2.9%) and none in group III. With regards to plantar sweating decrease in sweating was expressed in 43 patients(31.4%) while similar degree of sweating in 61 patients(44.5%) and increase in sweating in another 33 patinets(24.1%). CONCLUSION: Limited T2 sympathicotomy resection of the lower interganglionic neuronal fiber of the second sympathetic ganglion on the third rib showed immediate effect in palmar hyperhidrosis and caused lesser compensatory sweating and hand dryness.
Autonomic Nerve Block ; Ganglia, Sympathetic ; Hand ; Humans ; Hyperhidrosis* ; Interviews as Topic ; Neurons ; Postoperative Complications ; Surveys and Questionnaires ; Recurrence ; Ribs ; Sweat ; Sweating ; Sympathectomy

PURPOSE: Subacute necrotizing myelopathy(SNM) is a rare non-tumorous disease of spinal cord characterized by subacute clinical course of progressive neurological deterioration. We report MR findings of a patient with pathologically proved SNM. MATERIALS AND METHODS: 1 case of pathologically proved subacute necrotizing myelopathy. RESULTS: The patient was a 56-year-old man with progressive motor weakness and sensory loss of the lower extremities, and urinary and fecal incontinence for 11 months. Spine MRI revealed diffuse enlargement of the thoracic spinal cord from T2 to T7 level. Signal intensity of the expanded spinal cord was isointense relative to normal cord on T1 -weighted image and hyperintense on proton-density and T2-weighted images. On contrast enhanced T1-weighted image, there was diffuse homogeneous enhancement in the expanded cord lesion. CONCLUSION: MR demonstration of stable persistence of spinal cord lesion or atrophy over months or years with clinical findings of radual progressive neurologic deterioration may be helpful in the diagnosis of SN M(1 ).
Atrophy ; Diagnosis ; Fecal Incontinence ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Spinal Cord ; Spinal Cord Diseases* ; Spine