We have retrospectively analyzed the clinical and radiological outcome in 22 cervical spondylotic myeloradiculopathy patients who underwent combined front anterior decompression and fusion) and back (open door laminoplasty) surgery between Mar. 1991 and Jan. 1995. Clinical symptoms were evaluated by Japanese Orthopaedic Association(JOA) score and the recovery rate. Plain radiogram and MIR were taken before and after surgery, and then the cervical curvature, change of body to canal ratio and the A-P compression ratio of the cord were measured and compared to the clinical symptoms. Results : The mean JOA score increased from 10.1±3.3 preoperatively to 14.7±1.4 at the final follow-up with a mean recovery rate of 64.4%. No patients deteriorated as a result of the combined procedure. Post-op. radiograms showed an increasement of body to ratios (average 0.69±0.09 pre-op. to 1.0±0.13 post-op.) and maintenance or recovery of cervical Lordosis. On MRI, the A-P compression ratios of the cord were increased with recovery of subarachnoid space after the operation in most cases (average 38.4±7.6 pre-op. to 55.7±7.2 post-op.). Conclusion : This combined procedure safely and effectively resulted in decompression of the spinal cord and good functional recovery in patients with 1) anterior and posterior pathology, 2) narrow spinal canal and large spondylotic bar or herniated disc encroaching the spinal canal more than 5mm, 3) narrow spinal canal and kyphotic deformity, 4) narrow spinal canal and segmental instability, 5) multisegmental cord compression and severe radiculopathy.
Animals ; Asian Continental Ancestry Group ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Lordosis ; Magnetic Resonance Imaging ; Pathology ; Radiculopathy ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Subarachnoid Space

Magnetic Resonance Imaging(MRI) with 2.0 Tesla superconductive magnet developed by Korea Advanced Institute ofScience was performed in 25 patients with various abdominal diseases and compared with x-ray CT. MRI was obtainedwith spin echo technique using a variety of pulse sequence and various slice orientation including axial, sgittaland coronal section in order to evaluate the diagnostic value, limitation and to determine the optimal pulsesequency in various abdominal diseases. MRI demonstrated the capability of detecting the lesions shown on CT inall cases and also detected one case of diffuse hepatocellular carcinoma which was not seen on CT. MRI showedcapability of differentiation of various liver mass including hepatocellular carcinoma, hemangnioma and simplecyst. MRI showed better anatomical resolution of tumor in retroperitoneum and pelvis, however CT delineatedalimentary tract disease better than MRI did.
Carcinoma, Hepatocellular ; Humans ; Korea ; Liver ; Magnetic Resonance Imaging ; Pelvis

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Thanatophoric Dysplasia*

Congenital lipoid adrenal hyperplasia, the most severe form of congenital adrenal hyperplasia, is caused by mutations in the steroidogenic acute regulatory protien (StAR). It is characterized by failure of synthesis of all three classes of adrenal steroids and massive accumulation of lipids and cholesterol in the adrenal cortex. The computed tomography (CT) unequivocally delineated massively enlarged adrenal glands of fat-tissue attenuation, enabling early diagnosis and replacement therapy. We report a case of congenital lipoid adrenal hyperplasia, in which CT established that lipoid deposition at the adrenal cortex disappeared after the adrenal hormone replacement therapy.
Adrenal Cortex ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Cholesterol ; Early Diagnosis* ; Hormone Replacement Therapy ; Hyperplasia* ; Steroids

OBJECTIVE: We analyzed the clinical features of amniotic fluid embolism confirmed by autopsy or clinical dicision for making a plan of rapid diagnosis and intensive emergency care. STUDY DESIGN: We experienced 2 clincal cases in Ewha Mokdong Hospital and Severance Hospital at 1995, and reviewed the medical record & autopsy report of 15 cases in National Institute of Scientific Investigation from Jan, 1991 to Dec, 1995. RESULTS: The mean maternal age was 31+/-3 years. The mean gestational age was 40+/-1 weeks. The number of delivery were 1.4+/-0.8. The number of abortion history. were 2.6+/-2. The sexuality of fetus were six males (35 %), five females (29%), and unknown six cases (35 %) and the fetal mortality rate was 29 % (5 cases). The initial clinical symptoms and signs were hypotension (12 patients, 71%), vaginal bleeding(ll patients, 65%), cardiac arrest (6 patients, 35 %), dyspnea (5 patients, 29 %), and seizure (2 patients, 12%). In the case of normal spontaneous vaginal delivary (NSVD), the symptoms occurred during induction in 3 (18%), during delivery in 1 (6%), and after delivery in 9 (53%). In the case of Cesarean section, the symptoms occurred during section in 2 (12%), and after section in 1 (6%). There are one case whose symptoms occurred during 3rd gestational period. CONCLUSIONS: We should alert for the amniotic fluid embolism in the clinical findings of acute collapse and vaginal bleeding, respiratory symptoms, and seizure at any peripartum. With eary suspicion of this disease and aggressive intensive care we can reduce amniotic fluid embolism mortality rate and it's legal problem.
Abortion, Induced ; Amniotic Fluid* ; Autopsy ; Cesarean Section ; Diagnosis ; Dyspnea ; Embolism, Amniotic Fluid* ; Emergency Medical Services ; Female ; Fetal Mortality ; Fetus ; Gestational Age ; Heart Arrest ; Humans ; Hypotension ; Critical Care ; Male ; Maternal Age ; Medical Records ; Mortality ; Peripartum Period ; Pregnancy ; Seizures ; Sexuality ; Uterine Hemorrhage

In complication of infective endocaditis splenomegaly and splenic infarction are not uncommon but splenic rupture is very rare. We report a case of splenic rupture complicated by infective endocarditis in 1 71-yr-old man who had been suffered from rheumatic heart disease (aortic regurgitation and stenosis and mitral regurgitation). The patient was admitted to mild fever and generalized weakness for 20 days. Diagnosis of infective endocarditis due to Staphylococcus epidermidis was made by clinical manifestaions and blood culture study.On 34th day of admissionthe patient suddenly displayed the symptoms and signs of massive intraperitoneal hemorrhage. Splenic rupture was revealed by paracentesis and radiologic studies. Rupture of spleen is an uncommon and usually fatal complication of infective endocarditis. Therefore early diagnosis and prompt treatment must be performed.
Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Endocarditis* ; Fever ; Hemorrhage ; Humans ; Paracentesis ; Rheumatic Heart Disease ; Rupture ; Spleen ; Splenic Infarction ; Splenic Rupture* ; Splenomegaly ; Staphylococcus epidermidis

No abstract available.
Fever ; Humans ; Still's Disease, Adult-Onset* ; Urticaria*

PURPOSE: Hashimoto's thyroiditis is the most common cause of thyroid disease in children and adolescents. It shows a wide spectrum of thyroid functions, ranging from hypothyroidism to hyperthyroidism, with variable clinical course. This study was undertaken to investigate the clinical course and outcome of Hashimoto's thyroiditis with long-term follow-up in children and adolescents. METHODS: We analyzed retrospectively clinical data in 85 girls diagnosed as Hashimoto's thyroiditis in the pediatric endocrinology clinic at Asan Medical Center from January 1996 to June 2006. Of 24 patients, who had been followed up for more than five years, we investigated age at diagnosis, family history, initial thyroid function, initial thyroid autoantibody titers, changes of thyroid function, and changes of positivity rate of thyroid autoantibody. RESULTS: The mean age at diagnosis was 10.9+/-2.6 years. Goiter was found in about 95% of patients, whereas 5 patients presented with short stature. Positive family history of autoimmune thyroid disease was documented in 27 out of 85 patients (31.8%). At diagnosis, 34 of 85 patients (40.0%) were in euthyroidal status, 43 (50.7%) in overt or compensated hypothyroidism, and 8 (9.4%) in hyperthyroidism. Among the 24 patients followed up for more than five years, 7 patients were in euthyroidal status, 16 in overt or compensated hypothyroidism, and 1 in hyperthyroidism at initial presentation. Four patients initially diagnosed with euthyroidism remained in euthyroidal status, while 7 patients with hypothyroidism were shifted to euthyroidism. Overall, 15 out of 24 patients were in remission status at the last follow-up. Initial TSH level was significantly higher in non-remission group (P=0.016). Initial thyroid autoantibody titers were not correlated with remission rate. CONCLUSION: The clinical course of children and adolescents with Hashimoto's thyroiditis varied widely. After more than five years follow-up, 62.5% of patients remained or became euthyroid. Initial TSH level can be a prognostic factor of Hashimoto's thyroiditis.
Adolescent ; Child ; Endocrinology ; Follow-Up Studies ; Goiter ; Humans ; Hyperthyroidism ; Hypothyroidism ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

No abstract available.