We experienced one case of severe pituitary dwarfism in a 16 years old male boy that magnetic resonance image(MRI) revealed transection of the pituitary stalk with the ectopic location of posterior pituitary gland and hypoplastic anterior pituitary gland. The serum growth horrnone(GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient revealed normal response in TSH, prolactin and LH, FSH to TRH and LHRH respectively. So far, the primary cause of idiopathic pituitary dwarfism in many patients was due to hypoxic injury to hypothalmus by perinatal insults. In this patients, there was no history of perinatal insults and postnatal head trauma. We report a case of severe dwarfism due to hypogenesis of anterior pituitary gland.
Clonidine ; Craniocerebral Trauma ; Dwarfism ; Dwarfism, Pituitary ; Gonadotropin-Releasing Hormone ; Humans ; Levodopa ; Male ; Pituitary Gland ; Pituitary Gland, Anterior ; Pituitary Gland, Posterior ; Prolactin

Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).
Aneurysm* ; Carotid Artery, Internal* ; Mortality ; Subarachnoid Hemorrhage ; Transplants*

The “delta phalanx”, first named by BlundeII Jones in 1964, is a triangular(“delta-shaped”) or trapezoidal phalanx with C-shaped epiphyseal plate causing progressive angular deformity of the digit with growth. Neither splinting nor physical therapy is effective in improving the condition. Surgical correction is indicated and several methods of correction have been reported. Authors have experienced a rare case of “delta phalanx” occuring in the proximal phalanx of the syndactylous digit.
Congenital Abnormalities ; Growth Plate ; Splints ; Syndactyly

Fourty one cases of open fractures of tibial shaft complicated with varying degrees of soft tissue injuries were trested by one-plane unilateral external fixation with AO fixator. In seventeen csses among them, interfragmental lag screw fixation was applied in addition, for more rigidity and stability of the fixation. All of thern were followed up at least for one year and we obtained the following results. 1. Rigid stable external fixation provided by additional minimum internal fixation may not increase the rate of infection but rather enhance prompt primary bone healing. 2. One-plane unilatersl external fixation may facilitate good access to the wound for subsepuent reconstructive procedures, and enhance pain-free early full range of joint motion, thus promote early bone union. 3. Comparing with bilsteral fixation, there wss almost no difference in the union time of the fracture even with one-plsne unilatersl fixation.
Clinical Study ; External Fixators ; Fractures, Open ; Joints ; Soft Tissue Injuries ; Tibia ; Wounds and Injuries

PURPOSE: For the production and evaluation of the tissue-equivalent phantom. MATERIALS AND METHODS: We used agarous gel and oil as a basic component of the mixture and added Tween 80 for the stabilization of phantoms. We did the test for homogeneity and measured T1 and T2 relexation times of each phantom tube. RESULTS: T1 relaxation time ranged from 642 to 2781 msec and T2 relaxation times from 42 to 157 msec. Each phantom was significantly different in T1 relaxation time and T2 relaxation time (p < .0001). CONCLUSION: Tissue equivalent phantom may provide good information on the optimal sequence before MR imaging of patients and may be valuable if it is used with the patients' MR imaging.
Agar ; Humans ; Magnetic Resonance Imaging* ; Polysorbates ; Relaxation

CD44 is a hyaluronic acid receptor that exists as a standard 90-kd form (CD44H) as well as several CD44 variants isoforms are produced through alternative splicing. Alternatively spliced variants of the CD44 molecule have been found to be associated with invasive and metastatic potential of cancer cells and poor prognosis in several types of carcinoma. The purpose of the present study is to define the expression of CD44H and CD44v6 in ovarian tumors and to investigate whether the expression of these molecules is associated with adverse prognosis. We evaluated the expression of CD44 isoforms in 58 ovarian tumors by means of immunohistochemistry, and correlated between CD44 expression and the histologic types, tumor grade, peritoneal implants, pseudomyxoma peritonei and FIGO stage. While the CD44H was commonly expressed in ovarian tumors, the CD44v6 was expressed in a minor proportion of serous tumors in comparison with frequent expression of v6 isoform in mucinous tumors. The CD44H expression was significantly higher in stage I/II than in stage III. However, there was no correlation between the expression of CD44 and the presence of peritoneal implants or pseudomyxoma peritonei. These results suggest that CD44H could play an important role in the adhesive function in the lower stage of the ovarian tumor and reduced expression in the higher stage might be related to the metastasis and widespread invasion of ovarian carcinoma cells.
Adhesives ; Alternative Splicing ; Female ; Hyaluronic Acid ; Immunohistochemistry ; Mucins ; Neoplasm Metastasis ; Ovary ; Prognosis ; Protein Isoforms ; Pseudomyxoma Peritonei

No abstract available.
Aneurysm* ; Angiography* ; Circle of Willis*

Epidermal nevus syndrome is now delineated as a congenitally acquired syndrome consisting of deformities of the skin (various linear epidermal or organoid nevi), central nervous system, skeleton, cardiovascular system, and renal system. A 4-year-old girl had linear epidermal nevus on the right lower extremity, right ear lobe and anterior neck, and multiple skeletal abnorrnalities since birth. And she had an adult fist-sied, soft, nontender mass on the right lower abdomen since 2 years of age. Radiologic examination showed scoliosis of the thoracic spines, deformities of the lumbar spines, focal gigantisms of the left hand and right foot, and other skeletal abnormalities. Histological examination of the linear, verrucous lesion of the right leg showed hyperkeratosis and papillomatosis. The surgically removed abdominal mass revealed the finding of hydrosalpinx.
Abdomen ; Adult ; Cardiovascular System ; Central Nervous System ; Child, Preschool ; Congenital Abnormalities ; Ear ; Female ; Foot ; Hand ; Humans ; Leg ; Lower Extremity ; Neck ; Nevus* ; Organoids ; Papilloma ; Parturition ; Scoliosis ; Skeleton ; Skin ; Spine

PURPOSE: Retroperitoneal paraganglioma is a relatively uncommon neurogenic tumor, arising from paraganglial tissue. In our knowledge, there is few report about the radiologic findings of extraadrenal paraganglioma, therefore, here we document the adiologic findings of retroperitoneal paraganglioma with pathologic correlation. MATERIALS AND METHODS: In 5 patients with surgicopathologically confirmed extraadrenal paraganglioma and 1 clinjcolaboratorily confirmed case, we analyzed the ultrasonographic, computed tomographic and MRI findings, and correlated them with gross pathologic specimen. RESULTS: The location of the tumors was medial aspect of left kindey(n=2), superomedial aspect of right kidney hilum(n=2), and organ of Zuckerkandl area(n=2), UItrasonoram showed well-marginated mass(n=5), occasionally with irregular central necrosis with or without partially echogenic area suggesting hemorrhage(n=2). CT scan also showed well-marginated mass(n=6) with hemorrhagic necrosis(n--3) and contrast enhancement. One showed are shaped calcification along the capsule, and another case showed adhesion with aorta. In MRI, solid portion of the mass showed relatively low signal intensity on T1WI, increased signal on T2WI, and enhancement with gadolinium. Necrotic portion showed increased signal intensity on T1WI, and also showed increased signal intensity on T2WI, without contrast enhancement. Grossly the mass showed internal hemorrhagic necrosis of variable degree(n=6). CONCLUSION: If well-marginated mass is noted around the area of paraganglial distribution including organ of Zuckerkandl, especially with evidence of hemorrhagic necrosis and contrast enhancement, we must consider the possibility of paraganglioma despite no characteristic symptoms.
Aorta ; Gadolinium ; Humans ; Kidney ; Magnetic Resonance Imaging ; Necrosis ; Para-Aortic Bodies ; Paraganglioma* ; Tomography, X-Ray Computed

After the introduction of the central parenchymal pedicle by Hester(1985) and the round-block technique by Benelli (1988), several variations of periareolar reduction mammoplasty have been used by many authors. Periareolar reduction mammoplasty is a less aggressive procedure than traditional techniques and it produces less conspicuous periareolar scars while maintaining an acceptable overall result. We experienced 120 cases (60 patients) of periareolar reduction mammoplasty during the period from May 1994 to February 1998. We present the analysis of 60 cases of periareolar reduction mammoplasty. Periareolar reduction mammoplasty utilizing central parenchymal pedicle was performed in the first 40 patients, while a procedure utilizing the inferior dermal pedicle was done in the next 20 cases consecutively. The range of follow-up was from 1 to 5 years. Complications such as nipple areolar complex necrosis and sensory changes were reduced when the inferior dermal pedicle used. There were 5 cases of nipple areolar complex necrosis and sensory changes were reduced when the inferior dermal pedicle used. There were 5 cases of nipple areolar complex necrosis (6.2%), including 1 case of near total necrosis in cases utilizing the central parenchymal pedicle. But in the technique using inferior dermal pedicle, there was no skin flap necrosis. The central parenchymal pedicle technique has several advantages such as a wide operation field permitting complete breast contouring and better mobility of the remaining breast tissue. However, inferior dermal pedicle technique has relative superiority over central parenchymal pedicle technique in terms of anatomical rationale, as well as in the rate of complications without causing limitations in breast mobility for contouring. Such complications as nipple areolar complex necrosis, skin flap necrosis and sensory change of nipple were reduced when the inferior dermal pedicle technique was used. It is much easier to preserve the 4th intercostal nerve to the nipple anatomically. Periareolar reduction mammoplasty utilizing the inferior dermal pedicle is thought to be a reliable, reproducible method.
Breast ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Intercostal Nerves ; Mammaplasty* ; Necrosis ; Nipples ; Skin