Vertebral hemangioma is a slow-growing tumor which involves the vertebral body only. It is usually discovered incidentally on lateral radiographs of the spine and only rarely symptomatic. Compression of the spinal cord due to vertebral hemangioma is very rare. The authors report a patient who developed a progressive paraplegia and sensory change clinically resembling an intramedullary spinal cord tumor. Simple spine film gave us a hint that there was a vertebral hemangioma at T-5, but the clinical correlation was uncertain until spinal cord compression was demonstrated by MRI and the symptoms improved with operation. Selective angiography was normal. The histologic diagnosis was a cavernous hemangiona. As there was no associated spinal cord vascular malformation visualized during operation, her clinical presentation mimicking intramedullary spinal cord tumor was atypical one of compressive extramedullary mass. Following surgical excision, the patient improved dramatically and was discharged with only a residual hyperalgesia below the T-10 dermatome.
Angiography ; Diagnosis ; Hemangioma* ; Humans ; Hyperalgesia ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Neoplasms ; Spine ; Vascular Malformations

INTRODUCTION: There are three anatomic findings that correlate with a patient risk for developing anterior acromial impingement : acromial shape, anterior downsloping of the acromion. To analyze the effect of anterior and lateral downslopings and subacromial interval to the impingement syndrome retrospectively, the authors reviewed 32 patients who performed MRI of the shoulder joint in the Dankook university hoipital. MATERIALS AND METHODS: Eighteen males & fourteen females were reviewed and the average age was 46.6 years old. There were 23 cases of impingement syndrome and 9 cases of control group. The authors analyzed oblique coronal images and oblique sagittal images in shoulder MRI.
Acromion ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Shoulder Impingement Syndrome ; Shoulder Joint ; Shoulder

No abstract available.
Humans ; Insulin Resistance* ; Insulin*

The authors analyzed the stroke patients admitted to department of neurosurgery and neurology of Seoul National University Hospital between 1980 and 1987. Among the 883 ischemic stroke patients angiography was performed in 158 cases. Twenty-two cases of atherosclerotic carotid occlusive disease were detected. The peak incidence of carotid occlusive disease was in the 6th decade and sex ratio of male to female was 2.7:1. Most of patients had a long history of repeated ischemic attacks and the common symptoms and signs on admission were motor weakness, speech disturbance, sensory change and visual disturbance. The associated diseases were hypertension(40.9%), hyperlipidemia(31.8%), hyperuricemia(27.3%), dysarhythmia(22.7%), heart disease(27.2%) and diabetes mellitus(13.6). CT findings showed lesions on the middle cerebral artery(MCA) territory most frequently(40.9%) then watershed zone infarct(18.2%) and diffuse brain atrophy(18.2%). Angiographic findings showed multiple lesions in 50% and lesion sites were proximal internal carotid artery(ICA) in 51.9% then cavernous portion, supraclinoid portion, petrosal portion and extracranial distal ICA in order of frequency. Clinical outcomes after the medical or surgical treatment were improved in 45.5%, stable in 45.5% and late worsening in 9.1%.
Angiography ; Brain ; Female ; Heart ; Humans ; Incidence ; Male ; Neurology ; Neurosurgery ; Seoul ; Sex Ratio ; Stroke

Syndrome of inappropriate antidiutetic hormone(SIADH) secretion is the most common cause of hyponatremia in clinical medicine. Before diagnosis of the SIADH is made, other causes for a decreased diluting capacity and nonosmotic stimuli for AVP release need to be rule out. Disorders associated with SIADH can be divided into 4 major etiologic groups: malignancies, pulmonary diseases, central nervous disorders, and drugs. A 45-year-old woman was admitted due to maculopapular skin eruption and fever after taking medications for fever and myalgia. Generalized tonic clonic seizure was developed nine days later, and laboratory results showed marked hyponatremia. During the evaluation, treatment, and subsequent follow-up, the diagnosis of SIADH was confirmed, but the definitive cause was obscure. With fluid restriction, sodium replacement and demeclocycline therapy, she recovered completely 6 months later. We suggest that the SIADH might be related to drug-induced generalized maculopapular rash via menmgitis-like reaction in CSF as one of systemic adverse side effects to drugs rather than direct effect of related drugs.
Clinical Medicine ; Demeclocycline ; Diagnosis ; Exanthema* ; Female ; Fever ; Follow-Up Studies ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Lung Diseases ; Middle Aged ; Myalgia ; Seizures ; Skin ; Sodium

PURPOSE: To evaluate radiologic and clinical results of bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture. MATERIALS AND METHODS: Between April, 2005 and February, 2006, 17 patients treated by bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture were evaluated. All patients were reviewed clinically and radiologically after operation. RESULTS: All of 17 cases of fractures were completely united. In the anteroposterior radiographs, the average of preoperative angulation was corrected from 34.4° to 5.2°. Also, in the oblique radiographs, radiographic results of angulation correction were satisfactory which was corrected from 44.2° to 11.7°. Although, the averages of difference between postoperative and final follow-up angulations were 1.5° in the anteroposterior radiographs and 0.9° in the oblique radiographs, they were not statistically different. All patients were excellent clinically except 1 patient who has moderate joint stiffness after operation. CONCLUSION: Selecting of appropriate patients who is indicated, bouquet pin intramedullary nail technique for the 5th metacarpal neck fracture could be a good treatment method without complications.
Follow-Up Studies ; Humans ; Joints ; Methods ; Neck*

Primary Pigmented Nodular Adrenal Dysplasia (PPNAD) is a rare cause of Cushing's syndrome in infants and young adults. The familial occurrence, it may be variably associated with a complex of other pathologic characteristics that manifests extraadrenal disorders (includes cardiac myxomas, lentigines, mammary myxoid lesions, testicular tumors, pituitary adenomas, and neuroectodermal tumors) was considered indicative of Carneys complex. This was based on the failure of cortisol suppression by high-dose dexamethasone, either normal or suppressed basal adrenocorticotropic hormone (ACTH) levels, and normal radiographic studies of the sellar turcica, and adrenals glands is almost normal or slightlg eulaged.. Bilateral adrenalectomy has thus the only effective means of cure. The disease may be a component of a rare, but potentially dangerous complex of abnormalities that follow an autosomal-dominant mode of inheritance. Recently we experienced a case of Carney's complex composed by Cushings syndrome due to PPNAD with familial purple colored lentigines on their lips and report it with reviews of the literatures.
Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome* ; Dexamethasone ; Humans ; Hydrocortisone ; Infant ; Lentigo ; Lip ; Myxoma ; Neural Plate ; Pituitary Neoplasms ; Testicular Neoplasms ; Wills ; Young Adult

We describe the case of a patient with symptomatic left cervical ICA stenosis and aneurysm of the left distal anterior cerebral artery. She presented with chronic headache and recurrent attack of right hemiparesis, and underwent staged operations. Using the interhemispheric approach, the intracranial aneurysm was clipped, and there was no postoperative neurologic deterioration. Two months later, a carotid endarterectomy was performed. The patient recovered without complications and angiography revealed relief of carotid stenosis and non-visualization of the aneurysm. The coexistence of symptomatic carotid stenosis and an unruptured intracranial aneurysm poses a therapeutic dilemma; correction of significant stenosis of the internal carotid artery may increase the pressure and turbulence to which the aneurysm is subjected, while the intracranial approach to an aneurysm, when blood flow is decreased by carotid stenosis, may also involve increased risk. In view of the theoretical risk of increased blood flow and turbulence after carotid endarterectomy, aneurysm neck clipping followed by this procedure either in a single stage or separate stages seems to be the another safest management strategy.
Aneurysm* ; Angiography ; Anterior Cerebral Artery ; Carotid Artery, Internal ; Carotid Stenosis* ; Constriction, Pathologic ; Endarterectomy, Carotid ; Headache Disorders ; Humans ; Intracranial Aneurysm ; Neck ; Paresis

Diabetic insipidus may first present before, during or immediately after pregnancy. Pregnancy serves as a physiologic provocation test that unmasks latent diabetes insipidus. It may explain the very rare first occurrence of diabetes insipidus in the pureperium. Central diabetes insipidus occurring after delivery associated with a catastrophic delivery and postpartum hypopituitarism is more frequent entity. We recently experienced central diabetes insipidus patient, aggrevated polyuria and polydipsia after total hysterectomy due to cervical carcinoma, who had interesting past history of severe polyuria and polydipsia developed during puerperium of 1st pregnancy, 14 years ago. She have had quiet normal pregnancy and there was no definite postpartum complication of pregnancy at that time. There were no change of polyuria and polydipsia during and after second pregnancy and 2 another pregnancy terminated artificially compare to puerperium of 1st delivery. She has intact anterior pituitary gland functinally and anatomically, but the posterior pituitary hyperintense signal with pre-enhance Tl-weighted imaging was absent on MRI.
Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Humans ; Hypopituitarism ; Hysterectomy ; Magnetic Resonance Imaging ; Pituitary Gland, Anterior ; Polydipsia ; Polyuria ; Postpartum Period* ; Pregnancy

No abstract available.
Humans ; Pericardial Effusion*