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*

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

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

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

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

In order to have the statistical basis of intracranial aneurysms, the authors analyzed the cases of angiographically proven intracranial aneurysms which were admitted to the department of neurosurgery, Seoul National University Hospital from Sep. 1957 to June 1988. The results of analysis were summarized as follows; 1) Total number of patients was 564 and 64 patients had multiple aneurysms, so total number of aneurysms was 647. Peak age incidence was in the 5th & 6th decades and male to female ratio was 1 : 1.2. 2) Location of aneurysms were anterior communicating artery(32%), posterior communicating artery(28.1%), middle cerebral artery(21.5%) in the order of frequency. Posterior circulation aneurysms comprised 7.1% and multiple aneurysms were 11.3%. 3) Among 647 aneurysms, 368 aneurysms were neck-clipped(56.9%), and operative mortality was 4.9%. 4) After 1983, 300 patients of 344 aneurysms were admitted to the neurosurgical department. The size of aneurysm was most frequent in 6-10 mm in diameter(49.4%) and 5 giant aneurysms were detected. 5) Among 344 aneurysms, 253 aneurysms were neck-clipped(73.5%) and operative mortality were lowered to 2.4%. 6) Among 300 patients 287 patients had ruptured aneurysm. Angiographic spasm was detected in 32.1% and symptomatic spasm was in 19.5%. 7) Hydrocephalus was detected in 36.2% during the period of admission and follow-up. 8) Anterior communicating artery aneurysms ruptured most frequently among the multiple aneurysms. 9) Clinical state on admission was an important factor for the outcome and preoperative clinical state was related to the operative outcome and mortality.
Aneurysm ; Aneurysm, Ruptured ; Female ; Follow-Up Studies ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm ; Male ; Mortality ; Neurosurgery ; Seoul ; Spasm

OBJECTIVE: The authors evaluate the predictability of single voxel proton magnetic resonance spectroscopy(MRS) for hippocampal abnormalities in medial temporal lobe epilepsy(MTLE), lateral temporal lobe epilepsy(latTLE) and extratemporal lobe epilepsy(extraTLE). METHODS: Twenty healthy volunteers and 42 patients with MTLE, 17 with latTLE and 23 with extraTLE, were examined preoperatively with MRS. The NAA/(Cho+Cr) ratios were calculated from the MRS peaks obtained bilaterally from both hippocampi. RESULTS: The mean NAA/(Cr+Cho) ratios showed a stepwise increase from the ipsilateral hippocampus in the MTLE group to the normal control group. In the 42 MTLE patients, the mean NAA/(Cho+Cr) ratio value for the ipsilateral hippocampus was 0.39. This was 17.3% lower than the 0.489 measured for the contralateral hippocampus (p=0.005). This was also significantly lower when compared with the hippocampi of latTLE and extraTLE patients ipsilateral to the epileptogenic zone and also with the normal control group (p< 0.05). The mean ratio value of the contralateral hippocampi was also significantly lower when compared with the normal control group (p=0.000). The mean ratio value measured on postoperative MRS showed little metabolic recovery in the MTLE (from 0.455 to 0.481, p=0.48) compared to the latTLE (from 0.438 to 0.52, p=0.09). CONCLUSION: The MRS might be inconclusive in determining whether the non-epileptogenic hippocampus is affected by epileptiform discharge propagation from the epileptogenic hippocampus or from the remote epileptogenic zone other than the hippocampus. Therefore, physicians should be cautious when determining whether the contralateral hippocampus in MTLE or both hippocampi in neocortical epilepsy is abnormal and whether they should be resected together with the epileptogenic zone.
Epilepsy* ; Healthy Volunteers ; Hippocampus ; Humans ; Magnetic Resonance Spectroscopy* ; Protons ; Temporal Lobe