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

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

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*

OBJECTIVE: The authors characterize a syndrome of multiple neurogenic tumors in the spinal canal, which is unclassifiable by the current National Institute of Health(NIH) criteria for neurofibromatosis. METHODS: We retrospectively examined cases in which two or more spinal neurogenic tumors were detected by magnetic resonance(MR) imaging and which had been pathologically confirmed. Eighteen patients were recruited between February 1986 and March 2002. According to NIH criteria, eight cases were neurofibromatosis type 1(NF1), four were type 2(NF2), and six were neither type 1 nor type 2 (Unclassifiable: UC). The locations of lesions, clinical presentations, radiological findings, and pathological results with immunohistochemistry were reviewed. RESULTS: In the case of NF2, three of four cases were intradural tumors. Pathological examinations revealed neurilemmomas in two of four NF2 and all of the UC cases. In the case of NF1, pathological examinations showed seven neurofibromas and one neurilemmoma. Concerning UC, the age at presentation was middle-aged to late (mean age 48.5, range 35 to 64), which contrasted with ordinary NF2, where patients tended to become symptomatic before 20years of age. The pathological examinations of UC cases revealed neurilemmoma similar to most of NF2 and the immunohistochemical study showed characteristic of NF1. CONCLUSION: Multiple neurogenic tumors in the spinal canal are an under-recognized disease entity. Further studies for genetic aberration in multiple spinal neurogenic tumors are needed.
Humans ; Immunohistochemistry ; Neurilemmoma ; Neurofibroma ; Neurofibromatoses* ; Retrospective Studies ; Spinal Canal*

Spontaneous pneumomediastinum is defined as a clinical syndrome thatos characterized by the presence of air in the mediastinal space, which is not due to an old previous injury or surgery. The condition is caused by a sustained increase in the intraalveolar and intrabronchial pressure with extravasated air dissecting along the perivascular spaces of the mediastinum. This is an uncommon complication of sports activity. The most common symptom is chest pain. This diagnosis should be considered for younger people who present with pleuritic chest pain or dyspnea and a characteristic crackling feel (known as subcutaneous crepitation) when touching of the skin covering the chest wall or neck, and they look otherwise well with normal vital signs. Usually no treatment is required, but the mediastinal air will be absorbed faster if the patient inspires high concentrations of oxygen. We present here a case of spontaneous pneumomediastinum that occurred during a Taekwondo match, along with a review of the relevant literature.
Chest Pain ; Dyspnea ; Humans ; Mediastinal Emphysema ; Mediastinum ; Neck ; Oxygen ; Skin ; Sports ; Thoracic Wall ; Vital Signs

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