PURPOSE:There are some cases of false positive in neonatal screening for congenital adrenal hyperplasia. To understand its significance of the increased 17 alpha-hydroxyprogesterone(17 alpha-OHP) levels in the cases of positive result, we followed its levels during infancy. METHODS:From July 1997 to June 1998, totally 1,730 babies were screened for congenital adrenal hyperplasia(CAH) measuring 17 alpha-hydroxyprogesterone(17 alpha- OHP) using an enzyme immunoassay(EIA) on dried blood spots. In infants of positive result, the radioimmunoassay(RIA) was used measuring 17 alpha-OHP in serum. And we followed up the levels of 17 alpha-OHP during infancy. Cortisol and ACTH were also measured and followed up in the morning simultaneously. RESULTS:No CAH was detected during the study period. With the 13 ng/mL cutoff limit for 17 alpha-OHP before March 1998, the recall rate was 3.09%. With the 20 ng/mL cutoff limit after March 1998, the recall rate was decreased to 1.58%. Follow-up of the high levels of 17 alpha-OHP in positive cases showed a sharply decreased curve according to age. CONCLUSION: In clinically normal neonates, the high levels of 17 alpha-OHP at screening decreased continuously during infancy.
17-alpha-Hydroxyprogesterone* ; Adrenal Hyperplasia, Congenital ; Adrenocorticotropic Hormone ; Follow-Up Studies ; Humans ; Hydrocortisone ; Infant ; Infant, Newborn ; Mass Screening ; Neonatal Screening*

PURPOSE:There are some cases of false positive in neonatal screening for congenital adrenal hyperplasia. To understand its significance of the increased 17 alpha-hydroxyprogesterone(17 alpha-OHP) levels in the cases of positive result, we followed its levels during infancy. METHODS:From July 1997 to June 1998, totally 1,730 babies were screened for congenital adrenal hyperplasia(CAH) measuring 17 alpha-hydroxyprogesterone(17 alpha- OHP) using an enzyme immunoassay(EIA) on dried blood spots. In infants of positive result, the radioimmunoassay(RIA) was used measuring 17 alpha-OHP in serum. And we followed up the levels of 17 alpha-OHP during infancy. Cortisol and ACTH were also measured and followed up in the morning simultaneously. RESULTS:No CAH was detected during the study period. With the 13 ng/mL cutoff limit for 17 alpha-OHP before March 1998, the recall rate was 3.09%. With the 20 ng/mL cutoff limit after March 1998, the recall rate was decreased to 1.58%. Follow-up of the high levels of 17 alpha-OHP in positive cases showed a sharply decreased curve according to age. CONCLUSION: In clinically normal neonates, the high levels of 17 alpha-OHP at screening decreased continuously during infancy.
17-alpha-Hydroxyprogesterone* ; Adrenal Hyperplasia, Congenital ; Adrenocorticotropic Hormone ; Follow-Up Studies ; Humans ; Hydrocortisone ; Infant ; Infant, Newborn ; Mass Screening ; Neonatal Screening*

Neonatal diabetes mellitus (NDM) is defined as hyperglycemia that presents clinical symptoms within the first month of life and requires insulin therapy to maintain euglycemia. The diabetic condition may be transient, permanent, or transient with recurrence later in life. NDM is a rare clinical disorder. Three cases of NDM have been reported in Korea so far. We experienced two cases of NDM in twin brothers who were born with small for gestational ages. Their HLA typings were DR9 and DR14, and insulin autoantibody, islet cell antibody, GAD-reactive autoantibody, and insulin receptor antibody were not found. The genetic analysis with polymorphic DNA markers for chromosome 6 indicated paternal uniparental isodisomy.
Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Gestational Age ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Insulin ; Islets of Langerhans ; Korea ; Receptor, Insulin ; Recurrence ; Siblings* ; Twins* ; Uniparental Disomy

A multiparous 28-year-old woman, suffering ruptured intracranial aneurysm during pregnancy is presented. Clipping of the aneurysm was performed in 32 weeks of gestational age. Three weeks after operation, she delivered vaginally without complication. Delivery may be managed according to obstetrical indication following surgical correction of the aneurysm. The authors reviewed the literature, and discussed the neurosurgical and obstetric management of such patients.
Adult ; Aneurysm ; Female ; Gestational Age ; Humans ; Intracranial Aneurysm* ; Pregnancy* ; Rupture*

A case of iatrogenic false aneurysm of the superficial temporal artery is presented. Direct injection of Urograffin into the pulsatile mass showed aneurysmal dilatation, 3x2cm sized, of the superficial temporal artery. Aneurysm excision is indicated to reduce the risk of hemorrhage from the subsequent head trauma, to relieve headache, and for any cosmetic defect. The authors have reviewed the literature, and discussed the incidence, classification, pathogenesis, clinical and angiographic diagnosis, differential diagnosis, and treatment.
Aneurysm ; Aneurysm, False* ; Classification ; Craniocerebral Trauma ; Diagnosis ; Diagnosis, Differential ; Dilatation ; Headache ; Hemorrhage ; Incidence ; Intracranial Aneurysm* ; Temporal Arteries*

One case of multiple intracranial aneurysms is presented. On carotid angiogram, nine aneurysmal sacs including a giant aneurysm of left middle cerebral artery were detected on the right distal anterior cerebral artery, anterior communicating artery, bifurcation of both internal carotid artery, both middle cerebral artery, and left posterior communicating artery. The authors reviewed the literature, and discussed the incidence, determining the site of rupture, and the operative methods of multiple intracranial aneurysms.
Aneurysm ; Anterior Cerebral Artery ; Arteries ; Carotid Artery, Internal ; Humans ; Incidence ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Rupture

Advances in microneurosurgical treatment of arterial aneurysm have led to increased interest being focused on aneurysm situated within the posterior cerebral fossa. Despite this, reports of neurosurgical intervention in such cases are still rare and there is no report about the distal posterior cerebral artery aneurysm in Korea. An aneurysm of the posterior cerebral artery has been referred to as a "distinct rarity", making up about 0.26 to 2.7% of all cerebral aneurysms. Especially, the incidence of the distal posterior cerebral artery aneurysm is quite rare and most of them are saccular in shape and single in number. The authors report a case of P4 segment aneurysm of left posterior cerebral artery, successfully treated by clipping cross neck and reviewed the literature, and discussed their anatomy, clinical feature, location, and variable operative methods.
Aneurysm ; Incidence ; Intracranial Aneurysm* ; Korea ; Neck ; Posterior Cerebral Artery*

The authors described a case of tuberculous brain abscess, located on the sellar area with as episode of tuberculous meningitis on the past history. Tuberculous brain abscess, encapsulated collection of pus, is quite rare. Especially, occurrence around the sellar area is extremely rare. On brain CT scan, tuberculous brain abscess on sellar region was differented from pituitary adenoma, craniopharyngioma, germinoma, pyogenic brain abscess, etc. The history of previous tuberculous meningitis was meaningful for the diagnosis of our case. So, we have reported this case with review of the articles.
Brain Abscess* ; Brain* ; Craniopharyngioma ; Diagnosis ; Germinoma ; Pituitary Neoplasms ; Suppuration ; Tomography, X-Ray Computed ; Tuberculosis, Meningeal

Simultaneoulsy carpometacarpal fracture and dislocation is known to be uncommon past days. But Fisher1 reported that it is quite common injury of hand in 1984. Also high energy injury causes carpometacarpal joint fracture and dislocation, the result of treatment has wide spectrum of prognosis, so early diagnosis and treatment is essential. We reported 2 patients who had the fourth and fifth carpometacarpal fracture and dislocation.
Carpometacarpal Joints ; Dislocations ; Early Diagnosis ; Hand ; Humans ; Prognosis

PURPOSE: We intend to set up the plan by analyzing the case applying operative treatment for the diagnosis and treatment of the fourth and fifth metacarpal bone base fracture. MATERIALS AND METHODS: Among 15 cases treated operatively from January of 2004 to October of 2009, there were 9 cases being fifth isolated carpometacarpal fracture, 5 cases being the fourth and fifth carpometacarpal comminuted fracture, 2 cases accompanied by hamate body fracture, 10 cases were comminuted fracture of carpal bone or metacarpal bone. RESULTS: The 13 cases of 15 cases which have got operative treatment for the fourth and fifth carpometacarpal fracture were men, average age were 26.3 years old, injury mechanism were direct hit for 9 cases, slip-down for 6 cases. 12 cases were done closed reduction and pinning, 3cases were done open reduction because of comminution or accompanied by hamate fracture. CONCLUSION: Appropriate diagnostic tool such as computed tomography and careful physical examination are essential for good result of the fourth and fifth carpometacarpal fracture treatment.
Carpal Bones ; Fractures, Comminuted ; Humans ; Male ; Physical Examination