PURPOSE: We evaluated the diagnostic accuracy and clinical usefulness of fluoroscopy-guided bone biopsy. MATERIALS AND METHODS: A total of 31 patients with various skeletal lesions underwent fluoroscopy-guided bone biopsies. The targets were long bones in 16 cases, pelvic bones in 7 cases, spines in 6 cases, and ribs in the rest 2 cases. RESULTS: The overall accuracy was 71%(22/31). The accuracy was 100% in case of primary sarcoma and multiple myeloma. But it was low in malignant lymphoma(1/4), malignant fibrous histiocytoma(0/1), and nonossifying fibroma(0/1). CONCLUSION: Percutaneous fluoroscopy-guided bone biopsy is a simple, safe, not-expensive, and rather accurate diagnostic procedure in evaluation of bone tumors. In addition to that, it is useful in the managment planning and fllow-up of the patients.
Biopsy* ; Humans ; Multiple Myeloma ; Pelvic Bones ; Ribs ; Sarcoma ; Spine

No abstract available.

No Abstract available.
Academic Medical Centers* ; Infection Control* ; Korea*

Acute mountain sickness (AMS) occurs commonly in hikers who are rapidly exposed to high altitude environments. Despite the numerous reports of AMS, few studies have reported pallidal lesions associated with altitude sickness. A previously healthy 49-yr-old Korean patient, after ascent to 4,700 m, suffered symptoms consistent with AMS. After returning home, the patient showed changes in personality characterized by abulia, indifference, and indecisiveness. T2 weighted brain magnetic resonance imaging showed high signal lesions involving bilateral globus pallidus. Our case suggests that globus pallidus injury should be included in the differential diagnosis of patients with personality or cognitive change after recovery from AMS.
Altitude ; Altitude Sickness/*complications ; Behavior ; Brain/pathology ; Brain Damage, Chronic/*etiology/pathology ; Environment ; Globus Pallidus/*pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mountaineering

Osteogenic sarcoma is a malignant primary tumor of bone composed of a malignant connective tissue stroma with evidence of malignant osteoid, bone and/or cartilage formation. A 23 year old man was admitted to dental department of Yeungnam University hospital with chief complaint of swelling and pain on alveolar ridge of lower right molar region. It was certain of osteogenic sarcoma through clinical and radiographic features and biopsy. Surgical resection of the lesion was performed by partial mandibulectomy and resin plate insertion. By follow up check of the patient, we made good result of functional reconstruction without any sign of recurrence of the lesion.
Alveolar Process ; Biopsy ; Cartilage ; Connective Tissue ; Follow-Up Studies ; Humans ; Mandible* ; Molar ; Osteosarcoma* ; Recurrence

Surgical resection of esophageal cance has played a prominent role in both cure and palliation. The radiologic evaluation of postesophagectomy patients is directed at the detection of normal and pathological appearances after surgical resection. Since early detection of recurrent tumor is important in the management of patients who have undergone esophagectomy, we undertook a retrospective study to evaluate the findings of recurrence on CT in postesophagectomy patients. Between January 1988 and July 1991, 26 patients who had undergone transthoracic esophagectomy with esophagogastrostomy for epidermoid carcinoma of the esophagus with following reoccurance were examined by chest CT. The group included 25 male and one female patients were aged 45-71 years(mean, 53). All patients had studies done immediate post operative 7-10 days. The CT were performed with a CT 9800 scanner (GE Medical System, Milwaukee) after administration of oral contrast media and intravenous injection of contrast media. The findings seen on CT were cnfirmed by biopsy in five cases and by clinical, radiological follow-up manifestation in 21 cases. The abnormalities that were demonstrated on follow-up CT were adenopathy-mediastinal node(ten cases) or abdominal node(five cases), local recurrence-previous tumor site (five case), anastomotic siteI(two cases) or thoracases), peicardial effusion(two cases). Our results indicate that serial chest CT play an important role in the evaluation of the patients after transthoracic esophagectomy with esophagogastrotomy.
Biopsy ; Carcinoma, Squamous Cell ; Contrast Media ; Esophageal Neoplasms* ; Esophagectomy* ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Injections, Intravenous ; Male ; Recurrence ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed*

BACKGROUND: Semantic dementia (SD) is a temporal variant of frontotemporal lobar degeneration (FTLD), which is characterized by naming difficulty, decreased comprehension of words, prosopagnosia and object visual agnosia. We report clinical features, neuropsychological and neuroimaging findings of 4 patients with SD. METHODS: Of 55 patients diagnosed as having FTLD between Jan 1995 and May 2001 at Samsung Medical Center, four patients fulfilled the diagnostic criteria of SD proposed by consensus on FTLD diagnostic criteria. We investigated their clinical features such as presenting symptoms and abnormal behaviors, neuropsychological and neuroimaging findings. Neuropsychological tests included the Seoul Neuropsychological Screening Battery, the Korean-version of Western Aphasia Battery and Hanja reading and writing. All patients underwent brain MRI and FDG-PET. RESULTS: All of the patients showed naming difficulty as a presenting symptom. Language assessments showed severe naming and compre-hension difficulties with preserved fluency and repetition, which were compatible with transcortical sensory aphasia. Whereas Hangul reading aloud and writing were intact, three patients were impaired at Hanja reading and writing. Other neuropsychological tests were remarkable for prosopagnosia, object visual agnosia and memory loss. Brain MRI showed asymmetric temporal atrophies, mainly left antero-inferior temporal cortices. FDG-PET also showed hypome-tabolism in bilateral anterior temporal lobes, more severe on the left. CONCLUSIONS: Our SD patients had characteristic neuropsychological and neuroimaging findings, which can be differentiated from other neurodegenerative diseases. We also found Hanja alexia and agraphia in SD patients, which has not been reported yet.
Agnosia ; Agraphia ; Aphasia ; Aphasia, Wernicke ; Atrophy ; Brain ; Comprehension ; Consensus ; Dyslexia ; Frontotemporal Dementia* ; Frontotemporal Lobar Degeneration ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Memory Disorders ; Neurodegenerative Diseases ; Neuroimaging* ; Neuropsychological Tests ; Prosopagnosia ; Semantics* ; Seoul ; Temporal Lobe ; Writing

Early detection of AD in its initial or preclinical stage has become increasingly important. We report a 73-year-old woman who was confirmed to have AD by a cortical biopsy performed concomitantly during a shunt operation for hydrocephalus. The triads of hydrocephalus improved after the operation, as did follow-up neuropsychological and FDG-PET findings. However, 2.5 years after the operation, the patient developed cognitive declines with abnormal behaviors, which was considered to be an evolved form of AD from the preclinical stage.
Aged* ; Alzheimer Disease ; Biopsy* ; Brain* ; Female ; Follow-Up Studies ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure*

BACKGROUND: Isolated amnesia without dementia results from various etiologies. When caused by degenerative etiol-ogy, it is recognized as a subtype of Alzheimer's disease (AD) and was termed progressive isolated amnesia or primary progressive amnesia (PPAm). Patients with PPAm have rarely been reported. We describe neuropsychogical and neu-roimaging findings in 3 patients with PPAm. METHODS: Patient 1 (M/74) showed progressive amnesia for 8 years and then developed probable AD. Patient 2 (M/76) and 3 (F/69) showed severe progressive amnesia without dementia for 9 years. Neuropsycholgical evaluations were conducted 3 times in each patient at 1 to 4 year interval. Hippocampal vol-ume was measured by a manual tracing in 1.6 mm thick coronal MRI slices which was obtained perpendicular to the long axis of the hippocampus. RESULTS: Neuropsychological tests revealed verbal and nonverbal memory loss with preservation of attention, language, praxis, visuospatial and frontal-executive functions. Right and left hippocampal vol-umes for patient 1, 2 and 3 were 1580.46/1586.38, 682.96/609 and 1152.84/1272.50 mm3 respectively, a result indica-tive of severe hippocampal atrophy. CONCLUSIONS: Neuropsychological profiles and clinical course of our patients fur-ther support the view that PPAm results from degenerative etiology. Severe atrophy of the hippocampus with relative preservation of other association cortices suggest that PPAm may be another focal cortical atrophy syndrome involving medial temporal region.
Alzheimer Disease ; Amnesia* ; Atrophy ; Axis, Cervical Vertebra ; Dementia ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Memory Disorders ; Neuropsychological Tests

PURPOSE: With this study, we evaluated the operative and neuropsychological outcomes after epilepsy surgery in children. METHODS: We studied the surgical outcomes and the possibly related factors retrospectively by reviewing the medical records of 28 patients who underwent epilepsy surgery before the age of 15 years along with the battery of neuropsychological tests. RESULTS: The mean age of seizure onset was 84.8 months, and the mean period at the surgery after the onset of seizure was 62.4 months. Among 28 patients, 15 had complex partial seizures(CPS) only, 11 CPS with secondary generalization, and two simple partial seizures in addition to CPS. The types of the surgery included anterior temporal lobectomy with amygdalo-hippocampectomy(9 patients), extra-temporal or lateral temporal resection with temporal lobectomy(16 patients), and extra-temporal resection(3 patients). Evaluating their surgical outcomes, 21 patients belonged to Engel class I, five to class II, and each one to class III and IV respectively. There was no significant difference in full scale intelligence quotient(IQ) and verbal IQ after the epilepsy surgery. However, the performance IQ was higher in the older age group after the operation(P=0.011). When the patients were divided into two prognostic groups, the Engel classification after the surgery was the only significant influencing factor(P=0.037). CONCLUSION: The intelligence quotient and memory did not deteriorate after the epilepsy surgery. The overall neuropsychological outcomes improved in about half of the patients. And it was significantly influenced by the seizure outcomes after the surgery.
Anterior Temporal Lobectomy ; Child ; Classification ; Epilepsies, Partial ; Epilepsy* ; Generalization (Psychology) ; Humans ; Intelligence ; Medical Records ; Memory ; Neuropsychological Tests ; Retrospective Studies ; Seizures