Teratomas are neoplasm composed of a wide variety of tissues foreign to the organs or anatomic sites in which they arise. They generally arise in gonads but a few cases are described in extragonadal sites, such as sacro-coccygeal region, mediastinum, neck, and retroperitoneum. Most sacrococcygeal teratomas are encountered in infants, particularly in neonates, and a primary sacrococcygeal teratoma is a extremely rare neoplasm in adults. Recently, we experienced two cases of presacral teratomas arising in adult, therefore we present these cases with a brief review of the literatures
Adult* ; Gonads ; Humans ; Infant ; Infant, Newborn ; Mediastinum ; Neck ; Teratoma*

BACKGROUND : Borame hospital nuns geriatric wards with 120 beds (40 beds for patients in Dept. of Internal Medicine, 40 for patients in Dept. of Orthopedics 40 for patients in Dept. of Neurology) from December 1996. We studied clinical characteristics of admissions to acute geriatric wards in Borame hospital in order to assess current status of geriatric wards in Korea. METHODS : 334 patients admitted from December 1996 to May 1997 were studied. By reviewing clinical records of these patients, we studied clinical characteristics of patients in geriatric wards retrospectively. RESULTS : 1) Age distribution: 8.6% of patients were over 85 years old. 16.4% of patients were between age of 80-84. 20.0% between 75-79, 31.3% between 70-74, 26.3% between 65-69, respectively. 2) Disease: 43% of patients have single disease, 67% of patients have multiple disease(23% of patients with 2 disease, 25% with 3 disease, 6% with 4 disease, 3% with over 5 disease respectively). 3) Mortality rate :Total mortality rates were 4.3% with 6.1% of patients in Internal medicine, 3.2% of patients in Neurology. These rates were much higher compared with mortality rates of 2.4% in general wards but similar to those (6.7%) in general wards in Internal medicine. 4) Causes of admission: Malignancies were most common causes of admissions in males, and then cerebrovascular diseases, infectious diseases, musculoskeletal diseases, in order. Musculoskeletal diseases were most common causes, and then diabetes mellitus, infectious diseases, cerebrovascular diseases. CONCLUSION : The elderly patients tend to have multiple diseases, longer hospital stays and higher mortality rates compared with younger patients in general wards. but differences of hospital stays and mortality rates are less than be expected.
Age Distribution ; Aged ; Aged, 80 and over ; Communicable Diseases ; Diabetes Mellitus ; Humans ; Internal Medicine ; Korea ; Length of Stay ; Male ; Mortality ; Musculoskeletal Diseases ; Neurology ; Orthopedics ; Patients' Rooms ; Retrospective Studies

No abstract available.
Leiomyoma*

In order to determine the value of CT in the diagnosis of choledocholithiasis, the authors retrospectivelystudied 33 cases of choledocholithiasis proven by surgery from January 1983 to June 1985. Among them, 15 caseswere examined by both CT and ultrasonography. The results were as follows: 1. There were 12 men and 21 women withmean age of 57 years. 2. CT correctly diagnosed choledocholithiasis in 29(88%) of total 33 cases. There were 4false negative diagnoses and there were no false positive. 3. In 15 cases which were examined by both CT andultrasonography, 13(86%) cases were correctly diagnosed by CTand 7(46%) by utrasonography. 4. The majority(88%) ofcholedocholithiasis were demonstrated as calcific density and 4 cases(12%) were nearly isodense to pancreas. 5.Most cases were shown as homogenous density and 5 cases(16%) as ringlike structure with low density center andhigh density periphery. 6. Additional findings, such as intrahepatic and/or GB stones, pericholangitic abscess, GBempyema, ascites, and liver cirrhosis were also identified by CT. 7. CT is effective for noninvasive and accuratedetection of choledocolithiasis. So invasive cholangiography, such as E.R.C.P or P.T.C can be reserved in manycases of choledocholithiasis.
Abscess ; Ascites ; Cholangiography ; Choledocholithiasis ; Diagnosis ; Female ; Humans ; Liver Cirrhosis ; Male ; Pancreas ; Ultrasonography

A 40-year-old female patient who had tethered spinal cord with intraspinal lipoma and intractable pain of the lower leg and foot is reported. The pain started 5 years ago and exaggerated recently. A pea-size mass had been noted since birth at sacral region, which was excised 2 months prior to admission at the other clinic. Neurological examination revealed diffuse muscular wasting of the left foot, especially the sole, hypesthesia of the left sole with dysesthesia, bilaterally increased knee jerks, and absent left ankle jerk. The patient underwent L5 laminectomy, subtotal removal of extradural, intradural and intramedually lipoma with dural repair, and dorsal rhizotomy of ipsilateral L5 and S1 roots. At surgery, the neural elements were untethered with mass removal, adhesiolysis, and division of thickened arachnoid septum. The pain improved much after and was tolerable with some analgesics.
Adult* ; Analgesics ; Ankle ; Arachnoid ; Female ; Foot* ; Humans ; Hypesthesia ; Knee ; Laminectomy ; Leg ; Lipoma* ; Neurologic Examination ; Pain, Intractable* ; Paresthesia ; Parturition ; Rhizotomy ; Sacrococcygeal Region ; Spinal Cord*

The publisher wishes to apologize for incorrectly displaying the corresponding author's academic degree and position. We correct the corresponding author's academic degree from MD to DVM. The correspondig author belongs to the department of veterinary anatomy, college of veterinary medicine. The correct e-mail address is shint@jejunu.ac.kr.

BACKGROUND AND PURPOSE: Erythropoietin (Epo), originally recognized for its central role in erythropoiesis, has been shown to improve the outcomes in patients with various neurological disorders. The aim of this study was to elucidate the Epo expression pattern in the spinal cords of Lewis rats with experimental autoimmune encephalomyelitis (EAE) and to assess the systemic effect of Epo during the course of EAE. METHODS: We used an EAE model induced in Lewis rats by immunization with myelin basic protein. Immunized rats were given recombinant human Epo (rhEpo) intraperitoneally at a dose of 5,000 U/kg for 7 consecutive days, either starting on day 3 post-immunization (five rats) or on the day of clinical symptom onset (score > or =1, five rats). After immunization, the rats were observed daily for clinical signs of EAE. Epo expression was investigated by Western blot analysis and immunohistochemistry. RESULTS: Western blot analysis showed that, Epo expression was significantly elevated relative to control in the rat spinal cord during the peak stage of EAE (p<0.05), and then decreased thereafter. Immunohistochemistry demonstrated that Epo was expressed in some neurons and glial cells. Epo immunoreactivity was detected in ED1-positive macrophages and astrocytes in EAE lesions. Furthermore, we found that the intraperitoneal administration of rhEpo reduced both the disease severity and duration of paralysis in EAE rats, and reduced macrophage activity and increased Epo activity. CONCLUSIONS: Based on these findings, we postulate that Epo expression begins to increase at the start of EAE and that rhEpo administration leads to functional recovery from EAE paralysis.
Animals ; Astrocytes ; Blotting, Western ; Encephalomyelitis, Autoimmune, Experimental ; Erythropoiesis ; Erythropoietin ; Humans ; Immunization ; Immunohistochemistry ; Macrophages ; Myelin Basic Protein ; Nervous System Diseases ; Neuroglia ; Neurons ; Paralysis ; Rats ; Spinal Cord

External stereotaxic irradiation of intracranial lesions has recently gained its interest in the fields of not only radiation oncology but also neurosurgery. Its main goal is to deliver large doses to a relatively small target volume. Authors present methods of the stereotaxic radiosurgical irradiation using 6MV linear accelerator (Nelac-6) and isodose distribution by therapeutic computer (Therac 2000). We attempt to demonstrate the dose distribution on verification films.
Neurosurgery ; Particle Accelerators ; Radiation Oncology ; Radiotherapy*

BACKGROUND: Clonidine, a alpha2-receptor agonist, has sedative and decrease the MAC of anesthetics. Clonidine also has analgesic properties following intrathecal administration. This study evaluates the effects of clonidine on the onset time and duration of analgesia when added to bupivacaine for brachial plexus block. METHODS: Forty patients of ASA physical ststus 1 and 2I who scheduled for elective upper limb surgery were divided into two groups in randomized, double-bline fashion. The brachial plexus block was performed with 30 ml of 0.33% bupivacaine plus saline(1ml; n=20)or clonidine(150ug, 1ml; n=20). The following variables were recorded; onset time, duration of analgesia, sedation, heart rate and blood pressure. RESULTS: The onset time produced with the addition of clonidine was faster(15.6+/-5 vs 19+/-4 min). The duration of block, heart rate and blood pressure were not different between the groups. There were more sedation in the clonidine group. CONCLUSIONS: From the above results, adding clonidine to bupivacaine is an attractive adjuvants for brachial plexus block.
Analgesia ; Anesthetics ; Blood Pressure ; Brachial Plexus* ; Bupivacaine* ; Clonidine* ; Heart Block ; Heart Rate ; Humans ; Pharmacology ; Upper Extremity

PURPOSE: Endovascular therapy (ET) for peripheral arterial occlusive disease has increased dramatically in the past decade. ET is currently being performed by different specialists with available resources, with some of these resources being far superior to others, yet there have been no studies comparing the interventional outcomes according to the varying resources. The aim of this study was to analyze the outcomes of ET for superficial femoral artery (SFA) atherosclerosis using a mobile C-arm, in comparison to a historical control group. METHODS: Between March 2009 and December 2010, ET for SFA atherosclerosis was performed in 54 limbs from 47 patients using a mobile C-arm in the operation theater (mobile group). In contrast, a historical group for comparison consisted of 60 patients, for whom ET for SFA atherosclerosis was performed in 76 limbs using a fixed C-arm in the angiographic suite, between July 2003 and May 2008 (fixed group). The outcomes of ET for both groups were retrospectively analyzed by a medical chart review. RESULTS: There was no statistically significant difference in gender, age, risk factors, Trans-Atlantic Inter-Society Consensus (TASC) classification, intervention type, and postoperative blood creatinine levels between the two groups. However, procedural time was statistically higher in the mobile group. Patency rates at 1 year were 68.3% and 68.1% in the fixed and mobile group, respectively, which was not statistically significant. Subgroup analysis of 1 year patency rates for TASC A, B lesions and TASC C, D lesions were also similar. CONCLUSION: ET using the mobile C-arm in the operating theater is as effective as using the fixed C-arm, in the treatment of SFA atherosclerosis in terms of the technical success, patency, and early postoperative outcomes.
Arterial Occlusive Diseases ; Atherosclerosis ; Consensus ; Creatinine ; Endovascular Procedures ; Extremities ; Femoral Artery ; Humans ; Peripheral Arterial Disease ; Retrospective Studies ; Risk Factors ; Specialization