Psoriatic arthritis is a rare inflammatory joint disease associated with radiographic evidence of periarticular bone erosion and sometimes frank joints destruction among psoriatic patients. There have been only a few reports of atlantoaxial subluxation in patients with psoriatic arthritis in the world. The authors report a case of psoriatic arthritis with atlantoaxial subluxation. This 27-year-old man with a three year history of psoriatic skin lesion presented with painful limitation of neck and multiple joint deformities of the hands and feet, etc. We performed combined interspinous and Gallie fusion for the atlantoaxial subluxation and obtained good results of immediate and long term postoperative stability with Philadelphia neck collar only after this procedure.
Adult ; Arthritis, Psoriatic* ; Congenital Abnormalities ; Foot ; Hand ; Humans ; Joint Diseases ; Joints ; Neck ; Skin

In 1957, human skin infection by M. canis were firstly reported in Kyungsang province in Korea. Later, in 1960 new cases were also reported in the other province, the Choongchung. However, M. canis infection has been reported only sporadically in Seoul city. This extremely low incidenc in this area may not represent true negative rate but reflect lack of the alertness of .M. canis infection. During the years 1978 and 1979, 15 out-patients were diagnosed as M canis infection of the skin at the Department of Dermatology of Severance Hoapital, Yonsei University. These 15 patients were found to belong to six different families residing in the central Korea and never resided outside of that area, The Kyungki province. Majority of the cases(11/15) were clinically diagnosed as tinea corporis, as Kerion celsi and 4 cases were tinea capitis. Among them, combined infection by tinea capitis and tinea corporis were confirmed in two patients. Although the ages of the pateints were widely distributed from 2 to 36 years, children under age 10 were the major population among thern. Five domestic cats from 5 families were examined and confirmed to be infected by M. cams.
Animals ; Cats ; Child ; Dermatology ; Humans ; Korea* ; Microsporum* ; Outpatients ; Seoul ; Skin ; Tinea ; Tinea Capitis

Osteopetrosis is a rare disease by a generalized increase in skeletal density and by abnormalities of bone modeling secondary to defective osteoclastic function with impairment of bone resorption. The various cranial nerve palsies may occur secondary to bony encroachment on the cranial foramina. The authors report a case of osteopetrosis with trigeminal neuralgia. This 30-year-old woman presented with the recurring attacks of severe lancinating paroxysmal pain on her right face(mandibular division>maxillary division>ophthalmic division) for 10 years and anosmia, both blindness for 20 years. Her foramen ovale and optic canal narrowings were caused by osteopetrosis. The neuralgia was refractory to medical treatment. Percutaneous radio-frequency rhizotomy for trigeminal neuralgia was performed and pain relief have been obtained. She was satisfied with the procedure, even if with facial numbness. In the case of trigeminal neuralgia in young patient without abnormal mass lesion on brain radiologic imaging studies, it is important to investigate the bony abnormalities of skull base. The authors believe that radiofrequency rhizotomy is the first choice of treatment for trigeminal neuralgia caused by the bony abnormalities of skull base such as osteopetrosis.
Adult ; Blindness ; Bone Resorption ; Brain ; Cranial Nerve Diseases ; Female ; Foramen Ovale ; Humans ; Hypesthesia ; Neuralgia ; Olfaction Disorders ; Osteoclasts ; Osteopetrosis* ; Rare Diseases ; Rhizotomy ; Skull Base ; Trigeminal Neuralgia*

BACKGROUND/AIMS: Gastric carcinoma is a major cause of morbidity and mortality in Korea. It evolves through dysplasia to an invasive adenocarcinoma. The carcinogenesis of dysplasia and adenocarcinoma in the stomach was investigated by examining the levels of mutant p53 protein, p21(waf1/cip1), and cyclin D1 expression in gastric dysplasia and invasive adenocarcinoma. METHODS: Formalin- fixed paraffin-embedded tumors were examined immunohistochemically using the monoclonal antibodies to the 53 protein, p21(waf1/cip1) and cyclin D1. RESULTS: Mutant p53 protein, p21(waf1/cip1) and cyclin D1 expression were found in 66.6% (12/18), 72.2% (13/18) and 33.8% (6/18) of dysplasia, and 45.0% (9/20), 15.0% (3/20) and 30.0% (6/20) of invasive adenocarcinoma, respectively. CONCLUSIONS: These results suggest that p21(waf1/cip1), which is controlled by the p53 protein, plays a more important role in the carcinogenesis of the stomach than cyclin D1.
Adenocarcinoma* ; Antibodies, Monoclonal ; Carcinogenesis ; Cyclin D1* ; Cyclins* ; Korea ; Mortality ; Stomach*

Nontraumatic intracranial subarachnoid hemorrhage (SAH) attributable to the thoracolumbar dural arteriovenous fistulas (DAVFs) has been extremely rare. A 41-year-old male patient was admitted with severe acute headache, neck stiffness, and pronounced low-back pain radiating to both legs. The T2-weighted MR imaging showed irregular signal void and enlarged, varix like pouch formation with spinal cord compression at the T11-12 level. The angiogram revealed a DAVF.
Adult ; Central Nervous System Vascular Malformations ; Headache ; Humans ; Infarction ; Leg ; Male ; Neck ; Spinal Cord ; Spinal Cord Compression ; Subarachnoid Hemorrhage ; Varicose Veins

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy

We report four cases of traumatic aneurysm in the branches of external carotid artery and reviewed other cases from the literature in view of their clinical feature and management.
Aneurysm* ; Carotid Artery, External*

OBJECTIVE: To present the accuracy and safety of cervical pedicle screw insertion using the technique with direct exposure of the pedicle by laminoforaminotomy. METHODS: We retrospectively reviewed 12 consecutive patients. A total of 104 subaxial cervical pedicle screws in 12 patients had been inserted. We also assessed the clinical and radiological outcomes and analyzed the direction and grade of pedicle perforation (grade 0: no perforation, 1: <25%, 2: 20% to 50%, 3: >50% of screw diameter) on the postoperative vascular-enhanced computed tomography scans. Grade 2 and 3 were considered as incorrect position. RESULTS: The correct position was found in 95 screws (91.3%); grade 0-75 screws, grade 1-20 screws and the incorrect position in 9 screws (8.7%); grade 2-6 screws, grade 3-3 screws. There was no neurovascular complication related with cervical pedicle screw insertion. CONCLUSION: This technique (technique with direct exposure of the pedicle by laminoforaminotomy) could be considered relatively safe and easy method to insert cervical pedicle screw.
Humans ; Retrospective Studies

PURPOSE: As preoperative diagnostic tools have advanced, the rate of multiple early gastric cancer diagnoses have increased. The author investigated the clinicopathological features of multiple early gastric cancers to elucidate the clinical feasibility of minimally invasive gastrectomy such as laparoscopy or robot assisted gastrectomy for their surgical treatment. METHODS: One thousand one hundred and eighty-five open gastrectomies and 607 laparoscopies or robot-assisted gastrectomies for gastric cancers from January 2003 through August 2009 were retrospectively reviewed. Among them, 844 were diagnosed as early gastric cancers, of which 47 cases had multiple early gastric cancers. Twenty-seven cases underwent open gastrectomy and 20 cases underwent laparoscopy or robot assisted gastrectomy. The author analyzed clinicopathological features in these multiple early gastric cancers. RESULTS: The incidences of multiple early gastric cancers among the early gastric cancers were 5.6%. There were no statistical differences in the clinicopathological parameters except the type of gastrectomy and anastomosis. The distances of both proximal and distal margin show no statistical difference in both groups. The hospital stay was shorter in laparoscopy or robot assisted gastrectomy group (P=0.022). The postoperative complications developed 7 cases in open group and 1 case in laparoscopy or robot assisted gastrectomy group (P=0.046). During the mean follow-up period of 43.8+/-26.4 and 36.2+/-19.8 months, no recurrence was found in both groups. CONCLUSION: Laparoscopy or robot assisted gastrectomy are as acceptable as open methods to obtain a safe surgical margin, and to perform the desirable type of gastrectomy and radical lymph node dissection.
Follow-Up Studies ; Gastrectomy ; Incidence ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms

PURPOSE: To evaluate the role of [(18)F]fluorodeoxyglucose-positron emission tomography(FDG-PET) for the follow-up of patients with a renal cell carcinoma(RCC), and compare FDG-PET with conventional imaging modalities, including computerized tomography(CT), chest PA, bone scan and brain magnetic resonance imaging(MRI). MATERIALS AND METHODS: FDG-PET and conventional imaging techniques, includingCT, chest PA, bone scan and brain MRI, were performed on 69 patients who had undergone a radical nephrectomy and/or metastatectomy, with a final pathological diagnosis of a RCC. The final diagnoses of recurrences/metastases were established from the histopathological or clinical findings. RESULTS: Recurrences and metastases were present at 47 sites(34 patients). The results of FDG-PET were true positive and false negative in 44 and 3 of the 47 sites, respectively. The results of conventional imaging techniques were true positive and false negative in 40 and 7 of the 47 sites, respectively. The results of FDG-PET were true negative and false positive in 34 and 1 of the 35 patients, respectively. The results of conventional imaging techniques were true negative and false positive in 30 and 5 of the 35 patients, respectively. Therefore, FDG-PET was more sensitive, specific and accurate than conventional imaging techniques for the follow-up of patients with a RCC. CONCLUSIONS: FDG-PET accurately detected the postoperative recurrences and metastases in patients with a RCC. FDG-PET may have a role in the follow-up of patients with a RCC.
Brain ; Carcinoma, Renal Cell* ; Diagnosis ; Electrons* ; Fluorodeoxyglucose F18 ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Nephrectomy ; Positron-Emission Tomography* ; Recurrence ; Thorax