Tethered cord syndrome is one of the spinal dysraphism with low-lying conus medullaris frequently associated with spinal lipoma, diastematomyelia and thick filum. The clinical manifestation is variable from no overt symptoms for a long time to back pain, scoliosis, progressive neurological deficit of legs and incontinence. Therefore the diagnosis requires a strong clinical suspicion and aggressive investigation. We experienced a case of 1 day-old male infant who was presented with small soft mass on sacral area. Spinal ultrasonography and spine MRI revealed tethered cord associated with intradural lipoma. We reported a case of tethered cord syndrome with brief review of literatures.
Back Pain ; Conus Snail ; Diagnosis ; Humans ; Infant ; Leg ; Lipoma ; Magnetic Resonance Imaging ; Male ; Neural Tube Defects* ; Scoliosis ; Spinal Dysraphism ; Spine ; Ultrasonography

A rare case of intramedullary Cysticercosis, at the thoracic cord is introduced which was misdiagnosed as intramedullary tumor and was confirmed after operation. After myelogram developed progressive paraplegia, which was not improved after operation. The myelographic finding of intramedullary Cysticercosis can't differenciate from intramedullary tumor and we have to consider this condition making diagnosis of intramedullary tumor.
Cysticercosis* ; Diagnosis ; Paraplegia

PURPOSE: Patients requiring urethral reconstruction due to failed hypospadias repairs present a considerable technical challenge. Herein we report the experience of redo urethroplasties for complicated recurrent hypospadias. MATERIALS AND METHODS: From 1987 to 1997, we performed redo urethroplasty in 11 cases with complicated recurrent hypospadias. Types of recurrent hypospadias were coronal (1 case), distal shaft (4 cases), mid-shaft (1 case), and penoscrotal (5 cases) hypospadias. The interval between the last operation and redo operation was distributed from 8 months to 5 years. We analysed preoperative status, operative methods and their complications retrospectively. RESULTS: We performed urethroplasties using scrotal skin flap or buccal mucosal graft in only 2 cases. In spite of a paucity of usable penile skin, we performed urethroplasties with maximal use of remaining penile skin. Mathieu method was used in one case with coronal type. Mustarde operation was used in 4 cases with distal shaft hypospadias. And in 5 cases with penoscrotal type, we used Thiersch-Duplay method. Six of 11 patients had complications such as urethrocutaneous fistulas (4 cases) or recurrent hypospadias (2 cases) which were managed successfully later. CONCLUSIONS: Urethroplasty using penile skin maximally such as Mathieu, Mustarde, or Thiersch-Duplay methods appears to achieve success in patient with recurrent hypospadias subsequent to previous failed repairs.
Female ; Fistula ; Humans ; Hypospadias* ; Male ; Mustard Plant ; Retrospective Studies ; Skin ; Transplants

Plate fixation is being regarded as one of the reliahle fixation method in the management of tibial fractures. But this technique may leave many complications including infection. However, delayed local infection which developed several weeks after open reduction on the tibia has been rarely described as a complication in the literatures. The purpose of this study is to evaluate the contributing factors to the delayed locaI infection in tibial fracture treated with plate fixation. Authors reviewed and analyzed the 60 cases of tihial fracture that were treated with plate and screws from 1989 to 1996. Analyses dealt with fracture classification, laboratory and radiographic findings and the site of plate application. We defined a delayed local infection as a condition in which patient has infection signs on Jaboratory and physical examination at or over 8 week post-operation without any evidence of osteomyelitis on plain radiographs. We found 7 cases of delayed local infection out of 60 tibial fractures from 8 to 21 weeks postoperatively with an average of 14.1 weeks. All the 7 cases that had been treated with plate on medial aspect of tibia were treated by administration of antibiotics without surgery such as debridement or removal of hardwares. Authors concluded that the medial plating was the most important factor of the development of delayed local infection(Z=1.78).
Anti-Bacterial Agents ; Classification ; Debridement ; Humans ; Osteomyelitis ; Physical Examination ; Tibia ; Tibial Fractures*

Renal cell carcinoma takes up 85 per cent of primary malignant renal tumors. It frequently metastasizes to the adrenal gland, lung, bone, liver and nephrectomy site but rarely to the head and neck area. When metastasizes to head and neck area, it involves the gingiva, tongue, palate, parotid gland, uvula, mandible, and lip. When tumors are found in the salivary gland consisting of clear cells, it is impartant to carry out differential diagnosis of various primary tumors with clear cell and metastatic renal cell carcinoma. Patients' medical history, review of system, and pathologic findings would be helpful factors in the differential diagnosis. In this paper, we report on a case of renal cell carcinoma which had metastasized to the psubmandibular gland after a radical nephrectomy.
Adrenal Glands ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Gingiva ; Head ; Lip ; Liver ; Lung ; Mandible ; Neck ; Nephrectomy ; Palate ; Parotid Gland ; Salivary Glands ; Submandibular Gland* ; Tongue ; Uvula

BACKGROUND: Transcatheter closure of patent ductus arteriosus, using the Rashkind double umbrella occluder system, had been attempted in mulitcenter since non-surgical closure of patent ductus arteriosus by Rashkind. METHODS: Between July 1991 and June 1993, transcatheter closure of patent ductus arterious was attempted in 20 adult patients(21 trials). RESULTS: Seventeen female and 3 male patients was consisted of the study. The patient age ranged from 17 to 54 years(mean 30+/-9 years). Mean pulmonary artery pressure before closure was 18.5+/-6.0mmHg(range from 10mmHg to 30mmHg). The diameter of ductus ranged from 3.5mm to 8.0mm(mean 5.2+/-1.5mm), as determined by contrast injection through 11F Mullin sheath or 7F catheter. There was significant decrease of Qp/Qs from 2.6+/-1.1 to 1.5+/-0.4 immediately after transcatheter closure of ductus(p<0.01). There was significant decrease of left ventricular end-diastolic dimension by echocardiogram from 58.7+/-7.6mm to 53.6+/-6.5mm after transcatheter closure of ductus(p<0.01). Among the 21 cases, 16 cases(76.2%) had the clinical improvement without the support of surgical closure. One 17mm Rashkind umbrella was retrieved because of position and problem of deployment. There was no device embolic experience in 21 cases. There were 2 cases of hemolytic anemia during the follow-up period ; one case was surgically ligated and another 17mm device was implanted in the other case. CONCLUSIONS: Transcatheter closure of patent ductus arteriosus in adult patients can replace the surgical correction in selected patients.
Adult* ; Anemia, Hemolytic ; Catheters ; Ductus Arteriosus, Patent* ; Female ; Follow-Up Studies ; Humans ; Male ; Pulmonary Artery

No abstract available.
Eosinophils* ; Histamine*

Spinal muscular atrophy(SMA) is the second most common fatal disease of childhood with autosomal dominant mode of inheritance, and in its less severe form the third most common neuromuscular disease of childhood after Duchenne muscular dystrophy. The genetic defect was found to be on the long arm of chromosome 5(5q11.2-q13.3) where many genes and microsatellite markers were missing. One of the most important genes is the Survival Motor Neuron(SMN) gene which is homozygously missing in 90% of SMA patients. Another important gene, the Neuronal Apoptosis Inhibitory Protein(NAIP) gene was found to be defective in 67% of SMA type I patients. Studies so far suggest SMA occurs when the genes on the long arm of chromosome 5 are mutated or deleted. Recently our hospital encountered 2 SMA patients of type I and II respectively. These patients both had homozygously defective SMN genes but intact NAIP genes. We are reporting these cases with bibliographic review and discussion. Korean SMA patients presumably have defects in SMN genes similar to those found in European patients, although the siginificance of NAIP genes remains to be established. SMN gene defects can be easily diagnosed using PCR and restriction enzymes, and this method could be applied towards convenient prenatal diagnosis and towards screening for family members at risk.
Apoptosis ; Arm ; Chromosomes, Human, Pair 5 ; Diagnosis* ; Humans ; Mass Screening ; Microsatellite Repeats ; Muscular Atrophy, Spinal* ; Muscular Dystrophy, Duchenne ; Neuromuscular Diseases ; Neurons ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Wills

No abstract available.
Budesonide* ; Humans

Torsades de pointes is a polymorphic ventricular tachycardia associated with prolonged QT interval and increased U wave amplitude. It has been found to be induced by various drugs, electrolyte imbalances, and so on, but the mechanism of torsades de pointes has not been completely documented. Two hypotheses, early afterdepolarization and dispersion of repolarization have been known to be the possible mechanism. Terfenadine and astemizole are the antihistamines, known to be one of the etiologic agents of torsades de pointes, and factors associated with increased risk are significant liver disease, drug overdose, and concomitant administration of imidazole and macrolide antimicrobial drugs. There has been only one case reported that torsades de pointes had been induced by first-generation antihistamine, piprinhydrinate. We experienced a case of 43 year old male patient with torsades de pointes induced by first-generation antihistamine, hydroxyzine and treated successfully with drug cessation, MgSO
Adult ; Astemizole ; Drug Overdose ; Histamine Antagonists ; Humans ; Hydroxyzine* ; Isoproterenol ; Liver Diseases ; Male ; Tachycardia, Ventricular ; Terfenadine ; Torsades de Pointes*