A patient with extraskeletal cervical epidural Ewing's sarcoma who presented with cervical radiculopathy is reported. A 58-year-old woman presented with right posterolateral neck pain and upper extremity radiculopathy. The computed tomography myelography showed epidural and paravertebral masses on right side, with widening of the ipsilateral neural foramina at the C2-C3 level. On magnetic resonance images, the mass was isointense to soft tissue on T1-weighted images, hyperintense on T2-weighted images, and showed diffuse enhancement on GdTA enhanced T1-weighted images. The staged, combined posterior and anterior approach were done and the tumor mass was subtotally removed. During postoperative adjuvant chemotherapy with Cytoxane, Adriamycin, Vincristine, Prednisolone regimen, the patient died of severe compression of upper cervical cord by recurrent, extended tumor mass in the spinal canal.
Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Middle Aged ; Myelography ; Neck Pain ; Prednisolone ; Radiculopathy ; Sarcoma, Ewing* ; Spinal Canal ; Upper Extremity ; Vincristine

A total of 48 cases of tuberculous lesion in the lymph nodes (43 cases), lung (3 cases) and soft tissue (2 cases), was subjected to fine needle aspiration cytology(FNAC). The age of the patients ranged from 19 to 77 year-old (average 33.6 years in age) and the male to female ratio was 1: 4. Thirty-four cases (70.8%) demonstrated distinct granulomatous reaction with or without caseation necrosis, nine cases (18.8%) showed no granulomas, but large amount of necrotic debris with numerous polymorphonuclear cells and histiocytes, and five cases (10.4%) revealed acellular material only. The overall AFB positivity in smears was 62.5%. In areas associated with granulomatous reaction and necrosis, AFB positivity was 55.8%, while it was 80.0% in cases with acellular necrotic material. There were 2 cases of parasitic infestation which could not be easily differentiated from tuberculosis based on aspiration smears only.
Aged ; Biopsy, Fine-Needle ; Child* ; Female ; Granuloma ; Histiocytes ; Humans ; Lung ; Lymph Nodes ; Male ; Necrosis ; Tuberculosis ; Vesico-Ureteral Reflux*

We experienced one case of severe pituitary dwarfism in a 10 years old female girl. Magnetic resonance image (MRI) revealed transection of the pituitary stalk stalk with the formation of high intensity ectopic posterior lobe located at the median eminence and agenesis of an anterior lobe of pituitary gland. The serum growth Hormone (GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient had responses to TRH, normal TSH and partial prolactin response, respectively. There was not response LH and FSH to GnRH. The morning cortisol concentration and serum T4 concentration were decreased below the normal range. These findings and no hyperprolactinemia suggested the presence of a vascular connection between the pituitary gland and hypothalamus, which is not visible on MRI. Sofar, the primary cause of idiopathic pituitary dwarfism in many patients is injury to hypothalamus by perinatal insults. In this patient, there was no history of perinatal insults and postnatal head trauma but transection of the pituitary stalk. We report a case of severe pituitary dwarfism due to agenesis with brief review of related litereature.
Child ; Clonidine ; Craniocerebral Trauma ; Dwarfism, Pituitary* ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Hypothalamus ; Levodopa ; Magnetic Resonance Imaging ; Median Eminence ; Pituitary Gland* ; Pituitary Gland, Anterior* ; Prolactin ; Reference Values

No abstract available.
Prostate* ; Prostatectomy* ; Prostatic Neoplasms*

No abstract available.
Prostate* ; Prostatectomy* ; Prostatic Neoplasms*

No abstract available.
Growth Plate*

No abstract available.
Extremities* ; Oximetry* ; Oxygen*

Acquired syphilis rarely manifest itself in the skeleton, causing localised osteoscopic pain, commonly in the abscence of general systemic complaints. Diagnosis of bone syphilis can easily be made by clinical history, course of the disease, roentgeno-graphic findings, serological tests, therapeutic test of antiluetic treatment and, most reliably, by biopsy. We experienced a patient with syphilitic osteomyelitis of tbe tibia who had a history of sexual contact and the diagnosis was confirmed by serological tests and biopsy.
Biopsy ; Diagnosis ; Humans ; Osteomyelitis ; Serologic Tests ; Skeleton ; Syphilis ; Tibia

MEN type 1 is characterized primarily by the presence of functioning and nonfunctioning tumors or hyperplasia of the pituitary gland, parathyroid glands, and pancreatic islet cells. Pancreatic islet tumors in MEN type 1 produce different kinds of hormone which were pancreatic polypeptide, gastrin, glucagon, insulin and so on. To date, ten cases had been reported in Korea. We report another case with MEN type 1 having prolatin-secreating pituitary adenoma, parathyroid hyperplasia and insulinoma. A 36-year-old woman was admitted because of long-standing amenorrhea and recently diagnosed osteoporosis. Otherwise, she had been in good health except experiencing one episode of loss of consciousness after skipped meal. The blood chemistries were normal except hypercalcemia and hypophosphatemia. Hormonal studies revealed elevated levels of intact PTH and prolactin and decreased value of estradiol with low LH and FSH. The neck CT revealed 1 cm-sized nodule at posterior portion of right thyroid gland and 99mTc-sestamibi sintigraphy showed a increased uptake in left lower and right lower parathyroid glands. The sella MRI showed 0.7 cm-sized enhanced lesion in the left pituitary gland. The ratio of immunoreactive insulin to glucose was elevated and 3-4 pancreatic masses of variable size were identified by endoscopic ultrasonography and angiography. Subtotal parathyroidectomy and pyrolus-preserving pancreaticoduodenectomy with spleen-preserving distal pancreatectomy was done. Postoperative she had been doing well with normocalcemia and normoglycemia. Transsphenoidal adenonectomy was done 5 months later. Histologic examination of removed tissues revealed a single insulinoma, prathyroid hyperplasia and prolactin-secreating pituitary adenoma.
Adult ; Amenorrhea* ; Angiography ; Endosonography ; Estradiol ; Female ; Gastrins ; Glucagon ; Glucose ; Humans ; Hypercalcemia ; Hyperplasia ; Hypophosphatemia ; Insulin ; Insulinoma ; Islets of Langerhans ; Korea ; Magnetic Resonance Imaging ; Male ; Meals ; Multiple Endocrine Neoplasia Type 1* ; Multiple Endocrine Neoplasia* ; Neck ; Osteoporosis* ; Pancreatectomy ; Pancreatic Polypeptide ; Pancreaticoduodenectomy ; Parathyroid Glands ; Parathyroidectomy ; Pituitary Gland ; Pituitary Neoplasms ; Prolactin ; Technetium Tc 99m Sestamibi ; Thyroid Gland ; Unconsciousness

PURPOSE: The chronic kidney disease (CKD) is defined as structural or functional abnormalities of the kidney diagnosed by abnormalities of pathology, composition of blood or urine, imaging tests and glomerular filtration rate (GFR) less than 60 mL/min/1.73m2. GFR less than 60 mL/min/1.73m2 is known to increase the number of complications. This guideline is universally used but there are no studies on whether the guideline is applicable to Korean people, especially to elderly population. METHODS: We randomly selected 1,000 subjects aged more than 65 years who lived in Seong-nam city during September, 2005. We used the modified MDRD equation to estimate the glomerular filtration rate (eGFR) and categorized the subjects into 5 groups (group 1: GFR >70, group 2: 60-70, group 3: 50-60, group 4: 40-50, group 5: <40 mL/min/1.73m2). RESULTS: The mean creatinine level was 1.1 (+/-0.3) mg/dL and the mean value of eGFR was 60.9 (+/-12.9) mL/min/1.73m2. The frequency of subjects with eGFR less than 60 mL/min/1.73m2 was 48%. The frequencies of old age, female, hypertension, coronary heart disease, anemia, hypoalbuminemia, proteinuria, and increased waist circumference increased as eGFR fell. When evaluating the odds ratios of complications of CKD (Group 2-5 versus Group 1), the risk of coronary heart disease was increased in Group 3, 4, 5, hypertension in Group 4, 5 and diabetes mellitus, anemia, and proteinuria in Group 5, respectively. CONCLUSION: The prevalence of CKD in the elderly population was high. The elderly Koreans with CKD showed increasing comorbidities at a lower GFR.
Aged ; Anemia ; Comorbidity ; Coronary Disease ; Creatinine ; Diabetes Mellitus ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; Hypoalbuminemia ; Kidney ; Odds Ratio ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic ; Waist Circumference