Pleomorphic xanthoastrocytoma is histologically characterized by marked cellular pleomorphism of lipid-laden neoplastic astrocytes and bizarre giant cells showing mitotic figures and high cellularity. Inspite of its ominous-looking microscopic features, howerver, the prognosis is usually favorable. This tumor develops mainly in the supratentorial area of young people and frequently involves the leptomeninges. We experienced a case of pleomorphic xanthoastrocytoma in 18 year-old-male. In addition to the cellular pleomophism, the prominent reticulin fibers surround the individual tumor cells or the tumor cells nests. Immunohistochemical staining and electron microscopy revealed glial fibrillary acidic protein(GFAP) expression and pericytoplasmic basal lamina in the tumor cells.

No abstract available.
Transplants*

Anetoderma or Macular atrophy is a rare cutaneous disorder showing local atrophy and macular discoloration related to a local dermal defect of elastic tissiie without any other apparent change in the skin, which may show familial occurrence, called familial anetoderma. A 13-year-old female complained 3-year history of multiple asyrnptomatic atrophic macules on the trunk and both lower extremities, especially on both this. Elastic stain of skin lesion showed decrease of lastic tissue in the dermis. No other syst mic abnormalities were found on phisical examination. Her sister had same skin lesion on lower extremities and both buttocks, and had no ther systemic abnormalities. Despite infrequent occurence, the development of anetoderma among familial members possibly represents a congcnital defect of elastin. Because variou ocular, bony, cardiac, and gastrointestinal abnormalilies have been reported in familial anetoilerma, long-term follow up would be necessary.
Adolescent ; Anetoderma* ; Atrophy ; Buttocks ; Dermis ; Elastin ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Siblings ; Skin

No abstract available.
Fractures, Spontaneous* ; Prostheses and Implants*

Purpose: The purpose of this study was to compare the concurrent validity and test-retest reliability of ‘KPIMT Torticollis Protractor’, a smart phone and I-pad application for convenient range of motion measurement, and ‘Image J’, an analysis software with high reliability and validity, according to head tilt and active cervical rotation angle. This was done to determine the clinical utility of ‘KPIMT Torticollis Protractor’. Methods: Head tilt and active cervical spine rotation angles of 40 children with congenital muscular torticollis were measured using Image J and KPIMT Torticollis Protractor, respectively. The level of concurrent validity and inter-rater and intra-rater reliability between the two measurement methods were analyzed. Results: For forty participants, the concurrent validity between Image J and KPIMT Torticollis Protractor showed very high validity with ICC of ICC 0.977 (0.995-0.999), 0.994 (0.994-0.998), CVME% 0.71-0.72%, SEM% 0.31-0.34%, MDC% 0.86-0.94%. The test-retest intra-rater reliability showed very high reliability ICC 0.911 (0.911-0.966), CVME% 0.71%, SEM% 0.34-0.36%, MDC% 0.81-0.94%. The test-retest inter-rater showed very high reliability ICC 0.936 (0.933-0.957), CVME% 0.70%, SEM% 0.34-0.35%, MDC% 0.81-0.83%. Conclusion The KPIMT Torticollis Protractor, a smart phone and IPD application, is a highly reliable and valid device for angle measurement in children with congenital myotonia and can be easily used in clinical practice.

Clonic movement is an extremely rare complication that occurs after neuroaxial blockade. We have experienced three patients showing intermittent clonic movement on both lower extremities following spinal anesthesia or subdural administration of intended epidural steroid injection.The first and the second patients, 13-year-old boy and 51-year-old man, experienced clonic movement following standard spinal anesthesia with hyperbaric tetracaine with epinephrine for operation on lower extremities. The third one, 24-year-old man, was an outpatient for the treatment of intractable radiculopathy, previously had an L4 laminectomy. His clonic movement may have resulted from the accidental subdural administration of an intended epidural injection of 0.5% lidocaine 6 ml containing triamcinolone 40 mg. Clonic movement has appeared as the occurrence of intermittent, short-timed (about 2~5 seconds), severe annoying, bilateral involuntary muscle contraction on lower extremities at the stage of recovery. It sustained for about 4~19 hours. The treatment was mainly sedation with sedatives and inhalation anesthetics, and partially muscle relaxants or anticholinesterase. They recovered without any sequelae.
Adolescent ; Anesthesia, Spinal* ; Anesthetics, Inhalation ; Epinephrine ; Humans ; Hypnotics and Sedatives ; Injections, Epidural ; Laminectomy ; Lidocaine ; Lower Extremity* ; Male ; Middle Aged ; Muscle, Smooth ; Myoclonus* ; Outpatients ; Radiculopathy ; Tetracaine ; Triamcinolone ; Young Adult

OBJECTIVE: The aims of the Korean Neuro-Trauma Data Bank System (KNTDBS) are to evaluate and improve treatment outcomes for brain trauma, prevent trauma, and provide data for research. Our purpose was to examine the mortality rates following traumatic brain injury (TBI) in a retrospective study and to investigate the sociodemographic variables, characteristics, and causes of TBI-related death based on data from the KNTDBS. METHODS: From 2010 to 2014, we analyzed the data of 2617 patients registered in the KNTDBS. The demographic characteristics of patients with TBI were investigated. We divided patients into 2 groups, survivors and nonsurvivors, and compared variables between the groups to investigate variables that are related to death after TBI. We also analyzed variables related to the interval between TBI and death, mortality by region, and cause of death in the nonsurvivor group. RESULTS: The frequency of TBI in men was higher than that in women. With increasing age of the patients, the incidence of TBI also increased. Among 2617 patients, 688 patients (26.2%) underwent surgical treatment and 125 patients (4.7%) died. The age distributions of survivors vs. nonsurvivor groups and mortality rates according the severity of the brain injury, surgical treatment, and initial Glasgow Coma Scale (GCS) scores were statistically significantly different. Among 125 hospitalized nonsurvivors, 70 patients (56%) died within 7 days and direct brain damage was the most common cause of death (80.8%). The time interval from TBI to death differed depending on the diagnosis, surgical or nonsurgical treatment, severity of brain injury, initial GCS score, and cause of death, and this difference was statistically significant. CONCLUSION: Using the KNTDBS, we identified epidemiology, mortality, and various factors related to nonsurvival. Building on our study, we should make a conscious effort to increase the survival duration and provide rapid and adequate treatment for TBI patients.
Age Distribution ; Brain ; Brain Injuries* ; Cause of Death ; Diagnosis ; Epidemiology* ; Female ; Glasgow Coma Scale ; Humans ; Incidence ; Male ; Mortality* ; Retrospective Studies ; Survivors

This paper presents the result and statistical analysis of the experiment, in which selective anterior or posterior rhizotomy were carried out under microscopic surgery. The materials used for the experiment were 48 young rabbits, and they were divided into four groups. The group I, which was used as control, was subjected to lower dorsal bilateral laminectomies with dural incision, the group II to laminectomies with three right posterior rhizotomies, the group III to laminectomies with three right anterior rhizotomies, and the group IV to laminectomies with three right anterior and posterior rhizotomies. Scoliosis was induced in group Il, Ill and IV. There was no significant statistical difference in the degrees of curvatures among these three groups. The convexity of the curvature faced to the side of the divided roots. In group III and IV, scoliotic curvatures were obvious within two weeks, but there were no considerable changes thereafter. In group Il, the curves progressed slowly up to the 12th week. They were statistically significant at the 4th week and increased continuously thereafter. The histological findings in the group III and IV showed denervation atrophy of the paravertebral muscles at the apex of the curvature, but there was little or no muscle atrophy in the group I and II. We came to a conclusion from the experimental results that scoliosis may be induced not only by anterior root paralysis but also by selective posterior root paralysis.
Atrophy ; Denervation ; Laminectomy ; Muscles ; Muscular Atrophy ; Paralysis ; Rabbits ; Rhizotomy ; Scoliosis

No abstract available.

The residual tense false lumen following surgical repair of aortic dissection remains one of the most difficult and challenging postsurgical problems. Percutaneous fenestration of the dissecting membrane under the guidance of intravascular ultrasound has been recently introduced to depressurize the tense false lumen. A 63-year-old woman who underwent repair of acute type I dissection was readmitted because of claudication and numbness of the left lower extremity. Angiography, computed tomography, and magnetic resonance imaging clearly showed a dissection flap starting from the thoracic aorta distal to the left subclavian artery. Compressed true lumen by the markedly enlarged tense false lumen was also noted in the double-channeled descending thoracoabdominal aorta. Under intravascular ultrasound guidance, the intimal flap was punctured with a Brockenbrough needle advanced to the true lumen through a femoral artery, and then, a balloon catheter was introduced over the guidewire which was placed across the dissection flap. Desired fenestration was obtained successfully by inflation of the balloon without complications. After procedure, symptoms resolved promptly and she is currently(clinical follow-up of 12 months postfenestration) ambulating without claudication. In conclusion, percutaneous fenestration of the intimal flap is a technically feasible and an effective alternative procedure to surgical repair for restoration of perfusion to an ischemic extremity in selected patients complicated with aortic dissection.
Angiography ; Aorta ; Aorta, Thoracic ; Catheters ; Extremities* ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Hypesthesia ; Inflation, Economic ; Ischemia* ; Lower Extremity ; Magnetic Resonance Imaging ; Membranes ; Middle Aged ; Needles ; Perfusion ; Subclavian Artery ; Transcutaneous Electric Nerve Stimulation ; Ultrasonography