The ligamentum nuchae is a midline structure extending from the occiput to the spinous process of the 7th cervical vertebra. Radio-opaque formations in the soft tissues behind the processes of the cervical spine has been known to radiologists since Barsony's description in 1929. It may actually be a normal sesamoid, or it may have developed as a result of previous trauma. But this remains hypothetical in that histological endochondral ossification sequence has not yet been demonstrated. These are generally asymptomatic and of clinical significance only in so far as they may be confused with fracture or tumors. Two patients who had clinical symptoms with or without previous trauma visited and they were relieved of their clinical symptoms by surgical excision. Then, we report on two unusual cases which were symptomatic.
Humans ; Spine

BACKGROUND: Angiogenesis plays a critical role in human tumor growth and metastasis. Microvessel count, as a measure of tumor angiogenesis, has been significantly correlated with invasive and metastatic patterns in breast, prostate and cutaneous carcinomas. Materials and METHODS: Fifty patients with curatively resected non-small cell lung cancer were evaluated. Tumor tissues embedded in paraffin block were stained by anti CD 31 (PECAM, platelet endothelial cellular adhesion molecule) using immunohistochemical method to assess microvessel count. Microvessels were counted in the most active areas of neovascularization(microscopy, 200×). RESULTS: 1) Mean microvessel count was 47.1 ± 17.7(per 200×field) in total 50 cases. 2) Mean microvessel count of adenocarcinoma (54.4±19.9) was significantly higher than that of squamous cancer(43.9±16.2)(p<0.05), but there were no relationship between microvessel count and TNM stages. 3) Median survival time, 2-year and 5-year survival rates of the low microvascular group(microvessel count<45, 22cases) were 61 months, 80% and 40%, respectively, and those of the high microvascular group(microvessel count ≥ 45, 28 cases) were 46 months, 75% and 12%, respectively. As results, prognosis of low microvascular group is statistically significantly superior to that of the high microvascular group(p=0.0162, Kaplan-Meier, log-rank). CONCLUSION: Angiogenesis assessed by microvessel count can be used as one of the significant prognostic factors in non-small cell lung cancer.
Adenocarcinoma ; Blood Platelets ; Breast ; Carcinoma, Non-Small-Cell Lung* ; Humans ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Prostate ; Survival Rate

No abstract available.
Colorectal Neoplasms, Hereditary Nonpolyposis*

The gray vibrissae of Korean males(n =189) between 15 and 75 years old and females(n =111) between-15 and 74 years old who visited the department of otorhinolaryngology, Konkuk university Chungju hospital during 1996 to 1998, were counted for the purpose of estimating approximate age range in individuals of unknown age . The lowest age appearing gray hairs in both sexes was 15-year-old. The Pearson's correlation coefficient in both sexes was 0.490 (p<0.01). The age appearing gray vibrissae in females was slightly earlier than that of males, however, the differences between right and left sides of nasal cavity were insignificant. This method of counting gray vibrissae would be useful to estimate age range in personal identification together with other methods available until now.
Adolescent ; Aged ; Chungcheongbuk-do ; Female ; Hair* ; Humans ; Male ; Nasal Cavity ; Otolaryngology ; Vibrissae*

Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia that is associated with prolongation of the QT interval. Although it occurs in many clinical settings, torsade de pointes is most commonly caused by drugs. The second generation antihistamines, including terfenadine and astemizole, have little sedation or other adverse effects on the CNS. They have been used widely to treat various allergic diseases, but it has been reported that overdoses or combinations with antifungal agents or macrolide antibiotics may lead to TdP. We report a case of TdP that occured during com-bination therapy of terfenadine and ketoconazole.
Anti-Bacterial Agents ; Antifungal Agents ; Astemizole ; Histamine H1 Antagonists, Non-Sedating ; Ketoconazole* ; Tachycardia, Ventricular ; Terfenadine* ; Torsades de Pointes*

No abstract available.
Stevens-Johnson Syndrome*

PURPOSE: Although percutaneous nephrolithotomy (PCNL) has been accepted as a standard method for the management of large renal stones, the incidence of renal hemorrhage is relatively high. This study investigated the variables that affect bleeding during PCNL. MATERIALS AND METHODS: The medical records of 370 patients who underwent PCNL by a single surgeon from January 2005 to December 2010 were reviewed retrospectively. All patients were divided into two groups according to median blood loss (lesser bleeding group and higher bleeding group). Various clinical and perioperative factors including age, sex, stone size and position, degree of hydronephrosis, operative time, underlying disease, history of anticoagulant medication, presence of previous nephrostomy catheter, stone composition, and thickness of the renal cortex were assessed. For statistical assessment, univariate and multivariate logistic regression analyses were used. RESULTS: The mean patient age was 48.8 years (range, 22 to 75 years). Forty-three patients (11.6%) received a transfusion and 9 patients (2.4%) underwent angioembolization after surgery. The mean blood loss was 511.8+/-341.3 mL. Body mass index (BMI), stone size, stone position, operation time, and degree of preoperative hydronephrosis were predictive factors for severe bleeding during PCNL. CONCLUSIONS: On the basis of the results achieved by a single surgeon, staghorn stones, high BMI, large stones, prolonged operation time, and absence of hydronephrosis were significantly associated with the risk of severe bleeding during PCNL.
Body Mass Index ; Catheters ; Hemorrhage ; Humans ; Hydronephrosis ; Incidence ; Kidney Calculi ; Logistic Models ; Medical Records ; Nephrostomy, Percutaneous ; Operative Time ; Retrospective Studies

PURPOSE: The causes of encopresis are complex and multifactorial. Through application of new sophisticated techniques and armamentarium, it has been possible to find more specific aspects of the anorectal function in pediatric patients with refractory defecation disorders. However, quality research of which therapeutic option could be suitable, is still lacking. The current study was designed to assess outcome of treatment according to the treatment algorithm based on the clinical and physiologic findings. METHODS: 22 patients (15 boys, 7 girls) with encopresis were analyzed, retrospectively. For exclusion of the organic cause, barium contrast study and anoscopy were carried out in all cases. Patients were categorized and made treatment algorithm by using leading symptoms and findings of anorectal physiologic tests. Treatment outcomes were analysed in the basis of respective therapeutic options. RESULTS: Patients were categorized as constipation dominant group (n=15) and incontinence dominant group (n=7). Suggested etipathogeneses were as follows; fecal impaction and/or motility disorder (n=7), overflow incontinence (n=6), sensory defect of the rectum (n=4), puborectalis incoordination (n=3), anal hypertonia (n=2). Treatment options were as follows; conventional therapy (CT) only (n=7), CT plus biofeedback (n=9), CT plus balloon sensory retraining (n=4), and CT plus internal sphincterotomy or Nitroglycerine application (n=2). All patients were undertaken a toilet training and psychologic consultation. Regarding to the therapeutic outcome, 19 (86 percent) of overall 22 patients were improved in the mean period of 2.5 (range, 0.1-7) years follow-up. CONCLUSIONS: If therapy could be undertaken according to the optional algorithm based on the clinical and physiologic findings, it could be useful guide for clinical decision making to help the therapy. Moreover, through the combination therapy including medication, psychological consultation, and biofeedback treatment, encopretic children achieve acceptable outcome with a long-term compliance.
Ataxia ; Barium ; Biofeedback, Psychology ; Child ; Compliance ; Constipation ; Decision Making ; Defecation ; Encopresis* ; Fecal Impaction ; Follow-Up Studies ; Humans ; Nitroglycerin ; Rectum ; Retrospective Studies ; Toilet Training ; Treatment Outcome*

The distribution of GABA and/or glycine like immunoreactive nerve terminals on the soma of the masseteric gamma motoneurons were investigated using retrograde tracing of WGA-HRP (wheat germ agglutinin conjugated horseradish peroxidase) and postembedding immunogold labeling methods in serial ultrathin sections. Quantitative analysis of 140 nerve terminals apposing on somata of gamma motoneuron size less than 21 mm in average diameter was performed. The results obtained were as follows. 1. Synaptic covering % of apposing nerve terminals was 21.45+/-11.48% and packing density was 12.85+/-6.17. 2. Nerve terminals immunoreactive (IR) to GABA or glycine were F type containing pleomorphic vesicles with round shape predominant. Majority of nerve terminals immunonegative to GABA or glycine were S type containing spherical vesicles and few of them were F type. 3. 11.42+/-10.00% of examined nerve terminals were IR to GABA only, and 12.71+/-9.85% were IR to GABA and glycine, and 15.21+/-9.58% were IR to glycine only. 4. Synaptic covering % of nerve terminals IR to glycine only was highest (4.58+/-4.50%), followed in order by GABA and glycine (3.18+/-2.77%), and GABA only (2.38+/-2.06%). 5. Among all terminals, immunonegative nerve terminals (60.66+/-14.65%) were much more than nerve terminals immunoreactive to GABA and/or glycine (39.34+/-14.65%) These results show that inhibitory synaptic input and synaptic organization of the masseteric gamma motoneurons reveal characteristic features in contrast to that of alpha motoneurons and which may correlated to the electrophysi-ological characteristics of masseteric gamma motoneurons.
Animals ; Armoracia ; Carisoprodol ; gamma-Aminobutyric Acid* ; Glycine* ; Jaw* ; Presynaptic Terminals* ; Rats* ; Wheat Germ Agglutinin-Horseradish Peroxidase Conjugate

PURPOSE: To evaluate the plain radiographic and CT findings of the necrotizing fasciitis. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of 4 cases with necrotizing fasciitis. Three cases were proven pathologically. We evaluated pattern and extent of the gas shadows in plain films. CT findings were analysed, with emphasis on : (a) gas pattern, (b) extent, (c) location and involved site, (d) associated focal abscess, and (e) swelling of the adjacent muscles. RESULTS: On plain radiographs, four cases showed streaky or mottled gas densities in the pelvis, three cases in the perineum, one case in the abdomen, and two cases in the thigh. On CT images, gas pattern was mottled and streaky appearance with swelling of the adjacent muscles. Gasshadows located in the extraperitoneal space in four cases, fascial layer in four cases, and subcutaneous layer infour cases. There were gas shadows in pelvic wall, perineum, abdominal wall, buttock, thigh, and scrotum. Focallow density lesion suggestive of focal abscess was not visualized. CONCLUSION: Plain radiography is useful forearly diagnosis of the necrotizing fasciitis and CT is very useful for detection of precise location and extent of the disease. CT is also useful for differentiation of necrotizing fasciitis from focal abscess and cellulitis.
Abdomen ; Abdominal Wall ; Abscess ; Buttocks ; Cellulitis ; Diagnosis ; Fasciitis, Necrotizing* ; Muscles ; Pelvis ; Perineum ; Radiography ; Retrospective Studies ; Scrotum ; Thigh