The authors presented a case of gastroschisis with a pedunculated gallbladder embedded in hepatic tissue. The patient was born after fullterm gestation. Due to extensive abdominal wall defect, she succumbed 3 days after birth. There was a pedunculated mass measuring 2.5x1.5x1.5 cm between the liver and distended stomach without any attachment to the liver. The pedicle of the mass was connected to the common bile duct. Cut surface revealed that the mass was an accessory hepatic lobe encircling the gallbladder. The histologic feature of both accessory liver and gallbladder was markedly altered probably due to vascular obstruction. We could find only a single similar case in literlature. That case was associated with Beckwith syndrome and ours was associated with large atrial spetal defect, large patent ductus arteriosus, accessory spleen as well as gastroschisis. The common feature of abdominal wall defect might be a predisposing factor.

Between January 1992 and December 1995, 23 patients with chronic lower back pain involving lumbar disc degeneration and spinal stenosis underwent decompression and posterior lumbar interbody fusion. Two groups of patients were studied, and clinical symptoms, neurological signs and clinical results were compared. With regard to mechanical back pain and clinical results, posterior lumbar interbody fusion was superior to decompression, but as regards leg pain and neurologic signs, the two groups were similar. Posterior lumbar interbody fusion was of considerable benefit to patients with chronic lower back pain.
Back Pain ; Decompression* ; Humans ; Intervertebral Disc Degeneration ; Leg ; Low Back Pain* ; Neurologic Manifestations ; Spinal Stenosis*

We report the case of a 48-year-old man with schwannoma involving the orbit. Computerized tomography and magnetic resonance imaging revealed a 2X3X2cm-sized well-enhanced round lesion which mildly compressed the optic nerve. The patient underwent fronto-orbitotemporal craniotomy, with successful total removal of the tumor. To our knowledge, this is the first report of schwannoma involving the orbit : a review of the literature is also included.
Craniotomy ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurilemmoma* ; Optic Nerve ; Orbit*

Pituitary stalk interruption syndrome (PSIS) involves the occurrence of a thin or absent pituitary stalk, hypoplasia of the adenohypophysis, and ectopic neurohypophysis. Diagnosis is confirmed using magnetic resonance imaging. Patients with PSIS have a variable degree of pituitary hormone deficiency and a wide spectrum of clinical manifestations. The clinical course of the disease in our patient is similar to that of a syndrome of inappropriate antidiuretic hormone secretion. This is thought to be caused by failure in the suppression of vasopressin secretion due to hypocortisolism. To the best of our knowledge, there is no case report of a patient with PSIS presenting with hyponatremia as the first symptom in Korean children. Herein, we report a patient with PSIS presenting severe recurrent hyponatremia as the first symptom, during adolescence and explain the pathophysiology of hyponatremia with secondary adrenal insufficiency.
Adolescent ; Adrenal Insufficiency* ; Child ; Delayed Diagnosis* ; Diagnosis ; Humans ; Hyponatremia* ; Hypopituitarism ; Inappropriate ADH Syndrome ; Magnetic Resonance Imaging ; Pituitary Gland* ; Pituitary Gland, Anterior ; Pituitary Gland, Posterior ; Vasopressins

No abstract available.
Fertilization in Vitro* ; Humans* ; Micromanipulation* ; Pregnancy Rate* ; Pregnancy*

Female pelvic tuberculosis is almost invariably secondary to disease elsewhere, usually in the lungs. It is difficult to diagnose pelvic tuberculosis, because it is often a disease with absent or few non-specific symptoms. Pelvic tuberculosis should be considered in the differential diagnosis of all ovarian mass and pelvic malignancy. We report a case of retroperitoneal tuberculous lymphadenopathy that may be mistaken for pelvic malignancy, because of the nonspecific clinical features and radiologic findings. The diagnosis was made post-operatively by histopathology.
Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Lung ; Lymphatic Diseases* ; Retroperitoneal Space ; Tuberculosis

No abstract available.
Child* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha*

BACKGROUND: Although good clinical effects have been reported, immunotherapy with house dust mite ( HDM ) antigen - autologous specific antibody complex ( IC - IT ) is not yet accepted as an effective immunomodulating tool in HDM allergic diseases. We aimed to prove the clinical effect of IC - IT in HDM sensitized respiratory allergic subjects. Method : Six HDM sensitized respiratory allergic subjects were enrolled. Autologous D. farinae specific IgG was purified with DEAE ion exchange and affinity chromatography. After one year of IC - IT treatment the clinical effects were analyzed with symptom scores, methacholine PC20, ELISA assay of D. farinae specific antibodies and intradermal skin reactivity. Result : The rhinitis symptom score significantly improved after a one - year administration of IC - IT ( 1.23 +/- 0.30 vs. 0.37 +/- 0.15, p< 0.05), but no significant differences were found in asthma symptom score, intradermal skin reactivity to D. farinae and ELISA optic absorbances of D. farinae specific IgE, IgG, and IgG subclasses. Methacholine PC20 values improved in all 6 patients who were administered with IC - IT ( 0.35 vs. 1.66 mg/ml, p< 0.05 ). CONCLUSION: IC - IT may be efficient for management of HDM atopic asthma. Further studies are needed before clinical application of IC - IT in house dust mite atopic subjects.
Antibodies ; Asthma ; Chromatography, Affinity ; Dermatophagoides farinae* ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunotherapy* ; Ion Exchange ; Methacholine Chloride ; Pyroglyphidae* ; Rhinitis ; Skin

Dyspnea or dysphagia after occipitocervical fusion is well-known complications. It could be occurred when occipitocervical fusion is performed with the neck flexion position which leads to the narrowing of the airway and retropharyngeal space. However, we experienced a case of dyspnea and dysphagia after posterior C1-C2 fusion. A 68-year-old male showed no evidence of occipitocervical instability in preoperative studies. He complained of progressive dyspnea and dysphagia after C1-2 fusion and follow-up computed tomography (CT) and magnetic resonance (MRI) showed relatively narrow spinal canal at the level of C1-2 compared to preoperative studies and serial plain radiographic studies decreased occipitocervical (O-C2) angle gradually. Despite of conservative treatment, his symptom was not improved. So we did C1 posterior arch decompression and extended fusion to the occiput with neck extension position. Dyspnea and dysphagia gradually improved after the surgery and complete recovery was observed within a month. Though we did not know the causes of dyspnea and dysphagia exactly, two mechanisms were possible one was cord irritation due to anterior migration of C1 posterior arch after C1-2 fusion. The other was alar ligament disruption with microinstability between the occiput and atlas. We present the case of dyspnea and dysphagia after posterior C1-2 fusion.
Aged ; Decompression ; Deglutition Disorders ; Dyspnea ; Follow-Up Studies ; Humans ; Ligaments ; Magnetic Resonance Spectroscopy ; Male ; Neck ; Spinal Canal ; Succinates

Chronic subdural hematoma (SDH) is a well-known disease entity and is traditionally managed with surgery. However, when associated with spontaneous intracranial hypotension (SIH), the treatment strategy ought to be modified, as classical treatment could lead to unwanted consequences. A 59-year-old man presented with a case of SIH that manifested as a bilateral chronic SDH. He developed fatal extensive pneumocephalus and SDH re-accumulation as a complication of burr-hole drainage. Despite application of an epidural blood patch, the spinal cerebrospinal fluid leak continued, which required open spinal surgery. Chronic SDH management should not be overlooked, especially if the exact cause has not been determined. When chronic SDH assumed to be associated with SIH, the neurosurgeon should determine the exact cause of SIH in order to effectively correct the cause.
Blood Patch, Epidural ; Cerebrospinal Fluid ; Drainage* ; Hematoma, Subdural, Chronic* ; Humans ; Intracranial Hypotension* ; Middle Aged ; Pneumocephalus*