PURPOSE: Algorithms to get cross-sectional bone density pattern(transverse histogram) to predict the loosening of hip prosthesis using DXA(Dual X-ray Absorptiometry) have been developed. We performed this study to analyze the correlation between radiologic findings and densitometric pattern of the THRA(Total Hip Replacement Arthroplasty) patients. MATERIALS AND METHODS: Thirty-six hips of 32 THRA patients were evaluated. The duration between THRA and DXA was from 1 year 7 months to 15 years. On transverse histogram, the periprosthetic bone density patterns were classified as 3 types;type I, rigid fixation in 17, type II, definite loosening in 8, and type III, partial loosening in 11 cases. Surgical findings, plain X-ray findnings and transverse histogram using DXA were correlated. RESULTS: Among 14 cases performing revision for acetabular prosthesis loosening, 5 cases revealed loosening of fernoral stems while 9 cases revealed rigid fixation of femoral stems. Sensitivity was 100% for either plain X-ray or DXA. Specificity was 88%, 77% for plain X-ray and DXA respectively. CONCLUSION: This preliminary study reveals that periprosthetic bone density pattern on transverse histogram on DXA may be useful in the evaluation of the loosening. However, further study will be needed for clinical application.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Bone Density ; Hip ; Hip Prosthesis ; Humans ; Prosthesis Failure ; Sensitivity and Specificity

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

Hibernoma is a rare benign tumor that arises from vestiges of brown fat. Spinal intraosseous hibernoma has only recently been described in the literature, and only 12 cases have been reported to date due to its extreme rarity. Here, we report the case of a patient who was incidentally diagnosed with an intraosseous hibernoma in the thoracic spine, following a diverse imaging work-up and pathologic confirmation. We correlate the clinical presentation and imaging features of our case with those of previously reported cases during our review of the literature.

Hemangioblastomas are low-grade, highly vascular tumors that are usually associated with von Hippel-Lindau syndrome. Hemangioblastomas most commonly occur in the cerebellum, and intradural extramedullary hemangioblastoma of the cauda equina is very rare, especially in patients without von Hippel-Lindau syndrome. Herein, we report a case of intradural extramedullary hemangioblastoma of the cauda equina that was not associated with von HippelLindau syndrome, with a focus on its imaging characteristics and differential diagnoses. We compared the clinical presentation and imaging features of our case with those of previously reported cases in the review of the literature.

Hemangioblastomas are low-grade, highly vascular tumors that are usually associated with von Hippel-Lindau syndrome. Hemangioblastomas most commonly occur in the cerebellum, and intradural extramedullary hemangioblastoma of the cauda equina is very rare, especially in patients without von Hippel-Lindau syndrome. Herein, we report a case of intradural extramedullary hemangioblastoma of the cauda equina that was not associated with von HippelLindau syndrome, with a focus on its imaging characteristics and differential diagnoses. We compared the clinical presentation and imaging features of our case with those of previously reported cases in the review of the literature.

No abstract available.
Female ; Ovary* ; Teratoma*

A 42-year-old male was admitted to our clinic on May 4, 1980, because of slight neck stiffness, quadriparesis and urinary difficulty. On admission, neurological examination revealed alert mental state, slight neck stiffness, quadriparesis and loss of pain and temperature sense below the level of C3 sensory dermatome. All deep tendon reflexes were hyperactive and Babinski's sign was positive. Roentgenographic examination of the cervical spine showed widened interpedicular distance at C5 to C7 in A-P view. Myelogram disclosed widening of the dye column at C4 to T1 vertebral level, suggesting intramedullary tumor. Laminectomy was performed from the C5 to T2. The cord appeared to be widened and swollen at the C6-7 segment level. 1ml of yellowish pus was aspirated from the distended spinal cord at the C6 level. Mid-line posterior myelotomy was performed and hard cavity wall was visible. Upon incision of cavity wall, about 5ml of yellowish purulent pus exuded, allowing the cord to become "flaccid". The abscess cavity was irrigated with saline and penicillin solutions and a small rubber drain catheter was placed in the abscess cavity. The organism from the abscess was identified as Staphylococcus aureus. Postoperative course was uneventful. Antibiotic therapy was continued for four weeks after operation. The patient's condition was much improved and he could walk with assistance on discharge time.
Abscess* ; Adult ; Catheters ; Humans ; Laminectomy ; Male ; Neck ; Neurologic Examination ; Penicillins ; Quadriplegia ; Reflex, Babinski ; Reflex, Stretch ; Rubber ; Spinal Cord ; Spine ; Staphylococcus aureus ; Suppuration ; Thermosensing

BACKGROUND: The aim of this study was to evaluate antibiotic consumption by adult patients at a single university hospital in Korea between 2001 and 2012. METHODS: We used the 2004 World Health Organization Anatomical Therapeutic Chemical Classification System definition of defined daily doses (DDD) per 1,000 patient-days to calculate the annual antibiotic consumption for 18 antibiotic groups. Chi-square linear-by-linear analysis was performed to evaluate antibiotic consumption trends for each group. RESULTS: Average annual antibiotic consumption during 2001-2012 was 644.6 DDD/1,000 patient-days (standard deviation, 33.3 DDD/1,000 patient-days). Although no statistically significant change was observed during the study period, consumption of first- and second-generation cephalosporins, and aminoglycosides was significantly decreased, while that of beta-lactam/beta-lactamase inhibitors, fourth-generation cephalosporins, carbapenem, glycopeptide, linezolid, colistin, and quinolone increased significantly. CONCLUSION: The total amount of prescribed antibiotics did not change, but the use of broad-spectrum antibiotics increased during the study period.
Adult ; Aminoglycosides ; Anti-Bacterial Agents ; Cephalosporins ; Classification ; Colistin ; Hospitals, University ; Humans ; Korea ; World Health Organization ; Linezolid

Primary germ cell tumors of the mediastinum are rare, accounting 1-5% among all germ cell tumors and 10% of all neoplasms in this area. Approximately 85% of these tumors occur in men with a mean age 29 years. These tumors are mainly found in the anterior mediastinum and appear grossly as large lobulated masses. They are frequently invasive at the time of diagnosis and almost 90% of patients are symptomatic. Primary nonseminomatous germ cell tumor arising in the posterior mediastinum is very rare. We report a case of 37- year old male arising from the posterior mediastinum. Serum tumors markers including alpha-fetoprotein and beta-hCG which are usually elevated in germ cell tumor were not elevated. He was found to have a primary mediastinal embryonal carcinoma with pulmonary metastasis at open exploration. He was treated with debulking surgery and cisplatin-based chemotherapy, died of sepsis after 15 months postoperatively.
alpha-Fetoproteins ; Carcinoma, Embryonal* ; Diagnosis ; Drug Therapy ; Humans ; Male ; Mediastinum* ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal ; Sepsis

PURPOSE: We assessed the usefulness of manual reduction in patients with an acute scrotum. MATERIALS AND METHODS: We retrospectively analyzed the data of 61 consecutive males who had undergone surgical exploration for an impression of testicular torsion, focusing on the incidence, duration of symptoms, direction of testicular torsion and results of manual reduction. Of the 61 explorations, there were 46 (75.4%) and 15 (24.6%) cases of testicular torsion and torsion of a testicular appendage, respectively. RESULTS: Of the 46 testicular torsions, the symptoms were localized to the left side in 37 and to the right side in 9. While the mean symptom duration of the 31 in the orchiectomy group (89 hours) was significantly longer than that in the 15 salvaged testes (10 hours, p=0.003), the mean degree of rotation between the two groups was not significant (p=0.196). Information on the direction of testicular rotation was available in 44 cases, with medial rotation having occurred in 31 (70.5%) and lateral rotation in 13 cases. The clinical symptoms were improved in 4 of the 20 patients in who manual reduction was attempted; residual torsion was identified in 2 patients. CONCLUSIONS: Manual detorsion, the fastest way to relieve testicular ischemia, should be performed at an early offstage following presentation. However, in attempting the manual reduction, the urologist should consider the possibility that a quarter of patients with an acute scrotum do not have testicular torsion, with 30% of testicular torsions occurring in the lateral direction. Surgical exploration remains necessary to confirm the causes of an acute scrotum and to correct any residual torsion.
Humans ; Incidence ; Ischemia ; Male ; Orchiectomy ; Retrospective Studies ; Scrotum* ; Spermatic Cord Torsion ; Testis