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

The exact etiologies and mechanisms of ischemia in avascular necrosis of femoral head are still under investigation. But this condition seems to be increasing during a few decades with increasing use of steroid and alcohol abuse in Korea. The treatment modalities have been based on the stages of the disease by simple radiographic findings that do not describe the accurate pathological extent or localization. Therefore more sophisticated study is needed to treat the AVN of the femoral head well. Magnetic resonance images, simple radiographs, scintigraphs of 13 patients(22 femoral heads), who were admitted and treated at Seoul National University Hospital from April, 1989 to December, 1989 were correlated, to characterize the type of AVN by extent and location regardless of its stage and reveal the relationship between types and stages. It is the result of this study that the type of AVN as well as stage should be considered in determining the treatment modality.
Alcoholism ; Classification ; Head ; Ischemia ; Korea ; Magnetic Resonance Imaging ; Necrosis ; Seoul

Although the incidence of tuberculous arthritis of the hip is being decreased with improvement of hygiene, preventive measures and chemotherapy, it remains as important disease in orthopedic surgery. In the tuberculous arthritis of the hip, eradication of the disease with improvement of joint function is ideal treatment. But classical treatment of anti-tuberculous chemotherapy, synovectomy, and especially hip fusion which was done in most cases in adults, have their own limitation in functional results. Recently the methods of total hip replacement arthroplasty done in tuberculous arthritis with treatment of infection by antituberculous chemotherapy reported good results. During the period from January 1970 to December 1984, total hip replacement arthroplasty were done in 55 patients of tuberculous arthritis of the hip in Seoul National University Hospital. The average follow-up period was 3 years and 1 months. And, the following results were obtained. l. of the 55 cases, 50 cases(90.9%) were resulted in success without reactivation of tuberculosis, and 5 cases(9.1%) were resulted in failure. In those cases, the follow-up period were more than 1 year. 2 . The average period of immediate preoperative anti-tuberculous chemotherapy was higher in the success cases with 10.0 weeks than in the failure cases with 4.5 weeks. 3 . The average preoperative ESR was lower in the success case with 12.4mm/ hr than in the failure cases with 28mm/hr. 4 . Failure cases were restricted to active cold abscess in operative finding. 5. The positive bacteriology was fewer in the success cases with 4% than in the failure cases with 60%. 6. Follow-up functional results of the success cases were superior to any other methods of treatment. It is our conclusion that preoperative anti-tuberculous chemotherapy is important to reduce inflammatous reaction, and although granulation or caseation necrosis is found in operation field, total hip replacement can be successful if there is no active cold abscess.
Abscess ; Adult ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Bacteriology ; Drug Therapy ; Follow-Up Studies ; Hip ; Humans ; Hygiene ; Incidence ; Joints ; Necrosis ; Orthopedics ; Seoul ; Tuberculosis

Background & Objective: The MAPT H1 haplotype and SNCA single nucleotide polymorphism (SNP) rs356219 have been reported to have a synergistic effect on the risk of Parkinson’s disease (PD). Because the H1/H1 genotype has been reported to predominate in Korean population, we investigated the polymorphism of rs356219 in 878 PD patients and 559 controls. Methods: The SNCA SNP rs356219 was analyzed in 878 PD patients and in 559 healthy Korean subjects. Results: The G allele of SNCA SNP rs356219 was found to contribute to PD susceptibility with odds ratios (ORs) similar to those reported previously. However, the ORs were not as large as that of the SNCA rs356219 plus MAPT H1/H1 combination reported in the literature, which cast doubt on the existence of a synergistic effect between the two genotypes in our population. Conclusions: This study supports that the G allele of the SNCA SNP rs356219 contributes to PD susceptibility as reported previously, but it does not support the presence of a synergistic interaction between SNCA and MAPT.

We reviewed retrospectively 15 cases of perinephric abscess from 1970 to 1982 and compared these results to previously published data from 1970 to 1977 (Report I) 1. The organisms causing abscesses were determined as follows: S. aureus was in 7 cases (46%), E. coil in 4 cases (27%), Klebsiella in 2 cases (13%), Acinetobacter in 2 cases (13%), In addition, three patients had multiple abscess pathogens. 2. Laboratory evaluation revealed as follows: Pyuria was present in 4 cases (27%), Blood culture were positive in 2 cases (13%) and urine culture was positive in one case. The organisms isolated from blood and urine were felt to be the organism causing the abscesses. 3. There is no remarkable change in species of sensitive drugs, when comparing with that of previous Report I . 4. Four cases had underlying renal diseases (3 in chronic pyelonephritis and 1 in renal injury) and two cases had associated conditions (1 in impetigo and 1 in diabetes)
Abscess* ; Acinetobacter ; Humans ; Impetigo ; Klebsiella ; Pyelonephritis ; Pyuria ; Retrospective Studies

A clinical observation was made on 19 cages of nonvisualizing tuberculous kidney, who were admitted to national medical center during the period from January, 1981 to April, 1982. Following results were obtained. 1. Most common age group were from 3rd to 5th decade. 2. Most frequent symptom or complaint was grose hematuria and this was subsided after operation. 3. In laboratory findings, pyuria 178.9% and microscopic hematuria (78.9%) were identified. 4. The most common other site of tuberculosis was lung about 12 cases. 5. In microbiologic study for 24hr urine and caseous material from kidney, following answers were given. 1) 24hr urine AFB smear :+: 8cases Tuberculosis culture :+: 4cases 2) Caseous materiel from kidney AFB smear :+: 10 cases Tuberculosis culture :+: 2cases. 6. R.G.P. was tired in all cases, but could not insert the ureteral catheter due to ureteral stricture in 14 cases. 7. All cases of nonvisualizing kidneys were removed.
Constriction, Pathologic ; Hematuria ; Humans ; Kidney* ; Lung ; Pyuria ; Tuberculosis ; Tuberculosis, Renal ; Ureter ; Urinary Catheters

OBJECTIVES: This study examined the reliability and validity of the Korean version of Asperger Syndrome Diagnostic Scale (K-ASDS), to calculate the cut-off score in the diagnosis of Asperger syndrome. Further, we examined classification error rate when applying cut-off scores. METHODS: One hundred sixty-seven children participated in this study, including 46 with Asperger syndrome, 26 with PDD or PDD NOS, 43 with ADHD, and 52 normal children. RESULTS: An ANCOVA demonstrated no significant differences in the K-ASDS total score between the Asperger and the PDD & PDD NOS groups. However, these groups did show significantly higher scores than the ADHD and normal groups. Among the five subscales on the K-ASDS, the Asperger group obtained significantly higher scores on the language and cognition subscales than the PDD & PDD NOS groups. Two scales were found to be useful in distinguishing the Asperger group from the PDD & PDD NOS group through a discriminant analysis. According to an analysis of ROC curve, the cut-off score on the K-ASDS for the diagnosis of PDD including Asperger syndrome was 121. CONCLUSION: We discussed that K-ASDS has pretty limit.
Asperger Syndrome ; Child ; Cognition ; Humans ; Reproducibility of Results ; ROC Curve ; Weights and Measures

PURPOSE: To inform the necessity of mass screening, we performed a mass screening for the detection of ocular disorders of preschool children. METHODS: Ocular examination was performed on 60, 827 children in Korea (3-6 years of age) during the period from March to October, 2000. The total of 3, 254 children were shown to have either visual acuity of less than 0.5 or anisometropia of over 2 lines. Detailed eye examination was conducted on those 3, 254 children. RESULTS: The numbers of first mass screening were 60, 826. Diagnosis consisted of refractive errors in 2, 216, amblyopia in 664, and strabismus in 235. Among the types of refractive errors, myopic astigmatism was the most common type (34.0%). Astigmatism was combined with all other types in 1, 659 children. Refractive error was the most common cause of amblyopia (88.0%) CONCLUSIONS: To prevent and treat amblyopia or strabismus, early detection and adequate care at preschool age seemed to be very effective. Participation rate for this mass-screening of eye disease during preschool age will be more increased by efforts of constiutional support and parental cooperation.
Amblyopia ; Anisometropia ; Astigmatism ; Child* ; Child, Preschool ; Diagnosis ; Eye Diseases ; Humans ; Korea* ; Mass Screening ; Parents ; Refractive Errors ; Strabismus ; Vision Screening* ; Visual Acuity

Primary tumors of the heart are rare, three quarter of the tumors are benign, and nearly half of the benign heart tumors are myxomas. Cardiac myxoma usually originate in the left atrium about 75 percent, however, only 3 to 4 percent of myxoma are detected in the left ventricle. We report on a 32 years old woman with left ventricular myxoma who presented with shortness of breath, chest tightness, and general weakness. Acute pulmonary embolism and left ventricular myxoma were found on a perfusion lung scan and echocadiogram. A mass located on septal wall of left ventricle was excised en bloc. The patient recovered uneventfully and careful follow up has be performed periodically.
Adult ; Dyspnea ; Female ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Lung ; Myxoma* ; Perfusion ; Pulmonary Embolism* ; Thorax

PURPOSE: The present study was carried out to determine day-to-day differences in cortisol levels and the molar cortisol-to-dehydroepiandrosterone (DHEA) ratio (molar C/D ratio) in working subjects. MATERIALS AND METHODS: The cortisol and DHEA levels were measured from saliva samples collected 30 minutes after awakening for 7 consecutive days in full-time working subjects that worked Monday through Saturday. To determine the day-to-day differences within subjects, the collected data was analyzed using variance (ANOVA) for a randomized complete block design (RCBD). RESULTS: The cortisol levels from samples collected 30 minutes after awakening on workdays were similar to each other, but were significantly different from the cortisol levels on Sunday. The DHEA levels were not significantly different between the days of week. The DHEA levels on Monday and Tuesday were relatively lower than the levels on the other weekdays. The DHEA levels on Thursday and Friday were relatively higher than the other days. The molar C/D ratios on Sunday were significantly lower than those on workdays. The molar C/D ratios on Monday and Tuesday were significantly higher than those on Wednesday or other workdays. CONCLUSION: The cortisol levels and the molar C/D ratios demonstrate differences in adrenocortical activities between workdays and non-workdays, but the molar C/D ratio additionally represents differences in adrenocortical status between the first two workdays and other workdays. Thus, it is possible that the day-to-day differences in the cortisol levels and the molar C/D ratio represent the adrenal response to upcoming work-related stress.
Adult ; Analysis of Variance ; Dehydroepiandrosterone/*metabolism ; Female ; Humans ; Hydrocortisone/*metabolism ; Male ; Middle Aged ; Saliva/chemistry ; Work/*physiology