Chordoma is a rare distinctively malignant tumor thought to be histogenetically related to the primitive notochord, It is locally infiltrative but does not metastasize until late. The usual initial symptom is pain or some symptom caused by involvement of the nervous system. Involed in the order of frequency are the sacro-coccygeal area, the spheno-occipital area, and the other vertebral area. This case is a sacro-coccygeal chordoma that is confirmed by histologic examination. The lesion was treated by complete excision.
Chordoma ; Nervous System ; Notochord

Strumal carcinoid of the ovary is a rare turkor characterized by an intimate mixture of thyroid follicles and carcinoid. Herein is reported an ovarian strumal carcinoid in a serous cystadenoma from a 27-year-old pregnant woman. The thyroid follicular epithelial cells had immunohistochemically thyroglobulin and carcinoid tumor cells contained neuron-specific enolase, chromogranin and carcinoembryonic antigen. In addition, carcinoid cells showed neuroendocrine granules ultrastructurally. Calcitonin and amyloid were not found. This tumor may be originated from pluripotent endodermal germ cells on the basis of morphologic, immunohistochemical and ultrastructural studies.
Pregnancy ; Female ; Humans

Inflammatory pseudotumor of the urinary bladder is a proliferative spindle cell lesion that microscopically may suggest a sarcoma but that are benign without a recent history of an operation. The first such case was reported by Roth, in 1980, and thereafter about seven more cases were reported in medical literatures. We reported a case of inflammatory pseudotumor of the urinary bladder mimicking leiomyosarcoma. Patient was a 36-year-old woman with complaint of painless total and gross hematuria for 3 weeks. Partial cystectomy specimen showed a well-demarcated nodular mass of yellow white color, involving the submucosal and muscular layers. Microscopic examination revealed proliferating bundles of spindle cells interspersed with infiltration of many inflammatory cells including eosinophils. Spindle cells were positive for vimentin on immunohistochemistry and corresponding to myofibroblasts on the electron microscopic examination.
Female ; Humans

No abstract available.
Shoulder*

The purpose of this study is to evaiuate the results of the reconstruction of acetabular bone defect with morselized bone graft and screw fixed hemispherical cup in revision of failed acetabular cup. Thirty four revisions of an acetabular component that had been performed in 34 patients between 1988 and 1993 at SNUH, and had followed more than four years were included in this study. The revised acetabulum was evaluated clinically by Harris hip score and radiologically by evaluating the osseous union, incorporation and resorption of graft, the amount of migration and cup angle change of revised components and periacetabular radiolucency. The mean Harris hip score was improved 52 to 84. All of the bone grafts united by 6.4 months and incorporated by 13.1 months. The graft bone resorption less than onefourth of the initial graft thickness was 91.2% (31 cases). There was no significant difference between pure allograft and allograft mixed with autograft in clinical and radiological results. Of 34 cases, 2 cases (5.9%) required rerevision of acetabulum for aseptic loosening. The two complications, postoperative infection and trochanteric bursitis were managed successfully with conservative methods. The results of the present study confirm the success of revision of the acetabulum with use of a hemispherical component stabilized with multiple small screws and morselized bone grafts filling bone defects.
Acetabulum* ; Allografts ; Autografts ; Bone Resorption ; Bursitis ; Femur ; Hip ; Humans ; Postoperative Complications ; Transplants*

Neoplastic disease of the spine can be a most difficuIt and perflexing problem. Nineteen cases of tumors in the the spine were studied in the Department of Orthopedic Surgery, Seoul National University Hospital for 5 years and 6 months from January 1972 to June 1977. The results were as follows; 1. In 19 cases of tumors of the spine, primary tumor was 6 cases and metastatic tumor was 13 cases. 2. Primary tumors of the spine show hemangioma, osteochondroma, chondrosarcoma, giant cell tumor, chordoma, and chondromyxoid fibroma with each of one case 3. Primary sites of the metastatic tumors were lung (2 cases), genito-urinary system (2 cases), gastro-in testinal tract, skin, bone (each l case), and unknown (5 cases). 4. Thoracic and lumbar spines were most fregeuntly involved (75%). 5. Primary tumors were treated by radical excision and metastatic tumors by consevstive 6. Tumors of the spine must be differenciated from any diseases of the spine and the clinician must be alert that any spine lesion could be tumorous condition.
Chondrosarcoma ; Chordoma ; Fibroma ; Giant Cell Tumors ; Hemangioma ; Lung ; Orthopedics ; Osteochondroma ; Seoul ; Skin ; Spine

The latest recommendations for the diagnosis and management of crystal-induced arthritis, such as gout and calcium pyrophosphate dihydrate (CPPD) deposition disease, recognize the diagnostic potential of musculoskeletal ultrasonography (MSUS). MSUS allows rapid, highly sensitive, non-invasive detection of microcrystal aggregates in multiple anatomic areas, and can be used as a safe, reliable guide for aspiration of articular and periarticular specimens suitable for microscopic analysis. MSUS can also be used to monitor disease after treatment. Ultrasonographic differentiation between gout and CPPD deposition disease is based on the characteristics of crystal aggregates and their preferential localization in different anatomical areas. This rapid assessment may profoundly affect the clinical process, avoiding expensive, time-consuming diagnostic procedures. This article reviews the current status of and recent advances in MSUS imaging in crystal-induced arthritis.
Arthritis* ; Calcium Pyrophosphate ; Chondrocalcinosis ; Diagnosis ; Gout ; Ultrasonography

PURPOSE: Renal vascular clamping during a laparoscopic partial nephrectomy is a time-consuming procedure with a risk of renal ischemia. To study the feasibility of laparoscopic partial nephrectomy without renal arterial clamping, we compared the procedure with laparoscopic partial nephrectomy with vascular clamping. MATERIALS AND METHODS: Seventeen patients underwent laparoscopic partial nephrectomy without renal arterial clamping (group 1) from February 2004 to June 2008. The operative results were reviewed retrospectively and compared with those of 16 patients who underwent laparoscopic partial nephrectomy with arterial clamping (group 2). Patient characteristics did not differ significantly between the 2 groups. However, exophytic tumors were detected in 13 patients in group 1 and 3 patients in group 2 (p=0.001). Scores on the preoperative aspects and dimensions used for an anatomical (PADUA) classification were 6.9 in group 1 and 7.7 in group 2 (p=0.037). All surgeries by the transperitoneal approach were performed by a single surgeon. RESULTS: The mean operative times were 103 and 130 minutes in groups 1 and 2, respectively (p=0.312). The mean renal arterial clamping time of group 2 was 27.6 minutes (range, 20-42 minutes). The mean estimated blood loss was 327 ml in group 1 and 315 ml in group 2 (p=0.971). The mean postoperative change in the glomerular filtration rate was 20.11 ml/min/1.73 m2 in group 1 and 18.95 ml/min/1.73 m2 in group 2 (p=0.748). The mean times to postoperative initiation of ambulation and of oral intake were 1.6 and 1.7 days (p=0.486) and 1.3 and 1.6 days (p=0.811) in groups 1 and 2, respectively. The mean length of hospital stay was 7.4 and 7.9 days in groups 1 and 2, respectively (p=0.9). The mean tumor size was 2.1 cm (range, 1-7 cm) in group 1 and 3.3 cm (range, 1.5-9 cm) in group 2. CONCLUSIONS: Laparoscopic partial nephrectomy without renal arterial clamping is feasible for a localized renal tumor. However, patients should be selected carefully, such as those with an exophytic tumor.
Constriction ; Glomerular Filtration Rate ; Humans ; Ischemia ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Nephrectomy ; Operative Time ; Retrospective Studies ; Walking

The authors retrospectively reviewed the operative cases of 28 patients with lower cervical spine injury from August 1991 to July 1996. Data from charts were reviewed the following clinical parameters, e.g.) etiologies, neurologic findings, degrees of recovery, managements including operative treatments, and complications. The lower cervical injury was most common in men in the third decade. The most common cause, mechanism and site of lower cervical injury were motor vehicle accidents, flexion type injury and C5-6 respectively. The head trauma was frequently combined. In most cases operation for stabilization was done around two weeks after the trauma, but for decompression purpose it was done before two weeks. Three patients who had complete neural injuries died due to pneumonia, adult respiratory distress syndrome, and upper gastrointestinal bleeding. A neurological recovery rate was high in incomplete neural injury group. In conclusion, early reduction and decompression of spinal canal in incomplete neural injury group is favorable for good recovery. Careful attention should be paid on the patient with complete injury for the development of serious complications such as upper gastrointestinal bleeding, ARDS and pneumonia.
Craniocerebral Trauma ; Decompression ; Hemorrhage ; Humans ; Male ; Motor Vehicles ; Neurologic Manifestations ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Spinal Canal ; Spine*

PURPOSE: Most urologists, to our knowledge, recommend prostatic biopsy if serum prostate specific antigen(PSA) concentrations are between 4 and 10ng/ml(gray zone), even in the abscence of abnormal digital rectal examination(DRE). But the detection of prostate cancer has not been frequent in patients with negative DRE and gray zone of serum PSA. So, we investigated the detection rate of prostate cancer to evaluate the effectiveness of biopsy, and provide the clinical data which is needed to make an appropriate guideline for management in those patients in Korea. MATERIALS AND METHODS: We retrospectively reviewed 58 patients with negative DRE and serum PSA greater than 4ng/ml, in whom transrectal systemic biopsy was done between January 1, 1996 and July 31, 1998. Additionally we analysed 38 patients with negative DRE and serum PSA more than 4ng/ml in a Korean literature. We calculated the detection rate of prostate cancer in patients with gray zone of serum PSA and serum PSA greater than 10ng/ml, respectively. RESULTS: Prostate cancer was detected in 5 patients out of the 58 patients(8.6%), including 1 patient(3.7%) out of 27 patients with gray zone of serum PSA and 4(12.9%) out of 31 patients with serum PSA greater than 10ng/ml. Prostate cancer was detected in 4 patients out of the 38 patients in the literature(10.5%), including 1 patient(5.0%) out of 20 patients with gray zone of serum and 3 patients(16.7%) out of 18 patients with serum PSA greater than 10ng/ml. Combining the results of our current study with that of other Korean literature, total number of patients was 96, and 9(9.4%) of them proved to harbor prostate cancer, including 2 patients(4.3%) out of 47 patients with gray zone of serum PSA and 7 patients(14.3%) out of 49 patients with serum PSA greater than 10ng/ml. CONCLUSIONS: The detection rate of prostate cancer in Korean with negative DRE and gray zone of serum PSA is significantly lower than that in North American. Therefore it may not be effective to perform biopsy in all of those patients in Korea. Needed are Korean criteria of prostatic biopsy to detect prostate carcinoma in those patients, which can be acceptable in Korean.
Biopsy* ; Digital Rectal Examination* ; Humans ; Korea ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Retrospective Studies