No abstract available.
Epilepsies, Myoclonic* ; Neuroblastoma*

In shape and dimensions, the tibial plateaus are asymmetric with the larger medial tibial plateau and both have a posterior inclination with respect to the shaft of the tibia. Maximizing tibial coverage is an impotant consideration in total knee arthroplasty to provide stahility and load transfer and to improve long-term survival rate of the implants. Most tihial tray designs are symmetric, but several asymmetric designs are available. We evaluated the proximal tibial resection surface during total knee aithroplasty to delineate the tibial plateaus in korean. After tihial bone cut during 100 TKA procedures, the outline of tibial resection suiface was traced and rotational axis of true tibial component was marked intraoperatively. A line was drawn at the maximal anteroposterior (AP) diameter of lateral tibial condyle with parallel to rotational axis of component, and then a transverse axis was drawn at the midpoint of maximal AP diameter of 1ateral tibial condyle. Anteroposterior 10, 20, 30., 40% and midpoint from the media1 and lateral peripheries were calculated manually. The average AP medial 10, 20, 30 and 40% dimensions were 34.7, 43.8, 48.0 and 43.2mm, respectively. The average AP lateral 10, 20, 30 and 40% dimensions were 30.2, 38.4, 42.0 and 40.9mm, respectively. The ratio of medial/lateral AP dimensions 10, 20, 30 and 40% from periphery were 116.9, 114.7, 114.5 and 106.4%, respectively. From these data, we know the asymmetry of the proxirnal tibia1 plateaus in korean. We hope that rnore data will be ohtained in multicenter studies and it will help us to select tibia1 tray and to design the tibial component in korean. But, more accurate standard measures will he need to minimize an error of measurements.
Arthroplasty* ; Axis, Cervical Vertebra ; Hope ; Knee* ; Survival Rate ; Tibia

No abstract available.

Schizencephaly, first described by Yakovlev and Wadsworth in 1946, is a rare congenital anomaly characterized by gray matter-lined clefts that extend through the entire cerebral hemisphere, from the ependymal lining of the lateral ventricle to the subarachnoid space. Clinically, patients with schizencephaly present motor dysfunction such as hemiparesis, seizures, and variable developmental delay. Absence of septum pellucidum, gray matter heterotopia, polymicrogyria, and hypoplasia of optic nerves were also frequently found to be associated with schizencephaly. We experienced a case of open-lip schizencephaly in a one-day-old male infant with wide, tense fontanel, which was confirmed by MRI.
Cerebrum ; Humans ; Infant ; Lateral Ventricles ; Lip* ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development* ; Optic Nerve ; Paresis ; Seizures ; Septum Pellucidum ; Subarachnoid Space ; Transcutaneous Electric Nerve Stimulation

No abstract available.
Brain Stem* ; Classification* ; Hemorrhage*

Intradural ruptured discs are very rare occurrences and the incidence is reported to be 0.13% among total herniated discs, 90% of intradural ruptured discs are known to occur in the lumbar area. The symtoms and signs of the intradural disc are much more severe than those of the usual extradural herniated disc. MR imagings of the intradural disc demonstrate several typical findings, but intradural tumors must be ruled out. The authors present a case of intradural ruptured lumbar disc L4-L5 level in a 46-year-old female. Characteristic MR and operative findings of this case are reported. Pathogenetic mechanisms and differential diagnoses with certain intradural tumors and the extradural ruptured disc with similar MR findings are discussed.
Diagnosis, Differential ; Female ; Humans ; Incidence ; Intervertebral Disc Displacement ; Middle Aged

Malignant intracranial meningioma is a rare pathologic entity. Although the topic is widely discussed, there is little agreement in the literatures as to the histological and radiological features that warrant the diagnosis of malignant meningioma. An osteolytic lesion of the skull may have been suggested in several cases. But in adults, the most commonly suspected lesion is metastatic lesion;while meningioma is rarely suspected. Meningiomas are occasionally associated even with extracranial masses. However, most of these masses are firm, and are caused by hyperostosis. Extracranial soft-tissue masses rarely arise in meningiomas, thus, the presence of both osteolytic skull lesion and soft-tissue mass is exceedingly rare in meningiomas. The authors report a case of osteolytic malignant meningioma located at the frontal fossa extending to the subgaleal space appearing as an extracranial soft-tissue mass in a 19-year-old female. The clinical, radiological, neurosurgical, and histopathological features of these lesions are discussed together with a review of the literatures.
Adult ; Diagnosis ; Female ; Humans ; Hyperostosis ; Meningioma* ; Osteolysis ; Skull ; Young Adult

In magnetic resonance(MR) imagings with short tau inversion recovery(STIR) sequences fat signals are specifically suppressed. These imaging techniques, therefore, have been used to identify optic nerve lesions in the orbits, because there are a lot of fat tissues which may obscure the optic nerves in the orbit. The cervical spinal nerves or ventral primary rami of brachial plexus, during their courses in the necks between anterior and middle scalene muscles, are also surrounded by considerable amount of fat deposits. So we used these MR imaging techniques with already used posterior neck coil system, to image cervical spinal nerves directly, and to know whether there are certain signal changes in those nerves of the involved nerve roots, in 12 patients who were considered to have cervical radiculopathies by conventional diagnostic means. In MR neurography with STIR sequences(STIR MRN) of axial and coronal images, signals of the cervical spinal nerves of the involved roots were detected as fairly bright, and were discerned from signals of the spinal nerves of the uninvolved roots. We also measured contrast-to-noise ratio(CNR) of the spinal nerve signals of the involved and uninvolved roots in axial images. The average CNR value of the former was 4.48+/-0.889 and of the latter 1.40+/-0.274. Our fingings indicate that STIR MRNs can be helpful in limiting the lesions more accurately and in making surgical decisions for cervical radiculopathies caused by multileveled discs or spondylosis.
Brachial Plexus ; Humans ; Magnetic Resonance Imaging ; Muscles ; Neck ; Optic Nerve ; Orbit ; Radiculopathy* ; Spinal Nerves ; Spondylosis

OBJECTIVE: The authors performed instrumented anterior cervical fusion with either iliac autograft or fibular allograft for various clinical entities. The purposes of the study are to compare the fusion rate and the time to fusion according to graft material, and to identify the factors affecting fusion. METHOD:57 patients underwent instrumented anterior cervical fusion during 3 years between Jan. 1995 and Dec. 1997, among them 31 patients with iliac autograft(autograft group), and 26 patients with freeze-dried fibular allograft (allograft group). The clinical entities were trauma(n=0), soft disc herniation(n=), spondylotic radiculopathy(n=1), spondylotic myelopathy(n=6), and ossified posterior longitudinal ligament(n=). The method of fusion was either interbody fusion confined to disc space or strut fusion after corpectomy. Outcomes were assessed for fusion status and time to fusion, and comparison between autograft group versus allograft group. RESULT: Between autograft and allograft group there were no differences in distribution of perioperative clinical variables such as patients' age and gender, clinical entity, method of fusion, and length of fusion as determined by the number of disc space fused. Mean follow-up period was 19 months(range 10-28 months) in autograft group and 16 months(range 8-22 months) in allograft group. The fusion rate was 90% in autograft group and 85% in allograft group(p=.691). The median time to fusion was 7 months in autograft group and 15 months in allograft group(p<0.001). The perioperative variables affecting fusion, defined as those being significantly associated with the time to fusion, were the graft material(p=.000) and the length of fusion(p=.007). The rate of graft-related complications including donor-site morbidity was 41% in autograft group and 8% in allograft group. CONCLUSION: It is concluded that the use of freeze-dried fibular allograft in instrumented anterior cervical fusion is, though the time to fusion is delayed more than two times, as an effective way as the use of iliac autograft to achieve fusion, and is a better way to ameliorate graft-related complications.
Allografts* ; Autografts* ; Follow-Up Studies ; Humans ; Transplants

Most anterior communicating artery aneurysms arise in association with ipsilateral, dominant, proximal anterior cerebral artery(A1) segments and, as direct extensions of those vessels, are often somewhat directed toward the contralateral cerebral hemispheres. We classified the directions of the anterior communicating artery aneurysms based on three dimensional orientations of neck orifices and fundus projections which were then described schematically to demonstrate spatial orientations. We also analyzed 32 cases of anterior communicating artery aneurysm who had been operated on during recent 3.5 years according to this classification. Only the difference in the size of aneurysm in relation to the site of aneurysmal neck was statistically significant(p=0.0116), and there were no correlations between A1 hypoplasia and the site of aneurysmal neck, the projection of aneurysmal fundus and the size of aneurysm, and the intraoperative rupture and the projection of the aneurysmal fundus. Although meaningful clinical results could not be obtained, we believe this classification can be very helpful in planning traditional or endovascular surgeries for, and in understanding spatial directions of anterior communicating artery aneurysms.
Aneurysm ; Cerebrum ; Classification* ; Intracranial Aneurysm* ; Neck* ; Rupture