Diastematomyelia is an uncommon dysraphic condition in which the spinal cord is split, with or without a fibrous, cartilaginous, or bone septum. The septum usually occurs in the lower thoracic or lumbar regions. Most of the patients with this condition are children of less than the years old. The condition is much less common in adults. Congenital tumor associated with diastematomyelia is more uncommon finding. Now, authors report one case of diastematomyelia combined with intradural cystic teratoma who is eighteen years old female patient.
Adult ; Child ; Female ; Humans ; Lumbosacral Region ; Neural Tube Defects* ; Spinal Cord ; Teratoma*

BACKGROUND: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. METHODS: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. RESULTS: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. CONCLUSIONS: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.
Arthroscopy ; Clavicle ; Follow-Up Studies ; Humans ; Ligaments ; Tomography, X-Ray Computed

Among all of the spontaneous TCH(intracerebral hemorrhage), the presence of IVH(intraventricular hemorrhage) is showing higher mortality and morbidity. Since the introduction of EVD(extraventricular drainage) and direct intraventricular infusion of Urokinase as a effective therapeutic methods of IVH, it's mortality and morbidity has been decreased. But, in cases of hemorrhage extended into all ventricular chambers showes poor prognosis even the EVD and infusion of Urokinase. Authors analyzed 40 cases of IVH treated with simple EVD or direct intraven-tricular infusion of Urokinase. The results were as follows: 1) The most common age groups of IVH patients were 5th and 6th decades and 22 patients were male, 18 patients were female. 2) All 15 cases of Urokinase treated group revealted over the 7 point of Graeb score. 3) On admission, Glasgow coma scale scores were under the 8 at the 11 cases(73%) of Urokinase treated group and 18 cases(72%) of simple EVD group. 4) Time of cleared ventricles showed fast at the Urokinase treated group than simple EVD group. 5) Incidence of complications were similar on both groups. 6) Prognosis revealed lower morbidity and mortality at the Urokinase treated group than simple EVD group. 7) In cases of high Graeb score and low Glasgow coma scale on admission showed poor prognosis in both groups.
Female ; Glasgow Coma Scale ; Hemorrhage* ; Humans ; Incidence ; Infusions, Intraventricular ; Male ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator*

Cruciate paralysis, an unusual clinical entity, is "frequently undiagnosed or misunderstood", and can simulate the acute cervical central-cord injury syndrome. This rare injury pattern is characterized by weakness of upper extremities with little or no compromise of lower limb function following trauma to the superior cervical cord. The pattern of injury and clinical findings support selective damage to the corticospinal tract or upper motor neurons subserving upper limb function with the pyramidal decussation. Authors experience a case of curciate paralysis due to type 2 odontoid fracture and atlas dislocation.
Central Cord Syndrome ; Dislocations* ; Lower Extremity ; Motor Neurons ; Odontoid Process* ; Paralysis ; Pyramidal Tracts ; Upper Extremity

BACKGROUND: Because acute cholecystitis in elderly hip fracture is not easily distinguishable from other gastrointestinal symptoms and involves atypical clinical behaviors, it may not be diagnosed in the early stage. However, the exact incidences could not be reported. We utilized data from a nationwide claims database and attempted to assess the incidence of acute cholecystitis in elderly hip fracture patients and how cholecystitis affects mortality rates after hip fracture. METHODS: Study subjects were from the Korean National Health Insurance Service-Senior cohort. From a population of approximately 5.5 million Korean enrollees > 60 years of age in 2002, a total of 588,147 participants were randomly selected using 10% simple random sampling. The subjects included in this study were those who were over 65 years old and underwent surgery for hip fractures. RESULTS: A total of 15,210 patients were enrolled in the cohort as hip fracture patients. There were 7,888 cases (51.9%) of femoral neck fracture and 7,443 (48.9%) cases of hemiarthroplasty. Thirty-six patients developed acute cholecystitis within 30 days after the index date (30-day cumulative incidence, 0.24%). Four of the 36 acute cholecystitis patients (11.1%) died within 30 days versus 2.92% of patients without acute cholecystitis. In the multivariate-adjusted Poisson regression model, hip fracture patients with incident acute cholecystitis were 4.35 (adjusted risk ratio 4.35; 95% confidence interval, 1.66–11.37; P = 0.003) times more likely to die within 30 days than those without acute cholecystitis. CONCLUSION: Incidence of acute cholecystitis in elderly patients after hip fracture within 30 days after the index date was 0.24%. Acute cholecystitis in elderly hip fracture patients dramatically increases the 30-day mortality rate by 4.35-fold. Therefore, early disease detection and management are crucial for patients.
Abdominal Pain ; Aged ; Cholecystitis ; Cholecystitis, Acute ; Cohort Studies ; Femoral Neck Fractures ; Hemiarthroplasty ; Hip Fractures ; Hip ; Humans ; Incidence ; Mortality ; National Health Programs ; Odds Ratio

BACKGROUND: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. METHODS: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. RESULTS: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. CONCLUSIONS: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.
Arthroscopy ; Clavicle ; Follow-Up Studies ; Humans ; Ligaments ; Tomography, X-Ray Computed

The aim of the present study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) for low- to intermediate-risk prostate adenocarcinoma. Thirty-nine patients were retrospectively reviewed. The SBRT was delivered using the CyberKnife with the fiducial tracking method combined with In-tempo imaging. The gross target volume, which included the prostate only, was delineated on the fused CT/MRI scans. The prescription dose was delivered every other day as 5 fractions of 7.5 Gy. Venous blood was obtained before and after SBRT to assess the prostate-specific antigen (PSA) level. Toxicity was evaluated using the CTCAE, v4.03. The median follow-up time was 30.0 months. The median initial PSA level was 7.7 ng/mL. PSA levels decreased in all patients treated with SBRT, and after 5 months, the median PSA was less than 2 ng/mL. The rate of overall 3-yr actuarial biochemical failure free survival was 93.9%. Acute side effects were generally comparable with those of previous studies. The PSA change and toxicity after SBRT for low- to intermediate-risk prostate adenocarcinoma indicates favorable biochemical responses and tolerable levels of toxicity. Additionally short course treatment may produce cost benefit and convenience to patients.
Adenocarcinoma/*diagnosis/*surgery ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms/*diagnosis/*surgery ; Radiosurgery/*methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Image-Guided/*methods ; Risk Assessment ; Treatment Outcome

PURPOSE: The purpose of this study was to compare the clinical outcomes of arthroscopic anatomical double bundle (DB) anterior cruciate ligament (ACL) reconstruction with either selective anteromedial (AM) or posterolateral (PL) bundle reconstruction while preserving a relatively healthy ACL bundle. MATERIALS AND METHODS: The authors evaluated 98 patients with a mean follow-up of 30.8±4.0 months who had undergone DB or selective bundle ACL reconstructions. Of these, 34 cases underwent DB ACL reconstruction (group A), 34 underwent selective AM bundle reconstruction (group B), and 30 underwent selective PL bundle reconstructions (group C). These groups were compared with respect to Lysholm and International Knee Documentation Committee (IKDC) score, side-to-side differences of anterior laxity measured by KT-2000 arthrometer at 30 lbs, and stress radiography and Lachman and pivot shift test results. Pre- and post-operative data were objectively evaluated using a statistical approach. RESULTS: The preoperative anterior instability measured by manual stress radiography at 90° of knee flexion in group A was significantly greater than that in groups B and C (all p<0.001). At last follow-up, mean side-to-side instrumented laxities measured by the KT-2000 and manual stress radiography were significantly improved from preoperative data in all groups (all p<0.001). There were no significant differences between the three groups in anterior instability measured by KT-2000 arthrometer, pivot shift, or functional scores. CONCLUSION: Selective bundle reconstruction in partial ACL tears offers comparable clinical results to DB reconstruction in complete ACL tears.
Adolescent ; Adult ; Anterior Cruciate Ligament/*surgery ; Anterior Cruciate Ligament Reconstruction/*methods ; Arthroscopy ; Female ; Humans ; Male ; Middle Aged ; Organ Sparing Treatments/*methods ; Treatment Outcome ; Young Adult

PURPOSE: We evaluated the effect of early chemoradiotherapy on the treatment of patients with limited stage small cell lung cancer (LS-SCLC). MATERIALS AND METHODS: Between January 2006 and December 2011, thirty-one patients with histologically proven LS-SCLC who were treated with two cycles of chemotherapy followed by concurrent chemoradiotherapy and consolidation chemotherapy were retrospectively analyzed. The chemotherapy regimen was composed of etoposide and cisplatin. Thoracic radiotherapy consisted of 50 to 60 Gy (median, 54 Gy) given in 5 to 6.5 weeks. RESULTS: The follow-up period ranged from 5 to 53 months (median, 22 months). After chemoradiotherapy, 35.5% of the patients (11 patients) showed complete response, 61.3% (19 patients) showed partial response, 3.2% (one patient) showed progressive disease, resulting in an overall response rate of 96.8% (30 patients). The 1-, 2-, and 3-year overall survival (OS) rates were 66.5%, 41.0%, and 28.1%, respectively, with a median OS of 21.3 months. The 1-, 2-, and 3-year progression free survival (PFS) rates were 49.8%, 22.8%, and 13.7%, respectively, with median PFS of 12 months. The patterns of failure were: locoregional recurrences in 29.0% (nine patients), distant metastasis in 9.7% (three patients), and both locoregional and distant metastasis in 9.7% (three patients). Grade 3 or 4 toxicities of leukopenia, anemia, and thrombocytopenia were observed in 32.2%, 29.0%, and 25.8%, respectively. Grade 3 radiation esophagitis and radiation pneumonitis were shown in 12.9% and 6.4%, respectively. CONCLUSION: We conclude that early chemoradiotherapy for LS-SCLC provides feasible and acceptable local control and safety.
Anemia ; Chemoradiotherapy* ; Cisplatin ; Consolidation Chemotherapy ; Disease-Free Survival ; Drug Therapy ; Esophagitis ; Etoposide ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Radiation Pneumonitis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Thrombocytopenia

Skeletal remains collected from the archaeological fields must be maintained carefully, for being used in scientific studies on the physical characteristics, health status, and pathological disease of the ancient or medieval human populations. Even if Joseon Dynasty Human Sample Collection might be a good example for such studies, few of bone collections predated the Joseon Age (e.g. Goryeo Dynasty) have been established until now, possibly owing to poor preservation condition of archaeological sites in Korea. In this study, we performed anthropological studies on a few cases of Goryeo skeletons, which have been rarely reported by anthropologists in Korea. Judging from the preservation status of bones found in various types of Goryeo graves (e.g. earthen- or stone-chambered tombs), many cases seem to be cremated in accordance with Buddhist funeral rites. Goryeo bone collections must be constructed with the bones identified in the earthen tombs, which were preserved much perfectly than those of any other types of Goryeo tombs.
Anthropology, Physical ; Archaeology ; Funeral Rites ; Humans ; Korea ; Skeleton