The computed tomographic findings in 5 patients with the central neurofibromatosis were reviewed. Atypical choroid plexus calcification was evident in 3 of 5 patients in the anterior half of lateral ventricle, foramen of Monro and third ventricle. The cause of this abnormal calcification is unknown yet, but it may have the diagnostic significance for central neurofibromatosis.
Cerebral Ventricles ; Choroid Plexus* ; Choroid* ; Humans ; Lateral Ventricles ; Neurofibromatosis 2* ; Third Ventricle

Ossification and calcification of the spinal ligaments frequently cause pressure upon the spinal cord andnerve roots. Authors reviewed 150 cases of C-spine CT, 80 cases of T-spine CT, and 725 cases of L-spine CT whichwere carried out a Pusan Natina University Hospital for 2 years from May 1983 to May 1985. We analysed 34 caseswhich showed ossification of posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF) of these 955cases. The results are follows: 1. The male ot female ratio of spinal ligamentous ossification was 26:8. The 5thdecade group (24.41%) was the most prevalent age group. 4th decade(26.4%), 6th decade(23.52%), 7th decade(11.76),3rd decade (8.8%), and 8th decade(2.94%) in that order. 2. Of 955 cases of spine CT, the incidence of OPLL was 25cases(21.51%) and that of OLF was 10 ases(1.05%). 3. Regional incidence of spinal ligamentous ossification was asfollows. 1) In case of OPLL, cervical area was 19/150(12.67%) and lumbar area was 6/725 (0.83%). 2) In cases ofOLF, Thoracic area was 3/80(3.75%) and lumbar area was 8/725(1.10%). 4. The most frequent length of OPLL was 4body length (32%) and the most frequent locations are C4 and C5(68%). The types fo OPLL were 15 cases(60%) ofsegmental type, 8 cases(32%) of continuous type, and 2 cases(8%) of mixed type in that order. All segmental typeswere degree 1 or 2 and most continuous and mixed type (80%) were degree 2 or 3 dural sac effect. 5. The number ofinvolved interlaminar spaces in OLF was 1 to 5 interspaces and most of OLF were found at low thoracic and lumbararea. 6. There could be noted high correlation between the spinal ligamentous ossification and degenerative discdisease, The incidence of associated disc disease was 18/25(72%) in OPLL and 8/10(80%) in OLF.
Busan ; Female ; Humans ; Incidence ; Ligaments ; Ligamentum Flavum ; Male ; Ossification of Posterior Longitudinal Ligament ; Spinal Cord ; Spine

No abstract available.
Female ; Humans ; Pregnant Women*

We report a case of Hunter' s syndrome with characteristic nodules on the upper back. The patient was a 7-year-old Korean boy who presented with ivory-colored papules and nodules on both sides of the scapula, pectoral regions and lateral aspects of the upper arms. These lesione are regarded as pathognomonic cutaneous markers for Hunter s syndrome. He also presented with truncal hypertrichosis, retarded growth, short neck, round face, claw like contractures of hands, multiple joint contractures, and a clear cornea. Severely elevated glycosaminoglycan levels were present in the patient s urine samples. The patient s 5-year-old brother had similar clinical features.
Animals ; Arm ; Child ; Child, Preschool ; Contracture ; Cornea ; Hand ; Hoof and Claw ; Humans ; Hypertrichosis ; Joints ; Male ; Mucopolysaccharidosis II* ; Neck ; Scapula ; Siblings

OBJECT: There have been some controversies about the nature of peripheral neuropathy in patients with subacute comblned degeneration. Mayer concluded that the neuropathy was essentially demyelinating. And other reports which were based on pathologic or electrophyslological filldings have been saying axonopathy. We tried to find the nature of perlpheral neuropathy by doing conventional nerve conduction studies in 19 patients with subacute combined degeneration. SUBJECT AND METHOD: We included 19 patients with subacute combined degeneration, who were diagnosed by decreased serum vitamin B12(200pg/ml) and abnormal neurologic symptoms and/or signs. The patients were between 26 and 86 years of age. Eleven of them were male. We performed conventional nerve conduction studies Including H-reflex, When nerve conduction parameters deviated by more than 2SD from the normal mean value, they were consider as abnormal. RESULTS: nerve conduction studies were abnormal in 13/19. 11/13 with abnormal nerve conduction studies showed the pattern of peripheral polyneuropathy. Ten of them showed decreased amplitudes of sensory nerve action potentials or compound nerve action potentials with/wlthout mild slowing of nerve condcution. The abnormalities of the three patients with nerve conduction parameters of demyelinating range were confined to the distal segments of the median nerves. CONCLUSION: We thought that the results of the nerve conduction studies of our cases were compatible with axonopathy rather than demyelinopathy as a principal ]esion of the peripheral nervous system.
Action Potentials ; H-Reflex ; Humans ; Male ; Median Nerve ; Neural Conduction* ; Neurologic Manifestations ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Polyneuropathies ; Subacute Combined Degeneration ; Vitamins

BACKGROUND: There has been a lot of changes in prehospital medical environment with development of EMSS(emergency medical service systems). Especially in out-of-hospital cardiac arrest, the patients could survive when they are moved to the hospitals earlier. The purpose of this research is to know the status of EMSS in Korea by analyzing CPR(cardiopulmonary resuscitation) outcomes of out-of-hospital cardiac arrest patients at 3 hospital in the western area of Seoul and Incheon. METHODS: From July 1997 to June 1998, we collected data about out-of-hospital cardiac arrest victims at Ewha Womens University Mokdong Hospital, Catholic University Medical College St. Mary Hospital, and Kachon University Chung Ang Gil Hospital. We used same record form based on the 'Utstein Style'. RESULTS: CPR were performed in 265 out-of-hospital cardiac arrest patients at 3 hospitals. One hundred twelve(42.3%) patients recovered the spontaneous circulation at least once and eight(3.0%) patients discharged alive. One hundred ninety four(73.2%) patients died of medical causes, one hundred two(38.5%) cardiogenic and ninety two(34.7%) non-cardiogenic, and seventy(26.4%) patients died of traumatic causes. Initial EKG showed VT/VF(ventricular tachycardia/ventricular fibrillation) in thirty one(11.7%) patients, asystole in one hundred fifty one(57.0%) patients and other rhythms in eighty three(31.3%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. CONCLUSION: Overall survival rate of out-of-hospital cardiac angst patients was 3% which was poorer than that of the western country. The proportion of the cardiogenic cause was 3% which was only hart of the western country. VT/VF is relatively not common as a initial EKG rhythm. These differences might be due to difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS.
Cardiopulmonary Resuscitation ; Electrocardiography ; Female ; Heart Arrest ; Humans ; Incheon ; Korea ; Out-of-Hospital Cardiac Arrest* ; Prevalence ; Seoul ; Survival Rate

BACKGROUND: Urography(IVU) is considered the best first investigation in patient with suspected urinary calculi, but recently ultrasonography(USG), combined with a plain film of the abdomen, has been suggested as an alternative. METHODS: We undertaken study to see if this approch can be used in emergency patients and outpatients by radiologists with different amounts of ultrasound experence. Some 192 patients with suspected urinary colic presenting to Koo Hospital Emergency Department and Youngnam Universith Hospital outward Department(IM, URO, FM) over 12-month period were studied. They had a plain abdominal film(KUB) and USG examination of the kidney, ureter, bladder following hydration and subsequently underwent IVU. Of these, 22 patients passed a stone before their IVU. The data analysis was performed on the remaining 170 patients. Urography was used as the gold standard. RESULTS: Some 170 patients subsequently underwent IVU at a mean interval of 1.8 days after the ultrasound examination. In 91 of 170 patients the IVU was positive. In 97 of 170 patients the combination of JUB plus USG was positive, leaving three false negative KUB plus USG. Thus the sensitivity of KUB plus USG was 97%, specificity was 89%, positive predictive value was 91%, and negative predictive value was 96%. CONCLUSIONS: Our findings in this study suggest that in the hydrated patient the combination of KUB plus US is a very sensitive and relative specific screening test. Because of the high negative predictive value of KUB plus US, urography is not likely to be helpful when KUB plus US are negative. Urography is indicated only if KUB plus US findings are equivocal or if intervention is necessa.ry.
Abdomen ; Colic ; Emergencies ; Emergency Service, Hospital ; Humans ; Kidney ; Mass Screening ; Outpatients ; Sensitivity and Specificity ; Statistics as Topic ; Ultrasonography* ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urography*

No abstract available.
Fractures, Open* ; Tibia*

The femoral neck in children is dense and is small in diameter and its periosteum is thicker and stronger than that of an adult. Thus, fractures of the femoral neck in children, unlike the 60-year-old woman, are rare and usually require severe violence and this accounts for the high frequency of associated injuries. Since these fractures are rare and the femoral neck in children has many anatomic and physiologic differences, we have to consider some factors that work against treatment of these fractures. Twenty seven cases of fractures of the femoral neck in children which were treated at Severance Hospital, Yonsei University College of Mediicne from Jan. 1971 to Dec. 1980 were analyzed both clinically and radiologically and the following results were obtained. 1. Among the 27 patients, the ratio of boys and girls was 2:1 and the highest incidence was between the ages of 3 and 5 years. 2. The main course of fractures was traffic accidents, 14 cases (51.9%) and the other causes were falling from a height (37.0%) and a few cases of a slip and a fall. 3. According to the classification of Delbet and Colonna, the cervico-trochanteric fracture (40.8%) was the commonest type and 13 cases (48.1%) were displaced fractures. 4. Common associated injuries were pelvic bone fractures, skull fractures, cerebral concussion and soft tissue injuries. 5. Fifteen cases (55.6%) were treated by conservative treatment and ten cases (37.0%) by closed reduction & internal fixation. 6. 23 of the 27 cases were followed for from 6 months to 10 years, average 19 months. The results were analyzed according to Ratliffs assessment and 14 cases (60.9%) showed good results. 7. Total cases with complications were 14 (60.9%), the commonest complication being coxa vara (40.8%) and the other main complications being premature epiphyseal closure (39.1%) and avascular necrosis (30.1%). 8. Secondary treatment was done in 6 cases and correction osteotomy was done in 4 cases which had showed a poor result. 9. Finally, factors affecting results were type of fracture, degree of displacement, maintenance of reduction, interval between injury and treatment, complications and patients age. 10. The authors recommend closed reduction and internal fixation with some threaded pins for all type II and type III fractures.
Accidental Falls ; Accidents, Traffic ; Adult ; Brain Concussion ; Child ; Classification ; Clinical Study ; Coxa Vara ; Female ; Femur Neck ; Humans ; Incidence ; Middle Aged ; Necrosis ; Osteotomy ; Pelvic Bones ; Periosteum ; Skull Fractures ; Soft Tissue Injuries ; Violence

We had a female patient with soft tissue tumor involving large portion of Achilles tendon. After resection of tumor, Achilles tendon was reconstructed using an allogenic human fascia lata manufactured by Pfrimmer-Viggo. EMG findings on postoperative 8 months show marked improvement of function of medial and lateral gastrocnemius muscles. Biopsy specimen of fascia lata allograft, which was acquired during TAL 8 months postoperatively, shows myxoid degeneration, a few lymphocytic infiltration and some foreign body giant cells. Functional, histologic and EMG findings suggest that human fascia lata allograft could be used to bridge defect of Achilles tendon being resected during tumor surgery.
Achilles Tendon ; Allografts ; Biopsy ; Fascia Lata ; Fascia ; Female ; Giant Cells, Foreign-Body ; Humans ; Muscles