Chordoma arising from the notochordal remnants is a rare primary bone tumor in the cervicosacral region and is even more unusual in the thoracic region. The authors experienced a case of thoracic chordoma and report its CT and MR findings.
Chordoma* ; Notochord

Chordoma arising from the notochordal remnants is a rare primary bone tumor in the cervicosacral region and is even more unusual in the thoracic region. The authors experienced a case of thoracic chordoma and report its CT and MR findings.
Chordoma* ; Notochord

No abstract available.
Animals ; Locomotion* ; Rats* ; Spinal Cord Injuries* ; Spinal Cord*

Isolated fourth ventricle(IFV) is a rare entity producing symptoms of a progressive posterior fossa mass lesion. It is mainly reported in a patient who undergo shunt placement as its late complication. However, its surgical management has been difficult and its optional treatment remains controversial. We had an occasion to admit 19-year-old female to our hospital due to hydrocephalus: she had a history of meningitis when she was 2 years old. Ten years later, she was diagnosed as hydrocephalus and managed by lateral ventriculo-peritoneal shunting procedure. Seven years after the procedure, the patient presented with headache, nausea, truncal ataxia and nystagmus. Computed tomography and magnetic resonance image scan demonstrated markedly enlarged fourth ventricle: and thus, neuroendoscopic aqueductoplasty and aqueductal stent insertion was performed. The authors present a case of an IFV after lateral ventriculo-peritoneal shunting for hydrocephalus, which was treated successfully with a neuroendoscopic surgery. The technique of this procedure is described below.
Ataxia ; Child, Preschool ; Female ; Fourth Ventricle* ; Headache ; Humans ; Hydrocephalus ; Meningitis ; Nausea ; Stents* ; Ventriculoperitoneal Shunt ; Young Adult

Anticoagulant(heparin, warfarin) or thrombolytic agent(urokinase, tissue plasminogen activator) can be one of the causes of spontaneous ICH. Even though ICH related with anticoagulants and thrombolytic agents represent low incidence and slow progression, the final outcome usually very poor. Recently the use of anticoagulants and thrombolytic agents have been increased for recanalization of cerebral and myocardial infarction. Therefore, the importance of possible ICHs related to these agents need to be reemphesized. The authors analysed 18 patients of ICH related with anticoagulants and thrombolytic agents to evaluate the underlying mechanism, their characters, the factors which influence the formation of ICH and the prognosis. Eighteen cases of ICH related with anticoagulants and thrombolytic agents were analysed through the medical record, operation record and brain CT. In this study, patients in sixth decade showed the highest incidence. The most common primary disease was middle cerebral infarction(67%). Urokinase was most commonly infused for recanalization of cerebral and myocardial infarction. The mean duration between drug administration and hemorrhagic attack was 59 hours(with range from 1 hour to 96 hours). After onset of the hemorrhage, fourteen of eighteen cases revealed prolonged prothrombin time more than 1 1/2 to 2 times of control and nine of fourteen cases revealed prolonged thrombin time more than 1 1/2 to 2 times of cotrol. The mean volume of ICH was 31cc and locations of hemorrhage were lobar(45%), ganglionic(22%), thalamic(22%) and cerebellar(11%) in decreasing orders. Brain CT scans revealed that 12 cases were single hematoma and 6 cases were multiple hematoma. Twelve cases were treated conservatively and six cases were operated with stereotactic surgery(3 cases) and open craniotomy (3 cases). One case with stereotactic surgery and the other case with craniotomy were reoperated because of rebleeding and retained hematoma, respectively. The neurological condition before administration of anticoagulants and thromb-olytic agents was relatively good, but suddenly deteriorated after hemorrhage attack. Almost all cases(94%) prese-nted poor porgnosis as wholly dependent, vegetative and dead at discharge except one case of small cerebellar ICH. In this study, previously existed infarction and anticoagulants itself contributed to the occurrence of intracerebral hemorrhage. The prolonged prothrombin time may be useful predictable value in the formation of ICH. Although we could not find definitive factors to influence the prognosis, the mortality rate of multiple hematoma was much higher than single hematoma. The final outcome of these patients were very poor. Therefore, the choice of agents, dosage and duration of administration should be considered more judicious.
Anticoagulants* ; Brain ; Cerebral Hemorrhage* ; Craniotomy ; Fibrinolytic Agents* ; Hematoma ; Hemorrhage ; Humans ; Incidence ; Infarction ; Medical Records ; Mortality ; Myocardial Infarction ; Plasminogen ; Prognosis ; Prothrombin Time ; Thrombin Time ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator

The antihypertensive effect and side reactions of perdipine were evaluated in 30 patients with essential hypertension. The results were as follows; 1) Before medication and after 2, 4, 5 and 8 weeks of medication, the over all average systolic and diastolic blood pressure were 170+/-13/104+/-7, 152+/-13/93+/-6, 146+/-11/91+/-6, 143+/-9/90+/-7, and 141+/-10/89+/-7mmHg, respectively. In 89% of all cases, marked or moderate degree of antihypertensive effect was observed. 2) There were no significant changes in heart rates before and after treatment. 3) In 83% of all cases, improvement of symptoms were observed. 4) The side reactions of oral perdipine were mild constipation, anorexia, facial flushing, dizziness, and headache, respectively one case. but there were no side reactions which required discontinuing the treatment, except 1 case which discontinued the medication because of severe bradycardia and dizziness.
Anorexia ; Blood Pressure ; Bradycardia ; Constipation ; Dizziness ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension ; Nicardipine*

OBJECTIVE: To document the neurological recovery of the preganglionic lesion of brachial plexus, both clinically and electrodiagnostically. METHOD: Sixteen male and three female patients were evaluated. Ages of the patients ranged from 1 to 45 years with the mean age of 25.2+/-14.3 years. We studied retrospectively the improvements of 43 injured nerves and its innervated muscles of 19 patients retrospectively according to the complete or incomplete nature of the injuries by the electromyographic findings. We compred the results of initial and final examinations by the electromyographic and clinical findings including a muscle strength test. RESULTS: In the complete injuries, 84.0% of the cases showed a minimal or no improvement in muscle strength whereas in the incomplete injuries, 88.2% of the cases showed a greater than moderate improvement in muscle strength. The cases in which no compound muscle action potential could be evoked on the initial study, showed the improvements of greater than 3/5 muscle strength only in 20.0%. However 71.5% of cases with the initial amplitude between 0.1 & 0.5 mV and 100.0% of cases with the initial amplitude greater than 0.5 mV showed the muscle strength greater than 3/5. CONCLUSION: The prognosis for the neurological recovery was significantly poor in the complete preganglionic lesions of brachial plexus injuries but in the incomplete lesions, the prognosis was extremely good. It would be crucial for the initial CMAP being greater than 0.5 mV to expect the recovery of muscle strength to the functional level. Rehabilitative or operative management should be instituted based on the electrodiagnostic findings.
Action Potentials ; Brachial Plexus Neuropathies ; Brachial Plexus* ; Electrodiagnosis* ; Female ; Humans ; Male ; Muscle Strength ; Muscles ; Prognosis* ; Retrospective Studies

Propofol is widely used for supportive sedation in local and regional anaesthesia in plastic surgical procedure. We studied comparative effect of propofol comparing fontanel and midazolam that was previously used. From April 2003 to July 2005, 118 patients were reviewed whom propofol was used intravenous sedation in various plastic surgical procedures. In some cases, midazolam were used initially then converted to propofol. Patients were questioned for their satisfaction in group of propofol alone and midazoline and propofol combination. Vital sign(Blood pressure, Respiration rate) and O2 saturaion, sedation time, side effect and subjective satisfaction were evaluated. The result reveals that propofol is effective medicine for supplement intravenous sedative medicine for plastic surgeries especially when it was used with combination of midazolam.
Humans ; Midazolam ; Propofol* ; Respiration ; Surgery, Plastic*

OBJECTIVES: Because shipyard workers are involved with various manufacturing process, they are exposed to many kinds of hazardous materials. Welders especially, are exposed to bisphenol-A (BPA) during the welding and flame cutting of coated steel. This study was conducted to assess the exposure status of the endocrine disruptor based on the job-exposure matrix. The effects of the genetic polymorphism of xenobiotic enzyme metabolisms involved in the metabolism of BPA on the levels of urinary metabolite were investigated. METHODS: The study population was recruited from a shipyard company in the K province. A total of 84 shipbuilding workers 47 and 37 in the exposed and control groups, respectively, were recruited for this study. The questionnaire variables included, age, sex, use of personal protective equipment, smoking, drinking and work duration. The urinary metabolite was collected in the afternoon and correction made for the urinary creatinine concentration. The of the CYP1A1, CYP2E1 and UGT1A6 genotypes were investigated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods with the DNA extracted from venous blood. RESULTS: The urinary BPA level in the welders group was significantly higher than in the control group (p< 0.05). The urinary BPA concentration with the wild type UGT1A6 was higher than the other UGT1A6 genotypes, but with no statistical significant. From themultiple regression analysis of the urinary BPA, the regression coefficient for job grade was statistically significant (p< 0.05). CONCLUSIONS: The grade of exposure to BPA affected the urinary BPA concentration was statistically significant. However, the genetic polymorphisms of xenobiotics enzyme metabolism were not statistically significant. Further investigation of the genetic polymorphisms with a larger sample size is needed.
Biomarkers* ; Creatinine ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2E1 ; DNA ; Drinking ; Genotype ; Hazardous Substances ; Metabolism ; Personal Protective Equipment ; Polymorphism, Genetic ; Sample Size ; Smoke ; Smoking ; Steel ; Welding ; Xenobiotics

The piercing is increasing in western culture, and has also become gradually popular among Korean teenagers recently However, the accident happens sometimes such as loss of a bar into the tongue or mouth floor during the procedure. Because of the rare cases, few treatment of choices can be made when a bar is lost inside the mouth floor. In this case, the bar was removed under fluoroscope, without giving significant damage to the adjacent structure. 18 years old female patient visited the emergency room in our hospital. She attempted to pierce her tongue herself and could not find the bar which was lost in the mouth floor. The radiographs revealed that the needle was somewhere inside the mouth floor, but if incision were to be made it would be too deep to find the bar. The bar was reomoved through fluoroscope easily. Primary closure was done by 5-0 Vicryl and stitch-off was done 1 week later. The patient didn't have any speech problems and complications.
Adolescent ; Emergencies ; Female ; Fluoroscopy ; Humans ; Mouth ; Mouth Floor ; Needles ; Polyglactin 910 ; Tongue