Temporal arteritis is one of the most important causes of headache. If it is not recognized properly, patients might get werious complications such as blindness or stroke. Hence, early diagnosis and treatment with steroid are critical While temporal arteritis is frequently seen in western countries, it seems to be rare in Korea and is not reported in Korean literatures except one case report of the giant cell arteritis of the breast (1991). We report two patients, 66 and 75 years old males, who presented with 3 months history of throbbing headache in temporal regions. Erythrocyte sedimentation rate was accelerated in both cases. Superficial temporal artery was biopsied to reveal intimalthickening, elastic lamina fragmentation and a mild inflammatory cell infiltration. The patients responded dramatically to steroid therapy.
Aged ; Blindness ; Blood Sedimentation ; Breast ; Early Diagnosis ; Giant Cell Arteritis* ; Headache ; Humans ; Korea ; Male ; Stroke ; Temporal Arteries

No abstract available.
Scimitar Syndrome*

Since early 1980's high resolution ultrasound has been world-widely used for detection of cranial lesions ininfants but not widely used in korea. Authors prospectively analysed ultrasonographic findings of 107 cases whichwere confirmed by CT, autopsy or follow-up studies as supplement. the distribution of 107 cases was intracranialhematoma 40 cases, hydrocephalus 36 cases, hypoxic-ischemic encephalopathy 10 cases, porencephalic cyst 5 cases,cephalhematoma 5 cases, agenesis of corpus callosum 4 cases, medulloblastoma 2 cases and each one case of A-Vmalformation, intraventricular cyst, Dandy Walker cyst, lipoma and hydranecephaly. We could conclude thatneurosonography of infants was very useful and effective method in detection of cranial lesions such asintracranial hematoma, especially germinal matrix hemorrhage or intraventricular hemorrhage in preterm infant,hydrocephalus, hypoxic-ischemic encephalopathy and congenital anomalies.
Agenesis of Corpus Callosum ; Autopsy ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypoxia-Ischemia, Brain ; Infant ; Korea ; Lipoma ; Medulloblastoma ; Methods ; Prospective Studies ; Ultrasonography ; Walkers

Vertebral hemangioma is a slow-growing tumor which involves the vertebral body only. It is usually discovered incidentally on lateral radiographs of the spine and only rarely symptomatic. Compression of the spinal cord due to vertebral hemangioma is very rare. The authors report a patient who developed a progressive paraplegia and sensory change clinically resembling an intramedullary spinal cord tumor. Simple spine film gave us a hint that there was a vertebral hemangioma at T-5, but the clinical correlation was uncertain until spinal cord compression was demonstrated by MRI and the symptoms improved with operation. Selective angiography was normal. The histologic diagnosis was a cavernous hemangiona. As there was no associated spinal cord vascular malformation visualized during operation, her clinical presentation mimicking intramedullary spinal cord tumor was atypical one of compressive extramedullary mass. Following surgical excision, the patient improved dramatically and was discharged with only a residual hyperalgesia below the T-10 dermatome.
Angiography ; Diagnosis ; Hemangioma* ; Humans ; Hyperalgesia ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Neoplasms ; Spine ; Vascular Malformations

From Mar. 1985 to Dec. 1992, 170 cases of osteosarcoma, which were proved histologically were admitted in our department at least one time. Among them we analysed 89 cases of Ennekings stage IIB who took limb-salvage(54) or amputation(35) and followed our protocol, with non-randomized retrospective study. The average age of the 89 patiens was 17.0 years(7 to 57). Fifty-four cases of salvage group took neoadjuvant chemotherapy, 35 cases of amputation group took neoadjuvant or adjuvant chemotherapy. The result revealed prevalences of 2/54, 0/35 as to local recurrence; 15 of 54, 17 of 35 as to metastasis; 14 of 54, 15 of 35 as to death. Of the 2 patients who had a local recurrence, one died of metastasis and the other was lost follow up. According to Kaplan-Meier's plot 5-year continuously disease free survival rate for whole 89 cases of stage IIB was 43.1%, for salvage group 56.4%, for amputation group 34.0%. There were no signifcant difference in survival rate between salvage and amputation groups(p>0.05, by log-rank test). This result means the limb-salvage operation for Enneking's stage IIB osteosarcoma does not hinder patients survival.
Amputation ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteosarcoma ; Prevalence ; Recurrence ; Retrospective Studies ; Survival Rate

So far with the advancement in treatment modalities for malignant bone and soft tissue sarcomas the survival rate become higher. Till now there are some questions who can survive. Temporary procedure not affecting the treatment schedule would have more advantages than primary permanent one. When there is higher possibility of survival, this can be switched to permanent one. From Dec. 1986 to Jan. 1994, we had performed 40 cases of temporary arthrodesis after segmental resection of malignant bone and soft tissure tumors around the knee by using intramedullary nail andbone cement. Thirty eight cases of bone tumors[osteosarcoma(33), malignant fibrous histiocytoma(MFH)(3), chondrosarcoma(1), Ewing's sarcoma(1)] and 2 cases of soft tissue sarcomas[MFH(1), squamous cell carcinoma(1)] were analysed. Types of intramedullary nail used were rigid(Huckstep, 23 cases) or flexible(Ender, 17 cases). Six cases(15%) showed mechanical implant failure due to fracture (Huckstep;5, Ender;1) between 2 to 20 months after operation. Rearthrodesis using Ender nail and bone cement(5) or arthroplasty using Kotz prosthesis(1) were done for fractured cases. The other complicaitons were deep infection(2), peroneal nerve palsy(2), or transfixing screw fracture(2). Second reconstruction procedure was carried out in 2 cases with arthroplasty using Kotz prothesis. For IM nail, multiple Ender nailing seems to be superior to the Huckstep in mechanical strength. Contrary to the primary permanent reconsturction of the bone defect, this procedure has several advantages: 1) simple and does not hinder postoperative chemotherapy, 2) even in the extensively involved cases, can save the limb if the neurovascular structures are spared, 3) in Stage III, can save the salvagable limb, 4) economic and immediate stability can be helpful in the patient's quality of life, 5) two years later, when the survival approaches plateau, we can switch to another kinds of salvage operation, 6) Ender nail was superior to Huckstep in mechanical stability, 7) can be used for children expecting leg lengthening near puberty. It is useful for sarcoma patients around knee who require prolonged chemotherapy anbd whose life expectancy is relatively unexpectable.
Adolescent ; Appointments and Schedules ; Arthrodesis ; Arthroplasty ; Child ; Drug Therapy ; Epithelial Cells ; Extremities ; Humans ; Knee ; Leg ; Life Expectancy ; Peroneal Nerve ; Puberty ; Quality of Life ; Sarcoma ; Survival Rate

No abstract available.

Dermatomyositis is a severe, idiopathic systemic disorder with predominant involvement of skin and skeletal muscle. The association of adult dermatomyositis and malignancy in particular has generated much attention. The reported prevalence of cancers in this disease varies from 6.7% to 52.2%. We experienced a concurrent case of transverse colon cancer and dermatomyositis on 67 year old female patient and report with review of literatures.
Adult ; Aged ; Colon* ; Colon, Transverse ; Colonic Neoplasms* ; Dermatomyositis* ; Female ; Humans ; Muscle, Skeletal ; Prevalence ; Skin

PURPOSE: We analyzed the clinical outcome of osteosarcoma developed in distal radius and the effect of delayed treatment on prognosis. MATERIALS AND METHODS: Twelve patients with distal radius osteosarcoma were analysed. We categorized patients into two groups of standard treatment or non-standard treatment. The patients of standard treatment group are all stage IIB and non-standard treatment group includes five stage IIB and one stage III. RESULTS: Five-year overall survival and disease-free survival rates of standard treatment group were 100% and 83%. Five-year overall survival rate of non-standard treatment group was 44%. Between two group, there are differences in age, tumor size, surgery type, symptom duration. CONCLUSION: Distal radius osteosarcoma have good prognosis than other extremity osteosarcoma. Survival rate of non-standard treatment group were lower than standard treatment group. Although the prognosis of non standard treatment group is poorer, the duration till death was longer than that of other sites with similar condition. Further multi-institutional study should be needed.
Disease-Free Survival ; Extremities ; Humans ; Osteosarcoma ; Prognosis ; Radius ; Survival Rate

PURPOSE: We wanted to objectively evaluate the anatomy of the neonatal brain on ultrasound images, and so we reconstructed several oblique magnetic resonance images that corresponded with the oblique ultrasound images by using MRI and a multiplanar reconstruction program. MATERIALS AND METHODS: MRI 3D-SPGR axial scans of the brain were performed for two neonates and then we obtained the reconstructed MR images that were parallel with the direction of the sonographic oblique scanning plane. We made the anatomic models of the neonatal cranial ultrasound images by using axial MRI as the standard reference on the same screen. RESULTS: We created an anatomic atlas, with the representative six oblique coronal scans and six oblique sagittal scans that corresponded to the neonatal brain ultrasound images. CONCLUSION: This objective anatomic research with using MRI and a multiplanar reconstruction program for creating the ultrasound oblique brain images of a neonate will be very helpful for evaluating the ultrasonographic anatomy and to apply it to clinical practice.
Brain ; Humans ; Infant, Newborn ; Magnetic Resonance Spectroscopy ; Models, Anatomic