The clear cell variant of ependymoma is a rare, recently described, intracranial tumor which is composed of clear neoplastic ependymal cells. Clear cell ependymomas may share characteristic histologic features of oligodendrogliomas or central neurocytomas; striking nuclear uniformity, perinuclear halos, and numerous angulated capillaries. In contrast to oligodendrogliomas, however, clear cell ependymomas are noninfiltrating tumors with sharp boundaries. Perivascular pseudorosette formation is frequent. Oligodendrogliomas are usually nonreactive for GFAP compared to diffuse immunoreactivity of clear cell ependymoma. Central neurocytomas may also be differentiated by their immunoreactivity for synaptophysin. This is a case of clear cell ependymoma in a 40-year-old man. By computed tomography and magnetic resonance imaging scans, a well circumscribed cystic tumor with mural nodule was demonstrated in the right frontal lobe. It was 6cm in diameter and well enhanced. Histologically, it was sharply demarcated from the brain parenchyma. The cystic wall was lined by atypical ependymal cells, which "transformed" to clear cells in the solid area. The cells had uniform nuclei and perinuclear halos. Mitotic figures and necrotic foci were focally present. The cells were immunoreactive for glial fibrillary acidic protein (GFAP), while synaptophysin was negative. Electron microscopy revealed densely packed polyheadral cells with scant organelles and well developed intercellular junctions.
Adult ; Brain ; Capillaries ; Ependymoma* ; Frontal Lobe ; Glial Fibrillary Acidic Protein ; Humans ; Intercellular Junctions ; Magnetic Resonance Imaging ; Microscopy, Electron ; Neurocytoma ; Oligodendroglioma ; Organelles ; Strikes, Employee ; Synaptophysin

BACKGROUND: We assessed the effectiveness of arthroscopic capsular release for the treatment of adhesive capsulitis. Further, we tried to ascertain the clinical benefits, if any, of pancapsular release over selective capsular release, where the two differ by performing or not performing a posterior capsular release, respectively. METHODS: Thirty-five consecutive patients with either primary or secondary adhesive capsulitis who failed conservative treatment for more than 6 months were enrolled in the study. A total of 16 patients allocated in group 1 received a pancapsular release that comprises the release of the rotator interval, anteroinferior capsular, and the posterior capsular release, whereas 19 patients in group 2 received a selective capsular release that comprises only the release of the rotator interval release and anteroinferior capsular release. The clinical outcomes, visual analogue scale (VAS) score, Constant score, and range of motion, were assessed preoperative and postoperatively. RESULTS: In both groups, the preoperative VAS score, Constant score, and ROM showed a significant improvement by the 6-month follow-up. We found that the immediate postoperative internal rotation was significantly higher in group 1 than group 2. Despite significant differences seen between the two groups at the initial postoperative period, there were no significant differences in Constant score, VAS score, and the ROM at all the subsequent follow-ups between the two groups. CONCLUSIONS: Arthroscopic capsular release for the treatment of adhesive capsulitis is very effective. However, pancapsular release did not show any advantage over selective capsular release in terms of overall clinical outcome.
Bursitis* ; Follow-Up Studies ; Humans ; Joint Capsule Release* ; Postoperative Period ; Range of Motion, Articular

A full understanding of the potential anatomical variations of the renal veins and its branches is imperative for donor nephrectomies. Preoperative renal angiography is the most important study to evaluate renal vascular anatomy. By this technique. the renal arteries are well visualized. but it is almost impossible to obtain the exact informations of the renal veins and its branches. To prevent extensive manipulation of the kidney by profuse bleeding. the exact information of the renal veins and its branches is very important. Based on intraoperative observation of 240 consecutive cases of donor nephrectomies. we observett. the common renal vein variants. Left renal veins usually had two branches; adrenal vein proximally and gonadal vein distally. Lumbar veins were identified in 112 cases(56.7%) Lumbar veins were connected to renal veins posteriorly near the draining site of gonadal veins. Therefore it is very important to dissect very carefully the posterior part of renal vein around the insertion of gonadal vein because of the existence of lumbar vein which might cause troublsome bleeding by accidental tearing. Especially when the cases of angulated renal veins were observed by renal angiography. the more attention will be required due to the strong possibility or the existence of lumbar vein.
Angiography ; Gonads ; Hemorrhage ; Humans ; Kidney ; Nephrectomy* ; Renal Artery ; Renal Veins ; Tissue Donors ; Veins

BACKGROUND: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures. METHODS: Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group. RESULTS: The α angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of γ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively). CONCLUSIONS: No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).
Humans ; Humeral Fractures ; Humerus* ; Reference Values

Carotid endarterectomy is superior to medical treatment in preventing secondary stroke in patients with symptomatic high grade carotid stenosis. Transluminal angioplasty is a promising procedure as an alternative treatment for these patients. We report two cases of carotid angioplasty with Palmaz-Schatz stent in patients with carotid artery occlusive disease. One patient presented with decreased right visual acuity because of retinal arterial embolism. The angiogram demonstrated a discrete tight stenosis of right internal carotid artery carotid stenting with Palmaz-Schatz coronary stent was performed without any significant complications. The other patient presented with recurrent episodes of cerebral infarction, for which he had undergone left carotid erdarterectomy 3-years ago. The carotid angiogram demonstrated tight stenoses of both internal carotid arteries. Carotid artery stenting was performed at left and right internal carotid arteries without any complications. We suggest that stenting may be an effective and safe therapeutic alternative to surgical treatment in some selected patients with carotid artery occlusive disease.
Angioplasty* ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Cerebral Infarction ; Constriction, Pathologic ; Embolism ; Endarterectomy, Carotid ; Humans ; Retinaldehyde ; Stents* ; Stroke ; Visual Acuity

Trichorhinophalangeal syndrome is a genetic disease and divided into three differen types. Trichorhinophalangeal syndrome type I is characterixed by alopecia, a bulbous pear-shaped nose and cone-shaped epiphyses in the hand. Diverse clinical manifestations can be observed such as short stature, mandibular abnormality, winged scapula, etc. It is inherited in an autosomal manner, and may cause grave joint abnormalities which should be corrected early in life. We describe a 23-year-old woman with diverse clinical manifestations of trichorhinophalangeal syndrome type I, including prognathism and a winged scapula, two features which have not been previously described in the Korean literature.
Alopecia ; Epiphyses ; Female ; Hand ; Humans ; Joints ; Nose ; Prognathism ; Scapula ; Young Adult

We treated 160 patients with ureteral stones using extracorporeal shock wave lithotripsy (Siemens Lithostar, Germany) and evaluated many factors which influence the results of ESWL such as stone size, location, degree of ureteral obstruction. duration of impaction and adjuvant procedure. Our results showed that. in case of large stones (more than 1 cm in diameter), mid-ureteral stones, long-standing impacted stones or in-situ treatment, the success rates of ESWL were relatively poor. Therefore in cases accompanying the above-mentioned factors, in is necestary to recognize that the patients may be required to repeat ESWL. The results also suggest that the use of an ureteral catheter or stent may contribute to a slightly higher success rate. But we prefer in-situ extracorporeal shock wave lithotripsy to an ureteral stent because it is an invasive procedure.
Humans ; Lithotripsy* ; Shock* ; Stents ; Ureter* ; Ureteral Obstruction ; Urinary Catheters

No abstract available.
Pulmonary Edema*

Adrenal cortical carcinoma is a rare disease both in adults and in children. Most of these tumors are functional, especially in children, producing endocrine syndromes such as virilization, Cushing syndrome, hyperaldosteronism or feminization. We experienced a case of adrenal cortical carcinoma in a 7yr old boy who showed features of virilization such as rapid growth rate, penile enlargement, and pubic hair. This case was diagnosed with typical hormonal findings and abdominal MRI and confirmed by pathologic findings. He was successfully treated by total left adrenalectomy and has been followed up without problem over eight months.
Adrenalectomy ; Adrenocortical Carcinoma* ; Adult ; Child ; Cushing Syndrome ; Feminization ; Hair ; Humans ; Hyperaldosteronism ; Magnetic Resonance Imaging ; Male ; Rare Diseases ; Virilism

No abstract available.
Dislocations* ; Head* ; Hip* ; Necrosis*