The variations of the sigmoid sinus were studied in 50 Korean adults (average age 67). The classification of the shape and a measurement of the diameters of the sinus were done and the morpological. 1. The shape was classified into 4 types, and the round type was the most common in both sides. S shaped type was below 10% in both sides. 2. The breadth was regular in 54% of the right and in 70% of the left sinuses. According to the breadth change, the shape was classified into 4 shapes. 3. The average diameter was 8.6mm on the right side and 7.2mm on the left side. 4. Symmetry was present in 16% of all. 5. The right transverse sinus was absent in 1 case (2%) and the superior petrosal sinus did not open into the sigmoid sinus in 2 cases (4%). 6. Petrosqamous sinus was observed in 16%.
Adult* ; Classification ; Colon, Sigmoid* ; Humans

Posterior capsule opacification(PCO) is a common complication of cataract surgery. The presence of a posterior chamber intraocular lens has been shown to decrease the incidence of the development of PCO. Moreover, there are evidences that the design of intraocular lens may also alter its development. Extracapsular lens extraction with implantation of posterior chamber lens were operated on a consecutive series of 230 eyes. These were evaluated in the viewpoint of PCO development after surgery. All were sulcus fixed and their optic designs were devided into two groups; a group of convex-plano lens with continuous laser ridge including convex-concave lens and a group of biconvex lens. The incidence of PCO was lower in convex-plano lens with continuous laser ridge group(6.7%) than that of boconvex lens group(18.9%). The incidence of Nd:YAG posterior capsulotomy marked 0.0% in continuous ridged group and 1.8% in biconvex group(p<0.05, p Capsule Opacification* ; Cataract ; Incidence ; Lenses, Intraocular* ; Posterior Capsulotomy

No abstract available.
Tibia*

Craniometaphyseal Dysplasia is characterized by hyperostosis of craniofacial bones, with compression of cranial nerves at the foramina, and by changes in the metaphyses of long bones. The changes in long bones resemble to some degree those seen in pyle's disease, but have cretain differences and significant cranial abnormalities with which differential diagnosis could be made with certainty. An interesting and unusual patient diagnosed Craniometaphyseal Dysplasia was recently experienced by authors. The case report with brief review of literstures in presented.
Cranial Nerves ; Diagnosis, Differential ; Humans ; Hyperostosis

Although procedures to reproduce the lost thumb through osteoplastic reconstruction and adjacent finger transfer operations appeared reasonably successful in providing for better prehension, nonetheless the methods lacked predictabiiity and too often the results were unacceptable esthetically. In recent years the development of microsurgery and surgical experiences has made it possible to free one stage transplantation of toe to replace missing thumb. Based on our past experiences with limb replantation since 1975, we accomplished the first toe to thumb transplantation done in Korea on October 28, 1978. Therafter we succeeded in one stage toe-to-thumb transplanatation in five cases. The shortest follow up period was thirteen months, and the longest, twenty-three months. One cases was excluded in this report due to short follow up period. Excellent results were achieved in all cases. There were no limping or pain while walking after removal of great toes or second toe. Great toe transplantation is more favorable donor area than second toe in toe-to-thumb transplantation. Free toe-to-thumb transplantation on making a thumb in missing thumb is the most excellent method of thumb reconstruction, but skillful technique and specialized microsurgical training is mandatory.
Extremities ; Fingers ; Follow-Up Studies ; Humans ; Korea ; Methods ; Microsurgery ; Replantation ; Thumb ; Tissue Donors ; Toes ; Transplantation ; Walking

Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy.
Accessory Nerve* ; Cerebellar Ataxia ; Electromyography ; Female ; Hoarseness ; Humans ; Hypesthesia ; Intracranial Hypertension ; Middle Aged ; Needles ; Neurilemmoma* ; Spinal Cord Diseases ; Spinal Nerve Roots

Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.
Aged ; Astrocytoma ; Basal Ganglia ; Basal Ganglia Hemorrhage ; Biopsy ; Brain ; Brain Neoplasms ; Cerebral Hemorrhage ; Dysarthria ; Female ; Gadolinium ; Glioma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Intracranial Hemorrhage, Hypertensive ; Magnetic Resonance Imaging ; Paresis ; Ventriculoperitoneal Shunt

The aneurysm arising from fenestrated proximal anterior cerebral artery (ACA) is considered to be unique. The authors report a case of a 59-year-old woman who presented with a subarachnoid hemorrhage (SAH) secondary to a ruptured aneurysm originating from the fenestrated A1 segment of right ACA. The patient had another unruptured aneurysm which was located at the right middle cerebral artery bifurcation. She was successfully treated with surgical clipping for both aneurysms. From the previously existing literatures, we found 18 more cases (1983-2011) of aneurysms associated with fenestrated A1 segment. All cases represented saccular type of aneurysms, and 79% of the patients had SAH. There were three subtypes of the fenestrated A1 aneurysms depending on the anatomical location, relative to the fenestrated segment. The most common type was the aneurysms located on the proximal end of fenestrated artery (82%). Azygos ACA and hypoplastic A1 were frequently accompanied by the aneurysm (33% and 31%, respectively), and multiple aneurysms were shown in three cases (16%). Considering that fenestrated A1 segment is likely to develop an aneurysm, which has high risk of rupture, early management may benefit patients with aneurysms accompanied by fenestrated proximal ACA.
Aneurysm ; Aneurysm, Ruptured ; Anterior Cerebral Artery ; Arteries ; Female ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Rupture ; Subarachnoid Hemorrhage ; Surgical Instruments

OBJECTIVE: The prefabrication of customized cranioplastic implants has been introduced to overcome the difficulties of intra-operative implant molding. The authors present a new technique, which consists of the prefabrication of implant molds using three-dimensional (3D) printers and polymethyl-methacrylate (PMMA) casting. METHODS: A total of 16 patients with large skull defects (>100 cm2) underwent cranioplasty between November 2009 and April 2011. For unilateral cranial defects, 3D images of the skull were obtained from preoperative axial 1-mm spiral computed tomography (CT) scans. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of the cranium as a model. For bilateral cranial defects, precraniectomy routine spiral CT scan data were merged with postcraniectomy 3D CT images following a smoothing process. Prefabrication of the mold was performed by the 3D printer. Intraoperatively, the PMMA implant was created with the prefabricated mold, and fit into the cranial defect. RESULTS: The median operation time was 184.36+/-26.07 minutes. Postoperative CT scans showed excellent restoration of the symmetrical contours and curvature of the cranium in all cases. The median follow-up period was 23 months (range, 14-28 months). Postoperative infection was developed in one case (6.2%) who had an open wound defect previously. CONCLUSION: Customized cranioplasty PMMA implants using 3D printer may be a useful technique for the reconstruction of various cranial defects.
Computer-Aided Design ; Decompressive Craniectomy ; Follow-Up Studies ; Fungi ; Humans ; Methylmethacrylate ; Polymethyl Methacrylate ; Reconstructive Surgical Procedures ; Skull ; Tomography, Spiral Computed

Dermoid cysts are rare congenital tumors that occur primarily at the midline at a characteristic intradural location. However, dermoid cysts located at extradural and lateral regions have been rarely reported until now. In the present study, the authors demonstrate the unusual instance of an intracranial extradural dermoid cyst at the lateral sphenoid ridge. A 53-year-old woman admitted because of progressive headache and dizziness. The patient had no neurologic deficits, and magnetic resonance imaging with no contrast enhancement revealed a mass at the right sphenoid ridge. The mass was accompanied with sphenoid bone erosion visible on computed tomography. The patient underwent right pterional craniotomy, and the tumor including the capsule was totally resected. Presence of a dermoid cyst was confirmed with histopathological examination. The patient had no complications during the postoperative period. This study suggests that dermoid cyst should be considered for differential diagnosis of extradural and lateral intracranial masses.
Craniotomy ; Dermoid Cyst* ; Diagnosis, Differential ; Dizziness ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Postoperative Period ; Sphenoid Bone