Myxopapillary ependymoma generally arise in the conus medullaris and filum terminale of adult spinal cord. These tumors are readily recognized due to unique histopathologic features, however, their cytologic features are not well described. When only a tiny sample is obtained, cytologic examination using crush preparation may be a useful diagnostic tool to help appropriate intraoperative diagnosis. We present the crush cytologic features of myxopapillary ependymoma arising in thoracic and lumbar spinal cord of a 13-year-old boy. The patient had complained of paraparesis and back pain for 1 month. The MRI image revealed a relatively well demarcated intramedullary mass in T11-L1 levels. Crush preparation for cytology were performed by biopsy material. Crush cytologic findings revealed high cellularity and small sized branching papillary clusters on fibrillary or mucinous background. The tumor cells had uniform round or elongated nuclei. The cytoplasmic process of tumor cells were attached to the vascular wall. Between the tumor cells and vascular walls, the perivascular collar of globoid acellular stroma with metachromatic reaction on toluidin blue stain was noted. The crush preparation of myxopapillary ependymoma is considered as a simple and highly accurate diagnostic tool for differentiation from other intramedullary neoplasms of central nervous system.
Adult ; Male ; Female ; Infant, Newborn ; Humans ; Biopsy

We compared the clinical and radiographic outcomes between femoral varus osteotomy (23 hips) and Salter innominate osteotomy (18 hips) for treatment of Catteral is groups III and IV Perthes disease after 3-12 years follow-up. There were no statistically significant differences in the clinical outcomes using the lowa hip rating score and leg length discrepancy and in the final radiographic outcomes using the femoral head sphericity and Stulberg type between the two groups. However, neckshaft angle and center-edge angle were closer to normal value in the Salter innominate osteotomy group compared with the femoral varus osteotomy group. When the patients underwent femoral varus osteotomy at the older age (7 years), articulotrochanteric distance ratio and neck-shaft angle were significantly less than those of other patients. Salter innominate osteotomy may be better indi- cated as compared to femoral varus osteotomy, when physeal damage of proximal femur is obvious or highly suspicious particularly in the older children (7 years) with severe Perthes disease.
Child ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Leg ; Legg-Calve-Perthes Disease* ; Osteotomy* ; Reference Values

No abstract available.
Plummer-Vinson Syndrome*

The pelvis is a ring structure with strong ligamentous support. This support includes the symphysis pubis, the anterior and posterior sacroiliac ligaments, and the strong sacrospinous and sacrotuberous ligaments. Since the pelvis is a ring, disruption of any portion of the ring is always associated with disruption in another portion of the ring. Massive pelvic disruption is an important and often life threathening. The author reviewed 36 cases of unstable pelvic bone fractures treated at the Orthopedic department of Chonbuk National University Hospital from January 1982 to December 1989, and analized the causes of injury, types of fracture by Pennal and Tiles method, associated injuries, early and late complication, methods of treatment. The clinical results were obtained as follows: 1. The incidence of injury in male was almost same in female and most of the patients were in the 3rd to 5th decade of their life. 2. The causes of injuries were traffic accidents, fall-down, others. 3. The most common fractures of unstable pelvic bone fractures were type II fractures due to lateral compression and Type III fractures due to vertical shear(Br Penall and Tile). 4. The fractures of acetabulum and tibia and fibula were the most commonly associated bone and joint injuries. Also the injury on the genitourinary tract was the most commonly associated soft tissue injuries. 5. There are various mathods of treatment in unstable pelvic bone fracture. A satisfactory results of conservative treatment were 73% and operative treatment were 85%. 6. In unstable pelvic bone fractures we consider that the external fixstior should probably be the first choice of treatment.
Accidents, Traffic ; Acetabulum ; Clinical Study ; Female ; Fibula ; Humans ; Incidence ; Jeollabuk-do ; Joints ; Ligaments ; Male ; Methods ; Orthopedics ; Pelvic Bones ; Pelvis ; Pubic Bone ; Soft Tissue Injuries ; Tibia

Tumors of the central nervous system are the second most frequent neoplasm in children. In a review of 43 children with brain tumor under the age of 16 evaluated at a pediatric and neurosurgical department at Severance Hospital Yonsei University during a 61/2 year period, following results were obtained. 1. All 43 cases were diagnosed by pathological examination as well as brain CT scan. The sex ratio of male and female was equal. The age distribution was highest between 13-14 year of age and 7% of them were under 1 year of age. 2. There was a small preponderance of infratentorial tumors (51%) over supratentoral tumors (49%). 3. Among 43 verified brain tumors by pathological examination, glioma represented 75%, of which astrocytoma was the commonest neoplasm being 19 cases (45%) and remainder were medulloblastoma 10 cases (23%), choroid plexus droglioma 2 cases (5%), ependymoma 1case (2%). The rest were craniopharyngioma 6 cases (14%), choroid plexus papilloma 1 case (2%), neuroblastoma 2 cases (5%), pineal teratoma 1 case (2%), melanotic neuroectodermal turmor 1 case (2%). 4. The most common symptom was headache occuring 63% of the patients followed by vomiting, motor weakness, visual disturbance, gait distrubance, mental disturbance and seizure in order of trequency. Neurological signs showed positive Babinski sign, papilledema, cerebellar sign, 6th nerve palsy and facial weakness. 5. Plain skull X-ray changes were noted in 26 out of the 43 cases (61%). Those were suture separation of skull noted 35% of tumors followed in frequency by increased digital marking, sella changes and calcification. 6. In brain CT scan studies, the most common abnormal finding was solid mass shadow followed by cystic mass shadow, solid and cystic mass shadow. After contrast infusion, diffuse enhancement was the most common features. 7. 27 cases were treated by operation only, 15 by operation and radiotherapy, 1 by operation, radiation and chemotherapy. 8. Progonsis of brain tumor was very poor. 5 of 43 cases died within 1 month of diagnosis, 1 year survival rate was 19%, and 2 year survival rate was 16%. The survival rate was better in the group of patients in whom total or subtotal resection combined with radiotherapy was performed. 53% of cases were not able to follow-up or discharged anainst advice without proper treatment.
Abducens Nerve Diseases ; Age Distribution ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Central Nervous System ; Child* ; Choroid Plexus ; Craniopharyngioma ; Diagnosis ; Drug Therapy ; Ependymoma ; Female ; Follow-Up Studies ; Gait ; Glioma ; Headache ; Humans ; Infratentorial Neoplasms ; Male ; Medulloblastoma ; Neural Plate ; Neuroblastoma ; Papilledema ; Papilloma, Choroid Plexus ; Radiotherapy ; Reflex, Babinski ; Seizures ; Sex Ratio ; Skull ; Survival Rate ; Sutures ; Teratoma ; Tomography, X-Ray Computed ; Vomiting

No abstract available.
Craniocerebral Trauma* ; Head*

BACKGROUND: The pathogenic role of the hair follicle mite in rosacea is still a matter of debate. Although the hair follicle mite may induce a pathologic condition by dermal invasion or excessive number of mites, the number of mites necessary to induce a pathologic condition has not been established in Korea. OBJECTIVE: The purpose of our study was to know the causative role of the hair follicle mite in rosacea and the threshold value between 'normal' and 'abnormal' density of the hair follicle mite on Korean facial skin. METHODS: We applied skin surface biopsy to investigate the population density and distribution of hair follicle mites in the facial skin of 50 patients with rosacea (9 with episodic erythema, 29 with stage I, 12 with stage II), 7 patients with demodicidosis and 54 control subjects. The mites were counted in measured skin surface biopsy specimens obtained from three standard facial sites(2cm on cheek and chin, 1cm on nose) with cyanoacrylate glue. RESULTS: 1. The mean mite count per 5cm was 3.4+/-0.7 in control subjects and 10.7+/-1.9 in patients with rosacea(p<0.05) The density of Demodex(mite count/ 5cm) was significantly higher in patients with demodicidosis (115+/-14.2) than in the control (p<0.001) and rosacea patients(p<0.05). 2. The highest density of mites was found on the cheek in the control and diseased subjects. The incidence of hair follicle mites was higher on the nose than on the cheek in the control subjects and rosacea patients. In demodicidosis, the incidence of the hair follicle mites was higher on the cheek than on the nose. 3. The distribution of hair follicle mite was not significantly different among the three clinical stages of rosacea. The mite counts in stage II rosacea were higher than those of control subjects (p<0.05). 4. The distribution of the hair follicle mite in the control subjects was related to a increase of age but not related to sex. The distribution of the hair flooicle mites in rosacea patients was not related to age or sex. 5. Hair follicle mites were found in 33 out of 54 control subjects(61%) and in 40 out of 50 rosacea patients (80%). The mite counts of all control subjects and all rosacea patients were less than 5/cm and 10/cm, respectively. The mite counts of all demodicidosis patients were more than 10/cm. CONCLUSION: These results suggest that the increased nomber of mites play a part in the pathogenesis of rosacea and demodicidosis is a specifio disease entity differentiated from rosacea. When the density of the hair follicle mites is above 5 /cm2, a pathologic condition of the skin, such as rosacea and demodicidosis, would have to be considered. Demodicidosis should be suspected when the density of the hair follicle mites is above 10 /cm. In addition, skin surface biopsy is recommended as the most simple and useful clinical method in search of the distribution of the distrbution of the hair follicle mites.
Adhesives ; Biopsy* ; Cheek ; Chin ; Cyanoacrylates ; Erythema ; Hair Follicle* ; Hair* ; Humans ; Incidence ; Korea ; Mites* ; Nose ; Population Density ; Rosacea ; Skin*

Multiple studies have established that mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) exhibits reversible diffusion restriction in the white matter, including the splenium. There have been a few previous reports of the change in fractional anisotropy (FA) of MERS cases. Herein, we report the longitudinal changes in axial and radial diffusivity (AD and RD), and FA in a 15-year-old boy patient with MERS. Our case demonstrated that a MERS lesion had a significant drop of AD in the early period and gradual recovery. On the contrary, RD did not show any significant change.

No abstract available.
Appendicitis* ; Humans

Eleven patients underwent posterior sagittal anorectoplasty(PSARP) as a secondary procedure. Two of them had rectovaginal fistula and another two had rectocutaneous fistula. Six of the rest complained of frequent fecal soiling and the last one had severe anorectal stricture after perineal anoplasty. Five patients had lived with colostomy until the second operations were carried out. The ages at the time of the secondary PSARP were between 7 months and 29 years. Distal colostogram and MRI were taken to evaluate distal colon, position of the rectum and voluntary muscle. All patients had normal sacrum except one who had anorectal stricture. Seven patients, six with fecal incontinence and the other one with rectovaginal fistula had mislocated anorectums. Three patients, two with rectocutaneous fistula, the other one with anorectal stricture, had abdominal approach to obtain enough length of colon for pull-through procedure. With the posterior midsagittal approach, we could manage all the problems, rectovaginal fistulas, rectocutaneous fistulas, strictures and malpositioned rectums, without difficulty. No patients had serious complications except wound infection in one. All patients were satisfied with the results after redo-PSARPs even though normal continence has been achieved in only one patient. Seven patients who had continuous soiling or rectocutaneous fistula, needed no more diapers even though four of them showed fecal staining under stressful condition and the other three showed intermittent fecal leaking less than once a day. The rest three of the patients maintained their continence with support of drugs and/or enemas because of constipation. The PSARP is a popular procedure as a primary operation; however, our results suggested that this procedure also gave us a good opportunity for management of serious complication developed after primary anoplasties.
Colon ; Colostomy ; Constipation ; Constriction, Pathologic ; Enema ; Fecal Incontinence ; Fistula ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Rectovaginal Fistula ; Rectum ; Sacrum ; Soil ; Wound Infection