No abstract available.

Aneurysm of the splenic artery are the third most common intra-abdominal aneurysm, following aneurysms of the infrarenal aorta and iliac arteries. Splenic artery aneurysms (SAA) are the most frequent visceral artery aneurysms and account for more than two thirds of all lesions. Incidence of SAA are rare clinical entities(0.01-0.2%) that carry risk of rupture and fatal hemorrhage(35-100%). Fibroblastic dysplasia and atherosclerosis is fecund in the majority, and the fact that these aneurysms developes more commonly in female. Most patients are asymptomatic and the diagnosis is generally made incidentally. The treatment of patient with known SAA is dictated by several factors, including location, age, sex, present of symptom, size, pregnancy. We report ruptured splenic artery aneurysm with hemoperitoneum and review of the literature.
Aneurysm* ; Aorta ; Arteries ; Atherosclerosis ; Diagnosis ; Female ; Fibroblasts ; Hemoperitoneum ; Humans ; Iliac Artery ; Incidence ; Pregnancy ; Rupture ; Splenic Artery*

BACKGROUND: Dizziness is a common complaint in patients presenting at emergency departments. Dizziness is difficult to assess because it is a subjective complaint that cannot be measured. We report a clinical analysis of patients with acute dizziness: type, duration, symptom, incidence, etc. METHODS: We reviewed the clinical details and the results of vestibular function tests for 106 acutely dizzy patients who visited the Emergency Department of Wonkwang University Hospital during the period of Jul. 1999 through Dec. 1999. RESULTS: The most common etiology of acute dizziness was the peripheral vestibular system(66%). The most common disease of the peripheral vestibular system was benign paroxysmal positional vertigo(52.9%), and the second most one was vestibular neuronitis(42.9%). In the central nervous system, cerebrovascular accident(63.6%) was the most common cause. All of the patients had experienced a previous vertigo attack, and 42.4% of them had frequent attacks. Dizziness of the cochlear systems were usual in peripheral vertigo. The usual underlying diseases related with vertigo were hypertension, cerebral infarction and diabetes mellitus. CONCLUSION: Dizziness is a complex and frustrating symptom with numerous possible causes. In case with suspected central disorders, CT and MRI have a great diagnostic significance.
Central Nervous System ; Cerebral Infarction ; Diabetes Mellitus ; Dizziness* ; Emergencies* ; Emergency Service, Hospital ; Humans ; Hypertension ; Incidence ; Magnetic Resonance Imaging ; Vertigo ; Vestibular Function Tests

OBJECTIVE: Sinus pericranii (SP) is a rare vascular malformation characterized by abnormal communication between the extracranial and intracranial venous systems, usually involving the superior sagittal sinus (SSS) and occasionally, the transverse sinus. CASE REPORT: A 28-year-old man was presented with a round, fluctuant, nonpulsatile scalp mass in the frontal area near the midline, the size of which changed, depending on his head position. Magnetic resonance imaging showed an extracranial vein extending through a bony defect in the vertex of the skull and draining into the superior portion of the sagittal sinus. RESULTS: The lesion was completely removed by surgery. The presence of vascular endothelium in the pathologic specimen suggests a congenital or spontaneous origin. CONCLUSION: SP is a rare vascular malformation that requires surgical or endovascular treatment for the prevention of life-threatening complications.
Adult ; Endothelium, Vascular ; Head ; Humans ; Magnetic Resonance Imaging ; Scalp ; Sinus Pericranii ; Skull ; Superior Sagittal Sinus ; Vascular Malformations ; Veins

No abstract available.
Cervical Intraepithelial Neoplasia* ; Colposcopy* ; Conization*

To elucidate the clinical avaiability of FNAB, we reviewed retrospectively medical records of 30 patients who had infiltrative pulmonary lesion or pulmonary nodule or mediastinal mass, and got percutaneous fine needle aspiration biopsy using Westcott needle, 20~22 gauge, at the department of Pediatrics, Hanyang university hospital from July, 1986 to June, 1993. The obtained results were as follows: 1) There were 30 patients, aged 6 months to 15 years. 2) There were 17 male patients and 13 female patients with sex ratio of 1.3:1 3) Among 30 cases, we discovered 16 cases of infiltrative lesions, 7 cases of pulmonary nodules and 7 cases of mediastinal mass lesions. In mediastinal there were 4 cases of anterior mediastinum and 3 cases of posterior mediastinum. 4) Overall success rate on fine needle aspiration biopsy was 60% (18/30). The success rate was 50% (8/16) in infiltrative lesions, 50% (8/15) in pulmonary nodules and 71% (5/7) in mediastinal mass lesions, respectively. 5) Eight infiltrative lesione were diagnosed as Pneumocystis carinii pneumonia. Five pulmonary nodules were diagnosed as aspergillosis (2 cases), tuberculosis (1 case), mucormycosis (1 case), lung metastasis of metastasis of neuroblastoma (1 case). Five mediastinal mass lesions were diagnosed as teratoma (2 cases), lymphoma (1 case), malignant neurogenic tumor (1 case), ganglioneuroblastoma (1 case). 6) The complications occured in 20% (6 cases) among 30 procedures. All cases were due to pneumothorax: 3 cases spontaneously resolved, and 3 cases needed chest tube insertion. There were no death related with this procedures.
Aspergillosis ; Biopsy* ; Biopsy, Fine-Needle* ; Chest Tubes ; Child* ; Diagnosis* ; Female ; Ganglioneuroblastoma ; Humans ; Lung ; Lymphoma ; Male ; Mediastinum ; Medical Records ; Mucormycosis ; Needles ; Neoplasm Metastasis ; Neuroblastoma ; Pediatrics ; Pneumonia, Pneumocystis ; Pneumothorax ; Retrospective Studies ; Sex Ratio ; Teratoma ; Tuberculosis

BACKGROUND: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. METHODS: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. RESULTS: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. CONCLUSIONS: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.
Acromion ; California ; Clavicle* ; Humans ; Osteolysis ; Periprosthetic Fractures ; Shoulder ; Skin

BACKGROUND: Essential tremor is one of the most common types of movement disorders. Although it is sometimes prefaced with the term 'benign', it often causes significant disabilities. Clinical characteristics and responses to various drugs have not been investigated systematically in Korea. Therefore, we studied the clinical features, electrophysiologic findings, and drug responsiveness of essential tremor. METHODS: Forty-five patients were included in the study by clinical criteria for essential tremor. We investigated their clinical features including tremor type, involved sites, family history, and responsiveness to alcohol. We used an electromyography study to evaluate the contraction patterns between agonist and antagonist muscles and the frequency of tremor. Primidone and propranolol were prescribed to all the patients (N=30) with a sufficient washout period (more than 2weeks) for drug responsiveness. Drug responsiveness was estimat-ed with self-assessment scales. RESULTS: The mean age of patients at the onset of the tremor was 45 years and the average duration of the tremor was 11.1 years. Kinetic tremor was dominant in 17 patients (37.8%) and postural tremor in 28 patients (62.2%). Family history was found in 18 patients (40%) and alcohol reduced tremors in 18 (64.8%) out of 28 patients with sufficient alcohol intake. Co-contraction was seen in 18 patients (40%), alternative contraction in 15 (33.6%), and mixed contraction in 3 (6.7%). Mean frequency was 6.7 Hz. Propranolol reduced tremor in 24 patients (80%), and primidone in 27 patients (90%). CONCLUSIONS: It was concluded that essential tremor was heterogenous clinically and electrophysiologically. Primidone was found more effective than propranolol in reducing tremor.
Electromyography ; Essential Tremor* ; Humans ; Korea ; Movement Disorders ; Muscles ; Primidone ; Propranolol ; Self-Assessment ; Tremor ; Weights and Measures

Background: Inter1eukin-6(IL-6) is known to be produced by osteoblastic cells and to have impartant role in regulation of bone remodelling, Most previous studies indicated that IL-6 bas a major role in stimulating osteoclastic resorption by increasing recruitment and proliferation of preosteoclasts. But its autocrine effect on osteoblastic cells has not been well established yet. Therefore, we studied the effects of IL-6 on messenger RNA (mRNA) expression of proteins that are characteristic of osteoblastic cells in human bone marrow stromal (osteoprogenitor) cells (hRMSC). Methods: The expression of mRNAs for alkaline phosphatase, al(1)-collagen, osteopontin and decorin were studied by northern blot analysis after 3 7 days' treatrnent with IL-6 in the concenttation range of 101,000 U/ml. Results: The mRNA levels for any of the osteoblastic proteins studied did not change significantly by IL-6 treatment up to the concentration of 1,000 U/ml. Conclusion: These results suggest that IL-6 does not have a significant role in differentiatian or activities of human bone rnarrow stromal.
Alkaline Phosphatase ; Blotting, Northern ; Bone Marrow ; Decorin ; Humans ; Interleukin-6 ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteoclasts ; Osteopontin ; RNA, Messenger

PURPOSE: To report two cases of retinal detachment associated with von Hippel-Lindau syndrome, one case of rhegmatogenous retinal detachment combined with mild proliferative vitreoretinopathy and a case of tractional retinal detachment. METHODS: Case reports. Pars plana vitrectomy with membrane peeling and silicone oil tamponade were performed in all cases. Lens aspiration was also performed in one case. RESULTS: Successful retinal reattachment was obtained in all cases. Case 2 developed cataract and secondary glaucoma and was treated with phacoemulsification with posterior chamber lens insertion and YAG laser iridotomy. CONCLUSIONS: In two patients with retinal detachment occurring in von Hippel-Lindau syndrome, we could obtain successful retinal reattachment with stabilized visual acuity after performing pars plana vitrectomy and silicone oil injection.
Cataract ; Glaucoma ; Humans ; Lasers, Solid-State ; Membranes ; Phacoemulsification ; Retinal Detachment* ; Retinaldehyde* ; Silicone Oils ; Traction ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative ; von Hippel-Lindau Disease*