Spinal arteriovenous malformations(AVMs) and aneurysms should be suspected when patient present with subarachnoid hemorrhage and intracranial source has not been identified with neurologic findings attributable to the spinal cord. We report a case of subarachnoid hemorrhage(SAH) with ruptured spinal artery aneurysm associated with spinal cord AVM in 37-year old man who presented with sudden loss of consciousness with paraplegia. The result of CT-head arteriography of the brain was SAH with intraventricular hemorrhage but no intracranial aneurysm was identified. Spinal angiography revealed a cervical spinal cord AVM supplied by anterior spinal artery with an aneurysm in the feeder. The treatment of the spinal cord AVM was performed with liquid coil embolic agent, polyvinylacetylate(PVAc) and feeding artery aneurysm was treated with Guglielmi detachable coils(GDCs).
Adult ; Aneurysm* ; Angiography ; Arteries* ; Arteriovenous Malformations* ; Brain ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Neurologic Manifestations ; Paraplegia ; Spinal Cord* ; Subarachnoid Hemorrhage* ; Unconsciousness

No Abstract available.
Arthritis, Rheumatoid* ; Humans ; Osteoclasts*

Malignant leptomeningeal metastases involving both internal auditory canals (IACs) are rare and can mimic neurofibromatosis type 2 (NF2). Rapid progression of symptoms and involvement of facial nerve are characteristic clinical courses in contrast to the slow progression of symptoms in NF2. We report a rare case suspected to be metastatic tumor involving bilateral IACs, and presenting sudden bilateral hearing loss in a patient who was previously treated for adenocarcinoma of lung.
Adenocarcinoma ; Facial Nerve ; Hearing Loss, Bilateral ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Neurofibromatosis 2

Polyarteritis nodosa (PAN) is a systemic vasculitis involving small- and medium-sized arteries, which presents with necrotizing inflammation. PAN occurs as a systemic disease or as a limited form confined to a single organ. Few cases have been reported with single organ involvement, and even fewer have been reported with skeletal muscle involvement. Herein, we report the ultrasonography and magnetic resonance imaging findings in a rare case of PAN with limited muscle involvement in a 66-yearold man.

Polyarteritis nodosa (PAN) is a systemic vasculitis involving small- and medium-sized arteries, which presents with necrotizing inflammation. PAN occurs as a systemic disease or as a limited form confined to a single organ. Few cases have been reported with single organ involvement, and even fewer have been reported with skeletal muscle involvement. Herein, we report the ultrasonography and magnetic resonance imaging findings in a rare case of PAN with limited muscle involvement in a 66-yearold man.

Objectives: Osteoporosis and fracture are known complications of systemic lupus erythematosus (SLE). We assessed the prevalence and risk factors for osteoporosis in patients with SLE. Methods: A total of 155 female SLE patients were recruited retrospectively in 5 university hospitals. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and the fracture risk assessment tool (FRAX) for high-risk osteoporotic fractures was calculated with and without BMD. Results: The mean age was 53.7 ± 6.8 years, and osteoporotic fractures were detected in 19/127 (15.0%) patients. The proportion of patients having a high-risk for osteoporotic fractures in the FRAX with and without BMD, and osteoporosis by the World Health Organization (WHO) criteria were 25 (16.1%), 24 (15.5%), and 51 (32.9%), respectively, and 48.0–68.6% of them were receiving treatment. On multivariate logistic analysis, nephritis (odds ratio [OR] 11.35) and cumulative dose of glucocorticoid (OR 1.1) were associated with high-risk by the FRAX with BMD, and low complement levels (OR 4.38), erythrocyte sedimentation rate (ESR) (OR 1.04), and cumulative dose of glucocorticoid (OR 1.05) were associated with osteoporosis by the WHO criteria in patients with SLE. Conclusions Among Korean female patients with SLE, the proportion of patients having a high-risk of osteoporotic fractures by the FRAX tool was 15.5%–16.1% and the proportion of patients having osteoporosis by the WHO criteria was 32.9%. In SLE, nephritis, low level of complement, ESR, and cumulative dose of glucocorticoids may contribute to fracture risk.

Objectives: Osteoporosis and fracture are known complications of systemic lupus erythematosus (SLE). We assessed the prevalence and risk factors for osteoporosis in patients with SLE. Methods: A total of 155 female SLE patients were recruited retrospectively in 5 university hospitals. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and the fracture risk assessment tool (FRAX) for high-risk osteoporotic fractures was calculated with and without BMD. Results: The mean age was 53.7 ± 6.8 years, and osteoporotic fractures were detected in 19/127 (15.0%) patients. The proportion of patients having a high-risk for osteoporotic fractures in the FRAX with and without BMD, and osteoporosis by the World Health Organization (WHO) criteria were 25 (16.1%), 24 (15.5%), and 51 (32.9%), respectively, and 48.0–68.6% of them were receiving treatment. On multivariate logistic analysis, nephritis (odds ratio [OR] 11.35) and cumulative dose of glucocorticoid (OR 1.1) were associated with high-risk by the FRAX with BMD, and low complement levels (OR 4.38), erythrocyte sedimentation rate (ESR) (OR 1.04), and cumulative dose of glucocorticoid (OR 1.05) were associated with osteoporosis by the WHO criteria in patients with SLE. Conclusions Among Korean female patients with SLE, the proportion of patients having a high-risk of osteoporotic fractures by the FRAX tool was 15.5%–16.1% and the proportion of patients having osteoporosis by the WHO criteria was 32.9%. In SLE, nephritis, low level of complement, ESR, and cumulative dose of glucocorticoids may contribute to fracture risk.

PURPOSE: A multicenter study was performed to evaluate the clinical characteristics and the results of chemotherapy in patients with testicular tumor. MATERIALS AND METHODS: We retrospectively reviewed the records of 121 patients with testicular tumor treated at five university hospital between 1980 and 1997. We analyzed the clinical characteristics, additional treatments after orchiectomy and results of chemotherapy. RESULTS: Patients age ranged from 1 month to 74 years with a mean of 24 years. The common presenting symptoms were scrotal swelling in 63 patients, palpable mass in 50, and testicular pain in 12. The location of the tumor was on the right side in 62, left in 58, and both in 1 with lymphoma. The histologic type was germinal neoplasm in 101 patients, nongerminal neoplasm in 1, and other tumors in 19. Clinically, 76 patients(62.8%) were stage I, 16(13.2%) stage IIa, 12(9.9%) stage IIb, 3(2.5%) stage IIc, 9(7.4%) stage III and 5(4.1%) stage IV. After orchiectomy, 73 patients(60.3%) were underwent close observation, 30(24.8%) chemotherapy, 14(11.6%) radiation therapy, 3(2.5%) radiation plus chemotherapy and 1(0.8%) retroperitoneal lymph node dissection. Among the 33 chemotherapy patients, 12(36.4%) patients achieved a clinical complete remission(CR), 5(15.2%) partial remission(PR), 4(12.1%) minor response and stabilization, 5(15.2%) progression and 7(21.2%) patients were follow-up loss, and the overall clinical response rate was 65.4%. Among the 18 chemotherapy patients with nonseminomatous germ cell tumor(NSGCT), 9(50.0%) patients achieved a clinical CR, 4(22.2%) PR, 1(5.6%) minor response and stabilization, 2(11.1%) progression and 2(11.1%) patients were follow-up loss, and the overall clinical response rate was 81.3%. CONCLUSIONS: Our study group was relatively small and insufficient to evaluate the chemotherapeutic results, but NSGCT seems to have a better clinical response to chemotherapy.
Drug Therapy ; Follow-Up Studies ; Germ Cells ; Humans ; Lymph Node Excision ; Lymphoma ; Orchiectomy ; Retrospective Studies ; Testis*

Erythromelalgia is a rare clinical condition of unknown etiology characterized by severe burning pain in the distal limbs. It can be accompanied by pronounced erythema and increased skin temperature precipitated by heat or activity and can be improved by cooling the affected part. It can be divided into two categories, primary, which begins spontaneously at any age, and secondary, which is infrequently associated with diabetes mellitus. However, the significance of this association is little known. We report a rare case of intractable erythromelalgia in an adolescent with diabetes mellitus.
Adolescent* ; Burns ; Diabetes Mellitus* ; Erythema ; Erythromelalgia* ; Extremities ; Hot Temperature ; Humans ; Skin Temperature

Thoracoscopic sympathectomy is a common technique used to treat plamar hyperhiodrosis. The complications of thoracoscopic sympathectomy are rare. Recently, we experienced a complex regional pain syndrome(CRPS) after thoracoscopic sympathecotomy in a patient with hyperhidrosis. The treatment of this complication was chemical epidural sympathetic block and conservative pain control. The result of this treatment was good. The patient was recovered after one month.
Humans ; Hyperhidrosis* ; Pain, Postoperative ; Sympathectomy* ; Thoracoscopy