No abstract available.
Muscular Diseases*

There is a great variety of abdominal calcifictions of varying etiology. Among them, calcification in gastriccarcinoma is rare. To the best of our knowledge, there has been no previous report of calcifying mucinousadenocarcinoma of the stomach in Korea. In the present communication, we report two cases of this rare tumor. Thefirst case was 27 years old female who had anorexia and palpable mass in the epigastrium. By palpation, a firmnon-tender large mass ws felt in the epigastrium. A plain abdominal film showed numerous pnuctate calcificationsin the left upper quadrant. Film from an upper G-I series demonstrated findings of advanced gastric carcinoma withmultiple punctate calcifications involving the antrum and body. Gastroscopic biopsy proved the lesion to bemucinous adenocarcioma(signet ring cell type). The second case was 38 years old female who compained of nausea,vomiting and weight loss. On physical examination, she appeared normal. Routine laboratory tests were withinnormal limits. A plain abdominal film revealed stippled calcifications in the left upper quadrant medial to thesplenic shadow. The film from an upper G-I series showed a mass in the fundus and upper body of stomach withmultiple stippled calcifications along the lesser curvature. Subtotal gastrectomy was perfomred and the pathologicfindings was calcifying mucinous adenocarcinoma(signet ring cell type).
Adenocarcinoma, Mucinous ; Anorexia ; Biopsy ; Female ; Gastrectomy ; Humans ; Korea ; Mucins ; Palpation ; Physical Examination ; Stomach ; Weight Loss

We report a case of a solitary plasmacytoma of the skull base in an otherwise asymptomatic patient. The patient was investigated with plain x-ray films, computed tomography(CT), MRI. The solitary plasmacytoma of bone has a certain relationship to multiple myeloma and rarely been described in the skull base.
Humans ; Magnetic Resonance Imaging ; Multiple Myeloma ; Paraproteinemias ; Plasmacytoma* ; Skull Base* ; Skull* ; X-Ray Film

Chemical neurolysis can be an extremely effective intervention for reducing spasticity. Phenol nerve block as a method of chemical neurolysis has been used over 40 years, nevertheless, many clinicians remain reluctant to perform this procedure. This is largely due to the fear of its side effects and complications such as excessive muscle weakness or increased spasticity of antagonistic muscles. The purpose of this study was to titrate the nerve block effects of phenol with different concentrations and different volumes of the phenol solution. Left tibial nerves of forty eight adult rabbits were injected with phenol solution of different concentrations(5%, 4%, 3%) and volumes(0.3 ml, 0.2 ml, 0.1 ml) into the epineural sheath. Nerve conduction study of the gastrocnemius muscle was performed before and after the nerve blocks(1day, 1week, 2weeks, 4weeks, 8weeks). The proportion of compound muscle action potential(CMAP) amplitudes and areas before and after the nerve blocks was used for the evaluation of nerve block effect. There was a statistically significant difference in the proportion among three volumes of phenol solution(p<0.05). However there was no statistical difference in the proportion among three concentrations of phenol solution(p>0.05) although the higher concentration of phenol solution showed the tendency for smaller proportion. The area of histological degeneration appeared at 2 weeks following nerve block alongside the perineurium. The depth of degeneration area of nerve fascicle varied according to the distance from injection point. These data suggest that the nerve block effect of phenol can be titrated more easily with the volume of phenol solution rather than the concentration until 8 weeks after the nerve block. The variation of the extent of degeneration with different volumes of phenol solution seems to be the mechanism for the titration.
Adult ; Humans ; Muscle Spasticity ; Muscle Weakness ; Muscle, Skeletal ; Muscles ; Nerve Block* ; Neural Conduction ; Peripheral Nerves* ; Phenol* ; Rabbits ; Tibial Nerve

A 59-year-old woman was admitted to our hospital because of occipital headache and multiple cranial nerve dysfunction. The patient had been suffered from chronic otitis media. MRI of the brain showed a thickened and markedly enhanced dura mater in the temporal lobe. The patient underwent a left temporal craniectomy and dural biopsy. Histopathological examination revealed thickened duar amter infiltrated with giant cell, lymphocytic and plasma cell infiltration. The fungus, acid-fast and PAS stains were all negative. After administraion of steroid, cranial nerve disturbances and headache improved. The cause of the hypertrophpic intracranial pachymeningitis in this patient was thought to be related with the chronic otitis media, although the clinical course of the patient was similar to the idiopathic hypertrophic pachymeningitis.
Biopsy ; Brain ; Coloring Agents ; Cranial Nerves ; Dura Mater ; Female ; Fungi ; Giant Cells ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Middle Aged ; Otitis Media* ; Otitis* ; Plasma Cells ; Temporal Lobe

OBJECTIVE: The purpose of this study is to review retrospectively 28 patients with re-operation due to complications related to instrumentation from thoracic and lumbar spinal fusion surgery. METHODS: A total of 285 patients underwent spinal fusion surgery with instrumentation between 1996 and 2000. Of these, 11 men and 17 women(mean age 46 years, range 21 to 69 years) presented with complications related to instrumentation. Previous surgery was preformed for vertebral column instability secondary to fracture(4), spondylolisthesis(12), failed back surgery syndrome(7), osteomyelitis(1), herniated nuclus pulposus(4). All patients underwent repeated spinal surgery including removal of instrument, new instrument fixation, or I & D. The mean follow-up period after second operation was 19 months. RESULTS: The complications related instrumentation system include six interbody fusion system retropulsion, eight screw loosenings, five screw fractures, three screw malpositions, three osteomyelitis, and one donor site infection. After repeated surgery, eight became asymptomatic and did not require further treatment, but eleven showed persistent low back pain without neurological deficits and the remaining nine continued to have nerve root deficits. CONCLUSION: In conclusion, spinal fusion surgery with instrumentation offers an immediate postoperative stability of the thoracic and lumbar spine and enhances early fusion. However, it may be associated with few, but significant, complications which may permanantly. The proper selection of patients and meticulous surgical technique for surgery are probably the most important factors associated good outcomes and prevention of complications.
Follow-Up Studies ; Humans ; Low Back Pain ; Male ; Osteomyelitis ; Retrospective Studies ; Spinal Fusion* ; Spine ; Spondylolisthesis ; Tissue Donors

The prevalent ages at onset for Kawasaki Disease (KD) and Epstein-Barr virus (EBV) infection are known to be similar in Korea and Japan. We evaluated the correlation between EBV infection and KD. The antibodies to EBV such as anti-viral capsid antigen (VCA) IgG and IgM, anti-diffuse and restricted early antigen IgG (anti-EADR IgG), and the anti-EBV determined nuclear antigen IgG (anti-EBNA IgG) were examined in 29KD patients at five separate times sequentially during a period of one year, and also in 14 other children with a past history of KD. The results of each group were compared with those of age-matched controls. The positive rates of anti-VCA IgG and IgM at presentation in the KD patients were 41.4% (12/29) and 0% (0/29), respectively. Only one patient was found to be anti-VCA IgM-positive within two months. There were no cases of anti-VCA IgG except one, anti-EADR IgG and anti-EBNA IgG positive to negative seroconversion during the year. The children with a past history of KD showed higher anti-EBNA IgG-positive rates than the controls (p=0.04). There was no difference in the seropositive rates of the antibodies to EBV, cytomegalovirus, herpes simplex virus and herpes zoster virus. In conclusion, children with KD were noted to have normal immune responses to EBV infection. Children with a past history of KD seemed to be infected with EBV at a later age than children with no history of KD.
Mucocutaneous Lymph Node Syndrome/*virology ; Male ; Korea ; Infant ; Immunoglobulins/metabolism ; Immunoglobulin M/chemistry ; Immunoglobulin G/chemistry ; Humans ; Herpesvirus 4, Human/*metabolism ; Female ; Epstein-Barr Virus Infections/*complications ; Child, Preschool ; Antibodies, Viral/*chemistry ; Age of Onset

Spinocerebellar ataxia (SCA) type 6 was recently identified as a form of autosomal dominant cerebellar ataxia associated with the small expansion of CAG repeats. The number of CAG repeats varies from 4 to 18 on normal alleles and 21 to 30 on the SCA type 6 chromosome. SCA type 6 is characterized by cerebellar ataxia and dysarthria associated with cerebellar atrophy. Many patients with SCA type 6 have horizontal gaze-evoked nystagmus, and some have a limitation of eye movements on the upward and lateral gaze. A 59-year-old woman without any noticeable family history presented with slowly progressive cerebellar ataxia, dysarthria, and oscillopsia. She had vertical nystagmus and horizontal gaze-evoked nystagmus. Brain MRI revealed a moderate cerebellar atrophy, most prominent in the vermis, with relative sparing of the brain stem. A genomic polymerase chain reaction (PCR) analysis showed 24 CAG repeats at the SCA6 locus compatible with the sporadic SCA type 6.
Alleles ; Atrophy ; Brain ; Brain Stem ; Cerebellar Ataxia ; Dysarthria ; Eye Movements ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Nystagmus, Pathologic ; Polymerase Chain Reaction ; Spinocerebellar Ataxias*

Mycoplasma pneumoniae is the most common etiologic agent of pneumonia in school-aged children and young adults. It involves not only the respiratory system but includes extrapulmonary complications such as exanthem, hemolysis, arthritis, hepatic dysfuction, cardiac disease, and central nervous system disease. The pathogenesis of extrapulmonary involvements may be an autoimmune phenomena. Recent studies suggest that bronchial asthma can be initiated by Mycoplasma pneumoniae infection. We experienced a five-year-old girl suffering simultaneously from Guillain-Barr syndrome and initial bronchial asthmatic attack after mycoplasma pneumonia. She was admitted with lower-leg pain and weakness for three days. Ten days before admission, she was coughing and showed on a chest X-ray, pneumonic infitrations of both subhilar peribronchial areas. The titers of anti-mycoplasma antibody and cold hemagglutinin were 1:80 and 1:32, respectively. With a progression of paralysis to the upper extremities, she showed dyspnea, dysphagia and right facial palsy on the second hospital day. We performed a tracheostomy and started artificial ventilation. Unexpectedly, she showed continuous dyspnea, poor lung aeration and revealed severe hypoxemia in serial arterial gas analysis. Intravenous theophylline, high-dose corticosteroid and intravenous immunoglobulin therapy resulted in a progressive improvement of lung condition. She recovered completely from neurologic and pulmonic complications after five weeks.
Anoxia ; Arthritis ; Asthma* ; Central Nervous System ; Child ; Cough ; Deglutition Disorders ; Dyspnea ; Exanthema ; Facial Paralysis ; Female ; Heart Diseases ; Hemagglutinins ; Hemolysis ; Humans ; Immunization, Passive ; Lung ; Mycoplasma pneumoniae ; Mycoplasma* ; Paralysis ; Pneumonia ; Pneumonia, Mycoplasma* ; Respiratory System ; Theophylline ; Thorax ; Tracheostomy ; Upper Extremity ; Ventilation ; Young Adult

BACKGROUND: The H-reflex has been used to assess the proximal nerve conduction in radiculopathy or peripheral neuropathy. The purpose of this study was to evaluate the clinical usefulness of the H-reflex in the diagnosis of subclinical diabetic polyneuropathy. METHOD: Thirty-four diabetic patients (17 women and 17 men) who had neither motor nor sensory symptoms were selected (mean age 57.6 +/- 12.9 years). The duration of diabetes varied from 0.5 to 24 years (mean 6.2 +/- 5.1 years). None of the patients had any known cause of peripheral neuropathy other than diabetes. Twenty-seven healthy subjects (16 women and 11 men) were evaluated as an age-matched control group. H-reflex studies were performed using Braddom and Johnson's methods. The presence and latencies of the H-reflexes were examined in both legs. RESULTS: Twenty-four of the 34 patients (70.6%) had abnormal H-reflex responses (absent H-reflex in 17, prolonged latency in 7). However, only three out of the 27 control subjects (11.1%) had abnormal H-reflex responses (absent H-reflex in 1, prolonged latency in 2). CONCLUSIONS: Abnormalities in H-reflex studies have often been seen in diabetic subjects without overt neurological symptoms. This study suggests that the H-reflex study may be a useful screening tool in the diagnosis of subclinical diabetic polyneuropathy.
Diabetic Neuropathies* ; Diagnosis ; Female ; H-Reflex* ; Humans ; Leg ; Mass Screening ; Neural Conduction ; Peripheral Nervous System Diseases ; Radiculopathy