Developmental venous anomalies are congenital anomalies of the intracranial venous drainage and clinically asymptomatic. Cavernous hemangiomas are vascular malformations composed of dilated vascular channels lined with a single layer of endothelial cells without any intervening normal neural tissue. Although, cavernous hemangioma may be clinically silent, but frequently cause variable neurologic manifestations; intracranial hemorrhage, seizures, and focal neurologic deficits. Frequent association of these two diseases has already been reported and it has been suggested that cavernous hemangiomas not the developmental venous anomalies that cause the acute clinical symptoms. A 4 year old girl with sudden onset of headache, vomiting, gait disturbance and signs of unilateral cerebellar dysfunction 2 days before admission showed a 2.5x2.5cm sized hematoma with heterogenous signal intensity both in CT and MRI in the left cerebellar hemisphere. Four-vessel cerebral angiography revealed characteristic findings of developmental venous anomalies. Pathologic findings of the surgically removed hematoma disclosed typical feature of cavernous hemangioma. Based on the findings in this case and review of the literatures, we concluded that the possibility of other diseases such as cavernous hemangiomas must be considered in patients who has intracranial hemorrhage due to the developmental venous anomalies.
Cerebellar Diseases ; Cerebral Angiography ; Child, Preschool ; Drainage ; Endothelial Cells ; Female ; Gait ; Headache ; Hemangioma, Cavernous* ; Hematoma ; Hemorrhage* ; Humans ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Seizures ; Vascular Malformations ; Vomiting

Teratoma is very rarely developed in the third ventricle. We report a case of third ventricular mature teraroma in 12 year old boy with headache and precocious puberty. In TlWl and Gd-DTPA enhanced TlWl, the mass in the third ventricle showed mixed signal intensities with signal void and partial contrast enhancement. The tumor was confirmed as a mature teratoma including teeth and fatty tissue.
Adipose Tissue ; Child ; Gadolinium DTPA ; Headache ; Humans ; Magnetic Resonance Imaging* ; Male ; Puberty, Precocious ; Teratoma* ; Third Ventricle* ; Tooth

The etiology of spontaneous hemarthrosis of the knee joint in elderly pattents is still unknown. This report discusses seven spontaneous hernarthroses, three that were managed witla conservative measures such as aspiration, rest and knee immobilization because of poor general condition and four in which arthroscopic evaluation and treatment were performed. These patients were elderly indi.viduals without an obvious history of trauma. The roentgenograms of each involved knee demonstrated degenerative osteoarthritic changes of knee joint. Arthroscopic examination revealed denuded articular cartilage and subchondral bone exposure in four operative cases and degenerative meniscal tear in one case of four. These patients underwent mthroscopic debridement and did not experience recurrenees of the hemarthrosis. We think that the origin of the bleeding was most likely from the subchondral cancellous bone which was exposed due to degenerative change of the knee joint and the senile changes of the vessels around the knee joint with aging process may contribute the spontaneous bleeding into the knee joints.
Aged* ; Aging ; Cartilage, Articular ; Debridement ; Hemarthrosis* ; Hemorrhage ; Humans ; Immobilization ; Knee Joint ; Knee*

No abstract available.
Low Back Pain*

BACKGROUND: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. METHODS: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6-mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. RESULTS: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. CONCLUSIONS: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.
Biomechanical Phenomena ; Cadaver* ; Dislocations ; Ligaments* ; Muscles ; Scapula ; Shoulder

STUDY DESIGN: The authors retrospectively analysed the difference of clinical natures in contained vs. ruptured HIVD. OBJECTIVE: To compare contained HIVD with ruptured HIVD in respect of clinical symptoms, signs and the result after surgery. SUMMARY OF LITERATURE REVIEW: In contained disc herniation, the disc material remains beneath tile intact outer annulus. But, once disc material penetrates through the limit of posterior annulus, it is a ruptured herniation or disc extrusion/sequestration. There is few report concerning the clinical characteristics related to type of herniation. MATERIALS AND METHODS: Forty-six patients, treated by open discectomy from March 1990 to December 1994, were followed up for minimum two years. The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR, and severity of radiating pain were periodically followed up on the predesigned protocol. Result: Twenty patients had contained disc and remaining 26 had ruptured disc. The mean age of contained disc was 31.4 years and that of ruptured disc was 43.3 years. In preoperative examination, 18/26 cases of patients with ruptured discs, developed pain in less than 3 months, compared with 7/20 cases of does with contained ones. Motor deficit was positive in 25/26 cases (96.2%) of ruptured discs and 12/20 cases (60%) of contained ones. 23/26 cases (80.8%) of patients with ruptured discs, had sensory deficit compared with 12/20 cases (60%) of those with contained ones. There was no significant difference in SLR and DTR change between ruptured and contained disc. CONCLUSIONS: Factors such as age, motor and sensory deficits and duration of symptoms had correlation with the type of herniation, but SLR and DTR change showed no statistical difference in this study. Clinical outcome showed no significant difference between two groups, but in ruptured group, the results were getting worse with the time goes. On the basis of this study, we concluded that the clinical symptoms and signs were different between the two groups, but surgical results showed no statistical difference.
Diskectomy ; Humans ; Retrospective Studies

The cataract extraction in vitrectomized proliferative diabetic retinopathy(PDR) may be different from the ordinary non-vitrectomized patients in several points. We tried to know what`s the problems during the operation, how`s the visual outcomes and the postoperative complications in these eyes. In 18 previously vitrectomized PDR patients(25 eyes), we performed the extracapsular cataract extraction(ECCE) in 7 eyes and the phacoemulsification in 18 eyes. The intraoperative problems were insufficient dilation of pupil, unstability of (anterior and posterior) chamber depth, and difficulty in removal of cortex, which is firmly adherent to the posterior lens capsule. Opacity of posterior lens capsule, elevation of intraocular pressure, exudative pupillary membrane, posterior synechia and corneal edema were the major postoperative complications. In 22 eyes(88%), the visual acuity was increased more than 2 lines, Cataract extraction was easier and less postoperative complications these cases.
Cataract Extraction* ; Cataract* ; Corneal Edema ; Diabetic Retinopathy* ; Humans ; Intraocular Pressure ; Membranes ; Phacoemulsification ; Postoperative Complications ; Pupil ; Visual Acuity

In the developed countries in Europe and the United States, The spinal tuberculosis is of no serious problem due to the developed anti-tuberculotic agents and the advanced operative techniques. However, in Korea poor economic and other conditions prevent many patienta from getting proper treatments for spinal tuberculosis. We analysed 45 cases of spinal tuberculosis who were treated at our department during three years from June, 1972 to June, 1975 by operative treatment and being compared with these results that obtained conservative treatment. The results were obtained as follows; 1. There was most common in below 9 years old (28.9%) and common age incidence was below 35 years old (68.8), The sexual incidence was 22 in male and 23 in female. 2. Lower thoracic and upper lumbar were mostly involved, i.e thoracic (52.2%), lumbar (32.7%), thoraco-lumbar in orders. 3. Two affected vertebra was most common in 33 cases, number of affected vertebra averaged 2.5. 4. In laboratory finding, E.S.R. that was 50–60 mm/hr. in average of then admission wss shifted as normal range of 10–20 mm/hr. after cure of 5–6 months. 5. In 28 cases of operative treatment, anterior spinal fusion was done in 19 cases (67.9%), posterior spinal fusion in 8 cases(28.6%), one case(3.5%) was treated by thoracotransversectomy. 6. In consequence of pathologic exaraination and A.F.B. stain, the case of tuberculotic constitution was 18 in tissue pathology, and that of positive reaetion was 9 in direct smear for A.F.B. 7. The case that tuberculosis was limited at spine and was not found in other organs was 27, it got from 60% of the whole. 8. Average kyphotic angle of the thoracic region after operation was 4.3°, in 6 months was reduction of 1.8°, that of lumbar region after operation was 1.2°, in 6 months was reduction after operation was reduction of 0.7°, as change of radiologic kyphosis. 9. As a result of being cured during 18 months by operative or conservative methods, not a case is found in activity.
Constitution and Bylaws ; Developed Countries ; Europe ; Female ; Humans ; Incidence ; Korea ; Kyphosis ; Lumbosacral Region ; Male ; Pathology ; Reference Values ; Spinal Fusion ; Spine ; Tuberculosis ; Tuberculosis, Spinal ; United States

A retrospective study has been made of 784 cases of road traffic casualties who were treated at the Soon-Chun-Hyang Hospital between July 1980 and December 1981. This study was conducted to find out the nature and pattern of the traffic accident from the clinical and epidemiological standpoints. In additions, the mode of injury from the road accidents were persued which might help to reduce the misdiagnosis rate. The results obtained were as follows: l. In this survey, male dominated in numbers (casualty rate, 70%). The highest incidence was in the age group between 31–40 year (26.5%). The predominance was found in younger casualties (ages between 21–50 years, 72.1% of all casualties). 2. The large number of casualties followed the rush hours. There was a peak between 10PM to midnight. The explanation for this high incidence during the hours was the hurry-up life due to midnight crufew, pedestrian's carelessness and hurry-scurry, and the negligence of traffic rules, the poor labor conditions and weariness due to drivers long continuous working hours, especially in taxi drivers. The highest seasonal incidence was in October. 3. The high incidences were in drivers and students; the drivers were the commonest victims in car passenger accidents and students were injured by pedestrians accidents respectively. The causes of high risk of injury in drivers were intimately related with their vocational aptitudes, the employment status, the driving attitudes and car maintainances; and in students, their carelessness and emotional instability, unsolved mass transportation system and their negligence of traffic rules were listed as the causative factors. 4. Over 51.8% of all casualties were injured by passenger car accidents, and 21.5% were by truck and other types of special vehicles. 5. Approximately 60% of victims were injuried in the road as pedestrian and other 40% were in the car as passengers. In general, the pedestrian injuries were more serious than those sustained in the car as passengers. 6. About 40% of total pedestrian casualties sustained injury at pedestrian's cross road. 7. About 80%of injured drivers were in the drunken state on arrival, and 20.4% of pedestrians were also heavily drunken. 8. The trauma risk was about twice higher in the front-seated passengers than the rear-seated ones in the car. In buses, the highest incidence was in the passengers seated in the front 1/3 of the seats. 9. Orthopaedic (40.5%) and head injuries (38.2%) were the commonest types of the injuries among the hospitalized casualties; about 35% of total patients had the tibial fractures. 10. Of the 784 cases, 479(61.6%) victims arrived hospital within 30 minutes after accident, and among them only 94 cases (12%) were transported by ambulance from the accident site to the hospital.
Accidents, Traffic ; Ambulances ; Aptitude ; Craniocerebral Trauma ; Diagnostic Errors ; Employment ; Humans ; Incidence ; Male ; Malpractice ; Motor Vehicles ; Occupations ; Pedestrians ; Retrospective Studies ; Seasons ; Tibial Fractures ; Transportation

The cataract extraction in traumatic cataract with corneal laceration is likely to be different from the ordinary cataract extraction in several points. We tried to know the problems of the operation, the visual outcomes and the postoperative complications in these eyes. In 25 traumatic cataract with corneal laceration, we performed cataract extraction and corneal suture at the same time in 11 eyes and at different time in 14 eyes. The intraoperative problems were difficult anterior capsulotomy, corneal opacity, difficult lens delivery etc.The major postoperative complications were anterior chamber inflammation, corneal edema, posterior capsular opacity and exudative pupillary membrane. In 23 eyes[92%], the visual acuity was increased more than 2 lines. Cataract extraction in traumatic cataract with corneal laceration was very effective surgery, and cataract extraction after primary corneal suture has done had good results in severe corneal laceration with suspicious posterior capsular rupture and non-fitted preoperative preparation.
Anterior Chamber ; Cataract Extraction ; Cataract* ; Corneal Edema ; Corneal Opacity ; Inflammation ; Lacerations* ; Membranes ; Postoperative Complications ; Rupture ; Sutures ; Visual Acuity