We report 1 case of Fanconi's anemia which has severe pancytopenia, PDA, hypoplatic right thumb and cryptorchism with a brief review of related literature and references.
Cryptorchidism ; Fanconi Anemia* ; Male ; Pancytopenia ; Thumb

PURPOSE: To determine the accuracy of MRI on postoperative pain syndrome (POPS), including early complications such as hematoma or infection. MATERIALS AND METHODS: Of the 54 patients with the POPS, we analyzed pre-operative MRI findings compared with operative findings on 39 patients, excluding nonunion, instability, metal failure and pseudarthrosis, who underwent an operation for POPS from December 1994 to June 1997. There were 25 men (64.1%) and 14 women (35.9%), aged from 16 to 68 years (average 44.5 years). They were divided into 5 subgroups and calculated for sensitivity, specificity and positive predictability. RESULTS: MRI accuracy in recurred disc was 84%, scar adhesion, recurred or developed stenosis, infection and hematoma was 100% for each overall accuracy of MRI was 93%. Average interval of reoperation in POPS was 3.2 years. In 21 cases (53.8%), symptoms persisted without pain-free interval after first operation. CONCLUSIONS: Early complications, including hematoma and infection, are easily detected with MRI. Especially if patient complains of severe leg pain or neurologic deficit, MRI is a good diagnostic tool. MRI is a useful method for evaluation of most cases of POPS, but it is limited in evaluating recurred disc or scar adhesion only in T1, T2 weighted image. Therefore, Gd-DTPA enhancement is necessary for an accurate diagnosis.
Cicatrix ; Constriction, Pathologic ; Diagnosis ; Female ; Gadolinium DTPA ; Hematoma ; Humans ; Leg ; Magnetic Resonance Imaging* ; Male ; Neurologic Manifestations ; Pain, Postoperative* ; Pseudarthrosis ; Reoperation ; Sensitivity and Specificity

PURPOSE: Lymph node metastasis is an important factor for predicting the prognosis of colorectal cancer patients. However, approximately 60% of patients do not receive adequate lymph node evaluation (less than 12 lymph nodes). In this study, we identified a more effective tool for predicting the prognosis of patients who received inadequate lymph node evaluation. MATERIALS AND METHODS: The number of metastatic lymph nodes, total number of lymph nodes examined, number of negative metastatic lymph nodes (NL), lymph node ratio (LR), and the number of apical lymph nodes (APL) were examined, and the prognostic impact of these parameters was examined in patients with colorectal cancer who underwent surgery from January 2004 to December 2011. In total, 806 people were analyzed retrospectively. RESULTS: In comparison of different lymph node analysis methods for rectal cancer patients who did not receive adequate lymph node dissection, the LR showed a significant difference in overall survival (OS) and the APL predicted a significant difference in disease-free survival (DFS). In the case of colon cancer patients who did not receive adequate lymph node dissection, LR predicted a significant difference in DFS and OS, and the APL predicted a significant difference in DFS. CONCLUSION: If patients did not receive adequate lymph node evaluation, the LR and NL were useful parameters to complement N stage for predicting OS in colon cancer, whereas LR was complementary for rectal cancer. The APL could be used for prediction of DFS in all patients.
Colonic Neoplasms ; Colorectal Neoplasms* ; Complement System Proteins ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Methods* ; Neoplasm Metastasis ; Prognosis* ; Rectal Neoplasms ; Retrospective Studies

Colonoscopy is frequently used for lower GI tract screening tests. Although rare, splenic injury may develop in the high-risk patients on anticoagulants or antiplatelet agents. A 78-year-old female visited our hospital complaining of chest pain. She had taken antihyperlipidemic and antiplatelet agent with hyperlipidemia and 20%-stenosis in the left anterior descending artery. She was taken polypectomy after colonoscopy 4 years ago. The next day, after a follow-up colonoscopy for polypectomy, she complained epigastric and left upper abdominal discomfort. Pain intensity was not high, but next day, epigastric pain was increased, so coronary angiography was performed 2 days later using anticoagulants. Coronary angiography showed 40~50%-stenosis in the left anterior descending artery. Another antiplatelet agent was added. After 72 hours on colonoscopy, her pain was localized upper left abdominal area. Abdominal CT showed intracapsular bleeding in the spleen with a small amount of hemoperitoneum in the pelvis. Since her vital signs were stable, she was treated with conservative management. Her pain improved and discharged. One month later, she was taken Abdominal CT. CT showed the size of intracapsular fluid collection in the spleen was increased, but the whole fluid collection was liquidized. 2 weeks later, follow-up sonography showed the size of fluid collection conspicuously was reduced. The case reported herein is a splenic Injury after Colonoscopy in patient on antiplatelet agents.
Aged ; Anticoagulants ; Arteries ; Chest Pain ; Colonoscopy* ; Coronary Angiography ; Female ; Follow-Up Studies ; Hemoperitoneum ; Hemorrhage ; Humans ; Hyperlipidemias ; Lower Gastrointestinal Tract ; Mass Screening ; Pelvis ; Platelet Aggregation Inhibitors ; Spleen ; Tomography, X-Ray Computed ; Vital Signs

BACKGROUND AND OBJECTIVES: Pulmonary hypertension is characterized by abnormal proliferation of vascular endothelial cells and smooth muscle cells, and progressive pulmonary microvascular leakage that leads to pulmonary edema. This study was designed to investigate the protective effect of simvastatin on monocrotaline (MCT)-induced pulmonary hypertension and the role of the aquaporin (AQP) water channels. MATERIALS AND METHODS: Twenty one 8-week-old rats were randomized to the control, MCT (60 mg/kg, sc) and the MCT plus simvastatin (5 mg/kg/day, po) groups. Four weeks later, the systolic right ventricular pressure, the right ventricular hypertrophy, the medial wall thickness of the peribronchiolar artery and pulmonary arterioles and the renal function were measured to examine the effects of MCT and simvastatin in the rats. Western blotting for lung aquaporin1 (AQP1) and renal aquaporin2 (AQP2) was performed to analyze the effects of MCT and simvastatin on the AQP water channels. RESULTS: Treatment with simvastatin reduced the MCT-induced enhanced right ventricular pressure (32.3+/-2.1 vs. 52.4+/-3.9 mmHg, respectively; p<0.05), the right ventricular hypertrophy (0.32+/-0.03 vs. 0.48+/-0.07, respectively; p<0.05) and the increased medial wall thickness of the peribronchiolar artery (0.14+/-0.02 vs. 0.28+/-0.02, respectively; p<0.05) and pulmonary arterioles (0.15+/-0.04 vs. 0.29+/-0.11, respectively; p<0.05). The decreased expression of lung AQP1 and renal AQP2 protein after MCT treatment was normalized by simvastatin treatment (p<0.05). Additionally, simvastatin treatment significantly reduced the perivascular and interstitial edema in the rats' lungs without major alterations of renal function. CONCLUSION: These results suggest that simvastatin attenuates the MCT-induced pulmonary hypertension and the pulmonary edema by up-regulation of lung AQP1. Modulation of AQP may be one of the important mechanism of simvastatin.
Animals ; Aquaporin 2 ; Arteries ; Arterioles ; Blotting, Western ; Edema ; Endothelial Cells ; Hypertension, Pulmonary ; Hypertrophy, Right Ventricular ; Lung ; Monocrotaline ; Myocytes, Smooth Muscle ; Pulmonary Circulation ; Pulmonary Edema ; Rats ; Simvastatin ; Up-Regulation ; Ventricular Pressure

STUDY DESIGN: Thirty-seven patients with spinal tuberculosis were evaluated according to surgical method. OBJECTIVES: To evaluate the effectiveness of posterior spinal instrumentation in the surgical treatment of patient with tuberculous spondylitis. SUMMARY OF LITERATURE REVIEWS: There are many debates about the effectiveness of posterior spinal instrumentation combined with anterior interbody fusion in tuberculous spondylitis. MATERIALS AND METHODS: From January 1995 to June 2000, 37 patients were divided into two groups depending on their use of posterior spinal instrumentation. Group I consist of thirteen patients who were treated with conventional anterior corpectomy and anterior interbody fusion using autogenous strut bone graft. Group II was composed of twenty-four patients who were treated with conventional anterior corpectomy and anterior interbody fusion combined with posterior spinal instrumentation. Changes of corrected kyphotic angle and complication were measured using pre-, post-operative and follow-up radiographs and chart review. RESULTS: In group I, six cases (46.2%) showed loss of corrected kyphotic angle. Of these six cases, five cases had initial kyphotic angle of more than 20 dgree and three cases had involvement of two or more vertebrae. All six cases had thoracic or thoracolumbar involvement. Comparing two groups, maintaining corrected kyphotic angle and low complication rates were obtained in group II during follow-up period. The change of deformity as followed. In thoracic area, the mean kyphotic angle of 26.5 dgree was reduced to 18 dgree postoperatively, At the most recent follow-up, the mean kyphotic angle was 31.5 dgree in group I, a loss of correction of 13.5 dgree . In group II, the mean kyphotic angle was corrected from 27 dgrees to 13.5 dgree after surgery. At the most recent follow-up, the mean kyphotic angle was 17.5 dgrees, a loss of correction of 4 dgree . CONCLUSION: Posterior spinal instrumentation combined with conventional anterior corpectomy and anterior interbody fusion were found to be effective for preventing loss of kyphotic angle and for maintaining stable bone fusion in patients with mean
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Spine ; Spondylitis* ; Transplants ; Tuberculosis, Spinal

BACKGROUND: In Korean traditional medicine, human beings are classified into 4 groups accordance with the characteristics of physical constitution, named; Taeum, Taeyang, Soum, and Soyang. Most of Korean traditional doctors believe that the back ground of pathophysiology is differ among each group in many diseases. HLA is the most polymorphic gene and related with human immune response. It has been used for determination of individual identification, genetic diversity and a study of disease association in different ethnic group. It has well known that the most human inflammatory disease which thought to have some autoimmune basis are in some way promoted by genes of the HLA region. The purpose of this study is to observe the distribution of HLA-DR genotypes in 4 types of physical constitution in Korean traditional medicine. METHODS: Three hundred and ten Korean subjects(Soyang : 58cases, Soum :142cases, Taeum : 92cases, Taeyang : 18cases) were enrolled for this study. Genomic DNAs extracted by phenol/chroloform were amplified with allele specific primers and determined by 2% agarose gel electrophoresis with ethidium bromide staining for analysis of HLA-DR polymorphism. RESULTS: The genotype frequency of HLA-DR in a total or 310 Koreans was DR1 ; 7.2%, DR 2; 10.5%, DR 3;1.7%, DR 4; 19.9%, DR 5; 11.9%, DR 6;19.9%, DR 7; 7.0%, DR 8; 10.6%, DR 9; 8.7%, DR10;1.9%. There was no significant diffrence of HLA-DR genotype distribution among four physical constitution groups classified by Korean traditional medicine. CONCLUSION: Our results suggest that the classification of physical constitution in Korean traditional medicine is not related to HLA-DR genotypes.
Alleles ; Classification ; Constitution and Bylaws* ; DNA ; Electrophoresis, Agar Gel ; Ethidium ; Ethnic Groups ; Genetic Variation ; Genotype ; HLA-DR Antigens* ; Humans ; Medicine, Korean Traditional*

PURPOSE: Spontaneous subarachnoid hemorrhage(S-SAH) is a relatively rare disease with good clinical course and prognosis. The purpose of this study is to evaluate the cisternal blood distribution on CT in patient with S-SAH. MATERIALS AND METHODS: Out of 406 patients with subarachnoid hemorrhage on brain CT scan, 11 patients confirmed to be S-SAH by angiography and clinical follow-up were examined. We analysed the CT findings of these 11 cases retrospectively. RESULTS: Five patients had only perimesencephalic distribution of hemorrhage:the prepontine, the interped- uncular, and the suprasellar cisterns were involved in 4 cases each, the basal sylvian cistern in 3 cases, and the ambient cistern in 2 cases. The quadrigeminal and a portion of the lateral sylvians were also involved in 1 case each. Six patients revealed cisternal hemorrhage extending beyond the perimesencephalic cistern into the ventricles, cortical sulci, and lateral sylvian fissure. Intraventricular hemorrhage was noted in 3 cases of these 6 patients. CONCLUSION: Our study suggests that uncomplicated clinical course and normal anglographic finding are more important than CT distribution of cisternal hemorrhage in diagnosing S-SAH.
Angiography ; Brain ; Follow-Up Studies ; Hemorrhage ; Humans ; Prognosis ; Rare Diseases ; Retrospective Studies ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

Infectious intracranial aneurysm, so-called mycotic aneurysm, has been rarely reported after era of antibiotics. Infective endocarditis is the most common cause. It is commonly occurs in patients with valvular heart disease. The authors report a case of infectious intracranial aneurysm in the distal branch of the right middle cerebral artery with embolic cerebral infarction in the contralateral middle cerebral artery territory. The patient underwent surgical excision of the aneurysm after six weeks of antibiotics therapy. The pathological findings demonstrated severe inflammatory change in the adventitial layer but intact intimal layer. The clinical features and the pathogenesis is discussed with review of pertinent literature.
Aneurysm* ; Aneurysm, Infected ; Anti-Bacterial Agents ; Cerebral Infarction* ; Endocarditis ; Heart Valve Diseases ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery

No abstract available.
Angiomyolipoma* ; Tuberous Sclerosis*