Benign tumors and tumor like lesions in the foot are uncommon and those that are malignant are rare. Metastatic cancer of bone distal to the knee and elbow is unusual. By contrast, non-tumorous lisions that cause swelling, pretuberance, or deformity are common. Fifty two cases of tumors on foot were treated at our department from Jan. 1970 to Dec. 1991, we have treated fifty two cases of foot tumor and analysed their clinical characteristics. Bone tumors were more frequent than soft tissue tumors (2:1). Among soft tissue tumors benign tumors were frequent than malignant(1.4:1), and fibroma was the most frequent tumor(30%). Benign soft tissue tumors occured frequently at Edward and Michael's Zone 3(57%). Benign bone tumors has higher incidence than malignant(20:1). Osteochondroma was the most frequent tumor (48%). Predilection sites for osteochondroma and enchondroma of foot was distal phalanges and mitatarsal bone, respectively.
Bone Neoplasms ; Chondroma ; Congenital Abnormalities ; Elbow ; Fibroma ; Foot ; Incidence ; Knee ; Osteochondroma

Syndrome of inappropriate antidiutetic hormone(SIADH) secretion is the most common cause of hyponatremia in clinical medicine. Before diagnosis of the SIADH is made, other causes for a decreased diluting capacity and nonosmotic stimuli for AVP release need to be rule out. Disorders associated with SIADH can be divided into 4 major etiologic groups: malignancies, pulmonary diseases, central nervous disorders, and drugs. A 45-year-old woman was admitted due to maculopapular skin eruption and fever after taking medications for fever and myalgia. Generalized tonic clonic seizure was developed nine days later, and laboratory results showed marked hyponatremia. During the evaluation, treatment, and subsequent follow-up, the diagnosis of SIADH was confirmed, but the definitive cause was obscure. With fluid restriction, sodium replacement and demeclocycline therapy, she recovered completely 6 months later. We suggest that the SIADH might be related to drug-induced generalized maculopapular rash via menmgitis-like reaction in CSF as one of systemic adverse side effects to drugs rather than direct effect of related drugs.
Clinical Medicine ; Demeclocycline ; Diagnosis ; Exanthema* ; Female ; Fever ; Follow-Up Studies ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Lung Diseases ; Middle Aged ; Myalgia ; Seizures ; Skin ; Sodium

PURPOSE: This study was conducted to know the applications and limitations of three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT. MATERIALS AND METHODS: This study examined 25 patients who underwent temporal bone CT using a 16-row detector CT as a result of hearing problems or trauma. The axial CT scan of the temporal bone was performed with a 0.6 mm collimation, and a reconstruction was carried out with a U70u Sharp of kernel value, a 1 mm thickness and 0.5-1.0 mm increments. After observing the ossicles in the axial and coronal images, virtual endoscopy was performed using a three dimensional volume rendering technique with a threshold value of -500 HU. The intra-operative otoendoscopy was performed in 12 ears, and was compared with the virtual endoscopy findings. RESULTS: Virtual endoscopy of the 29 ears without hearing problems demonstrated hypoplastic or an incomplete depiction of the stapes superstructures in 25 ears and a normal depiction in 4 ears. Virtual endoscopy of 21 ears with hearing problems demonstrated no ossicles in 1 ear, no malleus in 3 ears, a malleoincudal subluxation in 6 ears, a dysplastic incus in 5 ears, an incudostapedial subluxation in 9 ears, dysplastic stapes in 2 ears, a hypoplastic or incomplete depiction of the stapes in 16 ears and no stapes in 1 ear. In contrast to the intra-operative otoendoscopy, 8 out of 12 ears showed a hypoplastic or deformed stapes in the virtual endoscopy. CONCLUSION: Volume rendering virtual endoscopy using a multi-row detector CT is an excellent method for evaluation the ossicles in three dimension, even though the partial volume effect for the stapes superstructures needs to be considered.
Ear ; Endoscopy* ; Hearing ; Humans ; Incus ; Malleus ; Stapes ; Temporal Bone ; Tomography, X-Ray Computed

Hashimotos thyroiditis has been associated with a various autoimmune disorders. The immunologic mechanisms involved in the pathogenesis of these disorders have not always been thought to be the same. Although it was demonstrated that there were high prevalence of abnormal thyroid function and autoantibody in autoimmune hemolytic anemia(AIHA) and Fisher-Evans syndrome(FES), AIHA combined with Hashimotos thyroiditis is rare in Korean literature. It was suggested that a common immunologic mechanism may be involved in the pathogenesis of both disease and the possibility of multiple autoimmune syndrome might present in autoimmune hematologic disorders. We experienced a 74-year old woman with a 12-year history of a hypothyroidism due to Hashimotos thyroiditis was hospitalized with sudden development of warm AIHA with positive Direct & Indirect Coombs test and pericardial effusion. Her thyroid function test showed subclinical hypothyroidism with the maintenance dosage of levothyroxine(100pg/day). With glucocorticoid and plasmapheresis, AIHA and pericardial effusion were corrected successfully. It is suggested that the prudent immunologic study is needed for the anemia developed in patients with Hashimotos thyroiditis with or without hypothyroidism.
Aged ; Anemia ; Anemia, Hemolytic, Autoimmune* ; Coombs Test ; Female ; Humans ; Hypothyroidism ; Pericardial Effusion* ; Plasmapheresis ; Prevalence ; Thyroid Function Tests ; Thyroid Gland* ; Thyroiditis*

OBJECTIVES: ECS could have therapeutic effects on psychiatric illnesses by inducing IEGs, which in turn regulates expression of their target genes. We observed AP-1 binding activity and identified AP-1 binding proteins in NMDAR1, late response gene of IEGs, which considered as the candidate gene for schizophrenia. METHODS: By gel shift assay and supershift assay, we observed binding activities and AP-1 binding proteins in NMDAR1. Because IEGs are induced rapidly but transiently by external stimuli, there is a possibility that the expression of IEGs is negatively feedbacked by their own products via their AP-1 binding sites. For that purpose, we also observed AP-1 binding activity of c-fos and c-jun via gel shift and supershift assay. RESULTS: ECS increased AP-1 binding activities of NMDAR1 gene, contributed by c-Fos and its related proteins. Peak of the increased binding was 60 minutes in both hippocampus and cerebellum. Though expression of c-Fos and c-Jun were increased by ECS, there were no changes in AP-1 binding activities after ECS. AP-1 sites of IEGs were binded by CREB, regardless of ECS. CONCLUSION: There is a possibility that ECS induced IEG expression, and then incresed expression of NMDR1 by binding of expressed IEGs to the AP-1 site of NMDAR1. ECS did not increase AP-1 binding activities of IEGs. This suggests that the regulation of IEGs' expression can not be influenced mainly by AP-1 site.
Animals ; Binding Sites ; Brain* ; Carrier Proteins ; Cerebellum ; Electroshock* ; Hippocampus ; Rats* ; Schizophrenia ; Transcription Factor AP-1*

Diabetic insipidus may first present before, during or immediately after pregnancy. Pregnancy serves as a physiologic provocation test that unmasks latent diabetes insipidus. It may explain the very rare first occurrence of diabetes insipidus in the pureperium. Central diabetes insipidus occurring after delivery associated with a catastrophic delivery and postpartum hypopituitarism is more frequent entity. We recently experienced central diabetes insipidus patient, aggrevated polyuria and polydipsia after total hysterectomy due to cervical carcinoma, who had interesting past history of severe polyuria and polydipsia developed during puerperium of 1st pregnancy, 14 years ago. She have had quiet normal pregnancy and there was no definite postpartum complication of pregnancy at that time. There were no change of polyuria and polydipsia during and after second pregnancy and 2 another pregnancy terminated artificially compare to puerperium of 1st delivery. She has intact anterior pituitary gland functinally and anatomically, but the posterior pituitary hyperintense signal with pre-enhance Tl-weighted imaging was absent on MRI.
Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Humans ; Hypopituitarism ; Hysterectomy ; Magnetic Resonance Imaging ; Pituitary Gland, Anterior ; Polydipsia ; Polyuria ; Postpartum Period* ; Pregnancy

We report a case of Lennox-Gastaut syndrome successfully treated by the removal of hippocampal gangliocytoma. A17-year-old girl was admitted due to intractable tonic seizure, generalized tonic clonic seizure, and frequent fallingdespite the administration of polypharmacotherapy. She was mentally retarded and had developmental delays. She had the first seizure at the age of 12 months and the pattern of seizures seemed to be drop attacks. Electroencephalogram (EEG) showed background slowing of about 7 Hz, multifocal spike and wave, and generalized spike and wave complex-es (1.5~3.5 Hz). Magnetic resonance image (MRI) revealed a small polycystic mass in the left parahippocampal gyrus and hippocampal atrophy. A left hippocampectomy and total resection of the tumor was performed. Histopathologically, the cysts were identical to gangliocytoma. Sixth months later, the frequency of seizures decreased to once a month No seizures have been reported since August 1998.
Atrophy ; Electroencephalography ; Female ; Ganglioneuroma* ; Humans ; Mentally Disabled Persons ; Parahippocampal Gyrus ; Seizures ; Syncope

The authors report a case of growing fracture of the skull, also called as leptomeningeal cyst, in a young boy who presented with symptoms of skull defect, headache, and pulsating mass on right posterior parietal area. Successful duroplasty and cranioplasty with autogenous bone were performed resulting in disappearance of all symptoms. The most significant factor contributing to the growing fracture is an underlying dura tear. A brief review of the relevant literature is also presented.
Arachnoid Cysts ; Headache ; Humans ; Male ; Rabeprazole ; Skull*

The authors report a case of growing fracture of the skull, also called as leptomeningeal cyst, in a young boy who presented with symptoms of skull defect, headache, and pulsating mass on right posterior parietal area. Successful duroplasty and cranioplasty with autogenous bone were performed resulting in disappearance of all symptoms. The most significant factor contributing to the growing fracture is an underlying dura tear. A brief review of the relevant literature is also presented.
Arachnoid Cysts ; Headache ; Humans ; Male ; Rabeprazole ; Skull*

No abstract available.
Leukemia, Monocytic, Acute* ; Leukemic Infiltration* ; Lymphatic Diseases* ; Skin*