Fetal cystic hygroma is a rare congenital malformation of the lymphatic system appearing as a single or multiloculated fluid-filled cavity, most often in the neck. A case of fetal nuchal cystic hygroma was diagnosed by Ultrasonography at 22 weeks of gestation and the diagnosis was confirmed at autopsy. We present the case with a brief review of literature.
Autopsy ; Diagnosis ; Lymphangioma, Cystic* ; Lymphatic System ; Neck ; Pregnancy ; Ultrasonography

Two cases of vaginal injury due to Coitus are presented. One is the case of the laceration of midportion of posterior vaginal wall with shock and the other one in the laceration of posterior vaginal fornix and pelvic peritoneum. They are all in multiparity. And a review of literature on vaginal injury due to coitus is made briefly.
Coitus* ; Female ; Lacerations ; Parity ; Peritoneum ; Shock

No abstract available.

No abstract available.
Bartter Syndrome*

Anterior glenohumeral instability is mainly due to the Bankart lesion and capsular stretch. The differentiation between the Bankart lesion and capsular laxity may not be readily apparent on clinical examination. So, increasing attention has been directed toward preoperative evaluation of the labral lesion and capsular laxity. MRI and MR Arthrogram of 55 shoulders, 40 stable shoulders and 15 unstable shoulders that were confirmed by arthroscopic surgery, were reviewed to evaluate the labral and capsular shapes, especially the lesions of labroligamentous complex. To evaluate and compare the capsular laxity, we measured the anterior capsular insertion type, capsular ballooning, capsular insertion angle and anterior band of inferior glenohumeral ligament. And the following results were obtained; 1) The shape of anterior labrum was varied in the superior, middle and inferior potions in 40 stable shoulders. The anterior labral lesions were shown as torn(eight cases), displaced(six cases) and no detectable labrum(one case), in 15 unstable shoulders. Also, there were a significant di fference in the evaluation of the anteior labrum shape between MRI and MR arthrography. 2) There were not a significant difference in the type III capsular insertion type, capsular ballooning and capsular insertion angle between the stable and unstable shoulders. However, it was found that the shape of the anterior band of the inferior glenohumeral ligament had definite difference between the two groups. And so, more experience and attention should be given for the accurate preoperative evaluation of the anterior labroligamentous complex in shoulder instability.
Arthrography* ; Arthroscopy ; Ligaments ; Magnetic Resonance Imaging ; Shoulder

No abstract available.
Brain Stem Infarctions*

We present a family of FSP with review of literatures. Seeligmuller (1876) and Strumpell (1880) were the first to describe familial case of spastic paraplegia characterized by progressive weakness and spasticity of the lower limbs with little or no involvement of the upper extremities. This syndrome is heterogenous in inheritance, age of onset, severity and associated signs. A pure type without complications has been named "Strumpell's FSP". We have recently experienced a case of 17 years old male who had bilateral weakness and stiffness of lower extremities, and gait disturbance with family history. Differential diagnosis, particularly with familial amyotrophic lateral sclerosis, is discussed.
Adolescent ; Age of Onset ; Amyotrophic Lateral Sclerosis ; Diagnosis, Differential ; Gait ; Humans ; Lower Extremity ; Male ; Muscle Spasticity* ; Paraplegia* ; Upper Extremity ; Wills

PURPOSE: To evaluate the early clinical results of lumbar microdiscectomy using minimally invasive tubular retractor (METRx-MD system, Medtronic Sofamor Danek, Memphis, TN), and to validate the merits of minimally invasive spinal surgery. MATERIALS AND METHODS: From April, 2003 to April 2004 we retrospectively studied a consecutive series of 45 patients who underwent lumbar microdiscectomy using minimally invasive tubular retractor. In all cases, minimally invasive approach using the tubular retractor were performed with a 2 cm sized paramedian incision. The following data were collected: clinical outcomes, operative time, intraoperative blood loss, need for blood replacement, time needed before ambulation, length of hospital stay, and complications. The clinical outcomes were assessed by the modified MacNab criteria. RESULTS: Minimally invasive tubular microdiscectomy was performed in 45 patients over a 12-month period with an average follow-up of approximately 8 months. The clinical outcomes assessed by MacNab criteria were excellent in 33 patients (73%), good in 10 patients (22%). The average operative time was 63 minutes (range, 35 to 95 minutes). The average blood loss was 62 mL (range, 50 to 110 mL). None of the patients needed blood replacement. With the exception of 2 patients, all patients could walk at the day of surgery. The average hospital stay was 2.3 days. None of the patients had dural tear, wound problem, or other complications. CONCLUSION: Lumbar microdiscectomy using tubular retractor can offer a useful modality for the treatment of lumbar herniated disc with the merits of minimally invasive spinal surgery. Further long-term, randomized, prospective investigations are needed to fully evaluate the impact of this technique.
Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Length of Stay ; Operative Time ; Wounds and Injuries

There are many complications after traumatic shoulder dislocation including redislocation, dislocation capsulitis especially in the older age and dislocation arthropathy. Redislocation rates have been primarily related to age at the time of initial dislocation, to lesser degree, athletic participation, length of immobilization, rehabilitative exercises, and time hefore return to sports or full activity. So we wanted to confirm the difference of the lesion between the young and the old at the initial dislocation. Arthroscopic evaluation of the twelve patients with an acute traumatic anterior dislocation of the shoulder was done to identify the intraarticular pathology within 10 days of the initial injury. All patients were taken MRI and evaluated under anesthesia. We classified these shoulders into two groups based on the age of patient. Young agegroup under 30 were seven patients and old age-group over 40 were five patients. And the following results were ohtained; 1. The detachment of the anterior labrum with the inferior glenohumeral ligament from the glenoid rim was primary finding and might cause the shoulder unstable under anesthesia in the young age-group under 30. 2. In the age-group over 40, there were the capsular tears with no labral lesion and these shoulders were stable under anesthesia 3. In acute traumatic anterior dislocation, examination under anesthesia was more closely related to the prediction of the extent of labro-ligamental detachment than MRI examination. 4. We believe that arthroscopic surgical intervention after the initial shoulder dislocation should be considered as a treatment option
Anesthesia ; Arthroscopy ; Dislocations* ; Exercise ; Humans ; Immobilization ; Ligaments ; Magnetic Resonance Imaging ; Pathology ; Shoulder Dislocation ; Shoulder* ; Sports

PURPOSE: The purpose of this study was to investigate and define the factors affecting the success of quad-sparing (QS) minimally invasive total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 120 patients(150 knees) were tried consecutively to undergo QS minimally invasive TKA from July 2004 to February 2005. Seventy knees (Group 1) could be performed with this technique, but 80 knees (Group 2) were failed and required further incision. Two groups were compared for clinical, radiological and postoperative data. These cases were also divided into three groups according to the time undergone surgery. For these three groups, we analyzed the clinical data and surgical results. RESULTS: Age, height, weight, body mass index and pre-operative knee score were not significantly related to the success of QS minimally invasive TKA. Greater preoperative range of motion, low patella height, and smaller size of the tibial implant were of a significant correlation with the success of surgery. As the number of cases were cumulated, the success rate of this method increased and the operating time was shortened. CONCLUSION: QS minimally invasive TKA could not be successfully applied to every patients. For the success of this surgery, adequate preoperative assessment of the patient and sufficient experience on this surgical technique would be necessary.
Arthroplasty* ; Body Weight ; Humans ; Knee* ; Patella ; Range of Motion, Articular