Femoral head and neck fractures during the course of avascular necrosis are rare with only few reports in the English literature. Moreover, there are very few reports on an analysis of the patterns of these fractures. Four cases of femoral head fracture caused by minor trauma, which were quite different from the crescent fractures during the course of avascular necrosis were analyzed in regard to the underlying disease, causes, sites, types, directions, pattern of fractures and the injury mechanism of the fractures. The results are reported with special regard to the pattern of the stress fracture of the femoral head and neck during the course of avascular necrosis.
Fractures, Stress ; Head* ; Neck* ; Necrosis*

Granular Cell Tumors(GCT) were originally described as myoblastic myomas. Subsequent scientific investigations elucidated the origin of this tumor as Schwann cells . Usually they have a predilection for head and neck, but also can occur in many other organs. This tumor is believed to originate from Schwann cells based on subsequent scientific investigations. Although it usually appears in the head and neck, it can also appear in other organs, as well. Endobronchial granular cell tumors are rather rare and should be differentiated from other common diseases of endobronchial location endobronchial diseases such as bronchogenic carcinoma and endobronchial tuberculosis, especially in Korea . We report a A case of a patient with an extremely rare condition of endobronchial granular cell tumor concurrent with malignant mediastinal tumor in a patient (delete) is reported.
Carcinoma, Bronchogenic ; Granular Cell Tumor* ; Head ; Humans ; Korea ; Myoblasts ; Myoma ; Neck ; Schwann Cells ; Tuberculosis

The appearance of a tumor in the chest wall is rare compared to that in any other part of the body. It can be classified into benign and malignant types and can be located in the rib, clavicle, sternum, cartilage and soft tissues. Tumors that are metastatic are commonly located in the lung, breast, bone and pleura. But, the soft tissue mass of anterior chest wall is rarely metastasized from a distant organ that is not confined to the thoracic cavity. This and thus has rarely been described. A 68-year-old man was admitted to our hospital with a chief complaint of resting dyspnea. A huge non-tender mass of about 10*15 cm in size was visible on his left lower anterior chest wall. We pathologically confirmed that the mass was a metastatic renal cell carcinoma of clear cell type by incision biopsy. Through an incision biopsy, the mass was pathologically confirmed as a metastatic renal cell carcinoma of the clear cell type.
Aged ; Biopsy ; Breast ; Carcinoma, Renal Cell* ; Cartilage ; Clavicle ; Dyspnea ; Humans ; Lung ; Neoplasm Metastasis* ; Pleura ; Ribs ; Sternum ; Thoracic Cavity ; Thoracic Wall* ; Thorax*

PURPOSE: There have been high rates of false positive and recall in neonatal screening test using the cut-off points set by the manufacturing company. So, it is necessary to re-evaluate the cut-off values to minimize the false positive rates. METHODS: We collected capillary blood in dry filter paper from 996 healthy neonates on the third day in cases of normal vaginal delivery or the fifth day in cases of Cesarean section. The levels of phenylalanine, galactose, 17-hydroxyprogesterone and branched-chain amino acids were measured using enzyme immunoassay. The results were compared with the original cut-off points set by the manufacturing company. RESULTS: The original cut-off points of four substances were 4.0mg/dL, 7.5mg/dL, 35ng/mL, and 8.0mg/dL, respectively, so that false-positive rates were 0.4, 1.6, 3.93, and 0.001%, respectively. When we set the cut-off point at 99.7 percentile using the data from healthy neonates, they should be 4.0mg/dL, 9.2mg/dL, 54.3ng/mL, and 8.0mg/dL, respectively. CONCLUSION: The false-positive and recall rates were higher in galactosemia and congenital adrenal hyperplasia when using the original cut-off points, suggesting that it would be reasonable to modify the cut-off point at 99.7 percentile after measuring those substances from enough of healthy neonates.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital ; Amino Acids, Branched-Chain ; Capillaries ; Cesarean Section ; Female ; Galactose ; Galactosemias ; Humans ; Immunoenzyme Techniques ; Infant, Newborn ; Metabolism, Inborn Errors* ; Neonatal Screening* ; Phenylalanine ; Pregnancy

PURPOSE: There have been high rates of false positive and recall in neonatal screening test using the cut-off points set by the manufacturing company. So, it is necessary to re-evaluate the cut-off values to minimize the false positive rates. METHODS: We collected capillary blood in dry filter paper from 996 healthy neonates on the third day in cases of normal vaginal delivery or the fifth day in cases of Cesarean section. The levels of phenylalanine, galactose, 17-hydroxyprogesterone and branched-chain amino acids were measured using enzyme immunoassay. The results were compared with the original cut-off points set by the manufacturing company. RESULTS: The original cut-off points of four substances were 4.0mg/dL, 7.5mg/dL, 35ng/mL, and 8.0mg/dL, respectively, so that false-positive rates were 0.4, 1.6, 3.93, and 0.001%, respectively. When we set the cut-off point at 99.7 percentile using the data from healthy neonates, they should be 4.0mg/dL, 9.2mg/dL, 54.3ng/mL, and 8.0mg/dL, respectively. CONCLUSION: The false-positive and recall rates were higher in galactosemia and congenital adrenal hyperplasia when using the original cut-off points, suggesting that it would be reasonable to modify the cut-off point at 99.7 percentile after measuring those substances from enough of healthy neonates.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital ; Amino Acids, Branched-Chain ; Capillaries ; Cesarean Section ; Female ; Galactose ; Galactosemias ; Humans ; Immunoenzyme Techniques ; Infant, Newborn ; Metabolism, Inborn Errors* ; Neonatal Screening* ; Phenylalanine ; Pregnancy

Spontaneous pneumomediastnum is a very rare complication of systemic autoimmune diseases. The precise mechanism of pneumomediastinum in dermatomyositis is not well known. Pulmonary alveoli rupture secondary to interstitial pneumonitis or pulmonary infarctions consequent upon vasculitis are the suggested mechanisms. Among the idiopathic inflammatory myopathies, dermatomyositis and polymyositis show similar clinical manifestations except skin lesions. But pneumomediastinum occurs exclusively in cases with dermatomyositis, not in case with polymyositis. In a literature review, patients with dermatomyositis and pneumomediastinum had some characteristic features. As compared with dermatomyositis without pneumomediastinum, CK level was normal in about half and concomitance of interstitial lung disease and cutaneous vasculitis were very frequent. We experienced a case of dermatomyositis with spontaneous pneumomediastinum and subcutaneous emphysema. Thus we report that with a review of the literature and analysis of reported cases.
Autoimmune Diseases ; Dermatomyositis* ; Humans ; Lung Diseases, Interstitial ; Mediastinal Emphysema* ; Myositis ; Polymyositis ; Pulmonary Alveoli ; Pulmonary Infarction ; Rupture ; Skin ; Subcutaneous Emphysema* ; Vasculitis

PURPOSE: The purpose of this study was to assess the usefulness of CT angiography(CTA) with spiral CT in evaluation of intracranial vascular lesions. MATERIALS AND METHODS: CTA and conventional angiography(CA) were performed in 22 patients with suspected intracranial vascular lesion. Nine patients had 10 aneurysms and 2 patients had arteriovenous malformation(AVM)s, while the remaining 11 patients had no vascular lesion. Twenty seconds after beginning injection of contrast media(100 mL with use of a power injector at the rate of 3 mL/sec), CT scanning(30-second continuous exposure and 60-mm length) was performed with a table speed of 2mm/sec and a section thickness of 2mm. The starting point was selected at the floor of the sella turcica. The resulting data were reformatted by MIP and SSD after reconstruction of 1 mm interval. For aneurysm, its size, shape, direction, neck and the relationship to adjacent vessels were compared to CA. RESULTS: The aneurysm diameter was ranged between 3mm and 20mm and all aneurysms were clearly visualized with CTA. CTA findings of the size, shape, direction, and neck of aneurysms and the relationship between aneurysm and adjacent vessels were well correlated with CA. In one case of aneurysm, calcification of the aneurysm wall was demonstrated on CTA. In one case of AVM, the nidus and its arterial supply and venous drainage were well visualized. In the other case of AVM, however, the feeding artery of AVM was not demonstrated on CTA(it was also unclear on CA). CONCLUSION: CTA with spiral CT may be useful in the evaluation of intracranial vascular lesion and valuable as a screening test for intracranial aneurysm.
Aneurysm ; Angiography* ; Arteries ; Drainage ; Humans ; Intracranial Aneurysm ; Mass Screening ; Neck ; Sella Turcica ; Silver Sulfadiazine ; Tomography, Spiral Computed*

PURPOSE: To investigate the causes of gastric wall shortening in early gastric cancer, upper gastrointestinal study was correlated with pathologic findings. MATERIALS AND METHODS: We evaluated 41 cases(M :F=1.7:1, average age=49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I; none, Grade II ;intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumor invasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, and morphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wall shortening on upper gastrointestinal series. RESULTS: Submucosal fibrosis was present in 4 cases in Grade I (n=21), 4 cases in Grade II (n=6) and 8 cases in Grade III (n=10). Positive conversing mucosal folds were seen in 5 cases in Grade I (n=17), 0 case in Grade II (n=2) and 9 cases in Grade III (n=9). Gastric wall shortening was significantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (p=.0001 and p=.002, respectively) CONCLUSION: Upper gastrointestinal finding of gastric wall protrusion in patients with early gastric cancer should not misinterprete as advanced gastric cancer since the finding could be a result of submucosal fibrosis.
Fibrosis ; Humans ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: To investigate the causes of gastric wall shortening in early gastric cancer, upper gastrointestinal study was correlated with pathologic findings. MATERIALS AND METHODS: We evaluated 41 cases(M :F=1.7:1, average age=49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I; none, Grade II ;intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumor invasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, and morphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wall shortening on upper gastrointestinal series. RESULTS: Submucosal fibrosis was present in 4 cases in Grade I (n=21), 4 cases in Grade II (n=6) and 8 cases in Grade III (n=10). Positive conversing mucosal folds were seen in 5 cases in Grade I (n=17), 0 case in Grade II (n=2) and 9 cases in Grade III (n=9). Gastric wall shortening was significantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (p=.0001 and p=.002, respectively) CONCLUSION: Upper gastrointestinal finding of gastric wall protrusion in patients with early gastric cancer should not misinterprete as advanced gastric cancer since the finding could be a result of submucosal fibrosis.
Fibrosis ; Humans ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: This study was conducted to evaluate success and perforation rates of pneumatic reduction and to find the predictors of reduction failure. METHODS AND MATERIALS: We reviewed 224 cases of pediatric intussusception diagnosed by air-enema between July, 1989 and June, 1992. The mean age was 9.8 months(range, 1 month to 3 years). Logistic regression analysis was used to find predictors of reduction failure. RESULTS: Successful reduction was achieved in 197 cases(87.9% of success rate). Bowel perforation occurred in two cases(0.9% of perforation rate). There were two statistically significant predictors of failure;(1) ileoileocolic intussusception(p<.001), (2) long duration of symptom(p<.001). Surgery was performed in 26 cases (11.6%), of which seven required bowel resection. CONCLUSION: Pneumatic reduction is a useful means in the management of pediatric intussusception with a high success rate and no mortality.
Child* ; Humans ; Insufflation* ; Intussusception* ; Logistic Models ; Mortality