Kallmann's syndrome is a rare condition, and this is defined as hypogonadotropic hypogonadism and anosmia or hyposmia. The syndrome may be associated with cleft lip, cleft palate, color blindness, skeletal abnormalities, renal agenesis, sensory neural hearing loss, obesity, etc. About 10 cases of Kallmann's syndrome have been reported in Korea, but there are no reports on cases of Kallmann's syndrome with atrophy of the frontal lobe, severe mental retardation and unilateral renal agenesis. We experienced a case of 17-year-old boy with abnormalities of the olfactory system, as was noted on magnetic resonance imaging (MRI). He had an atrophy of the frontal lobe, mental retardation, a micropenis and unilateral renal agenesis. Hormonal assay documented low levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone and thyroid-stimulating hormone (TSH). So, we report here on an unusual case of Kallmann's syndrome along with briefly reviewing the relevant medical literature.
Adolescent ; Atrophy ; Cleft Lip ; Cleft Palate ; Color Vision Defects ; Congenital Abnormalities ; Follicle Stimulating Hormone ; Frontal Lobe ; Genital Diseases, Male ; Hearing Loss ; Humans ; Hypogonadism ; Intellectual Disability ; Kallmann Syndrome ; Kidney ; Kidney Diseases ; Korea ; Luteinizing Hormone ; Magnetic Resonance Imaging ; Obesity ; Olfaction Disorders ; Penis ; Testosterone ; Thyrotropin

Two percent of neurological complications after spine surgery for various reasons have been reported. Most are static or improve with time. We encountered two cases of newly developed, progressive neurological deficits with severe pain radiating along the exiting root after posterior decompression, adhesiolysis, posterior lumbar interbody fusion (PLIF) with a cage for spinal stenosis after previous lumbar spine surgery. When explored, the severely tightened and less movable, edematous exiting root was entrapped by a pedicle without evidence of pedicle violation, direct injury, epidural hematoma or iatrogenic foraminal stenosis. A wider decompression with a resection of the pedicle reduced the root course and made it more movable. Immediately, the severe radiating pain subsided and the neurological deficit recovered. A progressive neurological deficit after spinal surgery for spinal diseases with foraminal stenosis can develop as a result of the inordinate manipulation of the root, which may provoke root edema, root self-entrapment around a pedicle and local ischemia. An image test and exploration should be performed immediately in cases of progressive single root neurological deficits immediately after spine surgery. Total decompression, even with a pedicle resection, should be considered to resolve the neurological deficits.
Constriction, Pathologic ; Decompression* ; Edema ; Hematoma ; Ischemia ; Neurologic Manifestations* ; Spinal Diseases ; Spinal Stenosis ; Spine*

Most elderly women experience a decrease in their bone density due to a deficiency of calcium intake, ovariectomy, or menopause. This study evaluated the usability of the microscrew as a skeletal anchorage system in these orthodontic treatment cases, using rats as a research group. The 4 month old sprague-dawley species rats were divided into two groups, the OS (Ovariectomy Screw), and the SS (Sham operation Screw) group. In both the OS and SS groups, microscrews were implanted into the palatal bone between the upper molar teeth and two upper incisors were retracted using NiTi coil spring with 75 g of force. After 3 days, the again after 7 days, 7 rats in each group were sacrificed. Three days before they were sacrificed, Alizarin red S was intraperitoneally injected, and their maxillary bone, tibia and blood from their hearts were taken. The components of the extracted blood were biochemically analyzed and non-decalcified grinding resin sections for maxillary bone and tibia were made. The sections were examined with a polarization microscope, and fluorescent microscope. Smaller concentrations of Ca and P, the inorganic substances closely related to bone density, were found in the extracted blood of the OS group. Both OS and SS groups showed a possibility of bone remodeling with a high concentration of ALP after 7 days. An increase in bone density on the tension and compression sides of the microscrew and the tension side of the tooth for both OS and SS groups was confirmed with a polarization microscope. However, the bone density of the pressure side of the tooth and apical side was decreased. More deposits of Alizarin red S in the bone after 7 days rather than 3 days seen with a fluorescent microscope suggested the existence of new bone formation.
Aged ; Animals ; Bone Density ; Bone Remodeling ; Calcium ; Female ; Heart ; Humans ; Incisor ; Infant ; Maxilla ; Menopause ; Molar ; Osteogenesis ; Osteoporosis ; Ovariectomy ; Rats* ; Rats, Sprague-Dawley ; Tibia ; Tooth

PURPOSE: To evaluate whether Extracorporeal Shock Wave Therapy (ESWT) is an effective treatment without side effects for chronically painful calcifying tendinitis. MATERIALS AND METHODS: Study subjects were 72 patients (17 males and 55 females) aged 37-64 years, with a mean of 48, showing chronic, symptomatic, calcifying tendinitis of the shoulder refractory to other conventional conservative therapies. Calcifications were type I or type II according to the classification of Gartner, and with a minimum diameter of 10 mm. Patients with type 3 calcific tendinitis were excluded, because this type has a strong tendency to spontaneous resolution. Extracorporeal shock wave therapy comprised one or two treatments, each consisting of 800 shocks, with a frequency of 120 impulse per minute and the energy density of 0.14 mJ/mm2. We assessed the presence and size of calcified deposits at 1, 3, 6 and 12 months by conventional radiography. All patients also underwent clinical examination, and the Constant (and Murley) score and pain were calculated. The intensity of pain was measured with the visual analogue scale (VAS) from 0 to 10 points, where 0 represents the absence of pain and 10 unbearable pain. RESULTS: One month after the treatment, complete resorption of the calcium deposits was observed in 19 patients (26%), partial resorption was observed in 26 patients (36%), and no modification in the calcium deposits was observed in 27 patients (38%). At six months the complete disappearance of the calcium deposits was noted in 42 patients (68%), but in the 10 patients (14%), calcium deposit appeared unchanged. This result is remained unvaried after 6 month follow-up. Using the Constant and Murley score, this study showed a significant decrease in pain and a significant increase in shoulder function (p<0.001). At six months, 76% of the patients presented satisfactory functional result. About 15% reported a subjective and objective recovery, and only 6 patients (8%), classified as poor result but in our series no differences were found between results at 6 month and 12 month follow-up. At 12 month follow-up there were differences in the Constant score between treated shoulder and contralateral side, respectively 77.6 (59-91) and 87.2 (74-96), but not significant. There were no side effects. CONCLUSION: ESWT is an effective treatment without side effects and an alternative therapy for chronically painful calcifying tendinitis of the shoulder refractory to conventional therapies.
Calcium ; Classification ; Follow-Up Studies ; Humans ; Male ; Radiography ; Shock* ; Shoulder* ; Tendinopathy*

BACKGROUND: Coronary artery spasm plays an important role in the pathogenesis of variant angina. However the precise mechanism (s) and the clinical characteristics of variant angina remain to be elucidated. We investigated the clinical characteristics and diagnostic features of variant angina. METHODS: The clinical characteristics and coronary angiographic findings were analyzed in 178 patients with angiographically documented coronary artery spasm, which developed spontaneously or was provoked by the admistration of intravenous ergonovine maleate. All patients were followed for at least 1 year or more or until their death. RESULTS: One hundred and eleven patients complained of chest pain which developed especially at night and in the early morning. One hundred and thirty three patients (74.7%) were smokers. The electrocardiographic findings at the time of admission showed no changes in 147 cases (82.6%), testes showed ST segment elevation in 22 cases (12.4%), ST segment depression in 2 cases (1.1%), T wave inversion in 7cases (3.9%). The treadmill test was performed in 135 cases, ST segment elevation was noted in 6 patients (4.4%) and ST segment depression in 18 patients (13.3%). All of the other results were within normal range. The ergonovine provovative tests for coronary spasms were safe and effective. The right coronary artery was the most prevalent site of coronary artery spasm. Drug treatment was applied initially to all patients, but only 115 patients (64.5%) received the follow-up. Of these three died from cardiac arrest. The rate of cardiac death was low (1.7%) in patient, which made it difficult to know the risk factors for the cardiac deaths. Two (1.1%) had cardiac arrest. They didn`t take any medication. Patients with variant angina usually responded well to nitrates and calcium antagonists. Thus nitrates and calcium antagonists are useful in preventing attacks and abolished attacks of variant angina. CONCLUSION: In this study, 13.2% of coronary artery disease was variant angina. The effectiveness of drug therapy and the prognosis of the patients was quite good in the group. But when chest pain happens, the adequate use of nitrate agents is needed because of cardia arrest or cardiac death in 2.8% of the patients.
Calcium ; Cardia ; Chest Pain ; Coronary Artery Disease ; Coronary Vessels ; Death ; Depression ; Drug Therapy ; Electrocardiography ; Ergonovine ; Exercise Test ; Follow-Up Studies ; Heart Arrest ; Humans ; Nitrates ; Prognosis ; Reference Values ; Risk Factors ; Spasm ; Testis

BACKGROUND: This study was to determine whether coronary flow reserve (CFR) of infarct related artery is related to the microvascular perfusion status in the infarct zone determined by myocardial contrast echocardiography (MCE) immediately after successful revascularization in patients with acute myocardial infarction and to the presence of non-contractile myocardium at follow-up. METHODS: CFR was measured immediately after successful revascularization in 21 patients 5+/-2 days after acute myocardial infarction. Then, myocardial perfusion status was evaluated by MCE. Myocardial opacification index (MOI) was calculated as the ratio of sum of reperfusion area to total risk area of infarct-related artery. Follow-up transthoracic echocardiography was performed 1 month after infarction. RESULTS: CFR was correlated with myocardial opacification index immediately after successful revascularization (r=0.79, p<0.001). CFR was significantly higher in patients with MOI score of 1 than in patients with MOI score smaller than 1 (2.15+/-0.29 vs 1.52+/-0.27, p<0.05), and higher but insignificantly in patients without non-contractile segments than in patients with (1.83+/-0.46 vs 1.63+/-0.4, p>0.05). CONCLUSION: CFR may be used to determine the microvascular perfusion status of the myocardium in the infarct zone. CFR immediately after successful revascularization seems to be associated more closely with myocardial perfusion status determined by MCE at that time than whether the non-contractile myocardium is presence or not after 1 month.
Arteries* ; Echocardiography ; Follow-Up Studies ; Humans ; Infarction ; Myocardial Infarction* ; Myocardium ; Perfusion* ; Reperfusion*

No abstract available.
Animals ; Nitric Oxide Synthase* ; Nitric Oxide* ; Rats* ; Spermatic Cord Torsion* ; Testis*

Nasal dermoid sinus cyst (NDSC) is a rare congenital malformation which results from anomalous embryological development and occurs in the midline of the nose. An accurate diagnosis using CT or MRI is essential for an appropriate surgical treatment, which in some cases entails cooperation between the neurosurgeon and the oromaxillofacial surgeon. Surgical extirpation is the treatment of choice, and various surgical approaches like vertical-dorsal rhinotomy, lateral rhinotomy, transverse rhinotomy, external rhinotomy, and bicoronal flap approach have been advocated. Rut in the case of intracranial extension, the craniofacial approach is required. We report a 5-year-old girl with NDSC who was successfully managed using the external rhinoplasty approach.
Child, Preschool ; Dermoid Cyst* ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Nose ; Rhinoplasty

BACKGROUND AND OBJECTIVE: Precise assessment of lesion severity is fundamental for the clinical decision making in the patients with coronary artery disease. Coronary angiography has limitation to projection imaging techniques. Intravascular ultrasound (IVUS) has been known to be a gold standard of morphological severity of coronary stenosis. Fractional flow reserve (FFR) is known to be a lesion specific functional index of epicardial stenosis that can be derived from intracoronary pressure assessed during maximal vasodilation. The objective of this study was to investigate the validity of fractional flow reserve for stenosis severity in comparison with IVUS. METHODS: The study population consisted of 24 patients with angina pectoris (M:F=19:5, age: 58+/-12 yrs). The IVUS and intracoronary pressure wire performed at 26 lesions after diagnostic coronary angiography. We measured angiographical diameter stenosis (DST), minimal luminal diameter (MLD), minimal luminal area (MLA) and reference area stenosis (r-AST). FFR was defined by the ratio of distal mean coronary pressure (Pd) to aortic mean pressure (Pa). RESULTS: FFR showed significant correlation with both r-AST (r=-0.93, p<0.00001) than DST (r=-0.79, p<0.0001). When the lesions with MLD less than 1.1 mm were excluded, considering the limitation of IVUS for the thickness of its catheter, FFR showed excellent correlation with r-AST with higher correlation coefficient (r=-0.96, p<0.00001). FFR showed significant correlation with MLA (r=0.87, p=0.0001) or MLD (r=0.83, p=0.0005). CONCLUSION: FFR with excellent correlation with r-AST measured by IVUS seems to be a useful lesion specific functional index for the assessment of coronary stenosis in angina patients.
Angina Pectoris ; Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Decision Making ; Humans ; Phenobarbital ; Ultrasonography* ; Ultrasonography, Interventional ; Vasodilation