Hypopituitarism and Legg-Calve-Perthes disease related to difficult delivery / 소아과

Legg-Calve-Perthes (LCP) disease is characterized by idiopathic avascular osteonecrosis of the epiphysis of the femur head. The main factor that plays a role in the etiology of the disease is decreased blood flow to the epiphysis. Many predisposing factors have been suggested in the etiology of LCP disease, and most have varying degrees of effects. Here we present the case of a boy aged 4 years and 10 months with complaints of short stature and a diagnosis of multiple hypophyseal hormone deficiency, in whom LCP disease and difficult birth-related pituitary stalk interruption syndrome were identified by anamnesis. The present case revealed that LCP disease and hypophyseal hormone deficiency could be secondary to difficult birth and that LCP disease could be secondary to insulin-like growth factor 1 deficiency. Additionally, to the best of our knowledge there is no published case on the relation between LCP disease and insulin-like growth factor 1 deficiency. Therefore, we believe that this case is worthy of presentation.

Volume estimation of the subcortical structures in Parkinson’s disease using magnetic resonance imaging: A methodological study

Background & Objectives: Parkinson’s disease (PD) is the most prevalent neurodegenerative disorder, beginning in the in the substantia nigra and spreading to the subcortical structures to the limbic cortices, and eventually to the neocortex and is characterized clinically by tremor at rest, bradykinesia, and rigidity. Regional brain atrophy is found to be an important marker of PD’s pathology. The aim of the current study was to compare the volumes of subcortical brain structures between healthy subjects and patients with PD using stereological (point-counting) and semi-automated segmentation methods. Methods: Twenty-four patients with PD and 23 age matched healthy subjects free of any psychiatric, neurological or cognitive impairment were included in our study. Magnetic resonance images were analyzed by using two methods. Results: Both methods showed a decrease in volume of caudate nucleus and lentiform nucleus in PD group compared to the control group. (p˂0.05). However, no significant differences was found between patient and control groups for the volume of thalamus (p>0.05). Also, no significant difference was found between point-counting and semi-automated segmentation methods for the volumes of subcortical structures in both two groups (p>0.05). Conclusion: Magnatic resonance imaging is helpful to facilitate the diagnosis in vivo of patients with PD, revealing atrophy of specific brain regions such as caudate nucleus and lentiform nucleus.

Intestinal obstruction due to anomalous congenital band

Intestinal obstruction caused by an anomalous congenital band is very rare in adults and children. ACBs [Anomalous congenital band] are bands that have no identifiable embryological or acquired basis. We report an unusual case of intestinal obstruction in a 23 year old male patient who was found to have an ACB forming a loop around the jejunum [Fig-1] and causing closed loop obstruction. This band was arising from the treitz ligamentum and looping around the jejunum, ending at the root of mesentery. This band was in addition, causing compression of blood supply to the proximal jejunum

Laparoscopic cholecystectomy in a patient with situs inversus: Advantage of 30 scope

Laparoscopic cholecystectomy is one of the commonest surgical procedures carried out in the world today. Symptomatic gallstones needs surgery also patients with situs inversus. We discuss our case and problems encountered during surgery and how to solve them. A 50-year-old male presented with recurrent epigastric and left hypochondriac pain for the last year. A diagnosis of gallstones in a patient with situs inversus totalis was made following clinical examination and radiological investigation. Laparoscopic cholecystectomy was subsequently performed and the patient made an uneventful recovery. Situs inversus presenting with symptomatic gallstones is very rare. Laparoscopic cholecystectomy and other abdominal surgical operations are more difficult in patients with situs inversus hence they are rarely practiced