A Case of Polyp with High Grade Dysplasia in Ulcerative Colitis / 대한소화기내시경학회지

Patients with ulcerative colitis (UC) have the increased risk of colorectal cancer. The risk of colorectal cancer development in UC is associated with the extent of colitis and duration of disease. It is generally agreed that there is little or no increased risk associated with proctitis or proctosigmoiditis. A dysplasia-associated lesion or mass (DALM) is difficult to distinguish from sporadic adenoma. The DALM indicate a high association with colon cancer. The presence of DALM as a premalignant lesion has been considered as an indication for colectomy because of the high risk of progression to malignancy within a short period. We report a case of polyp with high grade dysplasia in a 27-year-old man of ulcerative colitis confined to rectum and sigmoid colon.

Herniated Intervertebral Disc of Lumbar Spine in the Teenager / 대한정형외과학회잡지

Herniated intervertebral disc(HIVD) of the lumbar spine has been known to be relatively uncommon in the teenager and frequently be associated with trauma. However, with the changing life style and increasing sports activities, and most of all, with the advent of new imaging modalities, the incidence seems to be increasing gradually. In order to define the characteristic pattern of HIVD of teenager in the era of MRI, and to clarify the associated lesions, such as apophyseal ring fractures, authors performed this retrospective study in 55 teenager patients with HIVD(77 discs), in which MRI was used as main diagnostic modality. The following results were obtained 1) The incidence of the HIVD in teenager was 9.6%(55 patients) of total HIVD patients(575 patients) for 4 years from December 1989 to December 1993. 2) According to MRI findings, HIVD of the teenager could be classified into 3 distinct patterns; simple HIVD, lumbar apophyseal ring fracture(LARF), and vertebral rim lesion. 3) In simple HIVD, as for the MRI classification, protruded type was most frequent type and there was no sequestered type 4) In LARF, the incidence was 14.4% of teenager's HIVD and posterocephalad margin of L5 was the most common site of involvement. 5) Exophytic bony protrusion from the posterior margin of vertebral body, which we called vertebral rim lesion, could be defined on MR sagittal view in 6 cases.

Traumatic Intracerebral Hematoma

During a 36-month period, clinical outcome in 170 patients with traumatic intracerebral hematoma(TICH) was analysed. These patients represented 5.1% of 3328 consecutive patients with head injuries admitted to the Soonchunhyang University Chunan Hospital. The overall mortality was 33.5%. A significant number of patients(52.6%), who were not comators at the time of admission(GCS0.005) ; 2) the presence of associated lesions(p>0.01) ; 3) time delay of two hours or more from admission to operation(p>0.05) ; 4) actual midline shift of 4.5mm or above on initial CT scan(p>0.005) ; 5) obliteration of suprasellar cistern(p>0.005) ; 6) the presence of delayed traumatic intracerebral hematoma(DTICH) in non-surgical patients with GCS score of 8 or above(p>0.01). Age and location of hematoma did not affect outcome, but the patients with multiple located hematoma showed higher mortality than the others. Time delay in the treatment of TICH and DTICH contribute significantly to poor outocme. Rapidly progressive DTICH within 48 hours after trauma is high in mortality. Follow-up CT scan might as well be performed till 48 hours after injury and 8 hours after initial operation, even though neurological status did not alter for the worse.