Traumatic spondylolisthesis of the axis is the fracture of both pedicles and is called commonly as hangman' s fracture. The fractures with the anterior displacement more than 3mm and the angulation, more than 11 degrees were classified as unstable and the surgical methods were recommended for the treatment of the fractures. As for the surgical methods, anterior C2-3 fusion with plate fixation or transpedicular screw fixation were used. However, the differences between the clinical results of both methods were not reported in the literatures. In order to clarisy the clinical results of both methods, the authors evaluated the clinical results of 11 patients treated by anterior plate fixation and 7 patients treated by transpedicular fixation who were operated on between Mar. 1987 and,Jan: 1992. Minimum follow-up period was 12 months. 1. As the surgical complications, two cases of transient dysphagia in anterior fixation group and three cases of malinserted screw in transpedicular fixation group were observed. 2. Limitation of rotatory neck motion, less than 20 degrees in one direction was observed in four cases of transpedicular fixation group. 3. Anterior angulation, more than 10 degrees was noted in three cases of transpedicular group. 4. Mild intermittent neck pain was observed in two cases of anterior fixation group and two cases of transpedicular fixation group. Constant neck pain was present in three cases of transpedicular fixation group. 5. Over-all clinical results were excellent or good in all of anterior fixation group, and in four of seven transpedicular group. Although the clinical materials were limited in number, method of anterior plate fixation was recommended by the authors in the management of traumatic spondylolisthesis of axis, because of the easier technique and the better clinical results than the transpedicular screw fixation.
Deglutition Disorders ; Follow-Up Studies ; Humans ; Methods ; Neck ; Neck Pain ; Spine ; Spondylolisthesis

BACKGROUND: Tuberculous pleurisy treatment improve symptoms such as fever, chest pain, cough, and prevents the progression to active pulmonary tuberculosis and the development of residual pleural thickening that decrease diaphragm and rib cage movement. This study investigated how the degree of residual pleural thidkening affects the pulmonary function. METHODS: Fifty seven patients who were initially diagnosed as having tuberculous pleurisy, were treated with anti-tuberculous medication for 6 months and had residual pleural thickening between May 1998 and January 2000 at the Eulji university hospital were reviewed. A chest X-ray and pulmonary function test(PFT, Sensormedics 2200) were perfored. The predicted value (%) of the forced vital capacity(FVC), forced inspiratory vital capacity(FIVC) and total lung capacity(TLC) were measured. The residual pleural thickening was defined the average of the summation in the lateral chest at the level of the imaginary line intersecting from the cardiophrenic angle to the diaphragmatic dome and the lowest part of the costophrenic angle between them. The results were sorted into three grades according to pleural thickness; <2mm(grade I), 2~10mm(grade II), 10mm(grade III). RESULTS: 1. FVC(% pred) and FIVC(% pred) were statistically different between grade I and III, and II and III. However, there was no difference between the TLC(% pred) between each of the groups. 2. The pleural thickness that cause restrictive dysfunction(FVC<80%) and a statisticall difference, is 3 mm. CONCLUSION: The larger the extent of the residual pleural thickness after antituberculous medication, the greater the reduction in the FVC, FIVC, TLC. A pleural thickness of 3 mm is recommended as a guideline for diagnosing a restrictive pulmonary dysfunction.
Chest Pain ; Cough ; Diaphragm ; Fever ; Humans ; Lung ; Respiratory Function Tests ; Ribs ; Thorax ; Tuberculosis, Pleural* ; Tuberculosis, Pulmonary

Intraocular silicone oil is known to induce irreversible histological changes in retina. We enucleated an eyeball which was filled with silicone oil for 6 years following pars plana vitrectomy for the treatment of proliferative vitreoretinopathy. Purified 1000 cs silicone oil was used. The reattached retina tissue was examined histopathologically and immunohistochemically. Microscopic examination revealed severe retinal degenerations with many vaculoes in inner retina, the proliferation of glial cells, and the presence of phagocytes. The proliferation of the retinal pigment epithelium and the localized calcification of retinal tissues were also observed. Immunohistochemical study showed retinal tissue expressions of vimentin, S-100, and glial fibrillary acidic protein(GFAP). Electron microscopic examination of the retinal tissues demonstrated some phagocytes with large vacules, which probably had been filled with silicone oil. Our study confirmed that intravitreal silicone oil might damage the retinal tissues.
Neuroglia ; Phagocytes ; Retina* ; Retinal Degeneration ; Retinal Pigment Epithelium ; Retinaldehyde ; Silicone Oils* ; Vimentin ; Vitrectomy ; Vitreoretinopathy, Proliferative

PURPOSE: The purpose of this paper is to discuss the characteristic CT and MR findings in persistent hyperplastic primary vitreous(PHPV) and to compare the detectability of those findings in each modality. MATERIALS AND METHODS: We retrospectively evaluated CT and MR findings in 32 patients with PHPV. Twenty-five patients had CT, 13 patients had MR, and 6 patients had both CT and MR. RESULTS: Major findings of PHPV in 32 patients on both imaging modalities were lens deformity(78%), shallow anterior chamber(72%), heterogeneous vitreous opacity(72%), enhancing hyaloid artery or remnant of fibrotic hand(69%), and microophthalmos(67%). Minor findings were retinal detachment(22%), and vitreous hemorrhage(6%). In MRI, lens deformity(92%) and shallow anterior chamber(85%) were detected most commonly whereas in CT, opaque vitreous(80%) was the most common finding. Findings of enhancing hyaloid vessel or remnant of fibrotic band, considered characteristic of PHPV, were more commonly detectable in MR (85%) than CT(52%). CONCLUSION: Characteristic MR and CT findings of PHPV were lena deformity, shallow anterior chanber, heterogeneons vitreons opacity, enhanciny hgalind artery or remnant fibrotic band, and microphthalmos. MR seemed to be more useful than CT in detecting Globe pathology.
Arteries ; Congenital Abnormalities ; Humans ; Magnetic Resonance Imaging ; Microphthalmos ; Pathology ; Retinaldehyde ; Retrospective Studies

PURPOSE: To compare the efficacy, predictability, safety, and stability of Laser epithelial keratomileusis (LASEK) with conventional Laser in situ keratomileusis (LASIK) for correction of low to moderate myopia. METHODS: In this study, LASIK-treated 31 eyes of 17 patients and LASEK-treated 33 eyes of 17 patients were followed for 6 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, IOP, topography, keratometry, pachymetry and specular examination were performed. RESULTS: Postoperative mean UCVA was logMAR 0.02+/-0.09 in LASIK group and logMAR 0.01+/-0.09 in LASEK group. Postoperative mean refraction was 0.04+/-0.36D in LASIK group and 0.07+/-0.28D in LASEK group and there was no significant difference between 2 groups (P>0.05). 71.0%(22 of 31) of LASIK eyes and 81.8%(27 of 33) of LASEK eyes had an uncorrected visual acuity of 20/20 or better at 6 months after surgery. 87.1%(27 of 31) of LASIK eyes and 97.0%(32 of 33) of LASEK eyes achieved predictability within +/-0.5D at 6 months follow up. There was no decrease in best-corrected visual acuity of two Snellen lines or more in both groups. CONCLUSIONS: In this study, there was no difference in postoperative mean UCVA and mean refraction in LASIK and LASEK group. However, LASEK group had better results in UCVA of more than 20/20 and predictability but there was no significant difference between 2 groups.
Follow-Up Studies ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ* ; Myopia* ; Visual Acuity

Cutaneous adverse events associated with intravenous immunoglobulin (IVIG) have a relatively low significance, ranging from 0.4% to 6%. In Korean dermatology literature, eczematous reactions associated with the use of IVIG have been underestimated. A 34-year-old male presented with a 2-week history of multiple vesicles on both hands and diffuse eczematous lesions on the trunk and both arms. He had been diagnosed with Guillain-Barré syndrome and had received IVIG at a dosage of 0.4 g/kg/d for 5 days during hospitalization. One week after discharge, cutaneous manifestations developed, starting with tiny blisters on both hands and progressing to eczematous patches on the trunk and arms.Histopathologic examination revealed spongiotic dermatitis with intracorneal bullae formation. A diagnosis of palmar pompholyx and systemic eczematous reaction associated with the administration of IVIG was made. Treatment with systemic corticosteroid, antihistamines and topical steroid was initiated. At a 2-week follow-up, significant improvement was observed.

OBJECTIVE: Neurologic complications make a major contribution to morbidity and mortality in kidney transplant recipients. Most occur months or years after transplantation and may never come to the attention of the transplant surgeon. We report 5 cases of neurologic complications in kidney transplant recipients. Three of them were diagnosed as intracranial abscess by central nervous system infection and others were diagnosed as hypertensive encephalopathy. CASES: Three patients with intracranial abscess have experienced mild coughing, intermittent fever and pulmonary infection initially. During the treatment of pulmonary infection they experienced some of neurologic symptoms and signs, such as severe headache, loss of consciousness and dizziness. Brain MRI was performed and showed lesions of intracranial abscess. The etiologic organism were Nocardia in two cases and Staphylococcus epidermidis in one case. They were treated with stereotactic aspiration of abscess and antibiotics therapy. Two of them recovered but eventually one of them didn't recover. Two patients with hypertensive encephalopathy experienced severe headache, visual illusion and generalized seizure at the immediate postoperative period of kidney transplantation. Their systolic pressure was 190~210 mmHg and diastolic pressure was 140~150 mmHg. Brain MRI scan showed hyperintensity signals in T2WI and hypointensity signal in T1WI on bilateral occipital lobes. They were treated with antihypertensive agents and anticonvulsants. Seizure were well controlled and didn't recur. CONCLUSION: Meaningful survival in post-transplant neurologic complications is dependent on rapid diagnosis and initiation of effective treatment.
Abscess ; Anti-Bacterial Agents ; Anticonvulsants ; Antihypertensive Agents ; Blood Pressure ; Brain ; Brain Abscess ; Central Nervous System Infections ; Cough ; Diagnosis ; Dizziness ; Fever ; Headache ; Humans ; Hypertensive Encephalopathy ; Illusions ; Kidney Transplantation ; Kidney* ; Magnetic Resonance Imaging ; Mortality ; Neurologic Manifestations ; Nocardia ; Occipital Lobe ; Postoperative Period ; Seizures ; Staphylococcus epidermidis ; Transplantation* ; Unconsciousness

OBJECTIVES: There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the cortico-cerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. METHODS: We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores: posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination(K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. RESULTS: Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. CONCLUSION: In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.
Cerebellar Ataxia ; Cerebellar Diseases ; Cerebellum ; Cognition ; Diagnosis ; Gait ; Hope ; Humans ; Iron-Dextran Complex ; Korea ; Male ; Neurologic Manifestations ; Posture ; Schizophrenia ; Speech Disorders

PURPOSE: To study the relationship between the damage of retinal pigment epithelum and the lesion of choroidal vessels in various types of the serous retinal detachment(SRD) on fluorescein angiography(FAG) and indocyanine green angiography(ICGA). METHODS: FAG and ICGA were performed 81 eyes with various types of serous retinal detachment. The series comprised central serous chorioretinopathy(CSC, 63 eyes), toxemia of pregnancy(8 eyes), and Harada's disease(10 eyes). RESULTS: All the eyes showed dye leakage through the retinal pigment epithelium(RPE) by FAG. Of sixty-three eyes with CSC, sixty eyes showed choroidal tissue staining in late phase on ICGA. Delayed filling of ICG dye in early phase was present around the site of leakage on FAG in 48 eyes with CSC. In toxemia of pregnancy and Harada's disease, all the cases showed delayed choroidal circulation and leakage from choroidal vessels on ICGA. As a common feature, ICGA showed choroidal hypoperfusion or delayed choroidal circulation and choroidal vascular hyperpermeability in the three types of SRD. CONCLUSIONS: The authors presume that they might contribute to the damage of RPE. The pathogenesis of SRD may be related to the hypothesis fact that choroidal vascular hyperpermeability probably moves fluid into the subretinal space from the choroid.
Central Serous Chorioretinopathy ; Choroid* ; Fluorescein ; Indocyanine Green ; Pre-Eclampsia ; Retinal Detachment* ; Retinaldehyde* ; Toxemia