In one case of advanced systemic scleroderma hyperbaric oxygen therapy was performed. The treatrnent were given in an one-man pressure chamber (made in Korea) at a pressure of 2. 5 atmospheres absolute pressure (AT.A). The pressure was increased in 5-7 minutes, kept constant for 1.5 hours and lowered in 5--7 minutes. After 16 weeks of the treatment, regression of the skin contraction was achieved, together with improved mobility of the joints and healing of ulceration.
Atmosphere ; Hyperbaric Oxygenation* ; Joints ; Scleroderma, Systemic* ; Skin ; Ulcer

No abstract available.
Cardiopulmonary Resuscitation* ; Emergencies* ; Emergency Service, Hospital*

Neuralgic amyotrophy is an uncommon disorder characterized by acute onset of severe shoulder and upper arm pain followed by marked upper arm weakness. It is easily confused with other neck and upper extremity abnormalities, such as cervical spondylosis and cervical radiculopathy. The diagnosis is based on histroy, clinical findings, electromyography and excluding other disease. Early diagnosis and adequate treatment is important to avoid unnecessary tests and surgery, and prevent complications, especially adhesive capsulitis of the shoulder. 20-year old female patient presented with a history of severe pain involing left shoulder and upper extremity. 1 month after onset of pain suddenly, she noted weakness of left shouler muscles, especially abduction and flexion. At first visit in our clinic, she felt persistant pain for 4 months in the left shoulder, upper extremity and mild pain in the left lower extremity. She diagnosed with neuralgic amyotrophy with complex regional pain syndrome. Her pain managed with epidural block, sympathetic ganglion block, brachial plexus block, stellate ganglion block, intravenous regional block, intravenous local anesthetic infusion, oral analgesics, and exercise therapy. 5 months after the onset of pain, weakness of her shoulder muscles were fully recovered and 9 weaks after caring in our clinic, she had tolerable pain in her extremities and discharged.
Analgesics ; Arm ; Brachial Plexus ; Brachial Plexus Neuritis* ; Bursitis ; Diagnosis ; Early Diagnosis ; Electromyography ; Exercise Therapy ; Extremities ; Female ; Ganglia, Sympathetic ; Humans ; Lower Extremity ; Muscles ; Neck ; Radiculopathy ; Shoulder ; Spondylosis ; Stellate Ganglion ; Upper Extremity ; Young Adult

BACKGROUND: Among all facial fractures, nasal bone fractures are the most common, and they have been reduced by closed reduction (CR) for a long time. But several authors have reported suboptimal results when using CR, and the best method of nasal bone reduction is still being debated. We have found that indirect open reduction (IOR) through an endonasal incisional approach is a useful method for more accurate reduction of the nasal bone. METHODS: A retrospective chart review was performed of 356 patients who underwent reduction of a nasal bone fracture in our department from January, 2006, to July, 2011. We treated 263 patients with IOR. We assessed patients' and doctors' satisfaction with surgical outcomes after IOR or CR. We evaluated the frequency of nasal bleeding owing to mucosal injury, and followed the surgical outcomes of patients who had simultaneous dorsal augmentation rhinoplasty. RESULTS: According to the analysis of the satisfaction scores, both patients and doctors were significantly more satisfied in the IOR group than the CR group (P<0.05). Mucosal injury with nasal bleeding occurred much less in the IOR group (5.3%) than the CR group (12.9%). Dorsal augmentation rhinoplasty with IOR was performed simultaneously in 34 cases. Most of them (31/34) showed satisfaction with the outcomes. CONCLUSIONS: IOR enables surgeons to manipulate the bony fragment directly through the endonasal incisional approach. However, we propose that CR is the proper technique for patients under 16 and for those with comminuted nasal bone fractures because submucosal dissection in IOR can damage the growth or circulation of nasal bone.
Epistaxis ; Humans ; Nasal Bone ; Retrospective Studies ; Rhinoplasty

BACKGROUND: Automated external defibrillator(AED) represent a major breakdown to permit more widespread application of the principle of early defibrillation. Many recent efforts to improve emergency medical services(EMS) and increase survival rates are simply efforts to get defibrillation to patients as rapidly as possible. AED is major innovation for the prehospital care of ventricular fibrillation cardiac arrest patients. The purpose of this study is to evaluate the course of initial training to three different groups(nurses, firefighters, and EMT trainee) to use AED. METHOD: We studies the efficacy of education of AED to 33 nurses, 15 EMT trainee, and 16 firefighters. Training lasted 75 mins and included 45 mins an overview of defibrillation, protocols for using the AED, and operation of the AED(Laerdal Heartstart 3000),15 mins demonstraion.4 check list was used to grade the performance of cardiopulmonary resuscitation, operation of the AED, and the time required to deliver the first three defibrillations. RESULT: There were no statistically significant differences in performance and time required to deliver an electrical countershock among the groups(p=0.4). To the second test 92fo of all group completed all steps successfully. The step most often foiled was the preparing of the AED for defibrillation. CONCLUSION: In nurses, EMT trainee, and firefighters, it is both feasible and effective to train AED use irrespective of the degree of the trainee.
Cardiopulmonary Resuscitation ; Defibrillators* ; Education ; Emergencies* ; Firefighters* ; Heart Arrest ; Humans ; Survival Rate ; Ventricular Fibrillation

The transpetrosal transtentorial supra- and infratentorial combined approach has been used by many skull base surgeons for the total removal of large tumors in the cerebellopontine, petroclival, and dumbbell-shaped mass of the middle and posterior cranial bases. When surgeons use the retrolabyrinthine approach for hearing preservation, adequate exposure of the presigmoid dura might be hard to achive. In order to get a wider operating field with hearing preservation, the authors used the transpetrosal approach with partial labyrinthectomy for a large dermoid cyst in the cerebellopontine angle which extened to the middle cranial base through the Meckel's cave.
Cerebellopontine Angle ; Dermoid Cyst ; Hearing* ; Skull Base

Eclampsia and hypertensive encephalopathy share similar pathophysiological mechanisms, which present as vaso-genic edema and vasospasm. In majority of the patients, neurologic manifestations are reversible. A 31-year-old pregnant woman in her 40 weeks of gestation developed repeated attacks of seizure and confused mentality. As consciousness improved, multiple neurologic deficits were detected. Cerebral angiography a showed diffuse vasospasm. Six months later, neurologic manifestations were partially recovered. We report a rare case of eclampsia with irreversible neurologic deficits, in which cerebral vasospasm was confirmed by an angiography. (J Korean Neurol Assoc 19(5):537~540, 2001)
Adult ; Angiography ; Cerebral Angiography ; Consciousness ; Eclampsia* ; Edema ; Female ; Humans ; Hypertensive Encephalopathy ; Neuroimaging* ; Neurologic Manifestations ; Pregnancy ; Pregnant Women ; Seizures ; Vasospasm, Intracranial

Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare disease, which causes chronic progressive inflammation and thickening of the basal dura mater and produces multiple cranial neuropathies, headache, ataxia, and seizure. A 40 year-old man presented with a continuous, diffuse, dull headache with left periorbital pain, exophthalmos, ptosis and loss of visual perception. Brain MRI revealed thickened, highly enhanced pachymeninges in all supratentorial areas in association with the left cavernous sinus. A subsequent meningeal biopsy showed non-specific chronic inflammations of the pachymeninges. The patient dramatically responded to steroid therapy. To our knowledge, this is an extremely rare case of IHCP associated with Tolosa-Hunt syndrome. (J Korean Neurol Assoc 19(1):56~59, 2001
Adult ; Ataxia ; Biopsy ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Dura Mater ; Exophthalmos ; Headache ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Meningitis* ; Rare Diseases ; Seizures ; Tolosa-Hunt Syndrome* ; Visual Perception

PURPOSE: The focal ossification of auricular cartilage is an unusual clinical entity in which the ear becomes partially or totally rigid and immalleable. This condition may result from cold injury, local trauma, inflammation, or various systemic diseases. Patients may feel mild discomfort, but there are usually no other serious symptoms. We present a case of focal ossification of auricular cartilage in which the cause is unknown. METHODS: A healthy 58-year-old man presented with a 2-year history of hard mass of right posterior auricular area. He denied any precipitating historical events like cold injury and inflammation. Routine testing did not demonstrate systemic abnormalities. Ultrasonographic examination revealed a 22 x 10 x 11 mm sized heterogenous isoechoic mass showing an acoustic shadow. RESULTS: Excisional biopsy was performed under local anesthesia. Histological examination revealed the ossification with deposition of trabecular bone in normal elastic cartilage. The patient was healed without any problems and satisfied with the result. CONCLUSION: We report clinical experience of focal ossification of auricular cartilage, which is quite a rare clinical entity. It should be considered that there is the possibility of ossification of cartilage when it meets the benign mass of the ear.
Acoustics ; Anesthesia, Local ; Biopsy ; Cartilage ; Cold Temperature ; Ear ; Ear Cartilage ; Elastic Cartilage ; Humans ; Inflammation ; Middle Aged

PURPOSE: In recent years, obesity in children has become one of the major nutritional problems, and the trend is that number of obese children is increasing. The purpose of this research is to examine the incidence of obesity in pubescent school children in Seoul and Cheju, and to analyze body fat component, complications and eating habits of those obese children in order to obtain basic information for prevention of obesity in children in the future. METHODS: The total number of 4,555 junior high school students from 4 schools consisting of 1,234 boys and 3,321 girls were examined based on their height and weight. For those children, obesity index was calculated based on the 50th percentile obtained from standard weight for height of children proposed by the Korean Pediatric Association in 1985. The body fat component was measured and compared between 275 children of 530 obese children(11.6%) and 275 children from the control group by Futrex-5000 A body fat and fitness computer. Of those children, oral glucose tolerance test, blood pressure, and biochemical studies were performed on 31 children whose follow-up was possible, and their exercise load and eating habits were examined. RESULTS: It was found that 11.6% of the subject children were obese, which consisted of 12.4% in boys and 11.4% in girls. The study showed 11.4% obesity ratio in Seoul and 13.2% obesity ratio in Cheju, but the difference was insignificant. Percents of bodyfat was 25.3+/-5.7% (mean+/-SD) for control group, 32.9+/-4.8% for mild obesity group, 35.6% for moderate obesity group, and 37.2+/-4.0% for severe obesity group. The morbidity of complications of those 31 children whose follow-up was possible showed the highest percentage of 29.0% in hyperlipidemia, and lower percentage in hypertension, elevated AST and/or ALT, glucose intolerance, diabetes, respectively. The eating habit analysis showed the total calorie intake/total energy expenditure ratio of 1.10 which is higher in calories than energy consumption, and the food intake evaluation showed that 23.3% of fat was contained in total calorie intake. CONCLUSIONS: The childhood obesity becomes the primary cause of adult obesity, hypertension and diabetes, and therefore, eating habits and exercise load should be carefully observed in order to prevent childhood obesity. In addition to the health care provided currently by schools, regular physical check-up should undertaken for early diagnosis to conduct appropriate tests and treatment.
Adipose Tissue ; Adult ; Blood Pressure ; Child* ; Delivery of Health Care ; Early Diagnosis ; Eating ; Energy Metabolism ; Female ; Follow-Up Studies ; Glucose Intolerance ; Glucose Tolerance Test ; Humans ; Hyperlipidemias ; Hypertension ; Incidence* ; Jeju-do ; Obesity* ; Obesity, Morbid ; Pediatric Obesity ; Seoul