No abstract available.
Autografts ; Goldenhar Syndrome

Wernicke encephalopathy is usually accompanied with peripheral neuropathy, known as dry beriberi. In contrast, wet beriberi presenting as cardiovascular symptoms rarely occurs. The acute type of wet beriberi can be fatal, if untreated quickly. It is reported that the cerebellar vermis has a role of the coordination and control of cardiovascular and autonomic reflex activities. We report a 58-year-old man showing acute wet beriberi in Wernicke encephalopathy with cerebellar vermis lesion.
Beriberi* ; Cerebellar Vermis ; Humans ; Middle Aged ; Peripheral Nervous System Diseases ; Reflex ; Wernicke Encephalopathy*

Recent development and advances in arthroscopic surgical techniques for Anterior Cruciate Ligament(ACL) reconstruction have led to the single-incision techniques. Several potential pitfalls in the classic single-incision techniques were found and it has become necessary to develop a new, simpler method to overcome these problems. Seventy-five cases of arthroscope-assisted ACL reconstruction were prospectively studied. The radiologic results were compared between the group in which femoral tunnel preparation was performed by the tibia tunnel(classic technique, 35 cases) and the group in which the anteromedial portal was employed(modified technique, 40 cases). Significantly better results were obtained at the angle formed by the bone graft and the interference screw, the angle between the femoral tunnel axis and the anatomic axis of the femur, and the angle between the femoral tunnel axis and tibial tunnel axis in the modified technique(P<0.05). This study presents a modified arthroscope-assisted ACL reconstruction technique that uses the anteromedial portal for femoral tunnel preparation and insertion of interference screw. In the modified ACL reconstruction technique, the femoral tunnel preparation and femoral graft fixation were accomplished in the same direction and the femoral tunnel preparation was performed regardless of the tibial tunnel preparation, this allows the surgeon to handle the arthroscope freely and advance more posteriorly to get a better view of the posterior cortex.
Anterior Cruciate Ligament ; Arthroscopes ; Arthroscopy ; Axis, Cervical Vertebra ; Femur ; Knee ; Prospective Studies ; Tibia ; Transplants

BACKGROUND: The video-assisted thoracic surgery (VATS) with 2 mm thoracoscopy in primary spontaneous pneumothorax (PSP) was known to be unreliable in its accuracy and recurrence rate. We compared 10 mm VATS with 2 mm VATS in the results of operation. MATERIAL AND METHOD: From Sept. 1998 to Dec. 2002, 176 cases (10 mm VATS; 73 cases, 2 mm VATS; 103 cases) of PSP were treated by VATS bleb resection at Korea University Ansan Hospital. 10 mm thoracoscope, 5 mm port, and 5 mm instruments were used in 10 mm VATS group, and 2 mm thoracoscope, 2 mm ports and 2 mm instruments used in 2 mm VATS group. In the two groups, staples were inserted through 11.5 mm port for chest tube. RESULT: The mean follow-up duration was 20.8+/-16.1 months in 10 mm VATS group, and 13.9+/-8.2 months in 2 mm VATS. The most common indication of operation was a recurrent pneumothorax (34%) in 10 mm VATS and patient's desire (40%) in 2 mm VATS, respectively. The operation time, number of staples used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. Other significant variables affecting the operation time in linear regression analysis were the number of staples that used in operation, the presence of pleural adhesion, and type of pleurodesis and thoracoscope used in operation. However, R2 values were lower than 0.1. The postoperative recurrence rate was 2.7% in 10 mm VATS and 2.9% in 2 mm VATS. It was not significant statistically. Recurrent cases developed within 1 year in both groups but the difference was statistically insignificant. CONCLUSION: Although there were differences in follow-up duration between two groups, the operation time, number of staples that used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. And in 2 mm VATS, there were no technical difficulties during operation and no differences in recurrence rate from 10 mm VATS. As a result, we suggest that 2 mm VATS can be used in the treatment of PSP.
Blister ; Chest Tubes ; Drainage ; Follow-Up Studies ; Gyeonggi-do ; Hospitalization ; Korea ; Linear Models ; Pleurodesis ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted* ; Thoracoscopes ; Thoracoscopy*

Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is a slowing progressive ataxic disorder characterized by bilateral vestibulopathy, cerebellar ataxia and somatosensory impairment. Autonomic dysfunction is recently considered as a core feature in CANVAS in addition to these symptoms. In most cases, patients with CANVAS show cerebellar atrophy in brain imaging, but some cases show minimal or no atrophy of cerebellum. Brain (18F)-fluoro-2-deoxy-D-glucose positron emission tomography (¹⁸F-FDG PET) study can be a complimentary tool to diagnosis CANVAS in cases of no structural abnormality such as cerebellar atrophy. Hereby, we present a case of CANVAS with minimal atrophy of cerebellum but showing a prominent hypometabolism in cerebellum, thalamus and posterior cingulate cortex in ¹⁸F-FDG PET.
Atrophy ; Brain ; Cerebellar Ataxia ; Cerebellum ; Diagnosis ; Gyrus Cinguli ; Humans ; Neuroimaging ; Positron-Emission Tomography ; Primary Dysautonomias ; Thalamus ; Vestibular Neuronitis

Focal subarachnoid hemorrhage occasionally presents as transient focal neurologic episodes mimicking transient ischemic attack (TIA). Unless properly diagnosed, it may aggravate cerebral hemorrhage by administering antithrombotic agents. Therefore, clinicians need to be aware that such focal subarachnoid hemorrhage sometimes cannot be detected on noncontrast computed tomography and blood-sensitive magnetic resonance imaging can detect even a small amount of hemorrhage. We describe an 85-year-old woman with focal subarachnoid hemorrhage and possible cerebral amyloid angiopathy who presented transient left arm weakness recurrently, which mimicked TIA.
Aged, 80 and over ; Arm ; Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage ; Female ; Fibrinolytic Agents ; Hemorrhage ; Humans ; Ischemic Attack, Transient ; Magnetic Resonance Imaging ; Subarachnoid Hemorrhage

No abstract available.

Injuries to sural nerve through surgical incision or open wound in calcaneal fractures were reported as complications causing lateral hindfoot pain. But sural nerve entrapment by adhesive fibrous tissue after Essex-Lopresti axial fixation has not been reported. We report a case of sural nerve entrapment after Essex-Lopresti axial fixation which was successfully treated by nerve decompression.
Adhesives ; Decompression ; Nerve Compression Syndromes ; Sural Nerve* ; Wounds and Injuries

PURPOSE: Through the construction of a pulsatile flow model using an artificial heart pump and stenosis to demonstrate triphasic Doppler waveform, which simulates in vivo conditions, and to evaluate the relationship between Doppler waveform and vascular compliance. MATERIALS AND METHODS: The flow model was constructed using a flowmeter, rubber tube, glass tube with stenosis, and artificial heart pump. Doppler study was carried out at the prestenotic, poststenotic, and distal segments; compliance was changed by changing the length of the rubber tube. RESULTS: With increasing proximal compliance, Doppler waveforms show decreasing peak velocity of the first phase and slightly delayed acceleration time, but the waveform itself did not change significantly. Distal compliance influenced the second phase, and was important for the formation of pulsus tardus and parvus, which without poststenotic vascular compliance, did not develop. The peak velocity of the first phase was inversely proportional to proximal compliance, and those of the second and third phases were directly proportional to distal compliance. CONCLUSION: After constructing this pulsatile flow model, we were able to explain the relationship between vascular compliance and Doppler waveform, and also better understand the formation of pulsus tardus and parvus.
Acceleration ; Compliance ; Constriction, Pathologic ; Flowmeters ; Glass ; Heart, Artificial ; Pulsatile Flow* ; Rubber

PURPOSE: To investigate whether the result of RigiScan after intracorporeal injection could predict the result of duplex ultrasonography, and determine the necessity of duplex ultrasonography. MATERIALS AND METHODS: We performed both RigiScan and duplex ultrasonography after intracorporeal injection in 18 men with erectile dysfunction. All of the patients were evaluated by history taking, physical examination, laboratory test, hormonal tests, and neurologic examination before RigiScan and duplex ultrasonography. We measured maximal arterial diameter, peak systolic velocity, end-diastolic velocity using a 7 MHz. color Doppler unit and these results of duplex ultrasonography were compared with penile rigidity and tumescence measured by RigiScan. RESULTS: The positive and negative predictive value of RigiScan were 81.8% and 85.7%, respectively. The result of RigiScan was comparable with that of duplex ultrasonography and the accuracy of RigiScan was resonable. CONCLUSIONS: According to this results, duplex ultrasonography was needed if the response of RigiScan is abnormal after intracorporeal injection. However, duplex ultrasonography can be ommitted if the response of RigiScan is normal after intracorporeal injection.
Erectile Dysfunction ; Humans ; Male ; Mass Screening* ; Neurologic Examination ; Physical Examination ; Ultrasonography*