PURPOSE: The authors reviewed clinical features, response to treatment and recurrence rate of Tolosa-Hunt syndrome. METHODS: A retrospective chart review was performed on 6 patients, who fulfilled the diagnosis for Tolosa-Hunt syndrome according to the International Headache Society (IHS) classification of 2004. RESULTS: Every patient had orbital pain as a first symptom, followed by cranial nerve paresis. The third cranial nerve was most commonly involved (83.3%), followed by the sixth nerve (50%), the forth nerve (16.7%), and the first branch of the fifth cranial nerve (16.7%). Two of the patients showed multiple cranial nerve paresis (33.3%, 2 out of 6). All patients received high-dose steroid therapy for more than 5 days, and all patients had resolution of orbital pain within 72 hours of treatment. Full recovery of cranial nerve paresis occurred on average in 2.3 months (3 days to 12 months). During the 29 months of follow-up, 2 patients (33.3%) had a recurrence episode. CONCLUSIONS: Tolosa-Hunt syndrome responds well to steroid therapy, and full recovery is possible with proper treatment. The exact diagnosis and treatment of Tolosa-Hunt syndrome is important. Because Tolosa-Hunt syndrome often recurs after full recovery, the authors suggest a minimum follow-up period of 2 years.
Cranial Nerves ; Follow-Up Studies ; Headache ; Humans ; Oculomotor Nerve ; Orbit ; Paresis ; Recurrence ; Retrospective Studies ; Tolosa-Hunt Syndrome ; Trigeminal Nerve

Bilateral coronary artery fistula is very uncommon congenital anomaly which occupy small percentage of all congenital coronary artery fistula. About 20% of the cases associated with additional congenital heart disease. And it may cause congestive heart failure, especially severely in neonate. We experienced a case of neonate who was 1 day-old-male with bilateral coronary artery-right ventricular fistula associated with atrial septal defect and congestive heart failure. The Patient was admitted because dyspnea, cyanosis since birth. 2D ecgicardiogram and cardiac catheterization revealed that a fistulous communicating ; forming a large aneurysm, was noted from bilateral coronary artery emptied into the right ventricle, and there was oxygen step-up in right ventricle.
Aneurysm ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Cyanosis ; Dyspnea ; Fistula* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Infant, Newborn* ; Oxygen ; Parturition

No abstract available.
Aortography* ; Echocardiography* ; Humans ; Infant, Newborn* ; Radial Artery*

There are controversies in operative management of unstable fracture of fracture-dislocation of the spine. Posterior Stabilization is a good method and there are many benefits, such as the safety method, less complication, easiness to acquire more accurate reduction and more rigid fixation than other methods. Among 141 spinal injury patients who were admitted to this hospital from March, 1980 to November, 1985, twenty two cases of spine fracture and fractuar dislocation who were treated with surgical measures were evaluated and analysed. Our surgical measures were posterior wiring and fusion in cervical spine (7 cases), Harrington instrumentation with or without posterior fusion in thoracolumber spine (12 cases), and others (3 cases). Brief summary of the results is as follows: l. Eighty-six percent of angular deformity was corrected after posterior wiring and posterior fusion and 75%, after Harrington instrumentation, 73%, after Harrington instrumentation and posterior fusion. 2. Eighty four percent of displacement was corrected after posterior wiring and posterior fusion and 65%, after Harrington instrumentation, 71%, after Harrington instrumentation and posterior fusion. 3. Improvement of the neurologic status related to interval between injury and operation was 28% within 24 hours, 11% within a week. 4. No significant differences in the recovery of the neurologic signs were found according tothemethod of surgical treatments. 5. Except for the patients who were seriously compromised or required anterior decompression, immediate posterior stabilization is valuable to provide the better reduction, rigid fixation, promotion of recovery of neural function and early ambulation.
Clinical Study ; Congenital Abnormalities ; Decompression ; Dislocations ; Early Ambulation ; Humans ; Methods ; Neurologic Manifestations ; Spinal Injuries ; Spine

PURPOSE: We report a case of an intraorbital foreign body removed in a walk-in patient using a magnet under fluoroscopy. METHODS: A patient walked into the eye clinic complaining of ocular pain caused by foreign body that pernetrated into his right lower eyelid while mowing the lawn one day before he came to the hospital. Since an orbital foreign body was observed when the patient entered the hospital, and a high-density metallic response was diagnosed within the orbit from a computerized tomogram, we performed an emergency operation to take out the foreign body within the orbit. RESULTS: We removed the metallic foreign body, which was 5 mm in size and buried in the orbital fat, in an operation using a magnet under fluoroscopy. CONCLUSIONS: This study shows that fluoroscopy and magnets are an efficient operative means of removing foreign bodies that are found within the orbital fat layer and are difficult to access.
Emergencies ; Eyelids ; Fluoroscopy* ; Foreign Bodies* ; Humans ; Orbit

PURPOSE: This study was carried out to investigate the epidemiological characteristics and changes of prevalence for green tobacco sickness (GTS) for 2 years. METHODS: The author conducted a questionnaire survey on the tobacco harvesters (875 persons from 478 out of 555 tobacco harvesting households surveyed last year) in Cheongsong-gun for 4 days from May 26 to 29, 2003. RESULTS: The study subjects comprised 456 males and 419 females. The prevalence of GTS in 2002 was 50.5%, which was significantly higher than the 43.0% in 2001 (p<0.01). The incidence density of GTS in 2002 was 11.3 spells/100 person?working-days, which was lower than the 12.1 spells in 2001. Regardless of risk factors such as smoking, workingdays, and working hours, the prevalence of GTS in 2002 was higher than that in 2001. Among various GTS symptoms reported by the tobacco harvesters in 2002, cases of nausea were increased, while diarrhea, dyspnea and cough were decreased compared with 2001. The degree of GTS symptoms in 2002 was increased in 198 cases (64.5%), and decreased in 42 cases (13.7%). The proportion of harvesters who underwent treatment from their local medical facilities in 2002 was significantly decreased compared with that in 2001. CONCLUSIONS: In Korea, there are many tobacco-harvesting households, most of which may be stricken with GTS. It is very important for doctors to diagnose the disease exactly and to develop prevention methods for GTS. I expect that more extensive epidemiological studies including the incidence and associated risk factors will be needed. In addition, surveillance system and measurements of urinary cotinine should be conducted.
Cotinine ; Cough ; Diarrhea ; Dyspnea ; Epidemiologic Studies ; Family Characteristics ; Female ; Humans ; Incidence ; Korea ; Male ; Nausea ; Nicotine ; Poisoning ; Prevalence* ; Risk Factors ; Smoke ; Smoking ; Tobacco* ; Surveys and Questionnaires

OBJECTIVE: To evaluate the efficacy of prenatal multiplex PCR with chorionic villi, in the case of family history of DMD due to exon deletion. METHODS: DNA was extracted when cells' size are 1x 106 on T- flask surface area reach to 25 cm2 after 2 weeks from sex confirmation. Average DNA concentration was 50-100 ng and multiplex PCR test was performed from DNA extraction. RESULT: PCR was done for 17 exons devided into 4 groups. Seventeen exons were all amplified with their right size. CONCLUSIONS: This method is DNA analysis for prenatal diagnosis of DMD with chorionic villi in the family of DMD. This is useful when preimplantation genetic diagnosis is not available.
Chorion* ; Chorionic Villi* ; DNA ; Exons ; Humans ; Multiplex Polymerase Chain Reaction* ; Muscular Dystrophy, Duchenne* ; Polymerase Chain Reaction ; Preimplantation Diagnosis ; Prenatal Diagnosis*

Injuries from sea urchins are induced by from penetration of the calcareous spines into the skin. Apart from the transient episode of excruciating pain, there is usually no residual disability. Complications arise, however, when spines are embedded over bony prominences, or within joints. Two cases are reported with injury and protracted disability of fingers resulting from contact with the purple sea urchin, Anthocidaris crassispina, a common echinoderm inhabitant of the Korean east coast. After a latent period of several months in both cases, Case 1 presented as caseating granulomas in the synovium and case 2 exhibited as the usual soft tissue nonsynovial foreign body and noncaseating granulomas. There appears to be a paucity of published data regarding the effects of puncture wounds caused by the spines of this animal. The granulomas have appeared after a latent interval of several months in a proportion of the sufferers, suggests a delayed hyperserisitivity reaction similar to that produced by Mycobacterium species.
Animals ; Anthocidaris ; Bites and Stings* ; Fingers ; Foreign Bodies ; Granuloma ; Hand* ; Hypersensitivity, Delayed ; Inflammation* ; Joints ; Mycobacterium ; Punctures ; Sea Urchins* ; Skin ; Spine ; Strongylocentrotus purpuratus ; Synovial Membrane ; Wounds and Injuries

An increase in the volume of endoscopic procedures performed in recent times has led to increasing detection rates of asymptomatic gastrointestinal subepithelial tumors. However, accurate diagnosis and risk assessment of these tumors preoperatively is challenging. A 70-year-old man patient visited the emergency department for evaluation of melena. Emergency endoscopy revealed an ulcerated subepithelial tumor (8 cm in size) in the gastric cardia and fundus. Computed tomography and upper endoscopy performed at another hospital 6 months earlier were reviewed; the mass showed a significant increase in size (from 2 cm to 8 cm). The patient underwent surgical resection of the mass and was diagnosed with a high-risk gastrointestinal stromal tumor (GIST). In this article, we describe a rare case of a rapidly growing GIST at a rate significantly greater than commonly reported rates.

PURPOSE: To evaluate the clinical presentation, surgical outcome of rhegmatogenous retinal detachment(RRD) after laser refractive surgery and the relationship between RRD and laser refractive surgery. METHODS: We examined age distribution, refractive error, time interval of RRD onset after refractive surgery, shape and location of retinal break, extent of RD, refractive change and postoperative complications in fifteen patients who experienced RRD after LASIK(9 eyes), or PRK(6 eyes) from March 1993 to August 2001. RESULTS: 66% of patents were in twenties, 47% of patients developed RD within 1 year after refractive surgery, 80% of patients had horse shoe type retinal tear and refractive changes after RD surgery were within 2 diopters. Patients who had undergone LASIK had shorter time interval in developing RRD, more refractive change, and more complications than those with PRK. CONCLUSIONS: These results suggest that laser refractive surgery can be one of the cause of RD. LASIK had more association with RD than PRK. Thorough retinal exam will be needed in patients undergoing LASIK.
Age Distribution ; Horses ; Humans ; Keratomileusis, Laser In Situ ; Postoperative Complications ; Refractive Errors ; Refractive Surgical Procedures* ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Shoes