Twelve patient with fracture of the neural arch of the axis (hangman's fracture or traumatic spondylolisthesis of the axis) were treated at Kangnam St. Mary's Hospital between 1980 and 1986. There were three type I fractures, seven type II fractures, and two type III fracture. Non of these patients had neurological damage. Seven patients (five in type II and two in type III) in this series, underwent anterior interbody fusion operation between axis and third cervical vertebra following 6 weeks of cervical traction. The remaining five patients were treated conservatively by cervicel traction in the bed. Average follow up period was 24 months. The mean duration of fracture union was 10 weeks after trauma in 3 cases of type I and twelve weeks after trauma in 2 cases of type II which were treated conservatively. Otherwise in 5 cases of type II and two cases of type III which were taken anterior interbody fu sion, the mean duration of fracture union was 8 weeks in type II and 10 weeks in type III after surgery. All regained a stability of the cervical spines. Because the fracture healing of the neural arch invariably occurred through this study, it is felt that anterior interbody fusion between axis and third cervical vertebra is necessary surgical.procedure to gain the early stability if there is an evidence of persistant instability between axis and third cervical verbebrae even after 6 weeks of conservative traction treatment.
Follow-Up Studies ; Fracture Healing ; Humans ; Spine ; Spondylolisthesis ; Traction

Syphilitic aortitis, passing out of our mind, is the most common systemic manifestation of late syphilis and is more typically manifestated 10 to 30 years afterward. This diagnosis has been made less frequently in recent decades than in the past, because of public awareness of syphilis and screening program. Treponema pallidum lodge within vasa vasorum, especially ascending aorta cause the histologic changes, which are responsible for the three major forms of symptomatic cardiovascular syphilis, including aortic insufficiency, coronary ostial stenosis, and aortic aneurysm. We experienced a case of syphilitic aortitis with aortic insufficiency and aortic aneurysm in a 48-year-old man presented with progressive dyspnea. Echocardiography, chest CT, and later surgical correction were performed and surgical specimen revealed the histologic finding consistent with syphilitic aortitis. We report this case with a review of the literature.
Aorta ; Aortic Aneurysm* ; Aortitis ; Constriction, Pathologic ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Mass Screening ; Middle Aged ; Syphilis ; Syphilis, Cardiovascular* ; Tomography, X-Ray Computed ; Treponema pallidum ; Vasa Vasorum

The aim of this study was to evaluate endodontic irrigation methods with EndoVac(R) and EndoActivator(R) in the elimination of Enterococcus faecalis from the root canals. Extracted 70 human single-rooted teeth were used. The canals were instrumented by a crown-down technique with .04 taper ProFile to ISO size 40. After the teeth were autoclaved, the canals were inoculated with E. faecalis and incubated for 48 h. The teeth were randomly divided into three experimental groups of 20 teeth each according to canal irrigation methods and two control groups as follows: group 1 - EndoVac(R) group 2 - EndoActivator(R) ; group 3 - Conventional needle irrigation method. After canal irrigation using 2.5% NaOCl, first samples (S1) were taken using sterile paper point. And the canals were filled with sterile brain heart infusion (BHI) broth and incubated for 24 h, then second samples (S2) were taken. The samples were cultured on BHI agar plate to determine the numbers of colony forming units (CFU). In first sampling (S1), only one canal of conventional method among the all experimental groups was positive cultured. In second sampling (S2), EndoVac(R) group showed the least positive culture numbers of E. faecalis. There was statistically significant difference between the EndoVac(R) and conventional needle irrigation methods in the mean value of Log CFU. According to the results of this study, EndoVac(R) showed better efficacy than conventional needle irrigation method in the elimination of E. faecalis from the root canal.
Agar ; Brain ; Dental Pulp Cavity ; Enterococcus ; Enterococcus faecalis ; Heart ; Humans ; Needles ; Stem Cells ; Tooth

Adult ; Aneurysm ; Arteries ; Carotid Artery, Internal ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Angiography ; Parents ; Prospective Studies ; Recurrence ; Retinal Artery ; Retreatment ; Stents ; Stroke, Lacunar ; Thromboembolism

BACKGROUND/AIMS: A prospective study was performed to evaluate the efficacy of low dose administration of cisplatin (CDDP) and 5-fluorouracil (5-FU) by repeated arterial infusion via a percutaneously implantable port system (PIPS) for advanced hepatocellular carcinoma (phase II trial). METHODS: Ten patients with hepatocellular carcinoma belonging to TNM stage IV, but without extrahepatic spread, were enrolled. Nine patients had main portal vein thrombosis. All the patients were positive for HBsAg. Patients were repeatedly treated with an arterial infusion of CDDP and 5-FU (10 mg and 250 mg, respectively, for 5 hours on days 1-5) via a PIPS at four week intervals. The response was assessed by dynamic CT after two courses of chemotherapy. RESULTS: Insertion of PIPS was successful in 8 of 10 patients. Two patients could not receive a second course of chemotherapy because one died of progressive hepatic failure and the other developed local infection and pseudoaneurysm formation. All the remaining 6 patients exhibited tumor progression after two courses of chemotherapy. The median survival time was 89 days (range, 59-204). The causes of death were progressive hepatic failure in one patient and uncontrolled esophageal variceal bleeding in one patient. CONCLUSIONS: Arterial infusion chemotherapy with CDDP and 5-FU via a PIPS was not an effective treatment for patients with advanced hepatocellular carcinoma.
Aneurysm, False ; Carcinoma, Hepatocellular* ; Cause of Death ; Cisplatin* ; Drug Therapy ; Esophageal and Gastric Varices ; Fluorouracil* ; Hepatitis B Surface Antigens ; Humans ; Liver Failure ; Prospective Studies ; Venous Thrombosis

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BACKGROUND: There were two occurrences of typhoon and the floods in Korea from early to late September, 2000. The Korean Combat Police and policemen participated in cleaning activities at the flooded area. Leptospirosis broke out among these participants. This study describes the epidemiological and clinical characteristics of leptospirosis patients among policemen. METHODS: Of 16,750 individuals involved, 3,752 subjected to passive hemagglutination antibody (PHA) test at the Regional Health Care Units or the National Police Hospital. With 1 case of dead plus 12 cases which were turned out to be seropositive by PHA test and confirmed by microagglutination (MA) test, epidemiological and clinical characteristics were studied by questionnaire survey, laboratory test, and history of treatment while being hospitalized. RESULTS: The seropositive rate of leptospira antibody was 0.3% (12/3,752). All 12 seropositives were bare-footed while working at the flooded area and of these, 8 patients (67%) were noticed abrasions either on hand or feet. However, no statistically significant correlation was found between the duration of outdoor activity and the seropositive rate (r=-0.46, p=0.36). There were clinical difference among patients who has the same serotype of leptospirosis, physical conditions, circumstance and the same work area. Two abnormal EKG results are present, the one who complained of chest pain is myocardial ischemia and the other who didn't complain of any symptoms is sinus pause. Correlation between the febrile period before and the duration of fever after the use of antibiotics was estimated as; febrile period after antibiotics use = 0.102804 + 0.995327 x febrile period before antibiotics use (p=0.058). CONCLUSION: When leptospirosis is related to group activities, it is possible to educate in advance and to manage systematically afterwards, it may prevent the occurrence of leptospirosis or the related complications.
Anti-Bacterial Agents ; Chest Pain ; Cyclonic Storms ; Delivery of Health Care ; Electrocardiography ; Epidemiology ; Fever ; Floods ; Foot ; Hand ; Hemagglutination ; Humans ; Korea ; Leptospira ; Leptospirosis* ; Myocardial Ischemia ; Police ; Surveys and Questionnaires

Non-typhoid salmonella infection frequently associated with bacteremia has rarely been reported in immunocompromized patients with malignant neoplasms, diabetes or extended use of corticosteroids. Especially, concomitant pleural empyema and pericarditis due to non-typhoid salmonella infection is extremely rare. Here, we report a case of concomitant empyema and pericarditis in malignant thymoma with pleural metastasis complicated by salmonella group D infection with brief review of literature.
Adrenal Cortex Hormones ; Bacteremia ; Empyema* ; Empyema, Pleural ; Humans ; Neoplasm Metastasis* ; Pericarditis* ; Salmonella Infections ; Salmonella* ; Thymoma*

PURPOSE: The aim of this study was to evaluate whether or not the early use of steroid is useful for treating Mycoplasma pneumoniae pneumonia. METHODS: A prospective study was conducted on 85 patients with M. pneumoniae pneumonia admitted to Gwangju Christian Hospital between September 2015 and April 2016. A total of 85 patients were enrolled. Of these, 33 were treated with steroids (methyl-prednisolone 1 mg/kg/day), while 52 were not; both were treated with macrolides. The overall duration of fever was compared between the 2 groups and findings on chest radiographs were evaluated for their deterioration. RESULTS: The duration of fever after admission (1.36±0.92 days vs. 2.17±1.30 days, P=0.003) and the overall duration of fever (4.42±2.13 days vs. 6.07±2.59 days, P=0.003) were significantly lower in the steroid group. The duration of fever before admission was not different between the steroid and macrolide groups (3.06±1.74 days vs. 3.90±2.21 days, P=0.068). On chest radiographs taken 3 days later, 1 of 33 patients in the steroid group and 5 of 50 patients in the macrolide group worsened, although there was no statistically significant difference between the 2 groups (P=0.395). There was no significant difference in the duration of hospitalization between the 2 groups (6.72±1.54 days vs. 6.92±1.87 days, P=0.618). CONCLUSION: Early administration of steroids on patients with M. pneumoniae pneumonia reduced the duration of fever, but there was no difference in duration of admission and x-ray deterioration.
Fever ; Gwangju ; Hospitalization ; Humans ; Macrolides ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Prospective Studies ; Radiography, Thoracic ; Steroids

BACKGROUND: The cause and clinical course of the postoperative ARDS is, as of yet, not very well understood. The current study is a review of our experience on patients with ARDS after thoracotomy. MATERIAL AND METHOD: Between Jan. 1996 to Aug. 2001, a retrospective analysis was conducted on 32 post-thoracotomy ARDS patients among 4018 patients receiving thoracotomy inclusive of thoracoscopic surgery. RESULT: The incidence of ARDS after pneumonectomy cases was 5.3%(13/245), 1.3% after lobectomy(9/ 710), and 4.4% after esophageal surgery(10/226). Of the 32 ARDS patients, 31 had malignant disease. The remaining 1 patient had aspergillosis. In the majority, the cause of ARDS was unknown. The average onset was on the 7.4th postoperative day. In 10 cases, the initial lesion was in the right lower lung field(31.2%), in the left lower lung field in 9(28.1%), and in both lower lung fields in 12(37.5%) cases. In all, the initial lesion was in the lower lung fields in 96.9% of the cases(31/32). There was a significant relationship between the development of ARDS and intraoperative I/O balance. The overall mortality rate was 65.6%(21/32). In the earlier period of the study(1996-Jun, 1998) the mortality rate was 100%, but in the latter period(July, 1998-Aug, 2001) it was significantly reduced to 47.6%. CONCLUSION: The current data showed a higher incidence of postoperative ARDS in patients with malignant disease and in those receiving extensive lymph node dissection with either lobectomy or pneumonectomy, and also in patients receiving esophageal surgery. In addition, introperative fluid overload was also associated with an increased incidence of ARDS. Treatment outcome could be improved with prone positioning and NO gas inhalation
Aspergillosis ; Humans ; Incidence ; Inhalation ; Lung ; Lymph Node Excision ; Mortality ; Pneumonectomy ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Thoracoscopy ; Thoracotomy* ; Treatment Outcome