The serum creatinine level, excretory urogram, endogenous creatinine clearance value, urine culture and method of drainage of urine of 116 patients with spinal cord injury were examined and compared. The serum creatinine value was found to be poor indicators of renal deterioration in these patients. Combination of bilateral reflux and suprapubic drainage resulted in a greater degree of renal damage, but no reflux with intermittent catheterization group had a good result.
Catheterization ; Catheters ; Creatinine ; Drainage ; Humans ; Spinal Cord Injuries* ; Spinal Cord*

Xanthogranulnmatous pyelonephritis is an unusual chronic renal infection associated with renal calculi, urinary tract infection or obstruction in many cases. It is characterized by orange-yellow nodules of inflamed parenchymal tissue macroscopically and foamy lipid-laden histiocyte microscopically. We report a case of Xanthogranulomatous pyelonephritis in a 74 years old male.
Aged ; Histiocytes ; Humans ; Kidney Calculi ; Male ; Pyelonephritis ; Pyelonephritis, Xanthogranulomatous* ; Urinary Tract Infections

No abstract available.
Colonoscopy* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Nostril stenosis is a rare disease causing cosmetic problem and nasal airway obstruction. Various etiologies including iatrogenic cause the stenosis. Usually the shortage of internal lining of vestibule initiates secondary intention healing where granulation and contracture results in the stenosis. Many surgical techniques have been used to correct the stenosis. The objective of this article is to present a case of iatrogenic unilateral nostril stenosis which was successfully repaired with the use of auricular composite graft.
Constriction, Pathologic* ; Contracture ; Intention ; Nasal Obstruction ; Rare Diseases ; Transplants*

Abscess ; Drainage ; Exophthalmos ; Headache ; Hospitalization ; Humans ; Middle Aged ; Molar ; Orbit ; Periodontal Diseases ; Tomography, X-Ray Computed ; Toothache ; Visual Acuity

Traditionally, the repair of displaced anterior wall fractures of the frontal sinus has involved open reduction and internal fixation. Recent development of instrument and techniques for endoscopic brow-lifting has allowed access to anterior wall fractures of the frontal sinus without the need for a coronal incision. A 32-year-old man presented with a depressed anterior wall of the frontal sinus and underwent endoscopic reduction of the fracture. Through two small incisions above the hairline, an endoscope and instruments were inserted after the elevation of the forehead skin over the depressed anterior wall. Depressed bone fragments were successfully reduced with a bone hook inserted through a small incision over the forehead. The authors report this case with a brief literature review focusing on the endoscopic reduction of the anterior wall fracture of the frontal sinus.
Adult ; Endoscopes ; Forehead ; Frontal Sinus ; Humans ; Skin

A hand-arm vibration syndrome, local vibration illness, occurs in some workers who use hand held vibration tools. It consists of white fingers, diffusely distributed finger neuropathy, pain in the hand and arm, and a small excess risk of osteoarthritis. This study is aimed to identify effective methods to confirm local vibration illness among various health exams, which are mentioned in worker's special health exam regulation. In addition, this study is aimed to quantitatively assess the daily vibration exposure level as a major determinant of vibration illness. The subjects, 46 vibration workers, were selected according to the results of the first special health exam about vibration hazards at shipbuilding industry in 1997. They all had experiences of work related blanching of fingers. Fifteen controls, who had no vibration exposure at all, were also recruited to compare their test results with the results of vibration workers. We adopted 1 subjective and 6 objective tests to evaluate the effectiveness and feasibility for confirming local vibration illness. These tests were history taking of subjective symptoms according to the Stockholm classification, checking blood pressure of finger, checking grasp power, checking finger skin temperature, nail-bed pressing test, vibration perceptional threshold test, and skin prick test for pain perception. Among these, checking skin temperature, nail-bed pressing test, and vibration perception test included cold water provocations. We also estimated some vibration exposure levels of hand held vibration tools by using previously published data from one automobile company. In conclusion, history taking of subjective symptoms according to the Stockholm classification, nail-bed pressing test, and vibration perceptional threshold test were discovered to be effective to diagnose local vibration illness. Furthermore, vibration perceptional threshold on right fingers showed a dose-response relationship to daily vibration exposure levels. The parameter beta was 0.0005(+/-0.0002), and statistically significant by REM (random effects model).
Arm ; Automobiles ; Blood Pressure ; Classification ; Fingers ; Hand ; Hand Strength ; Hand-Arm Vibration Syndrome ; Osteoarthritis ; Pain Perception ; Skin ; Skin Temperature ; Vibration* ; Water

BACKGROUND: Korea is a highly prevalent area of isolated anti-HBc with a rate of 15%, but there is neither vaccination nor management guideline agreed. To know the management for Hepatitis B Vaccination for adults with isolated anti-HBc, we investigated immune response to hepatitis B vaccination in adults with isolated anti-HBc. METHODS: The 23 adults with persistent isolated anti-HBc, who visited a health promotion center from Dec. 1998 to Aug. 1999, were vaccinated with Hepavax?-B by the standard schedule (0, 1, 6 month) and anti-HBs titers were measured 1 month after 1st and 3rd vaccinations (1, 7 month). RESULTS: After the 1st vaccination, 18 (78.26%) developed anti-HBs seroconversion. Among them, 4 (17.39%) had titers of 10~49 mIU/ml, 8 (34.78%) 50~99 mIU/ml, and 6 (26.09%) more than 100 mIU/ml. All non-responders after the 1st vaccination remained as such even with 3 doses of complete vaccination. The majority of seroconverted group did not show more anti-HBs response with further vaccination. CONCLUSIONS: Since none of adults with isolated anti-HBc had a primary response, which indicated few false positive results. Therefore they should be excluded on vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine with a follow-up anti-HBs test is preferable for adults with isolated anti-HBc. If the test shows a seroconversion it would indicate protective immunity, if not, then occult infection may be suspected.
Adult* ; Appointments and Schedules ; Follow-Up Studies ; Health Promotion ; Hepatitis B Core Antigens* ; Hepatitis B* ; Humans ; Korea ; Vaccination*

This retrospective study describes and evaluates the effectiveness of a modified technique of conventional endoscopic dacryocystorhinostomy (DCR) that minimizes the obstruction of a neo-ostium by creating an enlarged marsupialized lacrimal sac using mucosal flaps. Forty-two patients who had undergone 46 endoscopic DCR at a tertiary medical center, from 2002 to 2004, for correction of lacrimal system obstruction were investigated. The surgical technique involves elevation of a nasal mucosal flap, full sac exposure using a power drill, and shaping of the mucosal flap to cover denuded bone and juxtapose exposed sac mucosa. Postoperative symptoms and endoscopic findings of the neo-ostium were evaluated. Mean duration of follow-up was 5.9 months. An eighty-three percent primary success rate was observed, without any serious complications. Obstruction of the neo-ostium with granulation tissue was observed in eight cases, among which six underwent revision with success in all cases. Overall, 44 (96%) of 46 cases experienced surgical successes. Endoscopic DCR, a procedure in which a large marsupialized lacrimal sac is created from mucosal flaps, yields a very satisfactory success rate with straightforward and highly successful revision available for those in whom the primary procedure yields a substandard result.
Treatment Outcome ; Surgical Flaps ; Nasal Mucosa/surgery ; Middle Aged ; Male ; Lacrimal Duct Obstruction/*surgery ; Lacrimal Apparatus/pathology/surgery ; Humans ; Follow-Up Studies ; Female ; Endoscopy/*methods ; Dacryocystorhinostomy/*methods ; Child ; Aged ; Adult ; Adolescent

Otolaryngologists are sometimes confronted with various complications. They may be minor or sometimes they can be major, and rarely fatal. Some complications can be prevented, but some are unavoidable. Five cases of major complications, which occurred during or after routine rhinologic surgery, are presented. Two patients died of toxic shock syndrome: one patient after endoscopic sinus surgery (ESS) and the other patient after closed nasal bone reduction. One patient died of acute myocardial infarction during the recovery of anesthesia after uneventful ESS. One patient had a lidocaine shock, which required treatment in the intensive care unit. One patient had a transient unilateral blindness after intranasal steroid injection. Though the 3rd and 4th cases of complications were unavoidable, the others could have been prevented if precautions had taken place. The presumed pathophysiology, possible prevention measures, and their implications in routine otolaryngologic surgery are discussed.
Anesthesia ; Blindness ; Humans ; Intensive Care Units ; Lidocaine ; Myocardial Infarction ; Nasal Bone ; Shock ; Shock, Septic