Spinal osteochondroms are very rare, and are thought to arise through a process of progressive endochondral ossification of aberrant cartilage of a growth plate, as a consequence of congenital defect or trauma. A case of diffuse type osteochondroma involving the posterior elements of L1-L5 that progressed after laminectomy in a 33-year-old man is reported. Usually, the spinal osteochondroma shows clear demarcation between tumor margin and normal spine elements, and can be exised completely. However, there was no clear demarcation between tumor and normal spine element in our case and therefore it was not possible to removal completely.
Adult ; Bone and Bones* ; Cartilage ; Congenital Abnormalities ; Growth Plate ; Humans ; Laminectomy ; Osteochondroma* ; Spine*

PURPOSE: To find out whether or not the computed tomographic (CT) classification systems of the calcaneal fracture are efficient in illuminating displaced posterior facet fragment and the degree of displacement can be evaluated by analyzing serial CT images. MATERIALS AND METHODS: Seventy-seven hundred calcaneal fractures were classified by CT classification systems including Sanders classification, and the sagittal rotation angle of the posteior facet fragment was measured on the plain lateral radiograph. Among the serial axial CT images, a number of images with the cortical bone embedded in the cancellous portion were recorded and any significant relationship between each data were evaluated. RESULTS: The conventional CT classification systems are rather insufficient in illuminating the extent of sagittal rotatory displacement. However, the number of CT images in which the cortical radiodensity was observed showed a significantly related with the degree of displacement. CONCLUSION: The conventional CT classification of the calcaneal fractures is unsatisfactory in expressing the degree of sagittal rotatory displacement of the posterior facet fragment; this problem may be alleviated by observing the number of axial CT images in which cortical radiodensity was revealed within the calcaneal body.
Calcaneus ; Classification

STUDY DESIGN: Retrospective study. OBJECTIVES: The purpose of this study was to compare factors that influence degenerative changes in patients undergoing total laminectomy and patients undergoing partial laminectomy. SUMMARY OF LITERATURE REVIEW: Lumbar or lumbosacral fusion with total or partial laminectomy may result in adjacent segment problems of the upper segment. However, the differences between the two procedures that may influence adjacent segment instability are still controversial. MATERIALS AND METHODS: We evaluated 95 patients, followed up for at least 2 years, who had been treated with short level (at most 2 levels) posterior lumbar interbody fusion with pedicle fixation, secondary to spinal stenosis. Treatment procedures included total laminectomy (42 cases) and partial laminectomy (53 cases). We analyzed the preoperative status of the intervertebral discs (Thompson grade), difference of disc height, and difference between preoperative segmental sagittal angle and last follow-up sagittal angle. We excluded cases that required revision secondary to infection, nonunion, or hematoma formation. However, we included cases that required revision due to adjacent segmental problems during the follow-up period. RESULTS: The mean age of the patients treated with total laminectomy was 59.0+/-10.9 years, and of the patients treated with partial laminectomy was 58.8+/-10.2 years. The preoperative Thompson grade showed no statistical difference. The difference in disc height and segmental sagittal angle between the preoperative and last follow-up examinations showed no statistical difference between the two groups. CONCLUSIONS: There was no significant difference in the radiographic or clinical outcomes based on removal or preservation of posterior structures. Nevertheless, we need further follow-up to evaluate adjacent segment degeneration.
Follow-Up Studies ; Hematoma ; Humans ; Intervertebral Disc ; Laminectomy ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis

The Teller acuity card procedure, which is a form of the preferential looking test, is a way of assessing visual acuity in preverbal patients. It has been shown to be rapid and easy test to perform. Teller acuity cards were used to detect amblyopia in 100 patients(from 2 months to 9 years) and the result was compared to the clinical judgement of amblyopia. The sensitivity, specificity and efficiency of Teller acuity card procedure compared to the clinical judgement of amblyopia were 71.43%, 94.94% and 90.00%, respectively. The authors found that the acuity cards could be used to detect amblyopia. However, the clinical judgement of amblyopia of the ophthalmologist was more sensitive in diagnosing amblyopia than the Teller acuity cards in the presence of various ocular disorders.
Amblyopia* ; Humans ; Sensitivity and Specificity* ; Visual Acuity

The Teller acuity card procedure, which is a form of the preferential looking test, is a way of assessing visual acuity in preverbal patients. It has been shown to be rapid and easy test to perform. Teller acuity cards were used to detect amblyopia in 100 patients(from 2 months to 9 years) and the result was compared to the clinical judgement of amblyopia. The sensitivity, specificity and efficiency of Teller acuity card procedure compared to the clinical judgement of amblyopia were 71.43%, 94.94% and 90.00%, respectively. The authors found that the acuity cards could be used to detect amblyopia. However, the clinical judgement of amblyopia of the ophthalmologist was more sensitive in diagnosing amblyopia than the Teller acuity cards in the presence of various ocular disorders.
Amblyopia* ; Humans ; Sensitivity and Specificity* ; Visual Acuity

Campylobacter jejuni enterocolitis is one of the common causes of acute infectious diarrhea, but most of them remain unrecognized by routine microbiologic examination. Its clinical manifestations are watery diarrhea, malaise, fever and abdominal pain. The clinical course is self-limited in majority of cases. However cases of Campylobacter jejuni infections as cholecystitis, pancreatitis, peritonitis or cystitis have been infrequently reported. Moreover, reactive arthritis, hepatitis, interstitial nephritis or hemolytic uremic syndrome rarely develops in Campylobacter jejuni enterocolitis. We experienced a patient with Campylobacter jejuni enterocolitis, who had shown complex clinical features manifested by pancreatitis and hemolytic uremic syndrome. We reported the case with literature reviews.
Abdominal Pain ; Arthritis, Reactive ; Campylobacter jejuni* ; Campylobacter* ; Cholecystitis ; Cystitis ; Diarrhea ; Enterocolitis* ; Fever ; Hemolytic-Uremic Syndrome* ; Hepatitis ; Humans ; Nephritis, Interstitial ; Pancreatitis* ; Peritonitis

Spinal Cord contusions in cats were produced experimentally by impact injuries to the surgically exposed cord at the second lumbar vertebral level. As a step in the investigation of the possible effect of spinal cord trauma on biochemical and ultrastructural changes in the injured cord, activities of lipid peroxidation were measured in the frozen-dried sample of the spinal cord and the fine structure of the myelinated nerve fiber in the white matter were observed before and after the cord injury. An increase of lipid peroxidation level was found as early as 30 minutes after the injury and the highest concentration was reached at 4 hours of injury. Fine structures of the myelinated nerve fibers were changed progressively with the lapse of time after the injury. By 1 hour after the contusion the myelinated nerve fibers showed moderately enlarged periaxonal space, attenuation and disarray of the myelin sheaths. By 4 hour after the contusion, there appeared disarray of the myelin sheaths, greatly enlarged periaxonal space and irregulary contoured axons. The effect of naloxone of the lipid peroxidation and fine ultrastructure of the myelinated nerve fibers were studied, and the results of this study suggested that naloxone have a beneficial effect on the change in lipid peroxidation and the preservation of the myelinated nerve fibers after injury.
Animals ; Axons ; Cats ; Contusions ; Lipid Peroxidation* ; Myelin Sheath* ; Naloxone* ; Nerve Fibers, Myelinated ; Spinal Cord Injuries ; Spinal Cord*

Purpose: Frequent neutropenia hinders uninterrupted palbociclib treatment in patients with hormone receptor (HR)–positive breast cancer. We compared the efficacy outcomes in multicenter cohorts of patients with metastatic breast cancer (mBC) receiving palbociclib following conventional dose modification or limited modified schemes for afebrile grade 3 neutropenia. Materials and Methods: Patients with HR-positive, human epidermal growth factor receptor 2–negative mBC (n=434) receiving palbociclib with letrozole as first-line therapy were analyzed and classified based on neutropenia grade and afebrile grade 3 neutropenia management as follows: group 1 (maintained palbociclib dose, limited scheme), group 2 (dose delay or reduction, conventional scheme), group 3 (no afebrile grade 3 neutropenia event), and group 4 (grade 4 neutropenia event). The primary and secondary endpoints were progression-free survival (PFS) between groups 1 and 2 and PFS, overall survival, and safety profiles among all groups. Results: During follow-up (median 23.7 months), group 1 (2-year PFS, 67.9%) showed significantly longer PFS than did group 2 (2-year PFS, 55.3%; p=0.036), maintained across all subgroups, and upon adjustment of the factors. Febrile neutropenia occurred in one and two patients of group 1 and group 2, respectively, without mortality. Conclusion Limited dose modification for palbociclib-related grade 3 neutropenia may lead to longer PFS, without increasing toxicity, than the conventional dose scheme.

BACKGROUNDS AND OBJECTIVES: C-Reactive protein (CRP) levels are powerful predictors of cardiac complications and death in patients with unstable angina unrelated with myocardial cell damage or myocardial ischemia. This study was performed to determine the optimal timing to measure CRP to predict cardiac events in patients with unstable angina. MATERIALS AND METHOD: The study was comprised 50 patients with unstable angina (Braunwald Class IIIb). We randomized the study subjects by the time of CRP elevation (> 8mg/L): Group A (on admission, 15 patients), Group B (during hospitalization, 19 patients), and Group C (at discharge, 19 patients). RESULTS: 1) CRP levels (median and range) of Group A, B, and C were 10.6 (8.2-24.2), 12.8 (8.1-33.7), and 10.3 (8.1-18.7) mg/L, respectively (p=S). 2) During clinical follow-up at a mean duration of 12 months, there were 1 death, 1 myocardial infarction, 6 revascularization therapy (PTCA or CABG) and 11 recurrent angina. 3) In Group A, 10 cardiac events (1 myocardial infarction, 4 revascularization therapy, and 5 recurrent angina) occurred. The elevated levels of CRP predicted cardiac events during clinical follow-up with sensitivity of 53%(10/19), positive predictive value of 67%(10/15), and negative predictive value of 74%(26/35). In Group C, 13 cardiac events were occurred. Sensitivity, positive and negative predictive value to predict cardiac events of elevated levels of CRP were 68%(13/19), 68%(13/19) and 81%(25/31), respectively. 4) Elevated levels of CRP (>8mg/L) were predictors for cardiac events in patients with unstable angina (Group A; p<0.05, Group B; p<0.05, Group C; p<0.001). However, by logistic regression analysis, CRP values > 8mg/L at discharge were only predictive of cardiac events with odd ratio of 6.01 (95% CI 1.50-44.3, p<0.05). CONCLUSIONS: CRP (> 8mg/L) was elevated in 38% of patients at discharge and elevated levels of CRP at discharge were only predictive of cardiac events in patients with unstable angina.
Angina, Unstable* ; C-Reactive Protein* ; Follow-Up Studies ; Hospitalization ; Humans ; Logistic Models ; Myocardial Infarction ; Myocardial Ischemia

OBJECTIVES: Pyrethroids are commonly used pesticides, and acute human poisoning by these insecticides is common in Korea. It has a high affinity to the sodium channel on cell membranes causing blockage, which results in neurotoxicity, hyperexcitation, and death. The purpose of this study was to analyze the clinical characteristics of acute pyrethroid poisoning. METHODS: To evaluate the clinical characteristics (age, sex, causative agents, cause of ingestion, severity of poisoning and its clinical feature, prognosis, complication and results of the treatment), we analyzed the clinical reports of 30 patients with pyrethroid poisoning who were admitted to Soonchunhyang Chunan hospital from January 1992 to July 1997. RESULTS: 1) 18 out of 30 patients with pyrethroid poisoning were male and the largest age group was above 60 years old. 2) The most common cause of ingestion was suicide, in 24 cases (80%). 3) There were 7 classes of causative agents of poisoning and all of these were classified into 2 grades according to the degree of WHO toxicity. Fenvlaerate and cypermethrin were the most common agents. 4) The degree of severity was classified into three groups - mild, moderate and life -threatened. Of these groups, mild poisonig was the most common. There was no significant difference in the age, type of pyrethoid and interval between pyrethroid ingestion and arriving at the emergency room between the three groups. However, the amount of ingestion was significantly higher in the life-threatened group. 5) The most common symptom of the patients was vomiting, in 19 patients. The classification were of three types (5 type I, 11 type II and 1 intermediate type) according to clinical characteristics. 6) There is no specific antidote, therefore therapy is generally supportive. There were three deaths, and the cause of death was respiratory failure. 7) The most common complication was pneumonia, in 3 cases (10%), which occured in almost all patients in the life-threatened group. CONCLUSIONS: The most common age group of poisoing was over 60 years old, and suicide was the most common cause of ingestion. Treatment is supportive, and most causal exposures require only decontamination. There were three deaths, and the cause of death was respiratory failure in each case. The most common complication was pneumonia.
Cause of Death ; Cell Membrane ; Chungcheongnam-do ; Classification ; Decontamination ; Eating ; Emergency Service, Hospital ; Humans ; Insecticides ; Korea ; Male ; Middle Aged ; Pesticides ; Pneumonia ; Poisoning* ; Prognosis ; Pyrethrins* ; Respiratory Insufficiency ; Sodium Channels ; Suicide ; Vomiting