The cauda equina syndrome is a relatively uncommon, but serious complication. And it can have grave long-term consequences for the patient. The purpose of the study is to analyse the causes, clinical courses and to find the methods of prevention of cauda equina syndrome following lumbar spine surgery. We reviewed 6 cases among 287 patients wbo had been operated on and followed for minimum 12 months at Seoul Adventist Hospital from March 1991 to March 1996. The obtained results were as follows. 1. All six cases was noted only in patients who had operative procedures for spinal stenosis and possible causes were 3 cases of epidural hamatoma, 1 case of unrecognized and recurred disc herniation, 1 case of retained ligament flavum and 1 case of pseudomeningocele formation due to unrecognized dura tear. 2. Progressive neurologic deficits, decreased perianal sensation and loss of anal wink were present in all cases and were diagnostic. 3. Only three cases which were occurred within 24 hours and early treated within 12 hours, had no specific residual neurologic deficits. In conclusion, it is recommended that operators should be very cautious during the spine surgery. And also early recognition and surgical decompression is very important. During early postoperative periods, only repeated and regular neurologic examinations will enable early diagnosis and treatment to reduce permanent neurological damage.
Cauda Equina* ; Decompression, Surgical ; Early Diagnosis ; Humans ; Ligaments ; Neurologic Examination ; Neurologic Manifestations ; Polyradiculopathy* ; Postoperative Period ; Sensation ; Seoul ; Spinal Stenosis ; Spine* ; Surgical Procedures, Operative

BACKGROUND: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program, is to identify people with diabetes at early stage so they might have advantages of early treatment to prevent complication of the disease. Oral glucose tolerence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolerence, bit the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA1 and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA1, for the ourpose of diabetes diagnosis with the OGTT as reference method. METHODS: In the study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungssang Hospital. Blood samples for HbA1 and fructosamone determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recom-mandations, The subjects were classified according to the American Diabetes Association classification. RESULTS: In our study, we observed fasting plasma glucose of 145.32+/-75.00mg/deciliter, two-hour plasma glucose of 245.83+/-155.22mg/deciliter, HbA1 of 7.06+/-2.77%, and fructosamine of 308.77+/-128.23 micromol/liter. The correlation coefficient between FPG and HbA1 was 0.9098(p<.05), between FPG and fructosamine 0.7953(p Blood Glucose ; Classification ; Cross-Sectional Studies ; Diabetic Angiopathies ; Diagnosis* ; Diagnostic Tests, Routine ; Fasting ; Fructosamine* ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Mass Screening ; ROC Curve ; World Health Organization

Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.
Republic of Korea ; Spine ; Wounds, Gunshot

BACKGROUND: The essential oil of Ocimum basilicum (EOOB) has a pleasant aroma and is known to have antimicrobial and insecticidal activities. In addition, it is used as a pain reliever in folk medicine. However, there are few reports on the antinociceptive activities of EOOB. METHODS: This study examined the antinociceptive effects of EOOB using formalin and a plantar test in mice. In the formalin test, EOOB (50 mg/kg, 100 mg/kg, 150 mg/kg) was administered intraperitoneally and the licking time of the mice was measured. In the plantar test, intraperitoneal EOOB (50 mg/kg, 100 mg/kg) was administered and the withdrawal latency was measured using the Hargreaves method. RESULTS: In the formalin test, EOOB (50 mg/kg, IP) showed significant decreases in licking time in the second phase. On the other hand, in the plantar test, there were no significant effects in any of the groups examined. CONCLUSIONS: These results support the traditional use of EOOB for the treatment of painful conditions. However, there is a need for more research to determine the active chemical constituents and the precise mechanism.
Animals ; Formaldehyde ; Hand ; Medicine, Traditional ; Mice ; Ocimum ; Ocimum basilicum ; Pain Measurement

PURPOSE: Population studies have reported that sensitization to inhalant allergens is rare in young children; however, most subjects in those studies had little or no symptoms or signs highly suggestive of allergic diseases. The aim of the present study was to assess the prevalence of sensitization to inhalant allergens in young children with symptoms and/or signs of allergic disease. METHODS: We analyzed the results of all specific IgE tests performed at our hospital laboratory in children younger than 6 years presenting with symptoms and/or signs highly suggestive of allergic diseases between 2008 and 2013. Specific IgE tests for Dermatophagoides pteronyssinus, Dermatophagoides farinae, Alternaria alternata, German cockroach, cat dander, egg white or egg yolk, milk, peanut, and soybean were performed on 295 children; a specific IgE concentration > or =0.35 or > or =0.2 IU/mL was considered positive. We also compared allergen sensitization rates using the two cutoff values. RESULTS: One hundred eighty-one children (61.4%) were positive to at least 1 allergen tested and 53 children (18.9%) were positive to at least 1 inhalant allergen when a specific IgE concentration > or =0.35 IU/mL was considered positive. The children were more likely to have asthma or allergic rhinitis when they were sensitized to any inhalant allergen, particularly house dust mites. The prevalence of sensitization to inhalant allergens increased with age (P<0.001). There was no significant difference in the prevalence of polysensitization among different age groups, but sensitization to both inhalant and food allergens significantly increased with age. CONCLUSION: Our results suggest that specific IgE tests to common inhalant allergens, particularly the house dust mites, may be considered when performing blood screening tests for young children presenting with symptoms and/or signs of allergic diseases.
Allergens* ; Alternaria ; Animals ; Asthma ; Blattellidae ; Cats ; Child* ; Dander ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Egg White ; Egg Yolk ; Humans ; Immunoglobulin E ; Laboratories, Hospital ; Mass Screening ; Milk ; Prevalence ; Pyroglyphidae ; Rhinitis ; Soybeans

PURPOSE: Wheezing following viral lower respiratory tract infections (LRTIs) in children <2 years of age is an important risk factor for the development of asthma later in life; however, not all children with viral LRTIs develop wheezing. This study investigated risk factors for the development of wheezing during viral LRTIs requiring hospitalization. METHODS: The study included 142 children <2 years of age hospitalized for LRTIs with at least one virus identified as the cause and classified them into children diagnosed with LRTIs with wheezing (n=70) and those diagnosed with LRTIs without wheezing (n=72). RESULTS: There were no significant differences in the viruses detected between the two groups. Multivariate logistic regression analysis showed that, after adjusting for potentially confounding variables including sex and age, the development of wheezing was strongly associated with parental history of allergic diseases (adjusted odds ratio [aOR], 20.19; 95% confidence interval [CI], 3.22-126.48), past history of allergic diseases (aOR, 13.95; 95% CI, 1.34-145.06), past history of hospitalization for respiratory illnesses (aOR, 21.36; 95% CI, 3.77-120.88), exposure to secondhand smoke at home (aOR, 14.45; 95% CI, 4.74-44.07), and total eosinophil count (aOR, 1.01; 95% CI, 1.01-1.02). CONCLUSION: Past and parental history of allergic diseases, past history of hospitalization for respiratory illnesses, exposure to secondhand smoke at home, and total eosinophil count were closely associated with the development of wheezing in children <2 years of age who required hospitalization for viral LRTIs. Clinicians should take these factors into consideration when treating, counseling, and monitoring young children admitted for viral LRTIs.
Asthma ; Child* ; Confounding Factors (Epidemiology) ; Counseling ; Eosinophils ; Hospitalization* ; Humans ; Logistic Models ; Odds Ratio ; Parents ; Respiratory Sounds* ; Respiratory Tract Infections* ; Risk Factors* ; Tobacco Smoke Pollution

BACKGROUND: The aim of this study was to elucidate the relationship of environmental tobacco smoke (ETS) exposure and the urine cotinine concentrations in Korean adolescents. METHODS: The study population was 1st grade high school adolescents (n = 1467, girls 22.2%) recruited from four high schools, two from Seoul, one from Kangleung and one from Woolsan. We obtained information on active smoking and ETS exposure through self-reported questionnaire and urine cotinine concentrations. RESULTS: The prevalence of active smoking was 6.9% in boys and 0.9% in girls. Median urine cotinine concentrations were 19.5 microgram/L (range, 0-2341 microgram/L) among smokers, and 0 microgram/L (range, 0-1359 microgram/L) among nonsmokers. The positive rate of urine cotinine among nonsmokers exposed to ETS was 2.9%. Boys were exposed to ETS in the order of frequency in PC room (79.6%), home (39.4%), school (11.5%), and public places (5.9%); girls were exposed in the order of frequency in home (40.9%), PC room (33.2%), public places (28.0%), and school (15.2%). The frequency and duration of ETS exposure were significantly larger and longer in boys than in girls. Boys contacted friends who smoked more than girls did (32.6% vs. 17.1%). Parents; smoking status was similar both in boys and girls. Any information on ETS exposure did not differ according to the detectable urine cotinine among nonsmoking adolescents. CONCLUSION: Low positive rate of urine cotinine and no association of urine cotinine with various ETS exposure history reflect that urine cotinine may not be a good marker for ETS exposure in Korean adolescents.
Adolescent ; Cotinine ; Friends ; Humans ; Prevalence ; Smoke ; Smoking ; Tobacco ; Surveys and Questionnaires

PURPOSE: The aim of this study was to determine whether allergic rhinitis (AR) without asthma is associated with bronchial hyperresponsiveness (BHR) and symptoms of asthma in Korean adolescents. METHODS: A questionnaire survey was conducted on 724 high school students (males 556; females, 168) from Seoul City. We also performed the lung function test, methacholine challenge test, skin prick test, and allergy-related blood biomarkers. This cross-sectional study was conducted in the subjects excluding current asthmatic patients. RESULTS: AR (+), BHR (+) patients tended to show a high prevalence of wheeze ever, a high diagnosis rate of asthma ever, low forced expiratory volume in one second (FEV(1)), low forced expiratory flow at the 25% and 75% of pulmonary volume (FEF(25-75%)) high total IgE and frequent sensitizaion to house dust mites compared with AR (-), BHR (-) patients. In atopy AR (+) group, wheeze ever and treatment of asthma during the last 12 months were significantly higher than atopy (-), AR (-) patients or atopy (+), AR (-) patients (P<0.05). In atopy (+), AR (+) patients, BHR and peripheral eosinophil percent were significantly higher than in other patients (P<0.05) and PC(20) was also significantly lower than in other patients (P<0.05). CONCLUSION: BHR in current AR was associated with FEV(1), FEF(25-75%), total IgE, and sensitization to house dust mites. Current AR was associated with symptoms of asthma, peripheral eosinophilia and BHR, regardless of atopy. This study showed a significant association between allergic rhinitis and asthma or BHR among Korean adolescents. This cross-sectional study supports the concept of 'one airway, one disease' between the AR and asthma.
Adolescent ; Asthma ; Biomarkers ; Cross-Sectional Studies ; Eosinophilia ; Eosinophils ; Female ; Forced Expiratory Volume ; Humans ; Immunoglobulin E ; Korea ; Methacholine Chloride ; Prevalence ; Pyroglyphidae ; Surveys and Questionnaires ; Respiratory Function Tests ; Rhinitis ; Rhinitis, Allergic, Perennial ; Skin Tests

BACKGROUND: The worldwide prevalence of obesity and allergic diseases has increased. We aimed to explore the relation of overweight to asthma, atopic dermatitis, allergic rhinitis and conjunctivitis in a sample of Korean adolescents. METHODS: We investigated the prevalence of symptoms of asthma and other allergic diseases by using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The survey was conducted among 1,499 high school students in 3 regions of Korea. RESULTS: The lifetime prevalence of wheezing (21.2% vs. 15.7%, P = 0.04), the 12 months-prevalence of wheezing (4.5% vs. 2.0%, P = 0.04), exercise induced wheezing (13.8% vs. 9.3%, P = 0.04), treatment of asthma (3.3% vs. 1.1%, P = 0.01) and the prevalence of symptoms of allergic rhinitis (11.0% vs. 5.1%, P = 0.001) were signifi cantly higher in overweight boys than normal weight boys, but not in girls. However, there were no signifi cant differences of the prevalence of symptoms and past history of atopic dermatitis and allergic conjunctivitis between overweight and normal weight groups. In boys, overweight increased the risk of the lifetime prevalence of wheezing (OR 1.54, 95% CI: 1.05-2.24) and 12 months-prevalence of exercise induced wheezing (OR 1.64, 95% CI: 1.05-2.55) after adjusting for confounding variables. CONCLUSION: Overweight could be a risk factor for the development of symptoms of asthma and allergic rhinitis in adolescent boys, whereas it was not a signifi cant risk factor for allergic diseases in girls.
Adolescent ; Asthma ; Confounding Factors (Epidemiology) ; Conjunctivitis ; Conjunctivitis, Allergic ; Dermatitis, Atopic ; Humans ; Hypersensitivity ; Korea ; Obesity ; Overweight ; Prevalence ; Respiratory Sounds ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors

BACKGROUND AND OBJECTIVES: The anterior ethmoid canal is the important surgical landmark in endoscopic sinus surgery, intranasal ethmoidectomy, and frontal sinus surgery. However it is not enough to evaluate the anterior ethmoid canal by coronal OMU CT, especially relating anterior to posterior relationship of the anterior ethmoid canal. The pulpose of this study is to evaluate the anterior ethmoid canal in 1 mm axial OMU CT and measure the five parameters relating the anterior ethmoid canal. MATERIALS AND METHODS: A prospective study was performed in 100 sinuses of 50 patients with chronic sinusitis who underwent endoscopic sinus surgery from May through July of 1998. RESULTS: The anterior ethmoid canal is well demonstrated by 1 mm axial OMU CT. The average of five parameters are 6.2+/-1.5 mm, 6.4+/-4.3 mm, 18.5+/-3.9 mm, 26.5+/-5.6 mm, 24.6+/-14.6degrees. However, there is no difference between the right and left side statistically. We observed that the anterior ethmoid canal is located just posterior to the frontal recess without anterior ethmoid air cell in front of the antirior ethmoid canal in 23%. CONCLUSION: The anterior ethmoid canal is well remarked by the 1 mm axial OMU CT. The length and directional angle of the anterior ethmoid canal is individually variable and there is no anterior ethmoid air cell in front of the anterior ethmoid canal in 23%. In these cases, the anterior ethmoid canal is more likely to be injured. So axial OMU CT may be useful in the radiologic evaluation for endoscopic sinus surgery in chronic sinusitis.
Frontal Sinus ; Humans ; Nasal Surgical Procedures ; Prospective Studies ; Sinusitis