Vascular injury is a serious but rare complication of hip procedures. Most of vascular complications reported in articles occured in vessels around hip joint and femoral artery. To date, report of popliteal artery occlusion during or after total hip arthroplasty was absent. The authors have experienced one case of popliteal artery occlusion after total hip arthroplasty. It was suspected that the cause of occlusion of this particular case was a excessive maneuvering of limb during operation and then, artheromatous plaque fracture or thrombosis made occulusion in popliteal artery. Angiographic embolectomy using a catheter was performed and circulation of limb was recovered. To reduce the risk of vascular complications after total hip arthroplasty procedure, we recommend a thorough evaluation of lower extremity circulation in risky patient. And if a vascular insult is suspected either during or soon after the procedure, then a vascular consultation with arteriography including popliteal artery should be obtained urgently. Delay in treatment could result in a deleterious outcome.
Angiography ; Arthroplasty, Replacement, Hip* ; Catheters ; Embolectomy ; Extremities ; Femoral Artery ; Hip ; Hip Joint ; Humans ; Lower Extremity ; Popliteal Artery* ; Thrombosis ; Vascular System Injuries

BACKGROUND: The fast EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used far transporting emergent patients. Authors, here upon, report the transporting experiences. METHODS: From Dec. 1, 1996 to Dec. 31,1997, Samsung Medical Centers EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. RESULT: A total of 65 patients were transported. Male to female ratio was 1.95 : 1. The mean transport time was 64.1min(10-160 min). Majority of the evacuated patients was surgical patients (General Surgery'16, Orthopedic surgery : 10, Neurosurgery : 6, Infernal medicine 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation amended The patients. No medical problems or deaths developed during the air evacuation period. CONCLUSION: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.
Aircraft* ; Critical Illness ; Emergencies* ; Female ; Humans ; Korea ; Male ; Neurosurgery ; Orthopedics ; Pediatrics ; Prospective Studies

Asbestos is a naturally occurring mineral in the Earth's crust, and it is not confined to the historic and current asbestos mining areas, but rather quite commonly encountered in certain geological environments across the world. The middle-west side of the Korean Peninsula (Chungnam province) has been composed of numerous talc and asbestos ore deposits derived from serpentine and dolomite. These areas have experienced epidemics of malignant mesothelioma and pleural plaques as a result of non-occupational "neighborhood" exposure and naturally occurring asbestos (NOA) exposure. However, asbestosis epidemics from environmental exposure were rare because asbestosis needs relatively high concentration of asbestos exposure. This review summarizes asbestosis epidemics which occurred in the residents who have lived past or current asbestos mining areas and natural in-place asbestos deposits (or asbestos-like mineral deposits) in the world, including Korean asbestosis endemics that occurred in Chungnam province, which has many historic asbestos mining. Also, this manuscript will describe effective public policies for managing NOA, minimizing potential hazards, and protecting public health from asbestos exposure.
Asbestos ; Asbestosis ; Calcium Carbonate ; Environmental Exposure ; Magnesium ; Mesothelioma ; Mining ; Public Health ; Public Policy ; Residence Characteristics ; Talc

No abstract available.
Lichen Nitidus* ; Lichens*

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the efficacy of cervical expansive laminoplasty for patients with quadriplegia due to traumatic cervical spinal cord injury (SCI) without skeletal injury. SUMMARY OF LITERATURE REVIEW: There are a few studies on the surgical results for acute cervical SCI without bony injury. MATERIALS AND METHODS: From 2003 to 2010, among the patients who visited emergency room with post-traumatic quadriplegia, 12 patients who had underwent cervical expansive laminoplasty for acute cervical SCI without body injury and cord compression on MR images were included in this study. We evaluate the pre-operative swelling on MRI, the change of neurologic symptoms at pre-, post operative state, respiration state, complication and survival period. RESULTS: The average of motor index scores at the time of admission to the emergency room was 23 (4–30), and the average was changed to 29(4–43) during the follow-up period. No significant neurological improvement was observed in 11 cases except 1 case. The average time for operation after the injury was 26 hours(9–72). 4 patients showed paradoxical respiration when they first visited emergency room and the symptom continued after the operation and during follow-up periods. Another 4 patients showed paradoxical respiration after the operation. In all 8 cases who showed paradoxical respiration, tracheostomy and occasional ventilation were needed. In the follow-up period, 6 patients died due to respiratory failure within 1 year after the surgery. All these patients presented severe spinal cord edema on preoperative MRI with paradoxical respiration. CONCLUSIONS: Efficacy of expansive laminoplasty for quadriplegic patients due to acute cervical SCI without bony injury may be limited. In many patients, no significant neurological recovery was observed but it was clearly identified that prognosis was related to the grades of spinal cord edema and paradoxical respiration.
Cervical Cord ; Edema ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Laminoplasty* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Prognosis ; Quadriplegia ; Respiration ; Respiratory Insufficiency ; Retrospective Studies ; Spinal Cord ; Tracheostomy ; Ventilation

PURPOSE: To compare clinical results and radiologic changes after arthroscopic and microscopic discectomy of lumbar disc herniation in teenagers who have no degenerative change. MATERIALS AND METHODS: From Jan 1990 to Aug 2001. 70 lumbar disc herniations were performed in patients below 20 years old who were admitted to our department, among these 67 cases (49:male, 18:female) were evaluated for at least 1 year. Their aver-age age was 18.1 years (13 ~20 years). Forty-six received microscopic discectomy and 21 arthroscopic discectomy. Mean follow-up duration was 26.4 months (12 ~88 months). RESULTS: Clinical results and disc height change were compared between the arthroscopic and microscopic discectomy groups using the criteria of MacNab, and the relationship between disc height change and clinical results, excised disc volume, opera-tive technique, body mass index and symptom duration were investigated. Clinically there was no significant difference between the two groups (p=0.425), and their results were the same as those of adults. At the 1 year-follow up, disc height changes showed no correlation with the method of operation (p=0.996) or the volume of the excised disc. Postoperative disc height in teenagers of lumbar disc herniation who showed no degenerative change significantly decreased with time, but no significant relation was observed between disc height changes and clinical results, operative technique, excised disc volume, body mass index, involved disc site or symptom duration between the two groups. CONCLUSION: We believe that arthroscopic discectomy is an effective method, if the patients status permits, because it has the advantages of non-invasiveness, short hospitalization period and earlier return to normal life.
Adolescent* ; Adult ; Body Mass Index ; Diskectomy* ; Follow-Up Studies ; Hospitalization ; Humans ; Young Adult

STUDY DESIGN: A retrospective study OBJECTIVES: To examine the influence of cervical spondylosis on an acute cervical spinal cord injury. SUMMARY OF LITERATURE REVIEW: There are no reports on the relationship between cervical spondylosis and acute cervical spinal cord injuries. MATERIALS AND METHODS: Twenty six patients who underwent operative treatment for acute cervical injuries with spinal cord injury were evaluated. The mean age and follow-up period was 58 years and 2.2 years, respectively. The evaluation was performed by examining the causes of the injuries, and the classification of fractures according to the presence of cervical spondylosis. This study compared the degrees of postoperative neurological recovery with motor index score in the groups with and without cervical spondylosis. RESULTS: Cervical cord injuries were more prevalent in the group 60 years and older; 17 cases vs. 9 cases in the group under 60 years. Eleven (65%) and 6 (35%) cases in the group 60 years and older had sustained a high and low energy injury, respectively. In contrast, mostly high energy injuries (8 in 9 cases) were encountered in the group under 60 years of age. A low energy injury could cause a acute cervical cord injury in the group 60 years and older, who also had cervical spondylosis. In those cases, previous cervical spondylosis might be one of the etiologic factors. CONCLUSIONS: The cases with cervical spondylosis in the group 60 years and older tended to show incomplete cord injury and good postoperative neurological recovery when they had sustained cervical cord injuries.
Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Cord ; Spinal Cord Injuries ; Spondylosis

STUDY DESIGN: This is a retrospective study analyzing the results of posterior lumbar interbody fusion(PLIF) with TPM cages in spondylolisthesis OBJECTIVES: The purpose of this study was to evaluate the clinical, radiologic results & affecting factors of PLIF with TPM cages in spondylolisthesis. SUMMARY OF LITERATURE REVIEW: The ordinary PLIF has 86-98% of radiologic union rate and clinical satisfactory rate. The problems of ordinary PLIF were graft breakage, donor site morbidity, limited bone resources, high failure rate using only transpedicular screw fixation. MATERIALS AND METHODS: From October 1995 to January 1999, 108 consecutive patients with spondylolisthesis were treated by PLIF with TPM cages, in which morcellized bone chips salvaged from posterior neural arch applied, and pedicle screw fixation. RESULTS: Preoperative Low Back Pain score(total 100 points) was improved from 47.4 points to 88.7 points at last follow-up. 10 point visual analogue scale was reduced to 1.5 point at last follow-up. In the end results, Ninty-two percent of patients rated as excellent or good. The preoperative value of slippage, 18.6% was achieved to 5.5% at last follow-up. The anterior intervertebral disc space height was increased from 10.0 to 16.2mm postoperatively. Fusion occurred in all patients except one. Groups below 60-year-old patient at the time of surgery showed better clinical results than those above 60 (p<0.05). No clear correlations were noted between sex, the types of spondylolisthesis, bone mineral density, smoking habits and obesity in clinical, radiologic results. CONCLUSION: PLIF with TPM cages is appeared to be a recommended procedure of choice to treat lumbar spondylolisthesis and this operation should be performed with a caution in aged patients.
Bone Density ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Low Back Pain ; Middle Aged ; Obesity ; Retrospective Studies ; Smoke ; Smoking ; Spondylolisthesis* ; Tissue Donors ; Transplants

We report a case of a 53-year-old woman with squamous cell carcinoma with lymph node metastasis who has had a recurrent painful bleeding papule on the right toe nail bed with resultant nail plate shedding over the past two years. X-ray and computer tomography examinations showed nearly total destruction of the distal phalanx of the right fifth toe and right inguinal lymph node enlargemet it. A nail bed biopsy specimen disclosed invading tumor masses composed of atypical squamous cells and multiple horn pearls. While squamous cell carcinoma of the nail bed is not usually aggresive and local removal is usually adequate, the possibility that metastasis or invasion of the adjacent phalanx or joint can occur should be kept in mind.
Animals ; Biopsy ; Carcinoma, Squamous Cell* ; Female ; Hemorrhage ; Horns ; Humans ; Joints ; Lymph Nodes* ; Middle Aged ; Neoplasm Metastasis* ; Toes

Kerion celsi is an inflammatory type of tinea capitis. We report a case of Kerion celsi caused by Micropsporum canis in 51 year-old man. When he visited our hospital, he suffered from hair loss and erythematous scaly patched and pustules on the scalp and papules on the face with tenderness and itching sensation. Cultures from scalp lesion and infected hair on Sabouraud glucose agar media showed Microsporum canis. Histopathologic findings showed graunlomatous changes in dermis and many spores around the hair shaft. Treatment was done topically with antifungal ointment and systernically with antibiotics, steroid and antifungsl agents. It is uncommon in adults, especially in men, but this condition must be considered when clinicians are evaluating patients with hair loss and nonspecific scalp dermatitis.
Adult* ; Agar ; Anti-Bacterial Agents ; Dermatitis ; Dermis ; Glucose ; Hair ; Humans ; Male ; Microsporum* ; Middle Aged ; Pruritus ; Scalp ; Sensation ; Spores ; Tinea Capitis*