Spinal cord infarction as a complication of spine surgery occurs rarely. Herein, a case of spinal cord infarction, which developed in a 69 year old woman following posterior decompression and internal fixation for a T11 bursting fracture, is descirbed. The anesthetic induction and intraoperative course were uneventful, except at the end of the procedure, where her blood pressure suddenly dropped from 130/90 to 90/60 mmHg. The patient was aggressively treated with a transfusion and vasopressor, the blood pressure then returned to its usual value within 10 minutes. However, during a physical examination in the recovery room, the patient was found to have flaccid lower limbs, with impaired sensory function below the T8 level. Her cord diameter had increased, and a high signal lesion was observed within the thoracic spinal cord, from T9 to T12 level on T2-weighted MR images, which was diagnosing as a spinal cord infarction, was and showed no improvement despite the immediate and aggressive treatment.
Aged ; Blood Pressure ; Decompression ; Female ; Humans ; Infarction* ; Lower Extremity ; Physical Examination ; Recovery Room ; Sensation ; Spinal Cord* ; Spine*

PURPOSE: This study was to verify the effects of a fluid therapy education program for aged stroke patients for preventing dehydration, pyuria and bacteriuria. METHODS: The study employed a non-equivalent control group pretest-posttest design in quasi experimental basis. Subjects were 38 stroke patients (20 in the experimental group and 18 in the control group) older than 65, hospitalized in a senior care center in S city, Korea. RESULTS: The amount of daily average fluid intake, normal ratio of blood urea nitrogen-creatinine ratio, serum Na+ and urine white blood cells were increased significantly in the experimental group. Normal ratio of bacteriuria increased in the experimental group, but not significantly. CONCLUSION: The education program is considered to be an effective nursing intervention tool for preventing dehydration and urinary tract infections which related to the secondary wellness of aged stroke patients. However, longer term study is necessary for better quality of nursing and developing more specific education programs for aged stroke patients usually hospitalized for a long period of time.
Bacteriuria ; Dehydration ; Education* ; Fluid Therapy* ; Humans ; Korea ; Leukocytes ; Nursing ; Pyuria ; Stroke* ; Urea ; Urinary Tract Infections

No abstract available.
Cardiotocography* ; Meconium* ; Pregnancy*

OBJECTIVE: Our purpose was to investigate the distribution of the result of 17,744 cervicovaginal smears and their pathologic results in Inha University Hospital to make a reference data. METHODS: During 28 months, May 1996 to August 1998, we performed 17,774 cervicovaginal smears and arranged them by the Bethesda system and compared them with their pathologic results. RESULTS: Among 17,744 smears, there were 93.2% of benign results, 2.9% of ASCUS, 0.9% of LSIL, 1.4% of HSIL, and 0.8% of SCC. The ASCUS/SIL ratio was 1.28. Among ASCUS, the high grade histologic outcome was composed 4.0%. Among LSIL, there were 15.7%, and HSIL 48.0%, SCC 56.1%, AGUS 9.3%, and Adenocarcinoma, the results was 69.2%. CONCLUSION: Among 17,744 smears, there were 93.2% of benign results, 2.9% of ASCUS, 0.9% of LSIL, 1.4% of HSIL, and 0.8% of SCC. The ASCUS/SIL ratio was 1.28. These results were very similar to other data and we would like to add our data to them as a reference. And the worse the smear results were, the worse the pathologic results were.
Adenocarcinoma

BACKGROUND: Molluscum contagiosum is a commom benign viral disease of the skin characterized by discrete, 2-5 mm, flesh colored, slightly umbilicated, dome-shaped papules with frequent grouping. But atypical presentation of site, number and size is recently not rare, it may give rise to difficulty in diagnosis. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological characteristics of various atypical molluscum contagiosa. METHODS: We reviewed medical records, clinical photographs, and histopathologic findings in biopsy specimens of 17 patients with molluscum contagiosa diagnosed at Korea Veterans Hospital from January 1990 to June 2001. The ratio of male to female patients was 3:1, and the mean age at diagnosis was 30 years(range: 3-67). RESULTS: 1. Most commonly involved sites were trunk(80%), extremities(30%), and perianal(12%). 2. The duration of the lesion is 15 days to 3 years. 3. The size of lesion is 2 mm to 50 mm. 4. The number of lesions is one to over a hundred. 5. The clinical features were multiple papules without umbilication(9 cases, 53%) and giant tumor(2 case), pyogenic granuloma-like lesion(2 cases), solitary papule with flat surface(2 cases). 6. The combined disease are atopic dermatitis(1 case), epidermal cyst(1 case), and liver cirrhosis(1 case), diabetes mellitus(1 cases). CONCLUSION: This study shows various atypical molluscum contagiosa in immunocompetent patients. Histopathological examination in atypical molluscum contagiosa is necessary for the proper diagnosis and treatment.
Biopsy ; Diagnosis ; Female ; Hospitals, Veterans ; Humans ; Korea ; Liver ; Male ; Medical Records ; Molluscum Contagiosum ; Skin ; Virus Diseases

Long QT Syndrome is characterized by syncope and fatal ventricular arrhythmia. Monotherapy with beta blockers is the first-line therapy. In patients with recurrent syncope despite therapy with beta blockers, combinations of the following modalities of treatment may be considered: pacemakers, left cervicothoracic sympathectomy, and implantable cardioverter defibrillators. Recently, we anesthetized a patient with Long QT Syndrome who underwent thoracoscopic left upper ganglionectomy for recurrent episodes of syncope and ventricular arrhythmia despite aggressive use of propranolol. Because of the increased risk of developing fatal ventricular arrhythmias during anesthesia and surgery, we performed a left stellate ganglion block prior to induction of anesthesia to prevent the ventricular arrhythmia that may be triggered by stimulation of the sympathetic nervous system and to assess the effect of surgical ganglionectomy on the QT interval. Following the block, the QT interval was shortened, and anesthesia and surgery was uneventful though anesthetic induction caused serious sympathetic responses. We recommend a left stellate ganglion block prior to induction of anesthesia in patients with Long QT Syndrome resistant to beta blocker to prevent fatal arrhythmia and to predict the efficacy of the surgical sympathectomy on the QT interval.
Anesthesia* ; Arrhythmias, Cardiac ; Defibrillators, Implantable ; Ganglionectomy ; Humans ; Long QT Syndrome* ; Propranolol ; Stellate Ganglion* ; Sympathectomy* ; Sympathetic Nervous System ; Syncope

Recently, we have encountered an increasing number of patients who have obtained topical steroids to self-treat various dermatosis. Tinea incognito has been used to describe a dermatophyte infection modified by corticosteroid treatment. Lesions are often atypical appearing and the diagnosis can be delayed or missed. We report a case of tinea incognito with ill-defined erythematous patch and nodules on the right upper eyelid and taken intermittently application with corticosteroid ointment over a period of l year. Mycologic studies including KOH mount and fungus culture were positive for hyphae and colonies of Trichophyton mentagrophytes. The lesion was treated with of itraconazole and cured 3 weeks later.
Arthrodermataceae ; Diagnosis ; Eyelids ; Fungi ; Humans ; Hyphae ; Itraconazole ; Skin Diseases ; Steroids ; Tinea* ; Trichophyton*

BACKGROUND: Many companies have developed different methods and products for allergen-specific immunoglobulin E (IgE) tests. Because there is no standardised reference method, external quality assessment (EQA) is important for allergen-specific IgE test to ensure the comparability and reliability of the results from different laboratories. We prepared specimens for EQA of allergen-specific IgE tests and evaluated their stability. METHODS: Four pooled sera with 24 selected allergen-specific IgE levels were prepared and stored at −80℃. The stability of allergen-specific IgE levels was assessed on days 1, 7, and 14 at −20℃, 2℃ to 8℃, and 20℃ to 25℃, and then after 3 months at −80℃. Mock proficiency tests were performed with the four sets of prepared external quality controls for six laboratories, using the commercial multiple allergen simultaneous test (MAST) methodology. RESULTS: About 150 specimens (650 µL each) for EQA were prepared; randomly selected specimens showed similar IgE levels for the 24 allergens (±1 class). The levels of allergen-specific IgE remained stable throughout the study period (P>0.05). Although mock survey results from six laboratories using four MAST assays revealed some variability with a difference (2–3 class), no consistent differences were observed through the allergens or MAST methods. Qualitative results from the mock survey showed 85.4% (cut-off of class 1) and 81.3% (cut-off of class 2) concordance with the results from ImmunoCAP (Phadia, Sweden). CONCLUSIONS: The pooled sera prepared for allergen-specific IgE tests might be adequate and useful for EQA.
Allergens ; Immunoglobulin E* ; Immunoglobulins* ; Methods ; Quality Control*

PURPOSE: To determine the magnetic resonance imaging (MRI) findings in patients with traumatic thoracic aortic injury and to assess the usefulness of MRI for the diagnosis of aortic injury. MATERIALS AND METHODS: Between May 1990 and June 2000, sixteen patients with blunt thoracic aortic injury underwent MRI. The findings were evaluated with regard to the type of aortic injury, aortic circumference, the size, direction and shape of the pseudoaneurysm, the intimal flap, and pseudocoarctation. Six patients underwent follow-up MRI, and any changes in the findings were assessed. RESULTS: MRI indicated that traumatic thoracic aortic injury comprised localized pseudoaneurysm in 15 patients and extensive aortic dissection in one. The aortic circumference was partially involved in all cases. Pseudoaneurysms were located at the aortic isthmus in 16 cases and the descending thoracic aorta in one. Two patients each had two lesions: two pseudoaneurysms in one, and aortic dissection and pseudoaneurysm in the other. The mean diameter and length of the pseudoaneurysms was 2.8+/-0.8 cm (mean+/-SD) and 3.3+/-1.0 cm (mean+/-SD), respectively. Their direction was anteromedial or anterolateral in 15 cases and posterolateral in two. All were saccular shaped. An intimal flap was present in seven cases and pseudocoarctation was demonstrated in ten. Follow-up MRI revealed changes in the size of a pseudoaneurysm or the length of an aortic dissection. CONCLUSION: The most common finding demonstrated by MRI in patients with traumatic thoracic aortic injury was an anteromedially-directed saccular pseudoaneurysm in the aortic isthmus. This modality was considered useful for evaluation of the entire aorta in cases of multiple pseudoaneurysms or aortic dissection.
Aneurysm, False ; Aorta ; Aorta, Thoracic ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging*

Craniosynostosis is a congenital anomaly characterized by premature closure of cranial sutures. Surgical intervention should be performed during infancy. However, surgical correction of craniosynostosis remains bone defect and secondary angle occasionally. Currently, publications investigating solutions to bone defect and secondary angle created by cranioplasty are getting much interest. We have used BoneSource(R) which is relatively safe as an implantable substance for providing solutions for this problem. From June 2002 to January 2004, five children with craniosynostosis underwent frontocalvarial contouring using BoneSource(R) and concurrent cranial vault remodeling. The patient ages ranged from 8.0 months to 4.9 years(mean, 2.5 years). The quantity of BoneSource(R) implanted ranged from 10 to 25g, with a mean of 13g. This paper presents the first series of children treated with BoneSource(R) for frontocalvarial contouring in the surgical correction of craniosynostosis. No patients experienced any complications. Our results shows excellent retention of contour without causing asymmetry or irregularity. No visible evidence of interference with craniofacial growth were observed. Through our experiences, BoneSource(R) is found to be very useful for frontocalvarial contouring in children undergoing correction of craniosynostosis.
Child ; Cranial Sutures ; Craniosynostoses* ; Humans