No abstract available.
Neurofibromatoses* ; Neurofibromatosis 1* ; Neurofibromin 1 ; Vitiligo*

OBJECTIVE: The purpose of this study is to investigate the incidence and types of skin lesions occurring in the patients with a spinal cord injury(SCI), traumatic brain injury(TBI), cerebrovascular accident(CVA), and an amputation. METHOD: Five hundred and eighty-nine charts from 1991 to 1997 were retrospectively reviewed. During the hospitalization, the skin lesions were examined by the dermatologists upon consultations. The patients were divided by their diagnosis of the SCI, TBI, CVA, and amputation. The incidence of the skin lesions were analysed. RESULTS: The number of patients was as follows; SCI 228, TBI 181, CVA 143, and amputation 37. The skin lesions occurred in 72 cases(12.9%) of which 30 cases(13.2%) occured in SCI, 21 cases(11.6%) in TBI, 15 cases(9.8%) in CVA and 7 cases(18.9%) in amputation. These include dermatophytosis 23 cases(23.9%), seborrheic dermatitis 21 cases(21.8%), pilosebaceous disorder 17 cases(17.7%) such as folliculitis, acne, and acneiform eruption, eczema 11 cases(11.4%), drug eruption 9 cases(9.4%), candidiasis 6 cases(6.3%), and others 9 cases(9.4%) such as steatocytoma multiplex, epidermal cyst, intertrigo, alopecia areata, and etc. The incidence of ANS related skin lesion such as seborrheic dermatitis and pilosebaceous disorder in SCI was significantly higher than in TBI and stoke, which the defect is in the brain(p<0.05). However, the incidence in other lesions such as dermatophytosis, eczema, and candidiasis was not significantly different between these two groups(p>0.05). The number of cases of ANS related skin lesions was 21(52.5%) and 3(42.9%) in SCI patients whose level of injury was from C1 to T6(in 40) and at or below T7(in 7) respectively. In contrast, the number of cases of other skin lesions such as dermatophytosis, eczema, and candidiasis was 15(37.5%) of C1 to T6 level and 4(57.1%) of at or below T7 level in the same SCI patients groups. CONCLUSION: This study illustrates that the incidence of skin lesion in rehabilitation unit is 72 cases of 589 patients(12.9%). The incidence of ANS related skin lesion is higher in the patients with spinal cord injury than brain lesion. And the level of injury is higher in SCI, the more skin lesions occur.
Acne Vulgaris ; Acneiform Eruptions ; Alopecia Areata ; Amputation ; Autonomic Nervous System ; Brain ; Candidiasis ; Dermatitis, Seborrheic ; Diagnosis ; Drug Eruptions ; Eczema ; Epidermal Cyst ; Folliculitis ; Hospitalization ; Humans ; Incidence ; Intertrigo ; Pressure Ulcer* ; Referral and Consultation ; Rehabilitation* ; Retrospective Studies ; Skin* ; Spinal Cord ; Spinal Cord Injuries ; Tinea

Carbamazepine is widely used to manage of seizures and symptomatic treatment of trigeminal neuralgia and central pain. We experienced two cases of exceedingly rare but potentially fatal side effects following carbamazepine administration. One traumatic brain injured patient developed pancytopenia 3 weeks after beginning to take carbamazepine for prophylactic management of seizure and the other C6 incomplete spinal cord injured patient receiving carbamazepine for the management of central pain sequentially developed syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 1 week after administration. Because of more frequent indications of carbamazepine, these side effects must be borne in mind and cautious administration will be desirable.
Brain ; Carbamazepine* ; Humans ; Inappropriate ADH Syndrome* ; Pancytopenia* ; Seizures ; Spinal Cord ; Trigeminal Neuralgia

PURPOSE: To evaluate the relevant clinical and radiographical findings for the diagnosis of an arteriovenous fistula after a lumbar discectomy. MATERIALS AND METHODS: Five patients with an arteriovenous fistula following a lumbar discectomy were preoperatively diagnosed and treated. We retrospectively evaluated the level of surgery, injured vessels, clinical symptoms, physical findings, and the interval between surgery and treatment. Effective and fast diagnostic methods for determining the presence of a postoperative arteriovenous fistula were evaluated. RESULTS: All of the arteriovenous fistulas resulted from operative injuries of the iliac arteries and veins. They were diagnosed after a mean time of 22 months (range 2 months-4 years) in spite of various symptoms and signs shortly after surgery. The arteriovenous fistulas were confirmed with angiography and were treated by surgery for 3 patients and by insertion of a stent-graft in 2 patients. Postoperative CT angiography showed the complete occlusion of the fistula tract and the normal blood flow. CONCLUSION: Essential clinical information and radiological examination, especially CT angiography with 3D reconstruction, is necessary to obtain to diagnose an arteriovenous fistula after a lumbar discectomy.
Angiography ; Arteriovenous Fistula* ; Diagnosis* ; Diskectomy* ; Fistula ; Humans ; Iliac Artery ; Retrospective Studies ; Veins

Although segmental or subsegmental atelectasis may occur during anesthesia, mucous plugging of a mainstem bronchus has been uncommonly reported in anesthetized patients with chronic respiratory disease. However, pulmonary atelectasis following mucous plugging may rarely result normal patients. We report this case of an allegedly healthy patient was developed a left main stem bronchus obstruction, resulting in subsegmental collapse of left lower lung after the induction of general anesthesia.
Anesthesia* ; Anesthesia, General ; Bronchi ; Humans ; Lung ; Pulmonary Atelectasis

PURPOSE: The aim of the study was to investigate and analyze bilateral incidence and morphology of complete discoid lateral meniscus (DLM) with possible relation to tears and symptoms in knee joints. MATERIALS AND METHODS: Thirty-eight consecutive patients with symptomatic or already-torn complete DLM on magnetic resonance imaging in a unilateral knee underwent diagnostic arthroscopy on both knee joints upon agreement. The presence and shape of complete DLM as well as presence and pattern of tear were recorded accordingly. RESULTS: In total, 89.5% (34 of 38 patients) showed bilateral complete DLM, and 84.2% yielded bilateralism with identical shape. Cape-slab was the most frequent shape, comprising 68.8% of patients with identically-shaped bilateral DLM overall. Tear patterns were more frequent, in the order of longitudinal, simple horizontal, radial, and degenerative; however, the morphological shape of complete DLM was not significantly related to tear incidence or pattern. Meniscus tears and knee symptoms occurred in the contralateral knee with incidences of 32.4% and 26.5% in patients with bilateral complete DLM, respectively. CONCLUSION: Based on these findings, more aggressive warning on the presence of discoid pathology and the need for evaluation on the contralateral knee should be considered during consultation with patients with symptomatic complete DLM in a unilateral knee in the outpatient clinic.
Adolescent ; Adult ; Arthroscopy/*methods ; Female ; Humans ; Incidence ; Knee Joint/*pathology ; Magnetic Resonance Imaging/methods ; Male ; Menisci, Tibial/*injuries/surgery ; Middle Aged ; Musculoskeletal Abnormalities/complications/diagnosis/epidemiology/*surgery ; Retrospective Studies ; Young Adult

Although there are many controversies about clear-cut guidelines for blood transfusion, blood transfusions are critically important and essential in many emergency cases involving trauma to abdominal organs. However, occasionally there are certain situations in which blood transfusions cannot be made, despite clear indications for urgent blood transfusion based on clinical and laboratory findings. One is the case in which the patient refuses to receive a blood transfusion for reasons based on religious beliefs. We present a case of successful perioperative management without blood transfusion in a patient, a Jehovah's Witness, with a massive hemoperitoneum due to an injury caused by a motor vehicle accident.
Blood Transfusion* ; Emergencies ; Hemoperitoneum* ; Humans ; Motor Vehicles ; Religion

Isolated spontaneous dissection of the superior mesenteric artery (SMA) is a rare cause of acute mesenteric ischemia. Two patients were successfully treated by percutaneous stent placement within the main trunk of the SMA. Emphasis is placed on the feasibility of nonsurgical management with percutaneous stent placement of isolated spontaneous dissection of the SMA.
Aneurysm, Dissecting/radiography/*therapy ; *Angioplasty, Balloon ; Female ; Human ; Male ; *Mesenteric Artery, Superior/radiography ; Middle Aged ; *Stents ; Support, Non-U.S. Gov't

Subungual keratoacanthoma is a rare, benign tumor occurring mainly on the thumb of middle-aged Caucasians. It presents as a painful keratotic papule or nodule accompanied by consequential partial onycholysis and bacterial infections. Unlike keratoacanthoma of other sites, subungual keratoacanthoma is not spontaneously resolved and surgical interventions have been recommended for treatment. It also needs to be differentiated from other subungual lesions, especially squamous cell carcinoma. We describe a case of subungual keratoacanthoma, which was completely resolved with extraction of the nail followed by oral methotrexate(MTX) medication.
Bacterial Infections ; Carcinoma, Squamous Cell ; Keratoacanthoma* ; Onycholysis ; Thumb

Objective: To investigate the relationship between aircraft noise and the results of audiological evaluation on tinnitus and hearing loss among residents near United States military air-bases in Pyeongtaek city. METHODS: Residents (n=492) exposed to aircraft noise were selected from eight villages near U.S. military air-bases (K-55 and K-6) in Pyeongtaek city. Residents (n=200) from five villages located at least 10 km away from the air-base were selected for the control group. All participants completed a questionnaire on tinnitus and audiological evaluations included pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE). Statistical analyses involved a general linear model and multiple logistic regression stratified by gender and data was adjusted by age, educational level, stress response index and noise type (i.e. military, agricultural and occupational). RESULTS: The equivalent noise levels (Leq) in the vicinity of the air-field were 73.4~81.5 dB (A). Tinnitus prevalence was 47.3% and odds ratio (OR) was 2.06 (95% confidence interval (CI): 1.09~3.88) among noise-exposed males. Tinnitus prevalence was 50.8% and OR was 1.97(95% CI: 1.17~3.30) among noise-exposed females. Tinnitus handicap scores among exposed group were significantly higher in functional, emotional, and catastrophic subclasses (p<0.001). PTA revealed hearing thresholds among the exposed group of 0.5 and 1 kHz (male right ear), 0.5 and 1 kHz (female left ear) and 0.5, 1, 2, 3, 4 and 6 kHz on female right ear that were significantly higher than those of the unexposed group. No significant difference in DPOAE was observed among noise-exposed males. However, significant differences were evident for noise-exposed females at 3175 and 4007 Hz. ORs of right female ears 3175 and 4007 Hz were 1.73(95% CI: 1.01~2.99) and 1.78(95% CI: 1.01~3.15). ORs of left female ears at 3175 Hz and 4007 Hz were 1.92(95% CI: 1.10~3.36) and 2.71(95% CI: 1.49~4.91) CONCLUSIONS: Aircraft noise may adversely affect hearing function and tinnitus.
Aircraft ; Audiometry ; Ear ; Electrolytes ; Female ; Hearing ; Hearing Loss ; Humans ; Linear Models ; Logistic Models ; Male ; Military Personnel ; Noise ; Odds Ratio ; Prevalence ; Questionnaires ; Tinnitus ; United States