PURPOSE: To evaluate the incidence of disc extrusion and neurologic deficit, the relation between disc extrusion and neurologic deficit and the treatment results according to our basic treatment principles in lower cervical facet joint fracture and dislocations MATERIALS AND METHODS: Twelve patients were evaluated, 8 male and 4 female with an average age of 41 years comprised the group. Six injuries were attributable to automobile accidents, 5 to fall from building, bed, floor and hill, and one to stand on her head. One case was distractive-flexion stage (DFS) 1, 9 cases with DFS 2 and 2 cases with DFS 3. Plain X-ray, CT, Myelo CT and MRI were used as a diagnostic tools. As a treatment criteria, feasibility of closed reduction, status of neuroglogic injury, and stability of injured spine were considered. Anterior cervical discectomy and fusion in accompanied disc extrusion, posterior reduction and fusion with triple wiring in unreduced dislocation, and anterior decompression and fusion in incomplete cord and root injury were selected as a basic treatment principles. RESULTS: Ten out of 12 cases (83%) showed neurologic deficits, 2 complete cord injury, 1 incomplete cord injury, and 7 radiculopathy. Nine out of 12 (75%) demonstrated disc extrusion and all disc extruded patients had neurologic deficits. Anterior cervical discectomy and fusion (ACDF) were performed in 5 cases, ACDF and posterior reduction with triple wiring (PRTW) in 4 cases, PRTW in 1 case, and skull traction and philadelphia brace in 2 cases. Seven radiculpathy patients were completely recovered and one incomplete cord injury patient can ambulate with spastic gait after surgery. There were 2 bed sore and 1 pneumonia in complications. CONCLUSION: Soft disc extrusion should be evaluated carefully with MRI and CT in lower cervical spine injury with the facet joint fracture-dislocations before the decision of treatment. As disc extrusion always accompanies neurologic deficit, it must be surgically treated by anterior cervical discectomy and fusion.
Automobiles ; Braces ; Decompression ; Diskectomy ; Dislocations* ; Female ; Gait Disorders, Neurologic ; Head ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Pneumonia ; Pressure Ulcer ; Radiculopathy ; Skull ; Spine ; Traction ; Zygapophyseal Joint*

No abstract available.
Carcinoma, Renal Cell* ; Prostate*

No abstract available.
Carcinoma, Renal Cell* ; Prostate*

Myasthenia gravis is a autoimmune neuromuscular disorder characterized by weakness and fatigability of skeletal muscles. The underlying defect is a decrease in the number of available acetylcholine receptors at neuromuscular junction due to an antibody-mediated autoimmune attacks. The course of myasthenia gravis during pregnancy is not predictable. We experienced a patient of myasthenia gravis associated with pregnancy who underwent cesarean section and transient neonatal myasthenia gravis of the newborn. We present this case with brief review of the concerned literatures.
Cesarean Section ; Female ; Humans ; Infant, Newborn ; Muscle, Skeletal ; Myasthenia Gravis* ; Myasthenia Gravis, Neonatal ; Neuromuscular Junction ; Pregnancy* ; Receptors, Cholinergic

PURPOSE: This study was undertaken to correlate the CT and histopathologic findings of abscess wall. MATERIALS AND METHODS: The CT findings of 12 patients with pathologically proven brain abscess were retrospectively analyzed with particular attention to the thickness, smoothness and uniformity of enhancing abscess wall, and the results were correlated with histopathologic findings. RESULTS: Two patients with acute cerebritis showed an isodense ring on non-contrast CT(NCCT), but a true capsule formation could not be identified at pathologic examination. Six other patients with isodense ring on NCCT consisted of early to late cerebritis(3 cases), late cerebritis to early capsule(1 case), early capsule(1 case), and late capsule(1 case). These 6 cases showed ring enhancement on contrast enhanced CT(CECT) and true capsule formation pathologically. There was no isodense ring on NCCT in the remaining four patients. They consisted of early to late cerebritis(2 cases), late cerebritis(1 case), and late cerebritis to early capsule formation(1 case). These also showed ring enhancement on CECT and true capsule formation pathologically. CONCLUSION: We found that it is difficult to predict the exact stage of brain abscess on preoperative CT findings. It is suggested that clinical findings and sequential dynamic CT may provide more detailed informations for evaluation of abscess staging.
Abscess ; Brain Abscess* ; Brain* ; Humans ; Retrospective Studies

Helicobacter pylori (H. pylori) causes chronic gastritis, peptic ulcer disease, primary B-cell gastric lymphoma, and adenocarcinoma of the stomach. The overall seroprevalence of H. pylori infection in Korea was 46.6%, and the seroprevalence increased with age and was highest in patients in their 40s. Only a fraction of people infected with H. pylori develop clinical disease. Mucosal inflammation is the basic mechanism underlying the disease development in which tissue destruction may be initiated and maintained by both the bacterial toxins and immune responses by the host. H. pylori infection can be diagnosed either by invasive techniques requiring endoscopy with biopsy (histological examination, culture, and polymerase chain reaction) or noninvasive techniques (urea breath test, serology, and detection of H. pylori antigen in stool specimens). The eradication of H. pylori infection is not easy and requires combinations of antibiotics. Even with the most effective treatment regimen currently available, the eradication is not successful in about 10~20% of patients. Seven-day triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) has been the first-line therapy for H. pylori infection in Korea. In case of failure, quadruple therapy (proton pump inhibitor, a bismuth salt, metronidazole, and tetracycline) is a very effective second-line regimen. If two or more eradication treatments fail, bacterial resistance to antibiotics should be evaluated and the regimen of third-line therapy should be selected according to the antimicrobial susceptibility results.
Adenocarcinoma ; Amoxicillin ; Anti-Bacterial Agents ; B-Lymphocytes ; Bacterial Toxins ; Biopsy ; Bismuth ; Breath Tests ; Diagnosis ; Endoscopy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inflammation ; Korea ; Lymphoma ; Metronidazole ; Peptic Ulcer ; Seroepidemiologic Studies ; Stomach

Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals.
Activities of Daily Living ; Cues ; Exercise ; Head ; Humans ; Immobilization ; Orientation ; Posture ; Vertigo ; Vision, Ocular

PURPOSE: This study was conducted to examine prerequisite-program performance of the hospital foodservice operation and develop measures for improvement of prerequisite-program performance. METHODS: Data were collected through surveys administered to 168 hospital dieticians in the Seoul, Incheon, Gyeonggi-do, Daegu, and North Gyeongsang areas. Out of total questionnaires, 65 questionnaires were usable and the response rate was 38.7%. Statistical analyses were performed using the SPSS program (ver 20.0) for chi2-test and one-way ANOVA. RESULTS: According to the result of the prerequisite-program evaluation, the percentage of 'appropriate', 'needs to be improved', and 'inappropriate' was 44.6%, 47.7%, and 7.7%, respectively. The score for the 'inappropriate' group was significantly lower than that of the 'appropriate' group or 'needs to be improved' group on the food safety management (p < 0.001), preparation facility management (p < 0.001), water management (p < 0.001), and storage.transportation management (p < 0.05) parts. Holding rate of foodservice facility and equipments in the 'appropriate' group were significantly higher than in the others on convection oven (p < 0.01), air conditioner (p < 0.01), three-compartment sink (p < 0.01), hot-holding equipment (p < 0.01), cold-holding equipment (p < 0.05), exclusive thawing refrigerator (p < 0.05), and sterilizer for sanitary shoes (p < 0.05) items. CONCLUSION: To improve the quality of hospital foodservice, foodservice managers and HACCP specialists should develop and implement a prerequisite-program and a HACCP plan considering the characteristics of the hospital foodservice operation.
Convection ; Daegu ; Food Safety ; Gyeonggi-do ; Hazard Analysis and Critical Control Points* ; Hospitals, General* ; Incheon ; Nutritionists ; Seoul ; Shoes ; Specialization ; Water