Spinal stenosis has several types of etiology such as degenerative, spondylolisthetic and postoperative, etc. Operative management for spinal stenosis is adequate decompression and stabilization of the unstable lumbar spine created by the decompressive procedure. We analysed 52 operative cases of spinal stenosis delete from January 1994 to October 1996. The following results were obtained 1) The male and female ratio was 1:1.9 and mean age was 52.1 years old 2) Mean follow-up period was 20.3 months 3) The involved site was one level in(28)(53.9%), two level in(19)(36.5%), and three levels in(5)(9.6%) 4) For decompression method, total laminectomy combined with foraminotomy and facetectomy was employed procedure. 5) For stabilization, bilateral posterolateral fusion was performed in major damaged facet joint and transverse process. Instrumentation was combined in 61.5% delete of all cases 6) According to the criteria of Kirkaldy-willis, excellent and good results were shown in 90.6% of fused group with instrumentation and 85% of fused group without instrumentation.
Decompression ; Female ; Follow-Up Studies ; Foraminotomy ; Humans ; Laminectomy ; Male ; Spinal Stenosis* ; Spine ; Zygapophyseal Joint

The authors report eight cases of thoracic stenosis due to ossification of ligamentum flavum. Motor and sensory deficits were found in all cases and urinary incontinence was found in one case. Diagnosis was made from simple x-rays, myelography, computerized tomography, myelography-CT, and magnetic resonance imaging. Treatment consisted of sufficient posterior decompressive laminectomy and medial facetectomy which resulted in satisfactory improvement in 6 cases, fair course in 1 case and poor course in 1 case.
Constriction, Pathologic* ; Diagnosis ; Laminectomy ; Ligamentum Flavum* ; Magnetic Resonance Imaging ; Myelography ; Urinary Incontinence

Salicylate, the active ingredient of aspirin can cause sensorineural hearing loss and tinnitus when plasma concentrations reach a critical level. The ototoxic mechanisms of salicylate remain unclear but hearing and tinnitus usually recovers a few days after intoxication. There have been few reports of salicylate-induced ototoxicity in Korea, and the majority is caused by a low dose of aspirin. Herein, we report a case of sudden hearing loss and tinnitus after acute salicylate intoxication and review recent updates on salicylate ototoxicity.
Aspirin ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Korea ; Plasma ; Sodium Salicylate ; Tinnitus

Cartilage-forming tumors are benign cartilaginous tumors that rarely affect the spinal canal. They account for 2% of all spinal tumors and 2.6% of all benign bone tumors, and involvement of the vertebral column is found in 3-5% of the cases. Pathologically, they may be classified as chondroma, osteochondroma, chondroblastoma and chondromyxoid fibroma. This oncotype may remain asymptomatic or may present as a hard paravertebral swelling, or -more rarely- be accompanied by a slowly developing neurologic syndrome. We report the case of a 38 -year- old man in whom pain in the left buttock and left leg developed. Surgery involved a left partial hemilaminectomy and the mass was totally excised.
Buttocks ; Chondroblastoma ; Chondroma ; Fibroma ; Leg ; Osteochondroma* ; Spinal Canal ; Spine*

Schwannoma is a benign tumor originating from the peripheral nerve sheath. A 16-year-old man have experienced progressive swelling of the nasal tip over 4 years. Computed tomography scan showed a 2.5 cm sized soft tissue density at the nasal tip. It distorted and dislocated the lower lateral cartilage. The mass was resected using an external rhinoplasty approach. The nasal tip was reconstructed by tip surgery and the soft tissue defect under the skin due to mass was filled with autologous dermal graft. The pathologic diagnosis was a schwannoma. A nasal tip schwannoma is extremely rare. Here, we present and discuss the clinical and surgical aspects of schwannoma arising on the nasal tip.
Adolescent ; Cartilage ; Humans ; Neurilemmoma ; Nose ; Peripheral Nerves ; Rhinoplasty ; Skin ; Transplants

Neurofibroma is a relatively common neurogenic tumor originating from schwann cells or fibroblasts in peripheral nerve sheaths. It is classified as solitary or multiple. Solitary lesions are not usually associated with neurofibromatosis or von Recklinghausen's disease. We report a case of solitary neurofibroma occurred in the right external auditory canal (EAC) in a 30-year-old male who complained of progressive hearing loss and earfullness for 5 years. This diffuse painless mass displaced the auricle laterally and obstructed EAC completely. The lesion was partially excised by retroauricular approach and diagnosed as neurofibroma. This patient does not have any other evidences of neurofibromatosis. A complete excision in this case was not mandatory as malignant change is rare; moreover, it would require extensive resection of periauricular skin, subcutaneous tissue, cartilaginous ear canal and temporalis muscle, followed by reconstruction. We present the clinical characteristics and therapeutic methods of a solitary neurofibroma originating from EAC.
Adult ; Aminocaproic Acids ; Ear Canal ; Fibroblasts ; Hearing Loss ; Humans ; Male ; Muscles ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nerves ; Schwann Cells ; Skin ; Subcutaneous Tissue

We present a case of a 19-year-old male with portal vein gas embolism resulting from accidental ingestion of 35% hydrogen peroxide. Hydrogen peroxide is a commonly used germicidal cleansing agent. When it is applied to tissues, catalase causes its rapid molecular decomposition with the release of oxygen bubbles. The patient recovered without sequelae. Hyperbaric oxygenation may be of benefit in patients with respiratory compromise or central nervous system symptoms from gas embolism in hydrogen peroxide ingestion.
Catalase ; Central Nervous System ; Detergents ; Eating* ; Embolism, Air* ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Hyperbaric Oxygenation ; Male ; Oxygen ; Portal Vein* ; Young Adult

BACKGROUND: Many investigators found that there were more severe and extensive atherosclerosis in patients with stable angina pectoris than those with unheralded acute myocardial infarction(AMI). But coronary angiographic findings in patients with or without stable angina pectoris(SAP) prior to acute myocardial infarction are somewhat controversial. And in many articles that compared the coronary angiographic findings between patients with and those without angina prior to acute myocardial infarction, the definition of angina and significant coronary artery stenosis were not uniform. So, coronary angiographic finding were compared between patients with and those without stable anginal pectoris prior to AMI according to scoring system suggested by Bogarty. METHOD: Coronary angiography was performed in 141 patients with AMI. Angiographic findings of patients with SAP prior to AMI were compared to those without SAP prior to AMI. Risk factors of coronary artery disease were also compared. RESULTS: 1) Numbers of the patients with SAP were 34(24%) and those without SAP were 107(76%). 2) Numbers of stenosed vessels, Numbers of tenosed lesions, extent index and percent of diffuse pattern were higher in SAP group(p<0.05). 3) Numbers of diseased vessels and occluded lesions were not different between two groups(Pvalue was 0.07 and 0.5, respectively). 4) patients with SAP were older than those without SAP(p = 0.03). 5) Sex ratio and prevalence of hypertension, diabetes and smoking were not different between two groups. 6) Lipid profiles were not different between two groups. CONCLUSION: Patients with SAP prior to AMI had more severe and extensive atherosclerosis than those without stable angina pectoris prior to AMI.
Angina, Stable* ; Atherosclerosis ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Humans ; Hypertension ; Myocardial Infarction* ; Prevalence ; Research Personnel ; Risk Factors ; Sex Ratio ; Smoke ; Smoking

BACKGROUND: Many investigators found that there were more severe and extensive atherosclerosis in patients with stable angina pectoris than those with unheralded acute myocardial infarction(AMI). But coronary angiographic findings in patients with or without stable angina pectoris(SAP) prior to acute myocardial infarction are somewhat controversial. And in many articles that compared the coronary angiographic findings between patients with and those without angina prior to acute myocardial infarction, the definition of angina and significant coronary artery stenosis were not uniform. So, coronary angiographic finding were compared between patients with and those without stable anginal pectoris prior to AMI according to scoring system suggested by Bogarty. METHOD: Coronary angiography was performed in 141 patients with AMI. Angiographic findings of patients with SAP prior to AMI were compared to those without SAP prior to AMI. Risk factors of coronary artery disease were also compared. RESULTS: 1) Numbers of the patients with SAP were 34(24%) and those without SAP were 107(76%). 2) Numbers of stenosed vessels, Numbers of tenosed lesions, extent index and percent of diffuse pattern were higher in SAP group(p<0.05). 3) Numbers of diseased vessels and occluded lesions were not different between two groups(Pvalue was 0.07 and 0.5, respectively). 4) patients with SAP were older than those without SAP(p = 0.03). 5) Sex ratio and prevalence of hypertension, diabetes and smoking were not different between two groups. 6) Lipid profiles were not different between two groups. CONCLUSION: Patients with SAP prior to AMI had more severe and extensive atherosclerosis than those without stable angina pectoris prior to AMI.
Angina, Stable* ; Atherosclerosis ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Humans ; Hypertension ; Myocardial Infarction* ; Prevalence ; Research Personnel ; Risk Factors ; Sex Ratio ; Smoke ; Smoking

BACKGROUND: In general, pulse pressure of a VPC depends on its prematurity and the site of origin. The pulse pressure of a VPC with a short coupling interval or originating from the left ventricle tends to be smaller. However, the hemodynamic change of a VPC originating from the right ventricular outflow tract (RVOT) is not well elucidated. In addition to their prematurity and the site of the origin of VPCs, the left ventricular filling profile (Ei/Ai ratio) during preceding control beats may affect the occurrence of a subsequent pulse deficit. The purpose of this study is to evaluate the hemodynamic change of different coupling intervals of VPCs originating from the RVOT. Furthermore, this study evaluates whether the left ventricular filling profile during preceding control beats significantly affects the occurrence of pulse deficits by VPCs. METHODS: In 12 open-chest dogs anesthetized with a -chloralose, sinus node crushing was done, and then a single bipolar ventricular pacing using sutured epicardial electrodes was done at 3 different sites: left ventricular apex (LVA), right ventricular apex (RVA), RVOT. At each site, a single bipolar pacing was done with a different coupling interval: 500 msec, 450 msec, 400 msec, 350 msec, 300 msec. During the production of VPCs, the mitral filling flow velocity and aortic TVI (time-velocity integral) using pulsed wave Doppler echocardiography, the femoral arterial pressure, the pulmonary arterial pressure, the electrocardiogram, and the intracardiac electrocardiogram were simultaneously recorded. RESULTS: The arterial pressure during VPC with a short coupling interval was significantly smaller regardless of the site of origin (p<0.05). The arterial pressure with VPCs originating from the RVOT was significantly more reduced than those from the RVA at a same coupling interval (p<0.05). However, the arterial pressure with originating from the LVA was insignificantly reduced than those from the RVOT. The pulmonary arterial pressure with originating from the RVOT was significantly reduced more than those from the LVA at a same coupling interval, except at the coupling interval of 500 msec (p<0.05). However, the pulmonary arterial pressure with VPCs originating from the RVA was insignificantly reduced than those from the RVOT. The aortic TVI during VPCs originating from the LVA was significantly reduced than those from the RVA or the RVOT at a same coupling interval (p<0.05). However, when the aortic TVI during VPCs originating from the RVOT was compared to that during VPCs from RVA, the former was significantly reduced at certain coupling interval (450 msec, p<0.05). A significant positive correlation was observed between the Ei/Ai ratio of preceding control beats and the pulse deficit coupling intervals during VPCs (p<0.05). CONCLUSION: The above results show that the origin of the site and the coupling interval of VPCs play a major role in determining hemodynamic outcomes during the occurrence of VPCs. The hemodynamic changes during VPCs originating from the RVOT seem to be similar with those during VPCs originating from the RVA. Furthermore, there is a positive correlation between the left ventricular filling pattern (Ei/Ai ratio) of preceding sinus beats and the pulse deficit coupling intervals of VPCs.
Animals ; Arterial Pressure ; Blood Pressure ; Dogs* ; Echocardiography, Doppler ; Electrocardiography ; Electrodes ; Heart Ventricles ; Hemodynamics* ; Sinoatrial Node ; Ventricular Premature Complexes*