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

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

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*

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

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

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: Legionella pneumophila has been recognized as an important cause of community-acquired pneumonia(CAP) requiring hospitalization. However, epidemiological data on the occurrence of legionella-related pneumonia is unavailable in Korea. The purpose of this study was to evaluated the etiological imprtance of legionella pneumophila serogroup 1 in patients hospitalized with CAP. METHOD: The CAP patient over 16 year-old were recruited from July 1999 to June 2000 at the Chunchon Sacred Heart Hospital. Fifty four patients (male 29, female 25, average age 63.8±15.3) were included in this study. A diagnosis of a legionella pneumophila infection was based on a urinary antigen test using the Binax Company enzyme immunoassay. The severity of pneumonia was assessed using the Fine's PORT scoring system. RESULT: The average Fine's PORT score was 99.7(±44.9). According to the risk classification proposed by the Infectious Disease Society of America, the number of patients in each class(from class I to class V) were 6(11.1%), 13(24.1%), 9(16.7%), 14(25.8%), and 12(22.2%), respectively. Thirty two patients(59.3%) were initially admitted to the intensive care unit. The mortality rate was 16.7%(9 in 54). In all patients, urinary antigens to Legionella pneumophila serogroup 1 were not detected. CONCLUSION: Legionella pneumophila may play little role in causing adult CAP in Korea. Therefore, the routine use of macrolide in the empirical treatment of the CAP patients based upon the ATS guidelines(1993) in Korea should be reevaluated.
Adult ; Americas ; Classification ; Communicable Diseases ; Diagnosis ; Female ; Gangwon-do ; Heart ; Hospitalization ; Humans ; Immunoenzyme Techniques ; Intensive Care Units ; Korea* ; Legionella pneumophila* ; Legionella* ; Legionnaires' Disease ; Mortality ; Pneumonia*

Actinomycosis is an indolent, slowly progressive infection caused by anaerobic bacteria, primarily of the genus Actinomyces, that colonize the mouth, colon, and vagina. A vital step in the development of actinomycosis is disruption of the mucosal barrier. Actinomycosis occurs most frequently at a cervicofacial, abdominal, and pelvic region. Thoracic actinomycosis usually follows an indolent progressive course with involvement of the pulmonary parenchyma and/or the pleural space. Rarely, pulmonary nodules or endobronchial lesions can occur. We report a case of a 62-year-old woman of chronic cough with sputum and pulmonary mass with consolidation at the right lower lobe on chest radiography. Fiberoptic bronchoscopic findings revealed a polypoid tumor like mass completely obstructing RLL lobar bronchus and a hard bony material embedded there. Histologic examination of the biopsy specimens demonstrated acute and chronic inflammation with calcified material and a sulfur granule, which led to the diagnosis of endobronchial actinomycosis. The patient responded to several bronchoscopic procedures and intravenous penicillin G.
Actinomyces ; Actinomycosis* ; Bacteria, Anaerobic ; Biopsy ; Bronchi ; Bronchoscopy ; Colon ; Cough ; Diagnosis ; Female ; Foreign Bodies* ; Humans ; Inflammation ; Middle Aged ; Mouth ; Pelvis ; Penicillin G ; Radiography ; Sputum ; Sulfur ; Thorax ; Vagina

Actinomycosis is an indolent, slowly progressive infection caused by anaerobic bacteria, primarily of the genus Actinomyces, that colonize the mouth, colon, and vagina. A vital step in the development of actinomycosis is disruption of the mucosal barrier. Actinomycosis occurs most frequently at a cervicofacial, abdominal, and pelvic region. Thoracic actinomycosis usually follows an indolent progressive course with involvement of the pulmonary parenchyma and/or the pleural space. Rarely, pulmonary nodules or endobronchial lesions can occur. We report a case of a 62-year-old woman of chronic cough with sputum and pulmonary mass with consolidation at the right lower lobe on chest radiography. Fiberoptic bronchoscopic findings revealed a polypoid tumor like mass completely obstructing RLL lobar bronchus and a hard bony material embedded there. Histologic examination of the biopsy specimens demonstrated acute and chronic inflammation with calcified material and a sulfur granule, which led to the diagnosis of endobronchial actinomycosis. The patient responded to several bronchoscopic procedures and intravenous penicillin G.
Actinomyces ; Actinomycosis* ; Bacteria, Anaerobic ; Biopsy ; Bronchi ; Bronchoscopy ; Colon ; Cough ; Diagnosis ; Female ; Foreign Bodies* ; Humans ; Inflammation ; Middle Aged ; Mouth ; Pelvis ; Penicillin G ; Radiography ; Sputum ; Sulfur ; Thorax ; Vagina