Variant angina is characterized by repeated attack at rest associated with ST-segment elevation on ECG and caused by the spasm of coronary artery. But, the pathogenesis of spasm is not well known. A 44-year old man was transferred for the management of intramural hematoma at descending thoracic aorta and uncontrolled hypertension. We started to control hypertension with nitroprusside, propranolol, amlodipine, and doxazocin. At 4th hospital day, severe chest pain, dizziness, and diaphoresis were developed, and ECG showed not only ST-segment elevation on lead II, III, aVF but also 2 degree AV block(Mobitz type II). CK-MB revealed 52.3 ng/dl. When coronary angiography performed emergently, it showed total occlusion of right coronary artery (RCA) and diffuse minimal narrowing of left anterior descending coronary artery (LAD). After nitroglycerin was infused via right coronary catheter, the RCA was opened completely, and reperfusion arrhythmia was developed. Medication were changed to nifedipine, diltiazem, nicorandil, isosorbide mononitrate and he had no more chest pain.
Adult ; Amlodipine ; Aorta, Thoracic ; Arrhythmias, Cardiac ; Catheters ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Diltiazem ; Dizziness ; Electrocardiography ; Hematoma* ; Humans ; Hypertension ; Isosorbide ; Myocardial Infarction* ; Nicorandil ; Nifedipine ; Nitroglycerin ; Nitroprusside ; Propranolol ; Reperfusion ; Spasm

Rieger's syndrome is a rare autosomal dominant developmental anomaly characterized by ocular and systemic abnomalities. These disorders are typically bilateral and usually diagnosed at birth or in the childhood. The most common ocular defects are hypoplasia of the iris, a prominent Schwalbe's line with iris strands and corectopia. A large number of patients have glaucoma due to devel-opmental defects of the anterior chamber angle structure. The authors experienced a case of Rieger's syndrome which was found in 31-year-old female, who had characteristic ocular and other systemic abnormalities. Associated glaucoma was well controlled by filtering surgery.
Adult ; Anterior Chamber ; Atrophy ; Edema ; Female ; Filtering Surgery ; Frontal Lobe ; Glaucoma* ; Glioblastoma ; Humans ; Intracranial Pressure ; Iris ; Neurofibromatoses ; Optic Atrophy ; Optic Nerve ; Optic Nerve Diseases* ; Parturition ; Skin

The Morel-Lavallée lesion (MLL) is a closed soft-tissue degloving injury, resulting in characteristic hemo-lymphatic fluid collection between the fascia and subcutaneous layers. The MLL was managed routinely with drainage and compression bandages, but sclerotherapy can be used in patients with chronic lesions refractory to first-line therapy. This paper presents a case of extensive recurrent chronic MLL treated with sclerotherapy using Abnobaviscum, which has been used to treat adhesion in malignant pleural effusion.

No abstract available.
Decompression* ; Spinal Stenosis*

No abstract available.
Anterior Cruciate Ligament* ; Knee*

BACKGROUND: Antistreptolysin O (ASO) has been widely used to diagnose Streptococcus Pyogenes infections and their sequelae, rheumatic fever and acute glomerulonephritis. Butt in some cases there is no elevation of ASO that it is necessary to add one or more tests detecting immune response to S. pyogenes.. The authors analyzed the distribution of antideoxyibonuclease (ADNase) B and antistreptolysin O (ASO) among the children of an elementary school in Seoul and calculated their upper limit of normal (ULN) value. METHODS: ADNase B concentrations were determined by nephelometry (Behring Nephelometer 100 Analyzer, Germany) on 236 sera of healthy elementary school children in Seoul. Throat cultures were taken at the same time to compare ADNase B lovels between S. pyogenes carriers and non-carriers. RESULTS: The distribution of ADNase B concentrations among school children ranged from 77 (detection limit) to 1616 IU/ml and the ULN was estimated to be 362 IU/mL. The carriers of S. pyogenes clad significantly higher ADNase B levels (mean 392 IU/ml) than carriers of non-group A beta-hemolytic streptococci (BHS, 236 IU/ml) oY non-carriers of BHS (234 IU/ml). The relationship between ADNase B (Y) and ASO (X) levels was Y=0.4X+173 (r2=0.209). CONCLUSIONS: The distribution of ADNase B levels showed no close correlation with that of ASO, and ADNase B test was considered to have additive value to ASO test for detecting S. pyogenes infection.
Antistreptolysin ; Child* ; Glomerulonephritis ; Humans ; Nephelometry and Turbidimetry ; Pharynx* ; Rheumatic Fever ; Seoul* ; Streptococcus pyogenes

Intramedullary myelitis due to bacterial meningitis associated with cervical epidural abscess is very rare. Its cause and clinical features are non-specific, therefore exact diagnosis is often missed or mistaken for other disease and immediate treatment may be delayed. We report a case of intramedullary myelitis due to epidural abscess presented with prominent symptoms of meningitis and manifestations of acute cerebrovacular accident. A 69 -year-old man was admitted due to right hemicranial headache with pain on right posterior neck and febrile sensation. At first, the patient's headache was improved by conservative therapy. Three weeks later, the patient showed abrupt right hemiparesis (MRC grade 2/5) with drowsy mentality. The CSF findings of the patient were compatible with acute bacterial meningitis. Cervical spine MRI showed cervical epidural abscess and extensive intramedullary myelitis from cervical to lumbar spinal cord. After antibiotic therapy, mentality of the patient became to be alert and right hemiparesis was improved to MRC grade 4/5. Follow up cervical spine MRI after several weeks represented that the lesions of cervical epidural abscess and intramedullary myelitis were significantly diminished.
Diagnosis ; Epidural Abscess* ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Myelitis* ; Neck ; Paresis ; Sensation ; Spinal Cord ; Spine

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

PURPOSE: In order to classify the involving patterns of maxillary sinus aspergillosis on CT that will be an important guidance for functional endoscopic sinus surgery(FESS) and to evaluate CT findings of each pattern. MATERIALS AND METHODS: We reviewed CT findings of 37 cases of maxillary sinus aspergillosis which were confirmed pathologically. These were classified into three patterns according to the location:the maxillary pattern(I), the infundibular pattern(11), and combined pattern(Ill). All cases were correlated with FESS findings. We also evaluated CT density, presence of contrast enahncement and calcifications, and surrounding bony changes of each pattern. RESULT: The combined pattern was most commonly seen in 24 of 37 cases(64.9%). The maxillary pattern was identified in 8(21.6%), with 5(13.5%)cases demonstrating the infundibular patttern. These patterns were consistent with FESS findings. Calcifications were seen in 28 cases(75.7%). 31 cases(83.8%) revealed hypodensity and 16cases among them showed peripheral enhancement. Central high density with peripheral low density rim was shown in 25%(2/8) of the maxillary pattern and 12.5%(3/24) of combined patttern. Surrounding bony changes were noted mainly in infundibular pattern and combined pattern. Erosion of uncinate process showed all cases of both patterns. Erosion or elevation of ethmomaxillary plate was seen in 3 of 5 cases of infundibular pattern and all cases of the combined pattern. CONCLUSION: CT fidnings of maxillary sinus aspergillosis can be classified into 3 patterns according to their distribution. These classification could be helpful for planning FESS approach. Calcifications are the most characteristic findings of maxillary sinus aspergllosis whereas CT density or enhancement pattern do not contribute to diagnosis.
Aspergillosis* ; Classification ; Diagnosis ; Maxillary Sinus*

The humerus is anatomically and phyelologically unique, such as, firstly, it is a non weight bearing bone, secondly, it has greatest range of motion, thirdly, when at rest while the person is standing, the axis of bone hangs vertically and is influenced by gravity, and conservative methods usually used in treatment. However, in the event of closed reduction failure, open fracture, multiple fracture, and old age, operative method may be employed. Authors reviewed and analzed 84 humeral shaft fractures which had been treated at the Department Orthopedic Surgery, Paik Hospital from Dec. 1979 to May 1988. The results were as follows : l. Among the 84 patients, male were 63 and female were 21. 2. The major causes of injury were a traffic accident. 3. The most frequent type and site of fracture was comminuted and middle one third. 4. The incident of radial nerve injury was 17 cases. 5. Of 84 cases, 22 cases were treated conservatively and 62 cases operatively. 6. The most common complication was non-union of 14 cases, of which 10 cases were treated with plate and bone graft and 4 cases with only bone graft.
Accidents, Traffic ; Female ; Fractures, Multiple ; Fractures, Open ; Gravitation ; Humans ; Humerus ; Male ; Methods ; Orthopedics ; Radial Nerve ; Range of Motion, Articular ; Transplants ; Weight-Bearing