This retrospective analysis describes the clinical characteristics, treatment, and long-term outcome of 30 patients with axis fracture admitted to our institution between January 1991 and December 1995. The incidence of axis fracture was 27.2% in the 110 cervical spine fractures. Among these, odontoid process fracture was the most common type, 19 cases(63%) followed by 8 hangmans fractures(27%), 3 miscellaneous fractures(10%). Hangman's fractures, odontoid type III fractures and miscellaneous fractures were treated with external immobilization devices. Remaining 11 odontoid type II fractures, and six patients with dens dislocation of 6 mm or greater were initially treated by early surgical stabilization. Individuals with dens dislocated less than 6 mm were treated by external immobilization only. Among the nonoperative group of acute axis fractures, there was no fusion failure. In the early operated group, all patients were stable clinically or radiologically. But three patients with posterior wiring and bone graft complained of their neck motion limitation.
Axis, Cervical Vertebra* ; Dislocations ; Humans ; Immobilization ; Incidence ; Neck ; Odontoid Process ; Retrospective Studies ; Spine ; Transplants

Theophylline has been used for more than 50 years to treat bronchial asthma, and theophylline toxicity continues to be an encountered clinical problem. With suicidal intention, a 61-year-old depressive male patient was sent to the hospital after ingestion of overdose theophylline. He had been followed up for bronchial asthma with about 10 microgram/ mL average plasma theophylline level. On arrival, he complained of dyspnea, palpitation and the plasma theophylline level was 252 microgram/mL. After 2 hours of ingestion, hypotension and tachycardia developed (Systolic blood pressure 50 mmHg, heart rate 190/ min). Other symptoms and signs were stuporous mental state and hypoxemia. Patient's peak plasma theophylline level reached 402 microgram/mL after 3 hours. beta-blocker, dopamine and midazolam were used for control of tachycardia, hypotension and prevention of seizure respectively. After Gastric lavage and administration of charchoal, he was treated with hemoperfusion for 3.5 hours, and serum level decreased. The patient was discharged in good health after 17 days.
Anoxia ; Asthma ; Blood Pressure ; Dopamine ; Dyspnea ; Eating ; Gastric Lavage ; Heart Rate ; Hemoperfusion* ; Humans ; Hypotension ; Intention ; Male ; Midazolam ; Middle Aged ; Plasma ; Seizures ; Stupor ; Tachycardia ; Theophylline*

BACKGROUND/AIMS: Fabry disease is an X-linked recessive and progressive disease caused by alpha-galactosidase A (alpha-GaL A) deficiency. We sought to assess the prevalence of unrecognized Fabry disease in dialysis-dependent patients and the efficacy of serum globotriaosylceramide (GL3) screening. METHODS: A total of 480 patients of 1,230 patients among 17 clinics were enrolled. Serum GL3 levels were measured by tandem mass spectrometry. Additionally, we studied the association between increased GL3 levels and cardiovascular disease, cerebrovascular disease, or left ventricular hypertrophy. RESULTS: Twenty-nine patients had elevated serum GL3 levels. The alpha-GaL A activity was determined for the 26 patients with high GL3 levels. The mean alpha-GaL A activity was 64.6 nmol/hr/mg (reference range, 45 to 85), and no patient was identified with decreased alpha-GaL A activity. Among the group with high GL3 levels, 15 women had a alpha-GaL A genetics analysis. No point mutations were discovered among the women with high GL3 levels. No correlation was observed between serum GL3 levels and alpha-GaL A activity; the Pearson correlation coefficient was 0.01352 (p = 0.9478). No significant correlation was observed between increased GL3 levels and the frequency of cardiovascular disease or cerebrovascular disease. CONCLUSIONS: Fabry disease is very rare disease in patients with end-stage renal disease. Serum GL3 measurements as a screening method for Fabry disease showed a high false-positive rate. Thus, serum GL3 levels determined by tandem mass spectrometry may not be useful as a screening method for Fabry disease in patients with end stage renal disease.
Adult ; Aged ; Fabry Disease/blood/*diagnosis ; Female ; Humans ; Kidney Failure, Chronic/blood/*therapy ; Male ; Middle Aged ; *Renal Dialysis ; Trihexosylceramides/*blood ; alpha-Galactosidase/genetics/metabolism