No abstract available.

STUDY DESIGN: Two case reports. OBJECTIVES: We present two cases of quadriplegia after posterior decompression with fusion caused by a suspicious reperfusion injury of spinal cord without remarkable surgical insult. SUMMARY OF LITERATURE REVIEW: Posterior decompression and posterolateral fusion have been reported as effective procedures in patients with multilevel myelopathy. However, postoperative spinal cord injury without remarkable intraoperative technical damage has been reported in a few articles. Reperfusion mechanism was suggested as one of the leading causes and reported in some animal models. MATERIALS AND METHODS: There was one case of ossification of the posterior longitudinal ligament and one developmental multilevel stenosis that underwent laminectomy with lateral mass instrumentation. After surgery, the patients presented with quadriplegia; MRI demonstrated swelling of the spinal cord and intramedullary lesion in two cases. RESULTS: After surgery, the patients presented with quadriplegia; MRI demonstrated swelling of the spinal cord and intramedullary lesion in two cases. CONCLUSION: Although patients with such a medical condition are rare, it is difficult to predict postoperative swelling of the spinal cord before surgery. The surgeon should thus be aware of such rare disease conditions involving the spinal cord before the surgical procedure.
Constriction, Pathologic ; Decompression* ; Humans ; Laminectomy ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Models, Animal ; Quadriplegia ; Rare Diseases ; Reperfusion ; Reperfusion Injury* ; Spinal Cord Diseases ; Spinal Cord Injuries ; Spinal Cord*

PURPOSE: Vascular calcification (VC) scores on simple plain radiographic films are known to be associated with coronary artery disease (CAD) and mortality. The present study was designed to demonstrate a correlation between VC scores of the hands and pelvis, and feet and lateral lumbar spine on plain radiographs. In addition, we analyzed the usefulness of checking all the plain radiographs for assessment of pre-existing CAD. METHODS: We recruited 61 hemodialysis (HD) patients from OO Dialysis Center. We checked the plain radiographic films of the feet, hands, pelvis, and lateral lumbar spine and evaluated VC scores with previously reported methods. We defined CAD based on myocardial scans, echocardiography, or coronary angiography. RESULTS: Positive associations were found between the VC scores of the feet, VC scores of the hands and pelvis, scores of abdominal aortic calcifications (AACs), and CAD. Approximately 30% of patients who had CAD could be missed based on a single VC scoring method. Patients who showed any one finding among the AAC scores >5, VC scores of the pelvis and hands >3 or arterial media calcifications of the feet on plain radiographs had a high sensitivity (93.8%) and a high negative predictive value (96.3%) for the presence of CAD. CONCLUSION: Each VC score was highly inter-correlated. All three VC scoring methods on plain radiographic films are useful screening tests for the presence of CAD in HD patients.
Coronary Artery Disease ; Coronary Vessels ; Dialysis ; Echocardiography ; Foot ; Hand ; Humans ; Mass Screening ; Pelvis ; Renal Dialysis ; Research Design ; Spine ; Tunica Media ; Vascular Calcification ; X-Ray Film

It is widely known that the cockroach is an inhalant allergen in atopic asthma and allergic rhinitis. Even though Bla g I and Bla g II are considered as the major allergens, several relatively high-molecular weight (MW) cockroach allergens have also been recently identified by IgE-immunoblot in western countries. However, the environmental control and diagnostic tests mainly focussed on Bla g I and Bla g II. Furthermore there is no data about major IgE-binding cockroach antigens in Korea. We performed this study to identify the major German cockroach allergens in Korean atopic children. By the results of allergy skin tests, 14 children with atopic asthma (9 were cockroach-sensitive and 5 were cockroach-nonsensitive atopics) were enrolled in this study. We conducted IgE immunoblot and autoradiographic analysis using Yonsei-extract of German cockroach antigen produced in our laboratory, individual sera from 9 cockroach- sensitive children, and the pooled sera of 5 house-dust-mites-only-sensitive children. We performed an allergic skin test to cockroach mix, and a radioallergosorbent test (RAST) using German cockroach crude extract on all subjects. German cockroach-specific IgE was detected in 6 out of 9 subjects by RAST. We identified at least 15 IgE-binding protein bands, and among them, the components of MWs of 76, 64, 50, 38, and <14 kilodaltons (kDa) were the major German cockroach allergens in study subjects. Therefore, Bla g I (25-30 kDa) and Bla g II (36 kDa) could not be the absolute indicators of German cockroach sensitization and parameters of environmental control.
Adolescence ; Allergens/analysis ; Animal ; Asthma/metabolism* ; Asthma/immunology ; Asthma/complications ; Child ; Child, Preschool ; Cockroaches/immunology ; Cockroaches/chemistry* ; Female ; Human ; Hypersensitivity/metabolism* ; Hypersensitivity/immunology ; Hypersensitivity/complications ; IgE/metabolism* ; Korea ; Male ; Tissue Extracts/metabolism*

For the experimental study of neural tube defect (NTD), a surgical model has advantages over other models in a few aspects. It causes less functional derangement of cells and the NTDs can be made selectively by surgery. The authors planned to use the surgical model for the experimental study of NTD. As the first step for the studies, the chronological changes of morphology during the early postoperative period were investigated using postincubation 3-day chick embryos. The objectives of this study are (1) the morphological evaluation of the surgical model as a method for studies of open NTD, and (2) the observation of morphological changes for the first 24 hours after surgery which include 'overgrowth' appearance and the continuity between the surface ectoderm and the neuroectoderm. The morphological changes were observed by light microscope and scanning electron microscope. Immediately after surgery, typical open NTDs were observed. Morphologically they were very similar to the appearance of spontaneous (non-surgical) open NTDs. The opened neural tubes were everted progressively and they looked rather flat at 24 hours after surgery. Cellular hyperplasia ('overgrowth' appearance) was noted within 24 hours after surgery and became more prominent during the 24 hours. There was increasing continuity between the surface ectoderm and the neural tissue until 24 hours after surgery when the continuity looked almost complete. In conclusion, surgically induced NTDs are morphologically very similar to spontaneous NTDs.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals ; Chick Embryo ; *Disease Models, Animal ; Evaluation Studies as Topic ; Neural Tube Defects/etiology/*pathology ; Postoperative Period

PURPOSE: To investigate the predisposing factors, clinical manifestations, treatment results and risk factors for treatment failure in Staphylococcus epidermidis keratitis. METHODS: Sixty-one eyes of 61 patients who were diagnosed with Staphylococcus epidermidis keratitis were included in the present study. The past history, location and size of ulceration, hypopyon, treatment results, and antibiotic susceptibility were reviewed retrospectively. A logistic regression analysis was performed to identify the main prognostic risk factors for treatment failure. RESULTS: Twenty-six eyes (42.6%) had previous histories of corneal traumas. Polymicrobial infections were observed in 31 cases (50.8%), including 11 cases (35.5%) combined with the Fusarium species. Twenty-five eyes (41.0%) had lesions located at the corneal center. The average size of ulceration was 7.3 +/- 7.2 mm2. Thirteen eyes (21.3%) with lesions that progressed or occurred in the corneal perforation underwent evisceration, penetrating keratoplasty or scleral graft. Risk factors for treatment failure were a history of previous keratitis (P = 0.003) and an ulcer exceeding 5.0 mm2 in size (P = 0.018). CONCLUSIONS: Staphylococcus epidermidis keratitis usually has a good prognosis, although a history of previous keratitis and a large ulcer size are risk factors for treatment failure.
Coinfection ; Corneal Perforation ; Eye ; Fusarium ; Humans ; Keratitis ; Keratoplasty, Penetrating ; Logistic Models ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus ; Staphylococcus epidermidis ; Transplants ; Treatment Failure ; Ulcer

BACKGROUND: Shivering is a frequent event during spinal anesthesia and meperidine is a well-known effective drug for prevention and treatment of shivering. Nefopam is a non-opiate analgesic and also known to have an anti-shivering effect. We compared nefopam with meperidine for efficacy of prevention of shivering during spinal anesthesia. METHODS: Sixty five patients, American Society of Anesthesiologists physical status I or II, aged 20-65 years, scheduled for elective orthopedic surgery under spinal anesthesia were investigated. Patients were randomly divided into two groups, meperidine (Group M, n = 33) and nefopam (Group N, n = 32) groups. Group M and N received meperidine 0.4 mg/kg or nefopam 0.15 mg/kg, respectively, in 100 ml of isotonic saline intravenously. All drugs were infused for 15 minutes by a blinded investigator before spinal anesthesia. Blood pressures, heart rates, body temperatures and side effects were checked before and at 15, 30, and 60 minutes after spinal anesthesia. RESULTS: The incidences and scores of shivering were similar between the two groups. The mean arterial pressures in Group N were maintained higher than in Group M at 15, 30, and 60 minutes after spinal anesthesia. The injection pain was checked in Group N only and its incidence was 15.6%. CONCLUSIONS: We conclude that nefopam can be a good substitute for meperidine for prevention of shivering during spinal anesthesia with more stable hemodynamics, if injection pain is effectively controlled.
Aged ; Anesthesia, Spinal ; Arterial Pressure ; Body Temperature ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Meperidine ; Nefopam ; Orthopedics ; Research Personnel ; Shivering

BACKGROUNDS/AIMS: The aim of this study was to compare operative versus non-operative management of patients with liver injury and to ascertain the differences of the clinical features. METHODS: From April 2000 to July 2012, 191 patients were admitted to Seoul St. Mary's Hospital and St. Vincent's Hospital for liver injuries. Of these, 148 patients were included in this study. All patients were diagnosed using computed tomography (CT). The liver injury was graded in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups: those who underwent surgery and those treated with non-operative management (NOM). There was a comparison between these two groups concerning the clinical characteristics, grade of liver injury, hemodynamic stability, laboratory findings, and mortality. RESULTS: According to the 148 patient records evaluated, 108 (72.9%) patients were treated with NOM, and 40 (27.1%) underwent surgery. Patients treated with NOM had significantly fewer severe injuries as rated using the Revised Traumatic Injury Scale, Injury Severity Score, and Glasgow Coma Scale. Grade of liver injury and number of patients with extravasation of contrast dye on CT and hemoperitoneum were higher in the operative group than in the NOM group. There were significant differences between the two groups for: heart rate, respiratory rate, systolic blood pressure, and mean hemoglobin levels at admission and after 4 hours. The operative group experienced a significantly higher mortality than the NOM group. CONCLUSIONS: The results of our study suggest that hemodynamic stability and the following should be considered for deciding the treatment for liver injuries: grade of liver injury, amount of blood loss, and injury scales scores.
Abdominal Injuries ; Blood Pressure ; Glasgow Coma Scale ; Heart Rate ; Hemodynamics ; Hemoperitoneum ; Humans ; Injury Severity Score ; Liver* ; Mortality ; Respiratory Rate ; Seoul ; Weights and Measures

Carcinosarcoma is a highly malignant tumor characterized by dual malignant histologic differentiation of epithelial and mesenchymal components. The tumor is extremely rare in the sinonasal tract. We report a case of a 62-year-old man with carcinosarcoma involving the maxillary sinus.
Carcinosarcoma ; Maxillary Sinus

OBJECTIVE: This is a retrospective review of 13 unstable Hangman's fractures who underwent posterior C2-3 fixation to describe clinical outcomes with a literature review. METHODS: Thirteen patients for unstable Hangman's fracture were enrolled between July 2007 and June 2010 were included in this study. The medical records of all patients were reviewed. Concurrently, clinical outcomes were evaluated using Neck Disability Index (NDI) scores and Visual Analogue Scale (VAS) scores during preoperative and postoperative follow up period. Plain radiographs were obtained on postoperative 1day, 1week, and then at 1, 2, 6, and 12 months. CT was done at postoperative 12 months in all patients for evaluation of bone fusion. The mean period of clinical follow-up was 17 months. RESULTS: Mean age were 43 years old. Bone fusion was recognized in all cases at the final follow-up. The average preoperative VAS score for neck pain was 8.3+/-1.1, while the final follow-up VAS score was 2.07+/-0.8 (p<0.001). The average immediate postoperative NDI was 84% points and final NDI was 22% points (p<0.001). There were one case of infection and 1 case of screw loosening. CONCLUSION: In the treatment of the patients with unstable Hangman's fracture, posterior C2-C3 fusions is effective and curative treatments to achieve cervical spinal stability.
Follow-Up Studies ; Humans ; Medical Records ; Neck ; Neck Pain ; Retrospective Studies