Complex regional pain syndrome (CRPS) type II is a syndrome that develops after nerve injury. Symptoms may be severe, and vary depending on the degree of sympathetic nerve involvement. As yet, there is no satisfactory treatment. We report the case of a female patient who had an L5 left transverse process fracture and an S2 body fracture, who developed symptoms of CRPS type II in her left lower leg that were aggravated during ambulation in spite of absolute bed rest for one month after the trauma. Several treatments, including bed rest, medication, and numerous nerve blocks were attempted, but the pain persisted. We finally tried injection of polydeoxyribonucleotide (PDRN) solution at the left L5 transverse process fracture site because we knew of the anti-inflammatory effect of PDRN. One day after this treatment, her symptoms had almost disappeared and three days later, she was discharged. We will also further discuss the possibility of using PDRN solution for the treatment of CRPS.
Bed Rest ; Causalgia* ; Female ; Humans ; Leg ; Nerve Block ; Polydeoxyribonucleotides ; Walking

This is a case report of double primary malignant cancer occurred aynchronously in the stomach and lymphoid tissue, We report this case with review of literatures about the criteria, age distribution, predisposing factor, inidence, immunity and susceptibility of the primary malignant neoplasms. This case was a 59-year-old man who had Hodgkins disease and tubular adenocarcinoma, of the stomach. The diagnoais was verified histologically, Although multiple primary neoplaas are rare, the possibility of that must be conaidered seriously, And its hereditary predisposition and other predisposing factor muat be researched with enthuaiasm.
Adenocarcinoma ; Age Distribution ; Causality ; Hodgkin Disease ; Humans ; Lymphoid Tissue ; Middle Aged ; Stomach

No abstract available.
Adenocarcinoma* ; alpha-Fetoproteins*

PURPOSE: To report two cases that showed clinical findings of recurrent keratoconus following penetrating keratoplasty. METHODS: A 39 year-old male and a 34 year-old female developed clinical signs of recurrent keratoconus in his left and her right eye 3 and 8 years after keratoplasty, respectively, and he underwent successful corneal regrafting. RESULTS: We confirmed recurrence of keratoconus histopathologically through the examination of the cornea of the recipient who underwent corneal regrafting and chromosomal study showed mosaicism, 47,XXY/46,XY. CONCLUSION: We report the histopathologic feature of one case of recurrent keratoconus for the first time in Korea.
Adult ; Cornea ; Corneal Transplantation ; Female ; Humans ; Keratoconus* ; Keratoplasty, Penetrating ; Korea ; Male ; Mosaicism ; Recurrence

OBJECTIVE: Both the paraspinal muscle sparing approach and percutaneous screw fixation are less traumatic procedures in comparison with the conventional midline approach. These techniques have been used with the goal of reducing muscle injury. The purpose of this study was to evaluate and to compare the safety and efficacy of the paraspinal muscle sparing technique and percutaneous screw fixation for the treatment of L5-S1 spondylolisthesis. METHODS: Twenty patients who had undergone posterior lumbar interbody fusion (PLIF) at the L5-S1 segment for spondylolisthesis were prospectively studied. They were divided into two groups by screw fixation technique (Group I : paraspinal muscle sparing approach and Group II: percutaneous screw fixation). Clinical outcomes were assessed by Low Back Outcome Score (LBOS) and Visual Analogue Scale (VAS) for back and leg pain at different times after surgery. In addition, modified MacNab's grading criteria were used to assess subjective patients' outcomes 6 months after surgery. Postoperative midline surgical scarring, intraoperative blood loss, mean operation time, and procedure-related complications were analyzed. RESULTS: Excellent or good results were observed in all patients in both groups 6 months after surgery. Patients in both groups showed marked improvement in terms of LBOSs all over time intervals. Postoperative midline surgical scarring and intraoperative blood loss were lower in Group II compared to Group I although these differences were not statistically significant. Low back pain (LBP) and leg pain in both groups also showed significant improvement when compared to preoperative scores. However, at 7 days and 1 month after surgery, patients in Group II had significantly better LBP scores compared to Group I. CONCLUSION: In terms of LBP during the early postoperative period, patients who underwent percutaneous screw fixation showed better results compared to ones who underwent screw fixation via the paraspinal muscle sparing approach. Our results indicate that the percutaneous screw fixation procedure is the preferable minimally invasive technique for reducing LBP associated with L5-S1 spondylolisthesis.
Back Pain ; Cicatrix ; Humans ; Leg ; Low Back Pain ; Muscles ; Postoperative Period ; Prospective Studies ; Spondylolisthesis

The low lumbar spine is deeply located in flexible segments, and has a physiologic lordosis. Therefore, burst fractures of the low lumbar spine are uncommon injuries. The treatment for such injuries may either be conservative or surgical management according to canal compromise and the neurological status. However, there are no general guidelines or consensus for the treatment of low lumbar burst fractures especially in neurologically intact cases with severe canal compromise. We report a patient with a burst fracture of the fourth lumbar vertebra, who was treated surgically but without fusion because of the neurologically intact status in spite of severe canal compromise of more than 85%. It was possible to preserve motion segments by removal of screws at one year later. We also discuss why bone fusion was not necessary with review of the relevant literature.
Animals ; Consensus ; Humans ; Lordosis ; Spine

BACKGROUND: Rhinocerebral mucormycosis (RCM) is an uncommon and fatal clinical syndrome resulting from an opportunistic infection caused by a fungus of the order Mucorales in immunocompromized patients. The mortality and morbidity in the patients with intracranial involvement is invariably high, and it was reported that most survivors had early diagnosis and received aggressive treatment. Therefore, we retrospectively reviewed four patients of pathologically confirmed mucormycosis to find out the clues for early diagnosis of RCM and for prediction of fatal intracranial involvement. METHODS: The clinical, radiological features and histo-pathological involvement sites in the patients with intracranial involvement were compared to those without intracranial involvement. RESULTS: All the patients had uncontrolled diabetes and were admitted with orbital involvement. On the precise physical examination, mucosal involvement was found in all patients; three of them in only nasal mucosa and one in oral palatal mucosa. Despite the vigorous antifungal therapy, two patients had intracranial involvement and expired. MRI finding of extensive sphenoid sinusitis adjacent cavernous sinus preceded the intracranial involvement of RCM, which was not found in the patients without intracranial involvement. CONCLUSIONS: Our findings suggest that early observation of oral or nasal mucosal changes might be an important clinical clue for differentiation of RCM from other causes of rhino-oculo-cerebral symptoms in uncontrolled diabetic patients, and that extensive sphenoid sinusitis might be an important radiological feature for predicting the fatal intracranial involvement of RCM.
Cavernous Sinus ; Diabetes Mellitus ; Early Diagnosis* ; Fungi ; Humans ; Magnetic Resonance Imaging ; Mortality ; Mucorales ; Mucormycosis* ; Mucous Membrane ; Nasal Mucosa ; Opportunistic Infections ; Orbit ; Physical Examination ; Retrospective Studies ; Sphenoid Sinus ; Sphenoid Sinusitis ; Survivors

No abstract available.
Aminophylline* ; Humans* ; Ritodrine* ; Uterus*

Idiopathic intracranial hypertension, a syndrome of obscure origin, occurs particularly in fat adolescent girls and young women. The usual symptoms are headache, blurred vision, a vague dizziness, horizontal diplopia and transient visual obscurations etc., and ophthalmoscopic examination reveals papillederma, due to increased ICP. Visual field testing usually shows slight peripheral constrictions with enlargement of the blind sports. CSF pressure is elevated in the range of 250 to 450 mm of water. Radiological or the other laboratory tests show no specific abnormalities. Treatment for idiopathic intracranial hypertension is focused on early detection and prevention of vision loss, the only permanent morbidity. Many different modes of medical treatment, including weight reduction, repeated lumber puncture, corticosteroids, diuretics, glycerol or carbonic anhydrase inhibitors, have successfully been tried up to 90% of the patients. In the remaining patients, particularly in those with measurable impairment of vision that does not respond to conventinal medical therapies, surgical procedure should be considered. We report a case of idiopathic intracranial hypertension successfully treated with optic nerve sheath fenestration.
Adolescent ; Adrenal Cortex Hormones ; Carbonic Anhydrase Inhibitors ; Constriction ; Diplopia ; Diuretics ; Dizziness ; Female ; Glycerol ; Headache ; Humans ; Optic Nerve* ; Pseudotumor Cerebri* ; Punctures ; Sports ; Visual Field Tests ; Water ; Weight Loss

Work-related musculoskeletal disorders (WMSDs) can be compensated through the Industrial Accident Compensation Insurance Act. We looked at the characteristics of WMSDs in worker's compensation records and the epidemiological investigation reports from the Occupational Safety and Health Research Institute (OSHRI). Based on the records of compensation, the number of cases for WMSDs decreased from 4,532 in 2003 to 1,954 in 2007. However the proportion of WMSDs among the total approved occupational diseases increased from 49.6% in 2003 to 76.5% in 2007, and the total cost of WMSDs increased from 105.3 billion won in 2004 to 163.3 billion won in 2007. The approval rate of WMSDs by the OSHRI accounted for 65.6%. Ergonomic and clinical characteristics were associated with the approval rate; however, the degenerative changes had a minimal affect. This result was in discordance between OSHRI and the Korea Workers' Compensation & Welfare Service. We presumed that there were perceptional gaps in work-relatedness interpretation that resulted from the inequality of information in ergonomic analyses. We propose to introduce ergonomic analysis to unapproved WMSDs cases and discuss those results among experts that will be helpful to form a consensus among diverse groups.
Accidents, Occupational ; Adult ; Cumulative Trauma Disorders ; Female ; Human Engineering ; Humans ; Low Back Pain ; Male ; Middle Aged ; *Musculoskeletal Diseases ; *Occupational Diseases ; Republic of Korea ; Risk Factors ; *Workers' Compensation/economics/trends