A 70-year-old female Patient was admitted due to the impression of lung abscess via local clinic. Chest P-A showed air shadow containing huge mass lesion in the right lower lung field, pericardio phrenic angle. But the patient complained of only mild upper respiratioy tract infection symptoms and the laboratory tests were within normal limits. Barium enema and chest C-T taken right after barium enema were performad in suggesting of the diaphragmatic hernia. Barium tilled transverse colon and associated omentum were in the right anterior hemithorax surrounded by the hernial sac. The mass lesion shown in the chest P-A was compatible with the diaphragmatic hemia, Morgagni type. Operative reduction of the herniated bowel and simple closure of the diaphragm was performed.
Aged ; Barium ; Colon, Transverse ; Diaphragm ; Enema ; Female ; Hernia, Diaphragmatic ; Humans ; Lung ; Lung Abscess ; Omentum ; Thorax*

STUDY DESIGN: This is a retrospective study analyzing the results of chip PLIF with pedicle screw instrumentation for various spinal lesions. OBJECTIVES: To analyze the clinical and radiologic results of chip PLIF and to compare the amount of blood loss and transfusion and operation time with the ordinary PLIF. SUMMARY OF LITERATURE REVIEW: The ordinary PLIF has 86-95% of radiologic union rate and 80% of clinical satisfactory rate. The problems of ordinary PLIF were donor site morbidity, limited bone resources, prolonged operation time and excessive blood loss. MATERIALS AND METHODS: Forty patients were treated by chip PLIF utilizing cubical chip bone obtained from spinous process, facets and lamina from October 1995 to October 1997. Twenty-four patients, followed up over 12 months, were included in this study. Radiologic union, disc space collapse and change of kyphotic angle were assessed by simple X-ray and clinical results by improvement of back pain, radicular pain and change of neurological deficits. Twenty-nine patients treated by ordinary PLIF were compared concerning the operation time, amount of blood loss and transfusion. RESULTS: The mean age was 51.5 years(27-68 years) and mean follow-up was 20.7 months(12-30 months). Complete radiologic union rate was 47.6%, which was lower than ordinary PLlf. Satisfactory clinical result rate was 79%, which was similar with other fusion methods. Operation time, amount of blood loss and transfusion were less than the ordinary PLIF. There were three complications that were one dural tear ailed two pedicle screw breakages. CONCLUSION: There was no relationship between radiologic union rate and clinical satisfactory result after chip PLIF. Although operation time is relatively short and blood loss is less, it's not a good method to obtain nice bony union in spinal lesions.
Back Pain ; Follow-Up Studies ; Humans ; Retrospective Studies ; Tissue Donors

No abstract available.
Acupuncture Therapy ; Ampicillin/pharmacology/therapeutic use ; Ankle/ultrasonography ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Cellulitis/complications/diagnosis/drug therapy/*microbiology ; Diabetes Mellitus, Type 2/complications ; Gram-Negative Bacterial Infections/complications/diagnosis/drug therapy/*microbiology ; Humans ; Hypertension/complications ; Magnetic Resonance Imaging ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Prevotella nigrescens/drug effects/*genetics/isolation & purification ; RNA, Ribosomal, 16S/*analysis ; Sulbactam/pharmacology/therapeutic use ; Tomography, X-Ray Computed

PURPOSE: Chlorine gas is a common irritant that usually causes mild respiratory symptoms. One severe symptom, RADS (Reactive Airway Dysfunction Syndrome), is not well known to physicians. We analyzed the clinical features of chlorine gas exposure. METHODS: We prospectively collected 25 cases of chlorine gas exposure near our emergency center on January 10th, 2007, and analyzed demographic data, event-to-ER interval, symptoms, and laboratory results based on medical records. RESULTS: Only 2 patients out of 25 were admitted because of severe symptoms, the rest were discharged without complications. Sixty percent of them visited the ER within 12 h of exposure. The most common symptoms were chest discomfort (60%), headache (40%), nausea (40%), throat irritation (26%), and cough (32%). Two out of eight dyspnea cases showed abnormal pulmonary function, but only one case was diagnosed as RADS. CONCLUSION: Most symptoms after chlorine gas exposure can be treated conservatively. However, patients with chlorine exposure should be followed up long term for delayed complications.
Chlorine ; Cough ; Dyspnea ; Emergencies ; Environmental Exposure ; Follow-Up Studies ; Headache ; Humans ; Hypersensitivity ; Nausea ; Pharynx ; Prospective Studies ; Thorax

STUDY DESIGN: The authors retrospectively analysed the recovery of clinical symptoms after surgical treatment of lumbar HIVD. OBJECTIVES: To investigate the incidence of clinical symptoms, the recovery rate and time after surgical treatment and the difference between L4-5 and L5-S1 lesion. SUMMARY OF LITERATURE REVIEW: There are many reports concerning the clinical result of surgical treatment for the HIVD. They usually describe the result as excellent, good, fair and poor. We can't get any information about the recovery rate and recovery time of each clinical symptom from the reports . MATERIALS AND METHODS: Thirty-eight patients were treated by one level open discectomy from march 1991 to december 1995, The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocol. RESULTS: In preoperative examination, SLR was positive in 82%, motor deficit in 76%, sensory deficit in 74%, DTR change in 50%, and radiating pain in 100%. The recovery rate of SLR was 96.8%, motor deficit ; 93.6%, sensory deficit ,78.6%, DTR change ; 21% and radiating pain ,84.2%. The average recovery time of SLR was 3.4 months, motor deficit ; 1.9 months, sensory deficit ; 5.3 months, DTR change ; 4.1 months and radiating pain ; 3.2 months. Motor and sensory deficit was more frequent in L4-5 lesion but DTR change was usually noted in L5-S1 lesion. The recovery rate and time showed no great difference between the two level. CONCLUSIONS: The recovery rate was higher in SLR, motor deficit and radiating pain rather than sensory deficit and DTR change. The recovery time was fastest in radiating pain but variable nature was noted in sensory deficit. Above results may be helpful to explain the prognosis of the lumbar HIVD.
Diskectomy ; Humans ; Incidence ; Prognosis ; Retrospective Studies

A 66-year-old woman was transferred to our hospital due to her right breast cancer. Preoperative breast MRI shows 1.9 cm malignancy on her right breast (cT1N0M0) and incidentally found osteosclerotic change of left coststernoclavicular region. Bone scintigraphy showed hot uptake and the possibility of bone metastasis was not excluded. However, because the bone metastasis is not common in early stage cancer and the costosternoclavicular region is not common site, other possibility should be considered. SAPHO syndrome can be diagnosed even in the absence of dermatosis when there is an axial or appendicular osteitis and hyperostosis, especially in costosternoclavicular region. Though breast imaging specialists are not accustomed to this disease entity, awareness and diagnosis of the SAPHO syndrome can help differentiate bone metastasis.
Acquired Hyperostosis Syndrome* ; Aged ; Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Humans ; Hyperostosis ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Osteitis ; Radionuclide Imaging ; Skin Diseases ; Specialization

A 47-year-old woman ingested about 12 mg of colchicine with suicidal intent. Colchicine, a highly poisonous alkaloid, is a commonly used treatment for gout, Bechet's disease, and familial Mediterranean fever. Despite the knowledge of its side effects, the risk of a significant overdose is under-appreciated. She suffered from acute multisystem toxicity, including gastrointestinal disorders, bone marrow suppression, alopecia, and probable pancreatitis, but she ultimately recovered with supportive therapy. We report a case of acute colchicine toxicity from a single overdose with a review of the literature.
Alopecia ; Bone Marrow ; Colchicine ; Familial Mediterranean Fever ; Female ; Gastroenteritis ; Gout ; Humans ; Middle Aged ; Pancreatitis

PURPOSE: Infection, foreign body reaction and decreased volume of implant are common complications after augmentation rhinoplasty with Gore-tex(R) implant. The author experienced two cases of recurrent foreign body granuloma in the patients who underwent Gore-tex(R) removal because of infection after augmentation rhinoplasty. and treated them with complete removal of Gore-tex(R). METHODS: Case 1: A 49 year-old female visited our clinic for recurrent foreign body reaction on nasal dorsum and tip area. The patient underwent augmentation rhinoplasty with Gore-tex(R) 3 years ago and implant was removed due to infection 9 months ago. Excision of the granuloma was performed and a piece of foreign body suspicious to be a Gore-tex(R) implant debris was detected under the subcutaneous pocket. The implant fragments were removed and nasalis muscle rotation flap was performed to cover the lesion. The specimen was proved to be Gore-tex(R) in histological study. Case 2: A 31 year-old-male with recurrent foreign body granuloma on the nasal tip area visited our clinic. 10 years ago, the patient had augmentation rhinoplasty with silicone implant and then, he underwent revisional rhinoplasty five times including nasal implant removal, which was performed 9 months ago. The authors excised the granuloma and found a small sized foreign body suspicious to be a Gore-tex(R) implant debris under the granuloma. The foreign body was excised and identified to be Gore-tex(R) in histological study. RESULTS: In both cases, the lesions were healed without any complications and there were no evidences of recurrence up to 6 months of follow-up. CONCLUSION: The Gore-tex(R) is known to be weak against mechanical force. These properties of Gore-tex(R) make it difficult to remove the implant completely. In the patient who have infection after augmentation rhinoplasty with Gore-tex(R), the operator should take care to perform the complete removal without remaining fragment of the implant.
Female ; Follow-Up Studies ; Foreign Bodies ; Foreign-Body Reaction ; Granuloma ; Granuloma, Foreign-Body ; Humans ; Muscles ; Recurrence ; Rhinoplasty ; Silicones

PURPOSE: It is generally accepted that anatomical structures of the soft tissue in Asian faces are quite different from those in Caucasian. It is presumed that these differences are due to collagen rich thick dermis and durable superficial musculo-apponeurotic system (SMAS) in Asian. We classified the aging lower eyelids and reviewed the operative procedures according to the types of aging lower eyelids in Asian. METHODS: We compared preoperative and postoperative photos of 117 patients over 30 years of age, who underwent lower blepharoplasty at the Kyunghee Medical Center from January 2001 to April 2006. We classified the patients based on the degree of skin laxity, presence of nasojugal groove and malar bag, the extent of aging process. We also reviewed the operative procedures according to each type of classification. RESULTS: We classified our patients into four types as following. Type I patients showed minimal skin-muscle excess confined to lower eyelids regardless of the facial line. For these patients, we performed only transcutaneous or transconjunctival blepharoplasty. In type II patients, nasojugal grooves were shown and skin- muscle laxity was limited to the medial side of imaginary vertical line at lateral margin of pupil. In these cases, we performed free fat graft or fat repositioning on nasojugal groove or fat removal and septal duplication confined to medial side. Type III patients displayed more advanced medial bulging and remarkable laxity over the lateral side, the same operation methods as those of type II were applied at the lateral side of the line. Type IV patients demonstrated extensive midfacial aging changes including malar bags and underwent superficial subciliary cheek lift. CONCLUSION: The lower eyelid aging of Asian is different from those of Caucasian. We think that our classification is useful in selection of appropriate operative procedure to address specific problems for Asian patients.
Aging ; Asian Continental Ancestry Group ; Blepharoplasty ; Cheek ; Collagen ; Dermis ; Eyelids ; Humans ; Muscles ; Pupil ; Skin ; Surgical Procedures, Operative ; Transplants