We describe the case of a 59-year-old man whose occipital condyle was fractured in a traffic accident, resulting in severe neck pain and blurred vision. Neurological examination revealed palsy of the right side sixth cranial and ipsilateral lower cranial nerve. In fracture of the occipital condyle, persistent neck pain and lower cranial nerve palsy may be common clinical features. Conventional plain radiography may often be inadequate for the detection and evaluation of this lesion, and high-resolution CT and coronal reconstruction is the diagnostic modality of choice. The patient was treated conservatively using a Philadelphia collar, and this led to excellent clinical improvement. To demonstrate this rare form of traumatic lesion in patients with sustained post-traumatic neck pain and lower cranial nerve palsy, the authors recommend CT of the craniocervical junction.
Accidents, Traffic ; Cranial Nerve Diseases* ; Cranial Nerves* ; Humans ; Middle Aged ; Neck Pain ; Neurologic Examination ; Paralysis ; Radiography

We describe the case of a 59-year-old man whose occipital condyle was fractured in a traffic accident, resulting in severe neck pain and blurred vision. Neurological examination revealed palsy of the right side sixth cranial and ipsilateral lower cranial nerve. In fracture of the occipital condyle, persistent neck pain and lower cranial nerve palsy may be common clinical features. Conventional plain radiography may often be inadequate for the detection and evaluation of this lesion, and high-resolution CT and coronal reconstruction is the diagnostic modality of choice. The patient was treated conservatively using a Philadelphia collar, and this led to excellent clinical improvement. To demonstrate this rare form of traumatic lesion in patients with sustained post-traumatic neck pain and lower cranial nerve palsy, the authors recommend CT of the craniocervical junction.
Accidents, Traffic ; Cranial Nerve Diseases* ; Cranial Nerves* ; Humans ; Middle Aged ; Neck Pain ; Neurologic Examination ; Paralysis ; Radiography

No abstract available.
Meningioma* ; Proliferating Cell Nuclear Antigen*

Hypertensive pontine hemorrhage usually causes profound, irreversible neurological deficits, with ominous prognosis, and is often fatal. There is controversy as to the appropriate treatment modality, but in general, surgical intervention is considered unethical. The authors report the outcome of hypertensive pontine hemorrhage in 13 patients whose Glasgow Coma Scale was 4-9, who on brain CT scan were seen to have over 10cc of hematoma and who underwent suboccipital craniectomy for hematoma removal. These patients could be divided in two groups: 'early'(9 patients), who underwent surgery within 24 hours of ictus, and 'late'(4 patients), who underwent surgery 6 to 20 days after ictus: all had shown neurological deterioration in spite of optimal medical treatment. Surgical outcome did not vary according to the extent of hematoma removal. For patients in the 'early' group, surgery was not useful, but three in the 'late' group, the GCS score improved to between 7 and 11. This study suggests that in hypertensive pontine hemorrhage, an early direct approach may not improve outcome, but for selected patients, who deteriorate during conservative treatment, surgery may be beneficial.
Brain ; Glasgow Coma Scale ; Hematoma ; Hemorrhage* ; Humans ; Prognosis ; Tomography, X-Ray Computed

Recently the change in medical informatics enabled us to use medical information whenever we want and wherever we are. There are many homepages on the web, which provide hospital information, medical counseling. Our multimedia center began its service as a internet Hospital in MIDAS Dongailbo, one of the major daily newspaper in Korea, on March 25th, 1997. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 1,000 counsellings which were called 'Dongailbo Internet Hospital' for March, 25th, 1997 through October 30th, 1997. Many questioners wanted to know treatment principles, to make a diagnosis, and to know specific medical knowledges. The most common questions are as follows: general and unspecified, musculoskeletal, skin, digestive, respiratory, neurological problems.
Computer Communication Networks ; Counseling* ; Diagnosis ; Internet ; Korea ; Medical Informatics ; Multimedia ; Periodicals* ; Skin

Recently the change in medical informatics enabled us to use medical information whenever we want and wherever we are. There are many homepages on the web, which provide hospital information, medical counseling. Our multimedia center began its service as a internet Hospital in MIDAS Dongailbo, one of the major daily newspaper in Korea, on March 25th, 1997. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 1,000 counsellings which were called 'Dongailbo Internet Hospital' for March, 25th, 1997 through October 30th, 1997. Many questioners wanted to know treatment principles, to make a diagnosis, and to know specific medical knowledges. The most common questions are as follows: general and unspecified, musculoskeletal, skin, digestive, respiratory, neurological problems.
Computer Communication Networks ; Counseling* ; Diagnosis ; Internet ; Korea ; Medical Informatics ; Multimedia ; Periodicals* ; Skin

The authors report a case of interhemispherical fissure arachnoid cyst with agenesis of the corpus callosum who was 11-year-old child suffering from partial seizure. The interhemispheric area is a rather uncommon site for arachnoid cysts. Careful analysis of the anatomical and radiological features of this case seems to suggest that two morp-hologically distinct types of cysts occurred in the interhemispheric area; (1) Interhemispheric cyst associated with agenesis of the corpus callosum(2) parasagittal cyst, not associated with such an anomaly. The interhemispheric fissure arachnoid cyst occurs in the midline, straddling the falx, and extends about equally on either side, compressing the medial surface of both hemispheres. A coronal CT or MRI view shows a "batwing" appearance of the lateral horns and dorsal displacement of the third ventricle. It should be stressed that a histologically heterogenous group of cysts(ependymal, glial, choroid epithelial, and arachnoid) may give rise to this same morphologic appearance. The anterior interhemispheric approach was performed and removal of cystic membrane was achieved. Postoperatively, there was no focal neurological deficit.
Animals ; Arachnoid Cysts ; Arachnoid* ; Child ; Choroid ; Corpus Callosum* ; Horns ; Humans ; Magnetic Resonance Imaging ; Membranes ; Seizures ; Third Ventricle

Hypertrophic osteoarthropathy(HOA) is a systemic disorder primary affecting the bones, joints, and soft tissues and characterized by several(or all) of the followings ; 1) Clubbing of digits, 2) Persistent new bone formation particulary involving long bones of the distal extremites, 3) Symmetric arthritis-like changes in the joints and periarticular tissue, most commonly the ankles, knees, wrist, and elbows, 4) Increased thickness of the subcutaneous soft tissues in the distal one-third of the arms and legs, and 5) Neurovascular changes of the hands and feet, including chronic erythema, paresthesis, and increase sweating. Most of cases of HOA are secondary to intrathoracic neoplasms, while the remaining few cases are secondary to other disease in the chest or elsewhere. We experienced a case of HOA in association with lung abscess in 26-yr-old male and reported with a review of literatures.
Ankle ; Arm ; Elbow ; Erythema ; Foot ; Hand ; Humans ; Joints ; Knee ; Leg ; Lung Abscess* ; Lung* ; Male ; Osteoarthropathy, Primary Hypertrophic ; Osteoarthropathy, Secondary Hypertrophic* ; Osteogenesis ; Sweat ; Sweating ; Thorax ; Wrist

Over Past years people have known rich medical information and knowledge through mass-media. It is needed to develop medical database, which makes people get proper medical information, So we made an effort to analysis health and medical consultation data. People easily access internet hospital of Gachon Medial School Gil Medical Center, coorperated with MIDAS Dongailbo. 4020 cases of "Questions and Answers "were conducted to access from March 25th, 1997 to March 25th, 1998. Using Java Servlet, Sybase, and Apache Web Server, we classified data. Those data present over 4000 databases, such as text (3644 cases), image (212 cases), moving picture (21 cases), and medical dictionary (416 dases). People can search symptome, or disease, what they want to know. Our database as a medical service is enhance people know about medical knowledge and information, so that they can take care of their health and prevent illness in advance.
APACHE ; Dictionaries, Medical ; Humans ; Indonesia ; Internet* ; Multimedia*

The diffuse nodular lung lesion has a diagnostic problem and should be made differential diagnosis. A chest X-ray of 62-year-old male patient with dyspnea showed small-sized scattered multinodular lesion on entire lung field. Bronchoalveolar lavage and transbronchial needle aspiration showed the non-specific findings, so open lung biopsy was done and revealed bronchioloalveolar cell carcinoma.
Biopsy ; Bronchoalveolar Lavage ; Diagnosis, Differential ; Dyspnea ; Humans ; Lung Diseases* ; Lung* ; Male ; Middle Aged ; Needles ; Thorax