Amyloidosis may be defined as a group of disorders of extracellular deposition of the fibrous protein amyloid in one or more sites of body with variable causes and pathogenesis which have in common characteristic histopathologic features. Primary localized corneal amyloidosis is confined in the cornea and has not the evidence of apparent preexisting disorder or systemic involvement. The incidence has been reported rare. We have experienced one case of corneal amyloidosis which is confirmed by the histopathologic evaluation. We report this rare case with literatures reviews.
Amyloid ; Amyloidosis* ; Cornea ; Incidence ; Preexisting Condition Coverage

In-flight medical emergencies are likely to increase as air travel continues to grow and as more elderly passengers with preexisting diseases fly long distances. Unscheduled landing for a medical reason is a serious situation for commercial air carriers. The common causes of unscheduled landings are cardiac and neurological problems. Physician passengers might be called upon to help ill or injured passengers at any time. Physicians play an important role in in-flight medical emergencies. Most airlines have installed the emergency medical kits and automated external defibrillator (AED), ambu bag, intubation set, etc. The management of in-flight medical emergences requires the assistance from welltrained crew, adequate medical equipments and medications, availability of physician passengers, and ground medical communications. This article summarizes the in-flight resources available for physician passengers when called upon for medical emergencies while on board.
Aged ; Defibrillators ; Diptera ; Emergencies* ; Humans ; Intubation ; Preexisting Condition Coverage

Systemic illnesses and preexisting disorders affecting the brain may decrease the seizure threshold in some conditions. For the non-neurologist, patient with new-onset seizure (NOS) is troublesome problem to manage properly. To verify the characteristics of patients with NOS, we analyzed their clinical features. From Jan. 1991 to Jul. 1995, 47 patients were consulted to the neurological department because of their NOS during the admission. We retrieved the medical records, laboratory data and consultation sheets. The most common cause of the NOS was a metabolic disorder (18 patients, 38.3%) and was followed by a previous cerebrovasular disease (6 patients, 12.8%). Ceneralized tonic-clonic seizure occurred in more than half of the patients (55.3%). Fifteen out of 26 initial EEGs revealed diffuse slowings only, whereas only four patients showed focal epileptiform discharges. Status epileptics occurred in seven patients and five of them died. Six patients out of 17 patients with metabolic causes died, comparing five patients out of 27 patients with other causes. It is suggested that the NOS associated with metabolic causes are most common in hospitalized patients and were associated with poor prognosis.
Brain ; Electroencephalography ; Humans ; Medical Records ; Preexisting Condition Coverage ; Prognosis ; Seizures*

Recreational diving is an exciting and adventurous sport, but is also potentially hazardous. Despite its inherent hazards, an increasing number of people enjoy SCUBA (self-contained underwater breathing apparatus) diving; the number of diving-related accidents is therefore also likely to increase. Divers might face physical or psychological stresses from the unfamiliar or hostile underwater environment, which can lead to fatal accidents. To investigate deaths related to SCUBA diving, a forensic pathologist should understand the types and mechanisms of injuries and illnesses unique to SCUBA diving. Postmortem examination of diving fatalities is therefore a formidable task for most forensic pathologists because cases are sparse and the process requires an understanding of diving physiology, diving equipment, and the underwater environment. The primary aim of autopsies in SCUBA diving fatalities is to detect evidence of pulmonary barotrauma, intravascular gas, or pre-existing illnesses. Standard autopsy protocol for SCUBA diving-related deaths should include methods to detect intravascular gas and gas accumulation in the tissue or body cavity through plain radiographs or Computerized Tomography (CT) scans. Analysis of the gas components is also helpful for determining the origin of the gas. Here, the author proposes a practical method for performing an autopsy on a person who died while SCUBA diving.
Autopsy* ; Barotrauma ; Diving* ; Humans ; Methods ; Physiology ; Preexisting Condition Coverage ; Respiration ; Sports ; Stress, Psychological

Charcot spinal arthropathy is a rare, progressive type of vertebral joint degeneration that occurs in the setting of any preexisting condition characterized by decreased afferent innervation to the extent that normal protective joint sensation in the vertebral column is impaired. The authors report on a case of Charcot arthropathy of the lower lumbar spine mimicking a spinal tumor following cervical cord injury.
Joints ; Preexisting Condition Coverage ; Sacrum ; Sensation ; Spinal Cord Injuries* ; Spinal Cord* ; Spine*

To evaluate trends, if any, anesthetic experiences of 10,000 cases in the total performed at the department of Anesthesiology, Han Kang Sung Shim Hospital, Choong Ang University, School of Medicine from Dec. 197I through Nov. 1976 were analyzed statistically according to anesthetic method, age, sex, department, anesthetic agent, anesthetic duration, physical status and cause of death. The results are as follows; 1. About forty-five percent of all surgical patients were emergency cases. 2. The spinal and regional blocks tended to increase compared with inhalation anesthesia. 3. The patients under 1 year and over 60-years of age also tended to increase. 4. In almost all cases, post-operative and post-anesthetic cause of death was due to the severity of preexisting disease itself and overall death rate of surgical patients who received anesthesia was 0.16% 5. Through this statistical study, we can perform anesthesia with more safety and ease, and also eliminate post-operative and post-anesthetic complications, with further study of new agents and techniques.
Anesthesia ; Anesthesia, Inhalation ; Anesthesiology ; Cause of Death ; Emergencies ; Humans ; Methods ; Mortality ; Preexisting Condition Coverage ; Statistics as Topic

Disease identity of dysmorphophobia and olfactory reference syndrome which used to be manifested by a kind of monosymptomatic somatic delusion is not yet established definitely. So many issues such as whether it be regarded as separate disease, or a spectrum of preexisting diseases such as schizophrenia or obsessive compulsive disorder and whether the monosymptom should be considered as a delusion or not are still on debate and the results are controversial. Consequently few is known about the etiology of the disorder.Obvioulsy, somatic delusion in dysmorphophobia and olfactory reference syndrome is the result of cognitive distortion of body image of the self. It reflects symbolic meaning of unresolved psychological conflict by defense mechanisms such as repression, dissociation, symbolization, projection, and so on. Though psychopharmacological and psychotherapeutic treatment modality has been reported, the treatment efficacy is unclear. Prognosis has been reported unfavorable and one of the leading causes has been thought to be treatment noncompliance. The authors experienced 2 cases of olfactory reference syndrome, so reported with literature review.
Body Image ; Defense Mechanisms ; Delusions ; Obsessive-Compulsive Disorder ; Preexisting Condition Coverage ; Prognosis ; Repression, Psychology ; Schizophrenia ; Treatment Outcome

The authors analized the 98 cases of cervical spine injuries without fracture or dislocation by hyperflexion/hyperextension of the neck. The peak incidence of the age was in the second to fourth decades(69.4%). There was a male preponderance with a sex ratio of. 1.8 : 1. Sources of trauma were motor vehicle accident, object falling on and motorcycle accident in the order of frequency. The common mechanisms of injury were flexion-extension, extension and flexion injury in the order of frequency. There were 10 cases of cervical cord injury without fracture or dislocation and operative management was given in 6 cases of them. The most common preexisting disease was congenital cervical stenosis. Surgical modality such as laminectomy, laminoplasty and anterior decompressive procedure made them improved. The authors discuss the mechanism of injury and surgical management of the patients with cervical cord injury in the absence of concomittent fracture or dislocation.
Constriction, Pathologic ; Dislocations* ; Humans ; Incidence ; Laminectomy ; Male ; Motor Vehicles ; Motorcycles ; Neck ; Preexisting Condition Coverage ; Sex Ratio ; Spine*

OBJECTIVE: The authors analyze the clinical characteristics of the geriatric brain tumors and suggest the treatment modality. METHODS: Patients older than 65years, managed between Jan 1980 and Feb 2002 in our department, were included in this study and the number of patients was 315. Age, sex, medical history, performance scale, treatment modality, morbidity and mortality as well as the incidence of brain tumor in this age group were analyzed. RESULTS: Geriatric brain tumors were comprised of 7.8% of the adult brain tumors. The mean age was 68.7 years and male to female ratio was 1 : 1.3. The most common one was meningioma(114, 36.2%), followed by metastatic tumor(49, 15.6%), high grade glioma(39, 12.4%), schwannoma(38, 12%) and pituitary adenoma(35, 10.5%) in the order of frequency. The incidence of pre-existing disease, such as hypertension(25%), caridiovascular disease(15%), diabetes melitus(12%) was high. Surgical outcome was good with acceptable operative morbidity and mortality rate 26% and 3% respectively. Frequent postoperative surgical complications were tumor bed bleeding and wound infection. During perioperative course, medical complications such as cardiovascular problem, delirium, pneumonia and sepsis were common. CONCLUSION: Incidence of combined medical problem in the geriatric patients was considerablly high. However, in the case of surgically accesible benign tumor or even malignant tumor, surgical treatment should be considered.
Adult ; Brain Neoplasms* ; Brain* ; Delirium ; Female ; Hemorrhage ; Humans ; Incidence ; Male ; Mortality ; Pneumonia ; Preexisting Condition Coverage ; Sepsis ; Wound Infection

BACKGROUND: Pulmonary aspergilloma is a potential life-threatening disease resulting from massive hemoptysis. Pulmonary aspergilloma has been treated surgically for many years, however, it has also had higher risk of mortality and complication rate. The purpose of this study is to analyze the operative methods and the types of complications. MATERIAL AND METHOD: Sixty patients who underwent surgical resection for pulmonary their medical reconrds. RESULT: The mean age was 46.3+/-13.4 years(range 20 to 76 years). The most common clinical presentation was hemoptysis which occurred in 48 patients(80%). Pulmonary tuberculosis was the most common pre-existing disease, occurri9ng in 28 patients(46.7%). The other associated lung diseases were bronchiectasis(n=11), silicosis(n=2), and chronic pnumonia(n=1). Operative proceudres wer lobectomy in 35 patients, pneumonectomy in 6, segmentectomy in 5, lobectomy and thoracoplasty in 3, segmentectomy and thoracopasty in 1, and cavernostomy in 10. The operative mortality was 6%(n=3) in lung resection patients but 0% in cavernostomy patients. The most common complications were prolonged air leakage, wound infection and postoperative bleeding. CONCLUSIONS: In most cases of pulmonary aspergilloma surgical resectin remains the only effective therapy. However, cavernostomy may be more effective for pulmonary aspergilloma patients with decreased pulmonary functions and for patients with high risk for lung resection.
Hemoptysis ; Hemorrhage ; Humans ; Lung ; Lung Diseases ; Mastectomy, Segmental ; Mortality ; Pneumonectomy ; Preexisting Condition Coverage ; Pulmonary Aspergillosis ; Thoracoplasty ; Tuberculosis, Pulmonary ; Wound Infection