Epidural hematoma associated with epidural anesthesia is rare. We describe a case of a epidural hematoma after continuous epidural anesthesia and analgesia for arthroscopic patella shaving. Anesthesia was indudced with 8 ml lidocaine, 2.0% with epinephrine, 1:200,000 and surgery proceeded. When additional boluses of bupivacaine were administered later, aspiration of the epidural catheter still yielded no blood. At the end of the operation, an epidural infusion of 0.125% bupivacaine was done 2 ml/hr by two-day infusor. In the third postoperative day, the patient suffered from acute myocardial infarction and then heparin was infused. In the fourth postoperative day, she complained lumbar back pain and developed depressed dorsiflexion (Grade II) of great toe in left foot during the infusion of heparin. Sagittal MRI showed posterior thickened epidural hematoma along the segments of T12-L4. Despite the delayed laminectomy and decompression, which was performed six days after her initial operation, she had a good postoperative response, followed by a complete neurological recovery.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Back Pain ; Bupivacaine ; Catheters ; Decompression ; Epinephrine ; Foot ; Hematoma* ; Heparin ; Humans ; Infusion Pumps ; Laminectomy ; Lidocaine ; Magnetic Resonance Imaging ; Myocardial Infarction ; Patella ; Toes

Granuloma gluteale infantum is a granulomatous lesion in the diaper area of infants. Athough usually seen in infants, it has been described in incontinent elderly patients. The causes of granuloma gluteale infantum are not clear, although child care equipment(ditergents1, diapers2, and starch3), corticosteroids2,4,5,6, candidial infection3 urine and feces7 have been postulated for its etiology. We report a case of granuloma gluteale infantum in a 5-month-old boy. He was healthy except for an asymtomatic 1.5×1.5cm sized, round, Rat-topped brownish and firm nodule on the perianal area, and two, 1×3cm and 1×6cm sized brownish plaques on the intertriginous area of the neck. The lesions were resistant to the treatment of systemic antibiotics. These nodules completely resolved in the three months after we tried to keep the diaper area clean without using any corticosteroids or other ointments and after changing from plastic diapers to cotton o A histological examination of the nodule on the perianal area showed mild hyperkeratosis, spongiosis, and focal infiltration of neutrophils in the epidermis. In the dermis, an inflammatory infiltrate composed of many lymphocytes, eosinophils, plasma cells, and histiocytes was
Adrenal Cortex Hormones ; Aged ; Anti-Bacterial Agents ; Child ; Child Care ; Dermis ; Eosinophils ; Epidermis ; Granuloma* ; Histiocytes ; Humans ; Infant ; Lymphocytes ; Male ; Neck ; Neutrophils ; Ointments ; Plasma Cells ; Plastics

No abstract available.
Colloid Cysts* ; Colloids* ; Lateral Ventricles*

We report a case of mycosis fungoides in a 30 year-old man who had been treated for multiple open fractures after a traffic accident. Histopathologic findings showed epidermotrophism wiih hyperchromatic haloed lymphocytes and atypical lymphocytic infiltration in the upper dermis. The infiltrated cells were positively stained with CD45Ro, but not with CD20. He had no evidence of extracutaneous involvement by laboratory studies, Skin lesions improved markedly after treatment with systemic PUVA therapy combined with topical corticosteroids for 3 months.
Accidents, Traffic ; Adrenal Cortex Hormones ; Adult ; Dermis ; Fractures, Open* ; Humans ; Lymphocytes ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides* ; PUVA Therapy ; Skin

The CT is a more accurate technique for detecting sclerotic bony change of osteritis condensans ilii thanplain radiograph. We analysed a comparison between CT and plain radiography of osteitis condensans ilii, acorrelation between osteitis condensans ilii and women of childbearing age. The result were as follow: 1. Theincidence of osteitis condensans ilii is 5.3% on KUB, 11.7% on CT when the width of iliac sclerosis is more than7.5mm as diagnsotic criteria. 2. We observed a osteitis condensans ilii between 19 years and 51 years of age, mostfrequently in fourth decade. 3. The width of iliac sclerosis is 10-13 mm in 3 cases of osteitis condensans ilii onboth CT &KUB, 7.5-9mm in 4 cases of osteitis condensans ilii on CT only. 4. The incidence of osteitis condensansilii is increased significantly when the width of iliac sclerosis is less than 7.5mm as diagnostic criteria. 5.Relatively high correlation between osteitis condensans ilii and delivary in our study (66.6%)
Female ; Humans ; Incidence ; Osteitis ; Radiography ; Sclerosis

Normal" spinal posture is generally accepted as moderate lordosis of the cervical and the lumbar sections ofspine and moderate kyphosis of the thoracic and sacrococcygeal sections. Among these normal range of the lumbarlordosis is less well defined. CT is very useful method to identified the bony structure and adjacent soft tissueof the spine, so it is very available method to detect accrate lumbar lordotic angle by using lateral Scanogram.Analysis and comparison of lumbar lordotic angles, crossing angle are drawn each parallel line to the superior endplate of body of 1st. lumbar vertebra and to the inferior end plate of the 5th. Lumbar vertebra, in 174 cases withbackache and 50 cases normal groups at Kangnam General Hospital Public Corporation, from Aug. 1985 to Jul 1986.Male and female were almostly same affected in backache group (1.1:1). And most lumbar lordotic angles were 10 degrees to 40degrees between all backache age group. On backache group, over all mean lumbar lordotic angleswere 24.7±8.9degrees but no significant difference at mean value of the each disease, such as HIVD, DegenerationSpondylosis or No Remarkable Finding group. On control group, over all mean ones were 29.2±8.0degrees. So,significant difference of lumbar lordotic angle between backache and control group, and most difference is at 5th.decade group(p<0.01).
Animals ; Back Pain ; Female ; Hospitals, General ; Humans ; Kyphosis ; Lordosis ; Methods ; Posture ; Reference Values ; Spine

Sixty six Colles' fracture were treated with radial slab or U-cast (sugar tong splint), from January 1982 through May 1984 at the Department of Orthopaedic Surgery of St. Mary Hospital. A prospective study was made and was evaluated under the subjective criteria of Gartland and Werley, and the objective criteria of Scheck. The results of this study were as follows: 1. All of 66 cases was closed fracture and the incidence was high in females who aged over 6thdecades. 2. In 43 cases of stable fracture, 18 (94.7 %) out of 19 cases treated with radial slab and 21 (87.5%) out of 24 cases treated with U-cast showed satisfactory result. 3. In 23 cases of unstable fracture, 6 (54.6%) out of 11 cases treated with radial slab and 9 (75%) out of 12 cases treated with U-cast showed satisfatory result. 4. As a result, we found that the result of the treatment with radial slab was superior to the U-cast for the stable Colles fracture, however, all of two methods were not staisfatory for the unstable Colles fracture although the U-cast group showed better result.
Colles' Fracture ; Female ; Fractures, Closed ; Humans ; Incidence ; Prospective Studies

Recently, accumulation of knowledge on cerebrovascular microanatomy and its hemodynamics and advances in interventional equipments, especially microcatheters, could make superselective embolization as well as for an adjunctive preoperative procedures The authors performed superselective angiography and embolization with Tracker microcatheter in 25 procedures out of 15 patients with brain arteriovenous malformations (AVMs). Complete embolization was done in 7 prtients (46.7%), nearly complete embolization in 6 patients(40.4%), and partial embolization in 2 patients (13.3%). The overall curative success rate of embolization was 86.7%. Five patients showed no complication at all. Mild complications, however, were observed in 7 patients (46.8%). Severe complications such as AVM or Tracker rupture were observed in 3 patients (20%). In conclusion, superselective embolization is and effective method for the treatment of brain AVMs, and multiple session embolizations could reduce the complication rate and increase the success rate.
Angiography ; Arteriovenous Malformations* ; Brain* ; Hemodynamics ; Humans ; Methods ; Preoperative Care ; Rupture

Sex cord tumor with annular tubules (SCTAT) is a rare ovarian neoplasm which usually occurs in two forms. In patients associated with Peutz-Jeghers syndrome, the tumors are usually small, bilateral or multifocal, and show benign clinical course. However, tumors from patients without the syndrome are often large, usually unilateral, and rarely show malignant behavior. Serous surface papillary carcinoma (SSPC) is an aggressive neoplasm which involves peritoneal linings, including ovarian surface. Recently, we encountered a case of an unusual combination of SCTAT and SSPC in the ovary of a 55-year-old Korean woman presented with abdominal distention for one year. Systemic review and physical examination were within normal limit, except for abdominal discomfort and distention. There was no stigmata of Peutz-Jeghers syndrome in all diagnostic examinations, including gastroscopy and colonoscopy. Pelvic computed tomography showed adnexal mass with multiple peritoneal nodules. Exploration revealed uterine and ovarian surfaces covered with multiple, yellow-white papillary nodules. However, the sizes of both ovaries were within normal limit. Typical serous papillary carcinomas were identified in nodules from peritoneum and ovarian surfaces. Well-circumscribed columnar epithelial cell nests composed of ring-shaped tubules encircling hyalinized basement membrane-like materials were found in the ovary away from serous surface papillary carcinoma.
Carcinoma, Papillary* ; Christianity ; Colonoscopy ; Epithelial Cells ; Female ; Gastroscopy ; Humans ; Hyalin ; Middle Aged ; Ovarian Neoplasms ; Ovary* ; Peritoneum ; Peutz-Jeghers Syndrome ; Physical Examination

Lichen nitidus is an uncommon chronic dermatosis characterized by its typical clinical and histopathologic findings and has rarely been described in association with other diseases. We observed a patient with an association of lichen nitidus and molluscum contagiosum, which to the best of our knowledge has not been previously reported in the literature. It remains to be further studied about a possible pathogenesis of lichen nitidus secondary to some viral infections such as molluscum contagiosum, etc.
Humans ; Lichen Nitidus* ; Lichens* ; Molluscum Contagiosum* ; Skin Diseases