Pancoast syndrome (PS) is characterized by a malignant neoplasm of the superior sulcus of the lung with destructive lesions of the thoracic inlet and involvement of the brachial plexus and cervical sympathetic nerves. The most common initial symptom of PS is shoulder pain; however, cough, dyspnea, and hemoptysis, signs often associated with lung cancer, are not as common. Investigation of PS can be difficult even with plain radiographs of the chest because it is surrounded by osseous structures such as the ribs, vertebral bodies, and manubrium. Due to these characteristics, orthopedic surgeons tend to make a misdiagnosis resulting in delay of appropriate treatment. Here we report on a patient who was supposed to undergo rotator cuff repair for his shoulder pain and weakness, and was eventually diagnosed with PS.
Bays ; Brachial Plexus ; Cough ; Diagnostic Errors ; Dyspnea ; Hemoptysis ; Humans ; Lung ; Lung Neoplasms ; Manubrium ; Orthopedics ; Pancoast Syndrome* ; Ribs ; Rotator Cuff* ; Shoulder Pain ; Superior Vena Cava Syndrome ; Thorax

Traumatic atlanto-occipital dislocation is usually fatal. To date, few cases have been reported in the literature because survival after traumatic atlanto-occipital dislocation is extremely rare. We present the case of a 47-year-old man with traumatic atlanto-occipital rotatory posterior dislocation combined with atlanto-axial rotatory subluxation and treated by occipito-cervical fusion using Bohlman's triple wiring technique.
Dislocations* ; Humans ; Middle Aged

The authors underwent the serum lipid study, involving the lipoprotein fraction, and the HDL-cholesterol mean values in normal Korean adults visited to Hanyang University Hospital, and also compared with the previously reported serum lipid studies. The results are as follows; 1) The mean values of triglyceride, total cholesterol, and phospholipid were 103.3+/-17.1mg%, 188.9+/-18.2mg%, and 196.7+/-19.8mg%, respectively. 2) Compared with the past 7 years triglyceride showed increasing tendency with significance, and cholesterol and phospholipid showed slightly increasing tendency. 3) In the serum lipoprotein fraction, the mean values of alpha-lipoprotein, pre-beta-lipoprotein, and beta-lipoprotein were 37.2+/-5.9%, 16.0+/-4.2%, and 48.6+/-5.2%, respectively. 4) Compared with the past 10 years, the alpha-, and pre-beta-lipoprotein showed increasing tendency, meanwhile, beta-lipoprotein revealed decreasing tendency. 5) The mean value of HDL-cholesterol was 52.3+/-14.6mg%, and the ratio of HDL-cholesterol to total cholesterol(HDL-cholesterol/total cholesterol) was 28.2+/-7.9. 6) Compared with the past 2 years, HDL-cholesterol level showed slightly increasing tendency.
Adult ; Cholesterol ; Humans ; Lipoproteins ; Triglycerides

Frequency of fracture of the acetabulum is becoming increasingly with the increase of automobile accident. If fractures are not accurately evaluated, classified and reduced anatomically, major sequelae and complications such as traumatic arthritis, joint instability and avascular necrosis of the femoral head were highly developed. The principles of treatment are to restore the fractured acetabulum to its normal anatomy, to maintain and/or restore function, and accordingly early joint motion to promote healing and to prevent joint adhesion. However, the treatment of displaced fracture of the acetabulum has been controversial: that is, should these fractures be treated by closed or open method? Judet et al(1964), Pennal(1980) and Matta et al(1986) advocated open reduction and internal fixation for displaced fractures of the acetabulum. Especially, Matta et al reported that displaced fracture must be reduced to a displacement of 3mm or less, in addition to congruent reduction of the femoral head with weight-bearing dome of the acetabulum, to achieve a satisfactory clinical result. However, some authors reported that, if closed reduction such as traction was used, good result could be obtained. We analysed 42 cases of acetabular fractures to compare the results of closed treatment with that of open treatment as well as its complication after each treatment. All were treated at Kang-Nam St. Marys Hospital from June 1981 to June l86. The complications were' developed in 7(29.2%) out of 24 cases of conservatively treated group, and 5 (27. 8 %) of 18 cases of surgically treated group. However, 7 (70%) of 10 conservatively treated cases of displaced fracture developed complication. In all conservatively treated cases, traumatic arthritis was developed. Five of 18 surgically treated patients developed complications, such as deep wound infection in two cases, traumatic arthritis in two cases, and avascular necrosis in one case. The causes of complication in 5 surgically treated cases were wrong surgical approach by wrong classification in three cases, failure of internal fixation in a case and inevitable avascular necrosis in a case, respectively. Thus, anatomical restoration of the joint surface offered the best chance for a symptom free hip and reduced the complication such as traumatic arthritis. Even though traumatic arthritis and avascular necrosis may develop later by other causes, total hip replacement surgery will be much eased, if the nor mal joint anatomy is restored at initial treatment. Proper selection of the best suited surgical approach analysing the type fracture to minimize the sequelae is mandatorily stressed when surgical treatment is indicated.
Acetabulum ; Arthritis ; Arthroplasty, Replacement, Hip ; Automobiles ; Classification ; Head ; Hip ; Humans ; Joint Instability ; Joints ; Methods ; Necrosis ; Traction ; Weight-Bearing ; Wound Infection

Amblyopia is a disturbance of spatial or form vision that develops early in life, usually in association with strabismus, anisometropia, high refractive errors and so on. It was reported that the visual functions obtained from the foveal region of an amblyopic eye resembled those obtained from the peripheral retina rather than central retina of a normal eye. We designed this experiment which examines the effects of diffusion blur on grating and Snellen acuity in normal and amblyopic eyes, using a liquid crystal window. We obtained the value of diffusion blur in 26 amblyopic eyes and then compared the result with that of normal eyes. The diffusion blur had a strong negative effect on both the Snellen and grating acuity but it had a more potent effect on grating acuity. Because there is a significant difference in the diffusion blur produced by an amblyopic eye and a normal eye at the same vision, there is a difference between visual function of amblyopic eyes and that of normal central retina.
Amblyopia* ; Anisometropia ; Diffusion ; Liquid Crystals ; Refractive Errors ; Retina ; Strabismus

Emphysematous pyelonephritis is a rare complication of severe acute pyelonephritis and a suppurative infection of the renal parenchyma characterized by the production of gas by bacteria through fermentation. Emphysematous pyelonephritis occurs in patient with diabetes mellitus or urinary obstruction. We review the diagnosis and management of emphysematous pyelonephritis and report a case of emphysematous pyelonephritis developed in renal tuberculosis.
Bacteria ; Diabetes Mellitus ; Diagnosis ; Fermentation ; Humans ; Pyelonephritis* ; Tuberculosis, Renal

No abstract available.
Mass Screening* ; Uterine Cervical Neoplasms*

Silicone gel sheets are widely used to treat keloids and hypertrophic scars. Scarclinic(TM) is a type of silicone gel sheet developed in Korea, and has been shown to improve the appearance of scars. However, Scarclinic(TM) has demerits that include weak adhesiveness, a color that differs from skin, and too great a thickness. Scarclinic-thin(TM) was recently developed with these disadvantages in mind. The purpose of this pilot study was to compare the effects of Scarclinic-thin(TM) and Scarclinic(TM) on scar appearance and wearer's comfort. From April 2010 to May 2010, Scarclinic-thin(TM) and Scarclinic(TM) were applied to treat a single scar in each of 8 patients. One half of each scar was treated with Scarclinic-thin(TM) and the other with Scarclinic(TM). After 3 months, scar quality and wearer's comfort were evaluated using the Vancouver Scar Scale(VSS) and an objective self-assessment scale (OSAS). Mean Vancouver Scar Scale scores for Scarclinic(TM) and Scarclinic-thin(TM) at 3 months were 3.4+/-1.3 and 3.3+/-2.0, respectively, and mean objective self-assessment scale scores were 21.7+/-4.5 and 22.3+/-2.9, respectively. No statistically significant difference was observed between Scarclinic(TM) and Scarclinic-thin(TM) in terms of Vancouver Scar Scale or objective self-assessment scale scores(p=0.83 and 0.70, respectively). Scarclinic-thin(TM) and Scarclinic(TM) are similar in terms of their scar improving effects and wearer's comfort.
Adhesiveness ; Cicatrix ; Cicatrix, Hypertrophic ; Humans ; Keloid ; Korea ; Pilot Projects ; Self-Assessment ; Silicone Gels ; Skin

This study was designed to identify doxorubicin as a permanent chemomyectomy agent that overcomes reversible effect of botulinum toxin A. Doxorubicin was assessed for its ability to bring about a permanent chemomyectomy and the effects of pretreatment were observed to assess its ability to prevent any complications brought about by doxorubicin. A total of thirteen rabbits were assigned to the control group(n=3) and two experimental groups(n=5 for each group). To investigate the myopathic changes following the injections of the agent, both orbicularis oculi muscles of the lower eyelids of each rabbit in the control group were directly injected with single dose of 0.2ml normal saline. Group I were injected with 0.5mg/0.2ml of doxorubicin into the right eyelid and 1.0 mg/0.2 ml of doxorubicin into the left. Group II were given an intravenous injection of 35mg/kg of allopurinol as the pretreatment, then 30minutes later injected with 0.5mg/0.2ml of doxorubicin into the right and 1.0mg/ 0.2ml of doxorubicin into the left. The rabbits were examined daily to monitor the onset, duration and size of skin necrosis and histologically examined two and four months after initial injections. The myopathic change after doxorubicin injection was persistent and irreversible. The dose related effects of doxorubicin chemomyectomy were confirmed by the histologic finding. Skin necrosis occurred in all cases of doxorubicin injection(both 0.5mg and 1.0mg), however the allopurinol pretreatment decreased the size of the skin necrosis in case of the high dose(1.0mg) of doxorubicin. The combined use of allopurinol and doxorubicin reduced the myopathic change more effectively than doxorubicin use alone. Further study is needed to determine optimal dose and administration method, which we feel will contribute to safer and permanent chemomyectomy.
Allopurinol* ; Botulinum Toxins ; Doxorubicin* ; Eyelids ; Injections, Intravenous ; Muscles ; Necrosis ; Rabbits ; Skin

Pheochromocytoma is a hazardous and dramatic cause of hypertension. This potentially lethal neoplasm originates in most cases in the adrenal medulla and less frequently in the cells of the extraadrenal paraganglion system which are disseminated along the paravertebral axis from the pelvis to the base of the skull. The organ of Zuckerkandl is paraganglia lying the abdominal aorta with highest incidence in the region of the inferior mesenteric artery and usually degenerate shortly after birth. In the literature, and additional one case of pheochromocytoma arising from the organ of Zuckerkandl associated with intracerebral hemorrhage which was treated recently in the Kyung Hee University Hospital is presented in this report.
Adrenal Medulla ; Aorta, Abdominal ; Axis, Cervical Vertebra ; Cerebral Hemorrhage* ; Deception ; Hypertension ; Incidence ; Mesenteric Artery, Inferior ; Para-Aortic Bodies* ; Parturition ; Pelvis ; Pheochromocytoma* ; Skull