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

The bone marrow biopsy is an integral part of the staging process in patients with malignant lymphomas. Bone marrow(BM) involvement indicates stage IV disease, but there are always a lot of cases in which clear separation is not possible when based on morphology alone. Additional difficulties are caused by morphologic discordance between the BM and the primary lymphoma. Immunohistochemical stain, mRNA in situ hybridization (ISH) for light chain restriction and polymerase chain reaction (PCR) for IgH CDR3 and TCRgamma were performed to find a minimal lesion and the clonality in formalin fixed paraffin embedded tissues of 39 primary lymphomas and corresponding BM biopsy specimens. As a result, nine morphologically negative bone marrows of 18 lymphomas were positive by PCR (Group I). Among the 6 lymphoma cases with morphologically suspicious BM involvement (Group II), one was confirmed to be positive for marrow involvement by both mRNA ISH and PCR and the other four by PCR alone. The positive bone marrows of Group I and II revealed gene rearrangement at the same site as the primary lesion, suggesting the same clonality. Thirteen of 15 lymphomas with morphologically positive BM (Group III) had the same clonality in the primary lymphomas and the BM lesion. Three cases among the Group III with morphologic discordance also revealed the same clonality by PCR. This study shows that a combination of mRNA ISH and PCR in addition to an immunohistochemical stain improves the diagnostic sensitivity in the detection of BM involvement and identification of clonality. Among the three different methods used, PCR is the most sensitive in detecting a minimal lesion.
Biopsy ; Bone Marrow ; Formaldehyde ; Gene Rearrangement ; Humans ; In Situ Hybridization ; Lymphoma* ; Paraffin ; Polymerase Chain Reaction ; RNA, Messenger

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

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

No abstract available.
Hyoid Bone* ; Mandibular Fractures* ; Masks*