Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Antifungal Agents ; Aspergillosis* ; Aspergillus ; Biopsy ; Blindness* ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Cranial Nerves ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Headache* ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination ; Optic Nerve ; Orbit ; Sphenoid Sinus* ; Sphenoid Sinusitis

No abstract available.
Carcinoma, Renal Cell* ; Genes, Tumor Suppressor*

BACKGROUND: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results. METHODS: We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up. RESULTS: Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication. CONCLUSIONS: We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.
Ankylosis ; Arm ; Arthroscopy ; Classification ; Follow-Up Studies ; Fracture Fixation ; Glenoid Cavity ; Humans ; Methods ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies ; Scapula

Isolated hypoglossal nerve palsy is a rare clinical condition and it causes deviation of the tongue and dysarthria. A 50-year-old female presented with tongue deviation to the left and mild dysarthria. She had no remarkable past medical history except several recent upper respiratory infections. On examination, the other cranial nerves were intact and she had no focal neurological signs. The findings of MRI and MR angiography were normal. Cerebrospinal fluid analysis revealed only mild elevation of protein. We diagnosed her as suffering with idiopathic isolated hypoglossal nerver palsy and we administered steroid therapy. The dysarthria was improved, but the tongue deviation still remained at 50 days after onset. We report here on a rare case of idiopathic isolated hypoglossal nerve palsy.
Angiography ; Cranial Nerves ; Dysarthria ; Female ; Humans ; Hypoglossal Nerve ; Hypoglossal Nerve Diseases ; Middle Aged ; Paralysis ; Respiratory Tract Infections ; Stress, Psychological ; Tongue

The SGO-T and SGP-T values were studied among 19 non-biliary surgical patients for control and 21 biliary tract surgical patients from Feb. to August 1969 in Chung Nam Medical Centor. The results obtained are as follows: 1. The SGO-T and SGP-T evels in the non-biliary surgical patients was in the normal range during pre-operative and postoperative days. 2. In patients with biliary disease SGO-T and SGP-T level were high beyond normal range on the pre-operative day. On the 1st postoperative day, these values were more elevated about 20 % and 11 %, respectively, but decreased gradually on the second and third postoperative days. 3 In biliary patients, the values were lower than pre-operative level on the 3rd postoperative day. On the other hand, values had not dropped to pre-operative level on the 3rd postoperative day in non-biliary patients.
Alanine Transaminase* ; Biliary Tract ; Hand ; Humans ; Reference Values

No abstract available.
Siderosis

PURPOSE: This study was aimed to investigate the optimum dose of diazepam to reduce the recurrence of febrile seizures and side effects in children with febrile seizures. METHODS: The subjects of this study included 528 children with febrile seizures (3 months-5 years of age) who were admitted to Eulji University Hospital (Daejeon, Korea) from January 2008 to December 2011. The children divided into four groups according to the dose of diazepam; Group I, 121 patients, received no diazepam therapy, group II, 129 patients, received oral diazepam in a single dose of 0.1 mg/kg after the febrile seizures, group III, 127 patients, 0.2 mg/kg, and group IV, 151 patients, 0.3 mg/kg, respectively. RESULTS: Seizures recurred in 6 of 129 children (4.7%) in group II, 1of 127 children (0.8%) in group III, and none of 151 children in group IV recurred. For the 121 untreated patients, febrile seizures recurred in 20 (16.5%) children. This study revealed a significant difference in the rate of recurrence of febrile seizures between children treated with diazepam and those who were not. And the recurrence rate was decreased by the increment of the dosage of diazepam, but there was no significant difference between groups. The side effects were observed in 19.9% of children treated with diazepam, 3.9% in group II, 12.6% in group III, and 39.7% in group IV, The rate of side effect was also increased with the increment of the dosage. CONCLUSION: An oral diazepam therapy will reduce the incidence of recurrent febrile seizures during the same febrile illnesses. We think the optimum dose of diazepam is 0.1 mg/kg or 0.2 mg/kg rather than 0.3 mg/kg. However, the use of oral diazepam after a febrile seizure should be carefully considered with weighing the benefits and potential adverse effects.
Child ; Diazepam ; Humans ; Incidence ; Psychotherapy, Group ; Recurrence ; Seizures ; Seizures, Febrile

We heraby report 10 cases of cardiac arrest associated with general anesthesia at Chungnam Medical Center during the period of Jan. 1967 through June 1972 as follows. (1) Among 10 cases, 3 cases recovered without complications and 7 cases expired. (2) Two pediatric patients showed remarkable recovery with treatment. (3) The expired 7 cases had been in very poor physical condition and recovery from cardiac arrest was delayed. The cause of death in one case was presumed to be air embolism.
Anesthesia, General* ; Cause of Death ; Chungcheongnam-do ; Embolism, Air ; Heart Arrest* ; Humans

There have been several reports of patients with isolated lesions of the cerebellar vermis presenting with clinical features similar to those of peripheral vestibulopathy. We report a case of small, isolated hematoma in the cerebellar vermis in a patient who presented with vertigo, ipsilesional nystagmus, and body lateropulsion to the contralesional side without the usual signs or symptoms of cerebellar dysfunction. Although they present with symptoms that mimic those of peripheral vestibulopathy, and brain computed tomography shows no abnormality, as there may be a small, isolated hematoma or infarction in the cerebellar vermis. Thus, brain magnetic resonance imaging should be performed in elderly patients with vascular risk factors.
Aged ; Brain ; Cerebellar Diseases ; Cerebellar Vermis ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Risk Factors ; Vertigo

Paraplegia resulting from the operative treatment of scoliosis is a serious complication feared most by orthopedic surgerns. Scoliosis Research Society reported the incidence of acute neurological complications resulting from the treatment of scoliosis as 0.72% in 1975. Thus, the importance of the development of some form of adequate practical spinal cord monitoring during major corrective surgery of the spine has become increasingly recognized as the surgery in this area has accelerated. In order to reduce the incidence of such neurological complications, intraoperative spinal cord monitoring has introduced since nineteen seventies. Monitoring of cortical somatosensory evoked potentials (CSEP) were applied in surgery of 31 cases of scoliosis and 4 cases of cervical spine lesions at Department of Orthopedic Surgery at Seoul National University Hospital, from Jan. 1982 to May 1985, and the following results were obtained. 1) Quantitative analysis of CSEP was done in 31 cases of scoliosis as grouping into preincision, preinstrumentation, postinstrumentation and skin closure periods. From preincision period, P1 and N1 latencies prolonged significantly across all periods but not from preinstrumentation period to subsequent periods. P1-N1 amplitude and P2-N2 amplitude were decreased significantly between preincision period and other periods but no significant change was noted from preinstrumentation period to skin closure period. (P<0.05) 2) Abnormal CSEP findings were noted during operations in 4 cases, in which acute neurological complications were prevented with CSEP monitoring. 3) We experienced a case in which CSEP was abolished on the concave side of the curve while CSEP was normal on the convex side, during distraction. So it is considered that the ankle electrode should be placed on the concave side of scoliosis to detect neurological complication. 4) Correctibility of deformity in scoliosis surgery was increased from 44.1% to 51.3% with the use of intraoperative CSEP monitoring without acute meurological complications. 5) CSEP monitoring during spine surgery is an effective method to prevent neurological complication.
Ankle ; Congenital Abnormalities ; Electrodes ; Evoked Potentials, Somatosensory ; Incidence ; Intraoperative Complications ; Methods ; Orthopedics ; Paraplegia ; Scoliosis ; Seoul ; Skin ; Spinal Cord ; Spine