Thermography is a sensitive and reliable method for diagnosis of radiculopathy. Skin temperature alterations of the involved dermatome named thermatone are diagnostic for sensory root involvement in radiculopathy which can be demonstrated by thermography. Digital infrared thermographic imaging system using computer is development and could measure thermal difference more exactly without hazards or discomforts to patient. Authors present 186 cases of thermographic evaluation in herniated lumbar disc disease by digital infrared thermographic imging system and the results are evaluated with literature review.
Diagnosis ; Humans ; Radiculopathy ; Skin Temperature ; Thermography

BACKGROUND: The risk of bleeding during extracorporeal membrane oxygenation (ECMO) is a potential deterrent in performing tracheostomy at many centers. To evaluate the safety of surgical tracheostomy (ST) in critically ill patients supported by ECMO, we reviewed the clinical correlation between preoperative coagulation status and bleeding complication-related ST during ECMO. METHODS: From April 1, 2012 to March 31, 2016, ST was performed on 38 patients supported by ECMO. We retrospectively reviewed and analyzed the medical records including complications related to ST. RESULTS: Heparin was administered to 23 patients (60.5%) for anticoagulation during ECMO, but 15 patients (39.5%) underwent ECMO without anticoagulation. Of the 23 patients administered anticoagulation therapy, heparin infusion was briefly paused in 13 prior to ST. The median platelet count, international normalized ratio, and activated partial thromboplastin time before ST were 126 ×109/L (range, 46 to 434 ×109/L), 1.2 (range, 1 to 2.3) and 62 seconds (27 to 114.2 seconds), respectively. No peri-procedural clotting complications related to ECMO were observed. Two patients (5.3%) suffering from ST-related major bleeding required surgical hemostasis. Minor bleeding after ST occurred in two cases (5.3%). No significant difference was found according to anticoagulation management (P = 0.723). No fatality was attributable to ST. CONCLUSIONS: The complication rates of ST in the patients supported by ECMO were low. Therefore, ST performed by an experienced operator, and with careful optimization of coagulation status, is a relatively safe procedure; the use of ST with ECMO should thus not be dismissed on account of the potential for bleeding caused by the administration of anticoagulants.
Anticoagulants ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Hemostasis, Surgical ; Heparin ; Humans ; International Normalized Ratio ; Medical Records ; Partial Thromboplastin Time ; Platelet Count ; Retrospective Studies ; Tracheostomy*

We present a case of perforating granuloma annulare which appeared as multiple small papular lesions with central umbilication on the dorsum of both foot and sides of foot, The patient was a 12 year-old female child who had slightly tender lesions of one month's duration. Histologic study showed perforation of the epiderrnis and release of the abnormal necrobiotic material transepiderrnally. The epidermal perforation communicated with area of granuloma annulare in the dermis that consist of necrobiotic collagen surrounded by palisading mononucler phagocytes in the dermis. All the lesions resolved spontaneously with a slight hyperpigmentation in 4 months. She also had erythematous tender nodules, which diagnosed as erythema nodosum, on both shins. The lesions responded to potassium iodide 1.0g for 2 weeks.
Child ; Collagen ; Dermis ; Erythema Nodosum ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Humans ; Hyperpigmentation ; Phagocytes ; Potassium Iodide

Diltiazem(Herben(R)) was orally administered in a daily dose of 180mg over 8 weeks to 15 patients with angina pectoris requiring minimum 5 tablets of nitroglycerin per week. The symptom of angina pectoris was scored according to frequency and character of anginal attacks and the number of nitroglycerin tablets used was recorded during the Diltiazem therapy. We noted significant decrease of the score of anginal attack and the number of nitroglycerin tablets used during the course of Diltiazem therapy. No significant change in blood pressure, heart rate and the product of systolic blood pressure and heart rate was noted during the course of Diltiazem therapy. It is possibel that Diltiazem improved ischemic heart disease by slightly decreasing myocardial oxygen demand and increasing blood flow to the ischemic areas by dilatation of coronary arteries and collateral vessels. There was no abnormal change in laboratory findings during the Diltiazem treatment. These findings suggest that Diltiazem(Herben(R)) is a favorable and safe antianginal agent useful for longterm treatment of anginal pectoris.
Angina Pectoris* ; Blood Pressure ; Coronary Vessels ; Dilatation ; Diltiazem ; Heart Rate ; Humans ; Myocardial Ischemia ; Nitroglycerin ; Oxygen ; Tablets

We report herein a case of pityriasis lichenoides et variloiformis acuta in a 48- year-old man, who has wide spread erythematous macule, papule, vesicle, hemorrhagic vesicle and reddish-brown crust on the neck, trunk, axillae and both extremities. He was treated successfully with tetracycline 2. 0 gm a day for 4 weeks.
Axilla ; Extremities ; Neck ; Pityriasis Lichenoides* ; Pityriasis* ; Tetracycline

Large-cell acanthoma is a generally hyperkeratotic, sharply demarcated patch on sun-exposed skin with the outstanding pathologic feature being composed of large, relatively uniform keratinocytes. We describe a case of large-cell acanthoma that involved the skin of the nasal bridge. Patient was a 56-year-old women with a tannish brown patch, 2 cm in size and of 5 years' duration. Controversial issues about nosologic entity of large cell acanthoma are discussed.
Female ; Humans

Aphakic or pseudophakic glau-oma is known to be at high risk for failure after filtration surgery. The authors retrospectively investigated the results of trabeculectomy in 14 eyes of 14 patients with glaucoma, seven aphakic and seven pseudophakic eyes, which were followed from six months to three years with an average ot 16.5 months. A conventional trabeculectomy without using antifibrotic agents was performed in all the eyes. The site of conjunctival incision was prepared on the virgin area of the conjunctiva; 8 superonasal, 4 inferonasal and 2 inferotemporal approaches. An average postoperative intraocular pressure reduction was 13.4 mmHg. The number of medications decreased in 11 eyes. A spontaneously developed functioning bleb was found in seven eyes. In other four eyes, the filtering bleb was formed with an aid of massage or needling. The remallllllg three eyes did not show a functioning bleb. Postoperative complications included hyphema in 3 eyes, overfiltration in 2 eyes, choroidal detachment in 1 eye, corneal edema in 1 eye and endophthalmitis in 1 eye.
Aphakia* ; Blister ; Choroid ; Conjunctiva ; Corneal Edema ; Endophthalmitis ; Filtering Surgery* ; Glaucoma ; Humans ; Hyphema ; Intraocular Pressure ; Massage ; Postoperative Complications ; Pseudophakia* ; Retrospective Studies ; Trabeculectomy

Spinal fusion has performed for instability and anatomical reconstruction since 1985 by Barthe. Bone grafts and synthetic materials has been used for spinal fusion, but they have several limitations and complications. Recently a new synthetic polymer B.O.P.(Biocompatible Osteoconductive Polymer) was developed and it overcome the limitations of other materials. The B.O.P. showed no foreign body reaction and gave scaffolding for the osteoconduction and osteointegration. Authors operated 35 cases of spinal fusion with B.O.P. and the results and literature reviews were discussed.
Bone Regeneration ; Bone Substitutes ; Foreign-Body Reaction ; Polymers ; Spinal Fusion* ; Transplants

Anterior interbody fusion has used for instability and anatomical reconstruction in various cervical diseases since 1958 by cloward. Bone grafts such as autograft, allograft, xenograft and synthetic materials were utilized in fusion as a graft material. But conventional fusion materials have problems including postoperative morbidity, transmission of diseases, foreign body reaction, collapse, prolongation of operation time. A new synthetic material, Biocompatible Osteoconductive Polymer(B.O.P) is developed and it was useful for cervical anterior interbody fusion as a substitute for other fusion materials.
Allografts ; Autografts ; Foreign-Body Reaction ; Heterografts ; Transplants

Relapsing polychondritis is a rare inflammatory disorder affecting the cartilaginous structures throughout the body. Although there is no pathognomonic laboratory tests, clinical features, when coupled with histopathologic findings, enable one to make a diagnosis of relapsing polychondritis. A 26-year-old man presented with purplish, swollen, and tender auricles and injected eyes. His symptoms had developed eight months ago and fluctuated irrespective of various medications such as corticosteroids and antibiotics. Histopathologic examination revealed loss of basophilic staining of the cartilage with some dissolution of its structures. Treatment was initiated with dapsone, However, the remission was too immediate to be considered as a effect of dapsone.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Basophils ; Cartilage ; Dapsone ; Diagnosis ; Humans ; Polychondritis, Relapsing*