A complete fracture dislocation at the cervicothoracic junction is rare and accompanied by severe spinal cord injury. This region is difficult to image with plain radiography, and to immobilize with external orthosis due to the biomechanical forces exerted in this transitional portion of the spinal column. We experienced a rare case in 52-year-old male victim of a car accident. He sustained paraplegia, and complained of dyspnea and neck pain of 10 days duration at another hospital. The delayed clinical rediagnosis was a C6 and 7 spinous process fracture and a cervicothoracic fracture dislocation, with complete transection of spinal cord, which was based on a clinical examination, simple radiography, CT and MRI. Skeletal traction was immediately applied, followed by a posterior pedicle screw to stabilize the spine and secure the grafts. Rehabilitation was initiated and the dysphagia and dyspnea, due to aspiration pneumonia, were improved, but no neurologic recovery was made after the 1st postoperative year.
Deglutition Disorders ; Dislocations ; Dyspnea ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck Pain ; Orthotic Devices ; Paraplegia ; Pneumonia, Aspiration ; Radiography ; Rehabilitation ; Spinal Cord ; Spinal Cord Injuries ; Spine ; Traction ; Transplants

No abstract available.
Blood Group Incompatibility* ; Bromelains*

PURPOSE: We report our experience of treatment of peritrochanteric fractures with newly designed proximal femoral nail. MATERIALS AND METHODS: We have studied 24 cases of the peritrochanteric fractures using PFN between Jun. 2001 and Aug. 2002 excluding 3 cases (1 case expired due to ARF and pulmonary complication, 2 cases were loss of follow-up). The mean age was 69.6 years and the mean duration of follow-up was 12 months. RESULTS: The mean medial cortical displacement of postoperative roentgenogram was 4.6mm, the mean anterior cortical displacement of postoperative roentgenogram was 4.1 mm, the mean degree of sliding of lag screw between postoperative and last follow-up roentgenogram was 1.2 mm. Neck-shaft angle was average 3.3degrees varus angulation (from postoperative average 131.1degrees to last follow-up average 127.8degrees). Allowed to begin weight-bearing at 1 week postoperatively, the mean union time was 10 weeks and all cases showed bony union and there were no evidence of delayed union or nonunion. Perioperatve complications were pulmonary embolism, DVT, varus deformity, 2 thigh pains, and so on. CONCLUSION: We obtained satisfactory results in treatment of the femoral trochanteric fractures using PFN in point of early ambulation, excellent union rate and minimal complication.
Congenital Abnormalities ; Early Ambulation ; Femur* ; Follow-Up Studies ; Hip Fractures ; Pulmonary Embolism ; Thigh ; Weight-Bearing

Eosinophilia-myalgia syndrome(EMS) is a systemic illness that occurred as an epidemic by ingestion of over-the counter L-tryptophan preparation in the United States in October 1989. We report a Korean case of EMS not associated with the ingestion of either L-tryptophan or other nutritional supplements such as lysine and niacin.
Eating* ; Eosinophilia-Myalgia Syndrome* ; Lysine ; Niacin ; Tryptophan ; United States

Idiopathic atrophoderma of Pasini and Pierini(IAPP) is an uncommon condition of unknown etiology and typically affects persons in the second and third decades of life. IAPP consists of asymptomatic grey to brown depressed lesions with "cliff drop" borders, which are usually bilateral and located on the trunk. A 40-year-old woman visited our department because of unilateral atrophic lesions on the abdomen, right arm, and posterior aspect of right thigh for 20 years. Laboratory evaluations were normal and histologic examination revealed significantly decreased thickness in dermis. We report an unusual case of idiopathic atrophoderma of Pasini and Pierini presenting unilateral distribution.
Abdomen ; Adult ; Arm ; Dermis ; Female ; Humans ; Thigh

No abstract available.
Cellulitis* ; Klebsiella pneumoniae* ; Klebsiella* ; Leg*

PURPOSE: We describe 2 cases of bilateral acute myopia associated with topiramate, a drug that has recently been prescribed for epilepsy or weight reduction. CASE SUMMARY: A 24-year-old woman and a 25-year-old woman, both previously devoid of ocular problems, visited our hospital with blurry vision after taking topiramate for weight reduction. A thorough medical history review and ocular examinations, including a slit lamp examination, were performed. CONCLUSIONS: Slit-lamp examinations revealed forward displacement of the lens-iris diaphragm, which resulted in myopia and anterior chamber shallowing. Discontinuation of topiramate and the administration of cycloplegic agents successfully resolved the symptoms.
Adult ; Anterior Chamber ; Diaphragm ; Displacement (Psychology) ; Epilepsy ; Female ; Fructose ; Humans ; Myopia ; Vision, Ocular ; Weight Loss ; Young Adult

STUDY DESIGN: Thirty-eight patients with thoracolumbar spinal tuberculosis were evaluated according to the surgical treatment method, either a one or two stage anterior debridement, with anterior or posterior instrumentation, respectively. PURPOSE: The aim of this study was to compare the effects of the one stage anterior debridement, with anterior instrumentation, to the two stage anterior debridement, with posterior instrumentation MATERIALS AND METHODS: Thirty-eight patients, with tuberculous spine, were divided into two groups depending on the surgical method. One group consisted of 21 patients treated with anterior debridement combined with anterior instrumentation, and the other group consisted of 17 patients treated by a two stage operation of anterior debridement combined with posterior instrumentation. The clinical outcomes were evaluated from the hematological laboratory findings, bone union in radiographs, change of kyphotic angle, duration of hospital stay and the medical cost during hospitalization. RESULTS: There were no recurrences of infection in either group and bone union was obtained within 6 months of the operation for all cases in both groups. The preoperative, postoperative and final follow-up kyphotic angle in the two groups were 18/20, 7/9 and 10/11 degrees, respectively. There was no significant difference in the decrease of the kyphotic angle between the two groups (p>0.05). However, group I was superior to group II in relation to the duration of hospital stay and the medical cost. CONCLUSION: We concluded that the one stage operation was the better of the operative methods for the treatment of active tuberculous spondylitis in a thoracolumbar spine.
Debridement* ; Follow-Up Studies ; Hospitalization ; Humans ; Length of Stay ; Recurrence ; Spine ; Spondylitis* ; Tuberculosis, Spinal

Lipoblastoma is a rare benign mesenchymal tumor that exhibits a tendency to invade locally but not to metastasize, and develops from embryonic remnants of white fat tissue. We experienced a case of lipoblastoma occurring in a 7-month-old girl. A small nodule developed on her right inguinal region at the age of 4 months. It had grown to be a 1.2x2.0cm in size, well-defined, volcano-like, ovoid erythematous nodule. Histopathologically it was composed of well-defined lobulated fat tissue with multivacuolated lipoblasts, undifferentiated mesenchymal cells such as stellate or spindle cells and minimal myxoid stroma. Electron microscopic findings demonstrated lipoblasts with eccentric nuclei and coarse chromatins. Complete local excision was done.
Adipose Tissue, White ; Chromatin ; Female ; Humans ; Infant ; Lipoblastoma*

STUDY DESIGN: The analysis was based on the sagittal and coronal correction of 64 cases of thoracic hyphokyphosis that were due to idiopathic scoliosis. PURPOSE: We wanted to compare the three pedicle screws and rod systems (using either a semirigid and rigid rod) from the view points of the coronal and sagittal plane correction during the surgical treatment of idiopathic scoliosis. SUMMARY OF LITERATURE REVIEW: There haven't been any reports that have compared the differences and their significance between the semirigid and rigid rod systems for correcting the thoracic hypokyphosis of idiopathic scoliosis. MATERIALS AND METHODS: After a minimum follow-up of 1 year, the results of the frontal and sagittal correction of each study group were compared. There were a total of 52 females and 12 males. The mean age at the time of surgical intervention was 16.4 (age range: 12~24). CD instrumentation with a rigid stainless steel rod (7 mm in diameter and 1200 N/mm for its stiffness) was used in group I (36 patients), and 4-CI instrumentation with a titanium alloy rod (6.35 mm in diameter and 1200 N/mm for its stiffness) was used in group II (18 patients). Xia instrumentation with a semi-rigid rod (6 mm in diameter and 600 N/mm for its stiffness) was used in group III (10 patients). For all patients undergoing the segmental pedicle screw fixation procedure, pedicle screws were inserted into every vertebra on the concave side, in the end of each vertebra and then alternately in every other vertebra on the convex side. We measured the preoperative and postoperative magnitude of the major and compensatory curves, the thoracic kyphotic angle on the standing radiographs and the flexibility of the curve. We statistically compared the correctability of thoracic kyphotic angle between the rigid and semi-rigid rods. RESULTS: The differences of preoperative and postoperative major curves in groups I, II and III were 47.3 degrees/12.7 degrees, 51.6 degrees/12.3 degrees and 49.6 degrees/13.3 degrees respectively. The thoracic kyphotic angle was 22.6 degrees/26.6 degrees, 22.0 degrees/26.9 degrees and 23.8 degrees/22.8 degrees, respectively. There was no significant difference for the correction of the coronal angle in each group, but groups I and II were superior to group III for the rate of correcting the kyphotic angle. CONCLUSION: The rod should be stiff enough to pull the spine posteromedially when using the derotation technique for the surgical treatment of idiopathic scoliosis.
Alloys ; Female ; Follow-Up Studies ; Humans ; Male ; Pliability ; Scoliosis* ; Spine ; Stainless Steel ; Titanium