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.

Injection medialization laryngoplasty is a procedure that has many advantages in treating vocal fold paralysis; however, undesired complications can occur. We experienced a case of a pulmonary embolism, suspected in a patient who had undergone an injection laryngoplasty with calcium hydroxylapatite (CaHA). The patient suffered dyspnea after undergoing the injection laryngoplasty. Chest embolism computed tomography (CT) scan revealed a new lesion of enhancing materials at the pulmonary vasculature in the right upper lobe. The CaHA embolism was suspected, and the patient was treated with warfarin for 12 months. The patient's symptom of dyspnea nearly disappeared and a follow up chest embolism CT scan revealed no signs of the previous lesion. Thus, we would like to report this rare case along with a review of the literature.
Calcium* ; Durapatite* ; Dyspnea ; Embolism ; Follow-Up Studies ; Humans ; Laryngoplasty* ; Paralysis ; Pulmonary Embolism* ; Thorax ; Tomography, X-Ray Computed ; Vocal Cord Paralysis ; Vocal Cords ; Warfarin

BACKGROUND: The number of the elderly living in a home for the aged is increasing as the socio-culture changes, but health management for the institutionalized elderly has been discontinuos, centered on the single treatment of the disease. The aim of this study is to collect baseline data which is for development of the health maintenance program for the elderly living in a house for the aged. METHODS: We reviewed the journals related to the health maintenance program for the elderly. We selected the contents about health management program for the elderly. 3 domain of the contens were done. The 3 domain were physical health (interview for health habit, physical exam, clinical test), mental health (Korean version of geriatric depression scale, Korean version of mini mental status examination), assessment of functional status (katz activities of daily living, lawtons instrumental activities of living).. 158 elderly people living in a home for the aged in Seoul have been researched since August 1996. RESULT: Total subjects were 158 (men 73, women 85). The average age was 78.1(+/-7.2). The rate of smoking, alcohol drinking, exercise were 32%, 20.4%, 34.4%, each. The rate of assitive device use was 28.3%. The prevalence of sleep distur-bance, urinary incontinence were 69.7%, 17.3%. The prevalence of gait disturbance was 38.4%. The occurrence rate of falling for last 1 year was 29.6%. The prevalence of fear of falling was 57.2%. The positive rate of VDRL was 12.3%, the prevalence of anemia was 48.7%. The prevalence of degenerative arthritis, hypertension were 44.2%, 31.3%, each. The prevalence of depression, dementia were 71.3%, 56.7%, each. The rate of elderly person dependent on one and more ADL was 8.1%. CONCLUSION: We found the health status of the elderly living in a home for the aged. On the basis of the results of the study, it is needed that continuous application of the program for management of the elderly in a home for the aged, keeping searching proper contents of examination and methods of measurement.
Activities of Daily Living ; Aged* ; Alcohol Drinking ; Anemia ; Dementia ; Depression ; Female ; Gait ; Humans ; Hypertension ; Mental Health ; Osteoarthritis ; Prevalence ; Seoul ; Smoke ; Smoking ; Urinary Incontinence

We report a case of mycosis fungoides in a 28 year-old female patient who had multiple, bizzare, kidney or annular shaped, erythematous to brownishaly patches and plaques on the trunk, buttock, upper and lower extremities. Histopathologic finclingm showed epidermotropism and Pautrir microabscess in the epidermis and sssatypical lymphocytes infiltration in the dermis. T cell marker in leukocyte common antigen were positively stained in an immunohistochemical study. The skin lesions were reproved markedly after treatment it a total dose of 45 x 10 IU recombinant interferonaiv combination with a total dose of 385 iules/art PUVA.
Adult ; Antigens, CD45 ; Buttocks ; Dermis ; Epidermis ; Female ; Humans ; Interferons* ; Kidney ; Lower Extremity ; Lymphocytes ; Mycosis Fungoides* ; Skin

We are reporting a case of molluscum contagiosum in a 3-year-old boy who showed a good response to diphenylcyclopropenone (DPCP) immunotherapy. The lesions were multiple, 2 to 7mm in size, centrally umbilicated, normal skin-colored papules of 7 months' duration which were distributed on the penoscrotal area, extremities and trunk. In spite of several treatments using extraction and curettage, new lesions developed continuously. The patient was sensitized with 0.1ml of 1% DPCP solution in acetone on his right shoulder and there-after challenged with solution of varying concentrations (0.05 to 0.1%) on his left shoulder once or twice a week to maintain a mild eczema. Clinical improvement was noted 1 week after sensitization and almost all of the lesions cleared after 8 week's treatment.
Acetone ; Child, Preschool ; Curettage ; Eczema ; Extremities ; Humans ; Immunotherapy* ; Male ; Molluscum Contagiosum* ; Shoulder

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

Hypereosinophilic syndrome represents a heterogenous group filisorders with the common features of idiopathic prolonged eosinophilia of undetectable cause and orgar, system dysfunction. We experienced a case af hypereosinophilic syndrome in a 58 year old man who has been suffered from fever, chilling, generelized exfoliative dermatitis, periorbital sngioedema and oral ulcer for 3 weeks duration. The blood eosinophil count was 7436/mm and skin, liver, bone marrow biopsy revealed marked infiltration of eosinophils. We treated him with co ticosteroid, but 5 months later, he died due to hepatoencephalopathy, hepatorenal syndrome, dissernimted intravascular coagulopathy and acute respiratory distress syndrome.
Biopsy ; Bone Marrow ; Dermatitis, Exfoliative ; Eosinophilia ; Eosinophils ; Fever ; Hepatorenal Syndrome ; Humans ; Hypereosinophilic Syndrome* ; Liver ; Middle Aged ; Oral Ulcer ; Respiratory Distress Syndrome, Adult ; Skin

Ambulatory BP monitoring was performed in a patients with pheochromocytoma before and after removal of the tumor. Before surgery, it did not show any significant diurnal variation. But, after surgery the diurnal variation was restored.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Humans ; Pheochromocytoma*