Anomalous development of the odonteid precess is an uncommon clinical occurence that can seriously impair the integrity af the atlantoaxial articulation. Absence of the odontoid process may be either congenital or acquired, but clinically the etiology is of little importance as the clinical signs and symptoms and the treatment are identical in both. We experienced a case of congenital absence of the odontoid process and good result was obtained from the posterior atlantoaxial fusion with hale-cast.
Odontoid Process

Decompression sickness is a disease caused by nitrogen bubbles in the tissues of divers who move too rapidly from environments of higher to those of lower atmospheric pressures. Nitrogen breathed in air under pressure dissolves in tissue fluids. When ambient pressure is reduced too rapidly, nitrogen goes out of solution faster than it can be circulated to the lungs for expiration. Gaseous nitrogen then accumulates in the joint spaces and peripheral circulation, impairing tissue oxygenation. We report a case of patient who experiencedneurogenic bladder and erectile dysfunction after decompression sickness. To our knowledge, this is the first case of neurogenic bladder and erectile dysfunction due to decompression sickness in the Korean literature.
Atmospheric Pressure ; Decompression Sickness* ; Decompression* ; Erectile Dysfunction* ; Humans ; Joints ; Lung ; Male ; Nitrogen ; Oxygen ; Urinary Bladder ; Urinary Bladder, Neurogenic*

A 54-year-old man presented to the emergency department with a chief complaint of suprapubic pain and inability to void for 1 day after self insertion of urethral foreign bodies. These foreign bodies were two beans self inserted compulsively into the urethra by the patient. On physical examination, two materials of oval shape in the bulbous urethra were palpable. Retrograde urethrogram showed a complete obstruction in the bulbous urethra. When possible, endoscopic removal should be used for urethral foreign bodies. However the beans of our case required surgical retrieval. We present a case of foreign bodies in the urethra with brief review of literature. To our knowledge, this is the first case of acute urinary retention due to beans in Korean literature.
Emergency Service, Hospital ; Fabaceae ; Foreign Bodies* ; Humans ; Middle Aged ; Physical Examination ; Urethra ; Urinary Retention*

No abstract available.
Prostate* ; Testis*

No abstract available.
Humans ; Stroke*

Since the first report by Berberich and Hirsch in 1923, conventional angiography had been playing essential roles in diagnosis and treatment in the field of Orthopedic Surgery. Angiography is still the most definitive method for evaluating arterial disease, and is also an invaluable aid in the diagnosis of certain abnormalities which characteristically alter the normal vascular pattern. But the clinical use of conventional angiography as a routine diagnostic study has been limited by the risk associated with arterial catheterization cost, and poor patient acceptance. With improvement of radionuclide angiography and development of the methods for the identification and amplification of signals from small quantities of intravascular administered iodinated contrast agent and their combination with image subtraction (so called digital subtraction angiography, DSA), we have partially substituted the DSA and Radionuclide angiography for conventional angiography in diagnosis and post-operative evaluation of orthopedic patients. We have analyzed and compared the 197 cases who had taken conventional angiography from August, 1981 to July, 1985, and 16 cases who had taken radionuclide angiography from January, 1983 to July, 1985, and 21 cases who had taken DSA from October, 1983 to July, 1985 in Department of Orthopedic Surgery, Seoul National University Hospital. The results were as follow: 1. Conventional angiography is the most reliable and most widely used method in diagnosis of peri pheral arterial disease and evaluating the distribution of peripheral circulation of patient who need arterial reconstruction. But the clinical use of the angiography has been limited by the risk of complications. 2. DSA is simple, relatively non-invasive and can be done in out-patient basis. DSA is particulary useful and can replace the conventional angiography in post-operative assessment of peripheral vascular reconstruction, in the assessment of blunt and penetrating peripheral arterial trauma, and in the evaluation of peripheral aneurysm and vascular malformation. 3. Radionuclide angiography is also simple, and has no morbidity and useful in the patients who may be allergic to the contrast medium. Radionuclide angiography is useful in the evaluation of obstruction of major artery, deep vein thrombosis, and in repeated post-operative evaluation of arterial reconstruction.
Aneurysm ; Angiography ; Angiography, Digital Subtraction ; Arteries ; Catheterization ; Catheters ; Diagnosis ; Extremities ; Humans ; Methods ; Orthopedics ; Outpatients ; Radionuclide Angiography ; Seoul ; Vascular Malformations ; Venous Thrombosis

We report 2 cases of serotonin syndrome with variable symptoms after being treated with antidepressants. A 57-year-old woman developed agitation, diaphoresis, and tremor after combination therapy with fluoxetine and trazodone. The second patient, a 76-year-old female woman, became partially disoriented and developed brief, jerky myoclonus of all extremities after discontinuation of sertraline and consecutive imipramine treatment. These two patients rapidly improved with supportive care. The serotonin syndrome is not always easy to diagnose and sometimes causes a serious and fatal event. For this reason, if possible, the practice of multiple serotonergic drugs should be avoided because of the risk for potential serious pharmacodynamic drug interactions. Clinicians should not view the serotonin syndrome as an idiosyncratic reaction, but rather, as a predictable one with a variability in occurrence and severity among patients. Heightened awareness by clinicians will help to minimize pharmacodynamically mediated interactions that may occur between prescribed drugs and, ideally avoid this syndrome.
Aged ; Antidepressive Agents ; Dihydroergotamine ; Drug Interactions ; Extremities ; Female ; Fluoxetine ; Humans ; Imipramine ; Middle Aged ; Myoclonus ; Serotonin Agents ; Serotonin Syndrome* ; Serotonin* ; Sertraline ; Trazodone ; Tremor

Mitochondrial tRNA(Leu(UUR)) A->G(3243) mutation accounts for 80% of all patients with MELAS(mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes), diabetes mellitus with deafness and progressive external ophthalmoplegia. Optic neuropathy has rarely been reported to be associated with the mutation. We found optic neuropathy in two patients with the mutation. To our knowledge, this is the first case report of optic neuropathy associated with the mutation in Korea.
Acidosis, Lactic ; Deafness ; Diabetes Mellitus ; Humans ; Korea ; Ophthalmoplegia, Chronic Progressive External ; Optic Nerve Diseases*

OBJECTIVE: The purpose of the study is to determine the effectiveness and safety of nicardipine infusion for controlling blood pressure in patients with subarachnoid hemorrhage (SAH). METHODS: We prospectively evaluated 52 patients with SAH and treated with nicardipine infusion for blood pressure control in a 29 months period. The mean blood pressure of pre-injection, bolus injection and continuous injection period were compared. This study evaluated the effectiveness of nicardipine for each Fisher grade, for different dose of continuous nicardipine infusion, and for the subgroups of systolic blood pressure. RESULTS: The blood pressure measurement showed that the mean systolic blood pressure / diastolic blood pressure (SBP/DBP) in continuous injection period (120.9/63.0 mmHg) was significantly lower than pre-injection period (145.6/80.3 mmHg) and bolus injection period (134.2/71.3 mmHg), and these were statistically significant (p < 0.001). In each subgroups of Fisher grade and different dose, SBP/DBP also decreased after the use of nicardipine. These were statistically significant (p < 0.05), but there was no significant difference in effectiveness between subgroups (p > 0.05). Furthermore, controlling blood pressure was more effective when injecting higher dose of nicardipine in higher SBP group rather than injecting lower dose in lower SBP group, and it also was statistically significant (p < 0.05). During the infusion, hypotension and cardiogenic problems were transiently combined in five cases. However, patients recovered without any complications. CONCLUSION: Nicardipine is an effective and safe agent for controlling acutely elevated blood pressure after SAH. A more systemic study with larger patients population will provide significant results and will bring solid evidence on effectiveness of nicardipine in SAH.
Aneurysm ; Blood Pressure ; Humans ; Hypertension ; Hypotension ; Nicardipine ; Prospective Studies ; Subarachnoid Hemorrhage