Cervical spine fracture can occur in patients with ankylosing spondylitis (AS) by even a minor trauma, which can lead to serious results. We report on the case of a 52-year-old male patient suffering from AS, who was admitted to our hospital with cardiac arrest due to fracture of the upper cervical spine without other organ injuries. A computed tomographic scan showed a cervical 2-3 level fracture and posterior dislocation of the upper cervical column. The patient was admitted to ICU, but died in hospital on day 3.
Cervical Vertebrae ; Dislocations ; Female ; Heart Arrest ; Humans ; Male ; Middle Aged ; Motor Vehicles* ; Spinal Fractures ; Spine* ; Spondylitis, Ankylosing* ; Whiplash Injuries

No abstract available.
Humans

We report a rare case of multiple intracerebral hemorrhage, subarachnoid hemorrhage, and intraventricular hemorrhage that developed after successful cardiopulmonary resuscitation (CPR). A 66-year-old man underwent CPR for about 10 minutes in his community hospital. At that time, his only sequela was ST depression in leads V3, and V4 with an ECG. There was no definite parenchymal lesion in the brain computed tomography (CT) scan taken in the community hospital, and the patient was transferred to Wonju christian hospital for post-resuscitation management. Upon arrival, echocardiographic findings showed akinesia of the anterior wall and anteroseptal wall together with decreased ejection fraction (34%). A cardiac enzyme assay showed a CK-MB concentration of 19.4 ng/ml and a troponin-I level of 1.66 ng/ml. He was mentally comatose and both pupils were isocoric and reflexive to light. We concluded that the cause of cardiac arrest was acute myocardial infarction (AMI), and the patient was treated with drugs including aspirin, clopidogrel, enoxaparin-sodium (1 mg/kg subcutaneous), and isosorbide dinitrate. At 10 hours after admission, a follow-up ECG showed ST elevation in lead I, aVL and all leads from V1 to V6. Right anisocoria was seen in neurologic examination at that time. A subsequent brain CT revealed multiple intracerebral hemorrhage, subarachnoid hemorrhage into all cisternal spaces, and intraventricular hemorrhage. Clotting evaluations yielded a prothrombin time (PT) of 14.6 sec., partial thromboplastin time (PTT) of 45.3 sec. and an INR of 1.32, and a hemoglobin count of 16.2 g/dL.
Aged ; Anisocoria ; Aspirin ; Brain ; Cardiopulmonary Resuscitation ; Cerebral Hemorrhage ; Coma ; Depression ; Electrocardiography ; Enoxaparin ; Enzyme Assays ; Follow-Up Studies ; Heart Arrest ; Hemoglobins ; Hemorrhage ; Hospitals, Community ; Humans ; International Normalized Ratio ; Intracranial Hemorrhages ; Isosorbide Dinitrate ; Light ; Myocardial Infarction ; Neurologic Examination ; Partial Thromboplastin Time ; Prothrombin Time ; Pupil ; Reflex ; Resuscitation ; Subarachnoid Hemorrhage ; Ticlopidine ; Troponin I

No abstract available.
Erythrocytes*

No abstract available.

No abstract available.
Head* ; Neck*

Colles' fracture is a common injury encountered in emergency departments. Despite the frequent experience of every orthopedic surgeon with Colles' fracture, considerable variation remains in the treatment of fracture of the distal radius. Everyone nearly agress that reduction of the fracture is not difficult, but maintenance of reduction is the problem. Eighty patients with Colles' fracture were treated with closed reduction and percutaneous pinning under the C-arm fields and followed up more than 1 year, from January 1990 to May 1993 at the Department of Orthopedic Surgery, Dae Han Hospital. The results of this study were as follows: 1. The fractures were classified according to the system of Gartland and Werley. Of the 80 cases, 12(5%) were type 1; 25(31%) type 2; and 43(54%) type 3. 2. Complications were such as; temporary neuropathy of median nerve 2 cases, redisplacement 2 cases, radiocarpal arthritis 1 cases, stiff hand 1 case and shoulder hand syndrome 1 case. 3. The overall assessment showed exellent in 29 patients(36.2%), good in 44 patients(55,0%) and poor in 7 patients(8.8%) under the subjective and objective criteria of Gartland and Werley and the objective criteia of Scheck. 4. The results were mainly correlated with maintenance of an anatomical reduction. 5. The percutaneous pinning was suitable for anatomical restoration and maintence, had less com plication and more advantage such as the early range of joint and simple technique. Conclusively, it was considered to be one of ideal method for the treatment of Colles' fracture in selected cases.
Arthritis ; Colles' Fracture ; Emergency Service, Hospital ; Hand ; Humans ; Joints ; Median Nerve ; Methods ; Orthopedics ; Osteotomy ; Radius ; Reflex Sympathetic Dystrophy

Open discectomy is one of usual treatment for herniated intervertebral disc. We may expect the reduction of height of intervertebral disc due to decreased volume by partial resection of herniated disc. But the effect of decreased height of intervertebral disc space to posterior joint and spinal canal has not been identified, and the correlation between the amount of reduced height and the changes of range of motion has been undetermined. Thus, we analyzed radiologic changes of disc height and segmental motion by the flexion-extension view in 20 patients who had undergone discetomy for prolapsed intervertebral disc from June 1989 to January 1991 who could be followed up for 3 years or more. As a result, lumbar discetomy associates with 1) significant decrement of disc height (average 14%), 2) decreased disc motion of involved segment without hypermobility (average 34%), 3) hypermobility of adjacent segment, 4) and posterior facet overriding consistent with recurred low back pain.
Diskectomy ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Joints ; Low Back Pain ; Range of Motion, Articular ; Spinal Canal

We report a case of an erythrodermic form of mycosis fungoides in a 68-year-old male, who showed generalized erythroderma with scales for 3 months. Lymphadenopathies in the inguinal and neck areas were present. Histopathological findings showed epidermotropism, perivascular atypical lymphocyte infilteration in the upper dermis, and dermatopathic lymphadenopathy in the inguinal lymph node. T cell markers were positively stained in the immunohistochemical study. These clinicopathological features were consistent with an erythrodermic form of mycosis fungoides(TNM IIl). The patient was treated with PUVA therapy and low dose chemotherapy.
Aged ; Dermatitis, Exfoliative ; Dermis ; Drug Therapy ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Male ; Mycosis Fungoides* ; Neck ; PUVA Therapy ; Weights and Measures

A fenestration of the vertebral artery is considered to be an unusual vascular variation that is defined as a bypass artery along the extracranial or at intracranial segment of the artery. A fenestration of the vertebral artery associated with an arteriovenous malformation at the cerebellopontine angle is extremely rare. We report a case of the ruptured arteriovenous malformation with a fenestration of vertebral artery. The embryologic genesis and clinical significance of a fenestration of the vertebral artery are discussed.
Arteries ; Arteriovenous Malformations* ; Cerebellopontine Angle* ; Vertebral Artery*