Traumatic atlanto-occipital dislocation is usually fatal. To date, few cases have been reported in the literature because survival after traumatic atlanto-occipital dislocation is extremely rare. We present the case of a 47-year-old man with traumatic atlanto-occipital rotatory posterior dislocation combined with atlanto-axial rotatory subluxation and treated by occipito-cervical fusion using Bohlman's triple wiring technique.
Dislocations* ; Humans ; Middle Aged

Purpose: To evaluate surgical outcome and effectiveness of inferior oblique (IO) myectomy on unilateral superior oblique palsy (SOP) as a primary treatment. Methods: This study is a retrospective review of the medical records of 99 patients who had undergone IO myectomy due to SOP as a first-line treatment. Sixty-five patients with hyperdeviation of 15 prism diopters (PD) or less were categorized into group 1, 22 patients with hyperdeviation between 16 PD to 20 PD into group 2, and 12 patients with hyperdeviation higher than 20 PD into group 3. Preoperative hyperdeviation, postoperative hyperdeviation, and improvement of head tilting were then compared between the 3 groups. Surgery was determined to be successful when the post-op residual hyperdeviation is less than 5 PD, or when the improvement of hyperdeviation and head tilting was noted, for the patients who had preoperative deviation less than 5 PD, and without hypercorrection. Results: All groups showed significant improvement of hyperdeviation, and the amount of correction was larger in group with larger preoperative hyperdeviation. 80.3%, 95.0%, and 90.9% of patients showed improvement of head tiling and success rate was 87.7%, 77.3%, and 50.0% in group 1, 2, and 3 respectively. Group 1 and 2, group 2 and 3 had no significant difference in success rate but only group 1 and 3 had significant difference. Conclusions Considering success rate with improvement of head position, self-titrating and possibility of overcorrection, IO myectomy could be an effective option as a first-line surgical treatment for unilateral SOP with hyperdeviation of 20 PD or less. However, due to a 50% success rate in patients with hyperdeviation larger than 20 PD, a secondary operation must be considered following IO myectomy, or a two-muscle procedure must be considered as a primary treatment.

No abstract available.
Wounds and Injuries

STUDY DESIGN: We retrospectively reviewed nine patients of lumbar extraforaminal disc herniation which underwent conservative or surgical treatment. OBJECTIVES: We evaluated the clinical characteristics, accuracy of diagnostic methods, and result of conservative or surgical treatment for the lumbar extraforaminal disc herniation. SUMMARY OF BACKGROUND DATA: Lumbar extraforaminal disc herniation represents an important component of lumbar disc herniation because of the difficulty in diagnosis and the difference in clinical characteristics and surgical approaches in contrast to usual intracanalicular disc herniation. MATERIALS AND METHODS: Nine patients which we have experienced from March 1994 to February 1997 were evaluated by physical examination, magnetic resonance imaging, EMG, and disco-enhanced computed tomogram. There were 4 males and 5 females, and average age was 42.4 years. RESULTS: The level of herniation was 4 cases at L4-5 and 5 at L5-S1. Radiating pain was chief complaint but low back pain was absent or mild. Accuracy of disco-enhanced computed tomogram was superior to that of magnetic resonance imaging. The results of conservative treatment were good in 2 cases(40%), fair in 2 cases(40%), and poor in 1 case(20%). And those of surgical treatment including partial laminectomy, medial facetectomy, and discectomy or extraforaminal approach were excellent in 3 cases(75%), good in 1 case(25%) according to the grading of MacNab. CONCLUSIONS: Lumbar extraforaminal disc herniation represents compressive symptoms of upper lumbar root of the involved level characteristically. Location and degree of disc herniation is an important tractor for determining the surgical approach, and disco-enhanced computed tomogram is a definite diagnostic method.
Diagnosis* ; Diskectomy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Retrospective Studies

Deposition of monosodium urate crystal in joints and periarticular soft tissue is regarded as one of the characteristics of chronic gouty arthritis. In spine, however, only nineteen cases of tophaceous deposits have been reported to date suggesting the rarity of clinical symptoms secondary to involvement of spine. Authors report a case of spinal stenosis due to hypertrophy of ligament flavum with monosodium urate deposits. The patient was 65 years of age with chronic gouty arthritis who underwent a decompressive laminectomy at L4-5. At surgery, hypertrophied ligament flavum that was covered with chalky amorphous materials was noted without any evidence of radiologic features. Microscopically, a portion of ligament flavum had been focally destoryed by amorphous material deposits that were surrounded by a thin layer of mononuclear and giant cells along with occasional sprinkling of chronic inflammatory cells and negative birefringence on polarizing microscopy.
Arthritis, Gouty ; Birefringence ; Giant Cells ; Humans ; Hypertrophy* ; Joints ; Laminectomy ; Ligaments* ; Microscopy ; Spinal Stenosis* ; Spine ; Uric Acid*

PURPOSE: The aim of this report is to investigate the efficacy of anorganic bovine bone xenograft(Bio-Oss(R) ) at maxillary sinus floor augmentation. MATERIALS AND METHODS: Two male patients who missed maxillary posterior teeth were included. They were performed maxillary sinus floor augmentation using anorganic bovine bone xenograft(Bio-Oss(R) ). After 10 or 13 months, the regenerated tissues were harvested using trephine drills with 2 or 4mm diameter and non-decalcified specimens were made. The specimens were examined histologically and histomorphometrically to investigate graft resorption and new bone formation. RESULTS: Newly formed bone was in contact with Bio-Oss(R) particles directly without any gap between the bone and the particles. The proportions of newly formed bone were 23.4~25.3% in patient 1(Pt.1) and 28.8% in patient 2(Pt.2). And the proportions of remained Bio-Oss(R) were 29.7~30.2% in Pt.1 and 29.2% in Pt.2. The fixtures installed at augmented area showed good stability and the augmented bone height was maintained well. CONCLUSION: Anorganic bovine bone xenograft(Bio-Oss(R) ) has high osteoconductivity and helps new bone formation, so that it can be used in maxillary sinus floor augmentation.
Humans ; Male ; Mandrillus ; Maxillary Sinus ; Osteogenesis ; Sinus Floor Augmentation ; Tooth ; Transplants

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

PURPOSE: This retrospective study was performed to identify the clinical characteristics of influenza B infection and compare to influenza A infection. METHODS: Medical records of patients diagnosed with influenza using a multiplex PCR test, admitted to Seoul St. Mary's Hospital, during the 2011-2012 influenza season were analyzed. Clinical and laboratory characteristics of influenza B patients were investigated and compared with those of influenza A patients. RESULTS: A total of 145 influenza patients were enrolled during this study period. Among these, 66 and 78 patients were diagnosed with influenza A and B, respectively, and 1 patient was diagnosed with co-existing influenza A and B. Cough (88.2%), rhinorrhea (77.1%) and sputum (60.4%) were the most common symptoms among these influenza patients, and most were diagnosed with upper respiratory infection (31.9%) or lower respiratory infection (49.3%). In comparison to influenza A patients, influenza B patients were older (4.7+/-4.1 years vs. 3.3+/-2.5 years, P=0.016), and the number of fever days before hospitalization were longer (3.0 days vs. 2.5 days, P=0.043). While sore throat (10.3% vs. 1.5%, P=0.039) and vomiting (20.5% vs. 6.1%, P=0.012) were more common in influenza B patients than in influenza A patients, other clinical and laboratory characteristics were not significantly different between the two groups. CONCLUSIONS: No significant differences in clinical and laboratory perspectives were manifested in influenza A and B infections. Preventive measures should be emphasized over treatment in influenza B due to prolonged fever duration before admission.
Child ; Cough ; Fever ; Hospitalization ; Humans ; Influenza B virus ; Influenza, Human ; Medical Records ; Multiplex Polymerase Chain Reaction ; Pharyngitis ; Retrospective Studies ; Seasons ; Sputum ; Vomiting

PURPOSE: Following planned posterior continuous curvilinear capsulorrhexis (PCCC) during cataract surgery in adults, we evaluated the clinical effects of visual acuity and prevention of posterior capsule opacity. METHODS: The clinical results were studied retrospectively by comparing 43 eyes of 43 patients who underwent cataract surgery with PCCC (the experimental group) and 46 eyes of 31 patients who underwent cataract surgery without PCCC (the control group). Preoperative and postoperative best corrected visual acuities (BCVAs) of patients were measured. BCVA (using log MAR) and the occurrence of posterior capsule opacity were closely monitored in both groups preoperatively, two months postoperatively, and at each group's final visit (14.6 months postoperatively for the experimental group and 15.7 months for the control group). One-piece plate intraocular lens was used in cataract surgery. RESULTS: Preoperative BCVA was lower in the control group but not significantly. The 2-month mean postoperative BCVA showed improvement in vision in both the control and experimental groups. In both groups, the BCVA was decreased at the final examination compared with the 2-month postoperative BCVA, and significant differences between the two groups were not observed. Under slit lamp examination, anterior hyaloid opacity was observed in 13 of 43 eyes that underwent PCCC. The decrease in BCVA in 13 eyes with anterior hyaloid opacity was significantly different (p < 0.05) compared with the 2-month postoperative BCVA. CONCLUSIONS: Considering the effort and operation skills required for PCCC, the clinical benefits are negligible. Since cataract surgery with PCCC can cause reduced vision due to anterior hyaloid opacity, side effects should be disclosed before PCCC is performed.
Adult* ; Capsulorhexis* ; Cataract ; Humans ; Lenses, Intraocular ; Retrospective Studies ; Slit Lamp ; Vision, Low ; Visual Acuity

Bokbunja (Rubus Coreanus Miquel) is a wild berry to Rosaceae genus of which application areas have been expanded due to many health effects. Bokbunja contains carbohydrates, protein, fats and dietary fibers as major components and various flavonoids such as tannins, volatile components including organic acids, alcohols and hydrocarbons as minor ones. Those active compounds attribute to increase in immune function, antioxidant and anti-inflammatory activity. Recently pure compounds have been isolated from the extracts for the development of medicines. We report here on two cases of acne vulgaris that was successfully treated with Rubus Coreanus Miquel extracts.
Acne Vulgaris ; Alcohols ; Carbohydrates ; Dietary Fiber ; Fats ; Flavonoids ; Fruit ; Hydrocarbons ; Propionibacterium acnes ; Rosacea ; Rosaceae ; Tannins