Optic ataxia is characterized by an impaired visual control of the direction of arm reaching to a visual target, accompanied by defective hand orientation and grip formation. In humans, optic ataxia is associated with lesions of the superior parietal lobule, which also affect visually guided saccades and other forms of eye-hand coordination. A 67-year-old woman presented with sudden, unilateral, direct optic ataxia in the right homonymous half field and saccadic abnormalities which consisted of prolonged latency, undershoot dysmetria, and decreased velocity. Brain MRI showed a left parieto-occipital watershed infarction. It is suggested that lesions of the superior parietal lobule and the adjacent parietal eye field are responsible for optic ataxia and saccadic abnormalities, respectively.
Aged ; Arm ; Ataxia* ; Brain ; Cerebellar Ataxia ; Female ; Hand ; Hand Strength ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Rabeprazole ; Saccades

No abstract available.
Molecular Biology* ; Shigella*

No abstract available.
Appendicitis*

No abstract available.
Intestinal Mucosa* ; Macrophages* ; Salmonella typhimurium* ; Salmonella*

Fractures about the knee including the distal femur and the proximal tibia not infrequently result in vaseular injuries of the popliteal artery and the distal part of the femoral artery. This is often followed by circulatory disturbance and jeopadizes the viability of the lower extremity. During the three and a half year period, from January 1973 to June 1976, 20 cases of vascular injuries complicated by fractures about the knee were treated at the Orthopedic Department of Busan National University Hospital. Review of the cases resulted in the following observations. 1. The lower extremity escaped amputation in 45% the cases (9 of the 20 cases) 2. Femoral arteriography showed that the site of injury was proximal to the Soleus insertion. in 17 cases. 3. Types of vascular injury were contusion in 9 cases, laceration in 7 and total disruption in 4. 4. 5 of the 6 extremities that were treated within 12 hours after injury survived, while only 2 out of t he 9 extremities treated after 24 hours following injury escaped amputation. 5. 6 of the 13 extermities (46%) tredted by interval fixation survived, while 1 out of 5 extremities (20%) treated by traction escaped amputation.
Amputation ; Angiography ; Busan ; Contusions ; Extremities ; Femoral Artery ; Femur ; Knee ; Lacerations ; Lower Extremity ; Orthopedics ; Popliteal Artery ; Tibia ; Traction ; United Nations ; Vascular System Injuries

The instability of the degenerative spondylolisthetic lumbar spine was clinically evaluated by patients symptoms and serial radiograms. With X-ray films of patients lumbar spine, the lumbosacral angle, the sacral angle, the vertebral height difference between anterior and posterior surface of the 5th lumbar vertebra and the level of intercristal line were analysed. And the results of treatment were analysed too. The Results were as follows: 1) In degenerative spondylolisthetic L3 and L4 spines, facets were arranged in sagittal plane and sacrum was vertically arranged, but in L5 facets were coronally arranged and sacrum and in horizontal plane. 2) The lumbosacral angle was 149.9 and the average difference between anterior and posterior height of L5 vertebral body was 3mm. These results revealed that sacrum was more vertical and the 5th vertebral body was more rectangular, so lumbar lordosis was decreased as a whole. 3) The intercristal line was passed at IA or L4–5 interspace in 72.1% of cases(normal:95.8%), so L4 vertebra was placed in higher level. 4) In group A posterolateral fusion was done in 2 cases. Among group B and C, operation was done in 9 cases;4 cases with laminectomy and 5 cases with laminectomy and posterolateral fusion. Two years after surgery, slipping and instability were far advanced in 2 laminectomized cases for whom posterolateral fusion was followed later. 5) Unstable group of degenerative spondylolisthesis with severe neurological symptoms and claudication must be treated by decompressive laminectomy and posterolateral fusion, especially in patients under 60 years of age. 6) Young woman having flattened lumbar curve without slipping, narrowed disc space of L4–5, high-seated L4 and vertical sacrum is thought to be in prespondylolisthetic stage of degenerative origin; therefore, intensive back muscle exercise to prevent the slipping should be performed and periodic X-ray examinations should be followed up to detect the progress of the disease.
Animals ; Back Muscles ; Female ; Humans ; Laminectomy ; Lordosis ; Sacrum ; Spine ; Spondylolisthesis ; X-Ray Film

Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So compliactions of the supracondyle fractures 'including joint.. stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed. 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989. Dec. To 1992. Jan. The results were as follows 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification, 4 cases were type A, 4 in type B, 12 in type C (10 in type C2&C3). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in consevative treatment and 67 in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.
Accidents, Traffic ; Classification ; Femoral Artery ; Femur* ; Fractures, Open ; Humans ; Joints ; Knee ; Male ; Weight-Bearing

Acute airway obstruction during endotracheal anesthesia is embarrassing and critical situation which requires early diagnosis and immediate management. The authors experienced extremely high inspiratory resistance and declared expiration time during endotracheal anesthesia for right pneumonectemy of lung cancer in the left decubitus position. A foreign material was suspected to be dislodged in the trachea distal to the endotrac-heal tube. But the surgical procedure did not allow to change the tube for examination. Ventilation was managed by rotating and moving the endotracheal tube frequently. After extubation, the patient expectorated a polypoid mass and the cause of the obstru-ction was proved to be a result of the detached and dislodged tumor mass of the lung, in diameter 3X1.5 cm.
Airway Obstruction ; Anesthesia ; Early Diagnosis ; Humans ; Lung ; Lung Neoplasms ; Trachea ; Ventilation

Primary irritant dermatitis is one of the most common skin disease caused by various hazardous chemicals produced from the environment. For the detection of skin irritant potency, in vivo models such as human and animal patch test have been used, Keratinocyte culture method which has been set up very recently is another alternative in vivo method of detecting skin irritarlcy. LVe have investigated the effects of three skin irritants, phenol, benzoyl peroxide (BP), and sodium lauryl sulfate(SLS) on the keratinocyte culture system. Prostaglandin E(PGE) measurement, cell count and electron microscopic observation were performed after adding three irritants of different concentrations to the cultured keranocyte cells. The main results of this study were as follows : 1. There were statistically significant decreased cell number in concentration of 10 M phenol, 10 4M BP and SLS. The order of cytotoxic potency was SLS>BP >phenol. 2. In case of PGE production, decreased PGE production was observed 6 hours after addition of the irritants, except 10 M phenol and 10M BP groups. Decrea sing tendency sustained until 24 hours, however all were statistically nonsignificant comparing with control group. 3. Electron microscopic finding showed that dilatation of endoplasmic reticulums in 10 M phenol group, condensation and dilatation of mitochondrias in 10 4M BP group, and most of the cells were swollen in 10 4M SLS group. These results suggest that cell count is a useful model for performing cytotoxi city test in keratinocyte culture decreased PGE production represents cytotoxic effect in high concentration of primary irritants and ultrastructural changes may reflect the different pathomechanisms in cytotoxicity.
Animals ; Benzoyl Peroxide ; Cell Count ; Dermatitis, Irritant ; Dilatation ; Dinoprostone ; Endoplasmic Reticulum ; Hazardous Substances ; Humans* ; Irritants* ; Keratinocytes* ; Mitochondria ; Patch Tests ; Phenol ; Prostaglandins E ; Skin ; Skin Diseases ; Sodium

OBJECTIVES: The purpose of this study was to assess the clinical features, microbiologic results, and the efficacy of perineal hygienic care of pediatric vulvovaginitis. METHODS: Forty-two unselected premenarcheal patients with symptoms or signs of vulvovaginitis who were attended the outpatient pediatric and adolescent gynecology clinic at Pundang CHA General Hospital from August 1997, to September 1999 were systematically interviewed and examined using a standardized format, studied microbiologically, and followed the efficacy of perineal hygienic measures prospectively. RESULTS: The median age of the patients was 4.8 years (range 2.9 years to 10.9 years). Vaginal complaints of 42 patients were discharge(79%), genital pain or irritation(31%), odor(17%), pruritus(14%), and vaginal bleeding(7%). On physical examination, vaginal discharge and vulvar erythema were noted in 17(40%) and 22(52%) patients, respectively. Aerobic bacteria or yeast excluding vaginal normal flora were found in 24 of 42 patients(57%). Convincing evidence of specific pathogens was found in 9 of 42 patients(21%) including one case of pinworm infestation. Isolated pathogens were H. influenza(3), S. pyogenes(2), K. pneumonia(2) and N. gonorrhea(1). No patients were found to have chlamydial infection or trichomoniasis. In 14 patients, risk factors were identified such as swimming(14%), bubble bath(5%), sexual abuse(5%), genital trauma(5%) and foreign body(2%). After two weeks instructions of perineal hygienic care, 26(62%) of 42 patients revealed complete resolution of symptoms and signs of vaginitis without antibiotics. Efficacies of perineal hygienic care were 94%(17/18) in the patients with normal flora alone, 60%(9/15) in the patients with organisms suspected for nonspecific infection and 0%(0/9) in the patients with specific pathogens(p<0.05). CONCLUSION: Majority(62%) of the pediatric patients with symptoms or signs of vulvovaginitis were cured with perineal hygienic care alone. And the efficacy of hygienic measure were higher in the patients without specific pathogens(79%, 26/33). Therefore, proper physical examination, microbiologic study and appropriate instructions of perineal hygienic care were more important than empirical antibiotic treatment in initial management of pediatric vulvovaginitis.
Adolescent ; Anti-Bacterial Agents ; Bacteria, Aerobic ; Enterobius ; Erythema ; Gynecology ; Hospitals, General ; Humans ; Outpatients ; Physical Examination ; Prospective Studies ; Risk Factors ; Vaginal Discharge ; Vaginitis ; Vulvovaginitis* ; Yeasts