A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

No abstract available.
Alexander Disease*

Blink reflex (BR) was known as a useful test fordetection of brainstem lesions and cranial neuropathy. We performed BR test in 52 non-insulin dependent diabetics, and the results were compared with 26 controls. In diabetics, 23 patients (44.2%) had abnormal results with delayed R1 in 20 (38.5%), delayed ipsilateral R2 in 6 (11.5%) and delayed contralateral R2 in 4 (7.7%). BR abnormalities were related to age and presence of peripheral neuropathy, but not related to duration of diabetes and fasting blood sugar level. It is suggested that BR test could be an additional electrodiagnostic tool for the diabetic neuropathy, especially to evaluate a subclinical brainstem or cranial nerve involvement.
Blinking* ; Blood Glucose ; Brain Stem ; Cranial Nerve Diseases ; Cranial Nerves ; Diabetic Neuropathies ; Fasting ; Humans ; Peripheral Nervous System Diseases

The incidence of metastasis to the spinal cord in patients with systemic carcinoma has been extimated to be 0.9 to 8.5%. Attempts to aggressively remove intramedullary spinal cord tumor may cause increased neurologic deficits and a worsend outcome. The authors present the case of a multiple intramedullary meetastatic spinal cord tumor which had metastasized from the lung to the thoracic spinal level. Pathologic diagnosis of the small cell carcinoma was made from the tumor specimen obtained by stereotaxic-guided neddle biopsy after which the patient was treated with radiotherapy and chemotherapy.
Biopsy ; Carcinoma, Small Cell* ; Diagnosis ; Drug Therapy ; Humans ; Incidence ; Lung ; Neoplasm Metastasis ; Neurologic Manifestations ; Radiotherapy ; Spinal Cord ; Spinal Cord Neoplasms

BACKGROUND: This study was conducted to evaluate the surgical outcomes of plate fixation using autologous iliac bone graft shaped in the form of a matchstick in clavicle nonunion resulting from prior surgical or non-surgical management. METHODS: From May 2005 to February 2013, 17 patients underwent surgery for clavicle nonunion. The mean age at the time of surgery was 48.8 years. The iliac bone was harvested and shaped into slivers approximately 3 cm long, which resembled matchsticks. After opening of the medullary canal, the plate and screws were applied and cancellous bone was placed at the nonunion site. Matchstick bone grafts which were longitudinally placed and encircled on the nonunion site were tied with periosteum using 3–4 stitches. Union was determined via postoperative plane X-ray. Clinical status was evaluated using the visual analogue scale score for pain, and Constant and American Shoulder Elbow Surgeon score. RESULTS: All patients had a stable radiological union at the follow-up. The mean duration from index operation to nonunion operation was 13.2 months (7–32 months). The mean follow-up period was 20.1 months (8–56 months), and the mean duration until union was 11.2 weeks (8–16 weeks). All clinical scores were improved at the final follow-up (p<0.001). The mean segmental defect was 3.3 ± 2.6 mm (1–18 mm); and the difference in clavicular length between operative and non-operative site was 5.9 ± 6.9 mm. CONCLUSIONS: Matchstick shaped autologous iliac bone grafting technique in clavicle nonunion is acceptable with a high union rate.
Bone Transplantation ; Clavicle* ; Elbow ; Follow-Up Studies ; Humans ; Periosteum ; Shoulder ; Transplants

This study was performed to observe the effectiveness of thymectomy in the management of myasthenia gravis. Twenty-seven myasthenic patients were undergone thymectomy at Keimyung University Dongsan Hospital between January 1981 and December 1990. The most prevalent age group was the 3rd decade and the myasthenic syrnptom developed below thirty in most. Seven patients had remission and 10 patients fared better after thymectomy. There was no significant effect with age and duration of the disease in the result of thymectomy. Those with less severe group had better response than more severe group and non-thymoma group had higher remission rate without statistical significance than thymoma group. There were better response and more complications in the group with maximal thymectomy than simple thymectomy. This study demonstrated that the effect of thymectomy was better in less severe, nontymoma and maximal thymectomy group in myasthenia gravis.
Humans ; Myasthenia Gravis* ; Thymectomy* ; Thymoma

After subarachnoid hemorrhage, transient hypoglycorrhachia is not unusual but prolonged hypoglycorrhachia has been reported rarely. We report a 67-year-old woman who show prolonged hypoglycorrhachia for more than one month after subarahnoid hemorrhage without evidences of infection and malignancy.
Aged ; Female ; Hemorrhage ; Humans ; Subarachnoid Hemorrhage*

We report a non-obese patient suffering from spastic gait and right leg paresis caused by thoracic spinal cord compression secondary to spinal epidural lipomatosis. Although spinal epidural lipomatosis is most often associated with the administration of exogenous steroid or endogenous Cushing syndrome, obesity also has been reported as a possible cause. However, idiopathic(non-glucocorticoid induced) spinal epidural lipomatosis in non-obese healthy man is an extremely rare disease and dose not have any good explanation for the abnormal fat deposition in spinal epidural space. We recently experienced a patient with idiopathic thoracic epidural lipomatosis in whom MRI and histopathology established the specific diagnosis. With a case report, brief review of the disease including clinical feature, diagnostic procedure and therapeutic considerations is described.
Cushing Syndrome ; Diagnosis ; Epidural Space ; Gait Disorders, Neurologic ; Humans ; Leg ; Lipomatosis* ; Magnetic Resonance Imaging ; Obesity ; Paresis ; Rare Diseases ; Spinal Cord Compression

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections in many communities. MRSA is usually resistant to beta-lactam antibiotics which are commonly used to treat methicillin-susceptible S. aureus (MSSA) infections, and initial discordant therapy for community-acquired (CA)-MRSA infections frequently lead to treatment failure. This study evaluated the clinical characteristics and risk factors associated with CA-MRSA infections among patients admitted to a large urban public hospital. MATERIALS AND METHODS: From January 1st 2001 through December 31st 2004, all patients for whom S. aureus was isolated from clinical specimen cultures within first 72 hours after admission to Gyeongsang National University Hospital were retrospectively analyzed. CA-MRSA isolate was defined as MRSA isolates from patients who had no established risk factors for MRSA infections. Patients with CA-MRSA infections were compared with patients with CA-MSSA infections. RESULTS: During the 4 years of the study, 41 patients with CA-MRSA infection and 102 patients with CA-MSSA infection were included, respectively. In univariate analysis, CA-MRSA infections were more common in such conditions that were the previous isolation of MRSA from 1 year through 3 years before admission (17.5% vs. 1.0%, O.R=21.4, P=0.001), previous hospitalization from 1 year through 3 years before admission (33.3% vs. 10.7%, O.R=4.16, P=0.007), and previous alcohol drinking history (22% vs. 6.9%, O.R=3.81, P=0.017). Bone and joint infections (22.0% vs. 7.8%, O.R=3.30, P=0.025) were more common in CA-MRSA infections than CA-MSSA infections. Multiple logistic regression analysis showed that the previous isolation of MRSA from 1 year through 3 years before admission (OR:6.59 [95% CI, 1.040-41.741]) was the only significant risk factor for CA- MRSA infections. CONCLUSION: The previous isolation of MRSA from 1 year through 3 years before admission was an independent risk factor for CA-MRSA infections.
Alcohol Drinking ; Anti-Bacterial Agents ; Community-Acquired Infections ; Hospitalization ; Hospitals, Public ; Humans ; Joints ; Logistic Models ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Retrospective Studies ; Risk Factors* ; Staphylococcus aureus* ; Staphylococcus* ; Treatment Failure