The occurrence of fistulous tract between the thoracic subarachnoid space and the pleural cavity due to injury is uncommon. The one was developed after traffic accident and treated by surgical repair of the fistula : The other was post-operative complication of costotransversectomy for T2 sympathectomy. The complication was realized by the surgeon who was aware of the small leakage of cerebrospinal fluid from the dura propria of the T2 nerve root at the time of surgery. Intermittent pleural punctures for drainage and semisitting position were followed by spontaneous closure of the fistula. These cases were reported so that the uncommon condition might be added to the differential diagnosis of pleural effusion.
Accidents, Traffic ; Cerebrospinal Fluid ; Diagnosis, Differential ; Drainage ; Fistula* ; Pleural Cavity ; Pleural Effusion ; Punctures ; Subarachnoid Space ; Sympathectomy

BACKGROUND AND OBJECTIVES: Ischemic preconditioning (IP) has been shown to reduce the infarct size and severity of arrhythmia in a post-ischemic reperfused heart. Angina before myocardial infarction reflects brief episodes of myocardial ischemia and may be a marker of ischemic preconditioning. We studied the effect of a history of previous angina on early outcomes (infarct size, left ventricular (LV) function and residual myocardial ischemia) for patients with acute myocardial infarction (AMI) after thrombolytic therapy. MATERIALS AND METHOD: We examined prospectively 58 consecutive patients who had AMI and arrived hospital within 6 hours after chest pain developed. IP was defined as prodromal angina within 24 hours before myocardial infarction. Patients were divided 2 groups:Group I (Gr I, 30 cases) without IP, Group II (Gr II, 28 cases) with IP. Thrombolytic therapy was done 23 cases (77%) and 21 cases (75%) respectively in each groups. Thereafter, electrocardiographic findings, infarct size on the basis of peak creatine kinase, LV function on the 2-D echocardiographic findings, recurrent myocardial ischemia were examined between 2 groups. RESULTS: In predischarge 2-D echocardio-graphic findings, LV dilatation and normal regional wall motion did not differ between two groups. But, there were significantly smaller creatine kinase (CK)-determined infarct size in Gr II than that in Gr I (peak CK level, Gr I:1566.3+/-960.0 IU/L vs Gr II:1066.9+/-773.2; p<0.05). The time interval between the onset of infarction and peak CK level was shorter in Gr II than that in Gr I (Gr I:18.3+/-8.3 vs Gr II:10.7+/-3.4 hours; p<0.001). There were significantly more common incidences of residual myocardial ischemia in Gr II (Gr I:26.7% vs Gr II:60.7%; p<0.01). CONCLUSION: Patients with a history of prodromal angina preceding myocardial infarction had small infarct size and earlier reperfusion of infarct related artery. However, there were significantly more common residual myocardial ischemia in these patients and a trend toward re-infarction on same previous infarction sites.
Angina Pectoris* ; Arrhythmias, Cardiac ; Arteries ; Chest Pain ; Creatine Kinase ; Dilatation ; Echocardiography ; Electrocardiography ; Heart ; Humans ; Incidence ; Infarction ; Ischemic Preconditioning* ; Myocardial Infarction* ; Myocardial Ischemia ; Prospective Studies ; Reperfusion ; Thrombolytic Therapy

Two cases of xeroderma pigmentosum in brothers without complicated by malignant changes were presented. The clinical and histopathological studies revealed characteristic features of the disease and literatures reviewed.
Humans ; Ichthyosis* ; Siblings* ; Xeroderma Pigmentosum*

Two cases of xeroderma pigmentosum in brothers without complicated by malignant changes were presented. The clinical and histopathological studies revealed characteristic features of the disease and literatures reviewed.
Humans ; Ichthyosis* ; Siblings* ; Xeroderma Pigmentosum*

A case of Lichen planus in 41 year old with predisposing emotional factor is reported here and reviewed therapeutic experiences and reveiwed of literatures. This patient who has been suffering from pruritic, dull erythematous maculo-papular eruptions of trunk and extremites which was preoccupied with imagination as if she were exposed sequela to atomic bomb explosion in Japan, World War II, is presented.
Adult ; Explosions ; Fibrinogen ; Humans ; Imagination ; Japan ; Lichen Planus* ; Lichens* ; Nuclear Weapons ; World War II

Late aseptic loosening of the acetabular component following total hip arthroplasty become increasing frequently after about 10 years and has become a more severe problem both in frequency and severity than femoral component loosening. The complexity of acetabular revision depends largely on the reconstruction required to restore normal anatomy due to acetabular bone loss. The clinical and radiologic results of acetabular revision using a porocoated acetabular component fixed to the pelvis with screws were studied in 36 patients (40 hips) who had moderate or severe acetabular loss. Acetabular revision in patients whose bone stock had already been destroyed provied more formidable problems at revision surgery. The mean Harris hip score was improved 46 to 84. Bone graft union was achieved by 7.4 months and incorporated by 16 months. The graft bone resorption was noted minor degree lateral to the cup. Of 40 cases, 2 cases required re-revision of acetabular cup for identifiable failure of fixation and one was showed probable loosening. The results of the present study suggest that revision of the acetabulum with use of a hemispherical cementless component stabilized with multiple screws and morselized bone grafts filling bone defects appears to be successful in restoring bone stock and providing a stable, pain-free reconstruction.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Bone Resorption ; Hip ; Humans ; Pelvis ; Transplants

No abstract available.
Knee Joint* ; Knee*

Recurrent episode of meningitis in infants and children frequently constitute a frustrating and distressing, both in determination of course and treatment. The authors are reporting a infected case of congenital dermal sinus with dermoid cyst in the subarachnoid space of cauda equina and conus medullaris which was cured after complete removal of cyst and sinus tract.
Cauda Equina ; Child ; Conus Snail ; Dermoid Cyst ; Humans ; Infant ; Meningitis ; Spina Bifida Occulta* ; Subarachnoid Space

No abstract available.
Acoustics*

There was a development of the diagnostic aids such as electromyography, discography, epidural venography, myelography, and CT in lumbar disc herniation. In 1984, Edgardo et al. described that the diagnosis of unusual extreme lateral disc herniation might be suggested by CT, but the diagnosis was made more certain with CT done after discography. Also, in 1986, Michael et al. reported,that the addition of CT to lumbar discography could help the clinician to obtain an anatomically valid diagnosis in people who, in spite of prior negative diagnosis evaluation, continue with significant clinical symptoms of low back pain and sciatica. The authors have studied 25 cases of CT after discography from July 1984 to June 1987. The results were as follows;1) CT after discography, which was a diagnostic method of direct visualization of nucleus pulposus herniation, shown same finding as previous CT in 16 cases and more accurate finding of herniated site snd size in 2 cases. 2) In one csse, the diagnosis of extreme lateral disc herniation, which was suggested by previous CT, made more certain with CT after discography. 3) There was false negative in 6 cases.
Diagnosis ; Electromyography ; Low Back Pain ; Methods ; Myelography ; Phlebography ; Sciatica