Historically a calibre persistent submucosal artery was most often described in the stomach. However in later years it was also discovered in the duodenum and jejunum. It is an uncommon and important cause of massive gastrointestinal bleeding in which failure of detection and early intervention would lead to death. In this paper we report a 27-year-old man with no significant medical history who presented at the emergency unit for recurrent melaena, haematochezia and hypotension. Initial investigations failed to localize the source of bleeding. Emergency exploratory laporatomy revealed a small jejunal mucosal nodule that was actively spurting blood. Histopathological evaluation identified a calibre persistent submucosal artery.
Arteries ; jejunum ; Gastrointestinal Hemorrhage ; Diameter ; Personal failure

It is a well known fact that obesity is an important cause of cardiovascular disease, emphasized by many studies. Recently, cardiovascular diseaase has been found to correlate not only to the extent of obesity, but also the fat distribution of the individual; especially, focusing on obesity of the abdomen. Unfortunately, the proposed indices for abdominal obesity are numerous, and the results vary according to the index chosen. Three-hundred and twelve bus drivers in November, 1995, were chosen as subjects of this study. The author chose to measure serum lipid levels, fasting blood sugar levels and blood pressure, that are thought to be important risk factors of cardiovascular diseases. Obesity indices were calculated using anthropometric measurements. We were able to evaluate the significance of obesity indices by examining correlations between these indices and the risk factors of cardiovascular disease. The results obtained were as follows: 1. The abdominal obesity indices and risk factors of cardiovascular disease, the levels of total cholesterol in the serum, fasting blood sugar levels, and diastolic blood pressure, increased significantly according to age. 2. There was a significant difference in the abdominal obesity indices according to drinking and smoking habits controlled for age. Among the risk factors of cardiovascular disease, triglyceride and diastolic pressures had significant differences according to the presence or absence of a drinking history controlled for age. 3. Although all obesity indices showed significant correlations, the weakest correlation was between BMI and abdominal diameter index and the strongest correlation was between sagittal diameter and sagittal diameter matched for height. 4. There was a negative correlation between HDL-cholesterol and obesity indices. The weakest correlation was between fasting blood sugar levels and both SD and SDH showed correlations with the risk factors. 5. There was a significant correlation between SD and total cholesterol in the serum and fasting blood sugars controlled for age, drinking, and BMI. 6. After categorizing the subjects into 2 separate age groups at the 40 year mark, in the less than 40 year old age group, controlled for drinking and BMI, the results of comparitive studies have shown correlations between total cholesterol serum levels and waist-hip ratio, conicity-index, and SD. There were correlations between fasting blood sugar levels and SD, ADI, and SDH. There were no correlations between obesity indices and both total cholesterol serum levels and fasting blood sugar levels in the greater than 40 year old age group. There were significant correlations between abdominal obesity indices and total serum cholesterol or fasting blood sugar levels in the less than 40 year old age group, but no correlations in the age group over 40. These correlated factors between abdominal obesity and cardiovascular disease are assumed to exist in Korea as well. Furthermore, in this study a high correlation was found between SD, SDH and the risk factors of cardiovascular disease. Even when controlled for age, drinking, smoking, and BMI, the correlations between risk factors of cardiovascular disease and these indices exist. Therefore, the obesity indices, SD and SDH may prove to be important prognostic indicators or risk factors of cardiovascular disease
Abdomen ; Adult ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Drinking ; Fasting ; Humans ; Korea ; Obesity* ; Obesity, Abdominal* ; Risk Factors* ; Sagittal Abdominal Diameter ; Smoke ; Smoking ; Triglycerides ; Waist-Hip Ratio

BACKGROUND: Lumbar plexus block by posterior approach has been used for thigh and hip surgery and unilateral low back pain and/or low extremity pain control. We measured the needle depth from the skin to the lumbar plexus and its relation with body indices in Korean. METHODS: Forty-eight (male 35, female 13) patients with unilateral low back pain and/or low extremity pain received lumbar plexus block by the posterior approach known as "psoas compartment block". We measured the distance from the skin to the lumbar plexus with the aid of a nerve stimulator and evaluated its relation to body mass indices such as weight, height, abdominal circumference and body mass index (BMI; kg/m2). RESULTS: The distance described above was 7.42 +/- 0.82 cm (range 6.0-9.5 cm) in males and 7.18 +/- 1.24 cm (range 5.3-10.0 cm) in females. Its relation to body weight was greater than with other body indices. The Pearson's coefficient between the distance and body weight was 0.745 in males and 0.842 in females. The predicted distance (cm) was 4.23 + 0.0471 x weight (kg) in males (adjusted R2 = 0.532) and 1.25 + 0.0975 x weight in females (adjusted R2 = 0.682). CONCLUSIONS: Body weight is the most important factor for prediction of the distance from the skin to the lumbar plexus. The distance was about 6-10 cm in korean patients.
Body Mass Index ; Body Weight ; Extremities ; Female ; Hip ; Humans ; Low Back Pain ; Lumbosacral Plexus* ; Male ; Needles* ; Sagittal Abdominal Diameter ; Skin ; Thigh

The purpose of this study is to measure the skin epidural distance(SED) of L3-4 interspace and to correlate SED with the individual constitutional data of patients such as body-weight, height, abdominal circumference and body mass index(BMI; kg/m2). In this study we examined 120 patients (45 men and 75 women) who had no pathological abnormality in L3-4 interspace such as herniated disc, spondylolisthesis and spinal stenosis in MRI study, although majority of patients had pathology below this level. The SED was measured under fluoroscopic guide with loss of resistance technique, and we also measured individual constitutional data of patients. Pearson's correlation analysis of the data showed that there were no correlations of statistical significance between SED and the height, abdominal circumference of the patient (p>0.01). But there were statistically significant correlations between SED and body-weight as well as BMI (p<0.0001). Linear regression analysis of these data showed significant correlations between SED and body weight(male r(2)=0.49, p<0.0001, y=0.37x18.1; female r(2)=0.31, p<0.0001, y=0.18x30.8), BMI(male r(2)=0.52, p<0.0001, y=0.89x23.1; female r(2)=0.35, p<0.0001, y=0.41x31.6).
Epidural Space* ; Female ; Humans ; Intervertebral Disc Displacement ; Linear Models ; Magnetic Resonance Imaging ; Male ; Pathology ; Sagittal Abdominal Diameter ; Skin* ; Spinal Stenosis ; Spondylolisthesis

Colonic pseudo-obstruction (CPO) is defined as marked colonic distension in the absence of mechanical obstruction. We aimed to investigate the clinical characteristics of CPO and the factors associated with the response to medical treatment by using a multicenter database in Korea. CPO was diagnosed as colonic dilatation without mechanical obstruction by using radiologic and/or endoscopic examinations. Acute CPO occurring in the postoperative period in surgical patients or as a response to an acute illness was excluded. CPO cases were identified in 15 tertiary referral hospitals between 2000 and 2011. The patients' data were retrospectively reviewed and analyzed. In total, 104 patients (53 men; mean age at diagnosis, 47 yr) were identified. Seventy-seven of 104 patients (74%) showed a transition zone on abdominal computed tomography. Sixty of 104 patients (58%) showed poor responses to medical treatment and underwent surgery at the mean follow-up of 7.4 months (0.5-61 months). Younger age at the time of diagnosis, abdominal distension as a chief complaint, and greater cecal diameter were independently associated with the poor responses to medical treatment. These may be risk factors for a poor response to medical treatment.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Colon/*pathology/surgery ; Colonic Pseudo-Obstruction/*diagnosis/*pathology/surgery ; Constipation/diagnosis ; Dilatation, Pathologic ; Female ; Humans ; Male ; Middle Aged ; Republic of Korea ; Retrospective Studies ; Sagittal Abdominal Diameter ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult