No abstract available.
Colon, Descending* ; Leiomyosarcoma*

As a adjuvant, 99m Tc-IDA complex cholescintigraphy has been used to differentiate the causes of jaundice,hepatocellular jaundice from the obstructive jaundice. So we conducted the retrospective study from the 41 casesof cholescintigraphy from the Mar, 83 to Sept. 84 at the Dept. of radiology in the Sonnchyunhyang university todetermine the etiology and differential points in the diagnosing the Jaundice. The following results wereobtainend; 1. As a 1st-ordered parameter, the leading edge hepatic parenchymal transit time was very significant in differentiating the causes of jaundice, among the hepatocellular jaundice, obstructive jaundice due to tumor,and obstructive jaundice due to cholelithiasis. (P<0.01 by X2-test) 2. As a 2nd-ordered parameter, hepaticclearance was very significant in differentiating the hepatocellular jaundice from the jaundice due to partialbiliary obstruction. (P>0.01 by t-test) 3. The difference in hepatic clearance between the biliary obstruction dueto tumor and that of the cholelithiasis, was not significant. (P>0.05 by X2-test) 4. The difference in bile ductdilatation among the hepatocellular jaundice obstructive jaundice due to tumor, and obstructive jaundice due tocholelithiasis, was singnificant in differentiating the causes of jaundice. (P<0.05 by X2-test) 5. Intrahepaticstone showed scintigraphic pooling with partial stasis. 6. Cholescintigraphy was useful to differentiated the Rotor's syndrome from the Dubin-Johnson syndrome, supplying the additional criteria.
Bile ; Cholelithiasis ; Jaundice ; Jaundice, Chronic Idiopathic ; Jaundice, Obstructive ; Retrospective Studies

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.
Acetazolamide* ; Arteriovenous Malformations* ; Brain* ; Humans ; Perfusion* ; Prognosis* ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Wandering Spleen*

No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

Although tumor necrosis factor (TNF)-alpha antagonist is a successful treatment modality for various autoimmune diseases, including rheumatoid arthritis (RA), ankylosing spondylitis and psoriatic arthritis, many adverse effects have been reported. Cutaneous adverse reactions of TNF-alpha antagonist include skin rash, urticaria, lupus like rash, seborrheic dermatitis and different kinds of psoriasiform dermatitis. We report a case of psoriasiform dermatitis during TNF-alpha antagonist treatment in a 50-year-old woman with RA. The patient has been treated with adalimumab. After 2 months, she developed pruritic erythematous eruption and desquamative lesions on the head and limbs, which were defined as psoriasiform change by a skin biopsy. These skin lesions are successfully treated with combination therapy, including cessation of adalimumab, corticosteroid and phototherapy.
Antibodies, Monoclonal, Humanized ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Biopsy ; Dermatitis ; Dermatitis, Seborrheic ; Exanthema ; Extremities ; Female ; Head ; Humans ; Middle Aged ; Phototherapy ; Skin ; Tumor Necrosis Factor-alpha ; Urticaria ; Adalimumab

BACKGROUND/AIMS: It have been reported that operative mortality and morbidity rate rise significantly when emergency cholecystectomy is performed in critically ill patients with acute cholecystitis(AC), and many studies have also concluded that delayed or interval laparoscopic cholecystectomy(LC) in patients with AC demonstrated high conversion rate and complication rate compared with early LC. However, if the acutely inflamed gallbladder(GB) is decompressed by emergent percutaneous gallbladder drainage(PGBD), it may decrease the technical difficulty of LC allowing successful delayed LC or may decrease the wound complication of delayed open cholecystectomy, when the patient is in better condition. The purpose of this retrospective study was to assess the outcome of delayed cholecystectomy focused on LC following PGBD in patients with AC METHODS: A total of 181 patients with AC were divided into PGBD(n= 66) and non-PGBD group(n= 115), and each group were subdivided into PGBD-delayed LC(after 72 hours of admission, n= 32), PGBD-open cholecystectomy(n= 20), non-PGBD-early LC(within 72 hours of admission, n= 40), non- PGBD-delayed LC(n= 17), non PGBD-open cholecystectomy group(n= 58) and others. PGBD group had higher incidence of comorbidity compared with non-PGBD group. Outcomes of cholecystectomy was assessed by conversion rate and morbidity rate(chi2 test), LC time and hospital stay(median test) for LC, and morbidity for open cholecystectomy in PGBD group compared with those of non PGBD group. RESULTS: PGBD promptly relieved of symptom of AC in 94 % of patients and showed 3 % of technical failure and 4.5 % of complication rate. Compared with non PGBD-early and delayed LC group, the PGBD-delayed LC group showed longer LC time(median 110 min vs 82.5, p < 0.05, vs 95 min), a little lower conversion rate(12.5 % vs 22.5 % vs 17.6 %), similar morbidity rate(19% vs 17.5 % vs 29 %) and prolonged total hospital stay(median 12.5 days vs 7 days, p < 0.001, vs 10 days). In open cholecystectomy series, PGBD group showed lower morbidity rate compared with non PGBD group(5% vs 24 %, p < 0.05) CONCLUSION: Unlike to open cholecystectomy series, PGBD did not significantly improve the outcome of LC for AC as assessed by conversion and morbidity rate and hospital stay compared with non PGBD. Thus we can conclude that although PGBD is a safe and effective emergency procedure for AC, it should be limited to higher risk group such as elderly or critically ill patients and to acalculous cholecystitis.
Acalculous Cholecystitis ; Aged ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute* ; Comorbidity ; Critical Illness ; Drainage* ; Emergencies ; Gallbladder* ; Humans ; Incidence ; Length of Stay ; Mortality ; Retrospective Studies ; Wounds and Injuries

The restoration of the fingernail is not simple in case of amputated distal fingertip which involved the pulp and nail. The nail should maintain a length of at least 2mm from the eponychium for an adequate grip and decent appearance. Various methods to reconstruct the fingernail bed are available. The nail bed graft from amputated finger or great toe, and free onychocutaneous flap are commonly used. The nail bed of the injured tip tends to be atrophied, deformed and failed as a graft. And the great toe is often turned down as a donor. We have restored satisfactorily the nail beds of three injured finger tips with eponychial cutaneous flaps. The pulps were reconstructed with either a reverse dorsal digital island flap or free pulp graft. Repeated again. A mean follow- up was six months. The nail grew up to the average of 3.7mm. All patients were satisfied with the length of the nail and met with good cosmetic results. An eponychial cutaneous flap is useful to restore the nail of the distal fingertip amputation. The procedure is relatively simple and morbidity is minimum.
Amputation ; Fingers ; Hand Strength ; Humans ; Nails ; Tissue Donors ; Toes ; Transplants

OBJECTIVES: To determine the utilization of oral health services in community health centers in Korea. METHODS: This cross-sectional study involved secondary analysis of data obtained from the 2011-2012 Community Health Survey. The data were analyzed to determine the utilization of community oral health services. A total of 458,417 people (weighted sample was 80,268,227) were included. A multistage probability proportional systematic sampling method was used. The dependent variable was the utilization of community oral health services. The independent variables were region (city, town, and district), demographic characteristics (gender, age, education, income, occupation, and basic livelihood security), oral health status, and overall health status. The differences in the utilization of community oral health services related to independent variables were analyzed using an independent t-test and ANOVA. Additionally, a Scheffe post-hoc test was performed. Statistical analysis was performed using PASW statistics 20.0 (SPSS Inc., Chicago, IL, USA), at the 5% significance level. RESULTS: The average utilization rate was 26.3% for community health care services and 4.3% for oral health services during the study period in Korea. Utilization was associated with old age and lower education and income levels (P<0.01). Furthermore, residents having poor oral health, chewing discomfort, and unmet dental needs most frequently used the community oral health services. CONCLUSIONS: The utilization of community oral health services was low in Korea. The needs and circumstances of communities should be considered and unique regional structural characteristics should be identified to plan and execute oral health programs and incorporate them with community health care services for overall community health.
Community Health Centers* ; Community Health Services ; Cross-Sectional Studies ; Education ; Health Surveys* ; Korea ; Mastication ; Occupations ; Oral Health*

The goals of reconstruction of orbital blowout fracture are to restore continuity, to provide support of orbital contents and to prevent functional and anatomic defects. Various materials such as autogenous and alloplastic implants have been used to reconstruct the defect of orbital wall fracture. Autogenous implants such as bone and cartilage have the advantages of excellent biocompatibility and low rates of infection. On the other hand, they have the disadvantage of donor site morbidity. Alloplastic implants have potential risk of tissue inflammation and migration within orbit or anterior to the skin although they are easy to use without any disadvantages of donor site morbidity. To cover these disadvantages of various materials, we used the resorbable materials in mesh form(Biosorb FX(R)) in orbital wall reconstruction. Seventeen patients with blowout fracture defect were operated with 0.8mm thickness resorbable material in mesh form and fourteen of them were followed-up (Minimum, 9 months; maximum, 30 months). The results were satisfactory in most cases. Some of them showed minor problems for a short time; One patient had persistent 2mm enophthalmos, but no further surgical correction was required. Transient diplopia in four patients disappeared in two weeks. Lower eyelid swelling in two patients lasted for more than two weeks, but no inflammation, migration or extrusion of implants were observed. Resorbable materials allow initial sufficient stability and are gradually resorbed through the physiologic process. So no permanent implants that might affect facial growth, create interference with radiologic imaging, or be susceptible to infection and extrusion remain. Resorbable mesh plates we used are made of copolymers of Dextro(D)-polylactic acid and Levo(L)-polylactic in 30: 70 ratio. They were well tolerated by tissue, giving adequate support to healing of bone defect. During the follow-up period(mean 14 months), no significant problems were observed.
Cartilage ; Diplopia ; Enophthalmos ; Eyelids ; Follow-Up Studies ; Hand ; Humans ; Inflammation ; Orbit* ; Polymers* ; Skin ; Tissue Donors