No abstract available.
Asian Continental Ancestry Group* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea*

Mesenteric lymphangioma was first recognized when an autopsy case was recorded in 1507 by Benevieni. It has been known clinically rare disease and probably a congenital developmental abnormality due to failure of drainage of peripheral primary lymphatic spaces. We experienced a case of abnormal rotation in intestine by mesenteric lymphangioma in a 8 years old male who showed vomiting and abdominal pain. A brief review of related literatures is also presented.
Abdominal Pain ; Autopsy ; Child ; Drainage ; Humans ; Intestines ; Lymphangioma* ; Male ; Rare Diseases ; Vomiting

Central pontine myelinolysis (CPM) by complicating rapid correction of severe hyponatremia has been widely reported. Additionally, CPM was occasionally reported among patients with post-liver transplantation, burns, chronic renal failure with dialysis, or other diseases associated with or not associated with other electrolyte changes or hyperosmolarity. However, there have been a few reports of CPM occurring in diabetic patients without documented electrolyte changes. This report is, to the best of our knowledge, the first report of CPM in type 2 diabetic patients without electrolyte changes in Korea. A 40-year-old man with type 2 diabetes mellitus with abruptly developed dysarthria and ataxia was admitted to our facility. He suffered from poor glucose control and multiple diabetic complications. Brain magnetic resonance imaging (MRI) revealed a well-defined bilateral symmetric hyperintense lesion in the central portion of the pons on T2- and diffusion-weighted images, which was consistent with CPM. After the patient's blood glucose and blood pressure normalized, his dysarthria and ataxia improved. Six months after discharge, follow-up MRI showed a persistent, but greatly reduced symmetric lesion in the central pons. It is certainly possible for CPM to be overlooked clinically in diabetic patients, but more cases could be diagnosed if careful attention was paid to this syndrome.
Adult ; Ataxia ; Blood Glucose ; Blood Pressure ; Brain ; Burns ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Dialysis ; Dysarthria ; Follow-Up Studies ; Glucose ; Humans ; Hyponatremia ; Kidney Failure, Chronic ; Korea ; Magnetic Resonance Imaging ; Myelinolysis, Central Pontine ; Pons ; Transplants

PURPOSE: Althoughpancreas injury is rare in abdominal trauma,it posesa challengeto the surgeon because its clinicalfeaturesare not prominentand the presence of main duct injurycannot be easily identified by imaging studies. Furthermore, severe pancreas injuries require a distal pancreatectomy or a pancreaticoduodnectomy which are associated considerable morbidity and mortality. We reviewed the clinical features of and outcomes for patients with pancreas injury. METHODS: For 10 years from Jan. 2001 to Dec. 2010, thirty-four patients were diagnosedas having pancreas injury by using an explo-laparotomy. Patients successfully treated bynon-operative management were excluded. Patients were divided into early (n=18) and delayed surgery groups (n=11) based on an interval of 24hours between injury and surgery. The clinical features of and the outcomes for the patients in both groups were compared. RESULTS: Males were more commonly injured (82.4% vs.17.6%). The mean age was 37.2 years. The injury mechanisms included vehicle accidents (62.9%, 22/34), assaults (20%, 7/34), and falls (11.4%, 3/34)). The head and neck of the pancreas was most commonly injured, followed by the body and the tail (16, 12, and 6 cases). Of the 34 patients, 26 (76.5%) patients had accompanying injuries. Grade 1 and 2 occurred in 14 (5 and 9) patients, and grade 3, 4, and 5 occurred in 20 (16, 3, and 1) patients. The early and delayed surgery groups showed no difference in surgical outcomes. Two patients with grade 3 in the early surgery group died after surgery,one due tomassive hemorrhage and the other due to septic shock. Of the five patients initially managed non-operatively,three developed peripancreatic necrosis and two developed pseudocyst. All five patients were successfully cured by surgery. CONCLUSION: All cases of pancreas injury in this study involved blunt injury, and accompanying injury to major vessels or the bowel was the major cause of mortality. Surgery delayed for longer than 24 hours after was not associated with adverseoutcomes.
Head ; Hemorrhage ; Humans ; Male ; Neck ; Necrosis ; Pancreas ; Pancreatectomy ; Shock, Septic ; Wounds, Nonpenetrating

Biliary-enteric communications caused by duodenal ulcers are uncommon, and choledochoduodenal fistula (CDF) is by far the most common type. Usually in this situation, food material does not enter the common bile duct because the duodenal lumen is intact. Here, we report a case in which cholangitis occurred due to food materials impacted through a CDF. Duodenal obstruction secondary to duodenal ulcer prevented food passage into the duodenum in this case. Surgical management was recommended; however, the patient refused surgery because of poor general condition. Consequently, the patient expired with sepsis secondary to ascending cholangitis.
Biliary Fistula ; Cholangitis* ; Common Bile Duct* ; Duodenal Obstruction ; Duodenal Ulcer ; Duodenum ; Fistula* ; Humans ; Sepsis

BACKGROUND: Median sternotomy can weaken the upper abdominal wall and result in subxiphoid incisional hernia. We evaluated risk factors associated with the development of subxiphoid incisional hernias after coronary artery bypass grafting (CABG). MATERIALS AND METHODS: Of 1,656 isolated CABGs performed between January 2001 and July 2010, 1,599 patients who were completely followed up were analyzed. The mean follow-up duration was 49.5+/-34.3 months. Subxiphoid incisional hernia requiring surgical repair developed in 13 patients (0.8%). The hernia was diagnosed 16.3+/-10.3 months postoperatively, and hernia repair was performed 25.0+/-26.1 months after the initial operation. Risk factors associated with the development of subxiphoid incisional hernia were analyzed with the Cox proportional hazard model. RESULTS: Five-year freedom from the hernia was 99.0%. Univariate analysis revealed that female sex (p=0.019), height (p=0.019), body surface area (p=0.046), redo operation (p=0.012), off-pump CABG (p=0.049), a postoperative wound problem (p=0.041), postoperative bleeding (p=0.046), and low cardiac output syndrome (p<0.001) were risk factors for the development of the hernia. Multivariable analysis showed that female sex (p=0.01) and low cardiac output syndrome (p<0.001) were associated with subxiphoid hernia formation. CONCLUSION: Female sex and postoperative low cardiac output syndrome were risk factors of subxiphoid hernia. Therefore, special attention is needed for patients with high-risk factors.
Abdominal Wall ; Body Surface Area ; Cardiac Output, Low ; Coronary Artery Bypass ; Coronary Vessels ; Female ; Follow-Up Studies ; Freedom ; Hemorrhage ; Hernia ; Herniorrhaphy ; Humans ; Risk Factors ; Sternotomy

About 50 cases of Listeria monocytogenes endocarditis were reported in worldwide literature in 1950-1995. Though clinical and laboratory data suggest a similarity with other types of bacterial endocarditis, the prognosis is more unfavorable and the mortality rate is higher. However, there has not been a report in Korean literature. We report a case of 55 year-old male with rapidly progressive native aortic endocarditis caused by L. monocytogenes. He had neither history of underlying cardiac disease nor definitive predisposing factor. He presented mild dyspnes, chest pain and febrile sensation for a week. Echocardiography showed large vegetation in aortic valve and severe aortic regurgitation. L. monocytogenes grew on blood culture. We underwent artificial aortic valve replacement due to rapidly progessive heart failure. A thromboembolism occured at right femoral artery on postoperative 2nd day was removed successfully. He discharged without any sequellae.
Adult* ; Aortic Valve ; Aortic Valve Insufficiency ; Causality ; Chest Pain ; Echocardiography ; Endocarditis* ; Endocarditis, Bacterial ; Femoral Artery ; Heart Diseases ; Heart Failure ; Humans ; Listeria monocytogenes* ; Listeria* ; Male ; Middle Aged ; Mortality ; Prognosis ; Sensation ; Thromboembolism

Primary endodermal sinus tumor (yolk sac tumor) of the mediastinum is rare. Most patients are young and male, and the great majority of tumors are found in the anterior mediastinum, and spontaneous hemothorax is a rare presentation of intrathoracic tumors. We report a case of spontaneous hemothorax associated with a posterior mediastinal endoderml sinus tumor occuring in a female patient. Brief review and related literatures were also presented.
Endoderm* ; Endodermal Sinus Tumor* ; Female* ; Hemothorax* ; Humans ; Male ; Mediastinum

Experimental animals were inhalated 50 ppm formaldehyde gas for 3 times with one hour exposure and one hour rest. The olfactory mucosa were taken from the animals on 4, 7, 9, 11 days and 2-6 weeks after the inhalation. The characteristics of the various glycoproteins and the mitotic activity of the olfactory epithelial cells were investigated using lectins and 5'-bromodeoxyuridine (BrdU, 50 mg/kg) which injected one hour before sacrifice of the animals. The results were as follows; 1. In experimental animals, the degenerative changes of the olfactory epithelium such as atrophy and squamous metaplasia were observed until 2 weeks after formaldehyde gas inhalation. 2. In control animals, positive reactions appeared in the supporting cell to PNA, SBA, WGA, ECL, PHA-L and in the olfactory cells to PNA, SBA, WGA, UEA and in the proper basal cell to GS-I, SBA, WGA, PHA-L. In experimental groups, the positive reaction was increased in the supporting cells to SBA, ECL, PHA-L and in Bowman's gland to used lectins except ECL, GS-I. 3. The number of BrdU labelled cells in the olfactory epithelium was 14.8+/-1.2/mm in the control animals. The mitotic activities were decreased to 4.8+/-0.8 mm in 2 weeks and recovered in 3 weeks after the gas inhalation. 4. To find the stem cells of olfactory receptor cells, double labelling method was performed with lectins which were specific for proper basal cells (GS-I or PHA-L) and BrdU immunohistochemistry. The ratio of globose/proper basal cells in BrdU labelled cells with GS-I lectin positive reaction was 82%/18% in control group, 39.3%/60.7% in lesion group and 55.5%/44.5% in recovery group.
Animals ; Atrophy ; Bromodeoxyuridine ; Epithelial Cells ; Formaldehyde* ; Glycoproteins ; Immunohistochemistry ; Inhalation ; Lectins ; Metaplasia ; Olfactory Mucosa* ; Rats* ; Stem Cells

The use of human umbilical cord blood-derived mesenchymal stem cells for cell transplantation therapy holds great promise for repairing spinal cord injury. Here we report the first clinical trial transplantation of human umbilical cord (hUCB)-derived mesenchymal stem cells (MSCs) into the spinal cord of a dog suspected to have fibrocartilaginous embolic myelopathy (FCEM) and that experienced a loss of deep pain sensation. Locomotor functions improved following transplantation in a dog. Based on our findings, we suggest that transplantation of hUCB-derived MSCs will have beneficial therapeutic effects on FCEM patients lacking deep pain sensation.
Animals ; Cartilage Diseases/etiology/therapy/*veterinary ; *Cord Blood Stem Cell Transplantation/veterinary ; Dog Diseases/etiology/*therapy ; Dogs ; Embolism/etiology/therapy/*veterinary ; Female ; Humans ; Mesenchymal Stromal Cells/cytology/*metabolism ; Spinal Cord Diseases/etiology/therapy/*veterinary ; Treatment Outcome