PURPOSE: To evaluate MRI findings of spinal cord according to mechanism in acute cervical spinal injury. MATERIALS AND METHODS: 25 patients under went MRI within 1 month after acute cervical trauma. Axial T1WI (TR/TE :500/20), gradient-echo (TR/TE :300/14), sagittal T1WI (TR/TE:500/20), proton (TR/TE :2000. 20 msec), T2WI (TR/TE :2000/80) were performed. In 11 pateints, post-enhancement T1WI was done. Change of spinal cord signal intensity on MRI in addition to the presence of abnormal changes of vertebral body, intervertebral disc and paraspinal soft tissue were evaluated. RESULTS: 15 patients had flexion injury, seven had extension injury and three had injury of unknon mechanism. Twelve patients showed /so-signal intensity on T1WI and high signal intensity on T2WI. Three patients showed low signal intensity on T1WI and high signal intensity on T2WI. Spinal cord hemorrhage occured in 10 patients. We found cord swelling in nine patients and cord compression in 12 patients. In nine patients with cord swelling, extent of cord injury was more than one segment of vertebral body. Ligamentous injury, disc injury, soft tissue injury occurred in 16(64%), 17(68%), 15(60%) patients respectively. Vertebral body fracture was found in 17 patients (68%). The levels of fracture were C6(eight patients) and C5(five patients). CONCLUSION: MRI is valuable in exaluetion of the spinal cord, intervertebral disc, and soft tissue lesions in acute cervical spinal injury. Prognosis is worse in flexion injury than in extension injury, and is well correlated with cord hemorrhage and lesion extent.
Hemorrhage ; Humans ; Intervertebral Disc ; Ligaments ; Magnetic Resonance Imaging ; Neurologic Manifestations* ; Prognosis ; Protons ; Soft Tissue Injuries ; Spinal Cord ; Spinal Injuries

Chromobacterium violaceum is a gram negative straight rod, 0.8-1.2 by 2.5 to 6.0 m, which is motile by one polar flagella and one to four lateral flagella. The organism inhabits soil and water and is often found in semitropical and tropical climates. Infections in humans are rare. We report a case of infection caused by strains of C. violaceum. A 38-year-old male patient was admitted to KyungHee University Hospital, Seoul, Korea on July 28th, 2003, after a car accident. The patient had multiple trauma and lacerations. He had an open wound in the left tibial area from which C. violaceum was isolated. The strain was resistant to ampicillin, tobramycin, ampicillin/sulbactam, ceftriaxone and cefepime, but was susceptible to amikacin, gentamicin, ciprofloxacin, levofloxacin, trimethoprim/sulfamethoxazole and piperacillin/tazobactam. The patient was treated successfully by debridement, cephapirin sodium and astromicine sulfate.
Wound Infection/*etiology ; Male ; Humans ; Gram-Negative Bacterial Infections/*etiology ; Chromobacterium/*isolation & purification ; Adult ; *Accidents, Traffic

Leiomyoma is the most common benign tumor of the esophagus, but it still occurs rarely, as compared with the incidence of cacinoma. There are no geographic or racial differences and manifestations are unusual and inconsistent. About 97% of the esophageal leiomyoma may oecur in intramural type and 1 of the tumor may be polypoid type. Considerable diagnostic problems may arise as well as problems of proper surgical management. We experienced a case of a 47-year old female with esophageal leiomyoma in the mid- point of the esophagus. The patient complained of substernal discomfort for 1 month and routine examinatian and gastrofiberscope were performed. The gastrofiberscopic finding was asmoothly protruded, round bean-sized polypoid mass in the midpoint of the esophagus which was removed by polypectomy. There were no other complications. So we reported this case with review of literature.
Esophagus ; Female ; Humans ; Incidence ; Leiomyoma* ; Middle Aged

Hepatitis B virus (HBV) is one of the major causative agents of chronic liver diseases in Korea. HBV has been classified into 8 genotypes by a divergence of >8% in the entire genomic sequence, and have distinct geographic distributions. There are limited data on the relevance between HBV genotypes and clinical outcomes in Korea. To investigate the clinical feature relating to HBV genotype in Korea, a total 120 serum samples with HBsAg (65 from Seoul and 55 from the other city in Korea) were obtained from each 30 chronic HBV carriers with asymptomatic carrier (ASC), chronic hepatitis (CH), liver cirrhosis (LC) and hepatocellular carcinoma (HCC). HBV genotype was determined by either enzyme-linked immunosorbent assay (ELISA) using monoclonal antibodies against genotype-specific epitopes in the preS2-region or the direct sequencing of small S gene. HBV genotypes were determined in 105 (87.5%) of 120 samples. HBV genotype C was identified in all HBV carriers with ASC, CH, LC, and HCC. Genotypes A, B, D, E, F and G were not detected in any of them. Genotype C HBV prevails predominantly among chronic carriers of the virus in Korea, irrespective of their clinical stages of liver disease and geographic origin.
Carrier State/*epidemiology/*virology ; Comorbidity ; Female ; Genotype ; Hepatitis B virus/*genetics/isolation and purification ; Hepatitis B, Chronic/*epidemiology/*virology ; Humans ; Korea/epidemiology ; Liver Diseases/*epidemiology/*virology ; Male ; Middle Aged ; Prevalence ; Research Support, Non-U.S. Gov't ; Risk Assessment/methods ; Risk Factors

Rumination syndrome is defined as a regurgitation of recently ingested food into the mouth with subsequent remastication and reswallowing or spitting out, and absence of structural disease. This is infrequent in adults of normal mental capacity. The true prevalence of rumination syndrome is unknown because few people have medical attention and most of physicians do not recognize this syndrome as a disease. Upper gastrointestinal manometry has been reported to show a characteristic pattern that confirms the diagnosis, namely, the occurrence of synchronous pressure spikes termed "R waves" at all levels in the stomach and small intestine. We assessed a 49-year-old male patient who complained of frequent effortless regurgitation of food. Ambulatory short-segment antroduodenal manometry with pH-metry showed simultaneous repeatetive contractions in all segments associated with regurgitation.
Adult ; Diagnosis ; Humans ; Intestine, Small ; Male ; Manometry* ; Middle Aged ; Mouth ; Prevalence ; Stomach

BACKGROUND AND OBJECTIVES:There are several methods to improve voice quality in the patients with paralyzed vocal cord, such as thyroplasty type I, injection, arytenoid adduction. The goal of surgical medialization of the paralyzed vocal fold is to attain complete glottic closure. The purpose of this study is to evaluate the effectiveness of thyroplasty type I through qualifying the vocal function and glottal gap. MATERIALS & METHODS: We experienced 20 cases of unilateral vocal fold paralysis who underwent thyroplasty type I. We performed preoperative and postoperative videoimage analysis (normalized glottal gap area) and computer-assisted voice analysis in all patients. RESULTS: The glottal gap was significantly reduced after thyroplasty type I. Postoperative voice quality was characterized by an improved pitch and amplitude perturbation (jitter and shimmer), maximum phonation time and subglottic pressure . But noise to harmonic ratio was not improved. CONCLUSION: Thyroplasty type I is an effective method in the point of regaining glottal closure and vocal function.
Humans ; Laryngoplasty* ; Noise ; Paralysis* ; Phonation ; Vocal Cord Paralysis ; Vocal Cords ; Voice Quality ; Voice*

Colonic lipomas represent mesenchymal origin tumors that are second most common benign colonic tumor after hyperplastic polyps and adenomatous polyps. The patho-genesis of them is not clear. Most patients are asymptomatic and the lesion is often detected incidentally at colonoscopy, operation, and autopsy. According to the size and the location of lipoma, it may cause intestinal obstruction, perforation, intussusception, and life-threatening bleeding. There have been many reports of small colonic lipomas removed by endoscopic resection. Giant lipoma which is greater than 2 cm in size has been associated with higher risk of perforation, thus it has been removed by surgery until now. We report a case of colonic giant lipoma inducing intussusception which could be removed by endoscopic resection.
Adenomatous Polyps ; Autopsy ; Colon* ; Colonoscopy ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Lipoma* ; Polyps

BACKGROUND: Chronic systemic inflammation in ESRD patients due to uremia and hemodialysis procedure itself comes into notice as a main factor for premature mortality secondary to rapid progressing atherosclerosis. Various pro-inflammatory cytokine, known to mediate these reaction of malnutrition, inflammation and atherosclerosis, are regulated by anti-inflammatory cytokine, such as IL-10. Quantitative production of IL-10 shows interindividual variability determined genetically by polymorphisms of promotor gene. The aim of this study was to measure the degree of IL-10 synthesis in ESRD patients treated with hemodialysis and evaluate the association with genotypes and cardiovascular risk factors. METHODS: The IL-10 genotypes for polymorphic bases at position at -1082 was determined in 66 chronic hemodialysis patients and 98 healthy subjects using highly specific PCR and the lipopolysaccharide (LPS)-stimulated IL-10 (sIL-10) release from whole blood were measured by ELISA. RESULTS: The distribution of the IL-10 genotypes in hemodialysis patients were similar to the general population, but the proportion of A allele in hemodialysis group was significantly higher (72.3% vs 59.8%, p=0.05). sIL-10 concentration were lower in hemodialysis patients compared with normal control (21.1 pg/mg vs 36.1 pg/mg, p=0.001) and both groups showed same relationship of sIL-10 with genotypes, that AA type was low producer. In multiple regression analysis, sIL-10 of normal group correlated negatively with age, creatinine, uric acid and existence LVH, and positively with albumin, hemoglobin. On the other hand, lower albumin, lower ejection fraction on echocardiography and existence of left ventricular hypertrophy were associated with higher sIL-10 in hemodialysis group. CONCLUSION: Polymorphisms by IL-10 genotypes were associated with production of IL-10 by endotoxin stimulation, and sIL-10 was lower in hemodialysis patients than in normal control. According to relation of sIL-10 with cardiovascular risk factors such as existence LVH, ejection fraction and malnutrition, it could be suggested that sIL-10 is useful marker in evaluating the risk of cardiovascular events.
Alleles ; Atherosclerosis ; Cardiovascular Diseases ; Creatinine ; Echocardiography ; Enzyme-Linked Immunosorbent Assay ; Genotype* ; Hand ; Humans ; Hypertrophy, Left Ventricular ; Inflammation ; Interleukin-10* ; Kidney Failure, Chronic ; Malnutrition ; Mortality, Premature ; Polymerase Chain Reaction ; Renal Dialysis* ; Risk Factors* ; Uremia ; Uric Acid

BACKGROUND/AIMS: The origin of gastric mucosa outside of the stomach may be developmental (heterotopic gastric mucosa) or acquired (gastric metaplasia). The aim of this study was to evaluate the endoscopic features, according to the subtypes, of the gastric mucosa outside the stomach in the duodenum. METHODS: A total of 30 consecutive patients who underwent esophagogastroduodenoscopy from January 2002 to August 2004 and who were confirmed histopathologically as having gastric mucosa outside the stomach were retrospectively analyzed. Twenty three patients were males and seven were females. RESULTS: Nine patients had heterotopic gastric mucosa and 21 patients had gastric metaplasia. Seven patients with heterotopic gastric mucosa were asymptomatic and 2 patients had dyspepsia, whereas 21 patients with gastric metaplasia had dyspepsia. The dyspepsia rate showed a significant difference between the two groups (p<0.001). Endoscopically, the appearance of the heterotopic gastric mucosa tended to resemble area gastricae (p=0.08). However, there were no statistically differences between the two groups for the endoscopic features of the duodenum. Other abnormal lesions in stomach and duodenum appeared more frequently in the gastric metaplasia than in the heterotopic gastric mucosa (p=0.004, p<0.001). There was no difference in the prevalence of Helicobacter pylori infection between the two groups. CONCLUSIONS: There are no specific endoscopic findings to differentiate heterotopic gastric mucosa from gastric metaplasia. The presence of symptoms and the associated gastroduodenal inflammatory lesions were more prominent in the gastric metaplasia compared with the heterotopic gastric mucosa.
Duodenum* ; Dyspepsia ; Endoscopy, Digestive System ; Female ; Gastric Mucosa* ; Helicobacter pylori ; Humans ; Male ; Metaplasia ; Prevalence ; Retrospective Studies ; Stomach

Gastrointestinal fistula is a disease of varying etiologies. It may occur spontaneously or as a result of an iatrogenic cause. Spontaneous fistula occurs as a result of an inflammatory process, malignancy or radiotherapy. The majority of fistula are caused by iatrogenic causes, most frequently as a complication of surgical intervention. Treatment of gastrointestinal fistulae usually consists of surgery and conservative management such as nutritional support and control of inflammation. Recently, it has been reported that gastrointestinal fistulae can be treated endoscopically using tissue adhesive agents such as Histoacryl and fibrin glue. We report two cases of gastrointestinal fistulae that were successfully treated by endoscopic local injection therapy with a review of literature.
Enbucrilate ; Fibrin Tissue Adhesive ; Fistula* ; Inflammation ; Nutritional Support ; Radiotherapy ; Tissue Adhesives