No abstract available.
Posterior Cruciate Ligament*

Pseudomeningocele after spine surgery can cause various symptoms, but it can also be silent. We experienced 3 cases of pseudomeningocele with different symptoms and we analyzed the characteristics of each case. A small pseudomeningocele without connection to the subarachnoidal space can show no symptoms. A pseudomeningocele with a small dural tear and it's abutted on the duramater at a small portion can produce sciatica and limitations of straight leg raising due to adhesion of the cauda equina around the dural tear. In addition, a large pseudomeningocele with a big dural and lamina defect can produce back tenderness furthermore, a patient with such a lesion can have low back pain and leg pain that are aggravated by an increment of abdominal pressure or by impact to the body and even by walking. Pseudomeningocele should be suspected when symptoms recur after spine surgery and especially in the case of dural tear during an operation
Cauda Equina ; Humans ; Leg ; Low Back Pain ; Sciatica ; Spine* ; Walking

We performed a primary vitrectimy using scleral depression technique for uncomplicated rhegmetogenous retinal detachment and intended to highlight the importance of scleral depression technique. The indications for the primary vitrectomy were eyes with multiple or posteriorly located retinal breaks, unidentified retinal breaks, vitreous opacities, strong vitreous tractions on the retina tear flap, and aphakic/pseudophakic retinal detachments, Removal of vitreoretinal traction and vitreous base dissection using scleral depression technuque were performed in sixty-eight eyes of rhegmatogenous retinal detachment uncomplicated with proliferative vitreoretinopathy of grade C or worse. Scleral segmental buckle or encircling was also placed in 60 of 68 eyes. The retina was reattached after the primary operation in fifty-seven eyes(80.9%), and after reoperations in remaining eleven eyes(19.1%). Postoperative visual acuity was 0.4 or better in thirty-eight eyes (55.9%), and worse than 0.025 in eight eyes(11.8%). Vitrectomy in conjuction with scleral depression technique would be effective in increasing surgical success rate in selected cases of retinal detachment surgery.
Depression ; Hexamethonium* ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreoretinopathy, Proliferative

Tuberculosis remains a serious infectious disease with primary features of pulmonary manifestation in Korea. However, duodenal tuberculosis is rare in gastrointestinal cases of extrapulmonary tuberculosis. Here, we report a case of primary duodenal tuberculosis mistaken as a malignant tumor and diagnosed with QuantiFERON-TB GOLD (Cellestis Ltd.) in an immunocompetent male patient.
Communicable Diseases ; Humans ; Korea ; Male ; Tuberculosis*

Osler-Weber-Rendu disease is a rare autosomal dominant disorder of fibrovascular tissues, characterized by a classic triad of mucocutaneous telangiectasias, recurrent hemorrhages, and a familial occurrence. Portosystemic encephalopathy in a patient with Osler-Weber-Rendu disease is rare, but we experienced a case presenting with recurrent portosystemic encephalopathy in Osler-Weber-Rendu disease. We report on a case of a 75-year-old female presenting with an altered mentality. Initial studies including brain imaging study did not reveal any specific cause for her mental status. She was diagnosed with the rare disease after a series of tests and received conservative treatment. Her neurological status recovered fully without complication after conservative treatment and she was discharged after 18 hospital days. This case demonstrated an extremely rare case of Osler-Weber-Rendu disease presenting as portosystemic encephalopathy treated successfully with conservative treatment. For patients who have shown hepatic encephalopathy without a definite cause, we recommend evaluation for the possibility of Osler-Weber-Rendu disease. Conservative treatment based on treatment of advanced liver cirrhosis could be an alternative solution.
Aged ; Brain/diagnostic imaging ; Electroencephalography ; Female ; Hepatic Encephalopathy/*diagnosis ; Humans ; Magnetic Resonance Imaging ; Pedigree ; Telangiectasia, Hereditary Hemorrhagic/*diagnosis ; Tomography, X-Ray Computed ; Vascular Malformations/etiology

Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. These foreign bodies can penetrate the bowel wall and cause severe complications. The peristalsis of the esophagus is not strong enough to prevent it from retaining swallowed objects. Hence, perforation from a foreign body is more likely to occur in the esophagus than in the rest of the gastrointestinal tract. A razor blade is a rare foreign body of the esophagus. Its sharpness and large size make it difficult to remove. A razor blade was very firmly impacted in the esophageal wall in our case, and the razor blade had not moved from the upper esophagus. A standard overtube has limitations to remove a razor blade inside the overtube's lumen. We report here on a case of using a wedge resected overtube made it possible to successfully extract a razor blade and no serious complications occurred after extraction of the razor blade.
Esophagus ; Foreign Bodies ; Gastrointestinal Tract ; Peristalsis

Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea.
Acute Disease ; Aged ; Aged, 80 and over ; *Angioplasty, Balloon ; Chronic Disease ; Female ; Humans ; Intestines/*blood supply ; Ischemia/surgery/*therapy ; Male ; Mesenteric Artery, Superior ; Mesenteric Vascular Occlusion/surgery ; Middle Aged ; Tomography, X-Ray Computed

Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea.
Acute Disease ; Aged ; Aged, 80 and over ; *Angioplasty, Balloon ; Chronic Disease ; Female ; Humans ; Intestines/*blood supply ; Ischemia/surgery/*therapy ; Male ; Mesenteric Artery, Superior ; Mesenteric Vascular Occlusion/surgery ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUND: Although rheumatic mitral stenosis is still a prevalent and clinically significant valvular heart disease in Korea, the natural history of rheumatic mitral stenosis has not been clearly determined yet. The present study aimed to evaluate the clinical and echocardiographic changes in patients with rheumatic mitral stenosis according to different therapeutic modalities. METHODS: A total of 91 patients (66 women; mean age, 50.9+/-12 years) with dominant rheumatic mitral stenosis and mitral valve area of less than 1.5 cm2 who were followed for more than 3 years (mean: 5.1 years) were included in this study. The subjects were divided into 3 groups according to the therapeutic modalities for mitral stenosis (A: medical therapy (n=31), B: percutaneous mitral valvuloplasty (n=30), C: mitral valve replacement (n=30)). Clinical and echocardiographic follow-up was performed before and immediately after therapeutic intervention such as percutaneous mitral valvuloplasty (PMV) and mitral valve replacement (MVR) and every year thereafter. Clinical symptoms and echocardiographic findings were compared between 3 groups. RESULTS: The patients of group B consisted of less females and more younger (p=NS). Clinical symptom of dyspnea was more severe in group B and C initially (A: 1.8+/-0.8, B: 2.5+/-0.8, C: 2.9+/-0.7; A vs. B, A vs. C, p<0.05) but more improved in group B and C (A: 1.6+/-0.5, B: 1.3+/-1.0, C: 1.6+/-0.5; A vs B, A vs. C, p<0.05) during the follow-up. The prevalence of atrial fibrillation did not change significantly during follow-up. Mitral valve area decreased significantly in A group from 1.1+/-0.4 to 0.9+/-0.3 cm2 (p<0.05), but, no significant change was observed in group B and C. No significant changes were observed in the left ventricular end-diastolic, end-systolic dimensions, and ejection fraction during the follow-up period. No clinically significant aggravations of associated valvular regurgitations and systolic pulmonary artery pressure were observed. CONCLUSION: In patients with mitral stenosis more than moderate severity, PMV or MVR is superior to medical therapy for controlling clinical symptoms and maintaining the mitral valve area. Therapeutic modality does not influence the change in the dimension and systolic function of the left ventricle. Accompanied other valvular regurgitation does not change significantly regardless of therapeutic modality, indicating that any additional therapy for associated valvular regurgitation is unnecessary.
Atrial Fibrillation ; Dyspnea ; Echocardiography* ; Female ; Follow-Up Studies ; Heart Valve Diseases ; Heart Ventricles ; Humans ; Korea ; Mitral Valve ; Mitral Valve Stenosis* ; Natural History ; Prevalence ; Pulmonary Artery

BACKGROUND/AIMS: Recently, the incidence of acute hepatitis A has increased nationwide and is related to the low rate of IgG anti-HAV. This study compared the prevalence of IgG anti-HAV in two university hospitals located in a large city and in a small city including a rural region according to age, gender, and the year of diagnosis. METHODS: IgG anti-HAV was measured in a total of 4299 patients, who visited Seoul or Guri Hanyang University Hospital between January 2002 and December 2006. RESULTS: The positive rates of the antibody in Seoul and Guri hospitals were 52.7% vs 57.1% in under the age of 1, 40.7% vs 42.2% in age of 1 to 4, 31.8% vs 30.3% in age of 5 to 9, 24.8% vs 27.1% in age of 10 to 14, 11.6% vs 18.2% in age of 15 to 19, 23.0% vs 20.3% in age of 20 to 24, 40.5% vs 42.9% in age of 25 to 29, 67.5% vs 75.0% in age of 30 to 34, 86.5% vs 88.1% in age of 35 to 39, 95.3% vs 93.6% in age of 40 to 44, 97.0% vs 98.7% in age of 45 to 49, and 98.5% vs 98.6% in patients who were more than 50, respectively. The positive rates of the antibody were not significantly different between two sites according to each age group and gender. CONCLUSIONS: The results confirmed the low rates of IgG anti-HAV, particularly in the ages of 10-24 that match the age group of recently increased incidence of acute hepatitis A nationwide. Therefore, measurement of the antibody and vaccination should be considered in this age group.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Hepatitis A/*epidemiology ; Hepatitis A Antibodies/*blood ; Hepatitis A Virus, Human/immunology ; Hospitals ; Humans ; Immunoglobulin G/*blood ; Infant ; Korea/epidemiology ; Male ; Middle Aged ; Rural Population ; Seroepidemiologic Studies ; Urban Population