No abstract available.
Nasal Polyps*

PURPOSE: The circular stapled hemorrhoidectomy established by A. Longo involves reducing the mucous membrane prolapse and blocking the end branches of the upper hemorrhoidal artery through transverse incision of a suitable section of the mucosa between the rectum and the anal canal. This study was undertaken to determine the efficacy and the safety of a circular stapled hemorrhoidectomy by comparing it with a conventional Milligan-Morgan hemorrhoidectomy. METHODS: One hundred thirty (130) patients with prolapsed hemorrhoids underwent surgical treatment with either a conventional (n=66)(conventional group) or a circular stapled (n=64) (stapled group) hemorrhoidectomy. The operation time was recorded, and the resected specimen was examined. The patients assessed their postoperative pain. Time to first bowel movement, hospital stay, and postoperative complications were analyzed. All patients received follow-up examinations at the out-patient clinic, and the time to return to work and the degree of their satisfaction were checked. RESULTS: The stapled group had a shorter average operation time (19.2 min. vs 26.1 min., P=0.016). The postoperative pain score in the stapled group was significantly lower than it was in the conventional group (P<0.05). Time to first bowel movement and hospital stay were not significantly different between the groups. Return to work was significantly faster in the stapled group (6.5 days vs 15.8 days, P<0.05). The degrees of satisfaction for the two groups were similar, and postoperative complications in the two groups were both similar and acceptable (6.1% vs 11.0%, P>0.05). CONCLUSIONS: A circular stapled hemorrhoidectomy offers a significantly less painful alternative to the conventional technique and is associated with an earlier return to normal activity. However, the long-term outcome needs to be evaluated further.
Anal Canal ; Arteries ; Follow-Up Studies ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Length of Stay ; Mucous Membrane ; Outpatients ; Pain, Postoperative ; Postoperative Complications ; Prolapse ; Rectum ; Return to Work

Wernicke's encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke's encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke's encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.
Acute Kidney Injury ; Adult ; Alcohol Drinking ; Ataxia ; Female ; Humans ; Hyperemesis Gravidarum* ; Neurologic Manifestations ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Shock ; Thiamine ; Thiamine Deficiency ; Uterine Hemorrhage ; Wernicke Encephalopathy*

When clinicians faced with an insufficient volume of supporting bone on ideally esthetic and biomechanical position for dental implantation, guided bone regeneration(GBR) was indicated. Although GBR has wide application at clinic, proper time of membrane removal remains qustionable in using non-resorbable membrane, such as non-expanded polytetrafluoroethylene(PTFE). The aim of this study was to compare the effect of maintenance period of PTFE membrane on bone regeneration in rabbit calvarial defects. Eight adult New Zealand white female rabbits were used in this study. Four defects were surgically made in their calvaria. Using a trephine bur, 4 'through and through' defects were created and classified into 3 groups, which were consisted of control group(no graft), experimental group 1(autogenous bone)and experimental group 2(deproteinized bovine bone; OCS-B(R)). The defects were covered with PTFE membrane(Cytoplast(R)). Membranes were removed after 1, 2, 4 and 8 weeks post-GBR procedure in 2 rabbits repectively. All rabbits were sacrificed after 8 week post-GBR procedure. Specimens were harvested and observed histologically. The results were as follow; 1) The use of graft material and membrane was necessary in GBR procedure. 2) When PTFE membranes were removed early, the most favorable bone regeneration was revealed in experimental group I, followed by experimental group II and control group. 3) On GBR, it is recommended that membrane should maintain for 4 weeks with autogenous graft. As well, the use of xenograft need longer maintenance period than autogenous bone. Further evaluations will be needed, such as histomorphologic research, more species and different kinds of graft materials. And on the basis of these studies, clinical researches would be required.
Adult ; Bone Regeneration* ; Dental Implantation ; Dental Implants ; Female ; Heterografts ; Humans ; Membranes* ; New Zealand ; Polytetrafluoroethylene ; Rabbits ; Skull ; Transplants

Background: Although the scallop sign is considered the most important risk factor for extensor tendon ruptures (ETRs) in patients with osteoarthritis of the distal radioulnar joint (DRUJ), previous reports provide a limited understanding of the changes at DRUJ, as risk factors were examined in plain radiographs of the wrist. The aim of this study was to assess the changes of DRUJ using axial images of computed tomography (CT) in patients with DRUJ osteoarthritis and associated ETRs and to evaluate the relationship between the changes of DRUJ and ETRs. Methods: Twelve patients with ETRs due to osteoarthritis of the DRUJ were enrolled. The changes of DRUJ were examined on axial images of CT and the following 8 parameters were measured: width of radius, anteroposterior (AP) length of radius, width of sigmoid notch (SN), AP length of SN, AP length of ulnar head, subluxation length of ulnar head, dorsal inclination of SN, and distance from Lister’s tubercle to SN. Radiological parameters of the DRUJ were measured in 60 control wrists without trauma or osteoarthritis, and the patient and control groups were statistically compared. Results: Statistically significant differences were observed between the patient and control groups in all the radiological parameters except for the AP length of SN and AP length of ulnar head. The width of radius, AP length of radius, width of SN, subluxation length of ulnar head, and dorsal inclination of SN were greater and the distance from Lister’s tubercle to SN was smaller in the patient group than in the control group. The width of SN, dorsal inclination of SN, and distance from Lister’s tubercle to SN were statistically significant risk factors among the 8 parameters. Conclusions ETRs due to osteoarthritis of the DRUJ was related to the changes of DRUJ, especially the changes around SN of the distal radius. In addition to the existing risk factors, a decreased distance from Lister’s tubercle to SN and increased dorsal inclination of SN were identified as new risk factors. Axial images of CT were effective to evaluate degenerative changes at the DRUJ.

Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm3 (32,400–203,904/mm3 ), and polymorphic leukocytes were 91.1%±2.6% (86%–95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6–10 hours), and the irrigation period was 8.2±3.2 days (4–15 days). The average length of hospitalization was 20.8±8.7 days (9–37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.

Suicidal strangulation by ligature (so-called self-strangulation) is distinctly uncommon. It is distinct from self-suspension in cases of hanging, the latter being a far more common form of suicide. Suicidal strangulation by ligature must be separated from homicidal strangulation by ligature. But clear distinction between the homicidal and suicidal strangulation by ligature is often impossible on the basis of the anatomical findings alone, although fractures of the larynx in suicidal strangulations are distinctly unusual. An accurate evaluation of circumstances, a thorough post-mortem examination, and inspection of the scene are extremely important in such cases. It is equally important to examine the type of noose and knot as well as the number of turns around the neck. We reports three cases of suicidal strangulation by ligature with brief review of literature.
Asphyxia ; Autopsy ; Larynx ; Ligation* ; Neck ; Suicide

One case of the iatrogenic injury of carotid artery is reported. The deceased person was a 54-yearold woman. She visited a local clinic because she had the severe pain on back and neck and the radiating pain of left lower extremity. Under the diagnosis of the herniated cervical disc, the operation was performed. After five hours from starting the operation, respiratory difficulty, facial cyanosis and syncope were found, suddenly. Cardiopulmonary resuscitation was performed, however eventually she died. The autopsy was performed. In the neck, large hematoma at the posterior portion of neck organ and perforation of right carotid artery were noted.
Autopsy* ; Cardiopulmonary Resuscitation ; Carotid Arteries* ; Cyanosis ; Diagnosis ; Female ; Hematoma ; Humans ; Lower Extremity ; Neck ; Syncope

We reviewed forensic autopsies and scene examinations performed at Central District of National Institute of Scientific Investigation, requested by every kinds of law enforecement agencies in Chungcheong area of Korea during the year of 2004, and analysed the data of forensic autopsies and scene examinations according to the cause of death and the manner of death. The results are as follows ; 1. Scene examination on the spot was performed in 49 cases ; Among these cases, 36 cases(73.5%) were unnatural deaths and the most common cause of death was trauma(20 cases). Autopy was performed in 23 cases(46.9%). 2. The total number of forensic autopsy were 643 cases(437 males and 206 females). The number of the forties(156 cases) and the thirties(114 cases) occupied almost half(42.0%) of all cases of autopsy. 3. Unnatural deaths were 448 cases(69.7%), natural 169 cases(26.3%), and the unknown 26 cases(4.0%). In 448 cases of unnatural deaths, suicide was 133 cases(29.7%), homicide 180 cases(40.2%), accident 86 cases(19.2%), and the undetermined 49 cases(10.9%). Homicide occupied 70.2% of trauma, 65.2% of blunt force injury excluding traffic and fall-down injury, and 83.6% of sharp force injury. The homicide rate in asphyxia was 35.8%. It showed no case of homicide in poisoning. 4. In 448 cases of unnatural deaths, traumatic deaths were 198 cases(44.2%). Blunt trauma was 61 cases(30.8%) and the leading cause of death in traumatic death. Of remaining 250 cases of unnatural deaths, there were 67 cases(14.2%) of asphyxia, 63 cases(14.1%) of thermal injuries, 59 cases(13.2%) of drowning, 49 cases(10.9%) of poisoning, and 10 cases(2.2%) of medical procedures. 5. Among 169 natural deaths, cardiac diseases were 98 cases(56.0%) and the leading cause of death in natural deaths. 29 cases(17.2%) of diseases involving digestive system and 26 cases(15.4%) of disease involving vascular system were followed. 6. Child deaths under the age of 10 were 35 cases. Among these cases, unnatural deaths were 21 cases(60.0%) and most of them were homicide and accident.
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Digestive System ; Drowning ; Heart Diseases ; Homicide ; Humans ; Jurisprudence ; Korea* ; Male ; Poisoning ; Suicide

PURPOSE: Hemodialysis remains the most important support for patients with end stage renal disease, and vascular access is an essential component for their life. Since 1966, internal arteriovenous fistula (AVF) has been used widely today. If vessels were not available for AVF, the alternative would be used such as prosthetic graft. But in 1997, the National Kidney Foundation-Dialysis Outcome and Quality Initiative (DOQI) recommended increased use of native arteriovenous fistula to improve overall patency and curtail angioaccess costs. This retrospective study is to review our experience and to evaluate the overall patency rate and the influencing factors on the patency of the AVF. METHOD: From March 1995 through October 2000, 111 fistulas were created of 111 patients in Eulji university hospital. Among them, 106 cases were able to follow up survey. The statistical analysis used by SPSS package. RESULT: The male versus female ratio was 1.22:1 and the age distribution was occurred on from 3rd decade to 9th decade. the common causes of renal failure was hypertension, glomerulonephritis and diabetes (62.1%). the autogenous graft fistulas were performed in 101 cases (wrist/antecubital fossa. 101/3), Goretex graft fistula were 7 cases. The early graft failures were 12 cases (11.4%) and the causes was thrombosis or stricture, and immaturation, psudoaneurysm, venous hypertension in order of frequency. At 12, 24, 36 months, the assisted patency rates of AVF were 80.4, 76.5, 71.3%, respectively. CONCLUSION: We could get higher patency rate of AVF due to liberal use of native veins and aggressive intervention of the failing AVF as recommendation of DOQI.
Age Distribution ; Arteriovenous Fistula* ; Constriction, Pathologic ; Female ; Fistula ; Follow-Up Studies ; Glomerulonephritis ; Humans ; Hypertension ; Kidney ; Kidney Failure, Chronic ; Male ; Polytetrafluoroethylene ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Thrombosis ; Transplants ; Veins