No abstract available.
Scalp* ; Superficial Back Muscles*

No abstract available.
Hand*

PURPOSE: The purpose of this study was to evaluate the phenomenon of diaschisis in the cerebellum and cerebral certex in patients with pure basal ganglia hemorrhage using cerebral blood flow SPECT. MATERIALS AND METHODS: Twelve patients with pure basal ganglia hemorrhage were studied with Tc-99m ECD brain SPECT Asymmetric index (AI) was calculated in the cerebellum and cerebral cortical regions as |CR-CL|/(CR-CL)x200, where CR and GL and the mean reconstructed counts for the right and left ROIs, respectively. Hypoperfusion was considered to be present when AI was greater than mean+2 SD of 20 control subjects. RESULTS: Mean AI of the cerebellum and cerebral cortical regions in patients with pure basal ganglia hemorrhage was significantly higher than normal controls (p<0.05): Cerebellum (18.68+/-8.94 vs 4.35+/-0.94, mean+/-SD), thalamus (31.91+/-10.61 vs 2.57+/-1.45), basal ganglia (35.94+/-16.15 vs 4.34+/-2.08), parietal (18.94+/-10.69 vs 3.24+/-0.87), frontal (13.60+/-10.8 vs 4.02+/-2.04) and temporal cortex (18.92+/-11.95 vs 5.13+/-1.69). Ten of the 12 patients had significant hypoperfusion in the contralateral cerebellum. Hypoperfusion was also shown in the ipsilateral thalamus (n=12), ipsilateral parietal (n=12), frontal (n=6) and temporal cortex (n=10). CONCLUSION: Crossed cerebellar diaschisis (CCD) and cortical diaschisis may frequently occur in patients with pure basal ganglia hemorrhage, suggesting that CCD can develop without the interruption of corticopontocerebellar pathway.
Basal Ganglia Hemorrhage* ; Basal Ganglia* ; Brain ; Cerebellum ; Humans ; Rabeprazole ; Thalamus ; Tomography, Emission-Computed, Single-Photon

A 9-year-old boy showed orofacial dyskinesia and psychic symptoms shortly after open heart surgery with deep hypothemia and cardiopulmonary bypass for congenital cyanotic heart disease. The choreothetosis progressed to be generalized and accompanied by mental deterioration. This involuntary movement partially responded only to repetitive administration of sedatives. After 3 month the patient expired with sudden development of ventricular tachycardia and cardiogenic shock.
Cardiopulmonary Bypass* ; Child ; Dyskinesias ; Heart Diseases ; Humans ; Hypnotics and Sedatives ; Hypothermia* ; Male ; Movement Disorders ; Shock, Cardiogenic ; Tachycardia, Ventricular ; Thoracic Surgery

No abstract available.
Plasma* ; Prostate* ; Prostatic Neoplasms* ; Stomach Neoplasms*

Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the "Streptococcus milleri" group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.
Abscess ; Aged ; Drainage ; Dyspnea ; Empyema ; Female ; Humans ; Immunocompromised Host ; Kidney Failure, Chronic ; Pleural Effusion ; Streptococcus ; Streptococcus constellatus ; Streptococcus milleri Group ; Thorax

BACKGROUND: To evaluate the effectiveness of minimally invasive surgery total hip arthroplasty (THA) using the two-incision technique as described by Mears. METHODS: From January 2003 to December 2006, sixty-four patients underwent total hip arthroplasty using the one-incision (group I) and two-incision (group II) technique by one surgeon. There were 34 hips in group I and 30 hips in group II. There was no difference in age, gender, and causes of THA between the two groups. We evaluated the operation time, bleeding amount, incision length, ambulation, hospital stay, and complications between the two groups. RESULTS: There was no difference in the bleeding amount between the two groups. Operation time was longer in the two-incision group than in the one-incision group. Operation time of the two-incision technique could be reduced after 15 cases. Patients started ambulation after surgery earlier in group II than group I, and the hospital stay was shorter in group II than in group I. There was no difference in clinical results between the two groups. There was no difference in component position of the acetabular cup and femoral stem between the two groups. Intraoperative periprosthetic fracture occurred in four cases (13.3%) in group II. CONCLUSIONS: Two-incision THA has the advantage of rapid recovery and shorter hospital stay. However, longer operation time and a high complication rate compared to one-incision are problems that need to be solved in the two-incision technique.
Arthroplasty, Replacement, Hip/*methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Surgical Procedures, Minimally Invasive/*methods

No abstract available.
Adult ; DNA Mutational Analysis ; Diabetes Insipidus, Nephrogenic/*complications/diagnosis/genetics/therapy ; Disease Progression ; Genetic Predisposition to Disease ; Humans ; Kidney Failure, Chronic/diagnosis/*etiology ; Male ; Mutation ; Phenotype ; Receptors, Vasopressin/genetics ; Renal Dialysis ; Tomography, X-Ray Computed

PURPOSE: Laparoscopic total extraperitoneal (TEP) repair of inguinal hernia is technically challenging enough to build high barrier to entry. The purpose of this study was to identify clinical factors influencing technical difficulty with laparoscopic TEP according to learning period. METHODS: We conducted a retrospective study of 112 adult patients who underwent laparoscopic TEP for unilateral inguinal hernia from January 2009 to September 2013. A technically difficult case was defined as the 70th percentiles or more in the distribution curve of operative time, major complication, or open conversion. RESULTS: The rate of body mass index (BMI) above 25 kg/m2 was significantly higher in the difficult group than the nondifficult group in the learning period of laparoscopic TEP (57.9% vs. 26.8%, respectively, P = 0.020). However, in the experience period, it revealed no statistical difference with technical difficulty (31.3% vs. 33.3%, respectively, P = 0.882). In multivariate analysis, BMI (> or =25 kg/m2) was identified as a significant independent factor for technical difficulty with laparoscopic TEP in the learning period (odds ratio, 4.572; P = 0.015). CONCLUSION: Patient's BMI (> or =25 kg/m2) can create technical difficulty with laparoscopic TEP only in the learning period, but not in the experience period. Therefore BMI could be applied as one of the guidelines for patient selection, especially for surgeons in the learning curve of laparoscopic TEP.
Adult ; Body Mass Index ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Laparoscopy ; Learning Curve ; Learning* ; Multivariate Analysis ; Operative Time ; Patient Selection ; Retrospective Studies

Primary aldosteronism is defined as hypertension, hypokalemia, increased serum aldosteron, decreased serum renin activity. It has been known that prolonged hypokalemia, renal cyst formation and impairment of renal function. However, nephrocalcinosis associated with primary aldosteronism is rarely reported. A 31-year-old male was admitted to our hospital because of abdominal pain and uncontrolled hypertention which developed 2 years earlier. At admission, blood pressure 180/100 mmHg. Biochemical findings indicated sodium 146 mEq/L, potassium 2.3 mEq/L, BUN 8.2 mg/dL, creatinine 1.1 mg/dL, calcium 10.7 mg/dL, phosphate 5.7 mg/dL, magnesium 1.8 mg/dL. Twenty-four hour urine collection indicated sodium 108 mEq, potassium 32 mEq, calcium 75 mg, phosphate 72 mg, magnesium 8.0 mg. The hormone study revealed PTH 22.7 pg/mL (normal: 9~55 pg/mL), ACTH 8 pg/mL (normal: 6~56.7 pg/mL), aldosterone 51.0 ng/dL (normal: 1~16 ng/dL), plasma renin activity below 0.01 ng/mL/hr (normal: 0.15~233 ng/mL/hr). Abdominal sonography showed homogenous increased medullary echoes and multiple calcification. The abdomen CT showed adrenal mass (1 x 1 cm) consistent with adrenal tumor. Adrenalrectomy was performed on the 16th hospital day and clinical symptoms, blood pressure and hypokalemia improved shortly after operation.
Abdomen ; Abdominal Pain ; Adrenocorticotropic Hormone ; Adult ; Aldosterone ; Blood Pressure ; Calcium ; Creatinine ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Magnesium ; Male ; Nephrocalcinosis* ; Plasma ; Potassium ; Renin ; Sodium ; Urine Specimen Collection