Spontaneous coronary artery dissection (SCAD) is a very rare cause of peripheral artery thromboembolism. It is especially rare to show symptoms of acute limb ischemia without chest symptoms during a hospital visit. In this case, a rare case of SCAD led to left heart failure and caused left ventricle thrombi, which in turn caused peripheral thromboembolism.
Arteries* ; Coronary Vessels* ; Extremities ; Heart Failure ; Heart Ventricles* ; Ischemia ; Thorax ; Thromboembolism*

The authors analyzed 52 patients with traumatic cervical fracture and dislocation admitted to the department of neurosurgery, Gyeongsang National University Hospital between July, 1989 and December, 1993. The most common age group was 21-30 years old, and 46 were male. The most frequent cause of injury was motor vehicle accident. High cervical injuries were 11 cases and mid-low cervical injuries were 41 cases. 34 cases had surgical intervention by anterior approach with bone graft only(5), anterior approach with bone graft and instrumentation(9), posterior approach with wiring and bone graft(18) and total laminectomy(2). The others had conservative treatment and immobilized by traction(9), Halo-vest(8) or neck collar(1). The average post of immobilization of conservatively treated patients was 9.7weeks, anterior approach without instrumentation was 9 weeks and posterior approach was 5.4 weeks, but patients who treated by anterior approach with instrumentation keep soft collar only. At final follow-up, no significant differences were noted between surgically and conservatively treated group but initial neurologic state correlates with prognosis, independent of modality of treatment. Thus the surgical intervention does not significantly influence the prognosis of the patient but shortens the duration of postoperative immobilization.
Dislocations* ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Motor Vehicles ; Neck ; Neurosurgery ; Prognosis ; Transplants

A case of thoracic epidural malignant melanoma metastasized from the eyeball is presented. The patient is a 28 year old male with the chief complaint of paraparesis. He underwent laminectomy and gross total removal of the mass Chemotherapy was thean administered postoperatively. The literature on this subject is briefly reviewed.
Adult ; Drug Therapy ; Epidural Space* ; Humans ; Laminectomy ; Male ; Melanoma* ; Orbit* ; Paraparesis

Surgery is a demanding and stressful field in Korea. Occupational stress can adversely affect the quality of care, decrease job satisfaction, and potentially increase medical errors. The aim of this study was to investigate the occupational stress and career satisfaction of Korean surgeons. We have conducted an electronic survey of 621 Korean surgeons for the occupational stress. Sixty-five questions were used to assess practical and personal characteristics and occupational stress using the Korean occupational stress scale (KOSS). The mean KOSS score was 49.31, which was higher than the average of Korean occupational stress (45.86) or that of other specialized professions (46.03). Young age, female gender, long working hours, and frequent night duties were significantly related to the higher KOSS score. Having spouse, having hobby and regular exercise decreased the KOSS score. Multiple linear regression analysis showed that long working hours and regular exercise were the independent factors associated with the KOSS score. Less than 50% of surgeons answered that they would become a surgeon again. Most surgeons (82.5%) did not want to recommend their child follow their career. Korean Surgeons have high occupational stress and low level of career satisfaction.
Adult ; Burnout, Professional/*psychology ; Female ; Humans ; *Job Satisfaction ; Male ; Middle Aged ; Quality of Health Care ; Questionnaires ; Republic of Korea ; Stress, Psychological/*psychology ; Surgeons/*psychology

Surgery is a demanding and stressful field in Korea. Occupational stress can adversely affect the quality of care, decrease job satisfaction, and potentially increase medical errors. The aim of this study was to investigate the occupational stress and career satisfaction of Korean surgeons. We have conducted an electronic survey of 621 Korean surgeons for the occupational stress. Sixty-five questions were used to assess practical and personal characteristics and occupational stress using the Korean occupational stress scale (KOSS). The mean KOSS score was 49.31, which was higher than the average of Korean occupational stress (45.86) or that of other specialized professions (46.03). Young age, female gender, long working hours, and frequent night duties were significantly related to the higher KOSS score. Having spouse, having hobby and regular exercise decreased the KOSS score. Multiple linear regression analysis showed that long working hours and regular exercise were the independent factors associated with the KOSS score. Less than 50% of surgeons answered that they would become a surgeon again. Most surgeons (82.5%) did not want to recommend their child follow their career. Korean Surgeons have high occupational stress and low level of career satisfaction.
Adult ; Burnout, Professional/*psychology ; Female ; Humans ; *Job Satisfaction ; Male ; Middle Aged ; Quality of Health Care ; Questionnaires ; Republic of Korea ; Stress, Psychological/*psychology ; Surgeons/*psychology

PURPOSE: Transumbilical laparoscopic-assisted appendectomy (TULA) is a single incision technique that uses a combined intra- and extracorporeal method. The aim of this study was to compare surgical outcomes of TULA with conventional 3-port laparoscopic appendectomy (LA). METHODS: A retrospective review of medical records between 2010 and 2014 identified 303 pediatric patients who underwent LA with uncomplicated acute appendicitis. Of these, 85 patients underwent TULA and 218 patients underwent conventional LA. Demographic data, clinical characteristics, perioperative outcomes and postoperative complications were compared between the 2 groups. RESULTS: The mean operation time in the TULA group was 30.39 minutes, which was significantly shorter than that of the LA group (47.83 minutes) (P < 0.001). The first day of oral intake after surgery was earlier (1.05 days vs. 1.32 days; P < 0.001) and the length of hospital stay was also shorter (2.54 days vs. 3.22 days; P < 0.001) for the TULA group than the LA group. Furthermore, the postoperative complication rate was lower in the TULA group (1 of 85, 1.25%) compared to the LA group (19 of 218, 8.7%) (P = 0.018). CONCLUSION: In conclusion, TULA procedure is recommended for uncomplicated appendicitis in children due to its simplicity and better postoperative outcomes.
Appendectomy* ; Appendicitis* ; Child ; Humans ; Laparoscopy ; Length of Stay ; Medical Records ; Methods ; Postoperative Complications ; Retrospective Studies ; Umbilicus

PURPOSE: An intracranial aneurysm, with or without subarachnoid hemorrhage (SAH), is a relevant health problem. The rupture of an intracranial aneurysm is a critical concern for individual health; even an unruptured intracranial aneurysm is an anxious condition for the individual. The aim of this guideline is to present current and comprehensive recommendations for the management of intracranial aneurysms, with or without rupture. MATERIALS AND METHODS: We performed an extensive literature search, using Medline. We met in person to discuss recommendations. This document is reviewed by the Task Force Team of the Korean Society of Interventional Neuroradiology (KSIN). RESULTS: We divided the current guideline for ruptured intracranial aneurysms (RIAs) and unruptured intracranial aneurysms (UIAs). The guideline for RIAs focuses on diagnosis and treatment. And the guideline for UIAs focuses on the definition of a high-risk patient, screening, principle for treatment and selection of treatment method. CONCLUSION: This guideline provides practical, evidence-based advice for the management of patients with an intracranial aneurysm, with or without rupture.
Advisory Committees ; Diagnosis ; Humans ; Intracranial Aneurysm* ; Mass Screening ; Rupture ; Subarachnoid Hemorrhage

An endoscopic mucosal resection (EMR) is considered to be a potential alternative to surgery for a gastrointestinal tumor on account of it being an improved technique. Since its introduction in Japan in the early 1980s, it is now an accepted modality for removing precancerous lesions or early gastric cancer from the GI tract because it is minimally invasive and preserves the patient's quality of life. The major complications of EMR is bleeding and perforation. The treatment guidelines for iatrogenic perforation after EMR have not been established. Herein, we report a successful case of EMR induced gastric perforation with fluid collection that was successfully treated with non-surgical management.
Gastrointestinal Tract ; Hemorrhage ; Japan ; Quality of Life ; Stomach Neoplasms

Antibody-mediated rejection (AMR) by preformed and/or de novo human leukocyte antigen alloantibodies is a leading cause of early and late allograft loss. In this review, we describe strategic approaches to various forms of AMR in clinical settings that are not based on pathologic classification, which is controversial for atypical AMR (C4d-, DSA-, subclinical etc.). For acute AMR, a variety of modalities like plasmapheresis, intravenous immunoglobulin, and anti-CD20 antibodies have been utilized singly, or in combination, with variable results; however, no established treatment for chronic AMR is known. Significant research efforts are being made for developing new and novel therapies. Improvements in clinical outcomes can be expected from studies evaluating innovative therapeutic concepts, such as proteasome inhibition or complement-blocking agents.
Antibodies ; Humans ; Immunoglobulins ; Isoantibodies ; Leukocytes ; Plasmapheresis ; Proteasome Endopeptidase Complex ; Rejection (Psychology) ; Transplantation, Homologous

PURPOSE: This study evaluated the effect of polishing techniques on surface roughness of polymethyl methacrylate (PMMA), as well as the influence of light-cured surface glaze and subsequent brushing on surface roughness. MATERIALS AND METHODS: A total of 60 PMMA specimens (10x10x5 mm) were made and then divided into 6 groups of 10 each according to the polymerization methods (under pressure or atmosphere) and the surface polishing methods (mechanical or chemical polishing) including 2 control groups. The mechanical polishing was performed with the carbide denture bur, rubber points and then pumice and lathe wheel. The chemical polishing was performed by applying a light-cured surface glaze (Plaquit(R); Dreve-Dentamid GmbH). Accura 2000(R), a non-contact, non-destructive, optical 3-dimensional surface analysis system, was used to measure the surface roughness (Ra) and 3-dimensional images were acquired. The surface roughness was again measured after ultrasonic tooth brushing in order to evaluate the influence of brushing on the surface roughness. The statistical analysis was performed with Mann-Whitney test and t-test using a 95% level of confidence. RESULTS: The chemically polished group showed a statistically lower mean surface roughness in comparison to the mechanically polished group (P = .0045) and the specimens polymerized under the atmospheric pressure presented a more significant difference (P = .0138). After brushing, all of the groups, except the mechanically polished group, presented rougher surfaces and showed no statistically significant differences between groups. CONCLUSION: Although the surface roughness increased after brushing, the chemical polishing technique presented an improved surface condition in comparison to the mechanical polishing technique.
Atmospheric Pressure ; Dentures ; Polymerization ; Polymers ; Polymethyl Methacrylate ; Rubber ; Silicates ; Tooth ; Ultrasonics