The Duodenal diverticulum is the rare cause of the common bile duct obstruction. We experienced a case of the diverticulum of the second portion of duodenum in a 59-year-old male, who complained recurrent attacks of right upper abdominal pain and fever since 16 months prior to admission. Duodenoscopic finding and UGI study revealed a typical duodenal diverticulum just side to the papilla of Vater. Diverticulectomy and cholecystectomy was performed and after than, he has been free front above mentioned symptoms. We reported a case of duodenal diverticulum which caused recurrent common bile duct obstruction.
Abdominal Pain ; Cholecystectomy ; Common Bile Duct* ; Diverticulum* ; Duodenum ; Fever ; Humans ; Male ; Middle Aged

The ankle is an important joint supporting the entire musculoskeletal system during standing and walking. Current opinion has emphasized necessity of anatomical reduction and rigid internal fixation for a displaced or unstable fracture of the ankle. The purpose of this study was to evaluate the correlation of the adequate surgical operative methods and postoperative care with prognosis. The authors analysed 104 cases of ankle fracture, treated operatively in Department of Orthopedic Surgery of Dae-Han Hospital from January 1991 to December 1994, followed up more than one year. The results were as follows: 1. According to the classification of Lauge-Hansen and Danis-Weber, the most common type was supination-external rotation and type B, respectively. 2. The most common cause of injury was slip down and the others were traffic accident, fall down and direct trauma. 3. According to the criteria of Meyer, the result of treatment was good or excellent in 94 cases (90.4%) radiologically and in 91 cases (87.5%) clinically. 4. The complications were 5 cases of traumatic arthritis, 3 cases of malunion, 2 cases of non-union and 1 case of infection. 5. The early ROM exercise after accurate reduction and rigid internal fixation was very important in treatment of fracture of the ankle.
Accidents, Traffic ; Ankle Fractures ; Ankle* ; Arthritis ; Classification ; Joints ; Musculoskeletal System ; Orthopedics ; Postoperative Care ; Prognosis ; Walking

Ten feet from 6 idiopathic congenltal clubfoot patients which had failed to respond to conservative mearsured were treated by aggreasive posteromedial release during infancy with generally good results. A modltication of Denis-Browne splint by splitting both aides and using dial lock to hold the foot still ln correeted position was found quite useful for post-operative maintenance.
Clubfoot ; Foot ; Humans ; Splints

Recently, the incidence of fracture and dislocation of the proximal humerus has been increased with increment of traffic accident and industrial accident. Although most proximal humeral fractures can be treated satisfactorily by simple conservative treatment, the displaced fracture or fracture-dislocatiion of the proximal humerus demands special treatment and judgement. It has been reported that the results of the surgical treatment of the unstable fracture of the proximal humerus was better than that of conservative treatment. The authors analysed 32 cases displaced fracture or fracture-dislocation of the proximal humerus treated operatively which were followed up more than 1 year at the Dae Han Hospital from June, 1990 to May, 1993. The obtained results were as follows; l. According to Neer's classification, there were 2-part fracture in 3 cases(9%), 3-part in 17 cases(54%), 4-part in 2 cases(6%), fracture-dislocation in 8 cases(25%) and head splitting in 2 cases(6%). 2. The clinical results by Neer's criteria were excellent in 9 cases(28%), good in 14 cases(44%), fair in 7 cases(22%), and poor in 2 cases(6%) among the 32 cases. 3. The complication were limitation of motion in 4 cases, avscular necrosis of humeral head in 2 cases, nonunion in 1 case, delayed union in 1 case, ectopic ossification in 1 case and malunion in 1 case. 4. In the unstable fracture of the proximal humerus treated by accurate reduction and rigid fixation with intensive rehabilitation can be obtained, relatively satisfactory results because of the inability to maintain an acceptable closed reduction.
Accidents, Occupational ; Accidents, Traffic ; Classification ; Dislocations ; Head ; Humeral Head ; Humerus ; Incidence ; Necrosis ; Ossification, Heterotopic ; Rehabilitation ; Shoulder Fractures

Water extract of dried ginseng, which is known as a histamine liberator and induces degranulation and disruption of mesenteric mast cells, is thought to contain many different chemical factors. The essential component, a saponin extract of dried ginseng, was obtained and administered to albino rats. Even minute amounts (l mg in 0.0l cc of normal saline solution) when locally injected into the mesentery of albino rats caused degranulation of mesenteric mast cells. Degranulation of mesenteric mast cells followed the intraperitoneal injection of a crude water extract, of an alcohol extract of dried ginseng, and a direct injection of both extracts into the connective tissue of mesentery. This degranulation is believed to be a saponin fraction of ginseng in the ginseng extracts.
Animals ; Mast Cells/*drug effects ; *Panax ; *Plants, Medicinal ; Rats ; Saponins/*pharmacology

Primary colonic lymphoma is a rare disease and open surgical biopsy is usually necessary for hietological confirmation. Despite the submucosal location of the tumors, histological confirmation is frequently made by endoscopic multiple punch biopsies. Recently, three patients were admitted to the hospital with right lower guadrant abdominal pain, mass and abnormalities in the right colon and cecum on the barium enema. We performed colonoscopy and found smooth surfaced polypoid mass with occasional shallow ulcerations without lobulation, so suspected lymphoma endoscopically but failed to confirm histologieal diagnosis by usual punch biopsy. Thereafter, all three cases were undergone to laparntomies, and two were confirmed to be non-Hodgkins lymphoma and the other was Hodgkins disease. Here, we present those three cases of endoscopically found colonic lymphoma with review of literatures.
Abdominal Pain ; Barium ; Biopsy ; Cecum ; Colon* ; Colonoscopy ; Diagnosis ; Enema ; Hodgkin Disease ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Rare Diseases ; Ulcer

PURPOSE: Vesicoureteral reflux(VUR) is known to be the main cause of childhood hypertension and renal failure. Knowing its familial occurrence, we determined the incidence of VUR and renal scar in asymptomatic siblings of Korean patients with primary VUR. METHODS: A total of 50 siblings from 37 index patients were included. Voiding cystourethrography(VCUG) and renal scintigraphy using 99mTc-DMSA were performed in these siblings from June, 1994 to May, 2001. Index patients were classified into two groups according to the presence of VUR in their siblings, and the clinical factors of the index patients such as age, sex, grade of reflux and renal cortical defect were compared between the groups. RESULTS: Among the 50 siblings, VUR were found in 8(16%) and renal cortical defects were detected in 8(16%) siblings respectively. The incidence of renal cortical defects was 87.5%(7 out of 8) in the VUR(+) siblings. There was a case of VUR(-) cortical defect in one sibling, presumed as a scar from an old VUR. There was no relationship among age, sex, grade of reflux and renal cortical defect of the index patient to the presence of VUR in siblings. CONCLUSION: This study confirmed a significant incidence of VUR(16%) and renal cortical defects(16%) in the asymptomatic siblings of patients with primary VUR in Korea. It is resonable to recommend screening studies to the siblings of patients with VUR for the early detection and prevention of probable reflux nephropathy.
Cicatrix* ; Humans ; Hypertension ; Incidence* ; Korea ; Mass Screening ; Radionuclide Imaging ; Renal Insufficiency ; Siblings* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Vesico-Ureteral Reflux*

PURPOSE: Vesicoureteral reflux(VUR) is known to be the main cause of childhood hypertension and renal failure. Knowing its familial occurrence, we determined the incidence of VUR and renal scar in asymptomatic siblings of Korean patients with primary VUR. METHODS: A total of 50 siblings from 37 index patients were included. Voiding cystourethrography(VCUG) and renal scintigraphy using 99mTc-DMSA were performed in these siblings from June, 1994 to May, 2001. Index patients were classified into two groups according to the presence of VUR in their siblings, and the clinical factors of the index patients such as age, sex, grade of reflux and renal cortical defect were compared between the groups. RESULTS: Among the 50 siblings, VUR were found in 8(16%) and renal cortical defects were detected in 8(16%) siblings respectively. The incidence of renal cortical defects was 87.5%(7 out of 8) in the VUR(+) siblings. There was a case of VUR(-) cortical defect in one sibling, presumed as a scar from an old VUR. There was no relationship among age, sex, grade of reflux and renal cortical defect of the index patient to the presence of VUR in siblings. CONCLUSION: This study confirmed a significant incidence of VUR(16%) and renal cortical defects(16%) in the asymptomatic siblings of patients with primary VUR in Korea. It is resonable to recommend screening studies to the siblings of patients with VUR for the early detection and prevention of probable reflux nephropathy.
Cicatrix* ; Humans ; Hypertension ; Incidence* ; Korea ; Mass Screening ; Radionuclide Imaging ; Renal Insufficiency ; Siblings* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Vesico-Ureteral Reflux*

AMP-activated protein kinase (AMPK), an important regulator of energy metabolism, is activated in response to cellular stress when intracellular levels of AMP increase. We investigated the neuroprotective effects of AMPK against scopolamine-induced memory impairment in vivo and glutamate-induced cytotoxicity in vitro. An adenovirus expressing AMPK wild type alpha subunit (WT) or a dominant negative form (DN) was injected into the hippocampus of rats using a stereotaxic apparatus. The AMPK WT-injected rats showed significant reversal of the scopolamine induced cognitive deficit as evaluated by escape latency in the Morris water maze. In addition, they showed enhanced acetylcholinesterase (AChE)-reactive neurons in the hippocampus, implying increased cholinergic activity in response to AMPK. We also studied the cellular mechanism by which AMPK protects against glutamate-induced cell death in primary cultured rat hippocampal neurons. We further demonstrated that AMPK WT-infected cells increased cell viability and reduced Annexin V positive hippocampal neurons. Western blot analysis indicated that AMPK WT-infected cells reduced the expression of Bax and had no effects on Bcl-2, which resulted in a decreased Bax/Bcl-2 ratio. These data suggest that AMPK is a useful cognitive impairment treatment target, and that its beneficial effects are mediated via the protective capacity of hippocampal neurons.
Acetylcholinesterase ; Adenoviridae ; AMP-Activated Protein Kinases ; Animals ; Annexin A5 ; Apoptosis ; Blotting, Western ; Cell Death ; Cell Survival ; Energy Metabolism ; Hippocampus ; Memory ; Neurons ; Neuroprotective Agents ; Rats ; Scopolamine Hydrobromide ; United Nations

Cases of hospital acquired pneumonia occurring during the 1st 12 months of Medico-Surgical ICU (Intensive care unit, MSICU) in operation were evaluated retrospectively to determine its incidence, common causative pathogens, outcome and radiological patterns with the new hospital setting providing a unique relatively aseptic environment. Among the 920 admitted patients, 73 episodes of nosocomial pneumonia on 63 patients were identified and the incidence rate was 7%. The most common pathogens were Pseudomonas. Staphylococcus, Serratia, and Enterobacter in the order of frequency of occurrence, and the gram-negative pathogens comprised 70%. Nosocomial pneumonia was more common after use of antibiotics due to such pathogens as Enterobacter, Acinetobacter, and Candida which caused poor outcome. Enterobacter had the greatest tendency to be related with poor outcome and Serratia the least. Overall mortality was 25%. Bronchopneumonia was the most common type of pneumonia caused by any pathogen except Acinetobacter which caused a mixed type of nosocomial pneumonia.
Cross Infection/epidemiology/*etiology/radiography ; Enterobacter/isolation & purification ; Humans ; Incidence ; *Intensive Care Units ; Outcome Assessment (Health Care) ; Pneumonia/epidemiology/*etiology/radiography ; Pseudomonas/isolation & purification ; Retrospective Studies ; Staphylococcus/isolation & purification