We present the case report of a 72-year-old female in whom diaphragmatic eventration and secondary gastric volvulus developed 10 years after a left partial pneumonectomy for a bronchiectasis. Eventration of the diaphragm is defined as an abnormal elevation of an intact diaphragm. The abnormally wide subdiaphragmatic space provides the potential for a gastric volvulus, which results from the strong negative intrathoracic pulling force created by the potential subphrenic space and paradoxical movement of the diaphragm. Unless this strong negative force is first eliminated, gastropexy alone will lead to recurrence. Obliteration of the subphrenic space by colonic displacement is a simple and effective way of abolishing this negative subdiaphragmatic pulling force. Treatment of gastric volvulus requires immediate surgical repair to prevent subsequent necrosis and perforation, with surgical correction of the underlying anatomic abnormality being the treatment of choice for gastric volvulus. We experienced a case of gastric volvulus due to diaphragmatic eventration who was treated with colonic displacement.
Aged ; Bronchiectasis ; Colon ; Diaphragm ; Diaphragmatic Eventration ; Displacement (Psychology) ; Female ; Gastropexy ; Humans ; Necrosis ; Pneumonectomy ; Recurrence ; Stomach Volvulus

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of 26.3 kg/m2 and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range (23.1 kg/m2) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.
Adenoids ; Body Mass Index ; Child ; Diagnostic Errors ; Diet ; Fatty Liver ; Follow-Up Studies ; Humans ; Hypertrophy ; Liver ; Obesity ; Physical Examination ; Polysomnography ; Reference Values ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Sinusitis ; Sleep Apnea, Obstructive ; Snoring

PURPOSE: Cervical neoplasias are known to be preventable. But the outcome of our efforts for early detection in Korea is disappointing. This study was undertaken to determine the level of screening participation in Korean women with cervical cancer and how the early detection of cervical cancer might be improved. MATERIALS AND METHODS: Two hundred and forty-nine women with cervical cancer diag- nosed and treated at Seoul National University Hospital from September 1996 to February 1998 were subjected to this study. Self-reported cervical cancer screening histories, med- ical records obtainable were reviewed and analysed. RESULTS: One hundred forty-seven women (147/249; 59.0%) hadn't got through the screen- ing at proper intervals. Ninety-nine women (39.9%) had never been screened and remain- ing 48 (19.3%) hadn't had their last Pap test 3 years before their diagnosis of nvasive cancer. Of the 150 women (60.1%) who had ever had a Pap test, only 47 (18.9%) had had annual Pap test during recent 5 years and 55 (22.1%) had had routine Pap test with interval between 1-3 years. Among 102 women who had at least one Pap test during recent 3 year, 73 (71.6%) had had a normal Pap report within three years of diagnosis, including 36 (35.3%) whose last normal Pap report was within a year of diagnosis. This results suggest the possibilities of smear-taking and/or reading errors. Women who had had routine Pap with interval less than 3 years had significantfy less chance of advanced tumor (FIGO stage Ib < ) than unscreened population. There was a statistically significant trend for the more younger and educated groups to be participated at the screening program with more shortened interval. All the other factors had failed to show significant correlation with adequacy or regularity of screening interval. CONCLUSIONS: Despite widespread chance of opportunistic cervical cancer screening, non-participants form the main reason for the failure of cervical cancer screening in Korea. So, far much efforts should be aimed at participating more women in cervical cytologic screening program, especially in the old-aged and less-educated groups.
Diagnosis ; Female ; Humans ; Korea ; Mass Screening* ; Nose ; Seoul ; Uterine Cervical Neoplasms*

Postpoliomyelitis syndrome is a common neurological disorder that occurs in patients who have experienced paralytic poliomyelitis. Recently, as a result of vaccination against poliovirus, incidence of poliomyelitis is exceedingly low. However, many patients with postpolio syndrome may encounter anesthesia when undergoing surgery, such as for correction of foot deformity and other operations. We report on a 45-year-old woman who experienced paralysis of her contralateral limb after operation on the left foot under spinal anesthesia. Postoperative electromyography/nerve conduction study (EMG/NCS) was performed in order to determine the cause of paralysis. Motor power of the sequelae involved leg showed improvement with time and recovered fully to the preoperative level at six months after the index operation. A precise evaluation, including a physical examination and EMG/NCS, should be performed preoperatively when spinal anesthesia is planned for postpolio syndrome patients.
Anesthesia ; Anesthesia, Spinal ; Congenital Abnormalities* ; Extremities* ; Female ; Foot Deformities ; Foot* ; Humans ; Incidence ; Leg ; Middle Aged ; Nervous System Diseases ; Paralysis ; Physical Examination ; Poliomyelitis* ; Poliovirus ; Postpoliomyelitis Syndrome ; Vaccination

Cockcroft and Gault's formula is frequently used to estimate creatinine (Ccr) in clinical practice. To determine the accuracy of such estimation in Korean patients, we measured simultaneously, serum creatinine and 24-hour urinary creatinine excretion in 696 Korean patients (male:350, female:346). Measured Ccr was significantly different from estimated Ccr in several age groups and the decrease of creatinine excretion with age is less than Cockcroft and Gault's estimation. We assumed that this difference can be due to difference of the body habitus and difference of urinary creatinine excretion per body weight between different races. So we divided the sample population into two groups and derived the new formula in one group with regression analysis between age and 24 hour urinary creatinine excretion per body weight for estimation of Ccr as Cockcroft and Gault derived their formula and applied it to another group to compare the new formula with Cockcroft and Gault's formula in Korean patients. The new formula was Ccr (mL/min)=[ (260-age)x weight (kg)]/[160 x serumCr (mg/dL)] for male and Ccr (mL/min)-[ (236-age) x weight (kg)]/[180 x serum Cr (mg/dL)] for female. Predictive accuracy of the new formula was significantly better than the Cockcroft and Gault's formula in the other sample population and also in subgroup of the patients with azotemia.
Azotemia ; Body Weight ; Continental Population Groups ; Creatinine* ; Female ; Glomerular Filtration Rate ; Humans ; Male

OBJECTIVES: Tetrasodium pyrophosphate (TSP) is used in processed meat products, as an emulsifier in cheese, and as a color preservative in soybean paste. However, little is known about its toxicity. This study was conducted to investigate the potential acute and repeated dose toxicity of TSP in Spraque Dawley (SD) rats. METHODS: In the acute study, animals were administered with oral or dermal doses of 2,000 mg/kg TSP. In the repeated dose study, animals were administered doses of 0, 250, 500, and 1,000 mg/kg by oral gavage five times a week for 90 days. RESULTS: In acute toxicity studies, no dead animals or abnormal necropsy findings were found in the control or treated group. In the repeated dose toxicity study, there were no significant changes in body weight in the 1,000 mg/kg treatment group, or food consumption, urinalysis, and hematology in any group. With regards serum biochemistry, the levels of total protein, albumin, A/G ratio, triglyceride, calcium and inorganic phosphate were altered at doses of 500 and 1,000 mg/kg. However, no changes were observed at the dose of 250 mg/kg. With regards histopathological findings, cortical tubular basophilia of the kidney increased at the dose of 1,000 mg/kg, but not at doses of 250 and 500 mg/kg. No significant changes were observed in other organs at doses of 250, 500, and 1,000 mg/kg. CONCLUSIONS: Based on the results, TSP is unclassified according to the Globally Harmonization System, with an LD50 value of over 2,000 mg/kg. The no observed effect level (NOEL) and no observed adverse effect level (NOAEL) were 250 and 500 mg/kg /day respectively and the target organ appears to be the kidney.
Animals ; Biochemistry ; Body Weight ; Calcium ; Cheese ; Diphosphates ; Hematology ; Kidney ; Lethal Dose 50 ; Meat Products ; No-Observed-Adverse-Effect Level ; Rats ; Soybeans ; Urinalysis

Deep vein thrombosis and pulmonary embolism are serious and fatal complications in orthopedic surgery. Most cases of symptomatic pulmonary embolism in knee surgery have been reported after total knee arthroplasty, but rarely after patella fracture. We report on a case of symptomatic pulmonary embolism after surgical treatment of a patella fracture in a 42-year-old female patient.
Adult ; Arthroplasty ; Enclomiphene ; Female ; Humans ; Knee ; Patella* ; Pulmonary Embolism* ; Venous Thrombosis

No abstract available.
Hepacivirus ; Hepatitis C* ; Hepatitis*

BACKGROUND: Recently, many studies have reported that university students have been suffering from stress because of their the uncertainty of their future and employment. Eating habits have often been considered as one of health-related behaviors that may be affected by life stress. The purpose of this study was to examine the association between stress and eating habits in university students. METHODS: A cross-sectional study was designed. The subjects were 282 university students which assessed their eating habits and stresses. The total numbs of students in the study 263. Eating habits were scored using a questionnaire consisting of three categories-regularity, balance, and preference. The stress was assessed by modified Korean version of BEPSI. RESULTS: The stress score was 2.4 and the total score of eating habits was 44.2. The regularity among the domains of eating habits was 14.1, the balance score was 16.1, and the preference was 14.0. In multiple regression after adjustment with confounding variables, stress had a negative relationship with eating habits. CONCLUSION: The relationship between stress and eating habits was statistically significant, especially in regularity and balance. It is important to know not only the health status, but also the factors associated with health such as stresses and eating habits in order to improve the health status of the university students. Further research needs to uncover causality and make a generalization.
Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Eating* ; Employment ; Generalization (Psychology) ; Humans ; Stress, Psychological ; Uncertainty ; Surveys and Questionnaires

Various invasive and non-invasive imaging techniques have been used for the diagnosis of cardiac disease. The recently introduced multidetector row CT (MDCT) shows rapid scan speed, high temporal resolution and large volume coverage in a single breath-hold. MDCT opens a new horizon for cardiac imaging because noninvasive coronary artery imaging has become feasible using MDCT. In this article, we illustrate the technical aspects of coronary CT angiography using MDCT.
Angiography ; Coronary Angiography* ; Coronary Vessels ; Diagnosis ; Heart Diseases ; Multidetector Computed Tomography*