Aneurysmal bone cyst uncommonly involves the pubic bone and tends to grow eccentrically and thin out overlying cortex. In the following case report, a 19-year-old male patient visited out hospital, because of dull pain in his left groin. He was diagnosed as aneurysmal bone cyst originated from the superior pubic ramus by CT guided needle biopsy. Transcatheter arterial embolization was effective in the treatment of this lesion such as complete consolidation after the procedure. At present, 2 years follow-up, no problem was noted at weight bearing as well as hip function or recurrence.
Aneurysm ; Biopsy, Needle ; Bone Cysts ; Follow-Up Studies ; Groin ; Hip ; Humans ; Male ; Pubic Bone ; Recurrence ; Weight-Bearing ; Young Adult

The main goal of spinal surgery using implant is a rigid fixation to provide the stability until solid fusion will occur. Recently, various implant fixation devices have been introduced and transpedicular screw fixation is the usual method. In the past, we obtained the implant-related complications like screw failure and rod breakage after using the modified Harrington rod. However, we obtained good results after follow up over one year using TSRH instrument. We experienced spinal surgery using TSRH instrument in 42 cases since 1991 and followed from one year to 28 months with average 16 months. We analyzed the 28 cases and evaluated the implant-related problems. The results were as follows: 1. Among 28 patients, 10 patients were operated due to fracture and 9 patients operated due to spinal stenosis. 2. The male patients were 16 cases and the female were 12 cases. 3. The TSRH instruments provided the rigid fixation with three points clamping mechanism. 4. The cross-linking plate of TSRH was found to increase stiffness and strength. 5. There were no case of screw breakage. 6. In functional results by Kirkaldy-Willis; foriteria the excellent cases were 15, and the good were 2 cases.
Constriction ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Spinal Stenosis

No abstract available.
Clavicle* ; Dislocations*

Primary aldosteronism is present in approximately 1% of unselectd hypertensive patients. Adrenal adenoma is a known as one of the surgically curable form of the hypertension. Hypertension is one of the contributing factors for the development of aortic dissection. Cincurrence of aortic dissection in patient with primary aldosteronism is extemely rare. Only one case wasconfirmed by autopsy and reported in the world literature. We report a case of DeBakey type 3 anortic aneursm in a 49-year old hypertensive female patient with primary aldosteronism due to left adrenal adenoma. She underwent left adrenalectomy uneventfully after stabilization of her blood pressure with maximal medical management including nitroprusside, aldactone, enalapril and inderal.
Adenoma ; Adrenalectomy ; Autopsy ; Blood Pressure ; Enalapril ; Female ; Humans ; Hyperaldosteronism ; Hypertension ; Middle Aged ; Nitroprusside ; Propranolol ; Spironolactone

Doxorubicin has characteristic chemomyectomy effect of the eyelid without disturbing other eyelid structures, but the major side effect of doxorubicin is the potential for eyelid skin injury as a result of the drug's toxicity in both animal and clinical studies. Verapamil may be used to reduce the dose of doxorubicin and the number of injections that would amplify the toxic effects of doxorubicin. This study was performed to determine whether there is an increase in the toxic effect of the doxorubicin as a result of verapamil pretreatment of the muscle. After 0.5mg, 1.0mg, and 2.0mg doxorubicin was injected in lower eyelids of each group, and equal dose of doxorubicin was injected fo11owing 1.0mg of verapamil injection in lower eyelid of each group, muscle cell loss were measured by light microscopy and side effect was observed. In verapamil and doxorubicin injection group, there was significant differences in the amount of preseptal muscle and even in the pretarsal muscle than the doxorubicin injection group in all doxorubicin doses. Verapamil, injected with a range of doses of doxorubicin, caused suhstantia11y increased muscle loss in the eyelid, compared with injection of doxorubicin alone. Skin ulceration, entropion or ectropion were not visible. Clinically, verapamil cotreatment might be useful to decrease the dose of doxorubicin injected and/or the total number of injections.
Animals ; Doxorubicin* ; Ectropion ; Entropion ; Eyelids ; Microscopy ; Muscle Cells ; Skin ; Skin Ulcer ; Verapamil*

Churg-Strauss syndrome is also known as allergic granulomatosis, and it is a rare systemic vasculitis that may affect multiple organ systems, and particularly the lungs.A 42-year-old woman with Churg-Strauss syndrome underwent endoscopic sinus surgery under total intravenous anesthesia with propofol and remifentanil. Anesthesia was performed uneventfully, but there were several issues of concern that evolved regarding the perioperative management of a patient with this syndrome.
Adult ; Anesthesia ; Anesthesia, Intravenous ; Churg-Strauss Syndrome ; Female ; Humans ; Piperidines ; Propofol ; Systemic Vasculitis

OBJECTIVES: The stress response involves the activation of the hypothalamic-pituitary-adrenal(HPA) axis and the sympathetic nervous system. Corticosteroids have been clearly demonstrated to cause anti-inflammatory and/or immnosuppressive effects in man including granulocytosis in part by decreasing migration into tissue, especially damaged tissues(myocardium), and circulating relative lymphocytopenia. To test whether automated measurements of the the increased serum cortisol-induced hematologic changes in the leukocyte differential significance or not in the initial differential diagnosis of acute myocardial infarction in acute chest pain syndromes. METHODS: 101 consecutive patients with myocardial infarction or myocardial ischemia presenting to the emergency room of Seoul Adventist Hospital with acute chest pain from January 1993 to August 1995(Retrospective group) and from December 1995 to March patients compatible with exclusion criteria in myocardial infarction were excluded. We measured automated leukocyte differential and serial CK-MB level in both groups, and the intial serum cortisol levels in prospective infarction group. RESULTS: 1) Total leukocyte and granulocyte counts were increased in acute myocardial infarction(p<0.01). 2) In acute myocardial infarction group, lymphocyte counts were slightly increased(p<0.05), but relative lymphocytes percentage more significantly decreased(p<0.01). 3) Serum cortisol levels are significantly raised early in the course of the acute myocardial infarction and prior to the elevation of the specific cardiac enzymes on the basis of analytic results of prospective infarction group. 4) Cortisol-induced changes in leukocyte differential were noted with time passes into reverse approximately 4 days later in our study. 5) The leukocyte differential does not shows significant changes in the retrospective myocardial ischemia group, so we arrive in careful conclusion that serum cortisol level seems does not increase. 6) No sexual differences were noted in leukocyte differential. CONCLUSIONS: The serum cortisol level and cortisol-induced leukocyte differential are helpful for initial differential diagnosis of acute myocardial infarction in acute chest pain sysdrome.
Adrenal Cortex Hormones ; Axis, Cervical Vertebra ; Chest Pain* ; Diagnosis, Differential* ; Emergency Service, Hospital ; Granulocytes ; Humans ; Hydrocortisone* ; Infarction ; Leukocytes* ; Lymphocyte Count ; Lymphocytes ; Lymphopenia ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Retrospective Studies ; Seoul ; Sympathetic Nervous System ; Thorax*

BACKGROUND: Among various measures to prevent deep venous thrombosis (DVT) in surgical patients, intermittent pneumatic compression of the legs is known to be effective without increasing the risk of bleeding. In this study, the coagulation/ fibrinolysis profile in patients undergoing gastrectomy with SCD Response Compression System, which detects individual venous refill time, was compared to that with elastic stocking using thromboelastography (TEG). METHODS: Fifty-eight ASA class I-II patients undergoing gastrectomy were randomized into two groups. Patients in ES group (n = 29) were treated with elastic stocking and patients in SCD group (n = 29) were treated with SCD Response Compression System. TEG analysis and traditional coagulation tests were performed on arrival in the operating room, after surgery in the postanesthetic care unit and on the morning of postoperative day 1. RESULTS: There was no significant difference in laboratory data between the two groups. Laboratory data at all time points were within normal limit in all patients. There was no significant difference in TEG data between the two groups. No evidence of a postoperative clinical coagulopathy (DVT or pulmonary embolism) was observed on routine history and physical examinations in any patient during hospitalization. CONCLUSIONS: The effectiveness of SCD Response Compression System in patients undergoing major abdominal surgery on coagulation/fibrinolysis system was similar to that of elastic stocking during perioperative period.
Fibrinolysis* ; Gastrectomy* ; Hemorrhage ; Hospitalization ; Humans ; Leg ; Operating Rooms ; Perioperative Period ; Physical Examination ; Stockings, Compression* ; Thrombelastography* ; Venous Thrombosis

PURPOSE: Iliac vein compression syndrome (IVCS) is a clinical condition accompanied by deep vein thrombosis (DVT) secondary to the compression of the left common iliac vein between the right common iliac artery and the lumbar vertebrae. The purpose of this study was to find differences in the clinical characteristics between IVCS and other DVT and to analyze the therapeutic outcomes of IVCS. METHODS: A total of 140 patients with DVT visited the Emergency Department of Seoul National University Hospital from January 2000 to December 2002. Of those patients, 20 patients were diagnosed as IVCS (14.3%). The medical records of patients with both IVCS and DVT were retrospectively reviewed and compared. RESULTS: All patients with IVCS presented with swelling confined to the left lower extremity. The IVCS group showed a higher incidence of females, more cardiovascular disease, and fewer malignancies than did the DVT group. There were no significant differences in age, other underlying diseases, abnormalities of coagulation, and the incidences of pulmonary embolism between two groups. Anticoagulation with heparin (100%), thrombolysis with urokinase (95%), balloon angioplasty (80%) and metallic stent insertion (75%) were performed for the treatment of IVCS. The prognosis fot the stent insertion group tended to be better, but the difference was not statistically significant. CONCLUSION: We suggest that IVCS should be considered in patients who present with swelling confined to the left lower extremity, are females, and have a cardiovascular disease. A multicenter study seems to be needed for further evaluation of IVCS.
Angioplasty, Balloon ; Cardiovascular Diseases ; Emergencies* ; Emergency Service, Hospital* ; Female ; Heparin ; Humans ; Iliac Artery ; Iliac Vein* ; Incidence ; Lower Extremity ; Lumbar Vertebrae ; May-Thurner Syndrome* ; Medical Records ; Prognosis ; Pulmonary Embolism ; Retrospective Studies ; Seoul ; Stents ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis*

BACKGROUND: Recent studies indicate that reactive oxygen species (ROS) are involved in persistent pain, including neuropathic and inflammatory pain. Since the data suggest that ROS are involved in central sensitization, the present study examines the levels of activated N-methyl-D-aspartate (NMDA) receptors in the dorsal horn after an exogenous supply of three antioxidants in rats with chronic post-ischemia pain (CPIP). This serves as an animal model of complex regional pain syndrome type-I induced by hindpaw ischemia/reperfusion injury. METHODS: The application of tight-fitting O-rings for a period of three hours produced CPIP in male Sprague-Dawley rats. Allopurinol 4 mg/kg, allopurinol 40 mg/kg, superoxide dismutase (SOD) 4,000 U/kg, N-nitro-L-arginine methyl ester (L-NAME) 10 mg/kg and SOD 4,000 U/kg plus L-NAME 10 mg/kg were administered intraperitoneally just after O-ring application and on the first and second days after reperfusion. Mechanical allodynia was measured, and activation of the NMDA receptor subunit 1 (pNR1) of the lumbar spinal cord (L4-L6) was analyzed by the Western blot three days after reperfusion. RESULTS: Allopurinol reduced mechanical allodynia and attenuated the enhancement of spinal pNR1 expression in CPIP rats. SOD and L-NAME also blocked spinal pNR1 in accordance with the reduced mechanical allodynia in rats with CPIP. CONCLUSION: The present data suggest the contribution of superoxide, produced via xanthine oxidase, and the participation of superoxide and nitric oxide as a precursor of peroxynitrite in NMDA mediated central sensitization. Finally, the findings support a therapeutic potential for the manipulation of superoxide and nitric oxide in ischemia/reperfusion related pain conditions.
Allopurinol ; Animals ; Antioxidants ; Blotting, Western ; Central Nervous System Sensitization ; Horns ; Humans ; Hyperalgesia ; Inositol Phosphates ; Male ; Models, Animal ; N-Methylaspartate ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Peroxynitrous Acid ; Prostaglandins E ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Reperfusion ; Reperfusion Injury ; Spinal Cord ; Superoxide Dismutase ; Superoxides ; Xanthine Oxidase