Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.
Aneurysm, False* ; Catheterization ; Catheters ; Coronary Angiography ; Femoral Artery ; Humans ; Middle Aged ; Peripheral Nervous System Diseases ; Renal Dialysis ; Rupture* ; Shock, Hemorrhagic* ; Thrombin

The feature of congenitial hand anomalies is multiple and complex. Polydactyly and syndactyly is one of the most common congenital anomalies of the upper limb. The statistical analysis of these anomaly is the basic study of congenital hand anomalies. However, the number of reports is small. The purpose of this study is to compare and analyze objective data and make a nation-wide statistical report on polydactyly and syndactyly. We used data from the National Health Insurance Corporation for reviewing polydactyly and syndactyly. We reviewed 3 years of data from 1998 to 2000 focusing on age, the number of operations, male to female ratio, the duration of hospital care and cost. The number of operations for polydactyly was 694 cases and for syndactyly was 574 cases. Therefore we may assume that polydactyly occurs 1:910 births and syndactyly occurs 1:1101 births. The duration of hospital care for polydactyly was 12 days and for syndactyly was 17 days. The full cost for the correction of polydactyly was 770,000 won and syndactyly was 1,220,000 won. The ratio of polydcatyly and syndactyly was 1.12:1. The operation for polydactyly and syndactyly was performed between the age of 1 and 2 in most cases. Male to female ratio of polydactyly was 1.14 :1 and syndactyly was 1.39:1. This study will be helpful to find appropriate treatment for congenital hand anomalies.
Female ; Hand ; Humans ; Male ; National Health Programs* ; Parturition ; Polydactyly* ; Syndactyly* ; Upper Extremity

Duplication cysts are rare congenital malformations, that may be detected anywhere along the alimentary tract, and they may communicate with the intestinal tract. Cystic duplication of the cecum is especially rare. About 80% of these cases are detected in the first 2 years of life as a result of an acute intestinal obstruction, which manifests as vomiting, recurrent abdominal pain, recurrent gastrointestinal bleeding and constipation. We report a case of intestinal obstruction secondary to a duplication cyst of the cecum in a neonate. The patient underwent surgery and was diagnosed subsequently, and is presently healthy.
Abdominal Pain ; Cecum ; Constipation ; Hemorrhage ; Humans ; Infant, Newborn ; Intestinal Obstruction ; Vomiting

PURPOSE: Mycophenolic acid (MPA) is the active agent of mycophenolate mofetil (MMF), which is an immunosuppressive drug. MPA is a selective inhibitor of inosine monophosphate dehydrogenase. The aim of this study was for demonstrate that mycophenolic acid induces apoptosis in human Jurkat cells via the generation of reactive oxygen species (ROS). METHODS: The cells were cultured in the presence or absence of MPA. Flow cytometric analysis was performed after propidium iodide staining. Western blotting for caspase 3, Bcl-2 and Bax proteins was also performed. RESULTS: MPA decreased the viability of Jurkat cells in a dose- and time-dependent manner. The MPA induced apoptotic cell death displayed nuclear fragmentation and sub G0/G1 phase arrest in the Jurkat cells. The expression of caspase-3 proteases in the MPA treated-Jurkat cells increased in a time-dependent manner. Treatment with MPA resulted in increased ROS generation in the Jurkat cells. There was a decreased expression of Bcl-2 and an increased expression of Bax protein in the MPA treated Jurkat cells. CONCLUSION: This result suggests that MPA-induced cytotoxicity is associated with a direct increase of both ROS generation and the expression of Bax protein.
Apoptosis ; bcl-2-Associated X Protein ; Blotting, Western ; Caspase 3 ; Cell Death ; Humans ; Inosine Monophosphate ; Jurkat Cells ; Mycophenolic Acid ; Oxidoreductases ; Peptide Hydrolases ; Propidium ; Reactive Oxygen Species

Taenia solium is a cestode parasite that infects various human organ systems and it causes several manifestations after ingestion of raw or undercooked pork that's infected with cysticerci. This infection is being now increasingly diagnosed in the more developed countries owing to immigration of tapeworm carriers from endemic zones, but intestinal perforation by parasite infection is a rare complication worldwide. Taenia solium has a complex two-host life cycle. Human beings are the only definitive host and they harbor the adult tapeworm, whereas both people and pigs can act as intermediate hosts and harbor the larvae or cysticerci. Although the majority of parasite-infected individuals are characterized by mild symptoms or none at all and this disease does no reveal overt morbidity, in certain circumstances this disease can lead to severe manifestations. Herein, we reported on two unusual cases of small bowel perforation caused by Taenia solium infection, and these patients were diagnosed at surgery. Efforts through antiparasitic treatment of endemic populations, development of pig vaccines and other measures that are underway will help control and eliminate this disease.
Adult ; Cestoda ; Developed Countries ; Eating ; Emigration and Immigration ; Humans ; Intestinal Perforation ; Larva ; Life Cycle Stages ; Parasites ; Swine ; Taenia solium* ; Taenia* ; Vaccines

PURPOSE: To evaluate the usefulness of functional MR imaging(fMRI) for language mapping and determination of language lateralization. MATERIALS AND METHODS: Functional maps of the language area were obtained during word generation tasks and decision task in ten volunteers(7 right handed, 3 left-handed). MR examination were performed at 1.5T scanner with EPI BOLD technique. Each task consisted of three resting periods and two activation periods with each period of 30 seconds. Total acquisition time was 162sec. SPM program was used for the postprocessing of images. Statistical comparisons were performed by using t-statistics on a pixel-by-pixel basis after global normalization by ANCOVA. Activation areas were topographically analyzed(p<0.001) and activated pixels in each hemisphere were compared quantitatively by lateralization index. RESULTS: Significant activation signals were demonstrated in 9 of 10 volunteers. Activation signals were found in the premotor and motor cortices, the inferior frontal, inferior parietal, and mid-temporal lobes during stimulation tasks. In the right handed seven volunteers, activation of language areas was lateralized to the left side. Verb generation task produced stronger activation in the language areas and higher value of lateralization index than noun generation task or decision task. CONCLUSION: fMRI could be a useful non-invasive method for language mapping and determination of language dominance.
Brain ; Hand ; Magnetic Resonance Imaging* ; Rabeprazole ; Volunteers

PURPOSE: To observe the pattern of glue cast formation when glue was injected into the different fow layersof a flow phantom, and to demonstrate the effect in an animal experiment. MATERIALS AND METHODS: A flow phantom model consisted of a circulating pump (Simon varistaltic pump, Manostat Corporation, U.S.A.) connected via a tygon tube with a specially designed glass tube. Flow of about 4ml/sec was maintained by saline. The glass tube consisted of (1) a small-caliber (2.4-3.2mm inner diameter) straight inflow portion (feeder), (2) a round, larg-caliber portion (nidus), and (3) a medium-caliber (6.7mm inner diameter) straight outflow portion (vein). Glue mixed with Lipiodol (glue: Lipiodol=1:1-3:1) was loaded into a 1cc syringe and slowly injected through a microcatheter ; cast formation along the glass tube was observed. The feeder and nidus portions were injected twelve times and the shape of the cast was compared. In an animal experiment, glue at various concentrations was used to stop rapid flow through a surgically-constructed arteriovenous fistula in porcine carotid artery. RESULTS: When mixture was injected into the straight inflow portion (1), it formed a cast along the wall of the glass tube, with a large cast in the nidus portion. Further injection caused enlargement of the cast in the nidus, but no change in the wall of the inflow portion. When mixture was injected into the nidus portion (2) of the glass tube, a cast formed continuously within the nidus. In the animal experiment, rapid injection of glue at a high conentration staunched flow through the arteriovenous fistula. CONCLUSION: Glue-Lipiodol mixture can be injected slowly and continuously under the surface of the polymerized glue cast which forms along the wall or slow flow portion (nidus) of the glass tube in an experimental flow phantom. However, the effect did not appear during rapid flow in the animal arteriovenous fistular model in which only rapid injection of glue which was either pure or at a glue concentration of more than 75% was effective.
Adhesives ; Animal Experimentation ; Animals ; Arteriovenous Fistula ; Carotid Arteries ; Ethiodized Oil ; Glass ; Polymers ; Syringes

PURPOSE: This study was aimed at analyzing the serotypes of group B streptococcus (GBS) isolated from Korean infants with invasive disease and evaluating their association with disease manifestation. METHODS: Data were retrospectively collected from invasive GBS infections at Gachon University Gil Medical Center from January 2006 to June 2012 and at Samsung Medical Center from April 2010 to November 2012. Serotypes were determined by slide agglutination test. RESULTS: A total of 37 cases were identified, which included 22 full-term infants and 15 preterm infants. Fifteen cases (40.5%) were early-onset, 19 (51.4%) was late-onset, and three (8.1%) was very late-onset. Early-onset diseases among preterm infants were higher than those among full-term infants (60.0% [9/15] vs. 27.3% [6/22], P =0.17). The most common manifestation was bacteremia (70.3%), followed by meningitis and septic arthritis. Among 24 isolates retrievable for serotyping, serotype III (41.7%) was most common, followed by V (16.7%), Ia, Ib, and II (12.5%, respectively), and non-typeable (4.2%). Serotype III was more common in isolates from full-term infants (10/22) than from preterm infants (0/15), whereas serotype V was more common in isolates from preterm infants (4/15) than from full-term infants (0/22) (P =0.002). No penicillin-resistant strain was detected, and resistance to erythromycin and clindamycin were both 64.9%. CONCLUSIONS: GBS is an important pathogen in both preterm and full-term infants, and serotype distribution of GBS causing invasive diseases can differ between preterm and full-term infants. It is necessary to monitor the nationwide epidemiology of GBS diseases, including in preterm infants, in order to prepare preventive measures without underestimating early-onset diseases.
Agglutination Tests ; Arthritis, Infectious ; Bacteremia ; Clindamycin ; Epidemiology ; Erythromycin ; Hospitals, University* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Korea* ; Meningitis ; Retrospective Studies ; Serogroup* ; Serotyping ; Streptococcus ; Streptococcus agalactiae

In healthy adults, diagnosis of aspiration of foreign body into tracheobronchial tree is not difficult because various symptoms such as dyspnea, coughing, or cyanosis develop when foreign b~y is aspirated into tracheobronchial tree. But unless a clear history of an aspiration event can be obtained diagnosis will be delayed. Early complications of tracheobronchial foreign body aspiration include asphyxia, cardiac arrest, dyspnea, laryngeal edema, and cyanosis. Late complications include pneumonia, lung abscess, bronchiectasis, hemoptysis, bronchial stenosis, arid polyp. Treatment is removal of foreign body by operation or bronchoscopy. Currently, flexible bronchoscopy is preferred in adults than rigid bronchoscopy. A 36-year-old male visited to Dongkang hospital due to productive coughing and dyspnea On auscultation, focal inspiratory wheezing was heard. On chest PA, mild emphysematous change was seen. Flexible bronchoscopy was done. Bronchoscopically, mucoid impaction, surrounding inflammation, foreign body lodged in the right lower lobe bronchus, and interbronchial fistula(between right middle and lower lobe bronchus) were seen Foreign body(2.4 x 1.3cm sized antacid package) was removed by flexible bronchoscopy. Later, history of aspiration of a piece of antacid package was found. We report a case of recurrent bronchitis with interbronchial fistula as a result of occult aspiration of foreign body with review of the literatures.
Adult ; Asphyxia ; Auscultation ; Bronchi ; Bronchiectasis ; Bronchitis ; Bronchoscopy ; Constriction, Pathologic ; Cough ; Cyanosis ; Diagnosis ; Dyspnea ; Fistula* ; Foreign Bodies* ; Heart Arrest ; Hemoptysis ; Humans ; Inflammation ; Laryngeal Edema ; Lung Abscess ; Male ; Pneumonia ; Polyps ; Respiratory Sounds ; Thorax

BACKGROUND: Recent evidence demonstrates that high doses of epoetin-alpha (EPO-alpha) can be administrated at extended intervals, despite its relatively short serum half-life. However, no prospective randomized trials on the effects of extended dosing intervals of EPO-alpha compared with darbepoetin-alpha (DA-alpha) have been performed. This study was designed to investigate whether a single biweekly (Q2W) administration of a high dose of EPO-alpha is as effective as DA-alpha for anemia in chronic kidney disease (CKD) patients not receiving dialysis. METHODS: Sixty non-dialysis CKD patients were equally randomized to either Q2W subcutaneous EPO-alpha (10,000 unit) or DA-alpha (50microg) therapy groups for the first 6 weeks. After a 6-week washout period, the participants of the EPO-alpha and DA-alpha treatment groups switched to the alternate regimen for 6 weeks. The mean hemoglobin (Hb) levels after erythropoiesis stimulating agent (ESA) therapy and percentage change in Hb levels from baseline to the end of the study were analyzed. RESULTS: The mean Hb levels of postESA therapy increased significantly compared with those of preESA therapy in both ESA regimens. The percentage increase in Hb levels and erythropoietin resistance index did not show a significant difference between the different ESA regimens. No difference was observed between the regimens regarding mean Hb levels after ESA therapy. Additionally, there were no serious adverse effects leading to withdrawal from treatment. CONCLUSION: Biweekly high doses of EPO-alpha therapy may be equally as effective as Q2W DA-alpha therapy in maintaining target Hb levels in non-dialysis CKD patients.
Anemia ; Cross-Over Studies* ; Dialysis* ; Erythropoiesis ; Erythropoietin ; Half-Life ; Humans ; Renal Insufficiency, Chronic*