No abstract available.
Leiomyosarcoma ; Vena Cava, Inferior

No abstract available.
Antibodies, Anticardiolipin* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

Fracture of acetabular are relatively uncommon, but when they occur they seem to pose management difficulties for attending surgeon. They are, however, important injuries because they may give rise to disabling symptoms. Furthermore, they are increasing in frequency due to the increasing number of traffic accidents. Forty cases of acetabular fracture were treated in the National Medical Center during the period 1980 to 1987. The short summary of observation were as follows : 1) There was a preponderance of young patients, the majority being in the 31–40 age group(68%). The ratio between males and females was 2.6:1. 2) The most common cause of injury was traffic accident(68%). 3) The most common associated fracture was pelvic bone fracture(48%), and most common associated other injury was abdominal visceral injury(30%). 4) The most common fracture was posterior wall fracture(28%) following to Judet & Letournel's anatomocal clsssification. 5) Twenty-five fracture(63%) were treated by conservative measures, and 15 fractures (37%) were treated by open reduction and internal fixation. 6) The results were as follows : excellent in 13(33%), good in 19(47%), fair in 5(13%), and poor in 3(7%). 7) The complication of acetabular fracture were traumatic arthritis in 6 cases, sciatic nerve injury in 2 cases, avascular necrosis of femoral head in 2 cases. 8) Not only choice of treatment but also determination of surgical approch require accurate assessment of the fracture pattern in this region of complex bony architecture by careful radiologic analysis.
Accidents, Traffic ; Acetabulum ; Arthritis ; Female ; Head ; Humans ; Male ; Necrosis ; Pelvic Bones ; Sciatic Nerve

High tibial osteotomy is now an accepted procedure in the treatment of osteoarthritis of the knee. Since the effect of this procedure is to shift the line of weight bearing from one compartment of the other, the procedure is of value in knees with osteoarthritis only when there is predominant involvement of one compartment. The osteoarthritis of knee developed bilaterally in many case, so simultaneous bilateral high tibial osteotomy under one anesthetic was considered. Eight cases of osteoarthritis with genu varum deformity were treated by simultaneous bilateral high tibial osteotomy at the Department of Orthopaedic Surgery of NMC during the,period from January, 1984 to December, 1987. The results were as follows: l. All case were female, and the mean age was 56 years old. 2. Preoperative mean varus angle were 4° in right, 3.4° in left, and postoperative mean valgus angle were 8° in right, 6° in left at final follow-up. 3. The results after average 2.2 years of follow-up were as follows: good in 5 cases(63%), fair in 1 cases(12%), poor in 2 cases(25%) 4. The complications were one proximal tibial fracture, one displacement of distal fragment, and one transient peroneal nerve palsy. 5. Mean immobilization period was 7 wks and mean hospitalization period was 48 days. 6. More rigid internal fixation was recommended in simultaneous procedure to reduce the period of hospitalization and early ambulation.
Congenital Abnormalities ; Early Ambulation ; Female ; Follow-Up Studies ; Genu Varum ; Hospitalization ; Humans ; Immobilization ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Osteotomy ; Paralysis ; Peroneal Nerve ; Tibial Fractures ; Weight-Bearing

No abstract available.
Thyroid Gland* ; Thyroiditis*

Carotid-cavernous fistula(CCF) is the most common arteria-venous fistula in the head and neck region which has characteristic ophthalmic findings and threat of visual loss. An analysis of clinical records was done of 21 CCF patients who visited the Department of Ophthalmology, Seoul National University Hospital from August 1, 1986 to July 31, 1990. Seventeen cases(81.0%) were of the direct type, and four cases(19.0%) were of the indirect or spontaneous type. Fifteen patients(88.2%) of the direct type had a definite history of recent head trauma. Clinical symptoms on the first visit included exophthalmos(76.2%), conjunctival injection(76.2%), noise in cranial cavity(76.2%), visual disturbance(61.9%), diplopia(42.9%), and ocular pain(28.6%). In general ocular examination, exophthalmometry revealed proptosis in all cases. In seventeen cases(81.0%) vascular bruit was heard with auscultation on the eyelid. Eleven cases(52.4%) showed a limitation of ocular movement and sixth nerve palsy was the most common type(45.5%). On funduscopic examination, nine patients(42.9%) showed engorged retinal vessels. Increased intraocular pressure(Ta>21 mmHg) was recorded in 9 patients(42.9%). Computerized tomography(CT) of orbit or brain, and percutaneous transarterial carotid angiography were used as a diagnostic procedure in all patients. In thirteen of 17 direct type patients detachable balloon embolization was done at the time of angiography, and in 12 cases(92.3%) fistulas were successfully embolized.
Abducens Nerve Diseases ; Angiography ; Auscultation ; Balloon Occlusion ; Brain ; Craniocerebral Trauma ; Exophthalmos ; Eyelids ; Fistula* ; Head ; Humans ; Neck ; Noise ; Ophthalmology ; Orbit ; Retinal Vessels ; Seoul

No abstract available.
Aflatoxin B1* ; Aflatoxins* ; Enzyme-Linked Immunosorbent Assay* ; Humans*

PURPOSE: Mycophenolate mofetil (MMF) given orally as 1000 mg twice daily has shown to be effective in the suppression of acute allograft rejection following renal transplantation. However, Korean transplant patients are usually administered with a lower dose of MMF (1~1.5 gm/day) than the recommended dose due to high incidence of gastrointestinal intolerance. The purpose of this study was to characterize the pharmacokinetic parameters of the mycophenolic acid (MPA), the active form of MMF, in Korean kidney transplant recipients. METHODS: The plasma MPA concentrations of 10 Korean kidney transplant recipients (7 men and 3 women) administered with a suboptimal dose of MMF (750 mg twice a day) were measured at 2 weeks of the MMF therapy by HPLC method. RESULTS: Plasma MPA concentration-time curve pattern of patients taking lower doses of MPA was consistent with previously reported profiles of patients taking the fully recommended doses. The plasma MPA concentration-time curve was characterized by an early sharp peak within 1 hour and a small second peak in some patients at 4~12 hours postdose. The mean ( SD) Cmax was 8.73 4.65micro gram/ml, and the mean MPA AUC was calculated as 18.45 4.25micro gram hr/ml. The mean fraction of free MPA, which is pharmacologically active, was 1.60 0.23% and this value seemed similar to previously reported data. The patient's age, weight, body surface area, and renal function did not influence the MPA AUC. However, a difference in AUC according to sex was statistically significant (P=0.0227). Free fraction of MPA appeared not to be affected by serum albumin and renal function when creatinine clearance was above 40 ml/min. Correlation analysis between each plasma concentration and AUC for the limited strategy of MMF therapeutic drug monitoring (TDM) resulted that the concentrations of predose, 1 hr post-dose, and 8 hr post-dose were positively related with AUC value, and their coefficients of correlation were 0.74545 (P=0.0133), 0.68485 (P=0.0289), and 0.63636 (P=0.0479), respectively. CONCLUSION: This study have shown that the pattern of the time-concentration profile of MPA was similar to the results of other studies performed with Caucasians, although there was interindividual variability of MPA AUC, Cmax, and Tmax.
Allografts ; Area Under Curve ; Body Weight ; Chromatography, High Pressure Liquid ; Creatinine ; Drug Monitoring ; Humans ; Incidence ; Kidney Transplantation ; Kidney* ; Male ; Mycophenolic Acid* ; Plasma ; Serum Albumin ; Transplantation

PURPOSE: Acute necrotizing pancreatitis (ANP) causes severe symptoms and shows a high mortality rate 10-40%. Proper operative strategies for the treatment of ANP are still disputed. The aim of this study was to review our experience of 29 cases of ANP, and to examine the possibility of using systemic inflammatory response syndrome (SIRS) criteria as a prognostic factor. METHODS: The medical records of 29 patients with ANP operated on at the Asan Medical Center between 1998 and 2005 were retrospectively reviewed. The patients were categorized by the presence or absence of SIRS before operation. 16 patients had SIRS preoperatively (SIRS group), and 13 did not (NSIRS group). The patients comprised of 27 men and 2 women, with a mean age of 44.7 years. RESULTS: The surgical indications were sepsis syndrome, persistent pancreatitis with severe pain and late complications. The infection rates were 94% and 62% in the SIRS and NSIRS groups, respectively. Diet was started 12.6 and 7.8 days after surgery in the SIRS and NSIRS groups respectively. Postoperative hospitalization in the SIRS and NSIRS groups were 57.8 and 30.9 days, with 3 and 1 mortalities respectively. In the SIRS group, 13 patients (81%) had necrosectomy and drainage, and 3 (19%) a pancreatic resection. In the NSIRS group, 7 patients (54%) had necrosectomy and drainage, and 6 (46%) a patinets resection. CONCLUSION: SIRS might be useful in predicting the prognosis of ANP after surgery. Necrosectomy and drainage procedures, but not in the early period of diseases, can be performed safely to avoid surgical complications and preserve the endocrine function.
Atrial Natriuretic Factor ; Chungcheongnam-do ; Diet ; Drainage ; Female ; Hospitalization ; Humans ; Male ; Medical Records ; Mortality ; Pancreatitis ; Pancreatitis, Acute Necrotizing* ; Prognosis ; Retrospective Studies ; Systemic Inflammatory Response Syndrome

PURPOSE: Insulinomas and nesidioblastosis are surgically curarable hyperinsulinemic hypoglycemic diseases; however the symptoms, diagnosis, and localization of these diseases are sometimes difficult. METHODS: From April 1990 to December 2008, patients with diagnosis of pancreatic insulinoma and nesidioblastosis were retrospectively reviewed. RESULTS: In the entire cohort, there were 6 patients with multiple endocrine neoplasia type 1 (MEN 1), 7 patients with nesidioblastosis, and 7 patients with multiple lesions. The incidence of neuroglycopenic symptoms (71.5%) was more prevalent than autonomic symptoms (26.5%). The pre-operative localization methods were computed tomography (CT), transabdominal ultrasonography, endoscopic ultrasonography (EUS), magnetic resonance imaging (MRI), angiography, selective arterial calcium stimulation with venous sampling (ASVS), and transhepatic portal venous sampling (THPVS) which had sensitivities of 75%, 40%, 75%, 64%, 48%, 20%, and 87%, respectively. During the second half of the study period, CT had a sensitivity of 83%. THPVS was the most sensitive method of all the diagnostic tools. Intra-operative palpation and ultrasonography were the most powerful modalities for tumor localization. The surgical treatments included enucleation (20%), distal pancreatectomy (51%), central pancreatectomy (12%), pancreaticoduodenectomy (15%), and near-total pancreatectomy (1.5%). From 2006, laparascopic surgery was used as the preferred treatment modality for insulinomas. CONCLUSION: Early diagnosis and precise localization is the most important aspect of treating insulinomas. For better localization, dual phase spiral CT and intra-operative ultrasonography play an important role in tumor localization.
Angiography ; Calcium ; Cohort Studies ; Early Diagnosis ; Endosonography ; Humans ; Incidence ; Insulinoma ; Magnetic Resonance Imaging ; Multiple Endocrine Neoplasia Type 1 ; Nesidioblastosis ; Palpation ; Pancreatectomy ; Pancreaticoduodenectomy ; Retrospective Studies ; Tomography, Spiral Computed