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*

BACKGROUND: Kidney transplant recipients inevitably take a life-long immunosuppressive medication to prevent graft rejection. Non-compliance to immunosuppressive medication is one of the main causes leading to acute and chronic rejection and diminished renal function, resulting in a return to dialysis, increased morbidity, or mortality with an additional health care cost and poor quality of life. The purpose of this study was to investigate actual medication compliance and its related factors. METHODS: A total of 222 functioning kidney transplant recipients were surveyed in a single center, and 25 patients were excluded due to incomplete responses. We reviewed medical records retrospectively, and the data were statistically analyzed with SPSS version 13.0. RESULTS: Among 197 patients, 113 (57.4%) were compliant to the immunosuppressive agents, and 84 (42.6%) recipients were non-compliant. Non-compliant patients were significantly younger (P=0.004), highly educated (P=0.004), employed (P=0.005), more likely to live alone (P=0.035), and drank more (P=0.001) than the compliant patients. Regarding psychosocial factors, more barriers (P=0.015), weak beliefs about the necessity of taking medications (P=0.001), strong beliefs about specific concerns related to medications (P=0.038), and low self efficacy (P=0.003) were identified in the non-compliant group compared with the compliant group. CONCLUSIONS: This study revealed that multiple factors affected medication compliance in patients taking immunosuppressants. It would be helpful to identify potential recipients with a risk for non-compliance based on their general characteristics and psychosocial factors, so they can be provided a specialized education program to promote compliance. This strategy may help produce more favorable long-term outcomes among kidney transplant recipients.
Compliance ; Dialysis ; Graft Rejection ; Health Care Costs ; Humans ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Medical Records ; Medication Adherence ; Quality of Life ; Rejection (Psychology) ; Retrospective Studies ; Self Efficacy

PURPOSE: Over the several decades, there has been a considerable improvement in the survival of patients who undergo renal transplantation due to newer immunosuppressive agents and development of surgical technique and post-operative management. However, life expectancy beyond 10 years is still considerably less than that in the general population. We studied the causes of patient death after kidney transplantation to determine the major causes of death, to decrease the mortality rate of patient and to increase the graft survival rate. METHODS: From Jan. 1990 to Dec. 2002, 1353 renal transplantation were performed at Asan Medical Center. There had been 63 cases of patient death and we reviewed the causes of death, recipient-donor relationship, immunosuppressive agents, history of rejection and the time of death after transplantation in these patients, retrospectively. RESULTS: The major causes of patient death were infection (36.5%), cardiovascular disease (14.3%), malignancy (9.5%), hepatic failure (11.1%), miscellaneous (11.1%) and unknown (22.2%). Thirty-nine (61%) of total death occurred in the first year of transplantation and major cause in first year of transplants was infection (46.2%). Of 63 deaths, 35(55.6%) were with graft function and 49 (77.8%) had history of rejection. The patients with brain- death donor had a higher death rate than that of the patients with living donors (3.7% vs 7.8%, P=0.002). The patients who had history of rejection have higher death rate than the patient with no history of rejection (22.6% vs 1.3%, P<0.001). CONCLUSION: Active efforts for the prevention of rejection and infection in early phase of transplantation and close surveillance of malignancy and cardiovascular disease in long-term follow up will decrease the death of transplanted patients and increase the graft survival rate.
Cardiovascular Diseases ; Cause of Death* ; Chungcheongnam-do ; Graft Survival ; Humans ; Immunosuppressive Agents ; Kidney Transplantation* ; Kidney* ; Life Expectancy ; Liver Failure ; Living Donors ; Mortality ; Retrospective Studies ; Tissue Donors ; Transplants

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