No abstract available.
Humans ; Survival Rate*

Congenital carpal coalition is an uncommon anomaly that results from an incomplete joint cavitation of the primitive carpus. Congenital carpal coalition between the capitate and hamate is generally believed to be asymptomatic and, thus, is usually discovered on radiographs taken for unrelated reasons. We report two cases of congenital carpal coalition (capitate-hamate) associated with pain of the wrist.
Carpal Bones ; Joints ; Wrist

A nation-wide study was performed to estimate the incidence of bladder, kidney, renal pelvis and ureter, prostate, testicular and other genitourinary cancer among Koreans in Korea using medical records of the inpatients of the beneficiaries of the Korea Medical Insurance Corporation (KMIC) from Jan. 1, 1989 to Dec. 31, 1989. The crude incidence rate of bladder cancer (ICD-9 188) is estimated to be 4.43 and 0.98 per 100,000 in males and females, respectively. Around 1,093 new cases of bladder cancer (895 male and 198 female) are estimated to occur in a year. The adjusted rate for the world population is 7.76 in males and 1.19 in females which is similar to that of Japanese in Osaka and Chinese in Shanghai, but lower than in American whites and blacks. The crude incidence of kidney, renal pelvis and ureteral cancer (ICD-9 189) is estimated to be 1.61 and 0.87 in males and females, respectively. Around 507 new cases of kidney, renal pelvis and ureteral cancer (332 male and 175 female) are estimated to occur in a year. The adjusted rate for the world population is 2.69 in males and 1.04 in females. In the prostate (ICD-9 185), the crude incidence rate of cancer is estimated to be 1.36. Around 274 new cases of prostate cancer are occurring in a year. The adjusted rate for the world population is 2.98 which is similar to the Chinese rate. The incidence of genitourinary cancer continuously increases with age.
Adult ; Age Factors ; Aged ; Carcinoma, Renal Cell/epidemiology ; Female ; Humans ; Incidence ; Kidney Neoplasms/epidemiology ; Korea/epidemiology ; Male ; Middle Aged ; Prostatic Neoplasms/epidemiology ; Sex Factors ; Urinary Bladder Neoplasms/epidemiology ; Urogenital Neoplasms/*epidemiology

Although cerebral thromboembolic disease is a rare extraintestinal manifestation of ulcerative colitis, it is one of the major causes of death in patients with the disease. A 29-year-old man who had a 7-year history of ulcerative colitis was admitted to our hospital complaining of nausea, vomiting, bloody diarrhea, and colicky abdominal pain. Fourteen days after admission, he developed sudden-onset left pure motor hemiplegia. Magnetic resonance imaging and angiography revealed an infarction involving the right temporo-occipital hemisphere and diffuse middle cerebral artery territory. Neck computed tomography angiography showed no evidence of cervical carotid or vertebral artery abnormalities, and transthoracic and transesophageal echocardiograms revealed no evidence of thrombi. Factor V was elevated to 176% (normal 50~150%) and protein S antigen had decreased to 57% (normal 60~150%). He was managed with antiplatelet agents and a total proctocolectomy.
Abdominal Pain ; Adult ; Angiography ; Cause of Death ; Cerebral Infarction ; Colitis, Ulcerative ; Diarrhea ; Factor V ; Hemiplegia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Nausea ; Neck ; Platelet Aggregation Inhibitors ; Protein S ; Thromboembolism ; Ulcer ; Vertebral Artery ; Vomiting

PURPOSE: To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. MATERIALS AND METHODS: Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. RESULTS: Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows:Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. CONCLUSION: These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.
Acinetobacter ; Acinetobacter Infections ; Catheters ; Ceftazidime ; Ceftriaxone ; Central Nervous System Infections ; Coagulase ; Coinfection ; Enterococcus ; Fever ; Gyeongsangbuk-do ; Humans ; Meningitis ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Muscle Rigidity ; Neurosurgical Procedures ; Retrospective Studies ; Staphylococcus ; Streptococcus pneumoniae ; Vancomycin

PURPOSE: To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. MATERIALS AND METHODS: Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. RESULTS: Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows:Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. CONCLUSION: These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.
Acinetobacter ; Acinetobacter Infections ; Catheters ; Ceftazidime ; Ceftriaxone ; Central Nervous System Infections ; Coagulase ; Coinfection ; Enterococcus ; Fever ; Gyeongsangbuk-do ; Humans ; Meningitis ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Muscle Rigidity ; Neurosurgical Procedures ; Retrospective Studies ; Staphylococcus ; Streptococcus pneumoniae ; Vancomycin

BACKGROUND/AIMS: Elderly patients often have high operative risk due to their comorbid diseases, and the feasibility of performing endoscopic submucosal dissection (ESD) for such patients should be investigated. The aim of this study is to evaluate the efficacy and safety of performing ESD in elderly patients. METHODS: From 2005 to 2007, 269 patients with gastric neoplasm were treated by ESD in our hospital. These patients were divided into the elderly patients who were 65 years of age or older and the younger patients. The number of enrolled elderly patients was 123. The en bloc complete resection rate and the complications were assessed and compared with those of the younger patients. RESULTS: The average age of the old age group of patients was 71.1. Of these patients, 53.7% had comorbid diseases and 51.2% revealed adenocarcinoma. The en bloc plus complete resection rate was 85.4%. Perforation during ESD occurred in 4.1% of the patients, and this was immediately closed with endoclips and then it was managed by conservative medical treatment. Bleeding occurred in 17.9% and there were no patients with severe bleeding. The en bloc plus complete resection rate and the complication rate for the elderly patients were not significantly different from those of the younger patients. CONCLUSIONS: The present study shows that ESD could be a safe and reliable treatment for gastric neoplasms in elderly patients.
Adenocarcinoma ; Aged ; Hemorrhage ; Humans ; Stomach Neoplasms

BACKGROUND/AIMS: Transient elastography as performed using the Fibroscan(R) is a useful noninvasive method for evaluating hepatic fibrosis. However, recent studies have found that liver stiffness measurement (LSM) values are inappropriately elevated in acute hepatitis or in the acute flare state of chronic hepatitis, suggesting that the LSM value obtained by the Fibroscan(R) is not a reliable marker for fibrosis. We retrospectively evaluated the clinical factors influencing the LSM value obtained using transient elastography as performed using the Fibroscan(R) in patients with chronic liver disease. METHODS: A total of 298 patients who were followed in Kungpook National University Hospital from November 2007 to May 2008 due to previously established liver cirrhosis or chronic liver disease were investigated using the Fibroscan(R), laboratory test, ultrasound, and/or abdominal computed tomography. RESULTS: The 298 patients were aged 47.8+/-12.9 years (mean+/-SD). The cut-off value for a diagnosis of liver cirrhosis was 12.5 kPa (as used in previous studies). Thirty-six patients (15%) and 202 patients (85%) with chronic liver disease without clinical manifestation of cirrhosis had LSMs of >12.5 kPa and <12.5 kPa, respectively. Multivariate analysis revealed that LSM values were unusually increased in patients with chronic liver disease who were older (P=0.007) or who had increased gamma gultamyltranspetidase (GGT) (P=0.022), decreased albumin (P=0.015), or increased total bilirubin (P=0.009). CONCLUSIONS: This study reveals that age, GGT, and albumin are clinical factors influencing LSM values. This reinforces the need to interpret LSM values in the context of a defined diagnosis, biochemical data, radiologic examination, and other clinical findings.
Adult ; Age Factors ; Bilirubin/metabolism ; Biological Markers/blood ; Chronic Disease ; *Elasticity Imaging Techniques ; Female ; Hepatitis/diagnosis/ultrasonography ; Humans ; Liver Cirrhosis/diagnosis/ultrasonography ; Liver Diseases/diagnosis/radiography/*ultrasonography ; Male ; Middle Aged ; Retrospective Studies ; Serum Albumin/metabolism ; Tomography, X-Ray Computed ; gamma-Glutamyltransferase/metabolism