Volvulus of the colon is a twisting of a redundant segment of the colon about it's narrow mesentery and sigmoid volvulus is the most common type. In many developing counteries this disorder is a common cause of obstruction of the intestine and in the western hemisphere it occurs in elderly patients who often have significant coexisting disease. This disorder may spontaneously reduce and recur as a chronic problem, but more frequently it becomes acute by obstruction, which may lead to strangulation and gangrene with high mortality if not treated promptly. Recently We have experienced 5 cases of signmoid volvulus, which were all in their twenties and had surgical operation. They had the triad of abdominal pain, distention, and absolute constipation. Plain abdominal roentgenogram was diagnostic in all cases The first line of treatment was nonoperative decompression with rigid sigmoidoscopy and successful in four of five. One Patient had emergency Hartman operation and other four had elective sigmoid resection with primary anastomosis.
Abdominal Pain ; Aged ; Colon ; Colon, Sigmoid* ; Constipation ; Decompression ; Emergencies ; Gangrene ; Humans ; Intestinal Volvulus* ; Intestines ; Male* ; Mesentery ; Mortality ; Sigmoidoscopy

No abstract available.
Chondrocytes* ; Ear* ; Intercellular Signaling Peptides and Proteins*

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.
Complement System Proteins ; Femur ; Neoplasm Metastasis ; Osteosarcoma ; Prognosis

Numerous hypotheses have been put forth over the years to explain the development of bipolar disorder. Of these, circadian rhythm hypotheses have gained much importance of late. While the hypothalamus-pituitary-adrenal (HPA) axis hyperactivation hypothesis and the monoamine hypothesis somewhat explain the pathogenic mechanism of depression, they do not provide an explanation for the development of mania/hypomania. Interestingly, all patients with bipolar disorder display significant disruption of circadian rhythms and sleep/wake cycles throughout their mood cycles. Indeed, mice carrying the Clock gene mutation exhibit an overall behavioral profile that is similar to human mania, including hyperactivity, decreased sleep, lowered depression-like behavior, and lower anxiety. It was recently reported that monoamine signaling is in fact regulated by the circadian system. Thus, circadian rhythm instability, imposed on the dysregulation of HPA axis and monoamine system, may in turn increase individual susceptibility for switching from depression to mania/hypomania. In addition to addressing the pathophysiologic mechanism underlying the manic switch, circadian rhythm hypotheses can explain other bipolar disorder-related phenomena such as treatment resistant depression and mixed features.
Animals ; Bipolar Disorder* ; Chronobiology Disorders ; Circadian Rhythm* ; Depression ; Depressive Disorder, Treatment-Resistant ; Humans ; Mice

No abstract available.
Intracranial Arteriovenous Malformations* ; Microsurgery*

No abstract available.

Objective: Vertebral artery dissecting aneurysm (VADA) is a rare and critical disease. VADA rupture can cause subarachnoid hemorrhage which is a major complication of VADA due to their high rebleeding rate and poor outcome. In the present study, ruptured and unruptured VADAs were compared by analyzing angiographic findings to determine useful predisposing factors for VADA rupture for appropriate treatment selection. Methods: Subjects with VADA treated during a 10-year period were retrospectively identified. The 57 cases diagnosed with VADA were divided into ruptured (n=15) and unruptured (n=42) groups. In addition, each case was analyzed using angiographic 3-dimensional (3-D) reconstructed images. Factors such as length, dilated and stenotic diameter, shape, and vessel around the vertebral artery (VA) were measured and statistically compared. Results: In the ruptured group, stenotic findings of the affected lesion were more common and severe than in the unruptured group. The average stenotic diameter was 2.27 mm (vs. 2.84 mm). And stenotic degree was 62% and 53% in the ruptured and unruptured groups, respectively. Posterior communicating artery (PcomA) flow was more common in the ruptured group (87% vs. 55%, p=0.028). Conclusions Based on angiographic findings, stenotic lesions, which may be influenced by PcomA flow, are more common in ruptured VADAs.

The authors report a very rare case of tuberculous spondylitis combined with a schwannoma of spinal cord. A 39-year-old man was admitted because of paraparesis(G1/G2). MRI showed severe cord compression at two different levels. One was by the bulged soft tissue and subligamentous abscess extending from T7 to T9 and the other was by an intradural extramedullary cord tumor at the level of T1-2. At first operation, T8 corpectomy and T7-9 plate fixation with autogenous iliac bone graft were performed. After then, Paraparesis was improved(G2/G3) postoperatively. The second operation underwent two weeks later. The tumor was totally removed and shortly after second operation, paraparesis was markedly improved(G3/G4). Histological diagnosis were tuberculous spondylitis and schwannoma, respectively. The authors reviewed this case where good surgical outcome was obtained by two stage operation.
Abscess ; Adult ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Neurilemmoma* ; Paraparesis ; Spinal Cord* ; Spondylitis* ; Transplants

A low iodine diet (LID) is the recommended preparation for radioactive iodine treatment. However, the recommended duration and stringency of LID are different among each recommendation. More stringent LID is expected in Korea because Korea is a iodine-rich region. We investigated the decrement of urine iodine excretion by two-week stringent LID for remnant thyroid ablation with radioactive iodine in Korean patients with thyroid cancer, prospectively. MATERIAL AND METHOD: From November 2006, patients who referred to our hospital for remnant ablation after total thyroidectomy were included in this study. To decrease total body iodine, our protocol included three strategies. First, we checked medication which could inhibit the radioactive iodine uptake. Second, the date of I-131 treatment was scheduled at least 3 months later if contrast agent had been used. The last strategy was two-week stringent LID education by specialized nutritionist. Before and after two-week stringent LID, 24hr-urine iodine was analyzed respectively. 24hr-urine creatinine was also analyzed for determining more valid 24hr urine sampling subgroup. RESULTS: Total 51 patients were finally enrolled. Average of 24hr-urine iodine excretion was significantly lowered (787+/-2242 -> 85+/-85 microgram/d, p=0.03) after LID and 74.4% of patients reached below the recommended urine iodine excretion level (<100 microgram/d). In subgroup (n=14), similar results was showed (505+/-666 -> 99+/-116 microgram/d, p=0.05) and 78.6% of patients met the criteria. CONCLUSION: Most patients could reach below the recommended urine iodine level after two-week stringent LID. Therefore, in our opinion, at least two-week stringent LID should be recommended in Korea.
Creatinine ; Diet ; Humans ; Iodine ; Korea ; Prospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

BACKGROUND AND OBJECTIVES: Adhesion of middle ear and mastoid cavity after mastoidectomy represents a potential source of surgical failure. GUARDIX-SL(R), absorbable anti-adhesive material, which is composed of sodium hyaluronate and sodium carboxymethyl cellulose, is an effective agent that widely used as a surgical adjuvant to decrease adhesion in the surgery. Therefore, we evaluated the clinical efficacy of the GUARDIX-SL(R) for the prevention of adhesion after mastoidectomy. SUBJECTS AND METHODS: This study was randomized and double-blinded. Conventional intact canal wall mastoidectomy was conducted in both control (n=14) and study group (n=10). To avoid bias because of different surgeons, we only included patients who were operated on by one surgeon. In the study group, 1.5 g GUARDIX-SL(R) was applied in the mastoid cavity at the end of mastoidectomy. To evaluate anti-adhesive effect of GUARDIX-SL(R), the volume of aerated area in the mastoid cavity was calculated and compared with temporal bone computed tomography performed at preoperatively and postoperatively. Besides, to assess the success of operation, pure tone audiometry was also performed at preoperatively and postoperatively. RESULTS: The volume of aerated area of mastoid cavity after mastoidectomy was more increased in GUARDIX-SL(R) group, but was not statistically significant in the GUARDIX-SL(R) group than the control. And all results of pure tone audiometry satisfied the criteria of successful operation which has been suggested by Otological Society of Korea. CONCLUSION: The results suggest that GUARDIX-SL(R) may be an efficacious and safe material in decreasing the incidence of adhesion after mastoidectomy.
Audiometry ; Bias (Epidemiology) ; Carboxymethylcellulose Sodium ; Ear, Middle ; Humans ; Hyaluronic Acid ; Incidence ; Mastoid ; Sodium ; Temporal Bone ; Tissue Adhesions ; Tympanoplasty