This paper presents the case of a ruptured hydrogel breast implant, along with its clinical, radiologic, and pathologic findings. Breast asymmetry is typically the most common clinical feature of breast implant rupture. In case of a hydrogel breast implant rupture, hydrogel spreads out after implant leakage and the breast is enlarged with swelling and edema. Intracapsular ruptures showed no significant collapse of the implants despite a collection of fluid surrounding the implant inside the capsule. However, extracapsular ruptures showed implant collapse and extensive inflammation or fibrosis extension to the muscle and chest wall. In this case, a large amount of fluid collection with enlarged implants inside the capsule and extracapsular granulomas were showed simultaneously. Since the use of silicone breast implants has been restricted, hydrogel implants have been used for some time as an alternative option for breast implants. However, hydrogel implants have been restricted because of their unpredictability and unreliability. This case report draws attention to an unusual presentation of complications following the insertion of hydrogel breast implants for augmentation mammoplasty.
Breast ; Breast Implants ; Edema ; Female ; Fibrosis ; Granuloma ; Hydrogel ; Inflammation ; Mammaplasty ; Muscles ; Rupture ; Silicones ; Thoracic Wall

PURPOSE: Anterior vaginal wall sling operation (by Raz`s method )for the treatment of stress urinary incontinence(SUI) associated with intrinsic sphincter dysfunction(ISD) may produce postoperative suprapubic discomfort and suture related problem such as pull-through and loosening. Stabilization of the bladder neck to the pubic bone decreases the tension placed on the anterior rectus fascia and lessens the possibility of suture-related pain and the risk of entrapment of ilioinguinal neve branches. At present, bone anchoring system is available in Korea but its cost sometimes limit the use of the kit. Therfore, we developed self-made titanium screw which is anchored to pubic bone at the time of anterior vaginal wall sling operation and acquired good short-term results. MATERIALS AND METHODS: Total 16 women who had SUI with ISD were treated by in-situ anterior vaginal wall sling using self-made titanium screw anchored to pubic bone to support the bladder neck and midurethra. Postoperative results were analyzed for 16 patients who has been followed up for more than 3 months after surgery. RESULTS: Overall cure rate was 100% at 3 months of follow-up. Complication included anemia in 2 patients, mild dysuria in 2 patients and osteitis pubis in 1 patient. After resting and antibiotic therapy, complications were subsided. CONCLUSIONS: In short term follow-up, anterior vaginal wall sling using self-made titanium screw was shown to be very effective treatment of SUI with ISD with simple technique and had relatively low cost, low complication rates. Long-term followup will be necessary to define the efficacy of this method.
Anemia ; Dysuria ; Fascia ; Female ; Follow-Up Studies ; Humans ; Korea ; Neck ; Osteitis ; Pubic Bone ; Suture Anchors ; Sutures ; Titanium* ; Urinary Bladder ; Urinary Incontinence*

No Abstract Available.
Adipose Tissue* ; Glomus Tumor*

Consideration of the nutritional status of patients with acute respiratory failure and mechanical ventilation is important for effective patient assessment and management. Patients with acute respiratory failure are at a high risk for developing malnutrition. High glucose intakes given during the administration of total parenteral nutrition (TPN) have been demonstrated to increase CO2 production. The workload imposed by the high CO2 production may precipitate respiratory distress in patients experiencing compromised pulmonary function. The authors report a case of successful weaning from mechanical ventilation in patient with post-operative ARDS by proper nutritional support and by changing the proportion of calories derived from carbohydrates and fats. Substitution of fat calories for carbohydrate in TNA solutions can reduce CO2 production and help wean patients from mechanical ventilation. Conclusively, the TNA (total nutrients admixture) system is more beneficial to patients with acute respiratory failure due to less CO2 production and surfactant production than TPN. For patients with hypercapnia, providing 25% to 30% of calories as carbohydrate and 50% to 55% of calories from fat may be beneficial.
Carbohydrates ; Fats ; Glucose ; Humans ; Hypercapnia ; Malnutrition ; Nutritional Status ; Nutritional Support* ; Parenteral Nutrition, Total ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilator Weaning* ; Ventilators, Mechanical* ; Weaning

Transcatheter arterial chemoembolization (TACE) improves the survival rate in patients with hepatocellular carcinoma (HCC). Despite the low probability, iatrogenic hepatic arterial dissections during interventional procedure are rarely created by the technical difficulties. Direct trauma from the guidewire, the tip of the catheter, or the jet of contrast injection can contribute to iatrogenic hepatic arterial dissections. We report one case of a female who had HCC necrosis caused by iatrogenic hepatic arterial dissection during TACE. Ischemia resulting from iatrogenic hepatic arterial dissection during TACE was smilar to the result of transarterial embolization for HCC on our case. To our knowledge, none of the similar cases was reported in previously published literatures.

OBJECTIVES: This study was conducted to compare between hallucination group and delusion group in patient with schizophrenia, using Brain (99m)Tc-ECD SPECT. METHODS: Among 16 patients with less than 3 schizophrenic episodes, 8 patients whose initial symptom was hallucination were assigned to the hallucination group, and other 8 patients with initial sumptom of delusion were assinged to the hallucination group. All of the patients clinically evaluated using the PANSS and BPRS. Both groups of patients and 8 healthy subjects underwent (99m)Tc-ECD SPECT. RESULTS: Score of thinking disturbance subscale of BPRS were significantly lower in the hallucination group than the delusion group. In SPECT analysis, the hallucination group showed significantly increased perfusion in some areas of the right temporal lobe, bilateral limbic lobes and left parietal lobe compared to delusion group. Both group had a reduced rCBF in some areas of the frontal lobe. CONCLUSION: The hallucniation group, compared with the delusion group, showed significantly increased regional cerebral blood flow in some regions. Therefore, this data suggests that different neural substrates may affect the process of auditory hallucination and delusion.
Brain ; Delusions ; Frontal Lobe ; Hallucinations ; Humans ; Parietal Lobe ; Perfusion ; Schizophrenia ; Temporal Lobe ; Thinking ; Tomography, Emission-Computed, Single-Photon

Adenosine is a short-acting coronary vasodilator, and it is widely used during pharmacological stress myocardial perfusion imaging. It has a well-established safety profile, and most of its side effects are known to be mild and transient. Until now, coronary vasospasm has been rarely reported as a side effect of adenosine during or after adenosine stress test. This study reports a case of coronary vasospasm which was documented on stress myocardial perfusion CT imaging during adenosine stress test.
Adenosine/*adverse effects/metabolism ; Aged ; Coronary Vasospasm/*chemically induced/pathology ; Humans ; Male ; Myocardial Perfusion Imaging/*methods ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Vasodilator Agents/*adverse effects/metabolism

The effects of electroacupuncture (EA) on the minimum alveolar concentration (MAC) and on the cardiovascular system were evaluated with dogs under isoflurane anesthesia. Eight healthy male beagles were randomly assigned to six study groups (five heads/group) with washout intervals of 7 ~ 31 days between experiments for recovery and anesthetic clearance. MAC of isoflurane and cardiovascular parameters were determined after EA at nonacupoint and and at acupoints LI-4, SP-6, ST-36 and TH-8. Electroacupuncture for 30 minutes at LI-4, SP-6, ST-36 and TH-8 acupoints lowered the MAC of isoflurane by 17.5 +/- 3.1%, 21.3 +/- 8.0%, 20.5 +/- 8.2% and 15.6 +/- 3.1%, respectively (p < 0.05). However, electrical stimulation of nonacupoint did not induce a significant change in MAC of isoflurane. In the cardiovascular system, the ST-36 group did not induce any significant change in cardiovascular parameters. In the TH-8 group, the mean and diastolic arterial pressure and the systemic vascular resistance were decreased. In the LI-4 group, cardiac output and cardiac index decreased after EA. These results indicate that EA at LI-4, SP-6 and ST-36 have advantages in isoflurane anesthesia in terms of reducing the dose of anesthetics and minimizing cardiovascular side effects.
Anesthesia, Inhalation/adverse effects/*veterinary ; Anesthetics, Inhalation/*pharmacokinetics/pharmacology ; Animals ; Blood Pressure/drug effects ; Cardiac Output ; Dogs/*metabolism/physiology ; Electroacupuncture/*veterinary ; Heart Rate/drug effects ; Isoflurane/*pharmacokinetics/pharmacology ; Male ; Pulmonary Alveoli/*metabolism ; Pulmonary Wedge Pressure/drug effects ; Random Allocation ; Vascular Resistance/drug effects

OBJECTIVE: Surgical drains are commonly used after the spine surgeries for minimizing hematoma formation, which can delay wound healing and may become a source of fibrosis, infection, and pain. The drain, however, may provide a direct route for infection if it is contaminated. Our objective was to survey the relationship between surgical drains and infection. METHODS: The 70 patients who had undergone single-level lumbar discectomy from April 2011 to March 2012 were retrospectively analyzed. Each patient's medical chart and magnetic resonance image were thoroughly reviewed after all the patients had been divided into the drainage and the nondrainage groups. The amounts and durations of the surgical drains in the drainage group were analyzed. Additionally, the levels of C-reactive protein, rates of infection, scores of preoperative and postoperative visual analog scale (VAS), and lengths of hospital stay after operation were compared between the 2 groups. RESULTS: In this study, 70 patients were retrospectively analyzed; out of which, 42 and 28 patients were included in the drainage and the nondrainage groups, respectively. Two of the postoperative infection cases in the nondrainage group required to undergo repeated operations. The frequency of the postoperative infection cases was higher in the nondrainage group than in the drainage group; however, there was no significant statistical difference between the 2 groups (p=0.157). CONCLUSION: Surgical drains did not elevate postoperative infection. Furthermore, drain tip cultures allowed us to detect postoperative infection at an early stage, and it led to faster initiation of antibiotics treatment.
Anti-Bacterial Agents ; C-Reactive Protein ; Diskectomy ; Drainage ; Fibrosis ; Hematoma ; Humans ; Length of Stay ; Retrospective Studies ; Spine ; Suction ; Treatment Outcome ; Visual Analog Scale ; Wound Healing

Androgen insensitivity syndrome is a genetic syndrome characterized by complete or partial resistance of end organs to the peripheral effect of androgen. The phenotype of this condition is female, despite the normal male karyotype 46,XY. This is the third most common cause of primary amenorrhea after gonadal dysgenesis and mullerian agenesis. There is a congenital insensitivity to androgens, transmitted by means of a maternal X-linked recessive gene responsible for the androgen intracellular receptor. Prophylactic gonadectomy in usually performed due to increased risk for development of malignancy and possible virilization. Pelviscopy provides a minimally invasive technique for the accurate diagnosis and also provides the opportunity for therapeutic management of these patients. Recently we experienced two cases of this syndrome and removed the gonad by pelviscopic surgery, so we presented them with brief review of literature.
Amenorrhea ; Androgen-Insensitivity Syndrome* ; Androgens ; Diagnosis ; Female ; Genes, Recessive ; Gonadal Dysgenesis ; Gonads ; Humans ; Karyotype ; Male ; Phenotype ; Virilism