We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 minutes, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography. Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.
Anaphylaxis ; Anti-Bacterial Agents ; Aorta, Thoracic ; Cardiopulmonary Resuscitation* ; Echocardiography ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Intensive Care Units ; Middle Aged ; Operating Rooms ; Renal Artery ; Ribs ; Stomach Neoplasms ; Survivors* ; Thorax ; Tomography, Spiral Computed

Bone imagings have played important role in early detection of acute osteomyelitis. In acute osteomylitis, bone scan findings precede the appearance of bone change on radiograph. Also, recent studies have reported accuracies of bone scan in diagnosis of osteomyelitis ranging from 84% to 100%. But, in above datas, bone scan reading were only qualitative studies. So we have reviewed Technetium-99m labelled methylen dipho sphonate(99mTc-MDP) scan on 21 patients who had been diagnosed acute osteomyelitis by clinical symptoms, blood culture, pus culture and operative findings from January, 1984 to September, 1985. The purpose of this study is to establish the quantitative study of bone scan using computed pixel counting method. The 21 cases were classified into group I and group II according to initial radiographic findihgs. The group I showed normal radiographic finding or soft tissue swelling without osseous change. The group II showed osseous change. The results obtained were as follows: 1. We obtained positive bone scans in the all cases which were confirmed acute osteomyelitis. 2. We experienced diagnosis of acute osteomyelitis by bone scan which was confirmed as early as 48 hours after onset of clinical symptom. 3, In group I, the average uptake ratio of 99mTc-MDP was 3.22±0.82 ranging from 2.20 to 4.80. 4. In group II, the average uptake ratio of 99mTc-MDT was 6.20±2.27 ranging from 4.00 to 9.40. (p <0.001).
Diagnosis ; Early Diagnosis ; Humans ; Methods ; Osteomyelitis ; Radionuclide Imaging ; Suppuration ; Technetium Tc 99m Medronate

No abstract available.
Amitriptyline* ; Humans

PURPOSE: Recently, indirect lymphangiography has been developed as a relatively good and noninvasive imaging modality of the lymphatic system at extremities. But the disadvantage of the indirect lymphangiography is a low contrast ratio between the surrounding tissues and the contrast media in lymphatic vessels, because dimeric nonionic contrast media is water soluble and diluted in the proximal leg lymphatic vessels. We could have relatively better image than previously published images for the leg lymphatic system, when we injected contrast media with adequate high pressure in intradermal space of the interdigital areas at the foot dotsum. So, we would like to report the results. MATERIALS AND METHODS: We could study all 9 lymphedemas(primary :6, secondary: 3) from April 1990 to May 1993 on outpatient base. They were diagnosed as lymphedema clinically and radiologically. Ten ml of dimeric nonionic aget, iotrolan(Isovist 300 ) was injected into intradermal space with five 30-gauge needles The injection speed was more than 0.2mi/min. We have done one side pedal lymphangiogram in 30 minutes. The evaluation of the anterior superficial lymphatics was accordig to the criteria of the Weissleder(2). RESULTS: The results were as follows:1. All lymphatic vessels from foot to inguinal area could be visualized. 2. Two or three inferior inguinal lymph nodes could be visualized about 42%. 3. The most common abnormal finding of the lymphedma was the neovascularization of the lymphatics on indirect pedal lymphangiogram. CONCLUSION: If we use adequate technique relatively high pressure injection, correct intradermal needle insertion, adequate soft tissue exposure technique indirect lymphangiography is considered to be a safe and noninvasive imaging modality for the evaluation of the lymphedema of lower extremity lymphatics including inferior inguinal lymph nodes.
Contrast Media ; Extremities ; Foot ; Humans ; Leg ; Lower Extremity ; Lymph Nodes ; Lymphatic System ; Lymphatic Vessels ; Lymphedema ; Lymphography* ; Needles ; Outpatients

No abstract available.
Abscess* ; Fistula*

No abstract available.
Blood Transfusion* ; Female ; Humans

Authors analysed the corpus callosum of Korean(27 male & 14 female) anthrolopologically by the method of Kappers and Ban, and obtained the following results ; 1. The mean height of corpus callosum of the Korean male was about 25.9mm and that of the female was about 25.6mm. 2. The mean length of corpus callosum of the Korean male was about 69.1mm and that of the female was about 69.9mm. 3. According to the callosum horizontal index, the length of the cerebral hemisphere of the Korean male was about 2.22 times longer than that of the corpus callosum, and that of the female was about 2.27 times longer. 4. According to the callosum parietal index, the height of parietal lobe of the Korean male and female was about 2.8 times higher than that of corpus callosum. 5. The mean value of the callosum index of Korean was about 0.374, which was greater than that of the Japanese and Chinese, but lesser than that of Battak. 6. The most common type of corpus callosum of the Korean was the type III and VI, but the type I and X were not appeared. 7. According to the type distribution in relation to the callosum horizontal index, the type VI at callosum horizontal index 0.44 was the most common types.
Asian Continental Ancestry Group ; Cerebrum ; Corpus Callosum* ; Female ; Humans ; Male ; Methods ; Parietal Lobe ; Rabeprazole

No abstract available.
Escherichia coli* ; Escherichia* ; Urinary Tract Infections* ; Urinary Tract*

A 42-year old man was admitted for treatment of a fracture of the medial condyle of the left femur. After 10 days of cast immbilization of the above mentioned extremity, erythematous papulo-vesicular eruption was noted under the external splintage. We concluded that this was an unusual allergic contact dermatitis which is caused by CaSO4.1/2H20, and proved it by patch test in our clinic.
Calcium Sulfate ; Dermatitis, Allergic Contact ; Extremities ; Femur ; Patch Tests

Epithelioid sarcoma is malignant tumor described by Enzinger, that is likely to be confused with a varety of benign and malignant conditions, especially a granulomatous process, a synovial sarcoma Or an ulerating squamous cell carcinoma. The tumor occurs chiefly in young adult and most commonly affects the soft tissue of the hand, the forearm and the pretibial region. The tumor is characteristically a slowly growing lesion but frequent recurrence is common and metastasis were most frequent in the lung. In this paper, we reported one case which is believed to be epithelioid sarcoma in the forearm.
Carcinoma, Squamous Cell ; Forearm ; Hand ; Humans ; Lung ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Sarcoma, Synovial ; Young Adult