The intestine is the third most commonly injured abdominal organ in blunt trauma. But we had a paucity of experience with these injuries. We experienced bowel ischemia in 55 year-old woman after motor-vehicle accident. She complained nausea, vomiting and weight, loss after traffic accident. We found mucosal hyperemia and intraluminal stenosis of duodenal second portion by the gastroscopy. So, we performed hypotonic duodenography and SMA and celiac angiograpby. Hypotonie duodenography showed a luminal narrowing from duodenojejunal junction to proximal jejunum and proximal dilatation, and SMA angiography showed 10 cm segment hypervascular staining of contrast medium in proximal portion. Therefore we performed jejunal loop segmentectomy. After operation she was discharged without complication.
Accidents, Traffic ; Angiography ; Constriction, Pathologic ; Dilatation ; Female ; Gastroscopy ; Humans ; Hyperemia ; Intestines ; Ischemia* ; Jejunum ; Mastectomy, Segmental ; Middle Aged ; Nausea ; Phenobarbital ; Vomiting

Advanced gastric cancer simulating early gastric cancer is increasing tendcncy due to development of diagnostic technology. A 64-year-old woman was admitted for epigastric discomfort. Endoscopy showed a small white mucus coated erosion and peripheral mucosal nodurarity on greater curvature side of antrum. Biopsy was resulted in adenocarcinoma. An upper GI series and abdominal sonography were normal. At surgery, advanced gastric carcinoma, Borrmann localized type IV in background of early gastric carcinoma, prepyloric antrum along the greater curvature with infiltration to the muscle layer and multiple lymphatic tumor emboli in serosa and perigastric adipose tissue and neural invasion and metastasis to 12 out of 28 perigastric lymph nodes with extranodal extension. 3 months later, distant metastasis such as cervical lymph node, pleural effusion, pericardial effusion, peritoneal seeding and ascites were noticed.
Adenocarcinoma ; Adipose Tissue ; Ascites ; Biopsy ; Endoscopy ; Esophagus* ; Female ; Humans ; Intestines* ; Lymph Nodes ; Middle Aged ; Mucus ; Neoplasm Metastasis ; Pericardial Effusion ; Pleural Effusion ; Serous Membrane ; Stomach Neoplasms* ; Stomach*

BACKGROUND/AIMS: Helicobacter pylori is found in more than 90% of patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Regression of lymphoma after H. pylori eradication was reported. Therefore, early detection of gastric MALT lymphoma is important. On reported several endoscopic findings, nonspecific gastritis with erosion and ulceration were common and there is no typical endoscopic findings. METHODS: Therefore we analyzed the endoscopic findings of 16 low-grade B-cell gastric MALT lymphoma confirmed by biopsy, PCR and immunostain and compared histologic change after eradicating H. pylori infection in patients who refused operation retrospectively from March 1995 to October 1996. RESULTS: The male: female ratio was 7:9 and mean age was 43,7 years ald (23-71 yr), On endoscopic findings of gastric MALT lymphoma, irregular shaped geographic superficial ulcer was 7 cases (43.7%), diffuse mucosal nodularity was 4 cases (25.0%) and erosion was 3 cases (18.7%). The most common site of MALT lymphoma was antrum and angle. H. pylori was positive in 87.5% (14/16 cases) and eradication of H. pylori was done in patients who refused operation and histologic improvement after H. pylori eradication was found in 62.5% (5/8 cases). CONCLUSIONS: The most common endoscopic findings of gastric MALT lymphoma was irregular geographic superficial ulcer but diffuse mucosal nodularity and erosions were also common. Therefore, biopsy must be taken, especially on the antrum and angle although nonspecific lesion may be suspected.
B-Lymphocytes ; Biopsy ; Endoscopy ; Esophagus* ; Female ; Gastric Mucosa* ; Gastritis ; Helicobacter pylori ; Humans ; Intestines* ; Lymphoid Tissue* ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Male ; Polymerase Chain Reaction ; Retrospective Studies ; Stomach* ; Ulcer

Of several possible configurations of pin fixation of a displaced supracondylar fracture of the humerus in children, the medial and lateral crossed pinning technique has been known to provide the greatest resistance to gross rotational displacement. A new technique with ipsilateral two lateral crossed pins was devised so as to avoid the ulnar nerve injury with good stability for fracture site. During the period from 1992 to 1994, 18 children with displaced supracondylar fracture of the humerus were treated by closed reduction and ipsilateral two lateral crossed pinning. Eighty nine percents of the final results were satisfactory. There were no ulnar nerve injuries and fixation loss in all cases from the treatment. This is a safe, simple and reliable technique for providing the good stability of fracture site as well as avoiding the ulnar nerve injury.
Child ; Humans ; Humerus ; Ulnar Nerve ; Ulnar Neuropathies ; United Nations

To study why the palmar capsular connections between radius and lunate remain intact in perilunate ligamentous injury of the wrist joint, and to compare the material properties of the short radiolunate, long radiolunate, and radioscaphoid region of the radioscaphocapitate ligaments (as the extrinsic ligaments) with those of the intrinsic ligaments of the previous papers, the anatomical and mechanical characteristics of those three palmar radiocarpal ligaments of twenty cadavers were measured and tested by a servo-hydraulic test machine. In spite of its small cross-sectional area (24% of short radiolunate ligament), the radioscaphoid ligament demonstrates a failure load of 58% and a stress of 260% of the short radiolunate ligament, and toughness similar to both the short and long radiolunate ligaments. This suggests that the radioscaphocapitate ligament may contribute as an initial constraint to perilunate injury. The failure load of the scapholunate ligament might be smaller than previously reported due to testing strain rate, which coupled with its short initial length may make it more vulnerable to injury at lower applied loads. The short radiolunate ligament, in spite of the largest width and cross-sectional area, has a failure load and toughness similar to the long radiolunate ligament. The material properties of short and long radiolunate ligaments may explain why the rest of the carpals persistently dislocate or fracture about lunate.
Cadaver ; Ligaments* ; Radius ; Wrist Joint ; Wrist*

Major depressive disorder(MDD) is one of the most common diseases with serious health consequences such as increased morbidity, disability, and mortality. Electroconvulsive therapy(ECT) has been used as a treatment for mental disorder since the 1930s. A growing number of recent publications support the conclusions that ECT is an effective and safe treatment for depressed patients. Dosing strategies, frequency, safety, side effects and efficacy of ECT in MDD will be considered. ECT may be an alternative to treatment with antidepressants.
Antidepressive Agents ; Depressive Disorder, Major ; Electroconvulsive Therapy ; Humans ; Mental Disorders

OBJECTIVE: The aim of this study was to develop a culturally sensitive instrument that addressed how individuals express and experience depression to detect this disorder in Koreans. We also assessed the validity, reliability, and diagnostic utility of this scale (Lee and Rhee Depression Scale; LRDS). METHODS: The sample consisted of 3,697 normal adults selected from 12 administrative districts (Do) and 448 Korean patients diagnosed with depression using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Reliability was calculated using Cronbach's alpha. Construct validity, discriminant validity, and concurrent validity were also measured. Receiver-operator-characteristic (ROC) analysis was employed to evaluate diagnostic efficiency. RESULTS: The LRDS was found to be a reliable instrument (Cronbach's alpha=0.95) consisting of six factors: negative thinking about the future, negative thinking about the self, worry and agitation, depressed mood, somatization, and loss of volition. Comparison of LRDS scores discriminated the group of patients with depression from the normal individuals in the control group. The measure showed good concurrent validity in that scores were significantly and strongly correlated with scores on established scales such as the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HAM-D), and the D scale of the Minnesota Multiphasic Personality Inventory-second edition (MMPI-2). Diagnostic efficiency was 77.7%, and the cut-off scores were 65 for males and 70 for females. CONCLUSION: To our knowledge, this is the first study to develop a depression-screening scale on the basis of Korean patients' complaints about the disorder. As a culturally sensitive tool, the LRDS will be useful in clinical and research settings in Korea.
Adult ; Axis, Cervical Vertebra ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Dihydroergotamine ; Factor Analysis, Statistical ; Humans ; Korea ; Male ; Mass Screening ; Minnesota ; Thinking ; Volition ; Weights and Measures

BACKGROUND/AIMS: Because colonoscopy is a painful procedure, analgesics and sedatives may be necessary as premedication. Midazolam reacts quicker, has a more excellent amnesic effect and fewer complications compared to diazepam. The effects of midazolam depend on dose, age, and rapidity of injection. According to several studies, side effects of midazolam were more common in high-dose injections (more than 5 mg) compared to low dose injections (0.03-0.05 rng/kg). Moreover, low dose injections were found to be as effective as high dose injections. However, there was no report about the effect and the side effects of midazolam in Korea. Therefore, we performed this study to determine the effect of low dose midazolam as premedication for colonoscopy. METHODS: We performed colonoscopy in 99 consecutive patients who were randomly selected (midazolam group: 50, placebo group: 49) prospectively from July 1996 to September 1996. Premedication was administered through intravenous injection of midazolam or saline 0.03 mg/kg, combined with intramuscular injections of meperidine 50 mg, and intravenous injections of Buscopan 20 mg in all patients. Blood pressure, puise rate, and O2 saturation by oxymeter were checked before, during, and 30 minutes after colonoscopy. The degree of amnesia, discomfort, cooperation and acceptance of the re-examination were checked.
Amnesia ; Analgesics ; Blood Pressure ; Butylscopolammonium Bromide ; Colonoscopy* ; Diazepam ; Humans ; Hypnotics and Sedatives ; Injections, Intramuscular ; Injections, Intravenous ; Korea ; Meperidine ; Midazolam* ; Premedication ; Prospective Studies

In Korea, careinoma of the cervix is the most common malignancy in women annually affecting 25 per every 100,000 female. The widespread use of the Papanicolaou smear has resulted in earlier detection of the tumor and a reduction in the number of patients with advanced disease, but the incidence of cervix. carcinoma is still the fifth most common malignancy in the world. Cervical carcinoma spreads to the small bowel primarily by direct extension from involved lymph nodes, most commonly from peraaortic or mesenteric nodes to the serosa of the bowel. But, the involvement of small bowel by cervical carcinoma is so rare, and shows a maximum incidence of small bowel involvement of less than 1.5%. We report a patient with squamous cell carcinoma of the cervix metastases to the second portion of the duodenum in whom the diagnosis was made by endoscopic biopsy of the lesion.
Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Duodenum* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Papanicolaou Test ; Serous Membrane ; Stomach*

Spontaneous thoracic epidural hematoma occur rarely. We present a case of spontaneous thoracic epidural hematoma without any identified etiology and discuss the symptoms, signs and pathophysiology of this disorder. Early diagnosis and treatment by surgery can result in good recovery.
Early Diagnosis ; Hematoma*