No abstract available.
Diskectomy*

No abstract available.
Humans ; Influenza A Virus, H1N1 Subtype/*isolation & purification ; Influenza, Human/*diagnosis

Although liposarcomas are second most frequently encountered sarcomas that occur in soft tissue, liposarcomas of the head and neck are very uncommon. Liposarcomas of the retropharyngeal space are rare and do not cause symptoms until they reach a large size to cause mass effect. Depending on the location of the pharyngeal tumor, patients may present with foreign body sensation on throat, swallowing difficulty, respiratory difficulty, a painless neck mass, or obstructive sleep apnea. Recently we have experienced a case of retropharyngeal liposarcoma causing obstructive sleep apnea, so we report our clinical experiences with a brief review of literature.
Deglutition ; Foreign Bodies ; Head ; Humans ; Liposarcoma ; Neck ; Pharynx ; Sarcoma ; Sensation ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

Human brucellosis is a newly emerging infectious disease in Korea, and the number of the patients with this disease has rapidly increased in recent years. To evaluate the most reliable method in diagnosing human brucellosis, a retrospective study was conducted. Medical records of patients admitted or followed-up at the outpatient department of a tertiary care university hospital during the past 5 years were reviewed. Among a total of 32 human brucellosis patients (24 males and 8 females), 21 (65.6%) were positive for standard tube agglutination test (STA) but negative for blood or bone marrow culture, 7 (21.9%) were positive for both STA and culture, and 4 (12.5%) were STA negative but culture positive. Based on these findings, we recommend that physicians include blood and/or bone marrow culture to obtain definitive diagnosis when clinical symptoms and signs strongly suggest the human brucellosis, even when STA is negative.
Agglutination Tests ; Bone Marrow ; Brucellosis ; Communicable Diseases, Emerging ; Humans ; Korea ; Male ; Medical Records ; Outpatients ; Retrospective Studies ; Tertiary Healthcare

BACKGROUND: During the secondary survey of advanced cardiac life support (ACLS), differential diagnosis to seek the cause of cardiac arrest is an important step in patient who failed to restore spontaneous circulation after the primary survey and resuscitation. This study was to evaluate the role of transesophageal echocardiography (TEE) for assessing the cause of cardiac arrest during the secondary survey of ACLS. METHOD: We performed biplane TEE during cardiopulmonary resuscitation (CPR) in 52 consecutive patients (31 male, 21 female, mean age: 58 years old) with cardiac arrest who failed to restore spontaneous circulation after the primary survey and resuscitation attempt. Initial presenting ECG rhythm was ventricular fibrillation in 7, asystole in 25, and pulseless electrical activity in 20 patients. TEE was performed immediately if spontaneous circulation was not restored after the primary survey and resuscitation. Possible causes of cardiac arrest were detected in 23 patients (44%) by TEE. Positive findings were observed in 3 (43%) of 7 patients with ventricular fibrillation, 12 (48%) of 25 patients with asystole, and 8 (40%) of 20 patients with pulseless electrical activity. TEE findings were as followings : pericardial effusion in 10, aortic dissection in 5, occlusion of mitral orifice by a thrombus or a mass in 2, main pulmonary artery thrombus in 2, thrombotic occlusion of the prosthetic valve in 1, hypertrophic cardiomyopathy in 1, and aortic stenosis in 1. Interventions including pericardiocentesis (n=10) and emergency thoracotomy (n=1) were attempted during resuscitation. Spontaneous circulation was restored in 16 patients (31%). One patient was discharged alive. CONCLUSION: TEE is an useful diagnostic tool to identify the cause of cardiac arrest during the secondary survey of ACLS.
Advanced Cardiac Life Support* ; Aortic Valve Stenosis ; Cardiomyopathy, Hypertrophic ; Cardiopulmonary Resuscitation ; Diagnosis, Differential* ; Echocardiography, Transesophageal* ; Electrocardiography ; Emergencies ; Female ; Heart Arrest* ; Humans ; Male ; Pericardial Effusion ; Pericardiocentesis ; Pulmonary Artery ; Resuscitation ; Thoracotomy ; Thrombosis ; Ventricular Fibrillation

Skeletal anterior open bite is a difficult problem to correct in orthodontic treatment. To treat adult patients who have skeletal anterior open bite, we considered two methods. Combination treatment of orthodontics & surgery and camouflage orthodontic treatment. In adults, treatment of severe skeletal anterior open bite consists mainly of surgically repositioning the maxilla or the mandible. However, camouflage therapy is often the treatment of choice for skeletal open bite patients who have mild to moderate skeletal discrepancies when growth modification is no longer possible. But excellent results generally require careful coordination of the orthodontic and surgical phases of treatment. This is a case report of a skeletal anterior open bite patients who were treated with orthodontic treatment and orthognathic surgery. First case was diagnosed as skeletal class I malocclusion & bimaxillary protrusion with anterior open bite, and finally treatment ended for removal of open bite with orthodontic procedure and bimaxillary anterior segmental osteotomy surgery. Second case was diagnosed as skeletal class II malocclusion with open bite & mandibular retrusion, and was treated with only camouflage orthodontics because she feared to have a surgery. In a regular follow up visit after debonding we proposed to the patient advanced genioplasty, and in her agreement her facial esthetics was improved through the surgery.
Adult ; Esthetics ; Follow-Up Studies ; Genioplasty ; Humans ; Malocclusion ; Mandible ; Maxilla ; Open Bite ; Orthodontics ; Orthognathic Surgery ; Osteotomy ; Retrognathia

BACKGROUND: Recent data showed prolonged administration of direct thrombin inhibitor might be needed to counteract the persistent thrombin activity and reduce the neointimal hyperplasia after arterial injury. We hypothesized that prolonged administration of LB30057, orally active direct thrombin inhibitor, might inhibit the vascular smooth muscle cell (SMC) proliferation in vitro and neointimal hyperplasia in rat carotid injury model. METHODS: In phase I, thrombin stimulated [methyl-3H] thymidine uptake was measured after LB30057 administration in cell culture study using rat aortic SMC. In phase II, LB30057 (low-dose: 5mg/kg, bid: mid-dose: 25mg/kg, bid: high-dose: 50mg/kg, bid) or placebo was administrated orally twice a day starting from 30minutes before injury until sacrifice for 14days in separated 2 sets of experiment. The histo-morphometric analysis for lumen area, intimal area, medial area, intima-to-medial ratio was performed. RESULTS: In vitro rat aortic SMC culture study, LB30057 inhibited thrombin-induced thymidine uptake. The mean neointimal area was significantly less in high-dose and mid-dose group than placebo group (high-dose vs. placebo: 0.14+/-0.02mm2 vs. 0.25+/-0.02mm2: mid-dose vs. placebo: 0.16+/-0.02mm2 vs. 0.29+/-0.03mm2, p<0.005) respectively and the mean ratio of neointima to medial area were significantly less in high-dose and mid-dose group than in placebo group (high-dose vs. placebo: 1.20+/-0.57 vs. 1.94+/-0.67, mid-dose vs. placebo: 1.58+/-0.29 vs. 2.39+/-0.27, p<0.05). There was no significant difference in the mean area of internal elastic lamina, external elastic lamina and mean luminal area between groups. In 2nd set experiment, the mean neointimal area (placebo: 0.29+/-0.03mm2, mid-dose: 0.16+/-0.02mm2: p<0.005), the mean area of internal elastic lamina and external elastic lamina were significantly less in mid-dose group than in placebo group. The mean ratio of neointima to medial area was significantly less in mid-dose group(1.58+/-0.29) than in placebo group (2.39+/-0.27) (p<0.05). CONCLUSION: LB30057 inhibits SMC proliferation in a dose dependent manner. Prolonged 14-day oral administration of LB30057 is effective in reducing the neointimal hyperplasia in rat carotid balloon injury model.
Administration, Oral ; Animals ; Cell Culture Techniques ; Cell Proliferation* ; Hyperplasia* ; Muscle, Smooth, Vascular* ; Neointima ; Phenobarbital ; Rats* ; Thrombin* ; Thymidine

BACKGROUNDS/AIMS: Pneumatosis intestinalis (PI) is a condition in which multiple gas-filled mural cysts develop in the gastrointestinal tract. Although its exact etiology remains obscure, PI is rarely observed in liver transplant (LT) recipients. METHODS: In 317 cases of adult living donor LT (LDLT) performed during 2011, PI developed in three patients during the 3 year follow-up. RESULTS: Of these three patients, the two who demonstrated PI at 6 weeks and 2 months after LT, respectively, were asymptomatic and showed no signs of secondary complications. Diagnosis was made incidentally using abdominal radiographs and computed tomography (CT) scans. PI was identified in the right ascending colon with concomitant pneumoperitoneum. These two patients received supportive care and maintained a regular diet. Follow-up CT scans demonstrated spontaneous resolution of PI with no complications. The third patient was admitted to the emergency room 30 months after LDLT. His symptoms included poor oral intake and intermittent abdominal pain with no passage of gas. Abdominal radiography and CT scans demonstrated PI in the entire small bowel, with small bowel dilatation, pneumoperitoneum, and pneumoretroperitoneum, but no peritonitis. Physical examination revealed abdominal distension but no tenderness or rebound tenderness. After 1 week of conservative treatment, including bowel rest and antibiotics therapy, PI and pneumoperitoneum resolved spontaneously without complications. CONCLUSIONS: We suggest that adult LDLT recipients who develop asymptomatic or symptomatic PI with no signs of secondary complications can be successfully managed with conservative treatment.
Abdominal Pain ; Adult* ; Anti-Bacterial Agents ; Colon, Ascending ; Diagnosis ; Diet ; Dilatation ; Emergency Service, Hospital ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Liver ; Liver Transplantation* ; Living Donors* ; Peritonitis ; Physical Examination ; Pneumoperitoneum ; Radiography, Abdominal ; Retropneumoperitoneum ; Tomography, X-Ray Computed

BACKGROUND: There have been many efforts to augment blood flow during cardiopulmonary resuscitation. These efforts have focused on maximizing the effect of cardiac pump or thoracic pump alone. However, considering that the heart is the biggest blood reservoir and increase of intrathoracic pressure can generate blood flow, simultaneous exploitation of both mechanisms may have synergistic effect. We hypothesized that simultaneous chest constriction in addition to sternal compression by standard CPR may have additive hemodynamic effects by preventing deformation of the chest and increase of intrathoracic pressure. METHODS AND RESULTS: we built a new mechanical device to perform compression and thoracic constriction simultaneously. The device consists of two main elements. Piston in the center is to depress the sternum. Strap is to constrict the thorax circumferentially. Strap is attached to both sides of the piston. When the piston is pushed down, it depresses the sternum and pulls on the thoracic strap. To detemine sump width to produce optimal hemodynamic effect, we measured hemodynamic parameters with variable widths of sump in two dogs after induction of ventricular fibrillation. Result of the experiment showed that 10 cm wide strap was determined to be most effective. We also determined optimal depth of compression to produce maximal hemodynamic effect with animal experiments using two dogs. Animal experiments showed that the highest aortic pressure could be generated when the sternum was depressed to 5 cm. Cardiopulmonary resuscitation using a new device could generate higher systolic aortic pressure, coronary perfusion pressure and end-tidal carbon dioxide tension in comparison with standard cardiopulmonary resuscitation in a pilot animal Study Using two dogs. CONCLUSION: New cardiopulmonary resuscitation method using a mechanical device designed by us could perform sternal compression and simultaneous thoracic constriction, and generate better hemodynamic effects than standard cardiopulmonary resuscitation in pilot animal experiments.
Animal Experimentation ; Animals ; Arterial Pressure ; Carbon Dioxide ; Cardiopulmonary Resuscitation* ; Constriction ; Dogs ; Equipment Design ; Heart ; Hemodynamics ; Perfusion ; Sternum ; Thorax ; Ventricular Fibrillation

Persistent cloaca is a very rare congenital anomaly with a single common perineal opening for the genital urinary and gastrointestinal tract, which is caused by abnormal formation of the urorectal septum. It has an incidence of 1 in 50,000 to 1 in 125,000 births and is much more common in females and in twin pregnancies. Pathologic findings of persistent cloaca include dilated bowel, hydrocolpos, urethral obstruction, hydronephrosis and oligohydramnios caused by obstruction of the bladder, vagina and intestine. Failure of the paired m llerian ducts to fuse also usually results in duplication of the uterus and vagina. Currently, the diagnosis depends on the prenatal sonography but the diagnosis may be very difficult due to the complex nature of the anomaly and variable appearances. We present a case of persistent cloaca with one opening confirmed by autopsy after therapeutic termination which was initially diagnosed by prenatal sonography.
Autopsy ; Cloaca* ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Hydrocolpos ; Hydronephrosis ; Incidence ; Intestines ; Oligohydramnios ; Parturition ; Pregnancy ; Pregnancy, Twin ; Urethral Obstruction ; Urinary Bladder ; Uterus ; Vagina