No abstract available.
Emergencies* ; Hematoma, Subdural, Acute* ; Trephining*

No abstract available.
Humans ; Hypertension* ; Perindopril*

The Kallmanns syndrome is the most common form of isolated hypogonadotropic hypogonadism in which anosmia or hyposmia resulting from agenesis of hypoplasia of the olfactory lobes is associated with LHRH deficiency, This syndrome is genetically heterogeneous and can be trans-mitted as an X-linked, autosomal dominant or autosomal recessive trait. The hypogonadotropic hypogonadism results in absent or incomplete pubertal development and may be associated with anosmia or hyposmia, mid-line defect(color blindness, cleft-lip or
Blindness ; Cryptorchidism ; Epiphyses ; Femur Neck ; Gonadotropin-Releasing Hormone ; Growth Plate ; Head ; Humans ; Hypogonadism ; Kallmann Syndrome ; Male ; Olfaction Disorders ; Olfactory Cortex ; Slipped Capital Femoral Epiphyses

BACKGROUND: Extended-spectrum cephalosporins and fluoroquinolones are important antimicrobials for treating invasive salmonellosis, and emerging resistance to these antimicrobials is of paramount concern. METHODS: A total of 30 Salmonella spp. clinical isolates recovered in Gyeongsangbuk-do from 2012 to 2013 were characterized using antibiotic resistance profiles and pulsed-field gel electrophoresis (PFGE). RESULTS: A high prevalence of multidrug-resistant isolates, mainly showing an ampicillin, nalidixic acid, chloramphenicol resistance pattern, was observed. Four extended-spectrum beta-lactamase (ESBL)-producing isolates (3 CTX-M-15 isolates and 1 CTX-M-27 isolate) were found. The bla(CTX-M-27) gene was carried by an IncF conjugative plasmid in the S. Infantis isolate. The bla(CTX-M-15) gene were carried by an IncF (2 isolates) or IncHI2 (1 isolate) conjugative plasmid in S. Enteritidis. In addition, a single mutation of GyrA, Ser83Thr (1 isolates), Asp87Tyr (9 isolates), Asp87Gly (4 isolates), and Asp87Leu (3 isolates), was detected in nalidixic acid-resistant Salmonella spp. isolates. XbaI PFGE analysis of all isolates revealed more than 19 different pulsotypes. The most common S. Enteritidis PFGE pattern (SEGX01.003) was associated with a larger number of cases of invasive salmonellosis than all other patterns. CONCLUSION: The information from our study can assist in source attribution, outbreak investigations, and tailoring of interventions to maximize disease prevention.
Ampicillin ; beta-Lactamases ; Cephalosporins ; Chloramphenicol Resistance ; Drug Resistance ; Drug Resistance, Microbial ; Electrophoresis, Gel, Pulsed-Field ; Fluoroquinolones ; Gyeongsangbuk-do ; Nalidixic Acid ; Plasmids ; Prevalence ; Salmonella Infections ; Salmonella*

PURPOSE: This study describes the CT findings of changes in the maxillary sinus after the Caldwell-Luc procedure. MATERIALS AND METHODS: The maxillary sinus-related findings in 35 cases among 20 patients(17 cases in 10 males and 18 cases in 10 females)who had undrgone the Caldwell-Luc procedure mean 14.6 years earlier were reviewed. CT scans were obtained in the axial and coronal planes, with 5mm thickness. By means of the t test, changes in the size of the bony wall of the maxillary sinus, as well as antral volume change, were compared with the normal maxillary sinus group(41 male and 23 female cases). Males and females were compared separately, and surgical bony defect of nasolabial antrotomy and nasoantral window, fibroosseous proliferation, compartmentation and mucosal thickening of the postoperative maxillary sinus were evaluated, as were findings of chronic or recurrent maxillary sinusitis and postoperative complications. RESULTS: Naso-labial antrotomy was clearly identified in 27 of 35 cases, and irregular bony surface in the remaining eight, as were 27 bony defects and one irregular bony margin among a total of 28 cases of nasoantral window. Due to shortening of the height of the orbit, reductions in maxillary width, nasoantral communication width and anteroposterior diameter of the maxilla, and widening of the width of the inferior meatus, the maxillary sinus tended to become hypoplastic and centripetally contracted. Reduced cavitary volume of the maxillary sinus was noted(p<0.05), and fibro-osseous proliferation(n=29), compartmentation(n=11), and mu-cosal thickening(n=22) of the postoperative maxillary sinus were also seen. There were findings of chronic si-nusitis(n=22), as well as complications of postoperative mucocele(n=3) and oroantral fistula(n=2) of the maxillary sinus. CONCLUSION: The characteristic maxillary sinus-related findings seen after the Caldwell-Luc procedure are helpful in distinguishing postoperative change from recurrent paranasal diseases and resulting complications.
Female ; Humans ; Male ; Maxilla ; Maxillary Sinus* ; Maxillary Sinusitis ; Orbit ; Paranasal Sinuses ; Postoperative Complications ; Tomography, X-Ray Computed

PURPOSE: Total mesorectal excision has been advocated as the effective operation for patients with rectal cancer to reduce the local recurrence rate after curative resection. Its rationale is to remove possible tumor foci at the mesorectum distal to the level of the rectal cancer. This study was undertaken to clarify the rationale for total mesorectal excision. METHODS: Total mesorectal excision was performed in 72 patients with rectal cancer who admitted in Severance Hospital between December, 1996 and December, 1997. The obtained mesorectums were classified to M0 (from the proximal margin to the distal margin of the tumor), M1 (from the distal margin to 2 cm below the distal margin), M2 (from 2 cm to 5 cm below the distal margin), and microscopic examination was done. RESULTS: The nodal metastases were detected in 7 cases and tumor deposits in 4 cases. Especially in M2 with Dukes' C2, the rate of nodal metastases was 3.6 percent and the rate of tumor deposits was 7.1 percent. The nodal metastases and tumor deposits in the distal mesorectum have no correlation with gross finding, size, location and differentiation of the tumor. CONCLUSIONS: En bloc excision of all mesorectal tissue down to at least 5 cm below the lower margin of the tumor is required for patients with advanced rectal cancer to remove possible metastatic lymph nodes and tumor deposits in the distal mesorectum.
Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Rectal Neoplasms* ; Recurrence

We experienced a case of primary sclerosing cholangitis(PSC) in a 40-year-old female who complained of jaundice and pruritus. Marked elevation of serum alkaline phophatase level, typical beaded appearance and pruned-tree appearance on endoscopic retrograde cholangiography, together with a finding of chronic obliterative fibrosing cholangitis on sono-guided gun biopsy specimen of the liver led to a confirmative diagnosis of PSC. The patient responded to ursodeoxycholic acid (UDCA), but was reluctant to treatment and died of hepatic failure 7 months later. PSC is a very rare disease in Korea. So far, only 5 cases including our present case have been reported in the Korean literature. Male-to-female ratio was 2:3 and the median age was 40(27-80 years old). Ulcerative colitis was associated in one case. Four cases involved both intra, and extrahepatic bile ducts and one case was reported to be confined in the intrahepatic bile ducts. Fatality was in 3 cases, 20 days, 36 days, and 7 months after the initial presentaion, respectively. The causes of death were acute cholangitis and sepsis in two, and hepatic failure in one. We herein report a case of PSC and clinical charateristics of the reported cases in Korea, and review the literature with an emphasis on UDCA treatment in PSC.
Adult ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biopsy ; Cause of Death ; Cholangiography ; Cholangitis ; Cholangitis, Sclerosing* ; Colitis, Ulcerative ; Diagnosis ; Female ; Humans ; Jaundice ; Korea ; Liver ; Liver Failure ; Pruritus ; Rare Diseases ; Sepsis ; Ursodeoxycholic Acid

A 42-year-old man without any signs or symptoms of illness underwent esophagogastroduodenoscopy (EGD) for a routine health check up. On esophagogastroduodenoscopy, multiple small and yellowish mucosal plaques were detected in the mid to distal esophagus. These plagues proved to be ectopic sebaceous glands of the esophagus according to the histologic examination. On the immunohistochemical staining with anti-Keratin 14, the basal cells and the heterotopic sebaceous glands were immunoreactive for keratin 14. The histogenesis of this extremely rare lesion is not completely clear. There have been some reports on ectopic esophagus sebaceous glands combined with esophageal cancer or gastric cancer. However, malignant transformation of the ectopic sebaceous gland itself has not yet been reported on. This case was regularly followed up for 12 months, and no interval change or malignant transformation was found both endoscopically and histologically.
Adult ; Endoscopy, Digestive System ; Esophageal Neoplasms ; Esophagus ; Humans ; Keratin-14 ; Sebaceous Glands ; Stomach Neoplasms

The common bile duct normally enters the posteromedial aspect of the second part of the duodenum. However, anomalous drainage of the common bile duct into the stomach, pyloric channel, duodenal bulb and fourth portion of the duodenum has been reported in the literature. An anomalous pancreatic duct, with ectopic drainage of the common bile duct, is particularly rare. Herein, we report the case of a 69-year-old woman who showed pancreatic ductal variation and anomalous drainage of the common bile duct into the duodenal bulb. The patient required a cholecystectomy and choledochoenteric anastomosis to relieve the obstructive jaundice and abdominal pain.
Abdominal Pain ; Aged ; Cholecystectomy ; Common Bile Duct* ; Drainage* ; Duodenum ; Female ; Humans ; Jaundice, Obstructive ; Pancreatic Ducts* ; Stomach