Lumbar hernias are rare posterolateral abdominal wall defects that may be congenital or acquired. There are two types of lumbar hernia, the superior lumbar hernia through Grynfeltt triangle, and the inferior lumbar hernia through Petit triangle. Many techniques have been described for the surgical repair of lumbar hernias including primary repair, local tissue flaps, and conventional mesh repair. But these open techniques require a large skin incision. We report a case of superior lumbar hernia, which was successfully repaired using a laparoscopic approach.
Abdominal Wall ; Hernia ; Skin

In this paper, waveform preserving coding technique is proposed for the bio-signals based on wavelet transform local maxima representation. In order to efficiently encode the bio-signal, it utilize the inherent property of bio-signals that sharp waves corresponding to the local maxima in wavelet domain contain the most of the clinically significant information in general. The testing sets of ECG and EEG are experimented to select the appropriate wavelet basis and to demonstrate the usefulness regarding to coding efficiency. The spline basis is more suitable in designing the coder than the Harr basis since the spline basis produces less number of local maxima than the Harr basis. The proposed wavelet method based on spline basis outperforms the conventional subband coding technique in terms of wave form degradation and coding efficiency. The actual transmission experiment using external communication network and the general personal computer demonstrates the applicability to telemedicine system handling the bio-signals.
Clinical Coding ; Electrocardiography ; Electroencephalography ; Microcomputers ; Telemedicine* ; Wavelet Analysis

PURPOSE: This study was performed to compare osteogenic capacity according to the scaffold, i.e., calcium metaphosphate on purified bovine collagen (Lubboc(R)). MATERIALS AND METHODS: Calcium metaphosphate and Lubboc blocks were immersed within a bone marrow cell suspension from New Zealand white male rabbit anterior superior iliac spine to produce cell-biomaterial complexes. These were cultured for 5 weeks in osteogenic media and differences with bone densitometry, light microscopic examination, electron microscopic examination, concentration of osteocalcin from osteoblasts were then evaluated. RESULTS: In light microscopic examination, more organized tissue was observed in the Lubboc(R) group. By electron microscopy osteoblasts and the matrix were densely overlapped on the surface of the Lubboc(R) group, whereas cells were scattered on the calcium metaphosphate. Immunohistologic examination for osteocalcin was definitely positive in the Lubboc(R) group, but the reaction on the calcium metaphosphate was unclear, and densitometry revealed that Lubboc(R) (0.028 gms/cm2) showed a statistically significant higher density than calcium metaphosphate (0.026 gms/cm2). CONCLUSION: Highly purified bovine collagen was more effective than calcium metaphosphate in osteogenesis in vitro.
Bone Marrow Cells ; Calcium* ; Collagen ; Densitometry ; Heterografts* ; Humans ; Male ; Microscopy, Electron ; New Zealand ; Osteoblasts* ; Osteocalcin ; Osteogenesis* ; Spine

Despite recent improvements in operative techniques, immunosuppression and organ procurement, failure of a hepatic allograft remains an important risk to liver recipients. In the absence of any effective method of extracorporeal support, the only alternative to death for these patients is retransplantation. The causes of hepatic allograft failure were listed as primary nonfunction, technical included hepatic artery thrombosis or portal vein thrombosis, and rejection. Hepatic artery thrombosis remain one of most serious complication after liver transplantation and can be associated with one of three typical syndrome: acute, massive hepatic necrosis, biliary tract necrosis and leakage, relapsing bacteremia. The early diagnosis of hepatic artery thrombosis is very important and screening with duplex ulrtasound can allow the recognition of early hepatic artery thrombosis. The emgent revascularization of hepatic artery thrombosis in asymptomatic patient and retransplantation in symptomatic patient lead to improved graft salvage and patient survival. We report one case of hepatic retransplantation due to hepatic artery thrombosis. The patient with 30 years old man underwent primary hepatic transplantation due to liver cirrhosis with hepatocellular carcinoma. After 6th postoperative day of primary transplantation, liver transaminase began to elevate and not responded to steroid pulse therapy. Thereafter bile leakage, evident in T-tube cholangiogram was noted. Explolaparotomy was performed and showed hepatic artery thrombosis and necrosis of donor aspect of extrahepatic biliary tree. On next day, retransplantation was performed. Thereafter secondary graft function was slowly regained but the patient was recoverd and discharged.
Adult ; Allografts ; Bacteremia ; Bile ; Biliary Tract ; Carcinoma, Hepatocellular ; Early Diagnosis ; Hepatic Artery ; Humans ; Immunosuppression ; Liver ; Liver Cirrhosis ; Liver Transplantation ; Mass Screening ; Massive Hepatic Necrosis ; Necrosis ; Thrombosis ; Tissue and Organ Procurement ; Tissue Donors ; Transplants ; Venous Thrombosis

Software modules for interactive display, manipulation and retrieval of medical images have been designed for a Picture Archiving and Communications System (PACS). The target of these modules is not for a high-end diagnostic workstation for radiologists, but for a PC-based low cost clinical workstation for a referring physician. This software is constructed based on a concept of an object-oriented language which is designed to be modular and expandable. It consists of several functional modules: (a) a communication module for image retrieval, (b) a standard module for the interpretation of the DICOM images, (c) a user interface module for the non-computer oriented clinicians and (d) a tool module for viewing and manipulating images as well as editing the annotation.
Image Processing, Computer-Assisted/instrumentation* ; Radiology Information Systems* ; Software*

Primary Signet-ring-cell adenocarcinoma of the urinary bladder is an extremely rare variant that promotes considerable interest, 21 cases reported as of 1981. Morphologically, this tumor is identical to signet-ring-cell carcinomas of the gastrointestinal tract, breast, lung and nasal cavity, and differentiation must be carried out with great care. Characteristically, primary signet-ring-cell adenocarcinoma carries a poor prognosis with early penetration of the mucosa, submucosa, and muscularis. This tumor is sessile, infiltrates early, extends locally to adjacent organs, and metastasized late. Many patients reported died of local extension with ureteral obstruction and uremia rather than wide spread metastasis. We are reporting two cases of primary signet-ring-cell adenocarcinoma of the urinary bladder treated with radical cystectomy and transurethral resection with radiotherapy, which died of local extension with ureteral obstruction and uremia, with pathological findings and review of the literatures.
Adenocarcinoma* ; Breast ; Cystectomy ; Gastrointestinal Tract ; Humans ; Lung ; Mucous Membrane ; Nasal Cavity ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Uremia ; Ureteral Obstruction ; Urinary Bladder Neoplasms ; Urinary Bladder*

BACKGROUND: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. PURPOSE: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. METHODS: Eleven rabbits were divided into two groups: control group (n=5) and deferoxamine pretreatment group (n=6). the left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with ethylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after tripheyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. RESULTS: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery (P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group (P<0.05) The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.
Arteries ; Blood Pressure ; Catheters ; Coronary Vessels ; Deferoxamine* ; Electrocardiography ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hydroxyl Radical ; Iron ; Ischemia ; Ligation ; Myocardial Infarction* ; Myocardium ; Necrosis ; Oxygen ; Rabbits ; Reperfusion ; Transducers, Pressure

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.
Abdomen ; Female ; Humans ; Physical Examination ; Spleen* ; Surgical Instruments ; Ultrasonography ; Viola ; Young Adult

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.
Abdomen ; Female ; Humans ; Physical Examination ; Spleen* ; Surgical Instruments ; Ultrasonography ; Viola ; Young Adult

PURPOSE: Epinephrine itself exhibits some cardiotoxicity. However, it rarely induces cardiomyopathy when used in standard doses during surgery for local hemostasis. This paper reports a rare case of stress-induced cardiomyopathy in a young woman after the local infiltration of epinephrine. METHODS: Corrective rhinoplasty was planned in a 20-year-old woman. Lidocaine mixed with epinephrine 1:100,000 was injected around the skin of the nose and nasal septum after inducing anesthesia, which resulted in sinus tachycardia and hypotension. Postoperative ECG showed a T wave inversion in the lead V2 and echocardiography revealed transient hypokinesia in the cardiac apex. Cardiac enzyme was mildly elevated. RESULTS: Symptoms and laboratory findings improved considerably, and the patient was discharged from hospital without complications on the sixth day after surgery. CONCLUSION: The prognosis of catecholamine-induced cardiomyopathy is generally favorable. However, it is important to be aware of the possible adverse effects of local epinephrine infiltration. This case highlights the need for caution when using epinephrine.
Anesthesia ; Cardiomyopathies ; Echocardiography ; Electrocardiography ; Epinephrine ; Female ; Hemostasis ; Humans ; Hypokinesia ; Hypotension ; Lidocaine ; Nasal Septum ; Nose ; Prognosis ; Rhinoplasty ; Skin ; Surgery, Plastic ; Tachycardia, Sinus ; Young Adult