Twin reversed arterial perfusion (TRAP) sequence is a rare specific anomaly of twin gestation with fused placenta and umbilical anastomosis. This syndrome occurs once in about 34,600 births and reported first by Beneditti in 1533. We report on prenatal diagnosis of a case of TRAP sequence with color Doppler sonography, this case is presented with a brief review of the literature.
Humans ; Parturition ; Perfusion ; Placenta ; Pregnancy ; Prenatal Diagnosis*

Fractures of the capitellum humeri are rare and the recommendations for treatment vary. It can involve a significant portion of the articular surface, rendering the elbow joint unstable. In this situation, it is desirable to reduce and internally fix the capitellar fragment, because this restores the articular surface and augments joint stability. We experienced two cases of capitellar fractures which one case was spontaneously anatomical reduced and the other case was treated by open reduction. In one case the capitellar fragment was spontaneous reduced to a stable position although it was noticed radiographically as an unstable displaced fracture preoperatively. The other case was treated by open reduction and internal fixation with 3.5mm, small, AO, cannulated screw and K-wire. Both cases are reported here with references.
Elbow Joint ; Joints

A 69-year-old male was admitted for dyspnea and chest pain. The patient had undergone coronary artery bypass graft surgery and tube thoracostomy three years ago. The chest radiograph showed pleural effusion, which was drained using a percutaneous catheter with CT guidance. However, residual pneumothorax was observed four days later. Despite insertion of the 12 Fr trocar-type tube, pneumothorax did not improve and air leaks were observed. Chest CT showed that the tube was placed in the left main bronchus. After removal of the tube, the patient recovered uneventfully from pulmonary hemorrhage and bronchial perforation without complications.
Aged ; Bronchi ; Catheters* ; Chest Pain ; Coronary Artery Bypass ; Dyspnea ; Hemorrhage ; Humans ; Iatrogenic Disease ; Male ; Pleural Effusion ; Pneumothorax ; Radiography, Thoracic ; Thoracostomy* ; Tomography, X-Ray Computed ; Transplants

A 67-year-old female presented to the emergency department with complaints of dyspnea and chest wall pain after a fall from a cultivator. Initial chest CT showed multiple left rib fractures, a loculated hematoma without active bleeding, and hemothorax. On the third day of admission, the chest X-ray showed an abrupt aggravation of haziness and the chest CT showed that the size of the hematoma had increased with active bleeding from the pulmonary artery. In cases of loculated hematomas adjacent to the hilum on CT scan, the diagnosis of pulmonary artery injury should be considered.
Aged ; Delayed Diagnosis* ; Diagnosis ; Dyspnea ; Emergency Service, Hospital ; Female ; Hematoma ; Hemorrhage ; Hemothorax ; Humans ; Lung* ; Pulmonary Artery* ; Rib Fractures ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.
Brain Death* ; Brain Injuries* ; Brain* ; Extracorporeal Membrane Oxygenation* ; Humans ; Kidney ; Liver ; Tissue and Organ Procurement ; Tissue Donors*

No abstract available.
Cerebrospinal Fluid* ; Spinal Fractures*

BACKGROUND: This study investigated the efficacy and safety of combined subacromial and intravenous patient-controlled analgesia for control of postoperative pain after arthroscopic rotator cuff repair. METHODS: Between May 2012 and August 2014, 60 patients who underwent arthroscopic rotator cuff repair with acromioplasty and received patient-controlled analgesia were studied prospectively. Cases were divided into 2 groups: combined subacromial and intravenous infusion group (group A, 30 cases) and solitary intravenous infusion group (group B, 30 cases). The visual analogue scale was used to record the patient's level of pain every 12 hours during postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia. RESULTS: The mean preoperative visual analogue scale score was 7.8 in group A and 7.6 in group B, and the immediate postoperative visual analogue scale score was 7.9 and 8.1 for each group. At postoperative time (From 12 hours to 72 hours after operation), the scores of combined subacromial and intravenous infusion were significantly lower than those of solitary intravenous infusion. Significant difference in the frequency of supplemental analgesic injections was observed between group A and group B (p=0.008). However, no significant difference in complication rate was observed between the two groups (p=0.562). CONCLUSIONS: Combined subacromial and intravenous patient-controlled analgesia after arthroscopic rotator cuff repair is more effective than solitary intravenous infusion without significantly increasing complications. Therefore, combined subacromial and intravenous patient-controlled analgesia could be a effective pain control method.
Analgesia, Patient-Controlled* ; Humans ; Infusions, Intravenous ; Methods ; Pain, Postoperative ; Prospective Studies ; Rotator Cuff*

As gastroduodenoscopy performed more frequently, case reports of human echinostomiasis are increasing in Korea. A Korean woman presented at a local clinic with complaints of abdominal pain and discomfort that had persisted for 2 weeks. Under gastroduodenoscopy, two motile flukes were found attached on the duodenal bulb, and retrieved with endoscopic forceps. She had history of eating raw frog meat. The two flukes were identified as Echinostoma hortense by egg morphology, 27 collar spines with 4 end-group spines, and surface ultrastructural characters. This report may prove frogs to be a source of human echinostome infections.
Animals ; Duodenal Diseases/*parasitology ; Duodenum/*parasitology ; Echinostoma/*isolation & purification ; Echinostomiasis/*diagnosis ; Endoscopy ; Female ; Humans ; Korea ; Middle Aged

Earlier work suggested that Ginseng saponin had an effect on osteoblast and other cells, but there has been no report on saponin effects on chondrocyte. The purpose of this study was to investigate the effect of saponin on cultured human chondrocyte. The chondrocyte was isolated from human articular cartilage of knee joint during notchplasty of ACL reconstructive procedure using collagenase, and cultured in standard medium and serum free deficient medium, with addition of saponin(0(control), 10, 20, 50 microgram/ml concentration). DNA, RNA synthesis of chondrocyte was estimated on 36 hours and 5 days of culture by measuring of thymidine and uridine uptake. Human collagen type I and II synthesis was estimated by reverse transcriptation-polymerase chain reaction on 36 hours of culture. Low dose saponin was found to enhance DNA, RNA, and collagen synthesis of chondrocytes which were cultured with a deficient medium in comparison to the controls. It promoted cell proliferation of the osteoblasts cultured with a deficient medium in comparison to the controls. But, high dose saponin was found to diminish the synthesis of DNA, RNA and collagen. In summary, the results showed that the saponin increased proliferation and differentiation of the chondrocyte cultured in deficient medium. Therefore saponin seemed to act as a physiologic stimulant on human chondrocyte. But further study should be done.
Cartilage, Articular ; Cell Proliferation ; Chondrocytes* ; Collagen ; Collagen Type I ; Collagenases ; DNA ; Humans* ; Knee Joint ; Osteoblasts ; Panax* ; RNA ; Saponins* ; Thymidine ; Uridine

Accompanying to the development of the knowledgment of mechanism and pathology of recurrent dislocation of the shoulder, accurate diagnostic tools to detect that pathology have been developed. During the period from May 1990 to May 1992, we treated 28 cases of recurrent anterior dislocation of the shoulder. Twenty-eight cases were examined with C.T. arthrography before the operation. Among the 28 cases, we identified the Bankart lesion in 20 cases by C.T. arthrography, and in 21 cases intraoperatively. We concluded that the C.T. arthrography is an accurate method for confirming the clinical diagnosis of recurrent dislocation of the shoulder and to be helpful in detecting the Bankart lesion and its severity or pathologic findings.
Arthrography ; Diagnosis ; Dislocations ; Methods ; Pathology ; Shoulder