We report on operational and rehabilitation management, as well as the outcome, of a patient who with sustained spinal cord injury from a high velocity gunshot wound to the lumbar spine. More specifically, a patient with a gunshot wound to the spine is more likely to sustain a complete injury and have a poor prognosis. As such, there should be concerns regarding associated and extended injuries related to bullet fragmentation as well as the possibility of long-term sequelae.
Forensic Ballistics ; Humans ; Prognosis ; Spinal Cord ; Spinal Cord Injuries ; Spine ; Wounds, Gunshot

OBJECTIVE: To assess the effect of electrical stimulation and weight-supported treadmill gait simulation on apoptosis in the muscles of rats with spinal cord injury. METHOD: Twenty seven rats with a model of complete spinal cord injury were assigned to one of the following groups: control (n=9), electrical stimulation (n=10), and exercise (n=8) groups. After a 2-week intervention period, they were sacrificed, and the pattern of apoptosis was analyzed by in situ DNA nick-end labeling (TUNEL), by DNA fragmentation assay, and by Western blot for Bax and Bcl-2 using specimens from the right hamstring muscles for all groups. RESULTS: The electrical stimulation group had increased apoptosis compared to the control group possibly due to overwork weakness, but there was no statistical significance between the groups. Apoptosis decreased in the exercise group compared with in the electrical stimulation and control group. The expression of Bcl-2 was most prominent in the exercise group, and it was significantly reduced in the electrical stimulation and control group. CONCLUSION: These findings suggest that exercise could play an important role in decreasing apoptosis by the up-regulation of Bcl-2 protein expression and that electrical stimulation might cause overwork weakness in rat models of spinal cord injury.
Animals ; Apoptosis ; Blotting, Western ; DNA ; DNA Fragmentation ; Electric Stimulation ; Gait ; Muscles ; Rats ; Spinal Cord ; Spinal Cord Injuries ; Up-Regulation

A Case of disseminated cryptococcosis in a 5-year old girl is reported. Although twenty four pediatric cases of cryptococcosis were reported in Korea for the past 15years, this case's clinical picture is interesting and make diagnostic difficulties from miliary tuberculosis. She was transferred from a local clinic under the impression of miliary tuberculosis with chest X-ray showing miliary shadows. Mantoux test showed strong positive. She was not vaccinated BCG and had a history of contact with tuberculous patient for a month. Cough, fever and abdominal pain were persisted in spite of antituberculous medications(INH & RMP). CSF examination revealed cryptococcus cyst. Facial skin lesions which looked like Moluscum contagiosum at first became to be umbilicated and disseminated. It was diagtococcal lesions with little inflammatory response. In spite of treatment with 5-FC and Amphotericin B, her general condition became worse and died of respiratory failure. A brief review of the literature was done.
Abdominal Pain ; Amphotericin B ; Child, Preschool ; Cough ; Cryptococcosis* ; Cryptococcus ; Female ; Fever ; Humans ; Korea ; Lung* ; Mycobacterium bovis ; Respiratory Insufficiency ; Skin* ; Thorax ; Tuberculosis, Miliary

The lung and stomach are very unusual sites for teratoma. The histologic findings of intrapulmonary and gastric teratomas are not different from those arising in usual sites, such as the ovary or testis. However, preoperative diagnosis is sometimes difficult to make partly because of unusual location. We report here two cases of teratoma, one intrapulmonary teratoma and the other gastric. The intrapulmonary teratoma in our study had an endobronchial tumor growth, which rules out mediastinal teratoma. Meanwhile gastric teratomas usually present as a submucosal tumor and most cases are reported in infancy and childhood. Gastric teratoma in this study occurred in a 27-year-old man. To the best of our knowledge, this case of intrapulmonary teratoma is the eighth and the gastric teratoma is the first to be reported in Korea.
Adult ; Case Report ; Gastrectomy ; Human ; Lung Neoplasms/surgery ; Lung Neoplasms/radiography ; Lung Neoplasms/pathology* ; Male ; Middle Age ; Stomach Neoplasms/surgery ; Stomach Neoplasms/radiography ; Stomach Neoplasms/pathology* ; Teratoma/surgery ; Teratoma/radiography ; Teratoma/pathology* ; Tomography, X-Ray Computed

No abstract available.
Behcet Syndrome* ; Renal Insufficiency*

OBJECTIVE: To determine the age-related changes in cardiac rehabilitation (CR) outcomes, which includes hemodynamic and metabolic factors, in patients with myocardial infarction (MI). METHODS: CR was administered for 8 weeks to 32 men (mean age, 54.0±8.8 years) who underwent percutaneous coronary intervention for acute MI between July 2012 and January 2016. The exercise tolerance tests were performed before and after the CR. The results were stratified based on a cut-off age of 55 years. RESULTS: In the whole patient group, the hemodynamic variables such as the resting heart rate (HRrest), systolic blood pressure (SBPrest), submaximal HR (HRsubmax), SBP (SBPsubmax), and rate pressure product (RPPsubmax) significantly decreased and the maximal HR (HRmax) and RPP (RPPmax) significantly increased. All metabolic variables displayed significant improvement, to include maximal oxygen consumption (VO2max) and ventilation (VEmax), anaerobic threshold (AT), and the maximal oxygen pulse (O2pulsemax). However, upon stratification by age, those who were younger than 55 years of age exhibited significant changes only in the HRrest and RPPsubmax and those aged 55 years old or greater displayed significant changes in all hemodynamic variables except diastolic BP. Both groups displayed significant increases in the VO2max, VEmax, and AT; the older group also exhibited a significant increase in O2pulsemax. The magnitude of the changes in the hemodynamic and metabolic variables before and after CR, based on age, did not differ between the groups; although, it tended to be greater among the older participants of this study's sample. CONCLUSION: Because the older participants tended to show greater hemodynamic and metabolic changes due to CR, a more aggressive CR program must be administered to elderly patients with MI.
Aged ; Anaerobic Threshold ; Blood Pressure ; Exercise Test ; Exercise Tolerance ; Heart Rate ; Hemodynamics ; Humans ; Male ; Myocardial Infarction* ; Oxygen ; Oxygen Consumption ; Percutaneous Coronary Intervention ; Rehabilitation* ; Ventilation

There is no consensus for the surgical indications, as well as the surgical technique, for the treatment of inferior vena cava (IVC) invasion by pancreas head cancer. The authors experienced a case of pancreas head cancer invading the anterior wall of the IVC. We performed en bloc excision of the anterior wall of the IVC combined with pancreatoduodenectomy in this case under the assumption that only a margin-negative surgical resection could offer a chance for cure. Technically, the sequence of dissection and addressing the IVC at the end of dissection are considered to be important to secure the operative field surrounding the IVC and to achieve a margin-negative resection. There has been no recurrence up to now, 8 months after the extensive radical operation.
Consensus ; Head and Neck Neoplasms ; Pancreas ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Recurrence ; Vena Cava, Inferior

There is no consensus for the surgical indications, as well as the surgical technique, for the treatment of inferior vena cava (IVC) invasion by pancreas head cancer. The authors experienced a case of pancreas head cancer invading the anterior wall of the IVC. We performed en bloc excision of the anterior wall of the IVC combined with pancreatoduodenectomy in this case under the assumption that only a margin-negative surgical resection could offer a chance for cure. Technically, the sequence of dissection and addressing the IVC at the end of dissection are considered to be important to secure the operative field surrounding the IVC and to achieve a margin-negative resection. There has been no recurrence up to now, 8 months after the extensive radical operation.
Consensus ; Head and Neck Neoplasms ; Pancreas ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Recurrence ; Vena Cava, Inferior

PURPOSE: Sexual dysfunction has been reported to be frequent in patients with acute myocardial infarction. One aim was to correlates the erectile function with the severity of coronary arterial disease in the acute myocardial infarction patients. MATERIALS AND METHODS: A total of 57 men, median age 55.7 years (range 29 to 81), with acute myocardial infarction who had received coronary angiography were evaluated about their erectile function with 15-item questionnaire, the International Index of Erectile Function (IIEF). History of vascular risk factors such as smoking, diabetes mellitus, and hypercholesterolemia were obtained. We compared the erectile function score to the number of occluded coronary vessels or patients age. RESULTS: One coronary vessel was involves in 16 patients (28.1%), more than 2 coronary vessels were involved in 25 patients (43,9%) while 16 patients (28.1%) showed free of occlusion. Seventy-four percent of patients claimed abnormal erectile function, mild erectile dysfunction in 19 patients (33.3%), moderate in 9 patients (15.8%), severe in 14 patients (24.6%). Erectile function score decreased significantly according to increasing in the number of coronary vessels involved (p<0.05) and in patients age (p<0.01). CONCLUSIONS: There was a significant correlation between erectile function and the severity of the coronary arterial disease in acute myocardial infarction patients. The age of patients also had a negative effects on the erectile function.
Coronary Angiography ; Coronary Vessels ; Diabetes Mellitus ; Erectile Dysfunction ; Humans ; Hypercholesterolemia ; Male ; Myocardial Infarction* ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking

The stenosing foramen of L5–S1 by several degenerative diseases is one of the challenging areas on surgical approaching because of the deeper depth and steep slope in the lumbosacral junction. The floating view using unilateral biportal endoscopic spine surgery rather than docking into the Kambin’s zone can make the foraminal structures seen panoramically and permit dynamic handling of various instruments without destroying the facet joint and causing iatrogenic instability. Fine discrimination of structural margins in helps of the higher magnification and gentle manipulation of neural structures just as in open spine surgery could be guaranteed using floating technique from the target structures. Selective decompression with preserving innocent structures including facet joints could relieve foraminal lesions at the L5–S1 and decrease the necessity of fusion surgery caused by wider decompression and iatrogenic instability.
Decompression ; Discrimination (Psychology) ; Endoscopy ; Lumbosacral Region ; Minimally Invasive Surgical Procedures ; Spinal Dysraphism ; Spinal Stenosis ; Spine ; Zygapophyseal Joint