Volvulus of the colon is a twisting of a redundant segment of the colon about it's narrow mesentery and sigmoid volvulus is the most common type. In many developing counteries this disorder is a common cause of obstruction of the intestine and in the western hemisphere it occurs in elderly patients who often have significant coexisting disease. This disorder may spontaneously reduce and recur as a chronic problem, but more frequently it becomes acute by obstruction, which may lead to strangulation and gangrene with high mortality if not treated promptly. Recently We have experienced 5 cases of signmoid volvulus, which were all in their twenties and had surgical operation. They had the triad of abdominal pain, distention, and absolute constipation. Plain abdominal roentgenogram was diagnostic in all cases The first line of treatment was nonoperative decompression with rigid sigmoidoscopy and successful in four of five. One Patient had emergency Hartman operation and other four had elective sigmoid resection with primary anastomosis.
Abdominal Pain ; Aged ; Colon ; Colon, Sigmoid* ; Constipation ; Decompression ; Emergencies ; Gangrene ; Humans ; Intestinal Volvulus* ; Intestines ; Male* ; Mesentery ; Mortality ; Sigmoidoscopy

Here, a case of a 59-year-old man with rotator cuff tear and impingement syndrome caused by an ossified coracoacromial ligament is presented. Ossification of the coracoacromial ligaments can occur because of degenerative changes due to trauma or repeated stress, which can lead to impingement syndrome. Therefore, when coracoacromial ligament ossification is present, rotator cuff damage due to impingement syndrome should be considered. Here, we conducted arthroscopic subacromial decompression, removal of the ossified coracoacromial ligament, and supraspinatus and subscapularis tendon repairs. We achieved satisfactory surgical outcomes without relapse; therefore, we report this case with a literature review.
Decompression ; Humans ; Ligaments* ; Middle Aged ; Recurrence ; Rotator Cuff ; Shoulder ; Shoulder Impingement Syndrome* ; Tears ; Tendons

No abstract available.

BACKGROUND: Nosocomial urinary tract infection (UTI) is the most frequent nosocomial infection and could be prevented through the intensive nosocomial infection control (NIC) or restricting the use of indwelling urinary catheter. The efficiency of the intensive NIC to prevent UTI for the patients with indwelling urinary catheter was investigated. METHODS: Study population consisted of 296 patients with indwelling urinary catheter in the intensive care unit (lCU) who didn't have UTI on admission. The incidence rates of nosocomial UTI were compared between 146 patients being provided with ordinary NIC from March 15 to July 31, 1995 (control group) and 150 patients being provided with intensive NIC from January 16 to October 31, 1996 (NIC group). RESULTS: There was significant decrease in the incidence of nosocomial UTI in the NIC group (35 UTI among 150 patients, 23.8%) than in me control group (68 UTI among 146 patients, 46.6%) (P<0.01). But there were no differences in age distribution, sex, admission route to the ICU and underlying diagnoses between two groups. Interval between insertion of urinary catheter and development of UTI was significantly prolonged in the NIC group (10.0 +/- 3.5 days) than in the control group(7.6 +/- 3.9 days) (p < 0.01) despite there were no differences in the duration of urinary catheterization in two groups. The most common organism isolated from the urine of the patients was Candida tropicalis in both groups and the other organisms were in the order of Enterococcus faecium, Pseudomonas putida, Staphylococcus epidermidis in the control group and in the order of Staphylococcus aureus, Acinetobacter baumannii, Enterococcus faecalis in the NIC group. Four of five Staphylococcus aureus isolated in NIC group were MRSA. CONCLUSION: This study result confirms the efficiency of intensive NIC fur decrease in the incidence of nosocomial UTI in patients with indwelling urinary catheter. But the incidence of nosocomial UTI should be decreased further through the continuous emphasis on NIC and it seems to be necessary to study the effect of each component of NIC with proper control of the risk factors for the development of nosocomial UTI in the future.
Acinetobacter baumannii ; Age Distribution ; Candida tropicalis ; Cross Infection* ; Diagnosis ; Enterococcus faecalis ; Enterococcus faecium ; Humans ; Incidence ; Intensive Care Units* ; Critical Care* ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas putida ; Risk Factors ; Staphylococcus aureus ; Staphylococcus epidermidis ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

OBJECTIVES: To investigate the work-relation of the asthma of a 51-year old aircraft maintenance worker and his working environment METHODS: For 2 weeks, the patient went back into his workplace. The pulmonary function test including FEV1 was performed every other day morning in the hospital and peak expiratory flow rate(PEFR) self-monitoring was done 6 times a day. RESULTS: The patient has been worked as aircraft maintenance worker in line maintenance department since 1968. The pulmonary function test(PFT) with bronchodilator confirmed the asthma of the patient. He showed positive response to 2-weeks workplace challenge test. On 3rd day after stopping challenge exposure, FEV 1.0 was 1.04 L(55 % of baseline measurement). The result of PEFR self-monitoring showed progressively deteriorating pattern, baseline PEFR was 6.02 L/min but PEFR on 3rd day after stopping exposure was 2.43 L/min. CONCLUSIONS: The present case could be occupational asthma based on positive results of PEFR monitoring. Further research will be needed to find the specific agent to cause asthma in aircraft maintenance workers exposed to aviation fuel and jet stream exhausts.
Aircraft ; Asthma* ; Asthma, Occupational ; Aviation ; Formaldehyde ; Humans ; Kerosene ; Middle Aged ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Rivers

Myotonic dystrophy is a multisystemic disorder inherited as an autosomal dominant trait. The characteristic clinical features include the presence of myotonia, atrophy of the muscles of the face and the sternocleidomastoids and numerous nonmusclar manifestations such as cataracts, frontal baldness, gonadal dysfunctions and cardiac abnormalities. We experienced one case of myotonic dystrophy with prolonged atrial flutter in 30-year-old male who was admitted because of palpitation. We present this case with reviewing literatures.
Adult ; Alopecia ; Atrial Flutter* ; Atrophy ; Cataract ; Gonads ; Humans ; Male ; Muscles ; Myotonia ; Myotonic Dystrophy*

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.
Complement System Proteins ; Femur ; Neoplasm Metastasis ; Osteosarcoma ; Prognosis

Bee stings can cause severe adverse reactions. There have been no cases of acute lung injury induced by bee sting acupuncture. We report a case of a 52-year-old male who required high flow oxygen therapy because of acute lung injury by bee sting acupuncture. The patient had been treated with live bee sting acupuncture by himself for knee pain. After self-injections of live bee sting, he immediately presented with generalized urticaria that remitted within 3 hours after taking an oral antihistamine. Ten days later, he visited our emergency department due to dyspnea and dizziness. He was diagnosed with acute lung injury by bee sting acupuncture based upon a history of symptom onset after exposure to the allergen and clinical test results. This case emphasizes that practitioners should consider potential risks of delayed-onset adverse reactions induced by bee sting acupuncture.
Acupuncture* ; Acute Lung Injury* ; Bee Venoms ; Bees* ; Bites and Stings* ; Dizziness ; Dyspnea ; Emergency Service, Hospital ; Humans ; Knee ; Male ; Middle Aged ; Oxygen ; Urticaria

BACKGROUND/AIMS: The prognosis of primary hepatocellular carcinoma is extremely poor because of its large size, portal vein thrpombosis, extrahepatic metastasis and underlying liver cirrhosis. The aim, of this study is to evaluate the usefulness of ultrasound screening test for early detection of hepatocellular carcinoma in high-ridk populations. METHODS: We analysed 119 patients who were diagnosed with hepatocellular carcinoma by ultrasonography screening test in Yonsei University Severance Hospital from the period of January 1990 to December 1996. RESULT: The mean follow-up duration to the diagnosis of hepatocellular carcinoma was 30 months (range 3-75). The number of patients with single lesion was 89(75%). The mean diameter of the tumor was 3.0 cm (range 1-10) , 82 patients (70%) had masses measured less than 3cm in diameter. The Number of patients with elevated serum alphafetoprotein level above 400ng/ml was 29(25%). The median survival was 28 months in screening group, significant compared with 7 months in control group (p<0.001). CONCLUSIONS: Ultrasound follow-up in high-ridk group of hepatocellular carcinoma mede it possible to detect small tumors in a high percentage of cases. This may lead to an increase in the number of potentially curable tumors and hence an increase in the overall survival rate. So ultrasound screening test is important in the high-ridk group of hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Liver Cirrhosis ; Mass Screening* ; Neoplasm Metastasis ; Portal Vein ; Prognosis ; Survival Rate ; Ultrasonography*

Fura-2 analogs are ratiometric fluoroprobes that are widely used for the quantitative measurement of [Ca2+]. However, the dye usage is intrinsically limited, as the dyes require ultraviolet (UV) excitation, which can also generate great interference, mainly from nicotinamide adenine dinucleotide (NADH) autofluorescence. Specifically, this limitation causes serious problems for the quantitative measurement of mitochondrial [Ca2+], as no available ratiometric dyes are excited in the visible range. Thus, NADH interference cannot be avoided during quantitative measurement of [Ca2+] because the majority of NADH is located in the mitochondria. The emission intensity ratio of two different excitation wavelengths must be constant when the fluorescent dye concentration is the same. In accordance with this principle, we developed a novel online method that corrected NADH and Fura-2-FF interference. We simultaneously measured multiple parameters, including NADH, [Ca2+], and pH/mitochondrial membrane potential; Fura-2-FF for mitochondrial [Ca2+] and TMRE for Psi(m) or carboxy-SNARF-1 for pH were used. With this novel method, we found that the resting mitochondrial [Ca2+] concentration was 1.03 microM. This 1 microM cytosolic Ca2+ could theoretically increase to more than 100 mM in mitochondria. However, the mitochondrial [Ca2+] increase was limited to ~30 microM in the presence of 1 microM cytosolic Ca2+. Our method solved the problem of NADH signal contamination during the use of Fura-2 analogs, and therefore the method may be useful when NADH interference is expected.
Animals ; Calcium ; Coloring Agents ; Cytosol ; Fura-2 ; Hydrogen-Ion Concentration ; Membrane Potential, Mitochondrial ; Membrane Potentials ; Mitochondria ; Muscle Cells* ; NAD* ; Rats*