No abstract available.
Colonic Neoplasms* ; Humans ; Hydromorphone* ; Intercellular Adhesion Molecule-1*

Hysteroscopy is a procedure that may appear minimally invasive, but may result in potentially disastrous complications. A hysteroscopy requires the insertion of a hysteroscope into the uterine cavity and the installation of a suitable distention medium for the visualization of the endometrium. Fluid overload due to the absorption of distention media during hysteroscopy can cause mild to severe complications, including hyponatremia, hypoosmolarity, nausea, vomiting, headache, arrhythmia, blindness, confusion, seizure, cerebral edema, brain herniation, and death. We report a case of a 41 year-old female patient who underwent elective hysteroscopic myomectomy under general anesthesia. Approximately 4 hours after the beginning of the surgery, the patient's serum sodium concentration dropped to 109 mM. She was treated with furosemide and recovered without sequelae.
Absorption ; Anesthesia, General ; Arrhythmias, Cardiac ; Blindness ; Brain ; Brain Edema ; Endometrium ; Female ; Furosemide ; Headache ; Humans ; Hyponatremia ; Hysteroscopes ; Hysteroscopy ; Nausea ; Seizures ; Sodium ; Vomiting

Pulmonary embolism is a not uncommon perioperative complication that results in substantial morbidity and mortality. However prompt diagnosis is difficult because clinical symptoms and signs of pulmonary embolism are not completely obvious. We report a case of severe pulmonary embolism on the first postoperative day of total abdominal hysterectomy in a patient transfused preoperatively for iron deficiency anemia caused by menorrhagia. We diagnosed pulmonary embolism by echocardiogram and chest spiral computerized tomography and the patient was moved to the intensive care unit. Tissue plasminogen activator was given and followed by continuous heparin infusion but the patient did not improve. He developed multiple organ dysfunction syndrome and died on the seventh postoperative day.
Anemia ; Anemia, Iron-Deficiency ; Female ; Heparin ; Humans ; Hysterectomy ; Intensive Care Units ; Menorrhagia ; Multiple Organ Failure ; Postoperative Complications ; Pulmonary Embolism ; Thorax ; Tissue Plasminogen Activator ; Tomography, Spiral Computed

Chronic pancreatitis is a rare problem in childhood and sometimes shows pancreatic calcification. The most common symptom is recurrent upper abdominal pain with or without associated nausea or vomiting. Pancreatic calcifications are virtually pathognomonic of chronic pancreatitis. In our case, however, chronic pancreatitis caused by multiple pancreatic stones in dilated pancreatic duct, which was very rare in childhood. Endoscopic retrograde cholangiopancreaticography (ERCP) is valuable in confirming the diagnosis and decision making process for further medical or surgical management of pancreatic disease. We experienced a case of chronic relapsing pancreatitis with pancreatic stones in 13-year-old girl who presented with recurrent upper abdominal pain. She was investigated with ERCP and treated by endoscopic sphincterotomy of sphincter of Oddi and by some stone removal with endoscopic basket. We report this case and review related literatures briefly.
Abdominal Pain ; Adolescent ; Cholangiopancreatography, Endoscopic Retrograde ; Decision Making ; Diagnosis ; Female ; Humans ; Nausea ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatitis* ; Pancreatitis, Chronic ; Sphincter of Oddi ; Sphincterotomy, Endoscopic ; Vomiting

The purpose of this study was to assess several indices of diet quality based on nutrient, food and food group intake of Korean adolescents based on several indices on diet quality according to residence area and body size. Using the data from the 1998 National Health and Nutrition Survey, twenty-four-hour-dietary recalls of a total of 1,110 Korean adolescents aged 13-19 years (male 543, female 567) were analyzed for nutrient adequacy ratio (NAR), index of nutritional quality (INQ), the number of foods (Dietary Variety Score, DVS) and food group consumed (Dietary Diversity Score, DDS). In doing that, it was attempted to apply only the minimum amount of solid foods of Kant's without inclusion of liquid foods because of the very limited variety in Korean foods. Based on weight length index, 13.1% of the subjects were categorized as obese, 14.2%, overweight, 44.4%, normal and 28.3%, underweight. Only vitamin B2 intake was higher in the obese group than in the underweight group. There was no meaningful difference in energy, protein and fat intakes according to the grade of the body size. In terms of residence area, intake of fat, niacin, vitamin B6 and folic acid were lower in the rural areas than in the metropolitan city. Only vitamin E intake was higher in the rural areas. Mean value of NARs (MAR) and INQs (mINQ) was also higher in the metropolitan city than in the rural areas, but there was no significant difference of these two values according to body size of the subjects. Mean DVS was 21.02 for total subjects, and has no difference between male and female and between metropolitan city and other medium-small city. But, the rural areas showed the lowest DVS of 19.05. Mean DDS in which five is a maximum score was 3.3 with no significant difference by sex and by residence area in male subjects. However, in female subjects, DDS in the rural areas was the lowest. According to body size of the subjects, there was no meaningful difference in both scores of DVS and DDS. In conclusion, most indices of nutrient intake and food and food group intake were not significantly different by body size of the subjects, while most indices were significantly different by residence areas: higher in the metropolitan city than in the rural area.
Adolescent* ; Body Size* ; Diet* ; Female ; Folic Acid ; Humans ; Male ; Niacin ; Nutrition Surveys ; Nutritive Value ; Overweight ; Riboflavin ; Thinness ; Vitamin B 6 ; Vitamin E ; Vitamins

PURPOSE: The primary purpose of this study was to demonstrate that the TRIGEN™ INTERTAN nail (InterTAN) could show better clinical outcome compared to the proximal femoral nail antirotation 2 (PFNA2) for treatment of intertrochanteric fracture in the elderly. MATERIALS AND METHODS: Between March 2009 and December 2013, 164 patients with intertrochanteric fractures who met our inclusion and exclusion criteria were enrolled in this study. Evaluation variables, including operation time, blood loss during the operation, incidence of perioperative complications, clinical results at the last follow-up, and radiographic findings were assessed for comparison of the 2 implants. RESULTS: Intraoperative lateral wall fracture was significantly higher in the PFNA2 group (p<0.05) and tip apex distance was significantly higher in the InterTAN group (p<0.05). Sliding of the proximal fragment at the last follow-up was significantly higher in the PFNA2 group. However, there was no significant difference in union rate, time to union, postoperative complications, and clinical outcomes at the last follow-up between the 2 groups. CONCLUSION: Based on these data, clinical outcomes at the last follow-up were equivalent between InterTAN and PFNA2.
Aged ; Follow-Up Studies ; Hip Fractures* ; Humans ; Incidence ; Postoperative Complications

BACKGROUND: Severe forefoot deformities, particularly those involving the dorsum of the foot, cause inconvenience in daily activities of living including moderate pain on the dorsal aspect of the contracted foot while walking and difficulty in wearing nonsupportive shoes due to toe contractures. This paper presents clinical results of reconstruction of severe forefoot deformity using the anterolateral thigh (ALT) free flap. METHODS: Severe forefoot deformities were reconstructed using ALT flaps in 7 patients (8 cases) between March 2012 and December 2015. The mean contracture duration was 28.6 years. RESULTS: All the flaps survived completely. The size of the flaps ranged from 8 cm × 5 cm to 19 cm × 8 cm. The mean follow-up period was 10 months (range, 7 to 15 months). There was no specific complication at both the recipient and donor sites. There was one case where the toe contracture could not be completely treated after surgery. All of the patients were able to wear shoes and walk without pain. Also, the patients were highly satisfied with cosmetic results. CONCLUSIONS: The ALT flap may be considered ideal for the treatment of severe forefoot deformity.
Congenital Abnormalities ; Contracture* ; Follow-Up Studies ; Foot ; Foot Deformities ; Free Tissue Flaps ; Humans ; Shoes ; Thigh* ; Tissue Donors ; Toes ; Walking

PURPOSE: This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements. METHODS: In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed. RESULTS: The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference. CONCLUSIONS: Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.
Bone Resorption* ; Bone Substitutes ; Bone Transplantation ; Dental Implants ; Humans ; Lifting* ; Neck ; Osseointegration ; Radiography, Panoramic ; Retrospective Studies* ; Sinus Floor Augmentation ; Tooth* ; Transplants*

The purpose of this study was to determine composition of food groups appropriate for the evaluation of the quality of total diet or food guide, using the data from the 1998 National Health and Nutrition Survey. Twenty-fourhour-dietary recalls of total 1,110 Korean adolescents aged 13 - 19 years (male 543, female 567) were analyzed for food group consumed (Dietary Diversity Score, DDS), intake patterns of food group, mean index of nutritional quality (mINQ) and nutrient adequacy ratio (NAR). Considering Korean food pattern different from the Americans, this study is to check if Korean 5 food groups with both of oil & sugar group and vegetable &fruit group, and a minimum amount of 30 g in grain group and 15 g in meat group modified from Kant's minimum amount, 15 g in grain and 30 g in meat, could also be appropriate for the diet evaluation of Korean adolescents. Combination of food group and minimum food intake per each food group used in the first trial were categorized into 6 kinds of types: 1) American 5 food groups with Kant's minimum amount as control or 2) American 5 food groups with modified Kant's minimum amount 3) Korean 5 food groups excluded by sugar with the modified amount 4) Korean 5 food groups with modified amount 5) American food groups added oil group with the modified amount 6) American food groups added oil & sugar group with the modified amount. In case of oil group or oil and sugar group, 5 g was quoted for the minimum amount. Correlation between DDS and indices of other diet quality in each type of food group composition were analyzed and the best food group composition was traced by comparing the correlation coefficients of DDS and mINQ or MARs at alpha < 0.01. There was no meaningful difference in weight length index of the subjects of eating or not-eating oil or oil & sugar, while the values of mINQ showed higher in the subjects eating oil but no difference in the subjects eating oil & sugar, compared to the group not-eating, respectively. In comparison of type 1 and type 2, correlation between DDS and indices of other diet quality showed higher in type 1 using Kant's amount. And comparing the type of a combined group of fruit & vegetable (type 3 and 4) and the type of separated group of fruit and vegetable (type 5 and 6). six groups of separated vegetable and fruit showed the higher correlation of DDSs and indices of diet quality. In case of being classified into six groups with oil, DDS showed correlation of r = 0.293 with INQ. While, being classified into six groups with oil & sugar instead of oil only, DDS showed correlation of r = 0.249 with INQ. Accordingly the type 5 with oil is regarded as the better food group type than the type 6 with oil & sugar. Since better result was shown in the composition of six groups with Kant's minimum amount, the comparative analysis on both of type 1 with oil and oil & sugar was finally performed. Then oil added type 1 showed higher correlation of DDS and indices of diet quality. These result indicated that it would be more appropriate to use six food groups with separate vegetable and fruit including oil group (oil-added type 1) rather than oil &sugar group for evaluat ion of dietary quality of Korean adolescents using DDS.
Adolescent* ; Diet* ; Eating ; Edible Grain ; Female ; Fruit ; Humans ; Mars ; Meat ; Nutrition Surveys ; Nutritive Value ; Vegetables

BACKGROUND: Ganz surgical hip dislocation via a posterior (Kocher-Langenbeck) approach is a popular procedure in the management of femoroacetabular impingement (FAI). We report the results of surgery performed through an anterolateral (Watson-Jones) approach in the management of anterolateral FAI. METHODS: Twenty-one hips in 20 patients (mean age at the time of operation, 17.3 years) were treated surgically using an anterolateral approach: 12 hips with Legg-Calvé-Perthes disease, three septic hips, three hips with avascular necrosis (combined with slipped capital femoral epiphysis [SCFE], femoral neck fracture, and developmental dislocation of the hip), two hips with epiphyseal dysplasia, and one hip with SCFE. All patients had anterolateral FAI. Surgical hip dislocation was performed in four hips with trochanteric osteotomy. Combined osteotomies were for neck lengthening in 11 hips, varus or valgus osteotomy in the proximal femur in four hips, and pelvic osteotomy in four hips. Clinical results were evaluated using a modified Harris hip score (mHHS). RESULTS: Range of hip flexion and abduction showed statistically significant improvement after surgery; however, the improvement in mean mHHS was not statistically significant. CONCLUSIONS: An anterolateral approach can be used as an alternative to a posterior approach in the management of anterolateral FAI with or without hip dislocation while safely preserving the blood supply to the femoral head and allowing simultaneous procedures in the proximal femur.
Dislocations ; Femoracetabular Impingement ; Femoral Neck Fractures ; Femur ; Head ; Hip Dislocation ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Neck ; Necrosis ; Osteotomy ; Slipped Capital Femoral Epiphyses