Herein, a new left renal vein stenting procedure (expandable metallic stent placement), which provided relief for an 18-year-old man incapacitated by an intermittent gross hematuria, is reported. The placement of an expandable metallic stent is a minimally invasive therapy, and a simpler and more physiological therapy than previous approaches to Nutcracker syndrome.
Adolescent ; Hematuria ; Humans ; Renal Veins ; Stents*

PURPOSE: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis. METHODS: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medpor(R)) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed. RESULTS: After partial orbital exenteration, the wound finally healed well without any additional abscess formation. CONCLUSIONS: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.
Prosthesis-Related Infections/diagnosis/*etiology/surgery ; Porosity ; Orbital Implants/*adverse effects ; Orbital Diseases/diagnosis/*etiology/surgery ; Magnetic Resonance Imaging ; Humans ; Follow-Up Studies ; Female ; Eye Enucleation ; Device Removal ; Aged ; Abscess/diagnosis/*etiology/surgery

PURPOSE: Prenatal diagnosis of congenital heart disease has been made by fetal echocardiography and its clinical impact on the outcome of complete atrioventricular septal defect(AVSD) cases has been analysed. METHODS: A retrospective study was performed for the fetal cases for complete AVSD diagnosed, confirmed postnatally or at second study and/or at autopsy and/or follow up at CHA hospital between January 1993 and December 2001. The outcome of complete AVSD has been analysed, and the associated anomalies & chromosomal defects has been described. RESULTS: There were 450 cases of significant CHD that had been diagnosed prenatally during the study period. Of whom 35 cases had complete AVSD, and 32 cases had complete AVSD associated with visceral heterotaxy. In the cases with complete AVSD who with chromosomal study, 53.8% had Down syndrome and an additional 7.7% had other chromosomal anomaly. Associated cardiac malformation was 34.2%. Extracardiac anomaly without chromosomal defect was founded in 5 cases(14%) included polydactyly, hydrocephalus, duodenal atresia, omphalocele, cleft lip and single umbilical artery. Among 35 fetal complete AVSD cases, 29 cases of complete AVSD has been terminated, 1 case died in utero, 1 case died at neonatal period and 4 cases were referred to cardiac center for planned delivery. The most common factors of termination were extracardiac and chromosomal anomaly. CONCLUSION: Among the significant CHD, incidence rate of complete AVSD was 7.8%. And the most of the complete AVSD has been terminated. 4 cases(11.4%) were referred to the cardiac center for planned delivery. The rate of termination was 82.9%. Fetal diagnosis of complete AVSD greatly increased the rate of termination.
Autopsy ; Cleft Lip ; Diagnosis ; Down Syndrome ; Echocardiography ; Follow-Up Studies ; Heart Defects, Congenital ; Hernia, Umbilical ; Heterotaxy Syndrome ; Hydrocephalus ; Incidence ; Polydactyly ; Prenatal Diagnosis* ; Retrospective Studies ; Single Umbilical Artery

Cartilage ; Cicatrix ; Cleft Lip ; Congenital Abnormalities ; Eye ; Humans ; Lip ; Orientation ; Rhinoplasty ; Succinates

Cimetidine is a well-tolerated H2-receptor antagonist widely used in the treatment of gastroduodenal diseases and allergic reactions such as urticaria. Numerous adverse reactions have been attributed to cimetidine, which is understandable in view of the attention and scrutiny the drug has received, its widespread use, and its systemic effects. The incidence of general side effects is less than 2%. The drug has caused an array of central nervous system disturbances, gynecomastia, and rarely hepatotoxicity, interstitial nephritis, bradycardia, hypotension, and even cardiac arrest. Cardiovascular side effects are extremely rare and have occurred during rapid intravenous injection. We report a case of anaphylactic shock after rapid intravenous injection of cimetidine.
Anaphylaxis* ; Bradycardia ; Central Nervous System ; Cimetidine* ; Gynecomastia ; Heart Arrest ; Hypersensitivity ; Hypotension ; Incidence ; Injections, Intravenous* ; Male ; Nephritis, Interstitial ; Urticaria

Reported cases of gastrosplenic fistulas are extremely rare in the literature. Malignancy is the primary cause in 50% of patients, followed by perforated peptic ulcer (40%). Fistulas can cause spleen rupture and potential bleeding that threaten the life of the patient. Lymphoma is the most common cause of malignancy complicated with gastrosplenic fistula. Most gastrosplenic fistulae caused by lymphoma eventually close following chemotherapy, although splenectomy should be performed to avoid further complications. We experienced a case of non-Hodgkin's lymphoma complicated with gastrosplenic fistula in a 21 year-old man. He was admitted to our hospital because of LUQ mass. On the abdominal CT, a splenic mass with central necrosis and gas was discovered. The biopsy specimen of the stomach and spleen displayed diffuse, large B cell type non-Hodgkin's lymphoma. After one cycle of CHOP chemotherapy, the LUQ mass was markedly regressed although the gastrosplenic fistula was still present on the follow-up CT. The fistula was treated by splenectomy and a partial resection of gastric fundus. Follow-up chemotherapy was continued after surgery.
Biopsy ; Drug Therapy ; Fistula* ; Follow-Up Studies ; Gastric Fundus ; Hemorrhage ; Hodgkin Disease* ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Necrosis ; Peptic Ulcer ; Rupture ; Spleen ; Splenectomy ; Stomach ; Tomography, X-Ray Computed ; Young Adult

PURPOSE: This study was designed to provide the basic data for the development of the management program for overactive bladder by ascertaining its prevalence among Korean women aged over 30 years, and the factors related to its occurrence. MATERIALS AND METHODS: The study was performed by using self-questionnaires through the community-based cross sectional study from May to July, 2000. The subjects consisted of 2869 women, aged over 30 up to 89 years, among those who understood and responded to the questionnaires, and was residing in Seoul, Kyongki Kangwon, Chungchong, YongNam, HoNam, Cheju proinces. They also did not have known neurological problem and diabetes mellitus. The data were analyzed by Student t-test, chi2-test, and multiple logistic regression with using SAS program. RESULTS: The results were as follows ; 1. They all experienced at least one of frequency, urgency, nocturia, urge incontinence for the past one year and 52.3% of the subjects had experienced symptom at least once in 5 voidings. The highest prevalence of overactive bladder was 86.2% in the category for 70 to 89 years, 74.3% for the sixties, 45.3% for the forties, 42.5% for the thirties. In the symptoms of 1499 women among subject, 19.4% of them had nocturia, 18.2% frequency, 10.5% urgency, 9.6% urge incontinence, 9.5% frequency and urgency, 5.9% frequency and nocturia. 2. The age(OR = 1.041, 95% Cl = 1.027, 1.055) and the menopause(OR = 0.696, 95% Cl = 0.527, 0.919) were related to overactive bladder occurrence. CONCLUSIONS: The above findings indicated that about the half of the women aged over 30 years had symptoms for overactive bladder, and the prevalence was higher in old women and the women with menopause. So, the prevention and management programs for overactive bladder are required to be developed, and the primary screening programs based on community shall be developed.
Diabetes Mellitus ; Female ; Gangwon-do ; Gyeonggi-do ; Humans ; Jeju-do ; Logistic Models ; Mass Screening ; Menopause ; Nocturia ; Prevalence ; Surveys and Questionnaires ; Seoul ; Urinary Bladder, Overactive* ; Urinary Incontinence, Urge

PURPOSE: The emergency department is prone to medical errors due to the patients'acuity and complexity. Collection and monitoring of data on medical errors are essential for setting priorities and improving patient safety. METHODS: Emergency physicians report medical errors voluntarily with an intranet-based error reporting system. The system is confidential and anonymous. Data on medical errors was collected at the emergency department of a tertiary teaching hospital with approximately 76,000 annual visits, during a nine-month period from April to December 2008. The collected data was analyzed prospectively. RESULTS: Of the 238 reports collected, 204 errors were analyzed. 90.6% of the errors were related to doctors and 21% were related to nurses. Error types were classified into clinical errors (57%), medication errors (7%) and administrative errors (35%). The levels of impact on patients caused by these errors were classified as near-miss in 28 (13%), no harm in 93 (45%), mild harm in 66 (32%), lethal in 5 (2%) and death in 2 (1%) cases. Errors that occurred in the elderly group (over 60 years of age) had more harmful impact than in other age groups (p=0.0003). The causes of these errors were human in 147 (72%), systems in 23 (11%) and both human and systems in 34 (17%). Most of these errors were preventable (99%). CONCLUSION: Data collected by the intranet-based medical error reporting system is useful to classify and analyze medical errors, and is also essential in the implementation of a patient safety system.
Aged ; Anonyms and Pseudonyms ; Emergencies ; Emergency Medicine ; Hospitals, Teaching ; Humans ; Medical Errors ; Medication Errors ; Patient Safety

Hepatic portal venous gas (HPVG) is a rare disease presenting as acute abdomen. There were first described in children with necrotizing enterocolitis in 1955. HPVG is caused by mesenteric ischemia but may have various etiologies. Predisposing factors that develop mesenteric ischemia include gastric ulcer disease, bowel obstruction, diverticulitis and sepsis. The presence of the air in the portal and mesenteric vein on radiographics has been associated with a mortality rate of more than 75% in earlier studies. Abdominal computed tomography has proven useful for detecting portomesenteric venous gas and pneumatosis intestinalis. We report a case of the patient with hepatic portal venous gas with pneumatosis intestinalis, which showed rapid progress of the disease and eventually died within 24 hours of admission.
Abdomen, Acute ; Child ; Diverticulitis ; Enterocolitis, Necrotizing ; Humans ; Ischemia ; Mesenteric Veins ; Portal Vein ; Rare Diseases ; Sepsis ; Stomach Ulcer

Malignant Sertoli cell tumor was diagnosed in a 5-year-old male Shih Tzu dog. Clinical features of the dog were anorexia, urinary incontinence, constipation, anemia, alopecia, and epistaxis. The dog also had unilateral cryptorchid testis in the abdomen. Several abdominal and thoracic masses were identified on radiography. Grossly, the cryptorchid testicular mass was markedly enlarged to 8 cm in diameter. On cut surface, firm and well demarcated milk-white neoplastic areas were irregularly separated by white fibrous bands. Histologically, the testicular mass was diagnosed as tubular pattern Sertoli cell tumor. In addition, abdominal and mediastinal lymph nodes metastasis were found. Immunohistochemically, the tumor cells were strongly positive for vimentin and neuron specific enolase, but negative for S-100 and cytokeratin.
Abdomen ; Alopecia ; Anemia ; Animals ; Anorexia ; Constipation ; Dogs ; Epistaxis ; European Continental Ancestry Group ; Humans ; Immunohistochemistry ; Keratins ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Phosphopyruvate Hydratase ; Preschool Child ; Sertoli Cell Tumor ; Testis ; Urinary Incontinence ; Vimentin