Developmental venous anomalies are congenital anomalies of the intracranial venous drainage and clinically asymptomatic. Cavernous hemangiomas are vascular malformations composed of dilated vascular channels lined with a single layer of endothelial cells without any intervening normal neural tissue. Although, cavernous hemangioma may be clinically silent, but frequently cause variable neurologic manifestations; intracranial hemorrhage, seizures, and focal neurologic deficits. Frequent association of these two diseases has already been reported and it has been suggested that cavernous hemangiomas not the developmental venous anomalies that cause the acute clinical symptoms. A 4 year old girl with sudden onset of headache, vomiting, gait disturbance and signs of unilateral cerebellar dysfunction 2 days before admission showed a 2.5x2.5cm sized hematoma with heterogenous signal intensity both in CT and MRI in the left cerebellar hemisphere. Four-vessel cerebral angiography revealed characteristic findings of developmental venous anomalies. Pathologic findings of the surgically removed hematoma disclosed typical feature of cavernous hemangioma. Based on the findings in this case and review of the literatures, we concluded that the possibility of other diseases such as cavernous hemangiomas must be considered in patients who has intracranial hemorrhage due to the developmental venous anomalies.
Cerebellar Diseases ; Cerebral Angiography ; Child, Preschool ; Drainage ; Endothelial Cells ; Female ; Gait ; Headache ; Hemangioma, Cavernous* ; Hematoma ; Hemorrhage* ; Humans ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Seizures ; Vascular Malformations ; Vomiting

BACKGROUND/AIMS: An updated chronic kidney disease (CKD) definition and classification were proposed by Kidney Disease: Improving Global Outcomes (KDIGO), with adoption of a new equation to estimate glomerular filtration rate (GFR) and albuminuria to evaluate kidney structural damage. This study was performed to estimate the prevalence of CKD in the Korean adult population as defined and classified by the KDIGO guidelines. METHODS: Cross-sectional samples of the fifth Korean National Health and Nutrition Examination Survey for 2011 to 2012 were examined for adults aged ≥ 19 years. CKD prevalence was determined based on decreased GFR and albuminuria. The GFR was estimated using the CKD Epidemiology Collaboration creatinine equation, and albuminuria was evaluated using the albumin-to-creatinine ratio (ACR) in spot urine. RESULTS: Of the 16,576 subjects participating in the survey, 10,636 (4,758 men, 5,878 women) were included in the present study. The prevalence of CKD was estimated as 7.9% (7.8% in 2011 and 8.0% in 2012, p = 0.770). The prevalence of low, moderately increased, high, and very high CKD risk prognosis was 92.0%, 6.3%, 1.1%, and 0.6%, respectively. The prevalence of albuminuria (ACR ≥ 30 mg/g) in individuals with GFR ≥ 60 mL/min/1.73 m² has reached 5.7%. The odds ratios of hypertension and diabetes to CKD were 3.4 and 3.1 in men, and 2.9 and 2.0 in women (all p < 0.001), respectively. CONCLUSIONS: A large percentage of CKD patients had albuminuria prior to a decrease in GFR. Regular laboratory tests for albuminuria for the high-risk group, and especially for hypertensive or diabetic patients, might improve detection of CKD at an early stage.
Adult* ; Albuminuria ; Classification ; Cooperative Behavior ; Creatinine ; Epidemiology ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney ; Kidney Diseases ; Korea ; Male ; Nutrition Surveys ; Odds Ratio ; Prevalence* ; Prognosis ; Renal Insufficiency, Chronic*

Uterine fibroids are the most common benign tumor of the female genital tract. Traditional therapy for symptomatic fibroids has been either myomectomy or hysterectony, depending on whether futhur fertility is desire. A promised new altermative therapy-embolization of the uterine arteries- is now available. A 29 year-old woman was diagnosed of uterine fibroid by ultrasonogram and other techniques. We have experienced one case of uterine fibroid necrosis after transarterial embolization. Now we report a case of uterine artery embolization for treattement of uterine fibriods with a brief review.
Adult ; Female ; Fertility ; Humans ; Leiomyoma* ; Necrosis* ; Ultrasonography ; Uterine Artery Embolization

BACKGROUND: Complex regional pain syndrome (CRPS) is categorized into sympathetically maintained pain (SMP) and sympathetically independent pain (SIP). Spinal cord stimulation (SCS) is a promising approach in the treatment of severely disabling CRPS. Patients with good responses to sympathetic block before SCS are more likely to have positive responses to SCS than those with negative responses. This study compared the effects of SCS in patients with CRPS, of SMP and SIP categories. METHODS: This was a retrospective study of 16 patients (SMP 8, SIP 8) with CRPS who had undergone trials of SCS. Eleven of the patients had permanent SCS device implants, and the pain relief levels at 1 and 6 months were recorded. RESULTS: Sixteen patients with severe, incapacitating, and therapy-resistant CRPS underwent SCS trials. Five patients (SMP 3, SIP 2) had poor pain relief during the trial despite adequate coverage. The remaining 11 patients (SMP 5, SIP 6) had permanent electrode implantation performed under local anesthesia and experienced good pain relief. The difference in VAS reduction was not significant between the two groups at the 1-month follow-up (P = 0.325) and the 6-month follow-up (P = 0.779). CONCLUSIONS: There were no statistically significant differences in VAS pain scores between the two groups. The favorable outcome in all 11 patients with only minor remaining symptoms or without remaining symptoms or severe recurrences suggests that SCS is an efficient treatment in SMP and SIP.
Anesthesia, Local ; Electrodes ; Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies ; Spinal Cord ; Spinal Cord Stimulation

PURPOSE: The purpose of the study was to evaluate the results and analyze various prognostic factors of hemiarthroplasty for proximal humeral fractures. MATERIALS AND METHODS: Thirty-one cases, who underwent hemiarthroplasties for proximal humeral fractures, were evaluated with ASES score at a mean follow-up of 45 months (1-8 years). Global Total Shoulder (Depuy.) (TS Gr) for 21 cases, and Global FX (Depuy.) (FX Gr) for 10 cases were used. Twentysix cases were acute fractures within one month after injury. There were two cases with delayed union and three cases with nonunion. Prognostic values of age, delay of surgery, fracture type, position of the greater tuberosity and design of implant were assessed. RESULTS: The most important prognostic factor was the design of implant. Mean score of FX Gr was significantly higher than that of TS Gr (84.4 and 77.6 respectively, p=0.036). Age, fracture type, delay of surgery and position of the greater tuberosity did not show any prognostic value. CONCLUSION: The clinical results of Hemiarthroplasty specially designed for the proximal humeral fractures has better than that of preexisting implant. Design of the implant was considered to be the most important prognostic factor of hemiarthroplasty for the proximal humeral fractures.
Follow-Up Studies ; Hemiarthroplasty* ; Shoulder ; Shoulder Fractures*

Despite the improved accuracy and increasing use of prenatal ultrasonography, fetal cholelithiasis is a rarely detected disease, and its natural history and clinical significance are not yet well defined. Many maternal and neonatal risk factors are associated with fetal cholelithiasis. Intrahepatic cholestasis of pregnancy could be a risk factor for fetal cholelithiasis, but no case reports in previous literatures have demonstrated this relationship. We present a case of fetal cholelithiasis in the late third trimester of pregnancy that was related to intrahepatic cholestasis of pregnancy, along with a brief review of associated literatures.
Cholelithiasis* ; Cholestasis, Intrahepatic* ; Female ; Humans ; Natural History ; Pregnancy Trimester, Third ; Pregnancy* ; Risk Factors ; Ultrasonography ; Ultrasonography, Prenatal

BACKGROUND: Cardiac anesthesia with cardiopulmonary bypass is associated with an increased risk of awareness. A new approach to intraoperative EEG procession, the bispectral index (BIS), may allow more reliable quantitative assessment of the level of consciousness during anesthesia. We evaluated the relationships between BIS and commonly used indices of depth of anesthesia in children. METHODS: In the isoflurane group, anesthesia was maintained using isoflurane 0.5 1.0 vol% inhalation, whereas the fentanyl group received high dose fentanyl-midazolam infusion. BIS, mean arterial blood pressure, and heart rate were recorded at baseline, at postinduction (Tbaseline), skin incision (Tincis), sternotomy (Tsterno), aortic cannulation (Tcannul), nadir temperature (Tnadir), immediate post-CPB (TpostCPB), sternal wire (Twire), and at skin closure (Tclose). RESULTS: BIS showed a significant change over time (P < 0.001), with significant differences between groups (P = 0.04). BIS increased significantly during the immediate post-CPB phase (TpostCPB versus Tbaseline, Tnadir, P < 0.01). No correlations were found between BIS and changes in heart rate or mean arterial pressure during surgery. BIS was higher in the fentanyl group than in the isoflurane group at Tincis, Tcannul, and Twire (P < 0.05). CONCLUSIONS: Even though BIS was relatively lower in the isoflurane group compared to the fentanyl group, we were still unable to demonstrate a relationship between the BIS and hemodynamic indices depth for any group. While the increase in BIS during the rewarming phase could reflect an increase in conscious level, larger prospective studies with postoperative memory test for awareness are necessary.
Anesthesia ; Anesthetics* ; Arterial Pressure ; Cardiopulmonary Bypass ; Catheterization ; Child* ; Consciousness ; Electroencephalography ; Fentanyl ; Heart Rate ; Heart* ; Hemodynamics* ; Humans ; Inhalation ; Isoflurane ; Memory ; Rewarming ; Skin ; Sternotomy ; Thoracic Surgery*

No abstract available.
Antibodies* ; Fetus* ; Heart Block* ; Heart*

Extra-ovarian yolk sac tumor arising in the omentum is extremely rare. As yolk sac tumor originated from the omentum has been rarely reported, its clinical information is very limited. The authors encountered a case of yolk sac tumor originated from the omentum, and reported the case herein. A 32-year-old woman was presented with developed low abdominal distension for a month. Magnetic resonance imaging findings were suggestive of ovarian malignancy with ascites and peritoneal seeding nodules. Explorative laparotomy was performed and then the findings from frozen biopsy of omentum were suggestive of poorly differentiated tumor though whether it was primary or metastatic was uncertain. Thus, staging laparotomy were performed. Histopathology confirmed that the tumor was a yolk sac tumor of omentum origin. Then, 6 cycles of postoperative adjuvant chemotherapy at intervals of 3 weeks were performed using bleomycin, etoposide, and cisplatin regimen. Four-year outpatient follow-up thereafter showed no relapse.
Adult ; Ascites ; Biopsy ; Bleomycin ; Chemotherapy, Adjuvant ; Cisplatin ; Endodermal Sinus Tumor* ; Etoposide ; Female ; Follow-Up Studies ; Humans ; Laparotomy ; Magnetic Resonance Imaging ; Omentum* ; Outpatients ; Rare Diseases ; Yolk Sac

BACKGROUND: There is an increasing need for making a more ideal artificial skin model. OBJECTIVE: To evaluate the effects of adipose tissue-derived mesenchymal stem cells (ATMSC) on the formation of epidermis and basement membrane in artificial skin models. METHODS: ATMSC were isolated from lipo-aspirated fat tissues, and their phenotypes were confirmed by cell surface markers. Three kinds of artificial skin models were made using three different dermal substitutes. The dermal substitutes in the three models contained fibroblasts only, fibroblasts together with ATMSC or ATMSC only. The formation of epidermis and basement membrane was evaluated by immunohistochemical stains and transmission electron microscopy. RESULTS: Among the three models, the model with both fibroblasts and ATMSC in the dermal substitute showed the most excellent formation of epidermis and, especially, basement membrane. In this model, the basement membrane proteins, laminin and type IV collagen, were expressed most apparently at the dermo-epidermal junction and, lamina lucida, lamina densa and anchoring fibrils were most evidently observed under transmission electron microscopy. Whereas, the model with only ATMSC did not show keratin 1 expression, suggesting that the 'skin-type' stratified squamous epithelium was not formed well. CONCLUSION: ATMSC together with fibroblasts can be used effectively in constructing artificial skin models.
Basement Membrane ; Collagen Type IV ; Coloring Agents ; Electrons ; Epidermis ; Epithelium ; Fibroblasts ; Keratin-1 ; Laminin ; Mesenchymal Stromal Cells ; Microscopy, Electron, Transmission ; Phenotype ; Proteins ; Skin, Artificial