BACKGROUND: Postoperative admission to the surgical intensive care unit (S-ICU) is commonly planned to prevent and treat complications, unnecessary admission to the S-ICU increases medical costs and length of hospital stay. This study aimed evaluated outcome and the predictive factors for mortality in patients admitted to the S-ICU after abdominal surgery. METHODS: The 168 patients admitted to the S-ICU immediately after abdominal surgery were reviewed retrospectively from January to December 2011. RESULTS: The mortality rate of patients admitted to the S-ICU after abdominal surgery was 8.9% (15 of 168). Two preoperative factors (body mass index [BMI] < 18.5 kg/m2 [p < 0.001] and serum albumin < 3.0 g/dL [p = 0.018]), two operative factors (the need for transfusion [p = 0.008] or vasopressors [p = 0.013] during surgery), and three postoperative variables (mechanical ventilation immediately following surgery [p < 0.001], sequential organ failure assessment [p = 0.001] and SAPS II [p = 0.001] score) were associated with mortality in univariate analysis. After adjusting for age, gender, and SAPS II by a Cox regression, which revealed that BMI < 18.5 kg/m2 (p < 0.001, hazard ratio [HR] 9.690, 95% confidence interval [CI] 2.990-25.258) and the use of mechanical ventilation on admission to S-ICU (p < 0.001, HR 34.671, 95% CI 6.440-186.649) were independent prognostic factors. CONCLUSIONS: In patients in S-ICU after abdominal surgery, low BMI and postsurgical mechanical ventilation should be considered important predictors of mortality.
Abdomen* ; Body Mass Index ; Humans ; Critical Care ; Intensive Care Units ; Length of Stay ; Mortality ; Postoperative Complications ; Prognosis* ; Respiration, Artificial ; Retrospective Studies ; Serum Albumin ; Ventilation

The syndrome of postural headache associated with low CSF pressure usually occurs after a dural puncture, myelography, or spinal anesthesia. However, it can also develop spontaneously or after minor trauma. Although the clinical and MRI findings of this syndrome are well described, radionuclide cisterno-graphic findings have not yet been clearly characterized. We report four patients presenting with postural headache associated with very low or unmeasurable CSF pressure. Three patients developed after minor trauma, while one developed spontaneously. Brain MRI revealed symmetric pachymeningeal enhancement in all four patients. Radionuclide cisternography demonstrated delayed migration of tracer to the cerebral convexity at 6 and 24 hours in three patients, and early soft tissue uptake suggestive of CSF leakage in one. We suggest that these radionuclide cisternographic findings are supportive evidences for the presence of intracranial hypotension and may provide useful information for appropriate treatment.
Anesthesia, Spinal ; Brain ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Myelography ; Punctures

The reliability of emergency ultrasonographic(US) detection of hemoperitoneum and solid organ injury in blunt abdominal trauma was evaluated retrospectively. From October 1,1995 to August 31,1996,90 patients were included in the study. Ultra- sonographic findings showed a sensitivity, specificity, and accuracy of 97.6%, 97.9%, and 98.1%, respectively, in detecting intraabdominal fluid collection. We believe that US in an emergency center is a quick, safe screening method in the evaluation of blunt abdominal trauma. In our department, US has replaced diagnostic peritonaeal lavage(DPL) and computed tomography(CT) as the screening study of first choice.
Emergencies* ; Hemoperitoneum* ; Humans ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

Although commercialization of mobile phones has raised much concerns about the effects of radiofrequency radiation on the human body, few experimental studies have been conducted on the effects of radiofrequency radiation on physiological homeostasis, immune and inflammatory responses. Therefore, we presently investigated the effect of 835 MHz radiofrequency radiation on spontaneous wheel exercise, hormone and cytokines levels in the plasm of mice. Mice were divided into 4 groups as control, exercise, radiofrequency radiation, radiofrequency radiation & exercise group. The body weight, corticosterone and blood cytokine levels were checked for 10 weeks. Followed by the exposure to radiofrequency radiation for 6 hours a day, the more increase in body weight was observed in the radiofrequency radiation & exercise group than in the spontaneous exercise group. When the amount of spontaneous exercise was measured for 10 weeks, the amount of exercise was increased in the both control and spontaneous exercise group, while the amount of exercise was decreased in the radiofrequency radiation group. To determine whether the homeostasis, immune and inflammatory responses are indirectly affected by radiofrequency radiation exposure, IL-1β, IL-6, IL-12 (p70), TNF-α, IFNγ, and GM-CSF were measured by ELISA kit, respectively. As a result, the blood levels of IL-6, IL-12 (p70) and TNF-α in the spontaneous exercise group were higher than that of control group, and each cytokine levels in the radiofrequency radiation & exercise group were lower than that of control group. However, the corticosterone, IL-1β, IFNγ and GM-CSF didn't show statistically significant differences in all groups. It has been confirmed that exposure to high frequency electromagnetic waves for a long time can affect the amount of exercise, body weight, and some inflammatory cytokines such as IL-6, IL-12 (p70) and TNF-α.
Animals ; Body Weight ; Cell Phones ; Corticosterone* ; Cytokines* ; Electromagnetic Radiation ; Enzyme-Linked Immunosorbent Assay ; Granulocyte-Macrophage Colony-Stimulating Factor ; Homeostasis ; Human Body ; Interleukin-12 ; Interleukin-6 ; Mice* ; Radiation Exposure

Hemangiomas are benign vascular tumors that result from the abnormal proliferation of vascular tissue. Thyroid hemangiomas can develop as a result of procedures such as fine needle aspiration or other secondary trauma.Primary thyroid cavernous hemangioma is an extremely rare condition, with only a few reported cases. In this report, we present the case of an 83-year-old woman who complained of progressively worsening symptoms of right neck obstruction. She was undergoing levothyroxine treatment for hypothyroidism, and there was no specific family history of thyroid issues. The patient presented with a goiter and obstructive symptoms, and denied any history of trauma or invasive procedures. Thyroid sonography revealed a 6.21 cm heterogeneous dominant solid nodule in the right lobe. Additionally, a large mixed cystic and 6 cm solid mass was identified in the right lobe on CT scan. Due to the significant size of the mass and the presence of obstructive symptoms, the patient underwent a right thyroid lobectomy without further evaluations. Histologic examination of the specimen revealed a cavernous thyroid hemangioma. This case report presents our experience in diagnosing cavernous thyroid hemangioma.

Purpose: This study aimed to investigate the correlation between serum creatinine levels and the presence and severity of radiographic knee osteoarthritis (OA) in individuals aged ≥50 years while adjusting for potential confounders. Materials and Methods: Cross-sectional data from the 2009–2011 Korea National Health and Nutrition Examination Survey comprising 3428 individuals aged ≥50 years were utilized. The Kellgren–Lawrence (K–L) grading scale was used to assess the radiographic presence and severity of knee OA. Logistic regression and receiver operating characteristic analyses were used to investigate the association between serum creatinine levels and the presence of knee OA, whereas ordinal regression was used to assess the impact of creatinine levels on knee OA severity. Results: The presence of radiographic knee OA conferred by low serum creatinine levels was found to be significant in both sexes [odds ratio (OR), 0.118; 95% confidence interval (CI), 0.045–0.314, p<0.001 for men; OR, 0.148; 95% CI, 0.040–0.549, p=0.004 for women]. Low serum creatinine was significantly associated with knee OA-graded K–L severity in each sex-based group [β, -1.923; standard error, 0.478; p<0.001 for men and β, -1.532; SE, 0.575; p=0.008 for women]. Conclusion Low serum creatinine level was associated with a higher presence of knee OA in both men and women, and was also linked to the severity of the disease. These findings suggest that the serum creatinine level may be a potential biomarker for assessing the presence and severity of knee OA.

The skin lesion of herpes zoster is typically limited to a single dermatome. The clinical appearance of herpes zoster in immunocompromised patients is usually identical to typical zoster, but lesions may be more severe and there can be multidermatomal involvement. The appearance of herpes zoster occurring in two non-contiguous dermatomes has been referred to as zoster duplex unilateralis or bilateralis. Herpes zoster duplex bilateralis is a rare manifestation of herpes zoster and almost all reported cases have in immunocompromised patients with hematologic cancer, patients taking immunosuppressant drugs for chronic illnesses and patients receiving chemotherapy for solid cancers. We report a case of herpes zoster duplex bilateralis, which was a diagnostic clue of human immunodeficiency virus infection.
Humans

A multiple primary malignant tumor is a disease mainly encountered in the of the older age groups. Attempts should be made to rule out a second primary malignant neoplasm in the elderly patients with unusual signs and symptoms. We encountered a case of a 67-year-old male with triple primary malignant tumors of the stomach, larynx, and lung. The patient had been treated with a subtotal gastrectomy for early gastric cancer in 1991 and a Laser laryngectomy for the laryngeal squamous cell carcinoma in 2003. In 2005, lung cancer was found with the biopsy revealing an adenosquamous carcinoma. Systemic chemotherapy was performed.
Aged ; Biopsy ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Drug Therapy ; Gastrectomy ; Humans ; Laryngeal Neoplasms ; Laryngectomy ; Larynx* ; Lung Neoplasms ; Lung* ; Male ; Stomach Neoplasms ; Stomach*

BACKGROUND: The cell-mediated immune reaction to tuberculosis infection involves a complex network of cytokines. The extent of inflammation, tissue damage and severity of the disease suggested to be determined by the balance between extent and duration of the proinflammatory cytokine response versus those of the suppressive cytokines. The systemic cytokine response in pathogenesis of tuberculosis can be assessed by measuring serum cytokine levels. METHOD: Serum interleukin-1 beta(IL-1 ), IL-2, IL-4, IL-6, IL-10, IL-12(p40), tumor necrosis factor-alpha(TNF-alpha), interferon-gamma(IFN-gamma) and transforming growth factor-beta(TGF-beta) levels were measured in 83 patients with pulmonary tuberculosis, 10 patients with endobronchial tuberculosis before treatment and 20 healthy subjects by using a sandwich ELISA. In patients with pulmonary tuberculosis, they were divided into mild, moderate and far advanced group according to the severity by ATS guidelines. To compare with those of pretreatment levels, we measured serum IL-1beta, IL-2, IL-4, IL-6, IL-10, IL-12(p40), TNF-alpha, IFN-gamma and TGF-beta levels in 45 of 83 patients with pulmonary tuberculosis after 2 and 6 months of treatment. RESULTS: 1) In sera of patients with active pulmonary tuberculosis(n=83), IL-1beta, IL-6(p<0.05), TNF-alpha, and IFN-gamma were elevated and TGF-beta was decreased comparing to control. IL-2, IL-12(p40), IL-4 and IL-10 were similar between the patients with tuberculosis and control. 2) In endobronchial tuberculosis, IL-6 and TNF-alpha were elevated and TGF-beta was decreased comparing to control. IL-12(p40) seemed to be elevated comparing to pulmonary tuberculosis. 3) Far advanced tuberculosis showed markedly elevated IL-6 and IFN-gamma level(p<0.05). 4) The significant correlations were noted between IL-1, IL-6 and TNF-alpha and between IL-12, IL-2 and IL-4(p<0.01). 5) After 2 and 6 months of standard treatment, the level of IL-6 and IFN-gamma was significantly decreased(p<0.05). CONCLUSION: These results showed that an altered balance between cytokines is likely to be involved in the extent of inflammation, tissue damage and severity of the disease tuberculosis. But, it should be considered diversities of cytokine response according to type of tuberculosis and immunity in clinical application and interpreting future studies.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Interleukin-1 ; Interleukin-10 ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Korea* ; Necrosis ; Transforming Growth Factor beta ; Tuberculosis* ; Tuberculosis, Pulmonary ; Tumor Necrosis Factor-alpha

Cicatrix ; Cleft Lip ; Congenital Abnormalities ; Lip