The seat belt is designed for safety in a motor vehicle and should be worn to prevent severe injuries. But, the seat belt itself can be an injury factor in combination with deceleration forces applied to fixation points of mobile viscera. Here, we present a 23-year-man with traumatic transection of the appendix, highly mobile viscera, following seat belt injury.
Appendix ; Deceleration ; Motor Vehicles ; Seat Belts* ; Viscera

Acute appendicitis is the most common indication for emergency abdominal surgery worldwide. The risks and benefits of incidental appendectomy during other operations have been debated for over a century. There is no right answer to the question of whether or not to perform incidental appendectomy. Although there are only a few indications where it is explicitly recommended such as in gynecological surgery, malrotation, and Ladd's procedure, incidental appendectomy is cost-effective in selected patient groups, especially in the young, without an increase in morbidity and mortality. In this review, the literature on incidental appendectomy was assessed from several perspectives.
Adolescent ; Appendectomy ; Appendicitis ; Costs and Cost Analysis ; Emergencies ; Female ; Gynecologic Surgical Procedures ; Humans ; Mortality ; Risk Assessment

Calcium channel blockers are used to treat hypertension. Unwanted side effects associated with calcium channel blockers are facial flushing, headache, palpitation, dizziness, peripheral edema, constipation, indigestion, nausea, gingival hyperplasia, facial edema and fatigue. Gingival hyperplasia is a rare adverse effect of calcium channel blockers. Calcium channel blockers are known to contribute to gingival hyperplasia. Among all calcium-channel blockers, the prevalence of gingival hyperplasia is highest with nifedipine. Amlodipine is used extensively for the management of hypertension. Several cases have been published since 1994 indicating that amlodipine may also promote gingival hyperplasia. Amlodpine-induced gingival hyperplasia has not reported yet in Korea. We report a case of gingival hyperplasia caused by amlodipine.
Amlodipine* ; Calcium Channel Blockers ; Constipation ; Dizziness ; Dyspepsia ; Edema ; Fatigue ; Flushing ; Gingival Hyperplasia* ; Headache ; Hypertension ; Korea ; Nausea ; Nifedipine ; Prevalence

BACKGROUND: Tsutsugamushi, leptospirosis and hemorrhagic fever with renal syndrome (HFRS) are the prevalent diseases among the acute febrile illnesses in Korea. Pulmonary involvement in the patients with these diseases remains poorly recognized in endemic regions, and this is despite reports of recent outbreaks and epidemic episodes. Pulmonary involvement and a higher CRP level as clinical manifestations show a more severe form of infection. The aim of this study is to analyze the correlation of pulmonary involvement and the CRP level in patients with acute febrile illnesses. METHODS: We retrospectively reviewed the clinical records of 105 patients who were diagnosed with tsutsugamushi, HFRS and leptospirosis from January 2002 to May 2008 in Chuncheon Sacred Heart Hospital. The radiographic images were retrospectively analyzed by two radiologists. We analyzed the pulmonary complications of the patients with these febrile diseases and we checked the CRP level at admission. RESULTS: The study included 105 patients who were diagnosed with febrile diseases. Of these patients, 32 patients had hantaan, 10 patients had leptospirosis and 63 patients had tsutsugamushi disease. 42 (40%) patients had pulmonary complications, 20 patients had pulmonary edema, 20 patients had pleural effusion and 2 patients had interstitial pneumonitis. The patients with pulmonary involvement showed a more severe form of infection and a higher CRP level than that of those patients without pulmonary involvement (p=0.0073). CONCLUSION: Pulmonary involvement in patients with acute febrile diseases might be correlated with a higher CRP level. Identification of this factor on admission might provide useful selection criteria for the patients who need early intensive care.
C-Reactive Protein ; Disease Outbreaks ; Heart ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Incidence ; Critical Care ; Korea ; Leptospirosis ; Lung Diseases, Interstitial ; Patient Selection ; Pleural Effusion ; Pulmonary Edema ; Retrospective Studies ; Scrub Typhus

No abstract available.
Lymphoma, Large-Cell, Anaplastic

A cystic parathyroid adenoma is rare. A case of primary hyperparathyroidism, with the cystic formation of a parathyroid adenoma and a severe bony lesion, is reported. A 52-year-old male was admitted due to pain in both hips and for evaluation of hypercalcemia. The plasma level of the intact parathyroid hormone(iPTH) was elevated to 1424pg/mL. Ultrasonography and the computed tomography revealed a parathyroid cyst on the left thyroid lower pole. Parathyroid scintigraphy detected a parathyroid adenoma. A radiograph showed a subperiosteal bone resorption on the phalanges, and a brown tumor(osteitis fibrosa cystica) on the femur shaft was noted. A surgical excision of the parathyroid adenoma was performed. The PTH level in the cystic fluid was increased. A histological examination confirmed a cystic parathyroid adenoma. The PTH level was normalized after the operation.
Bone Resorption ; Femur ; Hip ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Male ; Middle Aged ; Osteitis Fibrosa Cystica ; Parathyroid Neoplasms* ; Plasma ; Radionuclide Imaging ; Thyroid Gland ; Ultrasonography