No abstract available.

No abstract available.
Diaphragm* ; Ultrasonography*

PURPOSE: The postoperative morbidity and mortality for acute gangrenous cholecystitis (AGC) are higher than for acute nongangrenous cholecystitis (ANGC). However, preoperative predictive factors for the outcome of gangrenous cholecystitis have not been identified. The goal of this study was to determine the preoperative clinical predictive factors for the outcome of surgical treatment for acute gangrenous cholecystitis. METHODS: From January 2005 to December 2006, the medical records of 173 patients who underwent laparoscopic cholecystectomy for acute cholecystitis were reviewed and analyzed retrospectively. RESULTS: Among 173 patients with acute cholecystits, 57 (32.9%) had pathologically confirmed gangrenous cholecystits. Six variables were found to be associated with gangrenous cholecystits by univariate analysis: an age > or = 55 years, the presence of associated diseases, hypertension, fever (> or =37 degrees), an increased white blood cell count (> or = 15,450/mm3) and glucose. Four variables were identified that were associated with gangrenous cholecystits by multivariate analysis: an age > or = 55 years, the presence of associated diseases, hypertension, and an increased white blood cell count (> or =15450/mm3). CONCLUSION: The results of this study suggest that patients with an age > or = 55 years, the presence of associated diseases, hypertension, and an increased white blood cell count (> or =15450/mm3) have an increased risk of gangrenous cholecystitis and require immediate surgery.
Cholecystectomy, Laparoscopic ; Cholecystitis* ; Cholecystitis, Acute ; Fever ; Glucose ; Humans ; Hypertension ; Leukocyte Count ; Medical Records ; Mortality ; Multivariate Analysis ; Retrospective Studies

Authors observed many cases of vertical deviation in the patients complaining of marked asthenopia. Of 1275 cases who had refraction, there were 183 cases of vertical deviation (13.54%) in our clinic, during the last 2 years from July 1, 1973 to August 31, 1975. In the series of our observation, the females were much more frequent than the males in numbers, especially after 30 years of age group. The right hyperphoria was more frequent than the left. In the most of the vertical deviation, the degrees of deviation were less than one prism diopter and associated with low grade of refractive errors (less than +/- 0.5 diopter). If the marked refractive error was corrected without correction of vertical deviation, the headache appeared to be increased in the cases of marked refractive error associated with vertical deviation. In the majority of the cases who had vertical deviation, the headache (marked asthenopia) was complained of and in the many cases of them the head was tilted slightly to one shoulder. 1) In the many cases, the headache was occipital in character. 2) The headache seemed to be marked in looking the moving picture or on walking the streets (by the looking of moving objects). 3) The headache started easily by looking out of door in the railway journey or driving. 4) The headache occured usually by the exercise or home work and increased in the afternoon while they were comfortable early in the morning.
Asthenopia ; Female ; Head ; Headache* ; Humans ; Male ; Refractive Errors* ; Shoulder ; Walking

Spinal cord stimulation (SCS) has become an established clinical option for treatment of refractory chronic pain. Current hardware and implantation techniques for SCS are already highly developed and continuously improving; however, equipment failures over the course of long-term treatment are still encountered in a relatively high proportion of the cases treated with it. Percutaneous SCS leads seem to be particularly prone to dislocation and insulation failures. We describe our experience of lead breakage in the inserted spinal cord stimulator to a complex regional pain syndrome patient who obtained satisfactory pain relief after the revision of SCS.
Chronic Pain ; Dislocations ; Equipment Failure ; Humans ; Spinal Cord ; Spinal Cord Stimulation

An 18-year-old man collapsed at his workplace while putting desiccant into a cylindrical mixer, 2 m x 1 m in dimension, which contained rubber powder. His coworker found him collapsed, and he was transported to a hospital by a 119 rescue team, where he died. Prior to the incident, liquid nitrogen had been placed into the mixer to lower the temperature of the rubber powder. There were no injuries or disease that could have caused death. Analysis of the gas in the mixer revealed that the O2 concentration had dropped to 3.7% in 2 minutes following addition of the liquid nitrogen. Therefore, it was concluded that the cause of death was asphyxia due to oxygen deficiency caused by liquid nitrogen evaporation.
Adolescent ; Anoxia* ; Asphyxia* ; Autopsy ; Cause of Death ; Humans ; Nitrogen* ; Oxygen* ; Rubber

OBJECTIVE: Stenosis or herniated nucleus pulposus (HNP) occupying lumbar intracanal and foraminal area is an important cause of double radicular symptoms. Using the combined interlaminar and paraisthmic approach, we performed decompression surgery in patients with co-existing intracanal and foraminal lesions. The objective of this study is to describe usefulness and outcome of combined interlaminar and paraisthmic approach surgery and to analysis the cause of poor outcome. METHODS: Between Apr 2009 and Apr 2014, 78 patients (42 males and 36 females) with intracanal and foraminal lesions were enrolled in this study. Patients with a vacuum disc, spondylolisthesis, instability or an isthmic defect on the preoperative dynamic view radiograph were excluded from this study. All patients underwent surgery through a combined approach for discectomy and decompression. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. RESULTS: The results were excellent in 53 patients, good in 9, fair in 6 and poor in 10 during the follow-up. The outcome of the combined approach was excellent to fair in 87% (68 of 78) patients in our study. In the poor outcome group, three patients complained of early-onset relapsed pain (<1 month) and another seven patients complained of delayed-onset pain (>3 months). CONCLUSION: Combined approach for both intracanal and foraminal area lesions may be useful if selectively performed on patients whose facet joint is relatively intact, and that it is worthy of consideration as an alternative to fusion surgery; however, further studies are needed.
Constriction, Pathologic ; Decompression ; Diskectomy ; Follow-Up Studies ; Humans ; Male ; Radiculopathy ; Spinal Stenosis ; Spondylolisthesis ; Vacuum ; Zygapophyseal Joint

PURPOSE: The present study investigates the seasonal variations of acute angle-closure glaucoma in patients visiting the hospital. METHODS: Eighty-seven patients (94 eyes) who underwent laser iridotomy were retrospectively analyzed over 5 years. Monthly and seasonal variations were investigated and the difference in seasonal variations according to sex, age, and inhabited area were inspected. RESULTS: When evaluating monthly variations, acute angle-closure glaucoma occurred mostly in January (13.8%). Incidence of glaucoma was the highest in winter (29.9%), decreased in spring and summer (26.4%) and was lowest in autumn (17.2%). In big cities, the incidence trend was highest in spring (31.8%), lowest in autumn (19.7%) and slightly elevated in winter (27.3%). However, in small cities and rural areas, the incidence was highest in summer (42.9%) and winter (38.1%). There were significant differences between inhabited areas. CONCLUSIONS: Among the patients, seasonal incidence of acute angle-closure glaucoma was the highest in winter and decreased as autumn approached. There were differences of incidence between inhabited areas.
Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Incidence ; Retrospective Studies ; Seasons

PURPOSE: To compare the thickness of the lamina cribrosa (LC) and vascular factors of early normal-tension glaucoma (NTG) patients with high and low intraocular pressure (IOP) that are expected to be associated with the development of glaucoma. METHODS: Seventy-one Korean NTG patients with low IOP (the highest IOP <15 mmHg, 40 patients) and high IOP (the lowest IOP >15 mmHg, 31 patients) were included in this study. The thickness of LC and vascular factors were compared. The thickness of the LC was measured using the enhanced depth imaging method with spectral domain optical coherence tomography (Heidelberg Spectralis). RESULTS: The mean thickness of the central LC was 190.0 +/- 19.2 microm in the low IOP group and 197.8 +/- 23.6 microm in the high IOP group, but there was no statistical significant difference between the two groups (p > 0.05). The prevalence of self-reported Raynaud phenomenon was significantly higher in the low IOP group (33.0%) than the high IOP group (10.3%, p = 0.04). CONCLUSIONS: The laminar thickness did not significantly differ between the high and low IOP groups. However, the prevalence of Raynaud phenomenon was higher in the low IOP groups. These results suggest that the development of glaucoma with low IOP patients may be more influenced by peripheral vasospasm, such as Raynaud phenomenon, rather than laminar thickness in NTG.
Aged ; Cross-Sectional Studies ; Female ; Humans ; *Intraocular Pressure ; Low Tension Glaucoma/*diagnosis ; Male ; Middle Aged ; Nerve Fibers/pathology ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Raynaud Disease/*diagnosis ; Retinal Ganglion Cells/pathology ; Tomography, Optical Coherence ; Tonometry, Ocular ; Vision Disorders/diagnosis ; Visual Fields

Cytogenetic observations of loss of the distal portion of the Y chromosome long arm were found to be associated with disrupted spermatogenesis. The existence of a gene involved in the regulation of spermatogenesis, the azoospermia factor (AZF), was postulated. In this study, we screened the AZF region including DAZ and DAZH genes and observed the expression pattern of DAZ and DAZH transcript in infertile men with azoospermia and oligospermia by using a sequence-tagged site (STS)-based PCR method. PCR primers were synthesized for 11 STSs that span Yq interval 6, SRY, DAZ, and DAZH, functional DAZ homologue on chromosome 3. Microdeletions were detected in 4/32 (12.5%) azoospermic men and 1/11 (9%) severe oligospermic men. Only 2 of 5 patients had microdeletions of Yq that contained the 342 gene, whereas the other 3 patients had deletions extending from intervals 5L-6F proximal to the DAZ gene on Yq. Testis biopsies of the azoospermic patients revealed a variety from Sertoli cell-only syndrome to testicular maturation arrest. Of 4 men with clinical data available, average testis size was R: 13.8 co, L: 13.8 co, serum T was 4.0+/-1.25 ng/ml, LH was 3.63+/-1.90 mIU/ml, and FSH was 8.85 +/- 5.13 mIU/ml. These values did not differ significantly from the remainder of the patients tested. We could not observed the DAZ transcript in 2 patients, who have no mature spermatozoa. In 11,6% of patients microdeletions of the AZF could be detected. These deletions in the AZF region seem to be involved causing spermatogenic failure. But the frequency of microdeletions proximal to DAZ suggests that DAZ is not the only gene associated with spermatogenic failure.
Arm ; Azoospermia* ; Biopsy ; Chromosomes, Human, Pair 3 ; Cytogenetics ; Genes, vif ; Humans ; Male ; Oligospermia ; Polymerase Chain Reaction ; Sequence Tagged Sites ; Sertoli Cell-Only Syndrome ; Spermatogenesis ; Spermatozoa ; Testis ; Y Chromosome*