A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

No abstract available.
Sparganosis*

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Tears

No abstract available.
Pregnancy* ; Purpura*

No abstract available.
Pregnancy*

Background: The relationship between cystitis glandularis (CG) and bladder malignancy remains unclear. Methods: We identified the oncologic significance of CG at the molecular level using liquid chromatography-tandem mass spectrometry-based proteomic analysis of 10 CG, 12 urothelial carcinoma (UC), and nine normal urothelium (NU) specimens. Differentially expressed proteins (DEPs) were identified based on an analysis of variance false discovery rate < 0.05, and their functional enrichment was analyzed using a network model, Gene Set Enrichment Analysis, and Gene Ontology annotation. Results: We identified 9,890 proteins across all samples and 1,139 DEPs among the three entities. A substantial number of DEPs overlapped in CG/NU, distinct from UC. Interestingly, we found that a subset of DEP clusters (n = 53, 5%) was differentially expressed in NU but similarly between CG and UC. This “UC-like signature” was enriched for reactive oxygen species (ROS) and energy metabolism, growth and DNA repair, transport, motility, epithelial-mesenchymal transition, and cell survival. Using the top 10 shortlisted DEPs, including SOD2, PRKCD, CYCS, and HCLS1, we identified functional elements related to ROS metabolism, development, and transport using network analysis. The abundance of these four molecules in UC/CG than in NU was consistent with the oncologic functions in CG. Conclusions Using a proteomic approach, we identified a predominantly non-neoplastic landscape of CG, which was closer to NU than to UC. We also confirmed a small subset of common DEPs in UC and CG, suggesting that altered ROS metabolism might imply potential cancerous risks in CG.

PURPOSE: This study compared the accuracy of an abutment-framework (A-F) taken with open tray impression technique combining cementon crown abutments, a metal framework and resin cement to closed tray and resin-splinted open tray impression techniques for the 3-implant definitive casts. The effect of angulation on the accuracy of these 3 techniques was also evaluated. MATERIAL AND METHODS: Three definitive casts, each with 3 linearly positioned implant analogs at relative angulations 0, 30, and 40 degrees, were fabricated with passively fitted corresponding reference frameworks. Ten impressions were made and poured, using each of the 3 techniques on each of the 3 definitive casts. To record the vertical gap between reference frameworks and analogs in duplicate casts, a light microscope with image processing was used. Data were analyzed by two-way analysis of variance and the Tukey test. RESULTS: The open tray techniques showed significantly smaller vertical gaps compare to closed tray technique (P < .05). The closed tray and the resin-splinted open tray technique showed significantly different vertical gaps according to the angulation of implant (P < .05), but the A-F impression technique did not (P > .05). CONCLUSION: The accuracy of the A-F impression technique was superior to that of conventional techniques, and was not affected by the angulation of the implants.
Crowns ; Light ; Resin Cements

BACKGROUND AND OBJECTIVES:Traditionally, down beat nystagmus is regarded as a sign of central nervous system dysfunction. But, several years has passed since Herdman et al reported the down beat nystagmus developed during treatment maneuvers for posterior semicircular canal benign paroxysmal positional vertigo(BPPV). We undertook this study to evaluate the character and clinical analysis of the positional or positioning down beat nystagmus, to discuss the clinical significance of positional or positioning down beat nystagmus as a diagnostic criteria of superior semicircular canal BPPV, and to propose the new treatment method. MATERIALS AND METHOD:From November 1999 to March 2004, we sampled the 103 patients with positional or positioning down beat nystagmus. Of these patients, we selected 16 patients except for the patients with central nervous system dysfunction, nonspecific or artifact result, idiopathic origin. RESULTS:All of 16 patients had no sign and radiologic result of central nervous system disorder. 10 patients was reported or suspected the diagnosis of posterior semicircular canal BPPV. Fatigability was reported in 9 patients and reversibility was reported in 1 patient. Average latency was checked less than 2 seconds. CONCLUSION:Although the diagnostic criteria of superior semicircular canal BPPV that we reported was not controversial, we expect that this criteria is useful in diagnosis for patients with atypical positional or positioning down beat nystagmus. And the new treatment method that we reported will has the better results than previous method.
Artifacts ; Central Nervous System ; Diagnosis ; Humans ; Semicircular Canals ; Vertigo*

BACKGROUND: Infantile Hypertrophic Pyloric Stenosis (IHPS) is one of the most common surgical problems of early infancy and one for which an eminently successful surgical treatment has been available since the work of Ramstedt in 1912. A clinical study was begun to access further the accuracy of ultrasonography in identifying hypertrophic pylorus. METHODS: This study is a retrospective clinical analysis of 31 cases of IHPS treated at the Department of Surgery of Pohang St. Mary's Hospital from Jan. 1990 to Dec. 1997. RESULTS: (1) The most prevalent age group was between 3 weeks and 8 weeks in 24 cases (77.4%), and the ratio of males to females was 5.2:1. (2) Among the 31 cases, new born babies were 21 cases (67.7%). (3) In 30 cases (96.8%), the gestational age was between 37 weeks and 42 weeks, and the birth weight was more than 3.5 kg in 21 cases (67.7%). The body weight percentile at admission was lower than the 50 percentile in 31 cases. (4) Among the 31 cases, breast-fed infants were 15 cases (48.4%), milk-fed 13 cases (41.9%), and mixed-fed 3 cases (9.7%). B type blood group was 23 cases (74.2%), and O type was 4 cases (12.9%). (5) In 4 cases (12.9%), an inguinal hernia was noted as an associated anomaly. (6) The onset of symptoms was neonatal (1 week-12 weeks) in all 31 cases, and the duration of the symptoms was between 1 week and 2 weeks in 18 cases (58.1%). (7) Non-bile stained, projectile vomiting was noted in all 31 cases (100.0%), an olive-shaped mass in right upper quadrant of the abdomen was felt in 27 cases (87.1%), and visible peristalsis on the epigastrium was noted in 25 cases (80.6%). (8) On laboratory tests, 17 patients had leukocytosis, and anemia was observed in 2 cases. Hypokalemia was observed in 9 cases (29.0%), hypochloremia in 4 cases (12.9%), and moderate to severe alkalosis (CO2 content > 25 mEq) in 7 cases. (9) Among the 25 cases, for which an the ultrasonographic evaluation was performed, the length of the stenotic canal was from 16 mm to 20 mm in 23 cases (92.0%), and the thickness of the stenotic portion was from 5 mm to 6 mm in 21 cases (84.0%). (10) All 31 cases were surgically treated by using a Fredet-Ramstedt pyloromyotomy, and the mortality was nil. The average hospitalization was 9.4 days. (11) There was 1 case of duodenal perforation and 1 case of intermittent non-projectile vomiting after the operation. CONCLUSIONS: We conclude that early accurate diagnosis, adequate preoperative preparation of the fluid & electrolyte imbalance, immediate surgical correction, and scheduled careful oral feeding are important in treatment of IHPS. Ultrasonographic determination of pyloric muscle length and thickness is the most accurate of the currently available techniques. A Fredet-Ramstedt pyloromyotomy is a safe and successful surgical procedure.
Abdomen ; Alkalosis ; Anemia ; Birth Weight ; Body Weight ; Diagnosis ; Female ; Gestational Age ; Gyeongsangbuk-do ; Hernia, Inguinal ; Hospitalization ; Humans ; Hypokalemia ; Infant ; Leukocytosis ; Male ; Mortality ; Peristalsis ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Retrospective Studies ; Ultrasonography ; Vomiting

Bilateral coronary artery fistula is very uncommon congenital anomaly which occupy small percentage of all congenital coronary artery fistula. About 20% of the cases associated with additional congenital heart disease. And it may cause congestive heart failure, especially severely in neonate. We experienced a case of neonate who was 1 day-old-male with bilateral coronary artery-right ventricular fistula associated with atrial septal defect and congestive heart failure. The Patient was admitted because dyspnea, cyanosis since birth. 2D ecgicardiogram and cardiac catheterization revealed that a fistulous communicating ; forming a large aneurysm, was noted from bilateral coronary artery emptied into the right ventricle, and there was oxygen step-up in right ventricle.
Aneurysm ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Cyanosis ; Dyspnea ; Fistula* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Infant, Newborn* ; Oxygen ; Parturition