Recently, increased traffic accident has resulted in a corresponding increase in incidences of blunt trauma. Tracheal and main bronchial injuries artier blunt chest trauma can be life-threatening, and hence early diagnosis and early management of patients with such injuries are essential. A 3-year-old boy was transferred to the Department of Emergency Medicine after a motor vehicle accident in which he sustained multiple blunt injuries consisting of tracheal rupture, left main bronchial rupture, liver laceration, vitreous hemorrhage, and fracture of the iliac wing. The tracheal rupture was managed nonoperatively with intensive respiratory care, while the left main bronchial rupture was managed surgically by bronchoplasty. Postoperative course was uneventful and the patient was discharged without respiratory problems.
Accidents, Traffic ; Bronchi* ; Child, Preschool ; Early Diagnosis ; Emergency Medicine ; Humans ; Incidence ; Lacerations ; Liver ; Male ; Motor Vehicles ; Rupture ; Thorax ; Trachea* ; Vitreous Hemorrhage ; Wounds, Nonpenetrating

No abstract available.
Tibia*

PURPOSE: The aim of this study was to examine the relationship between tooth loss and sub-clinical atherosclerosis in Korean adults. MATERIALS AND METHODS: The subjects were part of a cohort study conducted in Ansan city by the Korea University medical school as part of the Korean Genome project. 749 subjects over than 40 years old were evaluated. After taking panoramic radiography, the amount of tooth loss was calculated. The intima-media thickness (IMT) was assessed by using ultrasonography at the common carotid artery. Traditional cardiovascular risk factors for atherosclerosis were also evaluated. The relationship between tooth loss and the IMT was evaluated using ANOVA with Scheffe's multiple comparison method in univariate analysis. Multiple regression analysis was also performed to determine the significance between the IMT and tooth loss. RESULTS: With age, tooth loss increased, but there was no significant increase in other traditional cardiovascular risk factors. Univariate analysis revealed the IMT to be positively related with the amount of tooth loss. Regression analysis of the IMT in the anterior and posterior tooth loss revealed that only the posterior tooth loss was significantly related with the IMT at all sites of the common carotid artery (right far wall, P = .015; left far wall, P = .008; right near wall, P < .001; left near wall, P = .001). CONCLUSION: This study verified the positive relationship between the increased tooth loss at the posterior area and the accumulation of atheroma in arteries.
Adult ; Arteries ; Atherosclerosis ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Cohort Studies ; Genome ; Humans ; Korea ; Plaque, Atherosclerotic ; Radiography, Panoramic ; Risk Factors ; Schools, Medical ; Tooth ; Tooth Loss

PURPOSES: To evaluate the effect of hormone replacement therapy(HRT) on serum insulin-like growth factors(IGFs) levels and to investigate if changes in serum IGFs reflect changes in BMD after HRT in postmenopausal women. MATERIAL & METHODS: IGF-I and IGF-II were measured by radioimmunoassay after Bio-spin P-10 seperation in sera obtained every 3 months from postmenopausal women who was taking premarin alone (premarin group; n=17) or premarin-medroxyprogesterone acetate(MPA group; n=42) for 1 year. Also, bone mineral density(BMD) were determined before and 1 year after HRT by dual energy X-ray absorptiometry(DEXA). All statistics were performed by Paired t-test, student's t-test, repeated measures ANOVA test, Pearson's coefficient. RESULTS: HRT increased BMD of the lumbar spine and proximal femur in both premarin group and MPA group, but any difference in degreee of increase in BMD was not noted between premarin group and MPA group. Compared with pretreatment levels, serum IGF-I levels decreased at 3, 6 and 12 months after therapy only in latter group whereas serum IGF-II levels increased at 6 and 12 months after HRT in both groups. Changes in serum IGF-I and IGF-II levels during therapy did not show any difference by the bone response to HRT. Changes in serum IGF-II levels after HRT did not correlated with the 1 year changes in BMD at any skeletal sites studied, but changes in serum IGF-I levels from pretreatment to 6 months after HRT was negatively correlated with change in BMD of Ward's triangle. CONCLUSION: HRT influences serum IGF levels in postmenopausal women and changes in serum IGF-I levels may predict the changes in BMD of Ward's triangle after HRT.
Bone Density* ; Estrogens, Conjugated (USP) ; Female ; Femur ; Hormone Replacement Therapy* ; Humans ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Postmenopause ; Radioimmunoassay ; Spine

The authors report seven cases of carotid-ophthalmic artery aneurysms who were surgically treated using the combined extradural-intradural or intradural approach from March, 1991, to December, 1993. Carotid-ophthalmic artery aneurysms are of considerably surgical interest because some of these were considered to have technical difficulties of clipping and disastrous surgical results. Removal of the anterior clinoid process and unroofing of the optic canal are the key points to exposure the operative field adequately. On the basis of these experiences, authors concluded that this approach is very useful, because of adequate surgical field and better mobilization of the internal carotid artery and optic nerve for direct clipping of carotid-ophthalmic artery aneurysm and basilar tip aneurysm.
Aneurysm* ; Arteries* ; Carotid Artery, Internal ; Optic Nerve

BACKGROUND: To explore an interaction(s) of endothelin with other blood pressure regulating systems, effects of either a high concentration of sodium chloride vehicle or pretreatment with atrial natriuretic peptide (ANP) on the pressor response to endothelin were investigated in rats. METHOD: Sprague-Dawley rats were anesthetized with thiopental (50mg/kg, IP) and were cannulated into left lateral cerebral ventricle. The left femoral artery and vein were also catheterized to measure blood pressure and to serve as an infusion route, respectively. Endothelin (10pmol) dissolved in either normal (0.15M) or high concentration (3.0M) of NaCl vehicle with ANP (1 nmol, ICV). For intravenous (IV) infusion, endothelin(1pmol/min) dissolved either in normal or high concentration of NaCl vehicle was infused for 20min. RESULT: ICV endothelin caused an increase of arterial pressure, in which the NaCl did not affect but ANP-pretreatment significantly attenuated the pressor magnitude. IV endothelin also increased the arterial pressure, which was potentiated by NaCl, ie, the maximum increase caused by the IV endothelin in the high NaCl vehicle was greater than the sum of that induced by endothelin (infused in normal NaCl vehicle) and that induced by high NaCl vehicle only. CONCLUSION: These results suggest that endothelin has separate central and peripheral pressor actions, in which the former is not affected by high NaCl but is attenuated by the ANP system and the latter is potentiated by high NaCl.
Animals ; Arterial Pressure ; Atrial Natriuretic Factor ; Blood Pressure ; Catheters ; Cerebral Ventricles ; Endothelins* ; Femoral Artery ; Rats* ; Rats, Sprague-Dawley ; Sodium Chloride* ; Sodium* ; Thiopental ; Veins

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

No abstract available.
Esophageal Atresia* ; Tracheoesophageal Fistula*

Baby walkers have been a major cause of injuries in young children. The main purpose of this study is to identify the pattern of injuries associated with baby walker. The data were collected from May 13 to June 15, 1998 from 438 mothers who have used or are using baby walkers for their children aged average 6 month old(range 1-33 month). It was founded that 19.2%(84 infants) of these children had walker-related accidents. The types of injuries included 'falling down'(52.4%), 'tiping over'(21.4%), 'being crashed into the wall'(17.9%), and burns(1.2%). These injuries predominantly involved the head and neck region(88%). The majority of injuries were minor, and most injuries occurred at home with the mother present. The most common reason to use the baby walker was to keep the infant happy and occupied. Although many parents used walker to promote walking, there was no supportive evidence that walkers helped babies learn to walk sooner. In conclusion, injuries among infants who use walkers are minor, but common. Also, baby walkers may cause a fatal injury to some infants. Therefore, child safety warning label policies, anticipatory safety guidance and quality control of infant walkers are needed to prevent injuries associated with a infant walker.
Child ; Head ; Humans ; Infant ; Infant Equipment* ; Mothers ; Neck ; Parents ; Quality Control ; Walkers ; Walking

In order to investigate the dietary intakes and physical characteristics in college women smokers, interviews using questionnaires were done on 33 smokers and 42 nonsmokers residing in seoul area. General living habits, dietary habits, food consumption frequency and nutrient intake by quick estimation were investigated through direct interviews with subjects. Subjects height, weight and blood pressure were measured, and body fat percentage were statistically analyzed using Bio-electrical Impedence Fatness Analyzer(GIF-891). All data were statistically analyzed by SAS PC package program ; percentage or mean and standard error were examined for each item, and the significant difference was evaluated by chi-square test or Student's t-test at alpha=0.05. In the analysis of taste and food preference, smokers consumed larger amount of alcohol and coffee than nonsmokers ; they also disliked sweet taste. The results of food consumption frequency data also showed that smokers consumed less fish, milk and fruits but consumed more instant foods than nonsmokers. As a result of anthropometric measurements, height, age, and body fat percentage showed no difference, but there was a significant difference in weight, BMI, systolic blood pressure, and diastolic blood pressure. Energy intake in nonsmokers was 1640 kcal/day(CHO : Pro : Fat=66.0 : 14.7 : 19.3), in smokers. Intakes of calcium, iron, vitamin C, vitamin A, vitamin B1, vitamin B2, and niacin in smokers were not significantly different from those of nonsmokers.
Adipose Tissue ; Ascorbic Acid ; Blood Pressure ; Calcium ; Coffee ; Energy Intake ; Female ; Food Habits ; Food Preferences ; Fruit ; Humans ; Iron ; Milk ; Niacin ; Nutritional Status* ; Riboflavin ; Seoul ; Thiamine ; Vitamin A ; Surveys and Questionnaires