We present two cases of traumatic aneurysms developing during aneurysmal surgery. The aneurysms were clipped without difficulty in both anterior communicating aneurysmal cases. To prevent the vasospasm, bypervolemic theraphy was begun and hypertension was induced postoperatively. The postoperative rebleeding occured within two weeks after initial aneurymal clipping in both cases. New aneursms developed near the clipped anterior communicating aneruysms ; A1 in one case, A2 in the other case. Minor arterial injury was considered to be the main cause of theses new aneurysmal formation and the hemodynamic stress induced by hypertension and hypervolemic therapy might contribute to the development of new aneurysms.
Aneurysm* ; Hemodynamics ; Hypertension

We present two cases of traumatic aneurysms developing during aneurysmal surgery. The aneurysms were clipped without difficulty in both anterior communicating aneurysmal cases. To prevent the vasospasm, bypervolemic theraphy was begun and hypertension was induced postoperatively. The postoperative rebleeding occured within two weeks after initial aneurymal clipping in both cases. New aneursms developed near the clipped anterior communicating aneruysms ; A1 in one case, A2 in the other case. Minor arterial injury was considered to be the main cause of theses new aneurysmal formation and the hemodynamic stress induced by hypertension and hypervolemic therapy might contribute to the development of new aneurysms.
Aneurysm* ; Hemodynamics ; Hypertension

Theophylline has been used for more than 50 years to treat bronchial asthma, and theophylline toxicity continues to be an encountered clinical problem. With suicidal intention, a 61-year-old depressive male patient was sent to the hospital after ingestion of overdose theophylline. He had been followed up for bronchial asthma with about 10 microgram/ mL average plasma theophylline level. On arrival, he complained of dyspnea, palpitation and the plasma theophylline level was 252 microgram/mL. After 2 hours of ingestion, hypotension and tachycardia developed (Systolic blood pressure 50 mmHg, heart rate 190/ min). Other symptoms and signs were stuporous mental state and hypoxemia. Patient's peak plasma theophylline level reached 402 microgram/mL after 3 hours. beta-blocker, dopamine and midazolam were used for control of tachycardia, hypotension and prevention of seizure respectively. After Gastric lavage and administration of charchoal, he was treated with hemoperfusion for 3.5 hours, and serum level decreased. The patient was discharged in good health after 17 days.
Anoxia ; Asthma ; Blood Pressure ; Dopamine ; Dyspnea ; Eating ; Gastric Lavage ; Heart Rate ; Hemoperfusion* ; Humans ; Hypotension ; Intention ; Male ; Midazolam ; Middle Aged ; Plasma ; Seizures ; Stupor ; Tachycardia ; Theophylline*

PURPOSE: Cephalomedullary nails (CMN) are commonly used for the surgical treatment of intertrochanteric fractures. This study aimed to evaluate overall postoperative local complications by reviewing patients who received surgical treatment using three different types of implants. MATERIALS AND METHODS: The study sample included 353 patients (107 males, 246 females) who underwent surgery using CMN for intertrochanteric fractures. Three different types of implants were used: i) the Gamma3® (Stryker) in 80 cases, ii) the Targon® PF (Aesculap) in 225 cases, and iii) the Compression Hip Nail® (Trademedics) in 48 cases. The mean age was 82.6 (range, 60–109) years and the average follow-up period was 15 (range, 6–80) months. Postoperative local complications and risk factors of cut-out were assessed. RESULTS: The most common complication was cut-out (n=26). Other complications included non-union (n=3), periprosthetic fracture (n=2), avascular necrosis (n=1), heterotopic ossification (n=1), and sleeve pull out (n=1). Multivariate analysis revealed that the cut-out group had a higher rate of poor reduction compared to the non-complicated group (P < 0.001). Although the mean tip-apex distance (TAD) was 18.4 mm in the non-complicated group, lower than that of the cut-out group (P=0.001), multivariate analysis revealed that TAD was not a significant risk factor for cut-out (P=0.065). CONCLUSION: Cut-out is the most common local complication associated with surgical treatment of intertrochanteric fractures using CMN. Proper reduction appears to be important in lowering the risk of cut-out. Maintaining low TAD is another critical factor in achieving sufficient fixation of lag screw to the subchondral bone of the femoral head.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Head ; Hip ; Hip Fractures ; Humans ; Male ; Multivariate Analysis ; Necrosis ; Ossification, Heterotopic ; Periprosthetic Fractures ; Postoperative Complications ; Risk Factors

BACKGROUND: Exposure to mercury is known to affect the nervous system and cardiovascular system, but effects of chronic exposure to mercury remain unclear. This study aimed to investigate the effects of high blood mercury concentrations on the health of patients living in the Yeong-dong region.METHODS: We analyzed the relationship between blood mercury concentration and cardiovascular risk and neuropathic symptoms for 555 patients whose blood mercury concentration was tested from 1999 to 2017. We analyzed the association of each lipid component and blood mercury concentration through a partial correlation method. We performed an analysis to determine the odds ratios (ORs) of hypertension, diabetes mellitus, and obesity to high blood mercury levels through a logistic regression model. We analyzed the association between mercury levels and neuropathic symptoms using a χ² test and calculated the OR.RESULTS: The average blood mercury concentration was 8.1±7.5 µg/L and 5.5±5.2 µg/L for males and females, respectively. There was a positive correlation of mercury concentration with high density lipoprotein cholesterol (r, 0.268, 0.219; P-value, <0.001). Among other cardiovascular disease risk factors, no significant correlation was found with high blood mercury level. A tingling sensation in females was related to a high blood mercury level (OR, 2.080; 95% confidence interval, 1.119–3.866).CONCLUSION: It was found that higher mercury concentrations could affect high-density lipoprotein cholesterol regardless of sex and can cause a tingling sensation in women.
Adult ; Cardiovascular Diseases ; Cardiovascular System ; Cholesterol ; Cholesterol, HDL ; Diabetes Mellitus ; Female ; Gangwon-do ; Humans ; Hypertension ; Hypesthesia ; Lipoproteins ; Logistic Models ; Male ; Methods ; Nervous System ; Obesity ; Odds Ratio ; Risk Factors ; Sensation

BACKGROUND: Appetite control and weight reduction is important for the treatment of chronic disease such as obesity, hypertension, and diabetes mellitus. Visual analogue scales (VAS) is widely used to assess appetite. We investigated the reproducibility and the validity of the Korean version of VAS for appetite which will be helpful for clinical use. METHODS: The subjects received the same test meal and 8 VAS questionnaires between 6 weeks. They started to fill out the questionnaire before lunch, continued after lunch every hour, and ended after dinner. The questionnaire was asked about hunger, satiety, fullness, prospective consumption, sweet, salty, savoury, and fatty. During the test meal, the subjects could eat ad libitum until 'comfortable satisfaction'; and after the test meal we calculated energy intake. We assessed the correlation between test-retest VAS for each appetite and evaluated the validity of VAS for hunger with energy intake as "gold-standard". RESULTS: The VAS curves of each appetite were similar between the test and the retest. The VAS of each appetite on the test day was strongly correlated with that on the retest day. The CRs of 4.5 hour mean VAS (20~34 mm) was smaller than the CRs of fasting VAS (35~54 mm). The correlation coefficient of Hunger VAS before dinner and the energy intake was 0.436 on the test day and 0.400 on the retest day. The VAS of the sweet was correlated to the total glucose intake (P<0.05), and the VAS of salty to the salt intake. CONCLUSION: The validity of the VAS score for appetite, especially hunger, sweet and salty taste was good. Indeed, the reliability of VAS for appetite was good to use this scale in a clinical setting.
Appetite ; Chronic Disease ; Diabetes Mellitus ; Energy Intake ; Fasting ; Glucose ; Hunger ; Hypertension ; Lunch ; Meals ; Obesity ; Sensation ; Weight Loss ; Weights and Measures ; Surveys and Questionnaires

OBJECTIVE: It is controversial whether routine or selective iron supplementation during gestation is needed. The aim of this study is to evaluate whether screening with serum ferritin during the first trimester of pregnancy could be identify women who need prophylactic iron supplementation. METHODS: According to the serum ferritin level of cut-off point of 30 microgram/L during the first trimester of pregnancy and the presence of iron supplementation during gestation, the subject was divided into 4 group that were as follows: serum ferritin level of 30 microgram/L and iron- supplemented group (n=40), serum ferritin level of >30 microgram/L and non iron-supplemented group (n=15). Maternal serum ferritin, TIBC, iron, hemoglobin, hematocrit, red cell indices (MCV, MCH, MCHC, RDW) were measured before 14 weeks of gestation and after 34 weeks of gestation. RESULTS: All hematologic and biochemical markers indicated more severe anemic status in the late pregnancy than during the first trimester of pregnancy. The effect of iron supplementation was profounder on the pregnant woman whose ferritin levels were below 30 microgram/L during the first trimester of pregnancy. Regardless of iron supplementation, the group (ferritin >30 microgram/L during the first trimester of pregnancy) showed relatively higher ferritin level in late pregnancy. CONCLUSION: The screening with serum ferritin level of cut-off point of 30 microgram/L during the first trimester of pregnancy may be useful to identify women who need prophylactic iron supplementation.
Biomarkers ; Erythrocyte Indices ; Female ; Ferritins ; Hematocrit ; Humans ; Iron* ; Mass Screening ; Pregnancy Trimester, First ; Pregnancy* ; Pregnant Women

Primary sternal osteomyelitis without predisposing factors is a rare condition, and it is hardly differentiated from metastatic bone tumor especially in patient with the history of primary malignancy because osteomyelities shares frequently common findings with metastatic bone lesion on 18F-FDG PET and bone scan. Although there have been several publications of primary osteomyelitis mimicking bone metastasis in the spine or extremities, we report a case of primary sternal osteomyelitis in the patient with lung cancer, which has, to our knowledge, not been reported before.
Extremities ; Fluorodeoxyglucose F18 ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Osteomyelitis ; Positron-Emission Tomography ; Spine ; Sternum

OBJECTIVE: To investigate the incidence of vocal cord palsy (VCP) in acute ischemic stroke patients and its influence on aspiration risk. METHOD: Fifty patients with first-ever acute stroke were enrolled. The mean age was 68.3 years and there were 21 men and 29 women. Based on clinical and neuroimaging findings, their stroke subtype was categorized into cortical/ subcortical (Group A), lateral medulla (Group B) and other brainstem (Group C). We examined them by using flexible fiberoptic rhinolaryngoscope and videofluroscopic swallowing study (VFSS) within 2 weeks after stroke onset. The Penetration - Aspiration Scale (PAS) was used to score each VFSS. RESULTS: Among the 50 patients, VCP was found in 15 (30%): 15.8% of group A, 100% of group B and 40% of group C. VCP was contralateral to the brain lesion in group A and ipsilateral in 85.7% of group B. Aspiration risk was found in 38% of the all patients and 53% of VCP had aspiration risk. No differences in the incidence of aspiration risk were noted according to VCP (chi-square=2.138, p=0.144). CONCLUSION: There was no relationship between VCP and aspiration risk in acute ischemic stroke patients. Although VCP is a known risk factor for aspiration, other factors are important in determining an effective swallowing.
Brain ; Brain Stem ; Deglutition ; Deglutition Disorders ; Female ; Humans ; Incidence ; Male ; Neuroimaging ; Risk Factors ; Stroke ; Vocal Cord Paralysis ; Vocal Cords

The fibromatosis is a broad group of benign fibrous tissue proliferations of similar microscopic appearance that are intermediate in their biological behavior between benign fibrous lesions and fibrosarcoma. Although various series have been reported of abdominal wall and extra-abdominal desmoid tumors, intra-abdominal desoids are extremely rare. We experienced a case with mesenteric fibroma-tosis occuring in a 30 year-old male. He was admitted to the Kangbuk Samsung hospital complaining of right lower quadrant abdominal mass and abdominal bloating sense. Utrasonography and computed tomography of the abdomen showed a solid mass in the left abdomen surrounded by loops of small bowel. At explorative laparotomy, there was a hard, well circumscribed round mass (25 X 15 X 12 cm) in the mesentery of the terminal ilem. After the tumor was dissected from the retro-peritoneum and surrounding tissues, segmental re- section of ileum with end-to-end anastomosis was performed. On the histopathologic examination, it was confirmed as mesenteric fibromatosis. A brief review of the literature on mesentery fibromatosis was done.
Abdomen ; Abdominal Wall ; Adult ; Fibroma* ; Fibromatosis, Aggressive ; Fibrosarcoma ; Humans ; Ileum ; Laparotomy ; Male ; Mesentery