No abstract available.
Carotid Artery, Common* ; Rupture*

After the definition of Cushing's ulcer, it is well recognized that neurosurgical patients have the high risk of acute gastrointestinal bleeding, especially in severe head trauma. Acute gastrointestinal bleeding after burn, respiratory failure, hepatic failure, renal failure and sepsis as "stress ulcer" also were studied. The prevention and management of bleeding was discussed in medico-surgical field for several years. Despite of these regimen, the prognosis of the bleeding have not significantly improved and bleeding affected the patient's outcome more than initial neurosurgical intervention. The authors experienced 25 cases of acute gastrointestinal bleeding among our neurosurgical patients between January, 1984 to June, 1988. We analysed these patients respectively and concluded as follows: 1) The incidence of acute gastrointestinal bleeding was 0.61%. 2) The bleeding developed on 12th day, average, and clinical manifestation were anemia, hematemesis and melena in order of frequency within the first 4-week in almost all cases. 3) The initial neurological sign such Glasgow Coma Scale may well predict the hallmark to suspect the acute gastrointestinal bleeding. 4) The systemic insults such as shock, renal failure, hepatic failure, respiratory failure and sepsis significantly affected to re-bleeding chance and rendered the patient's outcome poorer. 5) The overall mortality due to gastrointestinal bleeding was 32% and the operative mortality was 50%.
Anemia ; Burns ; Craniocerebral Trauma ; Glasgow Coma Scale ; Hematemesis ; Hemorrhage* ; Humans ; Incidence ; Liver Failure ; Melena ; Mortality ; Prognosis ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis ; Shock ; Ulcer

PURPOSE: To evaluate the clinical feature and the results of the treatment of Lisfranc joint fracture/dislocation with limited open reduction, pin fixation and Ilizarov external fixation. MATERIALS AND METHODS: From June 2001 to May 2003, six patients with Lisfranc fracture/dislocation were treated. The average periods of follow-up was 23 months. After limited open reduction on the second tarso-metatarsal joint, we performed pin fixation of the above joint. On the other Lisfranc joint fracture/dislocation, closed reduction and the application of Ilizarov external fixator was done. This rigid system produced the early partial weight bearing and joint motion of the injured foot and ankle joint. The parameters used were radiographic evaluation, patient's clinical assesment and the AOFAS midfoot score. RESULTS: We used the Myerson's criterier to evaluate the radiographic result. All cases could be achieved more than nearly anatomical reduction. Three cases of excellent and 3 cases of good result could be obtained in the evaluation of the patient's clinical assesment. The average AOFAS midfoot score was 87.2 (76~95) points. CONCLUSION: The treatment using Ilizarov external fixation on Lisfranc joint fracture/dislocation can be another useful method.
Ankle Joint ; Dislocations* ; Equidae ; External Fixators ; Follow-Up Studies ; Foot ; Humans ; Joints* ; Weight-Bearing

PURPOSE: Thyroid hormone is essential for development of the brain in early life. Thyroid dysfunction is more common in the first 2-4 postnatal weeks of life in premature infants than in term infants. This study aimed to identify the prevalence and clinical course of thyroid dysfunction in prematurity. METHODS: Premature infants admitted to and given neonatal screenings at Dankook University Hospital between April 1999 and March 2008 were included in this study. We retrospectively reviewed medical records and categorized subjects into six groups: normal, hypothyroidism, hyperthyrotropinemia, hypothyroxinemia, delayed onset of hypothyroidism, and delayed onset of hyperthyrotropinemia. METHODS: Among 599 subjects, 136 (23%) had initially abnormal thyroid function test (TFT); transient hypothyroxinemia was the most frequent condition (118, 20%). In addition, 8 (17%) of 46 subjects with initially normal TFT levels showed delayed onset of hyperthyrotropinemia with or without low free thyroxine (fT4). Thyroxine was prescribed for 10 patients (1.7%) due to low fT4 levels but was discontinued in 9 patients during follow-up. Thyroid scan confirmed ectopic thyroid in one patient. CONCLUSION: Thyroid dysfunction was frequently seen in premature infants, but most of the conditions were transient. In addition, some infants showed delayed TSH elevation on routine follow-up. Therefore, a recheck of the thyroid function of premature infants at 3-4 weeks is recommended, even if normal thyroid function is initially seen, especially in prematurity of less than 33 weeks of gestational age or birth weight of less than 2,500 grams.
Birth Weight ; Brain ; Follow-Up Studies ; Gestational Age ; Humans ; Hypothyroidism ; Infant ; Infant, Newborn ; Infant, Premature ; Medical Records ; Neonatal Screening ; Prevalence ; Retrospective Studies ; Thyroid Dysgenesis ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine

PURPOSE: Thyroid hormone is essential for development of the brain in early life. Thyroid dysfunction is more common in the first 2-4 postnatal weeks of life in premature infants than in term infants. This study aimed to identify the prevalence and clinical course of thyroid dysfunction in prematurity. METHODS: Premature infants admitted to and given neonatal screenings at Dankook University Hospital between April 1999 and March 2008 were included in this study. We retrospectively reviewed medical records and categorized subjects into six groups: normal, hypothyroidism, hyperthyrotropinemia, hypothyroxinemia, delayed onset of hypothyroidism, and delayed onset of hyperthyrotropinemia. METHODS: Among 599 subjects, 136 (23%) had initially abnormal thyroid function test (TFT); transient hypothyroxinemia was the most frequent condition (118, 20%). In addition, 8 (17%) of 46 subjects with initially normal TFT levels showed delayed onset of hyperthyrotropinemia with or without low free thyroxine (fT4). Thyroxine was prescribed for 10 patients (1.7%) due to low fT4 levels but was discontinued in 9 patients during follow-up. Thyroid scan confirmed ectopic thyroid in one patient. CONCLUSION: Thyroid dysfunction was frequently seen in premature infants, but most of the conditions were transient. In addition, some infants showed delayed TSH elevation on routine follow-up. Therefore, a recheck of the thyroid function of premature infants at 3-4 weeks is recommended, even if normal thyroid function is initially seen, especially in prematurity of less than 33 weeks of gestational age or birth weight of less than 2,500 grams.
Birth Weight ; Brain ; Follow-Up Studies ; Gestational Age ; Humans ; Hypothyroidism ; Infant ; Infant, Newborn ; Infant, Premature ; Medical Records ; Neonatal Screening ; Prevalence ; Retrospective Studies ; Thyroid Dysgenesis ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine

BACKGROUND: Since Ross and Sormeville first reported the use of aortic homograft valve for correction of pulmonary atresia in 1966, homograft valves are widely used in the repair of congenital anomalies as conduits between the pulmonary ventricle and pulmonary arteries. On the basis of these results, we have used it actively. In this report, we describe our experience with the use of cryopreserved valved homograft conduits for infants and children requiring right ventricle to pulmonary artery connection in various congenital cardiac anomalies. MATERIAL AND METHOD: Between January,1996 and December 2001, 27 infants or children with a median age of 16 months(range 9days to 18years) underwent repair of RVOTO using homograft valved conduit by two surgeons. We studied 22 patients who have been followed up at least more than one year. The diagnosis at operation included pulmonary atresia with ventricular septal defect (n=13), truncus arteriosus (n=3), TGA or corrected TGA with RVOTO (n=6). Homograft valved conduits varied in size from 15 to 26 mm (mean, 183.82 mm). The follow-up period ranged from 12 to 80.4 months (median, 48.4 months). RESULT: There was no re-operation due to graft failure itself. However, early progressive pulmonary homograft valve insufficiency developed in one patient, that was caused by dilatation secondary to the presence of residual distal pulmonary artery stenosis and hypoplasia after repair of pulmonary atresia with ventricular septal defect. This patient was required reoperation (conduit replacement). During follow-up period, there were significant pulmonary stenosis in one, and pulmonary regurgitation more than moderate degree in 3. And there were mild calcifications at distal anastomotic site in 2 patients. All the calcified homografts were aortic in origin. CONCLUSION: We observed that cryopreserved homograft conduits used in infant and children functioned satisfactorily in the pulmonic position at mid-term follow-up. To enhance the homograft function, ongoing investigation is required to re-establish the optimal strategy for the harvest, preservation and the use of it.
Allografts ; Child ; Constriction, Pathologic ; Cryopreservation ; Diagnosis ; Dilatation ; Follow-Up Studies* ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Infant ; Pulmonary Artery ; Pulmonary Atresia ; Pulmonary Valve Insufficiency ; Pulmonary Valve Stenosis ; Reoperation ; Transplantation, Homologous ; Transplants ; Truncus Arteriosus

During civil engineering construction near Sejong-ro, Jongro-ku, Seoul, cultural sites were found that are thought to have been built in the 15th century. This area was home to many different people as well as the leaders of the Yi dynasty. To gain further insight into the life styles of the inhabitants of the old capital, soil samples were collected from various areas such as toilets, water foundations, and drainage ways. Parasite eggs were examined by microscopy after 5 g soil samples were rehydrated in 0.5% trisodium phosphate solution. A total of 662 parasite eggs from 7 species were found. Species with the highest number of eggs found were Ascaris lumbricoides (n=483), followed by Trichuris trichiura (138), Trichuris vulpis (21), Fasciola hepatica (8), Clonorchis sinensis (6), Paragonimus westermani (4), and Metagonimus yokogawai (2). These findings indirectly indicate the food habits of the people in Yi dynasty.
Ascaris lumbricoides ; Clonorchis sinensis ; Drainage ; Eggs* ; Fasciola hepatica ; Food Habits ; Foundations ; Heterophyidae ; Korea* ; Life Style ; Microscopy ; Ovum* ; Paragonimus westermani ; Parasites* ; Seoul* ; Soil ; Trichuris ; Water

Extraskeletal Ewing's sarcoma is a very rare tumor which was first reported by Angervall and Enzinger in 1975. The common sites of extraskeletal Ewing s sarcoma are bony structures of lower extremities, paravertebral region, and pelvis, but rarely chest walL Microscopically, extraskeletal Ewing's sarcoma is indistinguishable from the Ewing's sarcoma of bone. We present here a case of extraskeletal Ewing's sarcoma of the left lateral chest wall in a 19-year-old male. Wide extirpation and postoperative combined chemotherapy were done, and we discuss the clinical picture, histopathology, therapeutic management, and prognosis with review of the literature.
Drug Therapy ; Humans ; Lower Extremity ; Male ; Pelvis ; Prognosis ; Sarcoma* ; Sarcoma, Ewing* ; Thoracic Wall* ; Thorax* ; Young Adult

BACKGROUND: There have been unexpected cases of failed alcoholic sympathectomy, even though satisfactory effects had been obtained in test blocks with a mixture of contrast media and local anesthetics. It was plausible to suspect the contrast media as a cause of the failure of alcoholic sympathectomy. So, the purpose of this study was to evaluate whether the contrast media can hinder the action of alcohol in alcoholic sympathectomy or not. METHODS: In Sprague - Dawley rats (200 300g), thoracic paravertebral sympathetic chains were exposed and planned regimens were injected in these regions. The rats were divided randomly into seven groups, group C (control group), group D (administration of dye just after exposure), group D-A30 (administration of dye just after exposure, administration of alcohol 30 min. after dye), group A30 (administration of alcohol 30 min. after exposure), group D-A0 (administration of dye just after exposure, administration of alcohol just after dye), group D-A60 (administration of dye just after exposure, administration of alcohol 60 min. after dye) and group D-A90 (administration of dye just after exposure, administration of alcohol 90 min. after dye). Degrees of cytoplasmic contraction were evaluated in the ganglion cells of each member of the experimental groups. RESULTS: The contraction ratios of cytoplasms in group D-A30 and A30 were greater than that of group C and D. The contraction ratios of cytoplasm in group D-A60 and D-A90 were greater than those of group D-A0 and D-A30. CONCLUSIONS: According to our results, the contrast media seems to hinder the action of alcohol in alcoholic sympathectomy.
Alcoholics* ; Anesthetics, Local ; Animals ; Contrast Media* ; Cytoplasm ; Ganglion Cysts ; Humans ; Rats ; Sympathectomy*

Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.
*Accidental Falls ; Adult ; Aneurysm, Dissecting/*complications ; Humans ; Infarction/*etiology ; Kidney Diseases/*etiology ; Male ; Renal Artery/*pathology ; Risk Factors