To maintain an adequate airway in a patient with tracheobronchial narrowing coming from various causes, prosthetic tracheobronchial stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. After insertion, precious reported complications were granuloma formation, dysphagia, suction catheter entrapment and fatal massive hemoptysis. We report a case of complication associated with expandible metallic scent with endobronchial stenosis due to tuberculosis.
Catheters ; Constriction, Pathologic* ; Deglutition Disorders ; Granuloma ; Hemoptysis ; Humans ; Palliative Care ; Stents* ; Suction ; Tuberculosis

No abstract available.
Cervix Uteri* ; Female

The treatment of massive bone and soft tissue defect in the lower leg has a high complication rate of nonunion, chronic infection, and amputation without well-vascularized tissue coverage of the open fracture. Despite adequate free soft tissue coverage, massive skeletal defect may result in segmental bone defects, angulation deformity, and limb length discrepancies. In the last decade, major advances have occurred in the Ilizarov method of distraction osteogenesis in lower leg salvage as a delayed procedure or simultaneous distraction after free-tissue transfer. The authors have performed Ilizarov transport in conjunction with muscle and musculocutaneous flap coverage in nine cases of lower leg salvage. The flaps consist of rectus, gracilis, latissimus dorsi, parascapular, and serratus muscle or musculocutaneous fashioning using ipsilateral or contralateral pedicle in consideration of vessel condiation. Revision, recorticotomy and flap elevation were also used as a secondary procedure for satisfactory results. The conclusions, were as follows: 1) Multidisciplinary team approach with conjoining departments at the time of preoperative evaluation, postoperative care and rehabilitation care; 2) Muscle flap covered with split-thickness skin graft was preferred to musculocutaneous flap; 3) To reduce the total reconstructive period, simultaneous free tissue transfer with Ilizarov distraction should be considered.
Amputation ; Congenital Abnormalities ; Extremities ; Fractures, Open ; Ilizarov Technique ; Leg* ; Myocutaneous Flap ; Osteogenesis* ; Osteogenesis, Distraction ; Postoperative Care ; Rehabilitation ; Skin ; Superficial Back Muscles ; Transplants

Symptomatic diffuse idiopathic skeletal hyperostosis (DISH) is not common. Gelfoam is one of the most commonly used topical hemostatic agents. But, in the partially moistened state, air retained in its pores may result in excessive expansion on contact with liquid. The onset of swallowing difficulty after anterior cervical spine surgery due to appling gelfoam is a rare complication. A 77-year-old man with swallowing difficulty was admitted to our hospital and we diagnosed him as DISH confirmed by radiological study. After removing the DISH, patient's symptom was relieved gradually. However, on postoperative day (POD) 7, the symptom recurred but lesser than the preoperative state. We confirmed no hematoma and esophageal perforation on the operation site. We observed him closely and controlled the diet. Three months later, he had no symptom of swallowing difficulty, and was able to be back on a regular diet, including solid foods. We present a complication case of swallowing difficulty occurring by gelfoam application.
Deglutition ; Diet ; Esophageal Perforation ; Gelatin Sponge, Absorbable ; Hematoma ; Hyperostosis, Diffuse Idiopathic Skeletal ; Spine

BACKGROUND: It is well known that growth hormone (GH) stimulates animal growth, but studies on metabolic effects of growth hormone have recently been increasing. The purpose of this study was to clarify the effects of growth hormone treatment on body composition and glucose metabolism in hypophysectomized growth hormone-deficient rats. METHODS: The 20-week-old rnale Sprague-Dawley rats were hypophysectomized and replaced with cortisol and thyroxine for 8 weeks, then administered with recombinant human growth hormone for 2 weeks. Group 1 consisted of intact controls (n 15), while group 2 consisted of hypophysectomized controls (n 12), and group three consisted of those with GH treatment (n 13). The body weights, body composition, blood glucose levels, plasma insulin-like growth factor-I (IGF-I) levels, euglycemic hyperinsulinemic clamp test, and glycogen synthase activities in gastrocnemius muscle were measured before and after growth hormone treatment. RESULTS: Plasma IGF-I levels in GH-treated group increased to intact control group levels after 2 weeks of GH treatment. There were significant changes in body composition after the treatment (fat mass significantly decreased and lean body mass significantly increased). There were no changes in glucose metabolism in peripheral tissue after 2 weeks of GH treatment. CONCLUSION: Human GH treatment (4 IU/kg/day) in adult hypophysectomized GH-deficient rats changed the body composition, but did not alter the glucose metabolism in peripheral tissue.
Adult* ; Animals ; Blood Glucose ; Body Composition* ; Body Weight ; Glucose* ; Glycogen Synthase ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hydrocortisone ; Insulin-Like Growth Factor I ; Metabolism* ; Muscle, Skeletal ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Thyroxine

No abstract available.
Glomerulonephritis, Membranous* ; Small Cell Lung Carcinoma*

Testicular teratoma contains more than one germ cell layer in various stages of maturation and differentiation. The teratoma occurs at all ages but is most common in the 25-30 year age group. It is relatively infrequently seen in childhood and infancy. In these age group, teratoma is a benign tumor. Recently, we experienced one case of incidental testicular teratoma during hydrocelectomy in 22 month-old child, The hydrocele is frequently associated with teratoma under age 4 years and is the most common misdiagnosis. So we report this one case of testicular teratoma with review of related literatures.
Child ; Diagnostic Errors ; Germ Cells ; Humans ; Infant ; Teratoma* ; Testis

PURPOSE: We conducted a retrospective analysis to determine if adjuvant chemotherapy prolongs overall survival in patients with pathologic stage IB lung adenocarcinoma who had undergone complete resection and were defined as high-risk by a newly developed recurrence risk scoring model. MATERIALS AND METHODS: Patients who underwent curative resection for stage IB lung adenocarcinoma were analyzed with a newly developed recurrence risk scoring model and divided into a low-risk group and a high-risk group. The patients in the high-risk group were retrospectively divided into two groups based on whether they underwent adjuvant chemotherapy or observation. Recurrence-free survival and overall survival were compared between these two groups. RESULTS: A total of 328 patients who underwent curative resection between 2000 and 2009 were included in this study, of whom 110 (34%) received adjuvant chemotherapy and 218 (67%) underwent observation without additional treatment. According to our risk model, 167 patients (51%) were high-risk and 161 (49%) were low-risk. The 5-year recurrence-free survival rates and overall survival were 84.4% and 91.5% in low-risk patients and 53.9% and 74.7% in high-risk patients (p < 0.001). In high-risk patients, the 5-year overall survival rates were 77% among patients who underwent observation and 87% among those who underwent adjuvant chemotherapy (p=0.019). CONCLUSION: Adjuvant chemotherapy prolonged overall survival among high-risk patients who had undergone complete resection for stage IB lung adenocarcinoma.
Adenocarcinoma* ; Chemotherapy, Adjuvant* ; Humans ; Lung* ; Recurrence* ; Retrospective Studies ; Survival Rate

OBJECTIVE: Percutaneous vertebroplasty is an effective treatment that relieves pain caused by vertebral compression fracture. However, vertebroplasty may increase the risk for subsequent vertebral compression fracture. The purpose of this study is to evaluate the incidence of and risk factors for subsequent fracture after vertebroplasty. METHODS: A retrospective analysis was performed for 112 patients who were diagnosed with a first osteoporotic compression fracture at a single level and underwent vertebroplasty at that level. Possible risk factors for subsequent fracture, such as age, sex, bone mineral density (BMD), location of treated vertebrae, pattern of cement distribution, cement volume, presence of intradiscal cement leakage, and direction of cement leakage, were analyzed. RESULTS: During the follow-up period, 18 new subsequent vertebral fractures developed (16.1%). Subsequent fractures were more common in osteoporotic patients (T-score < or =-2.5)(p=0.034, r=0.208). Intravertebral cement volume > or =3.5 cc were also associated with a significantly higher risk of fracture (p=0.012, r=0.238). CONCLUSION: Low BMD and volume of intravertebral cement were the factors most strongly associated with subsequent fracture after percutaneous vertebroplasty.
Bone Density ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Incidence ; Retrospective Studies ; Risk Factors* ; Spine ; Vertebroplasty

OBJECTIVE: Percutaneous vertebroplasty is an effective treatment that relieves pain caused by vertebral compression fracture. However, vertebroplasty may increase the risk for subsequent vertebral compression fracture. The purpose of this study is to evaluate the incidence of and risk factors for subsequent fracture after vertebroplasty. METHODS: A retrospective analysis was performed for 112 patients who were diagnosed with a first osteoporotic compression fracture at a single level and underwent vertebroplasty at that level. Possible risk factors for subsequent fracture, such as age, sex, bone mineral density (BMD), location of treated vertebrae, pattern of cement distribution, cement volume, presence of intradiscal cement leakage, and direction of cement leakage, were analyzed. RESULTS: During the follow-up period, 18 new subsequent vertebral fractures developed (16.1%). Subsequent fractures were more common in osteoporotic patients (T-score < or =-2.5)(p=0.034, r=0.208). Intravertebral cement volume > or =3.5 cc were also associated with a significantly higher risk of fracture (p=0.012, r=0.238). CONCLUSION: Low BMD and volume of intravertebral cement were the factors most strongly associated with subsequent fracture after percutaneous vertebroplasty.
Bone Density ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Incidence ; Retrospective Studies ; Risk Factors* ; Spine ; Vertebroplasty