Superior mesenteric artery (SMA) injuries remain a challenge to most trauma surgeons and continue to result in significant mortality despite aggressive management. We report successful management of a proximal SMA injury through endovascular treatment in a 56-year-old man. The patient presented with hypotension due to a stab wound after the epigastrium. He underwent emergency laparotomy and repair of the penetrated wall of the stomach. Right retroperitoneal hematoma at the initial laparotomy expanded and ruptured, requiring a massive transfusion. At the second laparotomy, we performed lateral arteriorrhaphy of the proximal SMA. Follow-up abdominal computed tomography angiography on post-injury day 7 showed a pseudoaneurysm on the left side of the SMA trunk. The patient was treated successfully with an endovascular stent graft.
Aneurysm, False* ; Angiography ; Blood Vessel Prosthesis ; Emergencies ; Endovascular Procedures ; Follow-Up Studies ; Hematoma ; Humans ; Hypotension ; Laparotomy ; Mesenteric Artery, Superior* ; Middle Aged ; Mortality ; Stomach ; Wounds, Stab

No abstract available.
Epidermal Cyst

The purpose of this study was to investigate the stress distribution of the abutment and supporting tissues according tot he slopes and types of the guiding plane of distal extension removable partial dentures. The 3-dimensional finite element method was used and the finite element models were prepared as follows. Model I : Kratochvil type guiding plane with 90degree to residual ridge Model II : Kratochvil type guiding plane with 95degree to residual ridge Model III : Kratochvil type guiding plane with 100degree to residual ridge Model IV : Krol type guiding plane with 90degree to residual ridge Distal extension partial denture which right mandibular first and second molar were lost was used and the second premolar was prepared as primary abutment with RPI type retainer. Then 150N of compressive force was applied to central fossae of the first and second molars and von Mises stress and displacement were measured. The results were as follows : 1. Model I and Model IV showed a similar stress distribution pattern and the stress was concentrated on the apex of the root of the abutment. 2. The stress was increased and concentrated on mesial side of the root of the abutment in Model II. The stress was concentrated on buccal and mesiobuccal side of the root of the abutment in Model III. 3. In Model I, the root of the abutment displaced and twisted a little in clockwise. In Model IV, the root of the abutment displaced to distolingually at apical region of the root and mesiobucally at cervical region of the root. 4. In Model II, the root of the abutment displaced to mesiolingually at apical region of the root and more displaced and twisted in counterclockwise at cervical region of the root. In Model III, the root of the abutment displaced to mesiobucally at apical region of the root and more displaced and twisted in clockwise at cervical region of the root.
Bicuspid ; Denture, Partial ; Denture, Partial, Removable* ; Molar

No abstract available.
Reticulocyte Count* ; Reticulocytes*

No abstract available.
Reticulocyte Count* ; Reticulocytes*

Replantation of a severed limb is an elective procedure and, as such, the decision to carry it out must be assessed anew in each case. The arm is progressively more valuable from shoulder to fingers, the leg, on the contrary, is progressively of less significance. Especially, the replantation of severed hand at the level of carpal bones or wrist joint is technically more difficult than at the level of forearm or arm. We have a successful case of replanted hand at the level of intercarpal joint without bony shortening.
Arm ; Carpal Bones ; Carpal Joints ; Extremities ; Fingers ; Forearm ; Hand ; Leg ; Microsurgery ; Replantation ; Shoulder ; Wrist Joint

PURPOSE: The purpose of this study was to evaluate US and CT features of choroidal osteoma. MATERIALS AND METHDOS: US and CT scans of seven cases of choroidal osteoma occurring in six patients were retrospectively analyzed. We analysed US and CT findings with particular attention to the location, size, and shape of calcification associated with choroidal osteoma, and sought the possible cause of the tumor, if any. RESULTS: None of six patients had any possible cause related to choroidal osteoma. All of seven cases of choroidal osteoma were manifested as calcified mass which were located in the posterior wall of the eyeball near the juxtapapillary region. Calcification ranged in size from 1 to 2 cm and had curvilinear shape. Both US and CT were equally useful to evaluate choroidal osteoma. CONCLUSION: By depicting the characteristic calcification, US and CT are useful imaging modalities in evaluating choroidal osteoma.
Choroid* ; Humans ; Osteoma* ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: Our aim was to evaluate the efficacy of a bladder neck closure (BNC) for the treatment of incontinence in children with a neurogenic bladder. MATERIALS AND METHODS: Between January 1995 and July 2002, 14 children (8 boys and 6 girls) underwent a BNC, with continent diversion. Information on the continence stati and complications following the BNC were evaluated. The mean age at the time of the operation and the follow-up period were 9.7 years, ranging from 6 to 22, and 21 months, respectively. All children suffered from neurogenic incontinence related to spinal bifida. The BNC were performed as primary procedures in 11 children and as secondary procedures in 3. During surgery, the bladder neck was transected and the bladder opening and urethral stump closed in two layers. A Mitrofanoff diversion, with appendix, was performed in all patients. RESULTS: After the BNC, all the patients were completely dry. As for the related complications with the BNC, no leakages or fistulae were seen in any of the patients. Bladder stones were seen in 2 patients, postoperative ileus in 2 and symptomatic urinary tract infection in 1. Stomal complications were seen in 2 patients. One patient each had some pain with the catheterization and mild stomal stenosis, but they all improved with no additional intervention. CONCLUSIONS: With the high success, and low complication, rates, it is concluded that a BNC, in conjunction with bladder augmentation and Mitrofanoff diversion, is highly efficacious in achieving dryness in pediatric urinary incontinence, when used as a primary, as well as a salvage procedure.
Appendix ; Catheterization ; Catheters ; Child ; Constriction, Pathologic ; Fistula ; Follow-Up Studies ; Humans ; Ileus ; Neck* ; Urinary Bladder Calculi ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Incontinence* ; Urinary Tract Infections

No abstract available.
Child ; Child, Orphaned* ; Humans

An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a well-defined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx.
Epidermal Cyst*