No abstract available.
Colposcopy* ; Early Diagnosis* ; Uterine Cervical Neoplasms*

In the orthopedic Department of Jeonbug National University Hospital, twenty-five open tibial shaft fractures were reviewed and analyzed with osteomedullography and bone scanning with radioactive isotopes from June 1981 to October 1983. The results are as follows. 1. The cases of injury were mostly traffic accident(70.8%) and majority was found between second decade and third decade. Males were 11 times more frequent than females. 2. In the shape and location of fractures, comminuted fracture(60%) was most common, and fracture of middle one third(48%), lower one third(28%) were in order. 3. In the open tibial fractures, Grade I. of soft tissue injury was most frequent(64%). As inthe plate fixation was required, we should it placed atypically on the posterior surface of the tibia. 4. In the osteomedullography at 3 months after treatment, the rate of positive finding was 80 and intraosseous crossing vein(Kaski sign 1) was observed most frequently. 5. In the profile of the bone scanning with radioactive isotopes, the rate of single-peak uptake was 76% and twin-peak uptake was 24%. 6. In the negative Osteomedullogram and twin-peak uptake on the profile of the bone scanning, bone graft was necessary. 7. In the case of difficult diagnosis for union process of tibia fracture, osteomedullography and bone scanning with radioactive isotopes were considered useful method of early diagnosis.
Diagnosis ; Early Diagnosis ; Female ; Fractures, Comminuted ; Fractures, Open ; Humans ; Jeollabuk-do ; Male ; Methods ; Orthopedics ; Radioisotopes ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Transplants

BACKGROUND: Treatment of skull base tumors is challenging due to limited access and presence of important neurovascular structures nearby. The success of a complete tumor resection depends on the extent of tumor exposure and secure field of view. While these tumors are often removed by transcranial endoscopic access, transfacial approach is sometimes required depending on the location and size of the tumor. This study describes various transfacial approaches in patients undergoing skull base tumor resection. METHODS: From March to November 2013, 15 patients underwent skull base tumor resection via transfacial accesses at a tertiary institution. Data were reviewed for patient demographics, type of access used, completeness of tumor resection, surgical outcome, and postoperative complications. RESULTS: Two clivus tumor patients underwent transmaxillary approach; three tuberculum- sellae and suprasellar-hypothalamus tumor patients underwent transbasal approach; three clinoid and retrobulbar intraconal orbital tumor patients underwent orbitozygomatic approach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wing tumor patients underwent zygomatic approach. In all cases, the upper and lower margins of the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumor removal in 5. There were no immediate major complications observed for the transfacial portion of the operations. The overall cosmetic results were satisfactory. CONCLUSION: Plastic surgeons can use various transfacial approaches according to the location and size of skull base tumors to secure a sufficient field of view for neurosurgeons.
Cavernous Sinus ; Cranial Fossa, Posterior ; Demography ; Humans ; Orbit ; Pons ; Postoperative Complications ; Skull Base*

Diverticular disease of the colon is frequently involved in Western countries, which in korea, it is regarding as rare disease. In Western the diverticulosis is mainly affected on left side and increasing in according to age and false type is more frequent than ture type. While in oriental countries, the diverticulosis of the colon is mainly affected on right side and it is more frequent in younger patients. Cecal diverticulitis is known to a very rare disease and very difficult to be differenciated from acute scopy has purnished another useful tool in the differential diagnosis of diverticular disease. We experienced a case of cecal diverticultitis which had been diagnosed by colonofiberscopy and reviewed literatures briefly.
Colon ; Diagnosis, Differential ; Diverticulitis* ; Diverticulum ; Humans ; Korea ; Rare Diseases

We experienced a case of aldosterone and cortisol secreting adrenal adenoma associated with pregnancy in a 23 year old female patient.The patient complained of severe thoraco-lumbar pain, weight gain, sweating, anxiety, and mild abdominal discomfort. On physical findings, hypertension, tachycardia, facial plethora, moon face, buffalo hump and truncal obesity were found.
Adenoma ; Aldosterone ; Anxiety ; Buffaloes ; Female ; Humans ; Hydrocortisone ; Hypertension ; Moon ; Obesity ; Pregnancy ; Sweat ; Sweating ; Tachycardia ; Weight Gain

PURPOSE: This study was conducted to confirm the effects of octreotide in patients with variceal bleeding. METHODS: We performed a retrospective analysis of 26 patients with variceal bleeding, who visited the Emergency Center of Seoul National University Hospital from January 1st to June 31st, 1996, the control group, and a prospective analysis of 28 patients with variceal bleeding, who visited the Emergency Center of Seoul National University Hospital from March 1st to August 31st, 1999, for the octreotideinfused group. The octreotide-infused group recieved a continuous infusion of octreotide, 25 microgram/hr, for 5 days after an initial bolus of 50 microgram. When active bleeding continued over 1 hour, over 5 pints of packed-RBC were needed for transfusion within 24 hours, or when the systolic blood pressure was under 90 mmHg, a ballon tamponade with Sengstaken-Blackemore tube was used. T-test and X2 test were used for statistical analysis(p<0.05). RESULTS: Forty-one patients were male(octreotide-infused group 22, control group 19) and 13 were female(octreotide-infused group 6, control group 7). The mean age was 55 years(octreotide-infused group 56 years, control group 52 years). There were no significant differences in vital signs, hemoglobin/hematocrit levels, and Child-Pugh's classifications between the octreotide-infused group and the control group initially. There was a significant difference in the rates of early bleeding control within 24 hours(p<0.05), but there were no significant differences in the rates of rebleeding, mortality within 1 week, and use of a balloon tamponade. CONCLUSION: Variceal bleeding is a serious complication of liver cirrhosis and has a high mortality rate. Octreotide is an effective vasoactive agent for control of early bleeding. Thus, octreotide should be used first before endoscopic definitive therapies, to stabilize the vital signs of patients and to secure a field for endoscopic procedures.
Balloon Occlusion ; Blood Pressure ; Classification ; Emergencies ; Esophageal and Gastric Varices ; Hemorrhage* ; Humans ; Liver Cirrhosis ; Mortality ; Octreotide* ; Prospective Studies ; Retrospective Studies ; Seoul ; Varicose Veins* ; Vital Signs

PURPOSE: To analyze the clinical and radiologic results of treatments in proximal femoral fracture with Proximal Femoral Nail-Antirotation (PFNA). MATERIALS AND METHODS: We retrospectively reviewed the results of 21 cases of proximal femoral fracture treated with PFNA from September 2006 to October 2007 which could be followed up for minimum of more than a year. The mean age was 61.5 (20~88) years old. Male were involved in 12 cases, female in 9 cases. The mean follow up was 14.3 (12~18) months. The Garden alignment index, Cleveland index, tip apex distance were evaluated by post-operative radiologic evaluation and complications of bone union, failure of internal fixation and deformity were evaluated by follow up radiologic findings. Clinical results were assessed by social function score of Jensen and mobility score of Parker and Palmer at last follow up. RESULTS: All fractures were united and the mean time to bone union was 15.7 (13~18) weeks. Garden alignment index showed good results of above 'good' in 15 cases (71.4%), Cleveland index showed 14 cases (66.4%) positioning in zone 5 and tip apex distance showed 17.81 (+/-5.65~27.52) mm in radiologic findings. The mean sliding of blade was 1.32 (0.34~2.94) mm in follow up radiologic findings and fracture of distal locking screw area was found in 1 case as a complication. Among 21 cases, the function before injury was completely recovered in 15 cases (71.4%) which were assessed by social function score of Jensen and 13 cases (61.9%) by mobility score of Parker and Palmer. CONCLUSION: We think that PFNA is effective osteosynthetic device for proximal femur fracture with satisfactory radiologic and clinical outcomes.
Congenital Abnormalities ; Female ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Male ; Nails ; Retrospective Studies

Muscle pain following succinylcholine chloride(SCC) is well documented, as are elevated serum potassium and increased creatine phosphokinase(CPK) levels. Pretreatment with a subparylsing dose of a non-depolarizing muscle relaxant before SCC is standard and accepted clinical practice in prevention of SCC induced fasciculation and associated sequlae but pretreatment redners the end-plate less sensitive to SCC: hence larger doses of SCC: hence larger doses of SCC are necessary to ensure adequate degree of relaxation. Recontly fahmy et al showed in a study that small doses of diazepam suppressed the fasciculation as well as the increase in serum potassium and creatine phosphokinase(CPK). Our study was undertaken to evaluate the effect of pretreatment with diazepam on the potential side effects of SCC. Eight cases were studied in four different groups. In the first group(control group): no diazepam was used, secoun group: with diazepam 0.05mg/kg, third group:: with diazepam 0.1mg/kg, grouth group: with diazepam 0.2mg/kg. As a result of this study, we can summarize as follows: 1) Diazepam pretreatment groups had no significant change in the prevention of muscle fasciculation following SCC than control groups. 2) Conditions for intubation were assessed as excellent to good in diazepam pretreatment and control groups. 3) The increase in serum potassium and CPK produced by SCC was not inhibited by diazepam pretreatment. 4) In the prevention of incidence of muscle pain, there were no significant difference between the control and diazepam pretreatment groups.
Creatine ; Diazepam* ; Fasciculation ; Incidence ; Intubation ; Myalgia ; Potassium ; Relaxation ; Succinylcholine

The pathogenesis of antiepileptic drug (AED) resistance is multifactorial. However, most candidate gene association studies typically assess the effects of candidate genes independently of each other, which is partly because of the limitations of the parametric-statistical methods for detecting the gene-to-gene interactions. A total of 200 patients with drug-resistant epilepsy and 200 patients with drug-responsive epilepsy were genotyped for 3 representative the single nucleotide polymorphisms (SNPs) of the voltage-gated sodium channel genes (SCN1A, SCN1B, and SCN2A) by polymerase chain reaction and direct sequencing analysis. Besides the typical parametric statistical method, a new statistical method (multifactor dimensionality reduction [MDR]) was used to determine whether gene-to-gene interactions increase the risk of AED resistance. None of the individual genotypes or alleles tested in the present study showed a significant association with AED resistance, regardless of their theoretical functional value. With the MDR method, of three possible 2-locus genotype combinations, the combination of SCN2A-PM with SCN1B-PM was the best model for predicting susceptibility to AED resistance, with a p value of 0.0547. MDR, as an analysis paradigm for investigating multi-locus effects in complex disorders, may be a useful statistical method for determining the role of gene-to-gene interactions in the pathogenesis of AED resistance.
Adolescent ; Adult ; Alleles ; Anticonvulsants/*therapeutic use ; Case-Control Studies ; Child ; Child, Preschool ; Data Interpretation, Statistical ; Drug Resistance ; Epilepsy/drug therapy/*genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Infant ; Male ; Polymorphism, Single Nucleotide ; Sodium Channels/*genetics

OBJECTIVE: Spontaneous intracranial hypotension(SIH) is a rare condition presented with cardinal postural headache and low CSF pressure. The authors describe the characteristic clinical features, imaging findings, and treatment methods in the patients with spontaneous intracranial hypotension. METHODS: Between May 1994 and Aug. 2001, eight patients were diagnosed with spontaneous intracranial hypotension based on characteristic radiologic and clinical findings in our department. All cases were shown diffuse meningeal enhancement(DME) on magnetic resonance(MR) image. Two cases had subdural hematoma. RESULTS: The most characteristic feature on Brain MR image is DME with/without subdural fluid collection. Radionuclide image reveals direct leaking point and rapid appearance of urinary bladder activity. Direct leaking points were detected in all four cases who performed radioisotope study. Autologous epidural blood patches were applied to four cases, and all of them were improved without complication. Among four patients treated with conservative method, three were improved, but one patient was died of spontaneous chronic subdural hematoma. CONCLUSION: We suggest that 1) meticulous studies need to be performed aggressively if SIH is diagnosed clinically and radiologically, 2) the most effective study may be radioisotope study, and 3) if leaking point is found, aggressive management such as autologous epidural blood patches is recommended.
Blood Patch, Epidural ; Brain ; Headache ; Hematoma, Subdural ; Hematoma, Subdural, Chronic ; Humans ; Intracranial Hypotension* ; Urinary Bladder