Acute gastric dilatation leading to gastric necrosis is rare but potentially fatal condition that can occur in patients with bulimia. It usually develops after a bulimic episode and it is not diagnosed with sufficient rapidity it may lead to gastric perforation followed by peritonitis, sepsis, shock, and death. Because of the rarity of this condition and the patients in whom it occurs, the clinician must maintain a high degree of suspicion when treating patients with eating disorders who present with abdominal pain after a binge. This case report describes a 24-year old woman with acute gastric dilatation due to binge eating, who had the gastrotomy and died of complications such as gastric necrosis and disseminated intravascular coagulation.
Abdominal Pain ; Bulimia ; Disseminated Intravascular Coagulation ; Feeding and Eating Disorders ; Female ; Gastric Dilatation ; Humans ; Necrosis ; Peritonitis ; Sepsis ; Shock

PURPOSE: The author performed this experimental study to investigate the changes in the tensile strength of a new insertion following a superior rectus recession in a rabbit's eye. METHODS: Conventional superior rectus muscle recession procedures with the hang-back suture technique were performed on New Zealand white rabbits (body weight 2~3kg), after which the disinsertional force was measured using a digital tension gauge on the 3rd, 5th, and 7th days, and then weekly for up to 8 weeks postoperatively. RESULTS: The postoperative disinsertional forces were as follows: 38.25 +/- 2.75, 165 +/- 31.27, and 167.25 +/- 26.99 g at the 3rd , 5th and 7th days, and 211.00 +/- 25.66, 222.75 +/- 26.66, 255.25 +/- 24.51, 271.50 +/- 38.25, 429.50 +/- 21.14 g at the 2nd, 3rd, 4th, 6th and 8th weeks respectively. The disinsertional forces linearly increased with the postoperative time period and there was a strong correlation with correlation coefficient being 0.903. CONCLUSIONS: We concluded that musculoscleral adhesion with hang-back suture maintained enough strength in early postoperative time period.
Rabbits ; Suture Techniques ; Sutures ; Tensile Strength*

Measurements of the diameter of the coronary artery (left main, left anterior descending branch, left circumflex branch, right) and the length of the coronary artery (left main, left anterior descending) were performed in 77 cases obtained from corpses with normal and mild atherosclerosis of coronary artery. Fifty-six males and 21 females were studied whose ages ranged from 15 -78 years old. The diameter of the coronary artery exponentially increased in accordance with the increase of age (left main coronary artery: lumen diameter=1.847+0.216 X age, R2=0.632, p<0.01; left anterior descending branch: lumen diameter=1.513 +0.241 X age, R2=0.539, p<0.01; right coronary artery:lumen diameter=1.830 +0.193 X age, R2=0.513, p<0.01; left circumflex branch: lumen diame-ter= 1.470+0.159 X age, R2=0.502, p<0.01). The lumen diameter of the left main coronary artery, the length of the left anterior descending branch and the thickness of the left anterior descending branch exponentially increased in accordance with the increase of the heart weight(left main coronary artery: lumen diameter=1.721+0.031 X heart weight, R2=0.338, p<0.01; left anterior descending branch: length=7.114+0.103 X heart weight, R2=0.313, p<0.01; left anterior descending branch: wall thickness=0.226+0.009 X heart weight, R2=0.256, p<0.01). But no significant difference was observed between the diameter, length of the coronary artery and various body indices, and heart weight. Microscopic and immunohistochemical studies on coronary arteries of 77 cases showed high frequency of diffuse intimal thickening with many smooth muscle cells and scanty macrophages and fragmentation of internal elastic lamina in arteries without atherosclerosis. These results indicate that the lumen diameter of coronary artery is closely correlated with age but not with various body indices and heart weight, and the length of the anterior descending branch is closely correlated with heart weight but not with age and various body indices. The results of the microscopic and immunohistochemical studies indicate that the early event of the atherosclerosis of the coronary artery is intimal thickening and fragmentation of internal elastic lamina.
Arteries ; Atherosclerosis ; Cadaver ; Coronary Vessels* ; Female ; Heart ; Humans ; Macrophages ; Male ; Myocytes, Smooth Muscle

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascites arising from liver cirrhosis, nephrotic syndrome and so on. Primary bacterial peritonitis (PBP) is a rare intraabdomial infection in the absence of underlying diseases or rupture of the viscus. The authors report an autopsy case of posttraumatic primary bacterial peritonitis in the otherwise physically healthy young female. She was beaten repeatedly around the abdomen with human physical instruments for a prolonged time.
Abdomen ; Ascites ; Autopsy ; Bacterial Infections ; Female ; Humans ; Liver Cirrhosis ; Nephrotic Syndrome ; Peritonitis* ; Rupture

BACKGROUND: The specificity of aortic alteration in the pathogenesis of aortic dissection has been challenged. To obtain comprehensive morphologic data that may enhance the appreciation of the pathogenesis of aortic disease in normal aorta among Koreans, we performed a morphologic study of aorta with aging. METHODS: The histologic and morphometric studies of ascending aorta without cardiovascular disease were carried out on seventy-two autopsy cases. Alcian blue-stained sections were subjected to morphometric study using image analysis system. The age range of the cases was from newborn to those who had been in their eighties. RESULTS: The most prominent feature of aging aorta was fragmentation and loss of elastic lamellae, and expansion of interlamellar spaces. Cystic medial necrosis of varying degrees was observed in almost every specimen. On the morphometric study, the percentage area of mucoid degeneration revealed no statistically significant differences among the varying age groups. Compared to males, female subjects exhibited significant mucoid degeneration (p<0.05). CONCLUSIONS: The alteration of elastic lamellae is increased with age. Cystic medial necrosis is not considered merely an aging phenomenon, but is enhanced in the aorta of females.
Age Factors ; Aging ; Aorta* ; Aortic Diseases ; Autopsy ; Cardiovascular Diseases ; Female ; Humans ; Infant, Newborn ; Male ; Necrosis* ; Pathology ; Sensitivity and Specificity

Acute epiglottitis is a local bacterial infection of the supraglottic area. Epiglottitis is generally caused by organisms which invoke an inflammatory response that develops rapid obstructive edema. The disease rarely progresses to abscess stage, either because medical intervention is sought or death by asphyxiation ensues. A 38-year-old, mentally ill but physically healthy woman died of airway obstruction caused by acute epiglottitis forming an abscess. She died unexpectedly and suddenly showing only minor nonspecific symptoms.
Abscess* ; Adult ; Airway Obstruction ; Bacterial Infections ; Death, Sudden* ; Edema ; Epiglottitis ; Female ; Humans ; Mentally Ill Persons

Hemophagocytic Syndrome (HS) is a systemic lymphohistiocytic proliferative disorder associated with infection or malignancies, particularly Epstein-Barr virus (EBV) HS is presented with high fever, skin rash, hepatosplenomegaly, and cytopenia. The characteristic pathologic finding is massive lymphohistiocytic infiltration with hemophagocytosis in various organs including bone marrow, liver, and spleen. Hyperproduction of cytokines by activated T lymphocytes has been presumed to account for the hemophagocytosis and clinical manifestations of HS. We report three childhood autopsy cases with HS which was confirmed by histopathologic examination. According to medical records, all cases had high fever with or without skin rash, cytopenia, AST/ALT elevation, and hyperfibrinogenemia, and showed multiple organ failure eventually. At autopsy, there were no specific gross findings except splenomegaly, but extensive lymphohistiocytic infiltration with hemophagocytosis was seen in various organs including lymph nodes, spleen, liver, and bone marrow. In one of three cases, EBV was identified with in situ hybridization method. As this disease has rapidly progressive clinical course with fatal outcome during childhood, so the possibility of HS should be considered in children presenting with high fever and hepatosplenomegaly.
Autopsy* ; Bone Marrow ; Child ; Cytokines ; Exanthema ; Fatal Outcome ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Liver ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Medical Records ; Multiple Organ Failure ; Spleen ; Splenomegaly ; T-Lymphocytes

Degenerative vascular disease, previous arterial surgery, long-term ureteral stenting, pelvis surgery, and radiotheraphy are reported as causes of artery-to-collecting-system communication.. Artery-to-collecting-system- communication associated with blunt trauma is rare, but potentially fatal. The diagnosis is very difficult and requires a high degree of suspicion. We were able to make the diagnosis based on the characteristic finding of contrast-enhanced computed tomography (CT) obtained in the early phase, equivalent to the finding obtained in the corticomedullary phase of the kidney. We report a case of artery to collecting system communication due to blunt abdominal trauma following a fall, which was treated by embolization.
Arteries* ; Diagnosis ; Kidney ; Pelvis ; Stents ; Ureter ; Vascular Diseases

Degenerative vascular disease, previous arterial surgery, long-term ureteral stenting, pelvis surgery, and radiotheraphy are reported as causes of artery-to-collecting-system communication.. Artery-to-collecting-system- communication associated with blunt trauma is rare, but potentially fatal. The diagnosis is very difficult and requires a high degree of suspicion. We were able to make the diagnosis based on the characteristic finding of contrast-enhanced computed tomography (CT) obtained in the early phase, equivalent to the finding obtained in the corticomedullary phase of the kidney. We report a case of artery to collecting system communication due to blunt abdominal trauma following a fall, which was treated by embolization.
Arteries* ; Diagnosis ; Kidney ; Pelvis ; Stents ; Ureter ; Vascular Diseases

PURPOSE: To evaluate MR findings of redundant nerve roots (RNR) of the cauda equina. MATERIALS AND METHODS: 17 patients with RNR were studied; eight were men and nine were women, and their ages ranged from 46 to 82 (mean63) years. Diagnoses were established on the basis of T2-weighted sagittal and coronal MRI, which showed a tortuous or coiled configuration of the nerve roots of the cauda equina. MR findings were reviewed for location, magnitude, and signal intensity of redundant nerve roots, and the relationship between magnitude of redundancy and severity of lumbar spinal canal stenosis (LSCS) was evaluated. RESULTS: In all 17 patients, MR showed moderate or severe LSCS caused by herniation or bulging of an intervertebral disc, osteophyte from the vertebral body or facet joint, thickening of the ligamentum flavum, degenerative spondylolisthesis, or a combination of these. T2-weighted sagittal and coronal MR images well clearly showed the location of RNR of the cauda equina; in 16 patients (94%), these were seen above the level of constriction of the spinal canal, and in one case, they were observed below the level of constriction. T2-weighted axial images showed the thecal sac filled with numerous nerve roots. The magnitude of RNR was mild in six cases (35%), moderate in five cases (30%), and severe in six cases (35%). Compared with normal nerve roots, the RNR signal on T2-weighted images was iso-intense. All patients with severe redundancy showed severe LSCS, but not all cases with severe LSCS showed severe redundancy. CONCLUSION: Redundant nerve roots of cauda equina were seen in relatively older patients with moderate or severe LSCS and T2-weighted MR images were accurate in identifying redundancy of nerve roots and evaluating their magnitude and location.
Cauda Equina* ; Constriction ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Intervertebral Disc ; Ligamentum Flavum ; Magnetic Resonance Imaging ; Male ; Osteophyte ; Spinal Canal ; Spondylolisthesis ; Zygapophyseal Joint