No abstract available.
Gardnerella vaginalis* ; Gardnerella*

The location of the sigmoid colon varies within the abdominal cavity, but its mesocolon is fixed to the left side. Right side fixation of the sigmoid colon is a very rare congenital positional anomaly. In addition, it has been reported that hepatocolic fistula is also a very rare disease that may present lower gastrointestinal bleeding. Here, the authors describe a case of a 71-year-old man who underwent surgery for hepato-sigmoidocolic fistula complicated by hepatocellular carcinoma and the right side fixation of the sigmoid colon.
Abdominal Cavity ; Carcinoma, Hepatocellular ; Colon, Sigmoid ; Fistula ; Hemorrhage ; Humans ; Mesocolon ; Rare Diseases

PURPOSE: To study the development of inferior shoulder subluxation after surgery for proximal humerus fractures. To analyze the mechanism development of such subluxation and the association between different types of proximal humerus fractures, quality of reduction achieved the method of operation performed. MATERIALS AND METHODS: A retrospective analysis of 45 proximal humerus fractures that were treated by surgery between March 1997 and July 2002 was done. All patients had a minimum of 12 months of postoperative follow up. Preoperative radiographs were classified by the Neer's classification. Different operative treatment methods, post reduction alignment and the degree of postoperative subluxation if present, were analysed. In order to evaluate effect of loss of negative intraarticular pressure, we compared this series with 15 cases of recurrent shoulder dislocation treated by open Bankart operation. RESULTS: 13 patients out of 45 (29%) developed immediate postoperative inferior shoulder subluxation. 3-part fractures of the proximal humerus showed a higher incidence of the same than the 2-part types. The better reduced fractures had lesser rates of subluxation. Open reduction (39%, 11 patients) results in an increased incidence of inferior subluxation than closed methods of reduction (13%, 2 patients). CONCLUSION: Inferior subluxation of the humeral head after surgery for the proximal humerus fracture can occur and persist till postoperative period of 2 months. Deltoid muscle tone affected by shortening of humeral neck plays an important role. Early active exercise for restoration deltoid tone may be effective in prevention of inferior subluxation.
Classification ; Deltoid Muscle ; Follow-Up Studies ; Head* ; Humans ; Humeral Head ; Humerus* ; Incidence ; Neck ; Postoperative Period ; Retrospective Studies ; Shoulder ; Shoulder Dislocation

Osteoma of the paranasal sinus is benign tumor, and it is mostly located in frontal and ethmoid sinus, produces symptoms of headache, nasal obstruction and ocular complication of exophthalmos, ocular pain, restricted ocular motility, and diplopia. Recently the authors have experienced one case of osteoma of ethmoidal sinus which could be removed by external ethmoidectomy.
Diplopia ; Ethmoid Sinus* ; Exophthalmos* ; Headache ; Nasal Obstruction ; Osteoma*

Midazolam is a type of anesthetic agent frequently used for conscious sedation during a variety of medical procedures. Anaphylactic reactions to midazolam are rarely reported. However, we observed a case of midazolam hypersensitivity in which emergency measures were required to ensure patient recovery after administration of midazolam as a sedative. The occurrence of the anaphylactic reaction to midazolam was confirmed by elevated serum tryptase levels. The current case report presents a discussion of our findings.
Anaphylaxis* ; Conscious Sedation ; Emergencies ; Humans ; Hypersensitivity ; Midazolam* ; Tryptases

BACKGROUND: This study was performed to evaluate the effect of group intervention by primary care physicians on the changes of drinking behaviors in Korean heavy drinkers. METHODS: A total of 32 male heavy drinkers participated in group intervention by family physicians of Chungnam National University Hospital. Initially, they were assessed for general characteristics, family function and drinking characteristics prior to the intervention conducted 4 times (about 40 minutes/each session). Reassessment on their drinking frequencies (times/week), drinking amounts (drinks/drinking day) and Alcohol Use Disorders Identification Test (AUDIT) score was achieved at directly, at 12 weeks and at 1 year after intervention. RESULTS: The mean drinking frequency was significantly (P < 0.01) decreased from 5.2 +/- 1.7 before to 3.5 +/- 2.4 at directly, 3.9 +/- 2.3 at 12 weeks and 4.0 +/- 2.3 at 1 year after intervention. The mean drinking amounts were significantly (P < 0.01) decreased from 17.0 +/- 16.5 before to 11.0 +/- 16.9 at directly, 14.2 +/- 17.8 at 12 weeks and 13.9 +/- 17.8 at 1 year after intervention. The mean AUDIT score was significantly (P < 0.01) decreased from 29.4 +/- 5.8 before to 19.1 +/- 11.0 at directly, 21.8 +/- 9.1 at 12 weeks and 23.0 +/- 9.4 at 1 year after intervention. The number of heavy drinkers and binge drinkers were significantly (P < 0.05) decreased from 32 (100%) and 32 (100%) before to 20 (62.5%) and 22 (68.8%) at directly, 23 (71.9%) and 24 (75.0%) at 12 weeks, and 22 (68.8%) and 19 (59.4%) at 1 year after intervention. CONCLUSION: It is suggested that group intervention by family physicians may be effective on the improvement of drinking behavior at 12 weeks and 1 year after the intervention in heavy drinkers.
Drinking ; Drinking Behavior ; Family Characteristics ; Follow-Up Studies ; Humans ; Male ; Physicians, Family ; Physicians, Primary Care ; Primary Health Care

Laparoscopic cholecystectomy is the treatment of choice for cholelithiasis. It is used more commonly than open cholecystectomy because of the convenience of a short hospital stay and earlier return to work, and for aesthetic reasons. Nevertheless, there are complications that are encountered more frequently than in open cholecystectomy due to the smaller operating window. Here, we report the case of a 73-year-old woman who underwent a laparoscopic cholecystectomy 15 years earlier and now presented with abrupt abdominal pain. Abdominal computed tomography (CT) revealed a past cholecystectomy with an abscess pocket abutting the abdominal wall, with a stone inside it. Incision and drainage were done and the stone was removed laparoscopically. This case shows that late complications, such as abscess formation due to lost GB stones during laparoscopic cholecystectomy, can occur, even after 15 years.
Abdominal Abscess ; Abdominal Pain ; Abdominal Wall ; Abscess ; Aged ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholelithiasis ; Drainage ; Female ; Humans ; Length of Stay ; Return to Work

PURPOSE: To determine the value of the CT scan in distinguishing an ischemic and a tumoral segment in coloniccarcinoma complicated by proximal bowel ischemia. MATERIALS AND METHODS: CT scans of twenty patients with ischemic colitis proximal to obstructing colonic carcinoma were reviewed retrospectively. The presence of anischemic segment proximal to colonic carcinoma were patho-logically confirmed in 12 patients, and the remaining eight patients showed typical radiologic findings of bowel ischemia on barium enema but on pathologic review showed only colonic carcinoma. CT scans were analyzed for the location, wall thickness, length, and enhancing pattern of both tumoral and ischemic segments in correlation with barium enema or surgico-pathologic results. Theresults of tumor staging shown on CT scan were compared with those of pathologic findings. RESULTS: On CT scan adistinction between ischemic and tumoral segments could be made in 15 patients (75%). The ischemic segments were contiguously proximal to the tumoral segment in 18 patients. In two patients, however, there was an intervening segment of normal bowel between the two segments and this was confirmed by pathology. Maximvm bowel wall thickness ranged from 0.8 to 4.5cm (mean, 2.0cm) in tumoral segments and from 0.6 to 1.5 cm (mean, 1.0cm) in ischemic segments (p<0.05). Tumoral segments were enhanced heterogeneously in 12 patients (60%) and homogeneously in the remaining eight, while ischemic segments were enhanced homogeneously in 14 patients (70%) and heterogeneously insix. Peripheral rim enhancement was seen only in the ischemic segments of four patients (20%). Comparing TNM tumorstaging of the CT scan with that of pathology, CT scan overstaged in two patients (10%) and understaged in one(5%). CONCLUSION: CT is a valuable tool for distinguishing an ischemic from a tumoral segment in patients with ischemic colitis proximal to colonic carcinoma. An understanding of this pathologic entity could reduce the possibility of over or understaging in cases of colonic carcinoma.
Barium ; Colitis ; Colitis, Ischemic* ; Colon* ; Enema ; Humans ; Ischemia ; Logic ; Neoplasm Staging ; Pathology ; Retrospective Studies ; Tomography, X-Ray Computed

Primary gastric squamous cell carcinoma represents a rare entity. Up to date, only seven cases have been reported in Korea. This paper reports a case of a 51-year-old male patient whose stomach cancer was diagnosed during general routine check-up. Upper gastrointestinal endoscopy showed a large ulcero-fungating mass on the body of the stomach. Histological examination of biopsy confirmed squamous cell carcinoma. An extended total gastrectomy including splenectomy and segmental resection of the large bowel was conducted. Postoperative adjuvant chemotherapy with capecitabine and oxaliplatin was followed. The patient has been following up the out patient's clinic after discharge.
Biopsy ; Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Endoscopy, Gastrointestinal ; Gastrectomy ; Humans ; Korea ; Male ; Middle Aged ; Splenectomy ; Stomach Neoplasms ; Stomach* ; Capecitabine

Primary gastric squamous cell carcinoma represents a rare entity. Up to date, only seven cases have been reported in Korea. This paper reports a case of a 51-year-old male patient whose stomach cancer was diagnosed during general routine check-up. Upper gastrointestinal endoscopy showed a large ulcero-fungating mass on the body of the stomach. Histological examination of biopsy confirmed squamous cell carcinoma. An extended total gastrectomy including splenectomy and segmental resection of the large bowel was conducted. Postoperative adjuvant chemotherapy with capecitabine and oxaliplatin was followed. The patient has been following up the out patient's clinic after discharge.
Biopsy ; Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Endoscopy, Gastrointestinal ; Gastrectomy ; Humans ; Korea ; Male ; Middle Aged ; Splenectomy ; Stomach Neoplasms ; Stomach* ; Capecitabine