Isolated infernal iliac artery aneurysms and rupture are relatively infrequent, often difficult to detect and therefore rarely considered in the differential diagnosis for abdominal pain. The consequences can be grave, The incidence of isolated iliac artery aneurysm is 1~2% of that of abdominal aortic aneurysm(AAA). The natural history is of gradual enlargement, with rupture the most common clinical presentation. The signs and symptoms of such an aneurysm are influenced by its concealed location within the bony pelvis. Awareness of these special characteristics improves the chances of early diagnosis and proper surgical treatment before possible rupture. Here is a case of ruptured aneurysm of left internal iliad artery. A 73-year-old man was presented to our emergency center with severe abdominal pain and voiding difficulty Abdominal Computed Tomography(Cf) and angiography showed ruptured aneurysm of left infernal iliad artery. Emergency operation was successfully performed for the ruptured internal iliad artery aneurysm.
Abdominal Pain ; Aged ; Aneurysm* ; Aneurysm, Ruptured ; Angiography ; Arteries ; Diagnosis, Differential ; Early Diagnosis ; Emergencies ; Humans ; Iliac Artery* ; Incidence ; Natural History ; Pelvis ; Rupture ; Rupture, Spontaneous*

INTRODUCTION: Osteoporosis, the most common metabolic bone disorder, is a condition of reduced bone density and increased susceptibility to fractures. Osteoporosis is a major public health problem and a significant cause of morbidity in postmenopausal women. Therefore family physicians as primary care physicians are in a key position for preventing and treating this disorder. So we studied the factors affecting to bone mineral density in postmenopausal women. MATERIALS AND METHODS: A total of 136 spontaneous postmenopausal women were participated in the study. They have measured spinal bone mineral density by dual energy x-ray absorptiometry from January 1992 to June 1995 at Yeungnam University Hospital. Age, height, weight, age at menarche and menopause, number of child and breast feeding child, history of oral pill ingestion, family history of osteoporosis, amount of milk and coffee ingestion, consumption of tobacco and alcohol and physical activity were assessed by qustionnaire and medical records. RESULTS: physical activity and weight were significant contributors. Physical activity is most the largest contributor. CONCLUSIONS: Among factors affecting to BMD in postmenopausal women, physical activity and weight were more important factors. Therefore continuous physical activity is significant factor to prevent osteoporosis in postmenopausal women.
Absorptiometry, Photon ; Bone Density* ; Breast Feeding ; Child ; Coffee ; Eating ; Female ; Humans ; Medical Records ; Menarche ; Menopause ; Motor Activity ; Osteoporosis ; Physicians, Family ; Physicians, Primary Care ; Public Health ; Tobacco

Typhlitis or neutropenic enterocolitis is a life-threatening, necrotizing process of the cecum whose incidence is increasing. Typhlitis presents as fever, abdominal pain, and diarrhea in neutropenic patients. As the incidence of typhlitis increases, emergency physicians must be aware of this rapidly progressive and potentially fatal disease. The definitive management of typhlitis is controversial. The most prudent course for the emergency physician is to initiate aggressive medical management early in the ED. We describe a 25-year-old man with severe neutropenia presented to the emergency department with fever, abdominal pain, diarrhea that began 2days earlier. Abdominal computerized tomography(CT) demonstrated diffuse concentric thickening of the cecal wall, intramural edema, inflammatory bowel changes but no free air and abscess formation. He was recovered by early diagnosis and aggressive medical therapy. We report a case of typhlitis with literature reviews.
Abdominal Pain ; Abscess ; Adult ; Cecum ; Diarrhea ; Early Diagnosis ; Edema ; Emergencies* ; Emergency Service, Hospital ; Enterocolitis, Neutropenic ; Fever ; Humans ; Incidence ; Neutropenia ; Typhlitis*

Recently, increased traffic accident has resulted in a corresponding increase in incidences of blunt trauma. Tracheal and main bronchial injuries artier blunt chest trauma can be life-threatening, and hence early diagnosis and early management of patients with such injuries are essential. A 3-year-old boy was transferred to the Department of Emergency Medicine after a motor vehicle accident in which he sustained multiple blunt injuries consisting of tracheal rupture, left main bronchial rupture, liver laceration, vitreous hemorrhage, and fracture of the iliac wing. The tracheal rupture was managed nonoperatively with intensive respiratory care, while the left main bronchial rupture was managed surgically by bronchoplasty. Postoperative course was uneventful and the patient was discharged without respiratory problems.
Accidents, Traffic ; Bronchi* ; Child, Preschool ; Early Diagnosis ; Emergency Medicine ; Humans ; Incidence ; Lacerations ; Liver ; Male ; Motor Vehicles ; Rupture ; Thorax ; Trachea* ; Vitreous Hemorrhage ; Wounds, Nonpenetrating

No abstract available.
Appendix* ; Fetus*

BACKGROUND: Hypothermia is a condition that can lead to serious complications and even to death in newborn. Although the temperature control is essential in neonatal care, it is often neglected during urgent transfer from local private hospitals. The purpose of this study is to evaluate the incidence and clinical outcomes of transfer induced neonatal hypothermia. SUBJECTS AND METHOD: In this retrospective study, subject is limited to transferred outborn babies with age less than 24 hours from June 1996 to May 1999. A total of 3,086 patients were admitted in NICU during the study period and inborn and outborn babies were 1,743(56%) and 1,343(44%) respectively. Among the 1,343 outborn babies, 212 babies were transferred from the private hospital within 24 hours of birth and were eligible for the study. Rectal temperature on arrival, transfer time, birth weight, gestational age, initial arterial gas study, and clinical outcome were compared. Statistical analysis has been done with chi-sqaure test and multiple logistic regression analysis. RESULTS: There were 84 cases(39.6%) hypothermia(<36degrees C> among the 212 babies and the rate of hypothermia in transfered babies have not decreased over the study period. There were significantly more hypothermia in lower gestational age (less than 28 weeks) and lower birth weight (less than 2,000gm) caused hypothermia significantly more than normal gestational age or normal range of birth weight. And time interval (less than 12 hour) from birth to arrival at emergency department was also significant factor in hypothermia. The mortality rate was three fold higher in hypothermia than normothermic or hyperthermic babies. CONCLUSION: This study shows that hypothermia during neonate transportation is a major cause of neonatal mortality and morbidity in prehopital care. Body temperature control during transport of neonates under 24 hours of age should be emphasized for the better outcome of treatment.
Birth Weight ; Body Temperature ; Emergency Service, Hospital ; Gestational Age ; Hospitals, Private ; Humans ; Hypothermia* ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn* ; Logistic Models ; Mortality ; Parturition ; Reference Values ; Retrospective Studies ; Transportation*

No abstract available.
Animals ; Brain* ; Inositol* ; Phospholipases* ; Rats*

No abstract available.
Animals ; Cerebellum* ; Inositol 1,4,5-Trisphosphate* ; Inositol* ; Rats*

Changes in the number, the immunoreactivities and the ultrastructures of sero- tonin immunoreactive mucosal mast cells[MMCs] in rat gastrointestinal tracts after vagus nerve stimulation were investigated by using light and electron microscopic immunocytochemical methods. The vagus nerves were electrically stimulated with a square wave pulse generator for a duration of 5 minutes each, a total of 8 times at 2 minute intervals. Serotonin immunoreactive cells of the connective tissues of the gastrointestinal tract were mainly located in the lamina propria, and a small number of the cells were also scattered in the submucosa. By using electron microscopic immunocytochemistry and Wright stain, the serotonin immunoreactive cells of the lamina propria and the submucosa were identified to be MMCs. A few large-sized serotonin immunoreactive connective tissue mast cells [CTMCs], showing strong metachromasia with the Wright stain, were located together with the MMCs in the submucosa of the stomach. In most of the gut regions of the control group, the majority of the MMCs did not show any serotonin immunoreactivities and only a few MMCs showed weak serotonin immunoreactivities. After stimulation of the vagus nerves, the number and the immnu- noreactivities of the serotonin immunoreactive MMCs dramatically increased in all gut regions observed, especially in the small intestines. In the samples treated with the electron microscopic immnunocytochemical methods, hardly any serotonin immunoreactivities were detected in the MMCs of the control group. However, the serotonin imrnunoreactivities of the MMCs were significantly increased after vagus nerve stimulation. The serotonin immnunoreactive products were localized, following vagal stimulation, both in the peripheral matrix of the granules and in the cytoplasm. Also, it was confirmed ultrastructurally that the Golgi complexes were expanded in the MMCs of the vagal stimulation group. The above results suggest that vagus nerve stimulation may activate serotonin biosynthesis in MMCs.
Animals ; Connective Tissue ; Cytoplasm ; Gastrointestinal Tract* ; Golgi Apparatus ; Immunohistochemistry ; Intestine, Small ; Mast Cells* ; Mucous Membrane ; Rats* ; Serotonin* ; Stomach ; Vagus Nerve Stimulation* ; Vagus Nerve*

This study was undertaken to investigate the ultrastructure of the neurons, neuroglial cells and capillaries in the area postrema[AP] of the Oriental discolured bat, Vespertilio superans. The AP of the bat was a single midline structure at the most caudal portion of the fourth ventricle. Most neurons in the AP were small cells, but their ultrastructure were similar to the typical neurons located elsewhere in the central nervous system. Astroglial cells and oligodendrocytes were also observed and showed their typical ultrastructure. Ultrastructural features of neurons, astroglial cells and oligodendrocytes were not changed during hibernating cycles. However, microglial cells were only found in the hibernating AP ; these cells were located in the parenchyma and near the blood vessels of the AP. Since the microglial cytoplasm was filled with phagocytotic inclusions, the nuclei of the these cells were eccentrically located. Phagocytotic cytoplasmic inclusions were shown to be composed of a dense irregular peripheral region and the pale round central region. A Large vacant space was often found in the electron lucent central region. Continuous and fenestrated capillaries surrounded by pericytes were found in the bat`s AP. Especially, Phagocytotic inclusions were found in the pericyte cytoplasm of the hibernating AP, and this result supports suggestion that pericytes might be phagocytotic cells. On the basis of the distributions of phagocytotic tells[pericytes and microglial cell], ultrastructure of these cells, morphology of their cytoplasmic inclusions, and the appearance of phagocytotic activity of the pericytes during the hibernating stage when microglial cells were observed, it can be concluded that pericytes may also participates in the formation of rrlicroglial cells. Tanycytes were also found in the bat AP.
Area Postrema* ; Blood Vessels ; Capillaries ; Central Nervous System ; Cytoplasm ; Ependymoglial Cells ; Fourth Ventricle ; Inclusion Bodies ; Microglia ; Neuroglia ; Neurons ; Oligodendroglia ; Pericytes