Acute cholecystitis after a colonoscopy is a rare event, and only eight documented cases are reported in the literature. A 35-year-old male underwent a screening colonoscopy. There was a 5-mm sessile polyp in the sigmoid colon, which was removed by using a hot snare polypectomy. Forty-eight hours after the colonoscopy, the patient visited our emergency department with epigastric pain and fever. Based on the clinical findings, laboratory data and radiologic imaging, our diagnosis was acute cholecystitis. Because no previous cases of this type have been reported to date in Korea, we publish the details of our patients who presented with a postcolonoscopy complication diagnosed as acute cholecystitis.
Adult ; Cholecystitis, Acute* ; Colon, Sigmoid ; Colonoscopy* ; Emergencies ; Fever ; Humans ; Korea ; Male ; Mass Screening ; Polyps ; SNARE Proteins

Acute cholecystitis after a colonoscopy is a rare event, and only eight documented cases are reported in the literature. A 35-year-old male underwent a screening colonoscopy. There was a 5-mm sessile polyp in the sigmoid colon, which was removed by using a hot snare polypectomy. Forty-eight hours after the colonoscopy, the patient visited our emergency department with epigastric pain and fever. Based on the clinical findings, laboratory data and radiologic imaging, our diagnosis was acute cholecystitis. Because no previous cases of this type have been reported to date in Korea, we publish the details of our patients who presented with a postcolonoscopy complication diagnosed as acute cholecystitis.
Adult ; Cholecystitis, Acute* ; Colon, Sigmoid ; Colonoscopy* ; Emergencies ; Fever ; Humans ; Korea ; Male ; Mass Screening ; Polyps ; SNARE Proteins

Hypopharyngeal perforation associated with traffic accident is a rare occurrence, which can cause serious morbidity and mortality if not diagnosed and treated early. We report an autopsy case of hypopharyngeal perforation following a traffic accident. A 32-year-old man hits his chin when his car hits highway guardrail. He complained continuous neck pain and died 5 days after the accident. Autopsy was performed, and death was due to undiagnosed retropharyngeal abscess with sepsis.
Accidents, Traffic ; Adult ; Autopsy ; Chin ; Humans ; Hypopharynx ; Neck Pain ; Retropharyngeal Abscess ; Sepsis

A seaman died after a jet of compressed air directed to his anus while working with his colleagues in deck of the ship. He suffered from abdominal pain and distension, and died 5 hours later in the ship. Autopsy was performed and revealed rupture of the splenic flexure of the colon and partial seromuscular tearing in the rectosigmoidal region. We concluded that the cause of death was tension pneumoperitoneum by the pneumatic colonic rupture. The need for education of the workers handling compressed air appliances is emphasized.
Abdominal Pain ; Anal Canal ; Autopsy ; Cause of Death ; Colon ; Colon, Transverse ; Compressed Air ; Handling (Psychology) ; Pneumoperitoneum ; Rupture ; Ships

BACKGROUND: There is still risk of acquiring HCV and HIV by transfusion due to window phase. Screening for HCV and HIV-1 by nucleic acid amplification testing (NAT) may improve blood safety allowing detection during the preseroconversion window in donors. METHODS: We investigated NAT usefulness using COBAS AMPLICOR analyzer (Roche). The following sample population were tested:1) 15,552 HCV/HIV-1 seronegative random blood donor samples for HCV and HIV-1 NAT;2) 696 high ALT and 271 HCV EIA positive samples for HCV NAT;3) 1,152 HIV-1 EIA reactive samples for HIV-1 NAT. NAT was performed on pools of 24 donations according to the assay protocol. RESLUTS: Six pools showed initial reactive reactions in HCV NAT and one pool showed initial reactive reaction in HIV-1 NAT. But no donor sample was found repeatedly reactive by this assay. CONCLUSIONS: Although there were false positive reactions, specificity of the NAT assay was high enough for the assay to be applied as a blood screening test and implementation of this assay is expected to improve blood safety and be useful for blood products use.
Blood Donors* ; Blood Safety ; False Positive Reactions ; HIV ; HIV-1* ; Humans ; Mass Screening ; Nucleic Acid Amplification Techniques ; Sensitivity and Specificity ; Tissue Donors

OBJECTIVE: To investigate the clinical effectiveness of emergency cervical cerclage in pregnant women with advanced cervical incompetence in the second trimester. METHODS: This study analyzed retrospectively the pregnancy outcomes of 20 patients who were offered emergency cerclage between June 2000 and April 2004. Group I was defined as the patients cervical dilatation without membrane prolapse. Group II was the patients with membrane prolapse into vagina, who were underwent amniocentesis to decrease intraamniotic pressure. RESULTS: The mean+/-SD gestational age at cerclage was 21.6+/-2.4 weeks (Group I: 21.0+/-2.5, Group II: 22.1+/-2.3). The mean cervical dilatation was 2.5+/-0.9 cm (Group I: 1.8+/-0.5, Group II: 3.2+/-0.8) and mean effacement was 79.0+/-12.9% (Group I: 68.8+/-11.6, Group II: 87.3+/-6.4). The mean interval from cerclage to delivery was 9.4+/-5.3 weeks (Group I: 11.1+/-6.1, Group II: 7.9+/-3.7) and mean gestational age at delivery was 31.0+/-6.0 weeks (Group I: 32.2+/-7.4, Group II: 30.0+/-4.9). The birth weight was 1.9+/-1.1 kg (Group I: 2.4+/-1.4, Group II: 1.6+/-0.8) and the perinatal survival rate was 75% (Group I: 77%, Group II: 73%). Cervix dilatation and effacement were significantly more advanced in group II compared to the group I (p<0.05). However, the duration of pregnancy prolongation and birth weight, gestational age at the delivery were not significantly different between both groups. CONCLUSION: This results suggest that emergency cervical cerclage might be an effective treatment in advanced cervical incompetence, and that the concomitant amniocentesis could help the cerclage in the patients with membrane prolapse.
Amniocentesis ; Birth Weight ; Cerclage, Cervical* ; Cervix Uteri ; Dilatation ; Emergencies* ; Female ; Gestational Age ; Humans ; Labor Stage, First ; Membranes ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnant Women ; Prolapse ; Retrospective Studies ; Survival Rate ; Vagina

OBJECTIVE: To report the method and efficacy of the site specific-defects repair in the endopelvic fascia and uterosacral ligament suspension for the correction of posthysterectomy vaginal vault prolapse. METHODS: This study was performed in 3 patients with posthyterectomy vaginal vault prolapse who underwent the surgery for the reconstruction of endopelvic fascia and the correction of vault prolapsed vagina by using uterosacral ligament suspension at the department of Obstetrics and Gynecology in Moon-Hwa Hospital. Among them, 1 patient was treated by laparotomy, and 2 patients were treated by laparoscope. RESULTS: The age of patients ranged from 49 to 67 years. The mean operation time was 111 minutes (105-120 minutes). The status of postoperative vagina was normal in all 3 patients, who were discharged 9 days after operation without symptoms. No complication or recurrence were found in them despite long-term follow-up for 24 months, 12 months, 7 months, respectively after operation. One patient has been treated with HRT therapy. CONCLUSION: The reconstruction of the defect of endopelvic fascia and uterosacral ligament fixation may be very safe, effective, and functional in the correction of vaginal vault prolapse. This study reports the treatment of vaginal vault prolapse using uterosacral ligament within Korea for the first time.
Fascia ; Follow-Up Studies ; Gynecology ; Humans ; Korea ; Laparoscopes ; Laparotomy ; Ligaments* ; Obstetrics ; Pelvic Organ Prolapse* ; Recurrence ; Vagina

PURPOSE: To analyze the causes of vocal cord fixation in laryngeal cancer and to demonstrate its spiral CT findings. MATERIALS AND METHODS: We retrospectively applied the five pathologic mechanisms of vocal cord fixationto spiral CT findings and evaluated mechanisms of fixed vocal cord in 16 patients with laryngeal cancer of T3 or more on staging. CT findings of another six patients (T2) showing one or more suspicious mechanisms of vocal cord fixation in conventional CT were compared with those of the 16 patients (T3 or more). RESULTS: In 16 patients with laryngeal cancer of T3 or more, the most common finding of vocal cord fixation was the complete replacement of the true vocal cord (including the thyroarytenoid and vocalis muscle) by the tumor and tumor invasion of the paralaryngeal space (n = 16). Other findings were tumor invasion and fixation of the cricoarytenoid joint (n = 9), interference with cord mobility by the bulky mass (n = 6), tumor invasion of the thyroid cartilage, with vocalcord fixation (n = 4) and subglottic tumor spread (n = 3). In another six patients (T2) with suspicious vocal cordfixation, conventional CT showed partial vocal cord invasion and intact or minimal invasion of the paralaryngeal space (n = 3), a bulky mass without vocal cord invasion (n = 1) and subglottic extension but movable vocal cord (n= 2). CONCLUSION: Although the cause of vocal cord fixation from laryngeal cancer may be due to one of five patterns of cancer spread, or to a combination of these, the most common spiral CT finding is complete replacement of true vocal cord by the cancer and tumor invasion of the paralaryngeal space. Accurate evaluation of vocal cord fixation and the extent of the tumor could be evaluated with spiral CT using the breathing technique.
Humans ; Joints ; Laryngeal Neoplasms* ; Respiration ; Retrospective Studies ; Thyroid Cartilage ; Tomography, Spiral Computed* ; Vocal Cords*

A volvulus of the colon is a twisting of a redundant segment of the colon at its narrow mesentery. A sigmoid volvulus is the most common type. This disorder may spontaneously reduce and recur as a chronic problem. However, it more frequently becomes acute as a result of an obstruction, which can lead to strangulation and gangrene with a high mortality if not treated promptly. Colonoscopic reduction and decompression is the preferred initial treatment for patients with a sigmoid volvulus who show no signs of bowel strangulation, which may be the cause of the high mortality associated with emergency surgery. We experienced 2 cases of a sigmoid volvulus in a 44-year-old female and a 51-year-old male. The sigmoid volvulus was diagnosed by simple abdominal film and treated successfully by an emergency colonoscopic reduction. We report our experience on the use of colonoscopy to treat sigmoid volvulus with a reviews of the relevant literlature.
Female ; Humans ; Mortality

OBJECTIVE: To evaluate the effectiveness and feasibility of the laparoscopy assisted mini-lap myomectomy (LAMM) as an alternative to laparotomy for patients with multiple or huge myoma unsuitable for laparoscopic myomectomy. METHODS: Uncontrolled retrospective study was done on the forty-six women with myoma of 16 or more gestational sized who were undertaken laparoscopy assisted mini-lap myomectomy. The operative procedures consisted of: 1) examination of pelvic cavity, 2) infiltration of diluted vasopressin, 3) enucleation of myoma, 4) suture of uterus, and 5) removal of myoma. The examination of pelvic cavity was always done using laparoscopy. Either the laparoscopic or mini-lap method for each of the remaining steps was determined depending on the characteristics of the cases. Before operation, patients with severe anemia were corrected by the administration of oral or parenteral iron. RESULTS: The mean age of the patients was 33.3 +/- 4.7 years, their mean gravidities and parities were 0.74 and 0.24, respectively. Of 46 patients, 28 women were married and 20 desired childbearing. The mean (+/-SD) myoma weight was 501 +/- 353 (range 130-1600) gm. The mean operation time was 87.0 +/- 31.3 minutes and blood loss was 208 +/- 239 mL. The mean incision length of mini- lap was 4.6 +/- 1.1 (range 2.5-6) cm. Postoperatively, 1 case of wound abscess occurred. Postoperative mild anemia was correctable with oral iron. Most patients were resumed normal activity within 3 weeks. The mean period of follow-up was 20 (range 6-58) months. Of 20 who desired childbearing, 15 women were follow-up and 9 women conceived. In 6 patients who underwent cesarean section, no significant adhesion or defect was found in the uterus. CONCLUSION: These results suggest that LAMM is feasible and safe minimal invasive method that could replace routine laparotomy in patients with huge myoma.
Abscess ; Anemia ; Cesarean Section ; Female ; Follow-Up Studies ; Gravidity ; Humans ; Iron ; Laparoscopy* ; Laparotomy ; Myoma* ; Pregnancy ; Retrospective Studies ; Surgical Procedures, Operative ; Sutures ; Uterus ; Vasopressins ; Wounds and Injuries