Renal artery aneurysm (RAA) is uncommon, and the coexistence of an abdominal aortic aneurysm (AAA) is an extremely rare condition with potentially high life-threatening mortality in case of rupture. Aneurysms can be treated by endovascular intervention or open surgery. Although most of aneurysms are treated by endovascular intervention, open surgery is often necessary for RAAs associated with the proximal renal bifurcation or the branches in the distal renal arteries. We report a rare case of coexisting RAA with AAA treated by hybrid method, consisting of endovascular aneurysm repair for AAA and open surgery for RAA located adjacent to the distal branches of the renal artery.
Aneurysm* ; Aortic Aneurysm, Abdominal* ; Gallbladder Neoplasms* ; Humans ; Mortality ; Renal Artery* ; Rupture

Portal vein (PV) thrombosis (PVT) is a rare condition with development of thrombosis in the PV and its branches. Further extension to the splenic and superior mesenteric vein (SMV) causes intestinal infarction, with a reported mortality of up to 50%. A variety of treatments for PVT exist including anticoagulation, thrombolysis, surgical thrombectomy, insertion of shunts, bypass surgery, and liver transplantation. We experienced a case of successfully treated by surgical thrombectomy with direct thrombolysis into the thrombosed-PV and SMV. A 31-year-old male presented worsening abdominal pain for one week. Preoperative contrast enhanced computed tomography scan revealed complete PVT extending to splenic vein and SMV. The PV was accessed surgically and opened by thrombectomy; visual inspection confirmed proximal and distal flow. Urokinase was administered directly into the inferior mesenteric vein with successful decrease in thrombus burden. The complete angiography showed complete dissolution of thrombosis in PV and SMV.
Abdomen, Acute* ; Abdominal Pain ; Adult ; Angiography ; Humans ; Infarction ; Liver Transplantation ; Male ; Mesenteric Veins* ; Mortality ; Portal Vein ; Splenic Vein ; Thrombectomy* ; Thrombosis* ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis

Four cases of newborn with tension pneumothorax induced by a conventional ventilator were admitted to our nursery from January 1. 1992 to June 30. 1992 and they were managed by high frequency ventilator (Infrasonic Infant Star Ventilator). In contrast, four cases of newborn with tension pneumothorax who were continuously on the conventional ventilator, were included as a control group. They were admitted to our nursery from July 1. 1991 to december 31. 1991 and they were managed by conventional ventilator with conservative treatment. 1) In the control group, who were continuously managed by the conventional ventilator after thoracostomy with water seal drainage, we changed ventilator setting appropriately in control group but they had poor arterial blood gas analysis. The arterial blood gas analysis within 24hr/within 72hr in control group were pH 7.192/7.195, Paco2 72.15/82.25, PaO2 78.92/83.875, HCO3-26.975/27.925 and conventional ventilator care did not show any definite benefit for improvement of arterial blood gas analysis and tension pneumothorax as well. 2) Two cases in control group expired on the 6th day of thoracostomy without any resolution of tension pneumothorax. 3) In contrast, four cases with tension pneumothorax managed by high frequency ventilator were improved. Tension pneumothorax and arterial blood gas analysis to normalize from 6hr of high frequency ventilation and four cases of tension pneumothorax were completely reabsorbed within 4days.
Blood Gas Analysis ; Drainage ; High-Frequency Ventilation* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn ; Nurseries ; Pneumothorax* ; Thoracostomy ; Ventilators, Mechanical*

No abstract available.
Drug Therapy* ; Humans ; Lung Neoplasms* ; Lung*

The purpose of this study was to investigate the causes of food impaction and to explore solutions as well. For this study, 39 patients with food impaction wee selected. 77 contact areas in these patients were investigated mobility, tightness of contact area, gingival index, plaque index, attachment loss, alveolar bone loss, proximal caries, marginal ridge distance and occlusal relationships. The results were as follows ; 1. Teeth without distal support were found to be the most frequent site of food impaction (41.6%). Food impaction was found to be more frequent in the upper teeth (66.2%) than the lower teeth (33.8%). 2. Food impaction was found in tight contact cases (71.4%). Alveolar bone loss was not found in the early stage of food impaction (83.1%) 3. The distance between the marginal ridges of food impaction sites (mean=0.48mm) was shorter than that of the control group. (mean=0.77mm) (p<0.001) 4. In 18.2% of t he cases, proximal carries were found at the food impaction site. 5. Food impaction affected patient's occlusion with the following frequencies ; cusp to marginal ridge relationship (72.7%), cusp to fossa relationship (3.9%) and stepped relationship (23.4%).
Alveolar Bone Loss ; Humans ; Periodontal Index ; Tooth

No abstract available.
Granuloma* ; Subphrenic Abscess*

To evaluate the relationships among the c-erbB-2 oncogene expression, DNA ploidy and other prognostic factors, an immunohistochemical study of the c-erbB-2 oncogene product and flow cytometric analysis of DNA ploidy were performed in paraffin sections of 42 cases of ovarian carcinomas. The results were as follows: 1) The positive reaction for c-erbB-2 oncogene product was observed mainly along the cytoplasmic membrane, and occasionally within the cytoplasm of the tumor cells. 2) Overall the positivity of c-erbB-2 oncogene expression was 45.2% of the ovarian carcinomas. By the histological types, the positivity was 35.7% in serous carcinoma, 80.0% in mucinous carcinoma, and 45.2% in endometrioid carcinoma; by the degree of differentiation, 57.1% in well differentiated carcinoma, 40.0% in moderately differentiated, and 27.3% in poorly differentiated; by the nuclear grading, 58.3% in grade I, 52.6% in grade II, and 18.2 % in grade III; and by the clinical staging, 57.1% in stage I, 42.8% in stage II, and 35.0% in stage III. The expression of the c-erbB-2 oncogene in the ovarian carcinomas was higher in the tumors of good differentiation, of the lower nuclear grade and of the lower clinical stage. 3) The incidence of DNA aneuploidy in the cases positive for the c-erbB-2 oncogene expression(47.3%) was higher than that in the negative cases(31.4%). From the above results, therefore, it is suggested that the c-erbB-2 oncogene may be involved in the early stage of ovarian carcinogenesis. Also suggested is that ovarian carcinomas positive for the c-erbB-2 oncogene in the early stages may have higher probability of having a DNA aneuploid cell line during the progress of the tumors.
Adenocarcinoma, Mucinous ; Aneuploidy ; Carcinogenesis ; Carcinoma, Endometrioid ; Cell Membrane ; Cytoplasm ; DNA* ; Incidence ; Oncogene Proteins ; Oncogenes ; Paraffin ; Ploidies*

Angiosarcoma is rare disease not only in Korea but throughout the world; it is all the more so on the skin. We made an observation on a case of angiosarcoma on the scalp of a 57 year-old man. Noteworthy in this case are: (1) the patient was suffered from a head trauma 6 years prior to onset of the disease, (2) the progress of the disease showed an extreme rapidity accompanied by severe headache intolerable by any medication, (3) no effect was resulted from X-ray irradiation, and (4) the patient survived for 7 months with the disease.
Craniocerebral Trauma ; Headache ; Hemangiosarcoma* ; Humans ; Korea ; Middle Aged ; Rare Diseases ; Scalp ; Skin

We analyzed 41 cases of burst fractures on the thoracolumbar junction which were operated with Kaneda and Cotrel-Dubousset implant at Chosun University Hospital between 1989 and 1993. The purpose of this study was to evaluate the radiologic sign, the amount of reduction, complications, and functional results. The results were as follows: 1. According to McGrorys Criteria to evaluate the posterior superior vertebral body angle of burst fractures, 33 out of 41 cases(80.5%) were positive and the average angle degree was 107.6°. 2. The average postoperative kyphotic correction was 15.4° in the Kaneda group and 13.8° in the C-D group. The average loss of correction at follow-up examination was 5° in the Kaneda group and 4.8° in the C-D group. 3. Indirect reduction was achieved in 10 cases(50%) and we obtained a good indirect reduction even though canal compromise was over 50%. 4. The pain at operative site was much more severe in the Kaneda group(6 cases) than in the C-D group(2 cases) and both groups experienced 2 cases each of implant failure. 5. According to Denis' pain and work scale, 28 cases(63.8%) had good and excellent, 8 cases had fair and 5 cases had poor results. In summary we recommend doing 1) a posterior instrumentation first for stability and indirect reduction, if it is not a severe neurologic symptom and 2) anterior decompression if it is a severe or progressive neurologic symptom.
Decompression ; Follow-Up Studies ; Neurologic Manifestations

In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*