A 62-year-old male with a smoking history of 30 pack-years presented with a 1-year history of a periumbilical pulsating mass. He had been treated for hypertension for 2 years. Physical examination revealed a huge pulsating mass in the periumbilical abdomen. Femoral and popliteal arterial pulses were palpable. Computed tomography showed arterial dissection in the proximal segment of the superior mesenteric artery, a huge aneurysm (52×50 mm) with mural thrombus and two smaller aneurysms (20×20 mm) in the right ileocolic and ileal branches, along with atherosclerotic changes. Interposition using the great saphenous vein was performed after aneurysmal isolation and ligation of jejunal branches in the sac. Distal flow was reestablished by end-to-end and end-to-side anastomoses of the right ileocolic and ileal branches, respectively. No complications were observed at 1-year follow-up.
Abdomen ; Aneurysm* ; Aortic Aneurysm, Abdominal* ; Follow-Up Studies ; Humans ; Hypertension ; Ligation ; Male ; Mesenteric Artery, Superior* ; Middle Aged ; Physical Examination ; Saphenous Vein ; Smoke ; Smoking ; Thrombosis

No abstract available.
Adult* ; Humans ; Liver* ; Rhabdoid Tumor*

Ischemic myelopathy is a rare and uncommon disease than the cerebral ischemia. Ischemia of spinal cord usually occur in the midthoracic regions (T4-T8). The major arteries supplying spinal cord are anterior and posterior spinal arteries. Anterior spinal artery is more responsible for the ischemic change of the spinal cord. We report a 45 years old man with ischemia of the spinal cord and acute renal failure due to rhabdomyolysis following the heavy alcohol ingestion.
Acute Kidney Injury ; Arteries ; Brain Ischemia ; Eating* ; Humans ; Ischemia* ; Middle Aged ; Rhabdomyolysis* ; Spinal Cord Ischemia ; Spinal Cord*

No abstract available.
Appendicitis* ; Child* ; Humans

No abstract available.
Heart Septal Defects, Atrial*

OBJECTIVE: This study was designed to investigate the mechanism of the primary afferent input to spread of contralateral hyperalgesia in the persistent muscle pain model in the rat. METHOD: Muscle pain was induced by twice repeated intramuscular injections of pH 6.0 buffered saline into the unilateral gastrocnemius muscle of the rats. Change of mechanical withdrawal threshold to von-Frey filament was measured after ipsilateral laser irradiation, anesthetic blockade with lidocaine and dorsal rhizotomy (L2~L6) to reduce primary afferent input from the tissue injury. RESULTS: Bilateral persistent mechanical hyperalgesia in the hind paw was evoked after second injection. Ipsilateral laser irradiation, lidocaine injection and dorsal rhizotomy had no effect on the contralateral spread of mechanical hyperalgesia. CONCLUSION: These results suggest that contralateral hyperalgesia was produced by, but didn't need to be maintained by inputs from an injury. Therefore, central nervous systems are responsible for the contralateral spread of hyperalgesia.
Animals ; Central Nervous System ; Hydrogen-Ion Concentration ; Hyperalgesia* ; Injections, Intramuscular ; Lidocaine ; Models, Animal* ; Muscle, Skeletal ; Myalgia* ; Rats* ; Rhizotomy

OBJECTIVE: Intolerance of uncertainty (IU) is a transdiagnostic construct in various anxiety and depressive disorders. However, the relationship between IU and panic symptom severity is not yet fully understood. We examined the relationship between IU, panic, and depressive symptoms during mindfulness-based cognitive therapy (MBCT) in patients with panic disorder. METHODS: We screened 83 patients with panic disorder and subsequently enrolled 69 of them in the present study. Patients participating in MBCT for panic disorder were evaluated at baseline and at 8 weeks using the Intolerance of Uncertainty Scale (IUS), Panic Disorder Severity Scale-Self Report (PDSS-SR), and Beck Depression Inventory (BDI). RESULTS: There was a significant decrease in scores on the IUS (p<0.001), PDSS (p<0.001), and BDI (p<0.001) following MBCT for panic disorder. Pre-treatment IUS scores significantly correlated with pre-treatment PDSS (p=0.003) and BDI (p=0.003) scores. We also found a significant association between the reduction in IU and PDSS after controlling for the reduction in the BDI score (p<0.001). CONCLUSION: IU may play a critical role in the diagnosis and treatment of panic disorder. MBCT is effective in lowering IU in patients with panic disorder.
Anxiety ; Cognitive Therapy* ; Depression ; Depressive Disorder ; Diagnosis ; Humans ; Panic Disorder* ; Panic* ; Uncertainty*

A 38-year-old man developed weakness in all limbs 3 days prior to admission. Motor examination showed decreased strength in the limbs, but sensory examination was normal. Deep tendon reflexes were hyperactive. Electrophysiological examination showed conduction blocks with nearly normal conduction velocities and terminal latencies in the motor nerves and normal amplitudes and velocities in the sensory nerves. Acute motor conduction block neuropathy with hyperreflexia may be another variant of Guillain-Barre syndrome.
Adult ; Extremities ; Guillain-Barre Syndrome ; Humans ; Reflex, Abnormal ; Reflex, Stretch

A 62-year-old female patient was scheduled for emergent explo-laparotomy under general anesthesia because of traffic accident. Preoperative checked chest x-ray showed multiple fractures of the ribs but didn't show the sign of pneumothorax or hemothorax. she had no dyspnea. Compared with previous value(PaO2; 210.5 mmHg), Arterial PO2 value(PaO2; 143.0 mmHg) was reduced significantly two hours after starting general anesthesia. Chest x-ray was taken in the operating room, which showed pneumothorax in the right side lung. The patient was treated with immediate closed thoracostomy. She recovered uneventfully three days later with complete resorption of the pneumothorax.
Accidents, Traffic ; Anesthesia, General* ; Dyspnea ; Female ; Hemothorax ; Humans ; Lung ; Middle Aged ; Operating Rooms ; Pneumothorax* ; Ribs ; Thoracic Injuries* ; Thoracostomy ; Thorax*

We report a case of rare cervical isthmic spondylolisthesis of C6-7 combined occult spinal bifida at C6, and review the radiologic finding, different diagnosis and treatment. A 23-year old female presented nuchal, back pain after traffic accident. Radiologic finding showed the 6th cervical isthmic defect, spondylolisthesis and dysplasia. The patient was conservatively treated about 8 weeks, and 10 months after injury, she was symptom free with full range of motion of cervical spine and she was followed up. Cervical spondylolysis is a very rare condition. This clinical importance is vulnerable to trauma. For whatever reasons, symptomatic patients need to be treated by conservative or surgical option.
Accidents, Traffic ; Back Pain ; Cervical Vertebrae ; Female ; Humans ; Range of Motion, Articular ; Spine ; Spondylolisthesis ; Spondylolysis