No abstract available.
Arteriovenous Malformations* ; Mouth Floor* ; Mouth* ; Tongue*

Acute colonic pseudoobstruction was first reported in 1948 by Sir H. Ogilvie. It is characterized by an acute, abrupt right-sided colonic distention in the absence of physical reasons for obstruction. If untreated, it may progress to cecal perforation, peritonitis, and death. Although primary cases have been reported, 87 percent of cases were secondary results of medical or surgical conditions. The most common medical conditions were infections, cardiac disease, and neurologic problems. In surgical conditions, cesarean section has been reported as the most common cause of Ogilvie's syndrome. In 1995, the first case of Ogilvie's syndrome complicated after a cosmetic surgical procedure(abdominoplasty) was reported by Bradley et al. We report a case of Ogilvie's syndrome complicated after breast reconstruction with TRAM flap that developed in the postoperative third day in 35-year old woman. The complications are primarily related to decreased flap perfusion. No reference of intestinal pseudoobstruction was found in the literature conducted in regard to complications of TRAM flap breast reconstruction.
Adult ; Breast* ; Cesarean Section ; Colon ; Colonic Pseudo-Obstruction ; Female ; Heart Diseases ; Humans ; Intestinal Pseudo-Obstruction ; Mammaplasty* ; Perfusion ; Peritonitis ; Pregnancy

No abstract available.
Pulmonary Artery*

Although sacrococcygeal mass is rare and usually found in infants or children, adolescent or adult patients with protruding mass in sacrococcygeal region occasionally come to us simply for a cosmetic problem. In this situation, even though there is no definite neurological deficit, it should be evaluated whether or not the underlying bony pathology or dural defect exists. Few cases about the sacrococcygeal mass have been reported in adults. We reviewed our cases including preoperative evaluation methods and postoperative diagnosis. From March, 1993 to February, 1997, we experienced 6 adult patients with sacrococcygeal mass and no neurological abnormality. Preoperative evaluation were made by plain X-ray, myelogram, computed tomography(CT), and magnetic resonance imaging (MRI), as needed. Postoperative diagnoses were 2 meningoceles, 2 lipomyelomeningoceles, 1 desmoid tumor, and 1 teratoma. From our experiences, CT or MRI is essential to evaluate the sacrococcygeal mass preoperatively. These methods can visualize the precise anatomic location and extent of the mass, its relation to the spinal cord, and associated bony abnormalities. MRI is superior to CT, especially in defining the nature of the mass and involvement of the spinal cord. Conclusively, even a simple mass in the sacrococcygeal region in adults needs MRI or CT evaluation, and MRI is the most valuable method of evaluating the mass preoperatively and provides important information to establish a treatment plan.
Adolescent ; Adult* ; Child ; Diagnosis ; Fibromatosis, Aggressive ; Humans ; Infant ; Magnetic Resonance Imaging ; Meningocele ; Pathology ; Sacrococcygeal Region* ; Spinal Cord ; Teratoma

Repetitive nerve stimulation (RNS) test was systematically performed in proximal and distal muscles of 142 cases with myasthenia gravis (MG) and 45 norrnal controls and then analyzed qualitatively. Diagnostic sensitivity was 75% based on abnorrnal decremental response in at least one muscle. The sensitivity increased from 56% in ocular MG to 96% in type Iib MG according to severity of disease. Higher diagnostic yield was noted in the orbiculans oculi in ocular MG and in the trapezius in gereralized MG. RNS test on proximal muscle showed a higher positive rate than that on distal muscles. When distal muscle testing was negative, there was an additional increase of 24% in proximal muscle testing. The posttetanic exhaustion (PTE) enhanced diagnostic sensitivitY as much as 8% in generalized MG. The posttetanic facilitation(PTF) and PTE were observed in 50% and 38% of generalized MG and were most prominent in MG with moderate severity. Five patterns on RNS findings were classified according to test paramcters. The most common response was the pattern which showed normal arnplitude of compound muscle action potential, decremental response at low rate stimulation, and PTF without PTE.
Action Potentials ; Muscles ; Myasthenia Gravis* ; Superficial Back Muscles

No abstract available.
Gonadal Dysgenesis, 46,XY*

The incidence of traumatic brain injury (TBI) has increased with the advanced technology of society. A careful evaluation of associated problems, initial severity, and complications is important for the acute management and rehabilitation of patients with TBI. To predict the rehabilitation potentials of patients with TBI, we have retrospectively investigated the causes, types of injury, associated problems, and complications in 186 patients and also assessed the rehabilitation outcomes by measuring the functional gains according to the types of brain injury and the initial severities evaluated by the Glasgow coma scale in 82 patients. The functional gains were measured by differences of the Mini-mental status examination, PULSES profile, and Barthel index of pre- and post-rehabilitation states. The incidence of TBI was highest in the 3rd decade men and the most common cause was a traffic accident (120 cases, 64.5%). The types of brain injury were a diffuse axonal injury, 87 cases (46.8%); epidural hematoma, 21 cases (11.3 %); subarachnoid hemorrhage, 25 cases (13.4%); subdural hematoma, 28 cases (15.1%); and intracerebral hematoma, 25 cases (12.9%). Common associated problems were fractures and injuries of nervous system. The 7th cranial nerve and the peroneal nerve were the most common injuries for cranial and peripheral nerves, respectively. Common complications were pulmonary and skin disorders. Total hospital stay and the duration for rehabilitation were not significantly different by the types of injury. Functional gain tended to be higher in the intracerebral hematoma compared to the other types of brain injury. The functional gain was statistically higher in patients with initial severity of moderate degree according to the Glasgow coma scale. In conclusion the moderate traumatic brain injured patients seem to have a higher potential for the good functional outcome.
Accidents, Traffic ; Brain ; Brain Injuries* ; Cranial Nerves ; Diffuse Axonal Injury ; Glasgow Coma Scale ; Hematoma ; Hematoma, Subdural ; Humans ; Incidence ; Length of Stay ; Male ; Nervous System ; Peripheral Nerves ; Peroneal Nerve ; Rehabilitation* ; Retrospective Studies ; Skin ; Subarachnoid Hemorrhage ; Treatment Outcome*

BACKGROUND: Bcl-2 protein is essential for neurodevelopment and it is implicated in various neurodegenerative diseases. However, little is known about the normal developmental expression of Bcl-2 and NeuN protein in hippocampus slice cultures. We performed this study to assess their morphological changes and developmental expressions of Bcl-2 and NeuN protein. METHODS: We cultured the hippocampus of an eight days postnatal Sprague-Dawley (SD) rat in slices of 450 m. We observed the morphological development and differentiation of the hippocampus slices. Additionally, we measured the developmental expression of Bcl-2 and NeuN, -actin protein by western blotting. RESULTS: The hippocampal slice cultures revealed matured structures as early as 6 days in vitro (DIV) and a relatively high degree of tissue organization until 18 DIV. After 21 DIV, there were migration of the cells away from the margins of the slices. NeuN expressions at 7, 13, and 19 DIV were 1.42 +/- 0.38 (meanSD, NeuN/ beta-actin OD ratio, insert number=4, each insert had 5 culture slices), 2.95 +/- 0.53, 1.58 +/- 0.42 respectively. Bcl-2 expression at 6, 12, and 18 DIV were 0.56 +/- 0.18 (mean +/- SD, Bcl-2/beta-actin OD ratio, insert number=4, each insert had 5 culture slices), 1.22 +/- 0.28, 1.03 +/- 0.25. CONCLUSIONS: Organotypic slice cultures of a rat's hippocampus shows morphological maturation within 14 DIV and the highest NeuN and Bcl-2 level at about 13 DIV. It is expected that these findings would be useful as baseline data in the field of research on neuronal development and aging processes.
Actins ; Aging ; Animals ; Blotting, Western ; Hippocampus* ; Neurodegenerative Diseases ; Neurons ; Rats* ; Rats, Sprague-Dawley

Primary pulmonary Hodgkin's lymphoma is a rare but distinct entity to be distinguished from nodal Hodgkin's lymphoma and from lymphomas involving lung secondarily. This lymphoma affects women more frequently than men, and typically involves superior portions of the lung. This case is reported to illustrate the clinical, radiographic and anatomic characteristics of the primary pulmonary Hodgkin's lymphoma. A 34-year-old woman presented for the evaluation of hemoptysis. A chest CT revealed a large poorly defined mass in the medial aspect of the right upper lobe, extending to the right mediastinum and trachea. The microscopic examination of the biopsied lesion revealed fibroblastic stroma infiltrated by a mixture of lymphocytes, histiocytes, and eosinophils. The clinical impression was inflammatory pseudotumor, presumably due to slightly favorable response to corticosteroid therapy. Two months later the patient's symptoms worsened despite the steroid therapy and a lobectomy was done. The specimen showed a soft to firm, pale yellow, ill defined mass, 10.0 8.0 cm, involving the visceral pleura. A few satellite nodules around the main mass were noted. The histologic findings were consistent with Hodgkin's lymphoma, nodular sclerosis type.
Adult ; Eosinophils ; Female ; Fibroblasts ; Granuloma, Plasma Cell ; Hemoptysis ; Histiocytes ; Hodgkin Disease* ; Humans ; Lung ; Lymphocytes ; Lymphoma ; Male ; Mediastinum ; Pleura ; Sclerosis ; Tomography, X-Ray Computed ; Trachea

No abstract available.
Pregnancy*