Pancreatic ductal rupture can be an elusive diagnosis. The early signs and symptoms are often vague, and when it goes unnoticed, ductal rupture results in inceased morbidity and mortality. Unfortunately, no diagnoatic test has proven reliable in its timely detection. Endoscopic retrograde cholangiopancreatography (ERCP) is routinely utilized to visualize the anatomy of the pancreatic duct in elective situation. But the utilization of emergent ERCP will allow detection of pancreatic rupture in clincal settings where surgery might not otherwise have been prompted by complications. In addition, present, timely visualization of the pancreatic duct will permit intelligent planning for pancreatic sugery. Recently, we experienced a case of 36-year-old female who had upper abdominal blunt trauma with heavy iron. Her serum amylase was high but the physical examination was vague. Emergent ERCP was performed and it revealed dye leak from rurptured pancreatic duct at tail portion of pancreas. Emergent distal pancreatectomy and splenectomy was successfully performed. So we report this case with a review of literatures.
Adult ; Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Female ; Humans ; Iron ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Physical Examination ; Rupture ; Splenectomy

No abstract available
Mycosis Fungoides*

OBJECTIVE: The authors evaluate the differences in the pedicle screw pull-out strength between an unaugmented screw and a screw augmented by high pressurized PMMA in an embalmed human lumbar cadaveric spine. METHODS: Pedicle screws were inserted in the 50 pedicles of cadaver lumbar spine after measuring the bone mineral density(BMD) of the specimens. The pedicle screw was inserted without augmentation on the left pedicle and with augmentation by a vertebral reconstruction with high pressurized PMMA on the right side. The pedicle screw was inserted before the hardening of bone cement on the right side. A computed tomographic scan was done to evaluate the location of the PMMA and PMMA/ screw interface. After that, a screw pullout strength test was performed. RESULTS: There were positive correlations between the pull-out strength and BMD in the control group (r=0.7339). The average pull-out strength of the augmented group was 168% greater than that of the control group(p<0.05). The pull-out strength of the augmented group was correlated with in the volume of the PMMA. CONCLUSION: A pedicle screw that is augmented with PMMA will provide a more rigid fixation than that of an unaugmented screw, especially in the low BMD group of the specimens.
Cadaver* ; Humans ; Polymethyl Methacrylate ; Spine

BACKGROUND: The bcl-2 is an oncogene involved in tumorigenesis by blocking apoptosis, or programmed cell death and over-expression of bcl-2 protein has been reported in several malignant tumors such as lung cancer, basal cell carcinoma, breast cancer and malignant melanoma. However, there have been only a few studies about bcl-2 expression of cutaneous T cell lymphoma. OBJECTIVE: The purpose of this study was to examine whether there is any difference in expression of bcl-2 between mycosis fungoides(MF), angiocentric T cell lymphoma, angioimmunoblastic T cell lymphoma, subcutaneous T cell lymphoma and anaplastic large cell lymphoma. We also evaluated the statistical significance between expression of bcl-2 and the prognosis of the diseases. METHODS: Routine paraffin sections of formalin-fixed 36 tissues (14 MF, 7 angiocentric T cell lymphoma, 5 subcutaneous panniculitic T cell lymphoma, 2 anaplastic large cell lymphoma, 1 angioimmunoblastic T cell lymphoma, 1 unspecified peripheral T cell lymphoma, 2 small plaque parapsoriasis, 2 psoriasis and 2 lichen planus) were labelled with anti-bcl-2 monoclonal antibody using an avidin- biotin-peroxidase complex. Normal skin for bcl-2 served as negative controls. RESULTS: The results were as follows. l. All cases of benign inflammatory diseases, small plaque parapsoriasis and patch stages of MF showed positive staining for bcl-2. Therefore, there were no differences in expression of bcl-2 among these diseases. 2. In the plaque and tumor stages of mycosis fungoides, statistically significancant differences in bcl-2 expression were not found during disease progression. 3. bcl-2 expression in peripheral T cell lymphoma (five in seven cases of angiocentric T cell lymphoma showed positive staining but all other peripheral T cell lymphoma was negative) decreased significantly (p<0.05) than that of MF. 4. No statistical significance was found between bcl-2 expression and prognosis of cutaneous lymphoma (p>0.05). CONCLUSION: These results suggest that the loss of bcl-2 expression may play a significant role in progression of cutaneous T cell lymphoma except in MF and angiocentric T cell lymphoma.
Apoptosis ; Breast Neoplasms ; Carcinogenesis ; Carcinoma, Basal Cell ; Cell Death ; Disease Progression ; Lichens ; Lung Neoplasms ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Lymphoma, T-Cell, Peripheral ; Melanoma ; Mycosis Fungoides ; Oncogenes ; Paraffin ; Parapsoriasis ; Prognosis ; Psoriasis ; Skin

OBJECT: In order to compare several Obstetric characteristics and outmmes of teenage pregnancy. METHODS: The 10 year clinical records of 11,583 women undergoing Cesarean section and delivery were reviewed in the department of Obstetrics and Gynecology, Incheon Christian Hospital from July 1, 1989 to June 30, 1999. There were seventy-eight pregnancies under age 20 and we compared them with two hundred pregnancies aged 20-29 who were randomly chosen during the same periods as the control group. RESULT: The following results were obtained. The proportion of birth by teenagers increased from 0.5% of all birth in 1989 to 2.61% in 1999. The most of cases were in high teen group, age 14- 19.The majority(50.5%) were in the age of 19. Seventy two cases(92.3%) had no previous pregnant history. Six cases had one previous pregnant history. The frequencies of prenatal care were significantly lower than that of the control group(p<0.05). The mean gestational period was 36+4weeks, and showed significant difference between the study group and the control group(39+3 weeks). The incidence of preterm labor was significantly different between the two proups(p<0.05). But the incidence of postterm delivery were not significantly different between the two groups. The mean weight gain of pregnant teenagers revealed 10.64kg, significantly less profound than the control group. The matemal weight gain of control group revealed 12.95kg, respectively. The mean birth weight(2.54kg) of infant was significantly less profound than the control group. The incidence of birth of small for gestational age(birth weight 1,500-2,499gm ; 14.5%) was significantly increased among study group than the control group(1%). The rate of abdominal delivery(21.8%) were not significantly decreased than the control group(47%). The incidence of cephalopelvic disproportion and malpresentation for cesarean section were somewhat higher than the control group, and were statistically significant(p<0.05). During the antepartun period, anemia, pyelonephritis, and preterm labor occurred more frequently in the teenage pregnancy than the control group, but not statistically significant. Among postpartum complications, incidence of anemia(51.3%) increased significantly. The perinatal mortality, intrauterine growth retardation, congenital anomaly occurred more frequently than the control group. CONCLUSION: These results show that pregnancy of teenage will be comeout high risk and complications. And then we will be more concern and study about teenage pregnancy.
Adolescent ; Anemia ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gynecology ; Humans ; Incheon ; Incidence ; Infant ; Obstetric Labor, Premature ; Obstetrics ; Parturition ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Pregnancy in Adolescence* ; Prenatal Care ; Pyelonephritis ; Weight Gain

Postoperative (pressure) alopecia is the temporary or permanent loss of hair that occurs following a prolonged immobilization during and/or after general anesthesia and intubation. The cause is considered to be pressure-induced ischemia. Although not an uncommon condition, it is frequently overlooked as a minor complication relative to a causative surgical procedure. We report a 22-year-old woman who was presented with focal hair loss of two weeks' duration after a 9-hour operation for a left brachial plexus injury. Histopathologic examination showed that nearly all terminal follicles were in catagen phase with marked atrophic change of subcutaneous fat.
Alopecia* ; Anesthesia, General ; Brachial Plexus ; Female ; Hair ; Humans ; Immobilization ; Intubation ; Ischemia ; Subcutaneous Fat ; Young Adult

OBJECTIVE: The authors describe four patients in whom we performed a single stage, pedicle subtraction and extension wedge osteotomy for the correction of sagittal imbalance by creating lumbar lordosis. METHODS: One patient presented with congenital hemivertebra, one with post-laminectomy kyphosis, and two with lumbar degenerative kyphosis. All patients suffered from back pain and were unable to walk due to forward stooping of the trunk. We performed a single stage, pedicle subtraction and extension wedge osteotomy for the correction of sagittal imbalance. RESULTS: The angles of correction were 37, 44, 45, and 49 degrees. No case had any neurologic complication. All patients reported complete relief of back pain and were able to upright standing. CONCLUSION: Single-level wedge osteotomy and reduction provide excellent sagittal correction of rigid kyphotic deformities in the lumbar lesion without neurologic compromise.
Animals ; Back Pain ; Congenital Abnormalities* ; Humans ; Kyphosis ; Lordosis ; Osteotomy* ; Spine*

No abstract available.
Pre-Eclampsia* ; Proteinuria*

PURPOSE: To investigate postoperative outcomes of endonasal dacryocystorhinostomy (DCR) using lacrimal sac flap and silastic sheet in patients with acquired nasolacrimal duct obstruction. METHODS: From November 2009 until December 2010, endonasal DCR with lacrimal sac flap was performed in 26 eyes (group 1) and conventional DCR without flap in 28 eyes (group 2). The anatomic and functional success rates and complications were analyzed and compared between the 2 groups. RESULTS: The anatomical success rate was 96.2% in group 1 and 85.7% in group 2. The functional success rate was 100% in group 1 and 92.9% in group 2. The success rate was higher in group 1 than in group 2, although not being statistically significant. Granuloma was found in 15.4% of patients in group 1 and 32.1% of patients in group 2. Synechia or membranous obstruction was not found in group 1, whereas synechia developed in 14.3% of patients in group 2. CONCLUSIONS: Endonasal DCR with lacrimal sac flap showed a greater success rate and lower formation of granuloma than conventional endonasal DCR without flap because of reduced inflammation and granulation tissue formation around retained bony spicles.
Dacryocystorhinostomy ; Dimethylpolysiloxanes ; Eye ; Granulation Tissue ; Granuloma ; Humans ; Inflammation ; Nasolacrimal Duct

We report a case of 21-year-old woman with atypical form of spinal tuberculosis. The patient had simultaneous involvement of C2, T4, T10, T11, L1-3 and S2, which resembles spinal malignancies. In this patient, pulmonary tuberculosis was not detected. However, biopsy revealed tuberculosis. The patient was treated successfully with surgery followed by anti-tuberculosis therapy. It is important to be aware that spinal tuberculosis may resemble spinal malignancy.
Biopsy ; Female ; Humans ; Tuberculosis ; Tuberculosis, Pulmonary ; Tuberculosis, Spinal* ; Young Adult