Intraaortic balloon counterpulsation (IAB) has been shown to prolong survival in the critically ill cardiac patients. Originally developed for use in the patients with cardiogenic shock, the indications have been expanded. But despite technical advances, the complication rate associated with IAB remains high. The most commonly reported complications include damage to the femoral artery and distal embolization. Other reported major complications are balloon rupture, limb loss, bleeding, systemic infection and bowel infarction. We report a patient complicated by ischemic colitis causing stenosis and intestinal obstruction after IAB insertion.
Colitis, Ischemic* ; Constriction, Pathologic* ; Counterpulsation* ; Critical Illness ; Extremities ; Femoral Artery ; Hemorrhage ; Humans ; Infarction ; Intestinal Obstruction ; Rupture ; Shock, Cardiogenic

No abstract available.
Bone Density* ; Gonads*

No abstract available.
Diabetes Insipidus* ; Empty Sella Syndrome*

Primary small cell cancer of the duodenum is very rare. Only six cases have been reported previously. The patient of this case report was a twenty-year-old male who suffered from frequent nausea and vomiting being accompanied by weight loss. The poorly differentiated neuroendocrine cancer was initially diagnosed by endoscopic biopsy and the patient underwent pancreaticoduodenectomy. The diagnosis was refined as primary small-cell neuroendocrine cancer of which the histological appearance was identical to pulmonary and extrapulmonary small-cell carcinoma. The neuroendocrine differentiation was demonstrated by the positive immunoreactions for neuron-specific enolase. This case emphasizes the need to include the duodenum as a possible primary site when metastatic small cell neuroendocrine carcinoma is seen in the absence of apparent pulmonary disease.
Biopsy ; Carcinoma, Neuroendocrine ; Diagnosis ; Duodenal Neoplasms* ; Duodenum ; Humans ; Lung Diseases ; Male ; Nausea ; Pancreaticoduodenectomy ; Phosphopyruvate Hydratase ; Vomiting ; Weight Loss

No abstract available.
Glucose Transport Proteins, Facilitative* ; Glucose* ; Humans ; Insulin* ; Metabolome*

BACKGROUND: The purpose of this study was to identify factors associated with recurrent pneumothorax after wedge resection in primary spontaneous pneumothorax in our hospital. MATERIAL AND METHOD: Two hundred thirty-five consecutive patient (98% males; mean age, 23.9+/-4.5 years) who had undergone video-assisted thoracoscopic surgery (VATS) were reviewed retrospectively. The two groups were divided as follows: group A, non-recurrent patients (225 patients [96%]); and group B, recurrent group (10 patients [4%]); the risk factors were compared between the two groups. The single and multiple factors that influenced the recurrence rate were analyzed using Cox's proportional hazard model. RESULT: There were no significant differences between the recurrent and non-recurrent groups in terms of gender, smoking, site of recurrence, degree of collapse, operative time, and number or weight of resected bullae. The recurrence rate was significantly more common in the following: younger ages, increased height/weight ratio, longer initial air leakage period, and shorter duration of chest drainage. Early aggressive exercise (<30 days) of patients after wedge resection increased the tendency for recurrence. CONCLUSION: Thoracoscopic wedge resection does not have a higher recurrence rate than open thoracotomy. However, young age, height/weight ratio, continuous air, and duration of chest tube placement were risk factors for a recurrent pneumothorax.
Blister ; Chest Tubes ; Drainage ; Humans ; Operative Time ; Pneumothorax ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Thoracic Surgery, Video-Assisted ; Thoracotomy ; Thorax

BACKGROUND: Organophosphate insecticides poisoning is one of the most common toxicologic emergencies in Korea. There have been few reports of organophosphate intoxication via parenteral route, although many reports on organophosphate intoxication by oral ingestion were present in the literature. This study aimed to validate the clinical characteristics of organophosphage intoxication according to the route of administration to the body. METHOD: Data were collected retrospectively by the review of the medical records from 49 patients with organophosphate intoxication. Severity of intoxication was classified by the Namba's Classification. Collected data were analysed and compared on the clinical features and laboratory findings between the patient intoxicated by inhalation or contact(parenteral group, n=23) and the other oral ingestion(enteral group, n=26). RESULTS: Severity class by clinical features was higher in enteral group than parenteral group. Severity class by serum cholinestetrase level was not positively correlated with severity class by clinical manifestations. Cholinesterase level tended to overestimate the severity of intoxication in parenteral group. Ventilator therapy and admission to intensive care unit were more frequently needed in enteral group than parenteral group in case that the severity class by clinical features was equal. CONCLUSION: In patients with organophosphate intoxication by parenteral route, serum cholinesterase level of the patient had disparity with clinical severity of intoxication. Considering this disparity, clinical severity should be considered as a more important indicator for treatment of organophosphate intoxication including atropinization, rather than serum cholinesterase level in patients intoxicated by parenteral route.
Cholinesterases* ; Classification ; Eating ; Emergencies ; Humans ; Inhalation ; Insecticides* ; Intensive Care Units ; Korea ; Medical Records ; Plasma* ; Poisoning ; Retrospective Studies ; Ventilators, Mechanical

Over the last 20 years, the frequency of multiple pregnancy has increased mainly because of the introduction of exogenous pituitary gonadotropins in the treatment of infertility. Since the advent of assisted reproductive technology, the concern about ectopic implantation of embryos has increased dramatically and it continues to be a major complication of in vitro fertilization and embryo transfer (IVF-ET). Bilateral tubal pregnancy is the least common type of ectopic implantation of two embryos. Of all extrauterine pregnancies, 1:725~1:1580 are bilateral1,2. Simultaneous tubal pregnancies have been reported in natural cycles, recently, after ovulation induction, in-vitro fertilization2,3. The high incidence of ectopic pregnancy associated with IVF-ET continues to be a problem and frequencies of between 2.4 and 12.4% have been only a few reports of simultaneous bilateral tubal pregnancies following IVF-ET4. This paper describes a case of a simultaneous bilateral tubal pregnancy after IVF-ET in a 33 year old patient. The diagnosis was confirmed by diagnostic laparoscopy performed 25 days after embryo transfer(sixth week of gestation), which revealed bilateral tubal pregnancy. Bilateral salpingectomy was performed. With a review of the literature on this topic, diagnostic aspects and treatment options are discussed.
Adult ; Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro ; Fertilization* ; Gonadotropins, Pituitary ; Humans ; Incidence ; Infertility ; Laparoscopy ; Ovulation Induction ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Multiple ; Pregnancy, Tubal* ; Reproductive Techniques, Assisted ; Salpingectomy

Some variables can influence the efficiency of leukocyte removal filter for red cell concentrates. We performed this study to evaluate whether the filtration efficiency for platelet concentrates(PCs) can be influenced by bedside filter(PXL8K, Pall Corporation, USA) used, platelet storage time and transient stopping of platelet agitation, and to measure the amount of cytokines released from donor leukocytes in PCs during the storage time. In addition, we examined the effect of leukocyte reduction by filtration before the storage of PCs on the subsequent generation of cytokines. Any of the above mentioned variables did not make significant differences. From day 1 to day 5, there were significant increases in IL-1 beta (<1 vs. 8.6 pg/mL, p<0.05), IL-8 (<10 vs. 455.3 pg/mL, p<0.05) and TNF-alpha (<4 vs. 16.6 pg/mL, p<0.05) in unflltered PCs, whereas no increased revels of cytokines were found in the cases of prestorage filtration.
Blood Platelets* ; Cytokines ; Dihydroergotamine ; Filtration* ; Humans ; Interleukin-1beta ; Interleukin-8 ; Leukocytes* ; Tissue Donors ; Tumor Necrosis Factor-alpha

Wilson`s disease is a hereditary disorder in hepatic excretion of copper that results in toxic accumulations of the metal in liver, brain and other organs. Though there have been some reports of Wilson's disease with hepatic, neurologic, psychiatric symptoms, or hemolytic anemia, a case of Wilson's disease with abnormal secretion of pituitary hormones is, to our best knowledge, the first report in Korea. We report a case of Wilson`s disease with abnormal secretion of pituirary hormones, chronic active hepatitis with feature of early cirrhosis and hemolytic anemia in 18-year-old man showing delayed puberty. And also we describe a case of successful desensitization to penicillamine in a penicillamine hypersensitivity.
Adolescent ; Anemia, Hemolytic ; Brain ; Copper ; Fibrosis ; Hepatitis, Chronic ; Hepatolenticular Degeneration ; Humans ; Hypersensitivity ; Korea ; Liver ; Penicillamine ; Pituitary Hormones* ; Puberty, Delayed