Adequate radiographic demonstration of renal injury following blunt abdominal trauma is an important guide totherapy. The diagnostic evaluation of renal injuries usually begins with excretory urography, but not providedetailed information about the extent of injury. The need for a more accurate noninvasive modality led us toinvestigate the use of CT. We evaluated with CT and excretory urography 30 selected patients suspected of havingmajor renal injury. Of these patients 11 were also underwent arteriography for assessment of renal arterialinjuries. In this paper, we wish to analyze the result of the above modalites, particulary angiography and CT. Thebrief results were as follow. 1. Among 30 patients, 21 cases were male and 9 cases were female. About one third ofthese occured between the age of 20-29. 2. All cases were nonpenetrating blunt traumas. 3. Renal injuries werecategorized into 3 groups. Category I is minor renal injuries(14 cases), II is major renal injuries(1 cases), andIII is catastrophic renal injuries(3 cases). 4. IVP is the most common inital diagnostic modality and good forscreening of patients, but lack of specificity. In our study the specificity is about 33%. 5. CT is more accuratein detecting hematoma, parenchymal laceration, fracture and extravasation of urine, but agiography is moreconfirmative in diagnosis of vascular injuries. 6. Conservative management was done in 19 cases; 13 cases ofcategory I and 6 cases of II. Operation was performed in 11 cases: 1 case of category, I, 7 cases of II and 3cases of III. 7. Associated injuries were noted in 17 cases(57%).
Angiography ; Diagnosis ; Female ; Hematoma ; Humans ; Lacerations ; Male ; Sensitivity and Specificity ; Urography ; Vascular System Injuries

V. parahaemolyticus was isolated from blood culture of a 34-year old female patient with HCV viral hepatitis and liver cirrhosis. V. parahaemolyticus is one of the frequent causative agents of gastrointestinal infection, but rarely causes septicemia. This case is thought to be the 3rd report of V. parahaemolyticus septicemia in Korea.
Adult ; Female ; Hepatitis ; Humans ; Korea ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio parahaemolyticus* ; Vibrio*

Mycoplasma pneumoniae is the only known human pathogen among the Mycoplasma species isolated from the human respiratory tract. This pathogen causes respiratory infections most commonly in school-aged children and young adults. It may causes a variety of pulmonary manifestations and a few complication. empyema(pyothorax) as a complication of mycoplasma infection in children has been rarely reported. We report these two cases of empyema(pyothorax) preceded by Mycoplasma pneumoniae pneumonia in 5-year-old boy and 6-year-old girl. They were successfully managed by administration of antibiotics as well as surgical drainage.
Anti-Bacterial Agents ; Child* ; Child, Preschool ; Drainage ; Empyema ; Empyema, Pleural ; Female ; Humans ; Male ; Mycoplasma Infections ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory System ; Respiratory Tract Infections ; Young Adult

Postherpetic neuralgia (PHN) is a sequela of acute herpes zoster infection and is defined as pain persisting more than 1 month. The patients with PHN suffer from a persistent neuropathic pain. There are many treatments for PHN but some people occasionally do not respond to the conventional therapies. Neurodestruction using neurolytic agents are beneficial to patients with severe intractable pain because of it's prolonged pain-relief and simplicity, inexpensiveness. We report a case that we managed successfully a patient with intractable thoracic PHN using intrathecal alcohol neurolysis.
Herpes Zoster ; Humans ; Neuralgia ; Neuralgia, Postherpetic* ; Pain, Intractable

Sarcoma is a malignant tumor originated from bone, cartilage, fat tissue, nerve, blood vessel, bone marrow, endothelium, etc. and for this reason it exhibits considerable variation not only clinical but histologic appearance. Osteosarcoma occurs chiefly in young persons and in patients older than 40 years it is usually associated with Paget's disease, irradiated bone, multiple hereditary exostosis or polyostotoc fibrous dysplasia and sometimes with preceding trauma. Radiographically it is divided into three forms: an osteoblastic or sclerosing type, an osteolytic type, and mixed type. Histologically it is divided into osteoblastic type, chondroblastic type, fibroblastic type. The treatment of osteosarcoma is radical excision, combined chemotherapy but the prognosis is poor and overall 5-year survival rate is 20-40%. We present two different type sarcomas of 22-year-old male and 56-year-old male patients which we performed surgical excision, combined chemotherapy and radiation therapy.
Blood Vessels ; Bone Marrow ; Cartilage ; Chondrocytes ; Drug Therapy ; Endothelium ; Exostoses ; Fibroblasts ; Humans ; Male ; Mandible* ; Middle Aged ; Nerve Tissue ; Osteoblasts ; Osteosarcoma* ; Prognosis ; Sarcoma ; Survival Rate ; Young Adult

A 60-year-old male with continuous ambulatory peritoneal dialysis was admitted because of abdominal discomfort and turbid dialysate. He had a history of chronic renal failure due to diabetic nephropathy. His WBC count of perpheral blood was 8,500/mm3 (neutrophil 92%), and that of dialysate was 1,400/mm3 (polymorphonuclear leukocyte 69%, lymphocyte 31%). Pure growth of Leclercia adecarboxylata was isolated from dialysate. The L. adecarboxylata isolate was susceptible to ampicillin, ampicillin/sulbactam, cephalothin, cefoperazone, cefoxitin, cefotaxime, ceftazidime, aztreonam, imipenem, gentamicin, tobramycin, amikacin, tetracycline, trimethoprim- sulfamethoxazole and ciprofloxacin. Cephalothin & amikacin were added into dialysate, and his clinical symptoms and turbidity of dialysate were resolved. L. adecarboxylata has been rarely isolated from clinical specimens. To our knowledge, this is the first report of L. adecarboxylata isolated from clinical specimen in Korea. On review of the world literature, we found only 7 cases of L. adecarboxylata infections. This microorganism has been isolated from lower extremity wounds and sputum as part of a mixed flora in 3 cases and 1 case, respectively, but it was the only microorganism isolated from cultures of blood in 3 cases. These 3 patients with bacteremia due to L. adecarboxylata had severe underlying diseases, and clinical symptoms were developed after invasive procedures. All of the L. adecarboxylata isolates from clinical specimens were susceptible to antimicrobial agents tested, and the responses to antibiotic therapy were excellent. It is difficult to identify this organism because its biochemical reactions are similar to those of Escherichia coli, therefore careful identification is required. And additional studies are necessary to determine the pathogenic potential and route of infection of this organism.
Amikacin ; Ampicillin ; Anti-Infective Agents ; Aztreonam ; Bacteremia ; Cefoperazone ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Cephalothin ; Ciprofloxacin ; Diabetic Nephropathies ; Enterobacteriaceae* ; Escherichia coli ; Gentamicins ; Humans ; Imipenem ; Kidney Failure, Chronic ; Korea ; Leukocytes ; Lower Extremity ; Lymphocytes ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory* ; Sputum ; Sulfamethoxazole ; Tetracycline ; Tobramycin ; Wounds and Injuries

Upper extremity deep vein thrombosis (DVT) is an unusual condition compared to lower extremity DVT, and it represents about 10% of all DVTs. We report a case of upper extremity DVT after clavicle fracture and immobilization.

Traumatic blunt aortic injury especially on proximal ascending aorta is a rare injury with a few reports. Generally emergency surgical management was performed. In this case, however, in multiple trauma with brain injury, emergency surgical management of aortic injury might result in unexpected secondary injury of the brain. Herein, we report a case of a 33-year-old man who was driving a truck was injured in a head-on collision. Evaluation revealed a pseudoaneurysm on his ascending aorta concomitant with epidural hemorrhage. He was treated by surgical management of his ascending aorta after 3 days from accident. There were no postoperative and neurologic complications and the patient was discharged after 18 days.

Antithrombin III deficiency is an autosomal dominant disorder, which is manifested by recurrent venous thromboembolisms, such as: deep vein thrombosis and/or pulmonary embolism, but arterial embolisms are very rare. We report a case of a patient with hereditary antithrombin III deficiency, manifested by myocardial infarction and deep vein thrombosis.
Antithrombin III Deficiency* ; Antithrombin III* ; Embolism ; Humans ; Myocardial Infarction* ; Pulmonary Embolism ; Thromboembolism ; Venous Thrombosis*

Trichloroethylene (TCE, C2HCl3), which was introduced as a gas for general anesthesia and analgesia in early 1900's has been widely used in industry as an organic solvent. Occupational exposure to TCE is an important medical problem. Manifestations of acute exposure to TCE include mucocutaneous irritation, hepatotoxicity, cognitive impairment, sleep, headache, respiratory insufficiency and death. We report a 38-year-old man who was admitted to a department of emergency medicine after occupational inhalation exposure to TCE. He rapidly developed semicoma and respiratory depression. After mechanical ventilation, hypercapnea and hypoxemia disappeared and his mental state again became alert. Careful evaluation and proper respiratory support are important for respiratory failure after occupational TCE inhalation.
Adult ; Analgesia ; Anesthesia, General ; Anoxia ; Emergency Medicine ; Headache ; Humans ; Inhalation ; Inhalation Exposure ; Occupational Exposure ; Respiration, Artificial ; Respiratory Insufficiency ; Trichloroethylene