No abstract available.
Clubfoot*

The PMT-air airplane crash accident occurred in June 25, 2007 in Sihanoukville, Cambodia. All 22 passengers and crew, including 13 Korean victims, were found dead. Human identification was done at the Cambodian-Russian Soviet friendship hospital. All of Korean victims were identified with fingerprint comparison, age estimation, comparison of belongings and examination of past medical history. In this identification process, the examination of antemortem data source with searching personal blog of internet had been proved efficient in human identification. The antemortem data collection with internet access may be useful and should be combined with classical antemortem data collection process because it is beyond spatial and time limitation.
Aircraft* ; Blogging ; Cambodia ; Information Storage and Retrieval ; Dermatoglyphics ; Forensic Anthropology ; Friends ; Humans ; Internet

STUDY DESIGN: Case report. OBJECTIVES: We report a case of Ogilvie's syndrome following posterior decompression surgery in a spinal stenosis patient who presented with acute abdominal distension, nausea, and vomiting. SUMMARY OF LITERATURE REVIEW: Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus, and is also known as acute colonic pseudo-obstruction. Early recognition and diagnosis enable treatment prior to bowel perforation and requisite abdominal surgery. MATERIALS AND METHODS: An 82-year-old woman presented with 6 months of worsening back pain with walking intolerance due to weakness in both legs. She had hypertension, asthma, and Cushing syndrome without bowel or bladder symptoms. Further workup demonstrated the presence of central spinal stenosis on magnetic resonance imaging. The patient underwent an L2-3 laminectomy and posterior decompression. Surgery was uneventful. RESULTS: The patient presented with acute abdominal distension, nausea, and vomiting on postoperative day 1. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. CONCLUSION: Ogilvie's syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after lumbar spinal surgery. Early diagnosis and initiation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.
Aged, 80 and over ; Asthma ; Back Pain ; Colon ; Colonic Pseudo-Obstruction ; Cushing Syndrome ; Decompression ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Enema ; Female ; Humans ; Hypertension ; Ileus ; Ischemia ; Laminectomy ; Laxatives ; Leg ; Magnetic Resonance Imaging ; Mortality ; Nausea ; Neostigmine ; Spinal Stenosis ; Urinary Bladder ; Vomiting ; Walking

OBJECTIVES: We report a case of Ogilvie's syndrome following posterior decompression surgery in a spinal stenosis patient who presented with acute abdominal distension, nausea, and vomiting.SUMMARY OF LITERATURE REVIEW: Ogilvie's syndrome is a rare and potentially fatal disease that can easily be mistaken for postoperative ileus, and is also known as acute colonic pseudo-obstruction. Early recognition and diagnosis enable treatment prior to bowel perforation and requisite abdominal surgery. MATERIALS AND METHODS: An 82-year-old woman presented with 6 months of worsening back pain with walking intolerance due to weakness in both legs. She had hypertension, asthma, and Cushing syndrome without bowel or bladder symptoms. Further workup demonstrated the presence of central spinal stenosis on magnetic resonance imaging. The patient underwent an L2-3 laminectomy and posterior decompression. Surgery was uneventful. RESULTS: The patient presented with acute abdominal distension, nausea, and vomiting on postoperative day 1. The patient was initially diagnosed with adynamic ileus and treated conservatively with bowel rest, reduction in narcotic dosage, and a regimen of stool softeners, laxatives, and enemas. Despite this treatment, her clinical course failed to improve, and she demonstrated significant colonic distension radiographically. Intravenous neostigmine was administered as a bolus with a rapid and dramatic response. CONCLUSION Ogilvie's syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after lumbar spinal surgery. Early diagnosis and initiation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.

PURPOSE: To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction inrabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CTscanning. MATERIALS AND METHODS: In 28 rabbits weighing 2.5-4kg, the segmental renal artery was occluded throughthe left main renal artery by embolization with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography andspiral CT scanning were performed before and at 2, 5, 8, 15, and 24 hours, and 3 and 7 days after occlusion of thesegmental renal artery. The location of infarcted areas and collaterals, as seen on PDUS and CT scans, wasevaluated by two radiologists. RESULTS: In all cases, as seen on power Doppler ultrasonography, infaretedareas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. Thelocation of the lesion closely corresponded to the location seen during CT scanning. After renal arterialocclusion, transiently congested capsular arteries, which were named 'capsular sign', were seen in 63% ofrabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Dopplerultrasonography, though it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterialocclusion. CONCLUSION: Power Doppler ultrasonography was useful for the diagnosis of renal infarction. Congestedcapsular artery seen in the early stage of renal infarction might be a characteristic finding of this condition,as seen on power Doppler ultrasonography.
Animals ; Arteries ; Diagnosis ; Estrogens, Conjugated (USP) ; Infarction ; Kidney ; Perfusion ; Rabbits ; Renal Artery* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Ultrasonography* ; Ultrasonography, Doppler

A prominent crista terminalis is a normal anatomic variant which consist of thick muscular bridge within the right atrium. However, it could be often misdiagnosed with an abnormal mass on the transthoracic echocardiography. The case report presented here, describe the findings of transthoracic echocardiography that suggested a right atrial mass in patients with pulmonary embolism. However, subsequent transesophageal echocardiography and cardiac computed tomography/magnetic resonance imaging differentiated a true right atrial mass from a prominent crista terminalis.
Echocardiography ; Echocardiography, Transesophageal ; Heart Atria ; Humans ; Pulmonary Embolism

The authors present a case of unilateral agenesis of internal carotid artery associated with an aneurysm at the unusual site. A 22-years old female was admitted with sudden headache and nausea. She was alert on admission and no focal neurologic deficit was detected. Brain computed tomography(CT) scan showed subarachnoid hemorrhage. In the cerebral angiography, right internal carotid artery was absent and an aneurysm was arisen from the junction of the right middle cerebral artery and posterior communicating artery. The blood supply of the right anterior cerebral artery was maintained from the left internal carotid artery via the anterior commuicating artery. The territory of the right middle cerebral artery was supplied from the basilar artery through enlarged right posterior communicating artery. Direct clipping of the aneurismal neck was performed through right pterional approach. In the postoperative high resolution CT scan, there was no carotid canal in the right skull base suggesting agenesis of the right internal carotid artery.
Aneurysm ; Anterior Cerebral Artery ; Arteries ; Basilar Artery ; Brain ; Carotid Artery, Internal* ; Cerebral Angiography ; Female ; Headache ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Nausea ; Neck ; Neurologic Manifestations ; Skull Base ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: Smoking and obesity are known risk factors for cardiovascular diseases, while low serum levels of high density lipoprotein-cholesterol is an independent risk factor for mortality from ischemic heart diseases. This study examines changes in the serum level of high density lipoprotein-cholesterol depending on changes in the state of smoking and body mass index. METHODS: A survey and blood check-up were conducted on medical examination, along with acts of smoking among male adults of 25 years or older who visited the health promotion center of Daegu Medical Center from 2007 to 2010, and the results were analyzed. The subjects were divided into two different groups, current smokers and abstainers, and body mass index, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, and triglycerides for three years were compared in both groups. Changes between the first and second visits in body mass index and lipid profiles of the two groups were compared to analyze changes after abstaining. RESULTS: The subject group which showed a significant increase in high density lipoprotein-cholesterol level was only abstainers whose body mass index had decreased by more than 0.5 kg/m2. CONCLUSION: Smoking cessation increases serum levels of high density lipoprotein-cholesterol. If reduction of body mass index and smoking cessation are combined, the risk of cardiovascular disease will be lower in proportion to the increase in serum high density lipoprotein.
Adult ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Health Promotion ; Humans ; Lipoproteins ; Male ; Myocardial Ischemia ; Obesity ; Risk Factors ; Smoke ; Smoking ; Smoking Cessation ; Triglycerides

BACKGROUND: Arterial pressure is the most commonly utilized guideline for the management of critically ill patients. However, the site of arterial pressure monitoring can impact the observed pressure. In patients undergoing cardiac surgery, peripheral arterial pressure can underestimate central aortic pressure and vasodilators magnify this phenomenon. There was also a large discrepancy between radial and femoral artery pressure in endotoxemic patients treated with vasopressors or hypothermic patients. We evaluated the effect of the continuous infusion of norepinephrine, the most commonly used vasopressor, on pressure and blood flow in both the brachial and femoral artery in dogs in normal condition. METHODS: Both the brachial and femoral arteries were cannulated for pressure monitoring and the other side arteries were exposed for the measurement of blood flow in 10 dogs. Two doses of norepinephrine (NE), 0.05 microgram/kg/min and 0.1 microgram/kg/min, were infused for 10 minutes each in sequence. Hemodynamic variables and blood flow were measured before the infusion of NE, and immediately after the infusion of the two doses of NE. RESULTS: NE increased both brachial and femoral arterial pressures with no difference between the two pressures. NE decreased blood flow in both brachial and femoral arteries even though cardiac output was maintained constantly which means NE caused the redistribution of blood flow. CONCLUSIONS: Unlike endotoxemic shock conditions or hypothermic vasoconstriction, NE didn't show different effects on pressure monitoring sites regardless of their diameter in normal condition. NE increased blood pressure and decreased blood flow in the same degree in both the brachial and femoral artery.
Animals ; Arterial Pressure ; Arteries ; Blood Pressure* ; Cardiac Output ; Critical Illness ; Dogs ; Femoral Artery* ; Hemodynamics ; Humans ; Norepinephrine* ; Shock ; Thoracic Surgery ; Vasoconstriction ; Vasodilator Agents

Patients suffering from idiopathic or self-induced edema are uniformly characterized by chronic use of furosemide, which leads to vicious cycle of edema. Among chronic furosemide users who don't have any other specific edema forming diseases, 9 patients from the outpatient clinic(OC) and 6 patients examined at the emergency room(ER) used it mainly for weight reduction and for cyclical edema, respectively. All of the ER group patients were presented with severe hypokalemia(2.04+/-0.2mEq/L; range 1.3 to 2.7 mEq/L) and alkalosis(748+/-0.01; range 7.44 to 7.51) but none from the OC group showed such results. Other baseline parameters including Plasma renin activity(PRA) and aldosterone level on recumbency, and FEn(2)were similar in both groups. In contrast, daily working hours(6.1+/-0.5 vs 10+/-0.6hr, p<0.01), average body weight gain between AM and PM(0.4+/-0.1 vs 0.9+/-0.lkg, p<0.01), peak weight gain interval(9+/-0.8 vs 5+/-0.1day, p<0.05), PRA(7.6+/-1.5 vs 23.5+/-7.2ng/ml/h, p<0.05) and aldosterone level(22.1+/-4.2 vs 64.8+/-10.4 ng/dl, p<0.01) on ambulation, and FEk. on normokalemia(ll+/-2A vs 36+/-7.7%, p<0.01) were statistically different between the two groups. In comparison to the OC group, both the amout of urine(617+/-39 vs 358+/-26ml, p<0.01) and the percent change of PRA(-14+/-4 vs -3+/-2%, p<0.05) and al-dosterone level(-17+/-5 vs -4+/-3%, p<0.05) after saline loading(lL over 1hr, IV) following ambulation were smaller in the Elt group. Moat of the ER group patients(5/6) required aldosterone antagonist (spironolactone) added to K+ supplement, but all of the OC group patients were managed to maintain an edema-free status with conservative treatment. In conclusion, patients with idiopathic edema seem to have more fluid transudation out of intravascular space during orthostasis with a prominent degree of deranged renin-aldosterone axis and K+ metabolism than those with self-induced edema.
Aldosterone ; Axis, Cervical Vertebra ; Body Weight ; Dizziness ; Edema* ; Emergencies ; Furosemide* ; Humans ; Metabolism ; Outpatients ; Plasma ; Renin ; Walking ; Weight Gain ; Weight Loss