BACKGROUND: Hepatic artery embolization for the treatment of iatrogenic biliary hemorrhage is a safe and effective alternative to open surgery. However, treatment with hepatic artery embolization can lead to hepatic ischemia or infarction. PURPOSE: To examine the site, frequency and clinical presentation of hepatic ischemia following selective hepatic artery embolization. MATERIAL & METHODS: We reviewed medical records of 11 hepatic ischemia patients on a retrospective basis, who received treatment between January 1997 to March 2009. RESULTS: Primary disease in 11 cases were early gastric cancer in 3 cases, chronic recurrent pancreatitis in 2 cases, choledochal cyst in 2 cases, chronic calculus cholecystitis in 2 cases, GB cancer in 1 case and recurrent HCC in 1 case. In all cases, embolized material was coil. Five cases (45.5%) resulted in hepatic abscesses and managed with percutaneous drainage, but 4 cases were died. CONCLUSION: Hepatic artery embolization is an effective method for the treatment of iatrogenic hepatic artery hemorrhage, but it has a high mortality due to liver infarction. For this reason, superselective embolization, or stent insertion, should be considered in high risk patients.
Calculi ; Cholecystitis ; Choledochal Cyst ; Drainage ; Hemorrhage ; Hepatic Artery ; Humans ; Infarction ; Ischemia ; Liver ; Liver Abscess ; Medical Records ; Pancreatitis ; Retrospective Studies ; Stents ; Stomach Neoplasms

This paper is aimed to study the incidence, age and sex distribution, and type of lateral meniscal lesion including discoid meniscus in Korea. It is reported higher incidence of lateral meniscal lesion in Korea. 132 cases with meniscal lesions were surgically treated at the Department of Orthopedic Surgery, Seoul National University Hospital between 1973 and 1982. Of the 98 patients who had lateral meniscal lesions, forty-four (44.9%) were found to have a discoid meniscus. The mean age of the patients with discoid meniscus was 17.9 years, and 30 patients of them were younger than 20 years of age. The patients with discoid meniscus were followed after meniscectomy for an average of 6 months. The summary of this study are as follows: l. Over-all incidence of discoid meniscus were 44 cases (33.3%) out of 132 cases of the meniscal disease. All forty-four cases had a lateral discoid meniscus, and they formed 44.9% among 98 cases of lateral meniscal injury. 2. The discoid meniscus was most frequent in the age group between 11 and 20 years old (65.9%), and was more prevalent in female by a ratio of 1.4. 3. Qf the 26 patients with torn discoid meniscus, twelve (46.2%) denied the history of trauma. 4. Symptom of click sound was present in 42 cases (95.5%), and the rate of positive McMurray sign was 81.8%.
Clinical Study ; Female ; Humans ; Incidence ; Korea ; Orthopedics ; Seoul ; Sex Distribution

Stabilization of the unstable spine created by the posterior decompression is as important as the decompression itself in the treatment of spinal stenosis. The purpose of this study is to evaluate the effectiveness of C-D pedicle screw fixation in stabilization after lumbar decompression, in reduction of spondylolisthesis and in restoration of the lumbar sagittal curvature. C-D pedicle screw fixation was performed in 102 spinal stenosis patients after posterior lumbar decompression and fusion during the period from March 1987 to December 1988. Their age ranged from 15 to 72 years with an average of 49.1 years. There were 34 males and 68 females. The follow up was from 6 to 21 months with an average of 12.5 months. The causes of spinal stenosis were degenerative in 50 patients, spondylolisthesis in 39, iatrogenic in 9 and degenerative lumbar scoliosis in 4. Objective clinical results showed significant improvement of claudication, SLR limitation, motor weakness, sensory and DTR changes in most patients. Following results were obtained from the study of C-D pedicle screw fixation after posterior decompression in lumbar spinal stenosis.1. C-D pedicle screws provide the secure fixation that allows early ambulation and shorter hospital stay. 2. C-D pedicle screws enable the reduction of spodylolisthesis at the time of posterior stabilization. 3. C-D pedicle screw fixation is successful in the restoration and maintenance of sagittal curvature of the lumbar spine. 4. C-D pedicle screw fixation enables the correction of scoliosis at the time of posterior decompression.
Decompression ; Early Ambulation ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Pedicle Screws ; Scoliosis ; Spinal Stenosis ; Spine ; Spondylolisthesis

No abstract available.
Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Thyroid Function Tests* ; Thyroid Gland*

The purpose of this study is to develop species-specific DNA probes and polymerase chain reaction (PCR) primers for detection and identification of Prevotella nigrescens (P. nigrescens) 9336. This study procedure includes (1) whole-genomic DNA extraction of P. nigrescens 9336 (2) construction of the genomic DNA library, (3) screening of strain-specific DNA probe by reverse dot Hybridization method, (4) confirmation of strain-specific DNA probe by Southern blot analysis, (5) determination of nucleotide sequences of strain-specific DNA probe. Thirty-five restriction fragments of P. nigrescens 9336 genomic DNA digested with the Hind III were obtained. Reverse dot hybridization and Southern blot analysis data showed that three of them, Pn10, Pn23, and Pn35, could be P. nigrescens 9336-specific DNA probes. These data indicated that these DNA probes could be useful in detection and identification of the P. nigrescens 9336.
Base Sequence ; Blotting, Southern ; Clone Cells* ; Cloning, Organism* ; DNA Probes* ; DNA* ; Gene Library ; Mass Screening ; Polymerase Chain Reaction ; Prevotella nigrescens* ; Prevotella*

PURPOSE: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. METHODS: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. RESULTS: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(+/-6.85). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value (9.02+/-6.42) and the most serious degree (P=0.004). The ISS level of injury (8.40+/-6.64) for patients moved from a secondary hospital was higher than that (6.49+/-5.57) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance (8.84+/-5.80). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, 16.42+/-8.56 and 11.23+/-6.97, respectively. CONCLUSION: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.
Abbreviated Injury Scale ; Accidents, Traffic ; Ambulances ; Arm ; Brain ; Child ; Emergencies ; Foot ; Humans ; Infant ; Injury Severity Score ; Light ; Medical Records ; Multiple Trauma ; Risk Factors ; Thorax ; Vital Signs

Central hypoventilation syndrome is a rare and fatal condition resulting from various central nervous system disorders that is characterized by a failure of automatic breathing. We report a case of central hypoventilation syndrome following posterior circulation stroke whose pulmonary function was improved by respiratory rehabilitation. A 59-year-old woman with a history of hemorrhagic stroke of the bilateral cerebellum was hospitalized due to pneumonia. A portable ventilator was applied via tracheostomy, recurrent episodes of apnea and hypercapnia impeded weaning. A respiratory rehabilitation program including chest wall range of motion exercise, air stacking exercise, neuromuscular electrical stimulation (NMES) on abdominal muscles, upper extremity ergometer, locomotor training, high-frequency chest wall oscillator, mechanical insufflation, and exsufflation was employed, as spirometry showed a severe restrictive pattern. A spontaneous breathing trial was started, and a portable ventilator was applied for 8 hours, only during nighttime, to prevent sudden apneic event. After 4 weeks of treatment, follow-up spirometry showed much improved respiratory parameters. This case suggests that respiratory rehabilitation can improve pulmonary function parameters and quality of life in central hypoventilation syndrome.
Abdominal Muscles ; Apnea ; Central Nervous System Diseases ; Cerebellum ; Electric Stimulation ; Female ; Follow-Up Studies ; Humans ; Hypercapnia ; Hypoventilation ; Insufflation ; Middle Aged ; Pneumonia ; Quality of Life ; Range of Motion, Articular ; Rehabilitation ; Respiration ; Respiratory Center ; Spirometry ; Stroke ; Thoracic Wall ; Tracheostomy ; Upper Extremity ; Ventilators, Mechanical ; Weaning

Here, we report a case of newly diagnosed diabetes, with concurrent pancreatic cancer manifested as hyperglycemic crisis, and aggravated by urinary tract infection. We summarize the initial clinical manifestations and pertinent laboratory, radiologic, and clinical findings in an elderly patient with hyperglycemic emergency. A review of the documents involving pancreatic tumors and hyperglycemic hyperosmolar state, which is an acute complication of diabetes mellitus, is presented. In the absence of other identifiable conditions, it is reasonable to speculate that some factor (or factors) produced by the tumor had a role in the metabolic decompensation. In addition, this discussion should be more carefully considered in the aged people group.
Aged ; Diabetes Mellitus ; Emergencies ; Humans ; Pancreatic Neoplasms ; Urinary Tract Infections

Basal cell carcinomas usually arise from the epidermis and show some epidermal connections. It is very unusual that basal celi carcinomas occur as subderrnal mass without epidermal connections. A 51 year-old female h;d an asymptomatic skin colored indurated plaque with linear old scar on the left side of nose fcr about 20 years. She had had a tumor that supposed to be a epidermal cyst, on the same site and the lesion was excised about 20 years ago. We performed the punch biopsy on her first visit which revealed hypertrophic scar. She was treated with intralesional injection of triamcinolone acetonide to reduce the size of hypertrophic scar. However, the lesion had not been reduced. She underwent the surgery to remove the scar at plastic surgery and the excisional biopsy showed a subdermal basal cell carcinoma. We recommend that the newly developed skin tumor in the pre-excised region should be required excisional biopsy instead of punch and close observation
Biopsy ; Carcinoma, Basal Cell* ; Cicatrix ; Cicatrix, Hypertrophic ; Epidermal Cyst ; Epidermis ; Female ; Humans ; Injections, Intralesional ; Middle Aged ; Nose ; Skin ; Surgery, Plastic ; Triamcinolone Acetonide

PURPOSE: Receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) have been shown to be important regulators of osteoclastogenesis during bone remodeling, and their expressions were examined during fracture healing in a mouse model of tibial fracture. However, studies linking RANKL and OPG in patients with head injury and fracture are lacking. We evaluated the changes in serum levels of RANKL and OPG in patients with head injury and fracture (head injury group) and in patients with fracture (fracture group) and compared these with levels found in healthy control subjects. MATERIALS AND METHODS: 18 male patients of head injury and fracture and 20 male patients of fracture alone were enrolled. 20 healthy men were recruited to serve as controls. Within the first few hours of admission to hospital, at 4, 8 and 12 weeks after injury 20 ml of blood were obtained from 18 patients with head injury and fracture and 20 patients with fracture only. RESULTS: RANKL levels were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. OPG levels were significantly higher in the head injury group than in the fracture group at 4, 8 and 12 weeks after injury. RANKL/OPG ratios were significantly lower in the head injury group than in the controls immediately after and 4, 8 and 12 weeks after injury, and were significantly lower in the head injury group than in the fracture group at 8 and 12 weeks after injury. CONCLUSION: We have shown changes in the profiles of RANKL, OPG and RANKL to OPG ratio. The altered RANKL, OPG and RANKL/OPG ratio in the head injury group lasted longer than in those of the fracture group.
Animals ; Bone Remodeling ; Craniocerebral Trauma ; Fracture Healing ; Head ; Humans ; Male ; Mice ; Osteoprotegerin ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B ; Tibial Fractures