To maintain an adequate airway in a patient with tracheobronchial narrowing coming from various causes, prosthetic tracheobronchial stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. After insertion, precious reported complications were granuloma formation, dysphagia, suction catheter entrapment and fatal massive hemoptysis. We report a case of complication associated with expandible metallic scent with endobronchial stenosis due to tuberculosis.
Catheters ; Constriction, Pathologic* ; Deglutition Disorders ; Granuloma ; Hemoptysis ; Humans ; Palliative Care ; Stents* ; Suction ; Tuberculosis

No abstract available.
Mandibular Fractures ; Osteomyelitis ; Transplants

Progressive muscular dystrophy is a genetically determined myopathy of unknown etiology and is a primary degenerative disease of skeletal muscle fibers. The authors reviewed 32 cases of progressive muscular dystrophy and made following observations. 1. The types among the 32 cases were as follows. 1) Duchenne type ; 16 2) Limb-Girdle type ;12 3) Facioscapulohumeral type ;3 4) Distal myopathy ;1 5) Ocular myopathy ;0 2. 13 of the 32 patients had relevant family history. 3. In general, creatinine excretion was decreased in 24-hour urine and creatine was increased. 4. 6 of the 10 patients tested had increased serum C.P.K. level.
Creatine ; Creatinine ; Distal Myopathies ; Humans ; Muscle Fibers, Skeletal ; Muscular Diseases ; Muscular Dystrophies

PURPOSE: Progressive shortening of telomeres, specialized chromosomal structures that have a function in chromosomal protection, positioning and replication, has been linked to cell senescence and aging. Telomeres are usually replicated by telomerase, the activation of which is essential for cells to overcome cellular senescence; and thus, indefinite proliferation/immortality and malignant progression are associated with telomere activity. However, little is known about the telomerase activity in adenomatous polyp and colorectal cancer. METHODS: To determine whether malignant progression depends on the activation of telomerase or not, we analyzed the telomerase activity in the mucosa of normal colon, adenomatous polyp and colorectal cancer by telomeric repeat amplification protocol (TRAP) assay and enzyme-linked immunosorbent assay (ELISA). RESULTS: Except for one case in which there was severe inflammation, telomerase activity was not detected in any case of histologically normal colonic mucosa. In contrast, enzyme activity was detected in 58.3% (7/12), 75% (15/20) of adenomatous polyps and colorectal carcinomas, respectively. Of these cases of adernomatous polyps, telomerase activity was positive in 40% (2/5) of tubular type, 66.7% (4/6) of villotubular type and 100% (1/1) of villous type; however, the difference in telomerase activity between tubular and villotubular types was not significant. Of these 20 cases of carcinomas, telomerase activity was positive in 100% (2/2) of well differentiated, 71.4% (10/14) of moderately differentiated and 75% (3/4) of poorly differentiated histologies. Taking into consideration the Dukes' classification, there was no significant difference in telomerase activity among stages A, B and C, except for D. CONCLUSION: These results indicate that telomerase activation in colorectal cancer may well correlate with malignant progression. The detection of telomerase activity may serve as a useful auxiliary tool for the diagnosis of colorectal cancer; nevertheless, the histological type of adenomatouspolyps, the histological differentiation and the stage of cancer may not correlate with telomerase activity.
Adenomatous Polyps* ; Aging ; Cell Aging ; Classification ; Colon ; Colonic Neoplasms* ; Colorectal Neoplasms ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Inflammation ; Mucous Membrane* ; Polyps ; Telomerase* ; Telomere

We performed a retrospective study of 12,307 patients who visited the emergency room of St. Paul's Hospital, secondary medical center, from January 1 to December 31,1996. The results were as follows : 1. Of 12,307 total patients, male to female ratio was 1.16:1 but after 7th decade, there were more female than male. And 3rd decade was the peak age group. 2. The majority o(patients visited our emergency room from noon to midnight (65% of total patients). 3. On average,33.7 patients visited our emergency room per day. Most patients visited on Sundays and other holidays(average 43.3 per day). 4. By monthly distribution, the patients Increased slightly during May, June, July, August and September. 5. Disease to injury ratio was 2.6:1. In disease, male to female ratio was 1 :1 and in injury, the male prominence had a the ratio 1.8:1 In 2nd decade, disease to injury ratio was higher (1.4:1) than that of other decade. And there were mostly disease patients in the group under 1 year old (19.2: 1). 6. Of 12,307 total patients,5,458 patients received only Intern's treatment (44.3%). In 3rd decade, the ratio of Intern's treatment was higher (54.4%). 7, The patients were categorized as follows, Infernal medicine 28.1%, Pediatrics 18.2fo, Orthopedic surgery 13.2%, Plastic surgery 7.4% etc. 8. Averaged admission rate was 25.3% and the rate of general surgery was the highest (49.5%). The rate of admission to intensive care unit (ICU) was 5.5% of total visiting patients and 21.8% of total admission patients. 9. The total patients transferred from other hospitals were 1152 (9.4%), 3.16 per day. The majority used non-emergency vehicles and only 8.5% of patients used the rescue service or ambulances. 10. The average transit time spent in the emergency room was 182 minutes. The longest was 246 minutes in March and the shortest 127 minutes in January.
Ambulances ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Intensive Care Units ; Male ; Orthopedics ; Pediatrics ; Retrospective Studies ; Surgery, Plastic

The frequency of stab wounds is gradually increasing and patients with stab wounds visit the hospital through the emergency room. Management options for patients with stab wound include mandatory exploration and selective observation, but recently many authors have emphasized the importance of selective conservation with development of diagnostic procedure and controversy still exists concerning the management of patients with stab wounds. We retrospectively analysed the clinical data of 78 patients with stab wounds who visited the emergency room of St. Paul's Hospital over 5 years from January 1 1992 to December 31 1996. The following results were obtained. 1) The most prevalent age group were the twenties & the thirties(58.9% of patient) and then most patients were of young age. The male to female ratio was 2.9: 1. 2) Most injuries occurred at night between 8p.m. and 4a.m.(61.5%) and during September injuries were most frequent. 3) The most common causes of stab wound were fighting(55.1%) followed by suicide (21.8%), then accidents including traffic accidents(16.7%) and robbery(6.4%). 4) The instruments most commonly used were knives(53.8%) and broken glass(28.2%). 5) Half of patients were drunk from alcohol and in 3 cases from an antipsychotic drug. 6) In 11 cases(14.1%), there were multiple wound sites and in 8 cases(10.3%) superficial wounds into subcutaneous fatty tissue. 7) According to stab wound sites, the extremities were wounded in 36 cases(46.2%), chest in 21 cases(26.9%), abdomen in 15 cases(19.2%) and neck in 7 cases(9.0%). 8) Emergency explorations were performed in 43 cases(55.1%) under general or regional anesthesia, which included neck in 4 cases(9.3%), chest in 3 cases(7.0%), abdomen in 11 cases(25.6%) and extremity in 25 cases(58.1%). In exploratory laparotomy, negative exploration rate was 18.2%. 9) Death occurred in 2 cases(2.6%). One died due to sepsis with multiple colon perforation and the other due to hypovolemic shock with Superior Vena Cava injury.
Abdomen ; Adipose Tissue ; Anesthesia, Conduction ; Colon ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Humans ; Laparotomy ; Male ; Multiple Trauma ; Neck ; Retrospective Studies ; Sepsis ; Shock ; Suicide ; Thorax ; Vena Cava, Superior ; Wounds and Injuries ; Wounds, Stab*

Sclerosing panniculitis refers to the skin induration and hyperpigmentation of the legs that often occurs in patients who have venous insufficiency. Sclerosing panniculitis is similar to those described under the designations hypodermitis sclerodermiformis or lipodermatosclerosis. Histologically the septa of the subcutis become thickening by inflammation and fibrosis. Adipocytes coalesce to form small and large pseudocysts. Some of these are lined by refractile, amphophilic crenulated membranes. This alteration was referred to as lipomembranous change. We report a case of sclerosing panniculitis in a 40-year-old female patient presented as induration and depression of the skin and subcutaneous tissues of the lower third of the leg.
Adipocytes ; Adult ; Depression ; Female ; Fibrosis ; Humans ; Hyperpigmentation ; Inflammation ; Leg ; Membranes ; Panniculitis* ; Skin ; Subcutaneous Tissue ; Venous Insufficiency

In vivo 31P NMR spectroscopic study of forearm wrist flexor muscles was performed in two groups of volunteers composed respectively of 6 sedentaries and 6 canoe athletes. A continuous isometric contraction of endurance exercises was adopted in oder to assess the endurance capacity and recovery potential of skeletal muscles. Differences in high energy phosphorus metabolism between the sedentaries and athletes were evaluated with and emphasis on the intracellular pH and Pi/PCr ratio as indicators of high energy phosphorus metabolism. There were no differences of baseline pH and Pi/PCr ratio between the two groups. The athletes sustained the exercise at more acidic intracellular pH and at a higher Pi/PCr ratio of intracellular conditions for an all-out than did the sedentaries. The recovery rate of pH showed no difference between the two groups. There was a tendency of faster recovery of Pi/PCr in athletes showing half recovery time(T1/2) of 39.0±3.0 seconds as compared to that of sedentaries (55.7±7.5 seconds). The recovery rate of Pi/PCr as a function of Pi/PCr ratio at a given period of time was significantly faster in athletes than in sedentaries (P<0.001). The correlation coefficient of the recovery rate of Pi/PCr against the Pi/PCr ratio was 0.985 and 0.914 respectively for the athletes and sedentaries. The pH and the Pi/PCR ratio at an all-out state can be used as indicators of endurance capacity and the recovery rate of Pi/PCr, as a reovery potential of skeletal muscles.
Athletes* ; Exercise ; Forearm ; Humans ; Hydrogen-Ion Concentration ; In Vitro Techniques* ; Isometric Contraction ; Metabolism ; Muscle, Skeletal* ; Muscles ; Phosphorus ; Volunteers ; Wrist

Mesocolic hernia is a rare congenital anomaly caused by an error of rotation of the midgut. It may be seen as total encapsulation of the small bowel or a single loop within a hernial sac. It may be asymptomatic or cause life-threatening intestinal obstruction. Symptoms, when present, are often chronic vague abdominal pain and intermittent obstructive episodes. We have encountered a 40-year-old woman with a congenital mesocolic hernia. Abdominal CT provided the diagnosis. She successfully underwent operation and discharged with good condition. Now we present a case of congenital mesocolic hernia with a review of some articles.
Abdominal Pain ; Adult ; Diagnosis ; Female ; Hernia* ; Humans ; Intestinal Obstruction ; Tomography, X-Ray Computed

Objectives: To determine the clinical characteristics of Korean patients with sporadic oculopharyngodistal myopathy. Methods: Three consecutive unrelated Korean patients with sporadic oculopharyngodistal myopathy participated in this study. Stepwise approaches were performed including careful clinical examination, electrophysiological study, pathology evaluation and genetic study. The literature on oculopharyngodistal myopathy was reviewed. Results: Clinically, our patients showed consistent features of initial distal limb weakness with variable ophthalmoplegia, bulbar weakness or proximal weakness. All the patients showed rimmed vacuoles and myopathic changes. Conclusion: Through the literature review and this study, we believe that initial distal limb weakness is a characteristic fi nding in patients with oculopharyngodistal myopathy in some ethnic groups.