The wandering spleen is a rare condition, in which the spleen is located in other than the left upper quadrant of the abdomen. The clinical manifestation is variable from asymptomatic to abdominal catastrophy due to torsion of the splenic pedicle. We experienced a case of torsion of wandering spleen in 8-year-old girl who admitted with fever, vomiting, abdominal pain, palpable left abdominal mass. She was diagnosed preoperatively with the aid of abdominal sonography and C.T. scanning. A splenectomy was performed and she made uneventful recovery. The case report illustrates some of the diagnostic and therapeutic considerations pertaining to wandering spleen with a brief review of related literature.
Abdomen ; Abdominal Pain ; Child ; Female ; Fever ; Humans ; Spleen ; Splenectomy ; Vomiting ; Wandering Spleen*

We report 3 cases of traumatic nail dystrophy,, developed in 11 years old girl (Case 1), 10 years old(case 2) and 15 years old boys(case 3) Dystrophic nails show transverse ridging with longitudinal axis on the both thumb nails in case 1 R 3, and transverse ridging with transverse axis on the left thumb nail in case 2 Mothers overprotection(case 1, 3) and indifference(case 2) were considered to be of the most important causes of the nail biting and playing with nails in our cases.
Adolescent ; Axis, Cervical Vertebra ; Child ; Female ; Humans ; Mothers ; Nail Biting ; Thumb

We compared radiologically two groups of total hip prostheses, 36 porous-coated and 51 hydroxyapatite-coated, which had been implanted in 87 hips of 73 patients with avascular necrosis of the femoral head. Radiographs were taken at postoperative 1 year and 2 year, and used to compare various radiological parameters between the two groups. For the acetabular side radioluscent line and osteolysis were evaluated, and for the femoral side radioluscent line, osteolysis, stress shielding. endosteal new bone formation, subsidence and cortical hypertrophy were evaluated; their location was identified according to the zones described by DeLee and Charnley for the acetabulum and according to those described by Gruen et al for the femur. In both groups there was no subsidence. In terms of osteolysis, stress shielding and cortical hyper-trophy there was no significant difference between the two groups throughout the period. Radioluscent line in the acetabulum was more common around the porous-coated cup, but was focal and not progressive. The rate of radioluscent line in the femur was a little higher around hydroxyapatite-coated stem especially in zone 5. Endosteal new bone formation was excellent in both groups, but was more extensive around hydroxyapatite-coated stem. This study suggests that hydroxyapatite coating play a certain role in terms of bony ingrowth.
Acetabulum ; Durapatite* ; Femur ; Head ; Hip ; Hip Prosthesis ; Humans ; Hypertrophy ; Necrosis ; Osteogenesis ; Osteolysis

We experienced a case of a 38 year old women in whom an alpha-fetoprotein producing carcinoma originated in the rectum. The patient had symptoms of hematochezia and bowel habit change, and a rectal examination revealed an ulcerative mass at the midrectum. The mass size was 6.5 cm 6 cm. The serum alpha-fetoprotein measured preoperatively was 9336 ng/ml, and the serum (carcinoembryonic antigen) was 6.4 ng/ml. The serum level of alpha-fetoprotein decreased to 830 ng/ml thirteen days after a low anterior resection. The tumor mass was a poorly differentiated adenocarcinoma. Using an immunohistochemical staining method, we detected alpha-fetoprotein producing cells in the tumor mass. During the follow up, the serum alpha-fetoprotein level began to increase continuously, and an abdomin opelvic CT scan showed a systemic, local tumor recurrence. Based on our experience with this patient and a review of the literature on the few cases previously reported, it seems that alpha-fetoprotein producing colorectal carcinamas have a tendency to produce frequent blood-borne metastasis and are associated with a poor prognosis.
Adenocarcinoma ; Adult ; alpha-Fetoproteins* ; Colorectal Neoplasms ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Humans ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms* ; Rectum ; Recurrence ; Tomography, X-Ray Computed ; Ulcer

Delusions of parasitosis is a type of monosymptomatic hypochondrial psychosis and is defined as the fixed belief that one is infested with living organisms, in t.he abscence of any objective evidence that such infestation exists. A 43 year-old woman had a 2-month history of generalized pruritus and skin ulceration on the buttock representing dermatitis artefacta. She also complained of seeing small black insects crawling on her whole body skin, especially on the pubic area without evidence of cutaneous invasion by the parasites. She had no evidence of other medical diseases. She was treated with oral pimozide, starting with 1mg/day to 3mg/day. In two weeks, clinical symptoms and false belief that she is infested with parasites subsided.
Adult ; Buttocks ; Delusions* ; Dermatitis ; Female ; Humans ; Insects ; Parasites ; Pimozide* ; Pruritus ; Psychotic Disorders ; Skin ; Skin Ulcer

No abstract available.
Cervix Uteri* ; Female

We have analyzed clinical results of forty-five patients who had spondylolisthesis which were operated using transpedicular screw fixation devices (CD or Steffee VSP system) between June, 1987 and March, 1992 at the department of Orthopedic Surgery of Kwang-ju Christian Hospital. Simultaneously we compared the postoperative results between two groups. The results were as follows: 1. The ratio of man and woman was 1: 2.2 and mean age was 44.3 years (44.8 years in degenerative type and 42.5 years in isthmic type). 2. The most common level was L4 on L5 and two-third of all cases were isthmic type. 3. The clinical results were satisfactory in 91% (41 cases) according to anthors modified evaluation system. There was no significant difference between degenerative and isthmic type. 4. The mean % of slip was improved from 23.3% preoperatively to 7.4% postoperatively and the mean slip angle was improved from 3.5 degrees preoperatively to-5.4 degrees postoperatively. 5. The devices which were used for operation were C-D instrument in 21 cases and Steffee VSP system in 23 cases. There was no difference in radiographic examinaton and clinical result between two groups. 6. The anterior fusion was done for 9 active young patients. The results were significantly satisfactory. 7. We consider the transpedicular fixation system is the most recommandable method of treatment for spondylolisthesis in providing excellent reduction of slippage and maintenance of reduction with rigid fixation device.
Female ; Gwangju ; Humans ; Methods ; Orthopedics ; Spondylolisthesis

PURPOSE: Calcium-activated potassium channels(KCa) may be involved in the transient outward current of the first phase of cardiac action potential. But it is still not clear whether cardiac myocytes express any Kca. We try to identify here the types of Kc, expressed in rat caridac myocytes. METHODS: We isolated total heart RNA from 50 rats(Spague-Dawley) and performed reverse transcription-polymerase chain reaction(RT-PCR) using specifically designed synthetic oligonucleotide primer sets. From the pure culture of cardiac myocyte, Kc, gene expression was detected by Southern blot analysis. RESULTS: RT-PCR revealed expressions of BKca(large-conductance Kca, rSlo) and S&,(small-conductance Kca, rSK1). We prepared cardiac myocytes pure culture(>9596 pure myocyte) using pure culture technique. RT-PCR and Southern blot analysis of rat cardiac myocyte showed only rSK1-specific band, but no rSlo-specific was detected. CONCLUSION: The expressions of more than one type of Kca are detected from rat heart. A sub-type of SKcrSK1, was expressed in cardiac myocyte, while the main subunit of BKca(rSlo) was found in cells other than myocytes, most likely in the smooth muscle of cardiac blood vessels.
Action Potentials ; Animals ; Blood Vessels ; Blotting, Southern ; Culture Techniques ; Gene Expression ; Heart ; Muscle Cells ; Muscle, Smooth ; Myocytes, Cardiac* ; Potassium ; Potassium Channels, Calcium-Activated* ; Rats* ; RNA

PURPOSE: The aim of this study was to estimate the degree of difficulty in total mesorectal excisions (TMEs) for rectal cancer by using statistical methods after analysis of factors affecting the resection time and incomplete resection. METHODS: A total of 63 patients who underwent a total mesorectal excision for rectal cancer were evaluated. MRI pelvimetry data {(transverse diameter (TD), obstetric conjugate (OC), interspinous distance (ID), sacrum length (SL), sacrum depth (SD)}, tumor size (TS), T stage, and body mass index (BMI) were prospectively analyzed. A stepwise multiple regression analysis was performed to determine the operating time prediction equation by using these variables, and the differences in the mean operating time hased on gross evaluations of each specimen were analyzed. RESULTS: A stepwise multiple regression with the operating time as a dependent variable led to the following equation: Operation time (min)=35.726-2.162xTD (cm)-2.324 x OC (cm) + 2.671 x SL (cm) + 1.274 x TS (cm), with r2=0.533 and SEE=5.438. The mean operating time according to a gross evaluation of the TME specimen was 20.0 +/- 7.3 min in complete TME cases (n=42) and 27.9 +/- 7.2 min in incomplete TME cases (n=21) (P<0.001). CONCLUSIONS: MRI pelvimetry data (TD, OC, SL) and tumor size were factors affecting the operation time in TMEs for rectal cancer, and the operating time could be predicted by using the equation of the present study. Also, the mean operating time in incomplete TME cases was longer than that in complete TME cases. Thus, the degree of difficulty of an operation for rectal cancer can be predicted by using these factors.
Body Mass Index ; Humans ; Magnetic Resonance Imaging ; Pelvimetry ; Prospective Studies ; Rectal Neoplasms* ; Sacrum

PURPOSE: The management of local recurrence after curative surgery of the rectal cancer remains difficult clinical problems to surgeons. This study was performed to analyze the outcomes of patients with local pelvic recurrence according to its recurrence type. METHODS: A total 109 patients with local recurrence were evaluated. Among the 109 patients 62 were local recurrence alone and 47 were both local and systemic recurrence. The recurrence type was classified as Central, Anterior, Posterior, Lateral and Perineal recurrence according to the relation of the tumor location and either intra pelvic organ and/or fixed pelvic structure. RESULTS: Only 26 (23.9%) of the 109 patients had curative resection and the remaining 83 (76.1%) patients had palliative exploration or nonsurgical procedure. The resectability according to the recurrence type showed that the Central and Anterior type was higher than other type of recurrences (P=0.001). When the primary operation was Abdominoperineal Resection (APR) the resectability was poorer than Low Anterior Resection (LAR) (P=0.0001). When comparing the patients with local recurrence alone, the 5 year survival rate was significantly higher patients treated by curative resection than palliative or non-resection group (P=0.002). Mean follow up period was 44.2+/-30.0 months and mean recurrence time between primary operation and recurrence was 26.0+/-22.7 months. CONCLUSIONS: Resection for central type of the recurrent is potentially curative, however treatment failure was common when the recurrence invaded fixed pelvic structure. Our data suggest that local pelvic recurrence should be treated with radical resection as can as possible.
Classification* ; Follow-Up Studies ; Humans ; Prognosis* ; Rectal Neoplasms* ; Recurrence* ; Survival Rate ; Treatment Failure