The incidence of contrast media extravasation has been increasing gradually. Most contrast media extravasations only can cause pain, swelling and erythema. However, in more severe cases, skin necrosis, ulceration, or compartment syndrome may occur, often necessitating a surgery. Early diagnosis and treatment should be established on the spot in order to avoid such a severe damage. We present a case of 42-year-old woman with a compartment syndrome in the right upper extremity caused by extravasation of computed tomography contrast media.
Adult ; Compartment Syndromes* ; Contrast Media ; Early Diagnosis ; Erythema ; Extravasation of Diagnostic and Therapeutic Materials* ; Female ; Humans ; Incidence ; Necrosis ; Skin ; Ulcer ; Upper Extremity*

No abstract available.
Neuroblastoma*

PURPOSE: Intrarenal reflux(IRR) is backflow of urine from the renal pelvis into the collecting ducts. IRR is the main cause of renal injury in children with vesicoureteral reflux (VUR) which leads to renal scars, hypertension, proteinuria, and chronic renal failure. The purpose of our study was to investigate the characteristics of intrarenal reflux. METHODS: We retrospectively reviewed the medical records of 80 patients who were diagnosed as having grades of III-V VUR from Jan. 2004 to Dec. 2006 in the department of pediatrics in Ajou University Hospital. The patients were divided into two groups according to the presence of IRR on voiding cystoureterogram and compared to each other for the possible factors associated with intrarenal reflux. RESULTS: Among 80 VUR patients, IRR(+) group comprised 17(21.3%) patients and 27 renal units(23.2%) and revealed younger age, higher grade of VUR, and more proteinuria compared to IRR(-) group. There were no significant difference in gender, laboratory findings and the rate of resolution in VUR or defects on renal scan between two groups. Also, intrarenal reflux mostly corresponded to the same site of photon defects on DMSA scan. CONCLUSION: We suggest that intrarenal reflux tends to be associated with younger age, higher grade of reflux, more proteinuria with no difference in resolution rate of VUR when compared to the VUR patients without IRR. From this study, we were able to understand the characteristics of intrarenal reflux in children with urinary tract infection.
Child ; Cicatrix ; Humans ; Hypertension ; Kidney Failure, Chronic ; Kidney Pelvis ; Medical Records ; Pediatrics ; Proteinuria ; Receptor, Insulin ; Retrospective Studies ; Succimer ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the incidence and risk factors of complications following posterior vertebral resection (PVR) for spinal deformity. METHODS: A review of 233 patients treated with PVR at one institution over a nine-year period (1997 to 2005) was performed. The average age was 33.5 years. Complications were assessed in terms of surgical techniques (posterior vertebral column resection [PVCR] and decancellation osteotomy) and etiologies of deformity. RESULTS: Local kyphosis was corrected from 51.4degrees to 2.7degrees, thoracic scoliosis 63.9degrees to 24.5degrees (62.6% correction), and thoracolumbar or lumbar scoliosis 50.1degrees to 17.1degrees (67.6%). The overall incidence of complications was 40.3%. There was no significant difference between PVCR and decancellation osteotomy in the incidence of complications. There were more complications in the older patients (>35 years) than the younger (p < 0.05). Hig her than 3,000 ml of blood loss and 200 minutes of operation time increased the incidence of complications, with significant difference (p < 0.05). More than 5 levels of fusion significantly increased the total number of complications and postoperative neurologic deficit (p < 0.05). Most of the postoperative paraplegia cases had preoperative neurologic deficit. Preoperative kyphosis, especially in tuberculous sequela, had hig her incidences of complications and postoperative neurologic deficit (p < 0.05). More than 40degrees of kyphosis correction had the tendency to increase complications and postoperative neurologic deficit without statistical significance (p > 0.05). There was 1 mortality case by heart failure. Revision surgery was performed in 15 patients for metal failure or progressing curve. CONCLUSIONS: The overall incidence of complications of PVR was 40.3%. Older age, abundant blood loss, preoperative kyphosis, and long fusion were risk factors for complications.
Congenital Abnormalities ; Heart Failure ; Humans ; Incidence ; Kyphosis ; Neurologic Manifestations ; Osteotomy ; Paraplegia ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Scoliosis ; Spine

OBJECTIVE: The authors would like to fine the relationship between zolpidem and nocturnal eating episodes in diverse psychiatric patients. METHOD: We evaluated case series of 6 patients who showed nocturnal eating episodes after takine zolpidem. RESULTS: We have experienced 6 cases who showed nocturnal eating behavior after taking zolpidem. They included 3 patients with schizoprenia, a patient with major depressive disorder, a patient with PTSD and a patient with bipolra I disorder. With reducing or discontiuation of of zolpidem, their nocturnal eating resolved. CONCLUSION: This finding strongly suggests the relationship between zolpidem and the nocturnal eating episode. Physicians should be aware that zolpidem might induce nocturnal eating behaviors.
Depressive Disorder, Major ; Eating* ; Feeding Behavior* ; Humans ; Stress Disorders, Post-Traumatic

PURPOSE: Prostatic manipulation and surgery have been shown to increase serum prostate-specific antigen (PSA). We studied the effect of ejaculation on the serum PSA levels. MATERIALS AND METHODS: We evaluated 131 men(16 to 64 years old) who had no history of surgery or inflammatory disease of the urogenital tract. The total serum PSA, free PSA, serum total testosterone, free testosterone, luteinizing hormone(LH), and follicular stimulating hormone(FSH) were evaluated 1 hour after ejaculation. RESULTS: A PSA level was detected in all the men. There were statistically significant changes of the serum PSA level before and after ejaculation. We compared the parameters between increased PSA group and the decreased PSA group. There were significant differences between the two groups on comparison of the total prostate volume(25.4+/-3.6g vs 15.1+/-4.2g, respectively) and the transition zone volume(7.1+/-2.7g vs 5.3+/-1.1g, respectively). CONCLUSIONS: Based on our data, ejaculation affects the serum PSA concentration in young men, and there seems to be a physiological relationship between ejaculation and the PSA level. The larger the prostate volume, the more ejaculation has an effect on the serum PSA level.
Ejaculation* ; Humans ; Lutein ; Male ; Prostate ; Prostate-Specific Antigen* ; Testosterone

Dopaminergic amacrine cells (DACs) are among the most well-characterized neurons in the mammalian retina, and their connections to AII amacrine cells have been described in detail. However, the stratification of DAC dendrites differs based on their location in the inner plexiform layer (IPL), raising the question of whether all AII lobules are modulated by dopamine release from DACs. The present study aimed to clarify the relationship between DACs and AII amacrine cells, and to further elucidate the role of dopamine at synapses with AII amacrine cell. In the rabbit retina, DAC dendrites were observed in strata 1, 3, and 5 of the IPL. In stratum 1, most DAC dendritic varicosities—the presumed sites of neurotransmitter release—made contact with the somata and lobular appendages of AII amacrine cells. However, most lobular appendages of AII amacrine cells localized within stratum 2 of the IPL exhibited little contact with DAC varicosities. In addition, double- or triple-labeling experiments revealed that DACs did not express the GABAergic neuronal markers anti-GABA, vesicular GABA transporter, or glutamic acid decarboxylase. These findings suggest that the lobular appendages of AII amacrine cells are involved in at least two different circuits. We speculate that the circuit associated with stratum 1 of the IPL is modulated by DACs, while that associated with stratum 2 is modulated by unknown amacrine cells expressing a different neuroactive substance. Our findings further indicate that DACs in the rabbit retina do not use GABA as a neurotransmitter, in contrast to those in other mammals.
Amacrine Cells* ; Dendrites ; Dopamine ; GABAergic Neurons ; gamma-Aminobutyric Acid ; Glutamate Decarboxylase ; Immunohistochemistry* ; Mammals ; Neurons ; Neurotransmitter Agents ; Retina* ; Synapses

BACKGROUND: Heat shock proteins (HSPs), or stress proteins, are immunodominant antigens of many microorganisms. In this study, we have detected the anti-HSP 70 antibody and tried to explain the role of the antibody with respect to the pathogenesis of SLE. Furthermore, we have attempted to find out the possibility to link the presence of the autoantibody with the monitoring and diagnosis of systemic lupus erythematosus (SLE). METHODS: A total of 80 samples from 55 SLE patients were screened for the presence of anti-HSP 70 antibodies. Simultaneously 59 healthy people were tested as a control group. The anti-HSP 70 antibodies were measured by enzyme-linked immunosorbent assay (ELISA) and confirmed by western blot in anti-HSP 70 antibody ELISA positive samples. The activity of disease state was confirmed by the patients' medical record and systemic lupus activity measure (SLAM). RESULTS: The mean optical density (O.D.450) of ELISA in healthy controls and SLE patients were 0.15+/-0.18 (mean+/-S.D.) and 0.13+/-0.14. The correlation of SLAM Score and ELISA O.D. was r2=0.19, P=0.014. And, the mean O.D. value of ELISA was 0.18+/-0.02 and 0.11+/-0.01 before and after treatment (P <0.05). We compared samples with SLAM Score. The O.D. of anti-HSP 70 ELISA in these patients were 0.20+/-0.02 and 0.08+/-0.002 before and after treatment respectively (n=10, mean+/-S.D., P <0.01). CONCLUSIONS: Anti-HSP 70 antibody was not a clinically useful diagnostic marker in SLE patients. However, the titer of anti-HSP 70 antibody can be used for the monitoring of the therapeutic effectiveness in these patients.
Antibodies ; Blotting, Western ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Heat-Shock Proteins ; Humans ; Immunodominant Epitopes ; Lupus Erythematosus, Systemic* ; Medical Records

PURPOSE: This study investigated the effects of early enteral feeding on the morbidities of extremely low birth weight infants (ELBWI) weighing less than 1,000 g. METHODS: We conducted a retrospective review of the medical records of sixty one ELBWI who were admitted to the neonatal intensive care unit of Inje University Busan Paik Hospital from January 2007 to October 2009. ELBWI were divided into two groups; the control group included ELBWI from January 2007 to March 2008, for whom enteral feeding was started beyond 3 days and the early feeding group included ELBWI from April 2008 to October 2009, for whom enteral feeding was started within 3 days. RESULTS: Gestational age and birth weight did not differ between the two groups. In the early feeding group, start day of enteral feeding (control group vs. early feeding group; 7+/-2days vs. 2+/-1days), time to achieve full enteral feeding (68+/-6 days vs. 22+/-2 days), and the duration of parenteral nutrition (58+/-6 days vs. 22+/-2 days) were significantly shorter, and weight gain at postnatal day 28 was significantly higher than that of the control group (P<0.001). No differences were observed in the incidence of sepsis and necrotizing enterocolitis and duration of hospitalization; however, the incidence of total parenteral nutrition induced cholestasis (44% vs. 7%) and bronchopulmonary dysplsia (78% vs. 24%) was significantly lower in the early feeding group. CONCLUSION: Early enteral feeding in ELBWI shortened the time to achieve full enteral feeding, improved weight gain, and decreased the incidence of brochopulmonay dysplasia and cholestasis.
Birth Weight ; Cholestasis ; Enteral Nutrition ; Enterocolitis, Necrotizing ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Parenteral Nutrition ; Parenteral Nutrition, Total ; Retrospective Studies ; Sepsis ; Weight Gain

Purpose: In elderly patients, femoral neck insufficiency fractures that occur without a history of trauma are difficult to diagnose and treat, so it is emphasized that early suspicion of fractures and additional diagnostic tests are conducted. Materials and Methods: Between December 2010 to December 2019, 12 femoral neck insufficiency fractures (group 1) were evaluated by comparing them with 50 traumatic femoral neck fractures of a similar age. Along with demographic data, neck cortical thickness, shaft cortical thickness, head diameter, neck width, trochanter width, shaft width, neck-shaft angle, hip axis length, femoral neck index on the simple radiographic image were compared. Results: Seven of the 12 cases were non-displaced fractures, and it took an average of 19.2 days to diagnose the fracture after the symptoms occurred. The height was smaller than the control group at 149.1 cm in group 1 and 157.2 cm in group 2 (p<0.001). The cortical thickness of the medial femoral neck showed significant differences between the two groups: 3.16 mm in group 1 and 4.11 mm in group 2 (p=0.004). There was no statistical difference in the other measurements. Conclusion Femoral neck insufficiency fracture often has a delayed diagnosis because of the characteristics of the fracture. The cortical thickness of the medial femoral neck in simple radiographic images can help suspect femoral insufficiency fractures in elderly patients when considered with detailed medical history taking and a physical examination.