"No-incision" bladder neck suspension, Gittes` operation, is a simple & effective technique among the various surgical technique. But occasionally patients was complained of long - term urinary retention and voiding difficulty after operation because or excessive traction of the nylon suture. We prevented them using chain cystourethrogram intraoperatively. This operation was performed under the spinal anesthesia which the patients can do the Valsalva maneuver during operation. Posterior urethrovesical angle was not significantly different between preoperative & intraoperative chain cystourethrogram. We corrected wide posterior urethrovesical angle to about 100 (mean angle of the normal range). Normal voiding after catheter removal & duration of admission was signiricantly decreased in intraoperative chain cystourethroram group(p<0.05). During 11 months follow-up, overall cure rate was 84.6% without long-term postoperatively voiding difficulty. We concluded that intraoperative chain cystourethrogram was useful methods for good results.
Anesthesia, Spinal ; Catheters ; Follow-Up Studies ; Humans ; Neck* ; Nylons ; Sutures ; Traction ; Urinary Bladder* ; Urinary Retention ; Valsalva Maneuver

Objective: Many trauma centers use their own criteria for major trauma patients, and these criteria are organized according to physiological causes and their related mechanisms. Mechanism related criteria have high sensitivity but low specificity. We confirmed 20 feet as a single factor for trauma team activation criteria. Methods: This study was retrospectively conducted in the Pusan National University Hospital trauma center, which is a level 1 trauma center in Busan. Patients were grouped as group 1, a fall from less than 20 feet; and group 2, a fall from more than 20 feet. We compare the two groups of prognostic factors using logistic regression analysis. Results: The relationship between the height of the fall and the patient’s prognosis showed a positive relationship on the logistic regression analysis. Yet the cut-off value of a 20 foot height showed poor predictive power for the patient’s prognosis. Conclusion In conclusion, as trauma team activation criteria, a 20 foot height seems to be a reasonable aspect of patients’ clinical prognosis between above 20 feet and below 20 feet. Yet it seems to be controversial as a cut-off value. Thus, more studies will be needed to identify a specific height for trauma team activation.

Due to increasing participation in outdoor activities, many people visit the emergency room for various symptoms after mistaking poisonous plants for medicinal herbs. The toxicity of Arisaematis rhizome is due to its content of calcium oxalate, which causes painful oropharyngeal edema, hypersalivation, aphonia, oral ulceration, esophageal erosion, and hypocalcemia. We report a case of accidental poisoning after chewing and spitting of the root of A. rhizome, resulting in focal symptoms-such as oral pain, swelling and drooling-that required only conservative management. A 54-year-old male and his 58-year-old wife developed oral pain, swelling and drooling after accidentally chewing and spitting the root of the A. rhizome plant as a medicinal herb. Their symptoms started immediately after chewing on and spitting out the root of A. rhizome, and they were unable to speak due to oral pain, swelling, and hypersalivation on arrival at the emergency department. They were treated with antihistamines and corticosteroids and painkillers. A few hours after treatment, they had improved and were discharged from the hospital.
Adrenal Cortex Hormones ; Aphonia ; Calcium Oxalate ; Edema ; Emergency Service, Hospital ; Histamine Antagonists ; Humans ; Hypocalcemia ; Male ; Mastication ; Middle Aged ; Oral Ulcer ; Plants ; Plants, Medicinal ; Plants, Toxic ; Poisoning* ; Rhizome ; Sialorrhea ; Spouses

We, herein, present a patient with no history of trauma who developed shoulder pain after undergoing low-voltage electric shock. According to the computed tomography, there was a multi-segmental fracture that extended into the glenoid cavity of the left scapula. A good outcome was obtained after open reduction and internal fixation. Emergency physicians should be aware of the possibility of scapular fracture extending into the glenoid cavity, especially in patients with shoulder pain after electrical injury.
Electric Injuries ; Emergencies ; Glenoid Cavity* ; Humans ; Scapula ; Shock* ; Shoulder Pain

Endovascular repair of inflammatory aortic aneurysms has been reported as an alternative to open surgical treatment. In selective cases, adjunctive bypass surgery may be required to provide an adequate landing zone. We report a case of endovascular repair of an inflammatory aortic aneurysm in a patient with Behcet's disease using a carotid-carotid bypass graft to provide an adequate landing zone. A 45-yr-old man with a voice change was referred to our hospital with the diagnosis of saccular aneurysm of the distal aortic arch resulting from vasculitis. Computed tomography showed a thoracic aortic aneurysm with thrombosis. Right to left carotid-carotid bypass grafting was performed. After 8 days, the patient underwent an endovascular stent graft placement distal to the origin of the innominate artery. The patient was discharged with medication and without postoperative complications after 5 days. Hybrid endovascular treatment may be suitable a complementary modality for repairing inflammatory aortic aneurysms.
Aortic Aneurysm, Thoracic/complications/radiography/*surgery ; Behcet Syndrome/*complications/surgery ; Blood Vessel Prosthesis Implantation/*methods ; Carotid Arteries/physiopathology/*surgery ; Coronary Artery Bypass ; Endovascular Procedures ; Humans ; Male ; Middle Aged ; Stents ; Thrombosis/complications ; Tomography Scanners, X-Ray Computed ; Vasculitis/complications

BACKGROUND/AIMS: Acute hepatic dysfunction combined with alcoholic hepatitis (AH) in alcoholic cirrhosis is related to hepatic hypo-perfusion secondary to intrahepatic necroinflammation, neoangiogenesis, and shunt. The hepatic vein arrival time (HVAT) assessed by microbubble contrast-enhanced ultrasonography (CEUS) is closely correlated with the severity of intrahepatic changes. We investigated the usefulness of HVAT to predict short-term mortality of AH in cirrhosis. METHODS: Thirty-nine patients with alcoholic cirrhosis (27 males) and AH were prospectively enrolled. HVAT study was performed within 3 days after admission using ultrasonic contrast (SonoVue®). The primary outcome was 12-week mortality. RESULTS: Twelve-week mortality developed in nine patients. HVAT was significantly different between the mortality and survival groups (9.3±2.0 seconds vs 12.6±3.5 seconds, p=0.002). The odds ratio of a shortened HVAT for 12-week mortality was 1.481 (95% confidence interval, 1.050–2.090; p=0.025). The area under the receiver operating characteristic curve of HVAT for 12-week mortality was 0.787 (p=0.010). The combination of MDF and HVAT ≥11.0 seconds resulted in an 87.5% survival rate even if the MDF score ≥32; however, HVAT < 11.0 seconds was related with mortality despite a MDF score < 32. CONCLUSIONS: HVAT using microbubble CEUS could be a useful additional index to predict short-term mortality in patients with AH and cirrhosis.
Alcoholics* ; Fibrosis* ; Hepatic Veins ; Hepatitis, Alcoholic* ; Humans ; Liver Cirrhosis, Alcoholic ; Microbubbles ; Mortality ; Odds Ratio ; Pilot Projects* ; Prognosis* ; Prospective Studies* ; ROC Curve ; Survival Rate ; Ultrasonics ; Ultrasonography*