We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 minutes, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography. Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.
Anaphylaxis ; Anti-Bacterial Agents ; Aorta, Thoracic ; Cardiopulmonary Resuscitation* ; Echocardiography ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Intensive Care Units ; Middle Aged ; Operating Rooms ; Renal Artery ; Ribs ; Stomach Neoplasms ; Survivors* ; Thorax ; Tomography, Spiral Computed

No abstract available.
Adhesives*

A survey of intestinal parasites was performed during the period from April 1970 to December 1971 in ROKA (Republic of Korea Army) soldiers. Samples were collected from 591 Army troops(enlisted men), 1,755 recruits at completion of 6 weeks basic training, 304 recruits during basic training and 245 stool specimens of students of ROKA Nursing School at Taegu area. Each of the specimens was examined one time or twice under the microscope, one for protozoan cysts stained with iodine solution and the other for helminth eggs. Findings were summerized as follows: A positive rate of intestinal parasites was 88.0 percent by Formalin-Ether concentration method and 89.2 percent by Kato's method. Of the 541 soldiers examined by Formalin-Ether concentration method, the infection rate of A. lumbricoides was 28.1 percent, T. trichiurus 79.3 percent, hookworm 14.2 percent, T. orientalis 30.7 percent, C. sinensis 7.8 percent and M. yokogawai 0.6 percent. Of the 1,532 soldiers examined by Kato's method A. lumbricoides showed positive rate of 45.8 percent, T. trichiurus 78.3 percent, T. orientalis 1 4.5 percent, hookworm 7.5 percent, C. sinensis 6.6 percent and Taenia sp. 0.6 percent. The incidence of E. vermicularis out of 822 samples was 19.8 percent from the anal swabs. E. histolytica was recovered in 4.2 percent among 541 samples, E. coli 6.1 percent and also infected G. lamblia, E. nana, I. butschlii and Chilomastix mesnili. Most of the infected cases revealed single or double infections.
parasitoloyg-helminth-nematoda-trematoda-cestoda-protozoa ; Ascaris lumbricoides ; Trichocephalus trichiurus ; hookworm ; Trichostrongylus orientalis ; Clonorchis sinensis ; Metagonimus yokogawai ; Taenia sp. ; Enterobius vermicularis ; Entamoeba coli ; Entamoeba histolytica ; Giardia lamblia ; Endolimax nana ; Iodamoeba butschlii ; Chilomastix mesnili ; epidemiology

Only several stages of conventional operation have been able to treat the open fracture of the limb with extensive bone and soft tissue loss. So we, authors, reviewed 25 cases of vascularized osteocutaneous fibulat transfer which were performed to the extensive bone defect of the limb and associated soft tissue injury(from May 13, 1982 to September 30, 1988). In 25 cases, one case was a chronic osteomyelitis combined pseudocarcinomatous epithelial hyperplasia of surrounding soft tissue, the other(24 cases) were the open comminuted fractures with the extensive bone and soft tissue loss of the limbs. The average size of the skin flap was 12.33 × 5.83cm, the average length of vascularized fibula was 16.5cm in length. The complications were fractures of grafted fibula, partial necrosis of both ends of the skin flap and uncontrolled infection of proximal end of grafted fibula. During postoperative period, the patency of the anastomoses were monitored by observing the color of the skin of buoy skin flap. The average amounts hypertrophied fibula at 12 months after operation were 20.6cm. And the following remarkable result were obtained. 1. With the uncontrolled bone infection, the vascularized osteocutaneous fibular transfer was able to be performed. 2. During the follow up period, the grafted fibula had been hypertrophied. 3. In roentgenogram, as compared with conventional bone graft, grafted bone was not resorbed and early united. 4. In adult, free fibula can be obtained and grafted as 23cm as long and the skin flap with fibula can be obtained and grafted as 21 × 7cm as large in or experience. 5. In the vascularized osteocutaneous fibula transfer, the patency of anastomoses was monitored indirectly by confirming skin flap. 6. The fractured fibula was united early by cast immobilization, and it was hypertrophied at the fracture site. 7. The vascularized osteocutaneous fibula transfer is also useful in application of the other long bones.
Adult ; Extremities ; Fibula ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Humans ; Hyperplasia ; Immobilization ; Microsurgery ; Necrosis ; Osteomyelitis ; Postoperative Period ; Skin ; Transplants

No abstract available.
Fibrosis* ; Recurrence*

Nasal chondromesenchymal hamartoma is a distinctive mixed mesenchymal lesion of sinonasal region with a complex histologic appearance and benign clinical course and clinicopathologically similar to those of the mesenchymal hamartoma of the chest wall of infancy. We report a case of nasal chondromesenchymal hamartoma occurred in the right nasal cavity in a 3-month-old female. She was admitted with a history of profuse nasal bleeding and obstruction. CT revealed complex solid and cystic mass, measuring 3.5x2.5x2.5 cm in dimensions which filled the right nasal cavity and extended into ethmoid sinus and cribriform plate. The received piecemeal fragments of tissue were brown tan-colored firm semitranslucent tissue with a cartilaginous appearance. Microscopically, the basic morphologic elements were irregular islands of hyaline cartilage and myxoid to spindle cell stroma with various cellularity.
Epistaxis ; Ethmoid Bone ; Ethmoid Sinus ; Female ; Hamartoma* ; Humans ; Hyaline Cartilage ; Infant ; Islands ; Nasal Cavity ; Thoracic Wall

No abstract available.
Enterococcus*

Gastric volvulus is a rare surgical disorder in the pediatric population. We experienced a case of gastric volvulus. A 2-year-old boy was admitted to hospital with abdominal distension. An upper gastrointestinal series showed reversal of the greater and lesser curvatures. Surgical exploration revealed an organoaxial volvulus of the stomach, and anterior gastropexy was performed.
Child, Preschool ; Gastropexy ; Humans ; Intestinal Volvulus ; Male ; Stomach ; Stomach Volvulus*

BACKGROUND: We compared factors associated with self-reported depression and, in particular, diagnosis and treatment of depressive symptoms in Korean adults. METHODS: The sample included 13,306 adults aged 19 years or older from the 2010 and 2011 Korea National Health and Nutrition Examination Survey (KNHANES V). Data were applied to the chi2 test and multivariate logistic regression analysis. RESULTS: The following characteristics of individuals are significantly associated with self-reported depression: female (vs. male, OR [odds ratio]=3.35), ages 50-59 years (vs. 60+, OR=1.45), economic status (low vs. high, OR=1.35; middle-low vs. high OR=1.29), unemployed (vs. employed, OR=1.23), education (elementary vs. college, OR=1.18; middle school vs. college, OR=1.27; vs. high school vs. college, OR=1.18), current smoking (vs. no, OR=1.19), high-risk alcohol consumption (vs. no, OR=1.18), perceived health (good vs. very good/excellent, OR=1.156; poor/fair vs. very good/excellent, OR=2.65), chronic disease (vs. no, OR=1.26), activity limitation due to health problems (vs. no, OR=1.74), and being in a sickbed during the past month (vs. not in a sickbed, OR=1.69). Living in a metropolitan area (vs. rural, OR=1.40) is significantly associated with greater odds of being diagnosed with depression. The odds of being treated for depression are lower for female (vs. male, OR=0.53). Greater odds of being treated for depression was seen for those with chronic conditions (vs. no, OR=1.73) and activity limitation due to health problems (vs. no, OR=2.05), as well as, those in a sickbed (vs. not, OR=1.88). CONCLUSIONS: Applying our findings, policy makers should address the lower rates of depression diagnosed in non-metropolitan areas to reduce regional variations, and also promote treatment in females.
Administrative Personnel ; Adult* ; Alcohol Drinking ; Chronic Disease ; Depression* ; Diagnosis* ; Education ; Female ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Smoke ; Smoking

STUDY DESIGN: A retrospective study was made of patients undergoing posterolateral fusion of the lumbar spine. OBJECTIVES: To compare the clinical outcomes of the patients who underwent posterolateral fusion of the lumbar spine with commercially available allogeneic bone graft with those patients in a similar consecutive control group who underwent posterolateral fusion of the lumbar spine with autogenic bone graft and to determine whether the commercially available allogeneic bone is useful for postero-lateral fusion of the lumbar spine. SUMMARY OF LITERATURE REVIEW: Major differences exist in the ability of an allogeneic bone graft to regenerate a viable cellular network as compared to an autogenic bone graft. This is related to the immunologic response of the host to the foreign bone. The fusion rate of deep freezing allogeneic bone graft was reported as 80-100%. MATERIALS AND METHODS: Seventy-nine patients with spondylolisthesis treated with decompression, fixation with pedicle screws and posterolateral fusion were retrospectively reviewed. Nineteen patients (group 1) were treated with commercially available allogeneic bone (Tutoplast) graft mixed with autogenic bone and the remaining 60 patients (group 2) were treated with autogenic bone graft. Operating time, amount of transfusion, duration of hospital stay, symptom improvement, fusion rate, duration of fusion, and complications were studied. RESULTS: There were no significant differences between the two groups in terms of duration of hospital stay, amount of transfusion, symptom improvement, and complications . However, there were significant differences between the allogeneic and autogenic groups in terms of operating time (212.3 versus 230.9 minutes), fusion rate (36.8% versus 98.3%), and duration of fusion (10.2 versus 6.4 months), respectively. CONCLUSIONS: Commercially available allogeneic bone is less useful for posterolateral fusion of the lumbar spine.
Decompression ; Freezing ; Humans ; Length of Stay ; Retrospective Studies ; Spine* ; Spondylolisthesis ; Transplants