Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

OBJECTIVE: The authors present the results of management outcomes for upper basilar artery aneurysms via transclinoidal approach. METHODS: Clinical and angiographic evaluations were performed in twenty two consecutive patients with upper basilar artery aneurysms(three of them had superior cerebellar artery aneurysms) treated by surgery via transclinoidal approach between January, 1990 and April, 2000. RESULTS: Of the 22 patients, fifteen patients had multiple aneurysms including basilar bifurcation aneurysms and basilar-superior cerebellar aneurysms. Seventy seven percent were in good preoperative neurological status(H-H grade I-III), 23% were in poor grade(H-H grade IV). The management outcome was:Glasgow outcome scale(GOS) I 54.5%, GOS II 18%, GOS III 13.6%, GOS IV 4.5% and GOS V(death) 9%. The major causes of morbidity were direct brain damage, perforator occlusion, vasospasm and meningitis. CONCLUSION: The management outcome of upper basilar artery aneurysms treated via clinoidectomy was good(72.5%). Transclinoidal approach is an acceptable alternative for upper basilar artery aneurysms.
Aneurysm ; Arteries ; Basilar Artery* ; Brain ; Humans ; Intracranial Aneurysm* ; Meningitis

BACKGROUND: Suction auto epidermal graft for the treatment of stable vitiligo has become popular clinically. In general, depigmented epidermis is removed by liquid nitrogen freezing for preparation of the recipient site. There have been some problems with the nitrogen freezing method, uneven repigmentation, appearance of Koebner's phenomenon on normal colored skin around the graft site, scar formation on recipients sites. In our view these resulted in unwanted damage to the dermis and epidermal and skin appendageal melanocytes of normal skin by freezing. OBJECTIVE: To introduce a method to remove the depigmented epidermis of recipient site with minimal unwanted damage to melanocytes and dermal tissue. METHODS: Using Ellman surgitron, irradiation equipment of 3.8MHz frequency the depigmented epidermis was removed with a blade electrode under rated electric power around 10 watts depending on the thickness of the epidermis. Operating mode was fully filtered current for minimal charring and destruction of tissue through pure micro-smooth cutting. RESULTS: In the case of removal of the epidermis with Ellman surgitron, oozing and inflammation decreased markedly compared with those applied with liquid nitrogen. And it was confirmed histopathologically that there was no significant unwanted destruction of healthy tissue. Moreover, the electrode of Ellman surgitron is designed to be apt to trace the margin of depigmented lesion. And Ellman surgitron features a continuously linear intensity setting for precise, predictable control to minimize tissue destruction and charring. So we were able to remove the epidermis of the shallow lesion looking like a pseudopod and of the thinnest part of the body like eyelid also. And we grafted normal epidermis successfully on the depigmented lesion. CONCLUSION: The removal of depigmented epidermis by radio-frequency gave satisfactory results in the suction auto epidermal graft by overcoming the defects shown as depigmented epidermis which were removed by liquid nitrogen freezing. And this method made patients comfortable because of less pain, a one day operation procedure and good results.
Cicatrix ; Dermis ; Electrodes ; Epidermis* ; Eyelids ; Freezing ; Humans ; Inflammation ; Melanocytes ; Nitrogen ; Skin ; Suction* ; Transplants* ; Trout ; Vitiligo

Gastric biopsy specimens from 140 patients (66 chronic gastritis, 33 gastric ulcers, 26 duodenal ulcers, 15 gastric cancers) were examined to investigate the topographic difference of inflammation, glandular atrophy, intestinal metaplasia, and Helicobacter pylori (H. pylori) colonization by the updated Sydney system. Density of H. pylori of the antrum was significantly higher in duodenal ulcers than in chronic gastritis, gastric ulcers, and gastric cancers. Inflammation of duodenal ulcers was predominantly antral and glandular atrophy and intestinal metaplasia of duodenal ulcer were significantly less than those of gastric ulcers and gastric cancers. Chronic inflammation of gastric ulcers and gastric cancers was higher in antrum than in corpus. Increasing atrophy of the antrum was associated with decreasing density of H. pylori of antrum itself, but increasing colonization of the corpus. This study reveals the inflammatory reactions of gastric mucosa differ in chronic gastritis, gastric ulcers, gastric cancers, and duodenal ulcers and suggests that antral atrophy fosters the colonization of oxyntic mucosa by H. pylori.
Atrophy ; Biopsy ; Colon ; Duodenal Ulcer ; Gastric Mucosa* ; Gastritis ; Helicobacter pylori ; Helicobacter* ; Humans ; Inflammation ; Metaplasia ; Mucous Membrane ; Stomach Neoplasms ; Stomach Ulcer

No abstract available.
Gastrin-Secreting Cells* ; Gastrins* ; Gastrointestinal Tract*

No abstract available.
Arm

No abstract available.
Carcinoma, Basal Cell ; Paget Disease, Extramammary

Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

PURPOSE: Recent randomized prospective data suggest that early hyperglycemia is associated with high mortality in critically ill patients and that tight glucose control leads to an improved outcome. This concept has not been carefully examined in trauma patients. The purpose of this study was to determine the relationship of different levels of early hyperglycemia to the clinical outcomes in trauma patients. METHODS: A retrospective study of 309 cases of trauma victims who visited the Emergency Department of Daegu Catholic University Hospital from March 2003 to February 2004 was made. Patients younger than 15 years of age and patients having diabetes mellitus were excluded. The records of all of these patients were reviewed for age, the Injury Severity Score (ISS), Glasgow Coma Scale (GCS) score, blood glucose, lengths of ICU and hospital stays, infection morbidity, and mortality. They were divided into three groups by their glucose level (> or = 110 mg/dl and < 110 mg/dl, > or = 140 mg/dl and < 140 mg/dl, > or = 200 mg/dl and < 200 mg/dl). Each group was subdivided into hyperglycemic and non-hyperglycemic subgroups. RESULTS: Hyperglycemia was associated with increased infection morbidity, and mortality. Patients with hyperglycemia (> or = 110 mg/dl, > or = 140 mg/dl, > or = 200 mg/dl) showed higher mortality compared to the corresponding non-hyperglycemic groups (< 110 mg/dl, < 140 mg/dl, < 200 mg/dl) [(0.7% vs 13.0%, 0.5% vs 22.7%, 2.6% vs 45.7%, respectively (p<0.001)]. A univariate logistic regression analysis revealed a significant relationship of age, ISS, GCS score, and blood glucose (> or = 110 mg/dl, > or =140 mg/dl, > or = 200 mg/dl) with mortality. A multivariate logistic regression analysis addressing the effects of age, ISS, and GCS score showed a significant relationship among age (p<0.001), ISS (p<0.001), glucose > or = 140 mg/dl (0.042), and death. In the univariate logistic regression analysis of these variables to infection, we observed a significant correlation between all examined variables and infection, except for glucose > or = 110 mg/dl. Glucose > or = 200 mg/dl (p= 0.007), age (p=0.014), and ISS (p<0.001) were independent predictors of infection in the multivariate logistic regression analysis. CONCLUSION: Early hyperglycemia was associated with higher injury severity, infection rate, and mortality rate. Early hyperglycemia defined as glucose > or = 200 mg/dl was an independent predictor of increased infection rate in trauma patients. Also, early hyperglycemia defined as glucose > or = 140 mg/dl showed a significant independent relationship to death.
Blood Glucose ; Critical Illness ; Daegu ; Diabetes Mellitus ; Emergency Service, Hospital ; Glasgow Coma Scale ; Glucose ; Humans ; Hyperglycemia* ; Injury Severity Score ; Length of Stay ; Logistic Models ; Mortality ; Prognosis* ; Retrospective Studies

OBJECTIVE: The objective is to describe the relationship of anatomical landmark required for the middle fossa approach to preservation of hearing. METHODS: Dissection of 16 fixed human cadaveric heads was performed. we identified a rhomboid-shaped middle fossa landmarks that serve as a guide to minimize cochlea injury. The points of this construct are as follows ; 1) the junction of the greater superficial petrosal nerve and the trigeminal nerve ; 2) the lateral edge of the porus trigemius ; 3) the intersection of the petrous ridge and arcuate eminence ; and 4) the intersection of the lines extended along the axes of the greater superficial petrosal nerve and arcuate eminence. Mean, minimum, and maximum measurements of all distances were determined. RESULTS: The average cochlea-geniculate ganglion distance measured in the dissected specimens was 3.0+/-0.8mm with a range of 1.2 to 4.1mm. The average cochlea-petrous carotid genu distance was 2.9+/-0.9mm with a range of 1.2 to 4.0mm. The average cochlea-internal acoustic meatus distance measured in the dissected specimens was 9.0+/-0.5mm with a range of 7.8-10.9mm. The average cochlea-mandibular nerve distance measured was 9.4+/-0.4mm with a range of 7.6-11.3mm. CONCLUSION: The middle fossa approach requires special knowledge of the anantomy to reduce the risk of damage to cochlea. It is important that the surgeon understand the surgical anantomy. The present study describes the simple geometric construct that proposes to assist in locating the cochlea.
Acoustics ; Cadaver ; Cochlea ; Ganglion Cysts ; Head ; Hearing ; Humans ; Trigeminal Nerve