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

Pathological study was performed on the 135 cases (137 lesion) of early gastric cancer (EGC) diagnosed during the period from 1970 to 1988. The gastrectomy specimens were obtained from Pusan National University Hospital and Pusan Paik Hospital. The statistical analysis was applied on the point of pathological and epidemiological aspects. The results obtained were summarized as follows: 1) The proportion of patients with EGC of all gastric cancer diagnosed in Pusan area during the period of 1970 to 1974 was 1.3%, those during 1975 to 1979 was 1.7%, those during 1980 to 1984 was 7.8%, and those during 1985 to 1988 was 20.0% respectively. 2) The model age group was 6th decade in both sexes. The average age of patients with EGC was 50. 1-year-old in men and 47. 9-year-old in women respectively. The sex ratio (M/F) was 2 : 1 but it was lower for young people than for old people. 3) The proportion of sites involved by the EGC in the stomach was as follows : the antrum 61%, the body 39%, and the cardia and fundus 0.01%. The intestinal type cancer more frequently involved the lower portion than the upper portion of the stomach. 4) Regarding the distribution of the gross types of EGC, the elevated group (Type I, IIa) accounted for 14%, the flat type (Type IIb) accounted for 4%, and the depressed group (Type IIc, III) accounted for 82%. There was no correlation between the gross type and the depth of the lesion. The elevated group was more frequent in intestinal type than in diffuse type. 5) The size distribution of the EGC was as follows : 46% of the lesions were smaller than 2.0 cm in diameter, 47% were between 2.1 to 5.0 cm, and 7% were larger than 5.1 cm. There was no correlation between the size of the lesion and the gross type. 6) The intestinal type of EGC was 77 lesions (56.2%) and the diffuse type 60 lesions (43.8%). The ratio of both types (I/D) was 1.3 : 1, and it was lower for younger people than for old people. 7) Ten of 135 cases (7%) had lymph node metastases. The metastatic rate of EGC confined to submucosa was much higher than that of EGC confined to mucosa only, but the metastatic rate was not related with the size of the lesion.
Female ; Male ; Humans ; Neoplasm Metastasis ; Stomach Neoplasms

Reflex ileus in acute abdominal disease were produced frequently due to cholecystitis, cholelithiasis, abscess in pelvic, appendiceal and diaphragmatic etc. But we found that a functional type of paralytic ileus due to ureteral stonetr renal stone was commonly seen on the plain roentgenogram. In these functional type of reflex ileus due to urinary stone, distension of the small intestine withgas may interfere with an accurate detection of the stone. It may lead to confusion in detecting ureteral stone and obstructive ileus. In this report, we analyzed how many cases would show a functional type of reflex ileus in urinary stone cases. 1. In 200 cases of urinary stone, reflex ileus with urinary stone were produced in 49 cases(21. 5%) 2. Many cases of ureteral stone were found on lower third of the ureter. (99 cases) 28 reflex ileus cases in 99 cases were produced (29.2%) 3. In reflex ileus due to urinary stone, we classified them by sex, age, location and stone size. The stone was often masked by nausea, vomiting, abdominal distention and reflex ileus on plain roentgenogram. So it is necessary to perform a complete urological study to detect urinary stone.
Abscess ; Cholecystitis ; Cholelithiasis ; Ileus* ; Intestinal Pseudo-Obstruction ; Intestine, Small ; Masks ; Nausea ; Reflex* ; Ureter ; Urinary Calculi* ; Urolithiasis ; Vomiting

No abstract available.
Abscess* ; Fistula*

No abstract available.

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

Carpometacarpal dislocations occur in less thsn 1% of osseous hand injuries. Sine Dec. 1987, two cases of multiple carpometacarpal dislocations were treated at Hanyang University Hospital. All of these were successfully treated by closed reduction and percutaneous pinning with K-wires. Follow-up periods were 6 months and 5 months respectively. All patients were asymptomstic, but one patient had occasional discomfort and diminished grip strength.
Carpometacarpal Joints ; Dislocations ; Follow-Up Studies ; Hand Injuries ; Hand Strength ; Humans

The utilization of CT-guided fine needle aspiration biopsy of bone has been the subject of considerable interest, since the introduction of the CT scanning. The CT-guided needle biopsy of 11 consecutive patients with avariety of "Etiology Unknown Spinal Disorders" resulted in a 100% yield of positive tissue diagnosis without significant complicaitons. The main advantage of CT guidance is the continuous direct observation of the needletip position in relation to the target volume, the more precise sampling from smaller and deeper lesion is another advantage. We are confident that localization of pathology by CT is the most accurate method for perform ingbiopses, and thus replaces the conventional ways of approaches and this could be utilized on the other organbiopsy in the future.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Needle ; Diagnosis ; Humans ; Methods ; Pathology ; Tomography, X-Ray Computed

No abstract available.
Aortic Aneurysm, Thoracic* ; Aortic Coarctation*

Many studies for LPS-induced cytokines, chemokines gene expressions have been reported, but results are highly diverse. The dose of LPS used, cell type studied or other technical factors may contribute to the differences. We investigated the cytokine mRNA expressions, interleukin-2 (IL-2), IL-6, IL-10 and IFNr, on thioglycollate (TG) elicited-mouse peritoneal macrophages stimulated with various concentrations, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1 ug/ml and 10 ug/ml, of LPS used by reverse transcription polymerase chain reaction (RT-PCR) and northern blot analysis. TG- elicited peritoneal macrophages expressed IL-6 and IFN-r mRNA in a dose-dependent manner. The expressions of IL-2 and IL-10 mRNA were dose-independent manner. In northern blot analysis, IL-6 mRNA expression was detected only in 10 ug/ml LPS concentration for short stimulation time (0.5 h), while IL-10 mRNAs were expressed evenly in all LPS concentrations. The expression of IL-6 mRNA was sustained until 72 h at 10 ug/ml concentration only, but IL- 10 mRNAs of all cases of LPS concentrations were sustained evenly until then. These results suggest that the concentration of LPS required for cytokine induction must be determined differently from gene to gene types, and although LPS concentration 10 ug/ml has not been used as an ordinary concentration in vitro cytokine study, 10 ug/ml of LPS might be more appropriate concentration in the study of IL-6 expression on mouse peritoneal macrophages.
Animals ; Blotting, Northern ; Chemokines ; Cytokines ; Gene Expression ; Interleukin-10 ; Interleukin-2 ; Interleukin-6 ; Macrophages, Peritoneal* ; Mice* ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger*