Acute colonic pseudoobstruction was first reported in 1948 by Sir H. Ogilvie. It is characterized by an acute, abrupt right-sided colonic distention in the absence of physical reasons for obstruction. If untreated, it may progress to cecal perforation, peritonitis, and death. Although primary cases have been reported, 87 percent of cases were secondary results of medical or surgical conditions. The most common medical conditions were infections, cardiac disease, and neurologic problems. In surgical conditions, cesarean section has been reported as the most common cause of Ogilvie's syndrome. In 1995, the first case of Ogilvie's syndrome complicated after a cosmetic surgical procedure(abdominoplasty) was reported by Bradley et al. We report a case of Ogilvie's syndrome complicated after breast reconstruction with TRAM flap that developed in the postoperative third day in 35-year old woman. The complications are primarily related to decreased flap perfusion. No reference of intestinal pseudoobstruction was found in the literature conducted in regard to complications of TRAM flap breast reconstruction.
Adult ; Breast* ; Cesarean Section ; Colon ; Colonic Pseudo-Obstruction ; Female ; Heart Diseases ; Humans ; Intestinal Pseudo-Obstruction ; Mammaplasty* ; Perfusion ; Peritonitis ; Pregnancy

No abstract available.
Erythrocytes*

No abstract available.
Erythrocytes*

BACKGROUND: To predict the therapeutic efficacy of osteoporosis, one or two years is needed to evaluate the therapeutic effect by the measurement of bone mineral density(BMD), whereas three to six months is sufficient with bone markers. Using this information, we can change therapeutic plan or modulate drug dosage if necessary. This approach would provide appropriate therapy for osteoporosis. The purpose of this study is to evaluate the association between the percentage change of BMD which was measured by peripheral quantitative computed tomography(pQCT), and bone markers after 1 year of hormone replacement therapy(HRT) in healthy postmenopausal women. METHODS: Bone mineral density of nondominant distal forearm in 89 postmenopausal women was measured by pQCT. We measured serum alkaline phosphatase(ALP) and intact osteocalcin(iOC, Novocalcin) as bone formation markers, urinary deoxypyridinoline(dPyr, PyriLinks-D(TM)) as bone resorption marker by using enzyme immunoassay. After 1 year of HRT, 54 subjects dropped out and 33 subjects were reevaluated. RESULTS: After 1 year of HRT, the drop-out rate was 61%. There was no significant difference in age, age of menopause, years since menopause, initial BMD, initial bone markers between remained and drop out groups. But osteocalcin level was significantly high in remained group(p=0.02). ALP(-27.6 %), iOC(-29.9%), dPyr(-25.2%) were significantly decreased after 1 year of HRT(p<0.001). Trabecular BMD was increased by 2.4%(p=0.003), but the percentage change of total and cortical BMD was not significant(p>0.05). The levels of BMD and bone markers between before and after was significantly correlated, demonstrating the homogeneity of response to HRT. The percentage change of trabecular BMD was negatively correhted with the percentage change of dPyr after HRT(r=-0.45, p=0.01). The variance of the percentage change of dPyr contributed to the percentage change of trabecular BMD by 20%. There was no correlation between the percentage change of total BMD or cortical BMD and the change of ALP, iOC, or dPyr after HRT. CONCLUSIONS: After 1 year of HRT in postmenopausal women, all biochemical bone markers were decreased significantly, whereas only trabecular BMD measured by pQCT was increased significantly. This result suggests that bone markers was more sensitive than BMD to monitor the therapeutic efficacy of HRT. The percentage change of trabecular BMD was correlated with the change of dPyr after HRT only. dPyr might be the most sensitive marker among bone markers tested. Therefore, we can predict the change of BMD after HRT through monitoring the levels of dPyr.
Bone Density* ; Bone Resorption ; Female ; Forearm ; Hormone Replacement Therapy* ; Humans ; Immunoenzyme Techniques ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis

PURPOSE: To compare the success rates, complications and cost effectiveness of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URS) using a Holmium: YAG laser to establish the more effective treatment for upper and mid ureter stones. MATERIALS AND METHODS: This retrospective study included 83 and 286 patients treated with URS and ESWL, respectively, for upper and mid ureter stones. URS was performed with a 7.5Fr semi-rigid ureterorenoscope and Holmium: YAG laser. ESWL was performed with Stonelith V.5 (PCK, Turkey). The stone sizes, success rates, postoperative complications and cost effectiveness were analyzed for each group. RESULTS: The overall success rates of the URS and ESWL were 97.6 and 82.5%, respectively. Success rates of URS were 98.4 and 95.2% when the stones were smaller and larger than 10mm, respectively. In the ESWL group, the success rates after the third session were 86.3 and 65.4% with stones smaller and larger than 10mm, respectively. The complication rates associated with URS and ESWL were 6 and 4.2%, respectively. The average cost of URS was lower than that of ESWL. CONCLISIONS: In our study, URS with Holmium: YAG laser was more efficacious than ESWL. Considering both the success rate and cost effectiveness, URS should remain the recommended first-line treatment for upper and mid ureter stones.
Cost-Benefit Analysis ; Holmium* ; Humans ; Lasers, Solid-State* ; Lithotripsy* ; Postoperative Complications ; Retrospective Studies ; Shock* ; Ureter* ; Ureteroscopy

The nuclear accumulation of p53 protein is known to correspond with mutation of p53 tumor supressor gene. To investigate the relationsbip between clinico-pathologic features and expression of p53 mutations, 65 cases of primary cervical carcinoma were analysed by an immunohistochemieal method using monoclonal antibody of p53. Immunostaining demonstrated varioua nuclear stinings of cancer cells in 48.4% of squamous cell carcinoma(51.9% in large cell carcinoma and 25.0% in small cell carcinomas) and 23.5% of adenocarcinoma(p<0.05) No differences in clinical stage and p53 positivity were found. There was no significant correlation between p53 positive cases and status of recurrence. This data suggests that p53 protein is not correlated with the disease progression and prognosis.
Carcinoma, Large Cell ; Cervix Uteri* ; Disease Progression ; Female ; Genes, p53* ; Prognosis ; Recurrence

Bleomycin is well recognized as an antineoplastic agent. Pulmonary toxicity is the most significant complication of bleomycin administration. The purpose of this study was to determine whether Captopril(an angiotensin converting enzyme inhibitor) can ameliorate pulmonary toxicity induced by bleomycin. Eighty mice were divided into two groups. The control group(n=40) received only bleomycin, and the other experimental group(n=40) received bleomycin in combination with captopril. Bleomycin was administered intraperitoneally to the mice, 8 mg/kg twice a week for 5 weeks. Captopril was administered in the feed at a regimen of 50 mg/kg everyday for 5 weeks. The animals were sacrified at 6 weeks later. Morphometric analysis with light microscopy was performed to the following parameters: the number of total pulmonary: cell count, percentage of consolidation of lung parenchyma and degree of fibrosis of lung parenchyma. The results were as follows; 1) In the control group, the number of total pulmonary cell count were 23.30+/-4.35/10(-8) m2 and the percentage of consolidation was 13.9+/-7.l%(P<0.01). 2) In the experimental group, the number of total pulmonary cell count were 18.39+/-3.48/10(-5) m2 and the percentage of consolidation was 9.8+/-4.8%(P<0.01). 3) There were no typical findings of pulmonary fibrosis in Massons trichrome stain, but early fibrotic change in the portion of severe consolidation and alveolar septal thickening in some control group. In conclusion, this study demonstrated that captopril ameliorates the pulmonary toxicity by bleomycin in the mice.
Animals ; Bleomycin* ; Captopril* ; Cell Count ; Fibrosis ; Lung ; Mice* ; Microscopy ; Peptidyl-Dipeptidase A ; Pulmonary Fibrosis

PURPOSE: To measure the magnetization transfer ratio(MTR) of intracranial tumors and to evaluate the difference of the character and the border of tumors on magnetization transfer image. MATERIALS AND METHODS: We prospectively reviewed magnetization transfer imaging(MTI) findings of intracranial tumors of 13 patients. 1.0T MRI machine was used. T1 weighted image(TRITE=700/14) and T1 weighted magnetization transfer image were obtained. The offset and bandwidth of magnetization transfer pulse were 1000 Hz and 250Hz, respectively. Postcontrast images were also obtained. MTR was measured at lesion area. RESULTS: The mean of normal MTR of white matter and gray matter in 7 normal volunteers were 37% and 29%, respectively. The MTR of each tumor was as follows;metastatic tumors(mean 16.3%), meningioma(mean 27.3%), oligodendroglioma(mean 20.2%), glomus jugulare tumor(mean 17.3%), gliomatosis cerebri(mean 27. 0%). The contrast of lesions were better at magnetization transfer image than at T1 weighted image. CONCLUSION: The MTR of the intracranial tumors is lower than normal tissue. Measurement of MTR at muirpie areas within the tumor can be useful for evaluation of indistinct border of the tumor.
Glomus Jugulare ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Prospective Studies

BACKGROUND: Early escharectomy has been shown to improve the survival rates and the treatment outcomes of major burn patients. However, its exact mechanism, especially in terms of the human immune system, has not been fully elucidated. This observational study, which placed a focus on adhesion molecules, was conducted to assess changes of soluble intercelluar adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin in major burn patients undergoing early eschar excision. METHODS: Seventeen ASA physical status II or III adult major burn patients, admitted for plastic and reconstructive surgery for burn wound care, were initially recruited. When early escharectomy was scheduled, a series of blood samples were obtained four times at 72 and 24 hours preop and 24 and 72 hours postop, respectively. Changing levels of sICAM-1, sVCAM-1, and E-selectin were measured using quantitative sandwich immunoassay techniques. RESULTS: All patients suffered from major burns. Early escharectomy does not appear to have any significant impact on the levels of sICAM-1 and sVCAM-1. On the other hand, E-selectin levels showed a significant decrease after escharectomy. CONCLUSIONS: Major burn injury certainly induces a systemic inflammatory response. Adhesion molecules behave in such a way that escharectomy has a limited immunomodulatory effect in major burns. This is probably related to the timing and extent of surgery, and the complex nature of burn related inflammation.
Adult ; Burns* ; E-Selectin ; Hand ; Humans ; Immune System ; Immunoassay ; Inflammation ; Observational Study ; Plastics ; Survival Rate ; Vascular Cell Adhesion Molecule-1 ; Wounds and Injuries

PURPOSE: This study was conducted to identify predictors of serious poisoning in patients with snake bite based on initial findings. METHODS: We conducted a retrospective study of patients with snake bite who were treated at the emergency department between January 2010 and December 2016. The patients were divided into two groups according to the severity of symptoms based on the traditional snakebite severity grading scale. The mild poisoning group (MP) was classified as those who had a grade I snakebite severity during the hospital stay, and the severe poisoning group (SP) was classified as patients who had grade I at the time of admission, but progressed to grade II-IV during hospitalization. Initial clinical manifestations and laboratory findings of the two groups were compared. RESULTS: Bite to hospital time intervals of SP were longer than those of MP (p=0.034), and the local effect score (LES) was higher in SP (p<0.001). Laboratory analyses revealed that creatine phosphokinase (p=0.044), creatine phosphokinase MB isoenzyme (CK-MB, p=0.011) and serum amylase (p=0.008) were significantly higher in SP. LES, CK-MB and serum amylase were significant prognostic predictors as indicated by univariate logistic regression analysis. Multivariate analysis revealed the following two significant predictors: LES (odds ratio=3.983, p<0.001) and serum amylase (odds ratio=1.020, p=0.017). CONCLUSION: In managing cases of snake bites, clinical manifestations and laboratory findings must be carefully evaluated. LES and serum amylase are predictive factors for severe poisoning, which is especially important to rapid determination of the intensive care of the patient.
Amylases ; Creatine Kinase ; Critical Care ; Emergencies* ; Emergency Service, Hospital* ; Hospitalization ; Humans ; Length of Stay ; Logistic Models ; Multivariate Analysis ; Poisoning ; Retrospective Studies ; Snake Bites* ; Snake Venoms ; Snakes*