Dissecting aortic aneurysm is an emergency condition which requires prompt diagnosis and management. From January 1992 to December 1996, 54 patients were admitted to our department. Patients were categorized according to the Stanford classification of aortic dissection and investigation of the clinical records utilized the retrospective method. Male constituted the majority, according for 38(70.4%) of the total number of patients, whereas females accounted for 16(29.6%). Mean age was 52.1+/-2.2 years old (range:25~82). Clinical findings included chest pain in 46 cases(85.2%), renal failure in 11(20.4%), aortic insufficiency in 10(18.5%) and stroke in 9(16.7%). Predisposing factors were hypertension in 48 cases(88.9%), Marfan's syndrome in 5(9.3%) and diabetes mellitus in 1(1.8%). 21 patients(type A:12, type B:9) underwent surgical treatment. There were three(2 in type A and 1 in type B) deaths in the surgical treatment group and nine(5 in type A and 4 in type B) deaths in the medical treatment group. These results reflect our current policy in the management of dissecting aortic aneurysm.
Aortic Aneurysm* ; Causality ; Chest Pain ; Classification ; Diabetes Mellitus ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hypertension ; Male ; Marfan Syndrome ; Renal Insufficiency ; Retrospective Studies ; Stroke

A statistical observations were made on total 79 In-Patients in the departments of dermatology, Dongsan Presbyterian Hospital, Kyungpook National University and Fatima Hospital, Taegu, Korea during the period from Sept. 1, 1975 to August 31, 1976.
Daegu* ; Dermatology* ; Gyeongsangbuk-do* ; Korea* ; Protestantism*

STUDY OBJECTIVES: To identify the value of symptoms in head trauma patients with alert mental status requiring a head CT scan. METHODS: A retrospective study was performed at an emergency center over 8 months period. Patients(age > or = 7) were enrolled if they presented with a Glasgow Coma Scale score of 15 and underwent head CT after head trauma. The symptoms and signs were recorded in the entry forms prior to head CT The symptoms found in the patients with normal CT were compared with those in abnormal CT showing intracranial injuries. RESULTS: Among the 168 patients, traumatic intracranial abnormality was identified in 34(20.2%) by CT. Skull fracture was idendified in 8(4.8%) in normal CT, 17(10.1%) in abnormal CT group by simple X-ray and CT. In the normal CT group without skull fracture, 65(52.0%) had headache, 61(48.8%) had loss of consciousness( LOC), 43(34.4%) had vomiting, 24(19.2%) had nausea, 7(5.6%) had dizziness. In the abnormal CT group without skull fracture, 14(77.8%) had heacache, 9(50.0%) had LOC, 9(50.0%) had vomiting, 2(11.1%) had nausea, 2(11.1%) had dizziness. The patients with headache were significantly more common in the abnormal CT group. CONCLUSION: A head CT is required in alert head trauma patients with any symptoms and signs of intracranial injuries, especially with headache.
Craniocerebral Trauma* ; Dizziness ; Emergencies ; Glasgow Coma Scale ; Head* ; Headache ; Humans ; Nausea ; Retrospective Studies ; Skull Fractures ; Tomography, X-Ray Computed ; Vomiting

BACKGROUND: Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 years of age. Computed tomography (CT) is an effective technique in the initial emergent evaluation of the abdomen and head following blunt trauma. Most chest indies are not seen on conventional chest radiography, or may be underestimated. But routine use of CT in the initial emergent evaluation of chest trauma is controversial. CT, however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the efficacy of emergent CT in patients with blunt trauma on the chest. METHODS: To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram(CXR) was carried out on 121 patients with blunt trauma on the chest. The interval between CXR and CT was less than 1 hour. RESULTS: Among 121 patients, 42 patients had normal initial chest roentgenogram in whom 19 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (49.3%and 45.1%respectively), whereas 65.7% (44/67) of patients had thoracostomy only by CXR. CONCLUSIONS : Although sometimes abused in patients with chest trauma, CT of the thorax is an effective method of detecting thoracic injuries and provides accurate information regarding their pattern and extent in the initial emergent diagnosis.
Abdomen ; Cause of Death ; Diagnosis ; Emergencies* ; Head ; Humans ; Pleural Effusion ; Pneumothorax ; Radiography ; Retrospective Studies ; Thoracic Injuries ; Thoracostomy ; Thorax* ; Tomography, X-Ray Computed

OBJECTIVE: To evaluate the accuracy of combined transvaginal ultrasound and beta-hCG discriminatory zone for diagnosing intrauterine pregnancy, abortion, and ectopic pregnancy in early abnormal pregnancy. METHODS: Initial ultrasound findings and beta-hCG level were compared with final pregnancy outcome in 164 early pregnant women who visit our hospital with vaginal bleeding or abdominal pain. The sensitivity, specificity, and predictive value by the combination of two diagnostic tools were calculated. Statistic analysis of collected data used x2 of SPSS(9.0). RESULTS: Of 90 women with normal outcome, 64(71.1%) had a gestational sac 5mm, and in 47 cases, the hCG level was above 1,800 mIU/ml. Transvaginal ultrasound was non-diagnostic in 47(28.6%) of 164 women, and especially, 43(53.1%) of 81 cases with beta-hCG levels below 1,800 mIU/ml. The portion of accurate ultrasound diagnosis was significantly higher in women above 1,800 mIU/ml (85.5%, 71 of 83 cases) compard with levels below 1,800 mIU/ml (37.0%, 30 of 81 cases) : P < 0.001; Relative Risk(RR) 2.31; CI 95%. Sensitivity of transvaginal ultrasound diagnosis of intrauterine pregnancy, abortion, and ectopic pregnancy was 90.2%, 79.3%, and 66.7% in women who presented with beta-hCG levels above 1,800 mIU/ml, and 41.0%, 23.5%, and 75% below 1,800 mIU/ml, respectively. And, negative predictive value was 83.9%, 89.7%, and 98.8% in each of intrauterine pregnancy, abortion, and ectopic pregnancy above 1,800 mIU/ml, and 64.6%, 60%, and 97.3% below 1,800 mIU/ml, respectively. CONCLUSIONS: The sensitivity, specificity, and predictive value of transvaginal ultrasound for diagnosing abnormal early pregnancy were poor except cases of ectopic pregnancy when beta-hCG levels were low than discriminatory zone. Ultrasound impressions were well related with beta-hCG levels.
Abdominal Pain ; Diagnosis ; Female ; Gestational Sac ; Humans ; Pregnancy Outcome ; Pregnancy* ; Pregnancy, Ectopic ; Pregnant Women ; Sensitivity and Specificity ; Ultrasonography* ; Uterine Hemorrhage

Localized pulmonary amyloidosis is a rare disease characterized by a deposition of amyloid limited to the lungs. We report a case of primary tracheobronchial amyloidosis which resulted in collapse of left lung and was confirmed by the Congo-red staining.
Amyloid ; Amyloidosis* ; Lung ; Rare Diseases

Localized pulmonary amyloidosis is a rare disease characterized by a deposition of amyloid limited to the lungs. We report a case of primary tracheobronchial amyloidosis which resulted in collapse of left lung and was confirmed by the Congo-red staining.
Amyloid ; Amyloidosis* ; Lung ; Rare Diseases

No abstract available.
Heat-Shock Proteins* ; Hot Temperature*

No abstract available.
Heat-Shock Proteins* ; Hot Temperature*

STUDY DESIGN: Retrospective clinical study. OBJECTIVES: To assess the efficacy of a cortical bone trajectory pedicle screw (CBT-PS) for the treatment of lumbar pyogenic spondylodiscitis. SUMMARY OF LITERATURE REVIEW: Pedicle screws were used for surgical treatment of pyogenic spondylodiscitis to prevent instability and deformity. CTB-PS are typically inserted from the inferomedial to superolateral direction of the pedicle and have yielded satisfactory results in degenerative or osteoporotic spinal disorders. MATERIALS AND METHODS: Eight patients with single segment lumbar pyogenic spondylodiscitis were analyzed. At first, anterior debridements and interbody fusions were perfomed with autogenous strut bone grafts, followed by posterior fixations and fusions with CBT-PS. The lordotic angles of operated levels were checked at the preoperative, postoperative, and final follow-ups. Visual analogue scales (VAS) were checked at the preoperative and final follow-ups. RESULTS: Lesion sites were found at four L3-4, three L4-5, and one L2-3. Follow-ups were held at 26.13±8.23 months. The lordotic angles at preoperative, postoperative, and final follow-ups were 12.13±3.09°, 14.63±3.16°, and 12.75±3.99°, retrospectively. There were significant differences between results from the preoperative-postoperative and postoperative-final follow ups. There was no difference in the preoperative-final follow up. There was a significant difference between the VAS at the preoperative and final follow-ups (8.13±0.83 and 2.38±0.92, retrospectively). Complete bony unions of were observed at the final follow-up in all cases. CONCLUSIONS: The advantages of using a CBT-PS for lumbar pyogenic spondylodiscitis included the ability to minimize damage from the screw for both the posterior structure damage and the operated anterior area to prevent instability and deformity, and to achieve rigid bone union. CBT-PS is a potential surgical option for pyogenic spondylodiscitis.
Clinical Study ; Congenital Abnormalities ; Debridement ; Discitis* ; Follow-Up Studies ; Humans ; Pedicle Screws* ; Retrospective Studies ; Transplants ; Weights and Measures