The author analysed CT findings and long-term outcomes of 67 patients with acute carbon monoxide poisoning. Low density lesions were demonstrated in 44 patients (65.7%). Hemorrhage and calcification also showed with low density lesions in 3 and 2 patients, respectively. The most common findings, seen in 22 patients, was bilaterally symmetrical round low density lesion in the globus pallidus and adjacent area of internal capsule with variable sizes. In 18 patients there were diffuse symmetrical low density lesion in the cerebral white matter, especially around the centrum semiovale, with slight or marked extension. Of 44 patients with CT abnormalities seven patients recovered without disability, fifteen recovered with some disability, eighteen remained in the vegetative state, and four died. The outcome of acute carbon monoxide poisoning depended on the severity of the cerebral white matter change in CT of brain. The size of the bilateral globus pallidus lesion was not heopful to determine the longterm outcome of acute carbon monoxide poisoning.
Brain* ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Globus Pallidus ; Hemorrhage ; Humans ; Internal Capsule ; Persistent Vegetative State

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy

Von Hippel-Lindau disease is a rare disorder which involves multi-organs including cerebellum and retina. Recently we have experienced 2 cases of von Hippel-Lindau disease. The case 1 was a 19-year-old female with chief complaint of severe headache accompanied by vomiting on admission. Computed tomogram of brain showed space occupying lesion in the posterior fossa. She was rapidly deteriorated and diagnosed as brain death on the basis of physical and neurological examination and electroencephalogram. Kidney specimens removed for the transplantation and cerebellum obtained by partial autopsy reveled bilateral renal cell carcinomas and hemangioblastoma, respectively, on the microscopic examination.. The case 2 was a 23-year-old male who visited to our hospital due to headache, gait disturbance, and visual loss in the right eye. The findings of brain CT, vertebral angiography, ophthalmoscope, retinal angiogram, and operation were compatable to cerebello-retinal angiomatosis. With reviewing of some literatures, we present 2 cases of von Hippel-Lindau disease.
Angiography ; Angiomatosis ; Autopsy ; Brain ; Brain Death ; Carcinoma, Renal Cell ; Cerebellum ; Electroencephalography ; Female ; Gait ; Headache ; Hemangioblastoma ; Humans ; Kidney ; Male ; Neurologic Examination ; Ophthalmoscopes ; Retina ; Retinaldehyde ; Vomiting ; von Hippel-Lindau Disease* ; Young Adult

No abstract available.
Exotropia*

PURPOSE: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. METHODS: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I(n=92), Merocel(R) was used for nasal packing, for Group II(n=152) vaseline gauze was used, and Rolled silastic sheet(RSS) with vaseline gauze packing(VGP) was used for Group III(n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. RESULTS: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased(p<0.05) and the postoperative complication(deviation) were decreased comparing to vaseline gauze packing and Merocel(R) packing, however, these differences were not statistically significant(p>0.05). CONCLUSION: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.
Anesthesia, General ; Dimethylpolysiloxanes ; Facial Bones ; Humans ; Nasal Bone ; Nasal Septum ; Nose ; Petrolatum ; Sensation

Nasoalveolar molding (NAM) device is an effective treatment for protruding maxilla in infants with cleft palate. However, only a few studies have investigated the effect of NAM devices on the treatment of protruding maxilla in infants with cleft lip only. We have designed a combination treatment using NAM devices prior to cheiloplasy for cleft lip-only patients with severe anterior protrusion of the premaxilla. Three cleft lip-only infants with 1-cm or more of premaxilla protrusion were included. Definitive cheiloplasty was performed at 6 months of age without any preoperative correction in infant 1. Cheiloplasty was performed in conjunction with the use of NAM device and lip adhesion in infants 2 and 3. Postoperative columella length and anterior-posterior dimension of the protruding premaxilla were compared amongst the infants. We were able to obtain satisfactory postoperative columella length and general nasal appearance.
Cleft Lip* ; Cleft Palate ; Fungi* ; Humans ; Infant ; Lip* ; Maxilla ; Orthodontic Appliances

In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm free flap was transferred to cover this 8x6 cm defect. The arterial anastomosis was successful, but no recipient vein could be identified within the wound bed. Instead, we used a donor venous end for the direct open venous drainage. In order to keep this exposed venous end patent, we applied heparin-soaked gauze dressing to the wound. Also, the vein end was mechanically dilated and irrigated with heparin solution at two hour intervals. Along with fluid management and blood transfusion, this management was continued for the five days after the operation. The flap survived well without any complication. Through this case, we were able to demonstrate that venous congestion can be avoided by drainage of the venous blood through an open vessel without the use of leeches.
Arm ; Bandages ; Blood Transfusion ; Drainage* ; Estrogens, Conjugated (USP)* ; Female ; Free Tissue Flaps ; Heparin ; Humans ; Hyperemia ; Leeches ; Middle Aged ; Pressure Ulcer ; Salvage Therapy ; Scalp ; Tissue Donors ; Veins ; Wounds and Injuries

OBJECTIVE: To evaluate the feasibility of laparoscopic salpingectomy using one-port in tubal pregnancy compared to conventional laparoscopic surgery. METHODS: From June 2008 to June 2011, 63 women were treated with laparoscopic salpingectomy due to tubal pregnancy, which was diagnosed by ultrasonography. These patients were divided into two groups. Of these 63 patients, 32 women were treated with conventional laparoscopic salpingectomy (CLS) in group I, 31 women underwent laparoscopic salpingectomy using one port (OPLS) in group II. In group I, rigid 0degrees or 30degrees, 10 mm laparoscope, rigid instruments were used. In group II, 30degrees, 10 mm laparoscope, rigid or flexible angulated tip instruments were used during the surgery. We reviewed and compared clinical characteristics, clinical outcomes of these patients. RESULTS: Patients in Group I were compatible with the patients in group II in clinical characteristics. Clinical outcomes were not different between two groups in terms of Hemoglobin change (g/dL), hospital stay (days), hemoperitoneum (mL), transfusion. Mean operative time was significantly longer in group II (59.7+/-15.7 min vs. 46.5+/-15.0 min, p=0.001). The mean length of skin incision was obviously shorter in group II; the difference was highly statistically significant (15.5+/-3.0 mm vs 23.5+/-3.0 mm, p<0.001). CONCLUSION: It seems that OPLS is feasible alternative to CLS to treat hemodynamically stable patients without complications. Additionally, this technique also results in better cosmetic outcomes than CLS. Randomized prospective clinical studies with larger scale are necessary in the future to confirm these results.
Cosmetics ; Female ; Hemoglobins ; Hemoperitoneum ; Humans ; Laparoscopes ; Laparoscopy ; Length of Stay ; Operative Time ; Pregnancy ; Pregnancy, Tubal ; Salpingectomy ; Skin

A clinical observation was made on the in-patient of injuries of genito-urinary tract in the Department of Urology, National Medical Center during the period from January, l97l to December, l976. The results were following: 1) Of 984 cases hospitalized, 80 cases were injury of genitourinary tract, giving a ratio of 8.1%. 2) Traffic accidents was the most frequent causes of the injury (SO.O%) and the next was fal1 down, iatrogenic, kick and blow etc. 3) The urethra was involved in the injuries in 29.0%, the bladder in 27.8% the kidney in 23.3%, external genitalia in 13.3%, ureter in 6.6%. 4) Average admission date of each organ was following: the longest organ was urethra (42. 9 days). the next were ureter. bladder. kidney. externa1 genitalia. 5) The age ranged from 5 years to 69 years. the most prevalent age range was 3rd decade (27.5%) and the next was 4th decade (23.8%)
Accidents, Traffic ; Genitalia ; Kidney ; Ureter ; Urethra ; Urinary Bladder ; Urology

BACKGROUND AND OBJECTIVES: Infection of congenital preauricular fistula leads to preauricular abscess. Generally, the treatment for preauricular abscess is focused on subsiding abscess. Although incision & drainage is major point of therapy, the study of bacterial species and antibiotics for preauricular abscess is scant in literature. So, we investigated the most common species that cause preauricular abscess and the choice of proper antibiotics by using the databse available from the last 10 years. SUBJECTS AND METHOD: Our studies, from January, 2000 to December, 2010, included 86 patients in total (all in patients & out patients). We performed a retrospective review of bacterial species and culture analysis of each preauricular abscess. RESULTS: In this study, it was shown that most common pathogens causing preauricular fistula infection were Staphylococcus (27.9%), Enterococcus (9.3%), streptococcus and Klebsiella (5.8%) and Peptostreptococcus (4.6%). And Amoxicillin/cavulanate, Ciprofloxacin, Clindamycin had excellent effects of minimal inhibitory concentration through multiple pathogens. CONCLUSION: The choice of antibiotics for preauricular abscess will be targeted on Staphylococcus, Enterococcus, Streptococcus and anaerobic infection. Amoxicillin/clavulanate or Ciprofloxacin are the most effective antibiotics.
Abscess ; Anti-Bacterial Agents ; Ciprofloxacin ; Clindamycin ; Drainage ; Enterococcus ; Fistula ; Humans ; Klebsiella ; Peptostreptococcus ; Retrospective Studies ; Staphylococcus ; Streptococcus