The diaphragmatic injury results from blunt or penetrating thoracoabdominal trauma. The diagnosis of diaphragmatic injury is difficult in the immediate postinjury period and is often delayed by late visceral herniation. Accurate diagnosis of diaphragmatic injuries is important, because overlooked and delayed diagnosis commonly lead to incarceration and strangulation of bowel. Despite of various diagnostic methods, the diagnosis is often missed and delayed. The development of video-assisted thoracoscopy can make it possible to diagnose the diaphragmatic injury safely and accurately. We experienced two cases of diaphragmatic injuries diagnosed by thoracoscopy. In first case, We found the rupture of the right diaphragm with herniation of liver in a 33-year-old female by thoracoscopic examination. She had visited Emergency Room, complaining of abdominal and pelvic pain and mild dyspnea after traffic accident. Chest X-ray showed elevation of the right hemidiaphragm. Chest CT and ultrasonogram revealed no abnormality except for diaphragmatic elevation. Another case was a 24-year-old female with laceration of diaphragm by stab wound on the left lower chest. With suspicion of diaphragmatic injury, thoracoscopic examination was performed. Both patients were successfully treated by a repair of injured diaphragm by approach via thoracotomy. The postoperative courses were uneventful.
Accidents, Traffic ; Adult ; Delayed Diagnosis ; Diagnosis ; Diaphragm ; Dyspnea ; Emergency Service, Hospital ; Female ; Humans ; Lacerations ; Liver ; Pelvic Pain ; Rupture ; Thoracoscopy* ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Wounds, Stab ; Young Adult

Tracheal stenosis can be caused by various etiologies, such as infectious disease, trauma from previous prolonged incubation, airway surgery, or external blunt trauma, and neoplasm. Recently, the development of emergency and intensive care units leads to the primary cause of airway stenosis using airway devices. The stenotic lesions can be produced at any level between the vocal cord and the site of the tip of the tube. Laryngotracheal stenosis may be due to prolonged endotrachel intubation, especially with large tube, large tracheostomy stoma, too highly placed oacheostomy, erosion by local infection, the prying action of heavyweight equipment that connects the tracheostomy to the ventilator, excessive cuff pressure, or erosion by the tip of the tube. Prevention of tracheal stenosis is of key importance by understanding and attending to these causes. We experienced three cases of tracheal stenosis occurred after use of airway devices. In first and second cases, We performed end-to-end anastomosis artier resection of stenotic segment of the trachea in a 22-year-ol4 female and a 25-year-old male. They ha6 been treated with prolonged endotracheal incubation and emergency tracheostomy, respectively, for a ventilatory support for the respiratory failure after falling down from a height. The stenotic lesions occurred at the cuff site in the first case and at the stomal level in the second case. In third case, We performed one-stage laryngotracheoplastic procedure for subglottic stenosis in a 23-year-old male. He had been treated with emergence tracheostomy which had been placed too high for a ventilators support for the respiratory failure after traffic accident. The stenotic lesion occurred at the stomal level. The postoperative courses were uneventful.
Accidents, Traffic ; Adult ; Communicable Diseases ; Constriction, Pathologic ; Emergencies ; Female ; Humans ; Intensive Care Units ; Intubation ; Male ; Respiratory Insufficiency ; Trachea ; Tracheal Stenosis* ; Tracheostomy ; Ventilators, Mechanical ; Vocal Cords ; Young Adult

No abstract available.
Child* ; Heart Arrest, Induced* ; Humans ; Oxygen*

No abstract available.
Heart Defects, Congenital*

The changes of electroencephalogram(EEG) in patients with dementia are most commonly studied by analyzing power or magnitude in certain traditionally defined frequency bands. However because of the absence of on identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to chaos theory, irregular signals of EEG cal also result from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the correlation dimension. The authors have analyzed EEG epochs from three patients with dementia of Alzheimer type and three matched control subject. The result showed that patients with dementia of Alzheimer type had significantly lower correlation dimension than non-demented controls on 12 channels. Topographic analysis showed that the correlation dimensions were significantly lower in patients with Alzheimer's disease on frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia with dementia of Alzheimer type have a decreased complexity of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating correlation dimension can be a promising tool for detecting changes in the complexity of brain dynamics.
Alzheimer Disease ; Brain ; Dementia* ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics*

No abstract available.
Hematoma*

The pathologic features of acute corrosive esophago-gastritis by ingestion of "Trapunc", a common commercial drain cleansing liquid, is presented. A 37-year-old woman ingested abut 30 ml of Trapunc (3 gm NaOH/100 ml) to commit suicide and received piecemeal esophagectomy and total gastrectomy 9 days after the episode. The esophagus and stomach were extremely friable and necrotic. The most part of the stomach showed acute toxic necrotizing gastritis which was manifested by extensive greenish brown discoloration due to liquefaction necrosis of the mucosa except for a few rugae along the greater curvature. The antrum and distal body revealed severe mucosal detachment and even transmural necrosis. The tissue reaction was basically the same as those of NaOH-induced corrosive esophago-gastritis of acute stage, although it appeared to be severer probably due to sodium hypochlorite, and additive constituent of the ingested cleanser. A unique distribution pattenr of mucosal involvement is discussed.
Female ; Humans

No abstract available.
Barium* ; Enema* ; Intussusception*

An immunohistochemical stain for p53 tumor suppressor gene product was performed in 59 primary lung cancers to study the relation between its expression and type of the tumor, degree of tumor differentiation,clinical stage and smoking. The results were as follows: 1. The expression of mutant p53 protein was noted in 28 of 59 cases(47.5%) of primary lung cancers. The p53 protein was expressed in 21 of 35(60%) squamous cell carcinomas, in 6 of 21(28.6%) adenocarcinomas, and 1 of 1(100%) small cell carcinoma. There was a significant difference in expression of p53 among the different histologic types of lung cancer(p<0.05). 2. The incidence of p53 protein expression did not correlate with the degree of tumor cell differentiation or the clinical stage of lung carcinoma(p>0.05). 3. The incidence of p53 protein expression was higher in smokers(current: 75%, former: 46.2%) than in non-smokers(5.6%) and was increased in direct proportion to the pack years. There was a statistically significant correlation between p53 expression and smoking(p<0.05). The mutation of p53 gene may often be an early event in the development of lung cancer and it is suggested that the smoking known as a risk factor for the development of the lung cancer may be associated with the transformation of p53 tumor suppressor gene into mutant p53 gene or oncogene.
Incidence ; Risk Factors ; Genes, Tumor Suppressor ; Lung Neoplasms

No abstract available.
Diabetes Insipidus* ; Diagnosis*