We have experienced two cases of Wernicke's encephalopathy associated with hypere-mesis gravidarum. Delay in it's diagnosis caused a protracted illness and persisting neurol-ogic deficits. Because of its association with chronic alcoholism, possibility of Wernicke's encephalopathy may not be considered in early stage of disease. The clinical feature, the principle of management and the prevention of Wernicke's encephalopathy are discussed.
Alcoholism ; Diagnosis ; Female ; Hyperemesis Gravidarum* ; Pregnancy ; Wernicke Encephalopathy*

The serous papillary cystadenoma of low malignant potential in the paratesticular tissue is a tumor characterized by its resemblance to ovarian serous papillary tumor of low malignant potential. Several possible origins have been proposed but it is thought to originate from the Mullerian-type epithelium just like ovarian serous tumor of low grade malignancy. Because of the rarity of this tumor, the natural history and treatment have not been established. Herein we report on a serous papillary cystadenoma arising in the paratesticular tissue of a 12 year old . To our knowledge, this is the first reported case in the Korean literature. The size of this cystic tumor in this patient was 0.9x0.9x0.8 cm and had a sponge-like cut surface. The papillary structure was lined by both ciliated and nonciliated secretory cells, the same cellular structure as the salpinx. Areas with just a few mitoses and stratification of epithelial cells were noted, but invasion into the paratesticular tissue was absent, suggesting borderline malignancy. He is doing well after 5 months follow up. Prognosis of this scrotal tumor is thought to be better than the ovarian tumor of similar histology due to a better possibility of early detection.

We had experienced 2 cases of acute subdural hematoma due to vitaimin K(vit. K) deficiency. They were 44-and 42-day-old. After the adminstration of vit.K1, prolonged prothrombin time(PT) and activated partial thromboplastin time(APTT) were corrected, so the surgical treatment ws performed. We supposed the predisposing factors were breast feeding and unknown hepatic pathology. No complication remained to one infant but the other multiple cerebral infarctions. The etiology, pathogenesis, diagnosis, prevention are discussed. We insist on neonatal administration of vit. K1 for the prevention of bleeding tendency. If intracranial hemorrhage develops, we must keep in mind that the early neurosurgical intervention may be needed.
Breast Feeding ; Causality ; Cerebral Infarction ; Diagnosis ; Hematoma, Subdural, Acute* ; Hemorrhage ; Humans ; Infant* ; Intracranial Hemorrhages ; Partial Thromboplastin Time ; Pathology ; Prothrombin ; Prothrombin Time ; Thromboplastin ; Vitamin K Deficiency ; Vitamins*

ICAM-l(Intercellular adhesion molecule-1) is an important early marker of immune activation and response. ICAM-1 is expressed on varous cell types and observed in a variety of diseases, including patients with asthma, melanoma, prostatic cancer, ovarian and colon cancer. Some authors demonstrated the expression of ICAM-1 protein in high-grade intraepithelial squamous neoplasia of cervix by immunohistochemistry and suggested that the expression was related to human papillomavirus infection. The aim of this study was to determine the serum levels of soluble intercellular adhesion molecule-1(sICAM-1) in patients with squamous cell carcinoma of the cervix, Serum levels of sICAM-1 were measured by enzyme-linked immunosorbent assay(ELISA), We evaluate invasive squamous cell carcinoma of the cervix (40), carcinoma in situ (16) and control (15) patients. Serum levels of sICAM-1 in healthy volunteers, in parients with carcinoma in situ and invasive cervical cancer were 150.1+/-41.3, 182.7+/-105.9, 189.8+/-60.0 ng/ml, respectively. Although the serum levels of sICAM-1 in patients with carcinoma in situ did not increase, serum levels of ICAM-1 in patients with invasive cervical cancer were significantly increased (control vs invasive cervical cancer, p < 0,05). From the above results, sICAM-1 is shed from the cancerous tissue in patients with squamous cell carcinoma of the cervix.
Asthma ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri ; Colonic Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Female ; Healthy Volunteers ; Humans ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Melanoma ; Papillomavirus Infections ; Prostatic Neoplasms ; Uterine Cervical Neoplasms*

No abstract available.
Diabetes Mellitus* ; Hearing* ; Humans

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin* ; Rabbits* ; Wound Healing* ; Wounds and Injuries*

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin* ; Rabbits* ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: Few studies have investigated magnetic resonance (MR) characteristics of traumatic posterosuperior rotator cuff tears involving the supraspinatus and infraspinatus. We hypothesized that traumatic rotator cuff tears may have MR characteristics distinguishable from those of non-traumatic tears. METHODS: Preoperative MR arthrography and intraoperative tear size measurements were compared in 302 patients who underwent MR arthrography and subsequent arthroscopic rotator cuff repairs for traumatic (group T, 61 patients) or non-traumatic (group NT, 241 patients) tears. The inclusion criteria for both groups were posterosuperior full-thickness rotator cuff tear and age between 40 and 60 years. For group T, traumas were limited to accidental falls or slips, or sports injuries, motor vehicle accidents; injuries were associated with acute onset of pain followed by functional shoulder impairment; and time between injury and magnetic resonance imaging (MRI) was 6 weeks or less. RESULTS: In group T, 72.1% of shoulders (44 patients) had tendon tears with blunt edges while 27.9% of shoulders (17 patients) had tears with tapering edges. In contrast, 21.2% of patients in group NT (51 patients) had blunt-edge tears, while 78.8% (190 patients) of tears had tapering edges. These results were statistically significant (p<0.001) and estimated odds ratio was 9.6. The size of tear did not vary significantly between groups. CONCLUSIONS: We found no exclusive MR characteristic to define traumatic tears. However, oblique coronal MRI of traumatic tears showed a significant tendency for abrupt and rough torn tendon edges and relatively consistent tendon thicknesses (without lateral tapering) compared to non-traumatic cuff tears.
Accidental Falls ; Arthrography* ; Arthroscopy ; Athletic Injuries ; Humans ; Magnetic Resonance Imaging ; Motor Vehicles ; Odds Ratio ; Rotator Cuff* ; Shoulder ; Tears* ; Tendons

Intramedullary nailing has become the most popular fixation method in the treatment of the shaft fractures of long bones especially of tibia and femur because it affords most rigid fixation of fracture via closed method which makes early rehabilitation possible. Nowadays intramedullary nailing of the humeral shaft is being performed by many surgeons with good results. Newer implants and better surgical techniques are being developed, which suggests application of this method can be widened. Purpose of this study was aimed to define whether intramedullary nailing could be an effective method or not in the treatment of humeral shaft fractures by documenting the practical points in the application of intramedullary nailing of humerus, effectiveness in fracture healing, any complications or obstacles. We managed thirteen humeral shaft fractures with closed locked intramedullary nailing with distal fanning devices(Seidel nail) from March 1993 to April 1994. Average follow-up period was 14 months(12 months-18 months). The results were as follows; 1, Union of the fracture was obtained at average 12.9 weeks(9 weeks-20 weeks) postoperatively except one case of nonunion, in which case, union was obtained at postoperative 10 months finally. 2. Among the 13 cases, painful limitation of shoulder motion remained in 6 cases. This complication was more common in the cases with protruded proximal end of the nail. Above results suggest that locked intramedullary nailing seemed to be one of the useful method in the treatment of the humeral shaft fractures. However, destruction and irritation of shoulder by the nail was found to be a grave problem, and we found that further investigations should solve this problem.
Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fracture Healing ; Humerus ; Methods ; Rehabilitation ; Shoulder ; Surgeons ; Tibia

A case with a true posterior communicating artery aneurysm is reported, who had been managed by early surgical neck clipping and post-operative intensive cares for numerous complications. The small saccular aneurysm was located at the proximal posterior communicating artery and directed superiorly. A lacunar infarct developed at right anterior thalamus post-operatively, which had resulted probably from the occlusion of a fine posterior communicating arterial perforator. Aneurysms of the posterior communicating artery itself are saccular or fusiform. Great cares should be taken in surgical aneurysmal neck clipping to avoid any injury of the perforators and the oculomotor nerve;trapping of the posterior communicating artery to treat fusiform or wide-necked aneurysms will result in unpredictable outcomes.
Aneurysm ; Arteries ; Intracranial Aneurysm* ; Neck ; Stroke, Lacunar ; Thalamus