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Forearm*

The Duodenal diverticulum is the rare cause of the common bile duct obstruction. We experienced a case of the diverticulum of the second portion of duodenum in a 59-year-old male, who complained recurrent attacks of right upper abdominal pain and fever since 16 months prior to admission. Duodenoscopic finding and UGI study revealed a typical duodenal diverticulum just side to the papilla of Vater. Diverticulectomy and cholecystectomy was performed and after than, he has been free front above mentioned symptoms. We reported a case of duodenal diverticulum which caused recurrent common bile duct obstruction.
Abdominal Pain ; Cholecystectomy ; Common Bile Duct* ; Diverticulum* ; Duodenum ; Fever ; Humans ; Male ; Middle Aged

The effect of persistant mild hyperglycemic hyperinsulinemia on the development of the insulin resistance in rats was studied in vivo. Also, the characteristics of the insulin resistance compared with the insulin resistance of STZ diabetic rats. Persistant mild hyperglycemic hyperinsulinemic rat model was produced by ingestion of glucose polymer for 8 days. The glucose disappearance and infusion rate was measured by hyperinsulinemic euglycemic clamp to"Imique at steady state of blood glucose and insulin levels. The clamped level of blood glucose was 100 mg/dl, and the clamped levels of insulin were 70 pU/ml (physiologic condition) and 3000 pU/ml (supramaximal condition). Hepatic glucose producticon rate was calculated using measured data. And the glycogen synthetic capacity of skeletal muscle(soleus) and liver was measured after 2 hours of hyperinsulinemic euglycemic clamp study. The glucose disappearance and glucose infusion rate in glucose polymer group was decreased in the both physiological and supramaximal insulin level compared to the rate of the normal control group. The rate of STZ diabetic group wase lowest at supramaximal insulin level among two another experimental groups. The hepatic glucose production rate of glucose polymer group was decreased compared to normal control but increased in STZ diabetic group.
Animals ; Blood Glucose ; Eating ; Glucans ; Glucose ; Glucose Clamp Technique ; Glycogen ; Hyperinsulinism* ; Insulin Resistance* ; Insulin* ; Liver ; Models, Animal ; Rats*

Several shorter-term alternatives for whole-day ambulatory monitoring of BP using Pressureometer III or standard sphygmomanometer were evaluated in 12 male hypertensive patients. Averages of BP reading at 8 AM once, consecutive 3 readings either by Pressurometer or manual, serial readings during 2-hr intervals of 8-10 AM and 2/4 PM were compared with that of 24-hr ambulatory, non-invasive BP readings. Both systolic and diastolic 2-hr Bp averages in the morning were correlated more strongly with 24-hour averages(r=0.91 and 0.91), than were those of the 3 readings(r=0.88 and 0.66) or single reading(r=0.49 and -0.35) alternatives. In conclusion, the average of serial readings obtained during 2-hr monitoring period from 8 to 10AM is a reliable predictor of 24-hr ambulatory BP and represents it more closely than the conventional single or multiple BP readings.
Blood Pressure Monitoring, Ambulatory* ; Humans ; Male ; Monitoring, Ambulatory ; Reading ; Sphygmomanometers

The influence of normal late pregnancy on insulin action and insulin secretion was studied in the Sprague-Dawley female rats. On 20th day after mating, intravenous glucose tolerance test(IVGTI) was performed in non pregnant control and pregnant rats. As results of IVGTT, glucose disappearance rate was not significantly different in both groups, but secretory response of insulin was significantly(p<0.05) increased in pregnant rat. And the ratio of insulin/ .glucose was significantly higher in pregnant rats, which means existence of insulin resistance. These insulin resistance was overcomed by increased secretory response of pancreatic insulin. Insulinogenic index( A insulin/glucose - 5 min) was highly significantly (r=0.62, p<0.01) correlated with progesterone concentration. Glycogen level and amounts of "C-glucose incorporated into glycogen after IVGTT were significantly(p<0. 05) decreased in the liver, but were not changed significantly in soleus. Glycogen synthase activity of soleus and liver was not differ significantly in the both groups. Insulin binding at varying concentrations of insulin to crude membrane of pregnant liver was not significantly different from control. In conclusions, although these pregnant rats were normal glucose tolerance due to increased secretory response of insulin, that was correlated with progesterone concentration, pregnant rat had insulin resistance. The mechanisms of insulin resistance were not related to defect of insulin binding phase and glycogen synthase, but suggest pre-receptor and/or postreceptor phase.
Animals ; Female ; Glucose ; Glucose Tolerance Test ; Glycogen ; Glycogen Synthase ; Humans ; Insulin Resistance* ; Insulin* ; Liver ; Membranes ; Pregnancy ; Progesterone ; Rats* ; Rats, Sprague-Dawley ; Receptor, Insulin

The muscle glycogen is an important energy source for muscle contraction especially in prolonged exercise. One of the important factors for improvement of physical performance in athletes is the storage of extra-amount of glycogen (supercompensation) in liver and muscles. During 120 minutes treadmill exercise (intensity of exercise was approximatly 80% VO2max), the glycogen concentration was significantly decreased to 36% in liver and 46% in muscles after 60 minutes exercise. At 90 and 120 minutes of exercise, the level of glycogen concentration of liver and muscles statistically were not different from the levels of the 60 minutes exercise. The repletions of glycogen in the liver and muscles in overnight fasted control(C) and 120 minutes treadmill exercise(E) groups during l80minutes after glucose ingestion were investigatect. ln the liver, the concentration of glycogen in C and E groups were markdly increased till 120 minutes after zlucose ingestion, hut the levels of concentration at 180 minutes were decreased comparing to the levels of 120 minutes in both groups. In the muscles, the repletion of glycogen at 60, 120 and 180 minutes of C and E groups were significantly increased comparing to 0 minute of respective groups in the soleus and plantaris muscles. In soleus(SOL), the repletion of glycogen in all of the E groups was significantly higher than that of the respective C groups. However, the repletion of glycogen in all of the E groups of plantaris was revealed higher tendency comparing to respective C groups. Mean repletion rates of glycogen in liver and muscles after glucose ingestion were highest during the first 60 minutes in all groups and the rates of E groups were 2-3 times than those of respective C groups. These results suggest that the glycogen supercompensation in the muscle be provided with decrement of glycogen concentration by exercise, increment of glucose uptake by muscuiar contraction itself and increased insuJin level, and the activation of glycogen synthetase by insulin.
Animals ; Athletes ; Eating* ; Glucose* ; Glycogen Synthase ; Glycogen* ; Humans ; Insulin ; Liver* ; Muscle Contraction ; Muscles ; Rats*

We reviewed 12 patients with iatrogenic urethral injuries in pelvic surgery from May 1993 to May 1996. The patients ranged in age from 27 to 52 years (mean age 47). The diagnosis of urethral injury was made intraoperatively in 8 (66.7%) and postoperatively in 4 cases (33.3%). The ureteral injury patterns in intraoperative diagnosis group at recognition were classified into complete transsection in 5, partial transsection in 2 and ligation in 1 case. The clinical findings of postoperative diagnosis group were ureterocutaneous fistula in 1, ureteral obstruction in 2, and ureterovaginal fistula in 1 case. Presenting symptoms were fever in 1, urine leakage in 2, and flank pain in 1 case. The treatments in intraoperative diagnosis group included ureteroureterostomy in 4, ureteroneocystostomy in 2, and simple closure in 2 closes. In postopeative diagnosis group the treatments were initiated soon after establishment of the diagnosis, and consisted of ureteroneocystostomy with psoas hitch in 2, ureteral stunting with ureteroscope in 1, and ureteroureterostomy in 1 case. The RESULTS were good in 7 cases (87.5%) of intraoperative diagnosis group and 2 cases (50.0%) of postopertive diagnosis group. Of the 3 poor resulted cases 2 were managed with percutaneous nephrostomy, and 1 with ureteral stenting. We concluded that prompt recognition of ureteral injuries at occurrence with immediate repair RESULTS in few complications. Injuries detected postoperatively required more complicated procedures to repair the ureter. Because most of the ureteral injuries occurs by the non-urologic surgeon, especially gynecologist or general surgeon, it is important to let them know the fact that immediate repair of the ureter is important and cooperative relationships between urologist and non-urologist are also important during pelvic surgery.
Diagnosis ; Fever ; Fistula ; Flank Pain ; Humans ; Ligation ; Linear Energy Transfer ; Nephrostomy, Percutaneous ; Stents ; Ureter* ; Ureteral Obstruction ; Ureteroscopes

PURPOSE: We performed the study prospectively to evaluate the advantage of fat suppression MR in the diagnosis of rotator cuff injury. MATERIALS AND METHODS: Ten symptomatic patients were studied with both conventional T2WI and FST2WI using chemical shift technique. Each image was analyzed for the assessnent of injuries, conspicuity of the lesion, the presence of effusion in subacromial bursae and joint space, and presence of humeral head injury. Arthroscopy was done in 4 patients following MRI. RESULTS: We could made presumptive diagnoses on FSMR as identical as on conventional MR in six cases(1 normal, 2 tendinitis, 2 partial thickness tear, 1 full thickness tear), two of them were confirmed by arthroscopic procedures. Two cases of partial thickness tear proved by arthroscopy were detected on FST2WI, whereas they were considered tendinitis on conventional T2Wl. There were another 2 cases who showed tendinitis on FSMR, but normal on conventional T2Wl. They, however, were not confirmed by either arthroscopy or surgical procedure. CONCLUSION: We found the FSMR were superior to conventional T2Wl in the conspicuity of lesions and detection of joint effusion and abnormalities on the humeral head. We think FSMR of the shoulder could have significant diagnostic advantages over the conventional spin-echo MR imaging.
Arthroscopy ; Diagnosis ; Humans ; Humeral Head ; Joints ; Magnetic Resonance Imaging ; Prospective Studies ; Rotator Cuff* ; Shoulder ; Tendinopathy

Acute epiglottitis is an inflammatory process of supraglottic region, which involving the epiglottis andhypopharynx region. This disease can be recognized easily radiologically and virtually all death are preventable.The lateral neck radiograph with soft tissuse technique is of critical value when the diagnosis is in doubt andusually characteristic when compared to the normal. Authors reviewed available lateral neck radiograph of 92 casesamong the 95 cases of clinically confirmed adult epiglottitis during 4 years in wallace Memorial Hospital. Theresults are as follows; 1. Male to female sex ratio was 13:2. 2. The most common age group was 4th decade. 3. Themost common clinical symptoms are sore-throat (87%) and dysphagia(87%). 4. The radiologic findings are swelling ofhypopharynx(92%), vallecular narrowing or obliteration (92%), uvula swelling (33%), narrowing of airway adjacentto epiglottis (17%), swelling of prevertebral soft tissue(8%).
Adult ; Diagnosis ; Epiglottis ; Epiglottitis ; Female ; Humans ; Male ; Neck ; Sex Ratio ; Uvula

Trichoadenoma is a rare cutaneous tumor that was first described by Nikolowski in 1958. It usually occurs as a single tumor on the face and its size varies from 3 to 50mm in diameter. It may arise any time during adult life. This tumor is less mature than trichofolliculoma and more differentiated than trichoepithelioma, and it is considered as a benign tumor with differentiation toward the infundibular portion of the pilosebaceous canal. In this report, we describe a 61-year-old women who developed trichoadenoma on the left shoulder of 3 years duration. The lesion was asymptomatic and had grown slowly. Histopathological findings showed numurous horn cysts with central keratinous material and solid tumor islands reaching to the deep dermis. Immunohistochemical studies showed negative findings for eccrine differentiation.
Adult ; Animals ; Dermis ; Female ; Horns ; Humans ; Islands ; Middle Aged ; Shoulder