Juvenile Polyposis Syndrome is a rare condition that is characterized by the development of multiple polyps in the gastrointestinal tract. It is a hamartomatous disorder that was first described in families in 1964. Both sporadic and familial cases with autosomal dominant inheritance have been reported on. Juvenile Polyposis Syndrome is regarded as a distinct from the solitary juvenile polyps that develop in 2% of children and adolescents, and the latter have no malignant potential. We report here on a case of Juvenile Polyposis Syndrome in an 18 year old male along with a review of the relevant literature. The patient had various numbers of different sized pedunculated polyps that were observed throughout the entire gastrointestinal tract.
Adolescent ; Child ; Gastrointestinal Tract ; Humans ; Intestinal Polyposis ; Male ; Neoplastic Syndromes, Hereditary ; Polyps ; Wills

BACKGROUND: This study was to investigate success rate, immediate complications, and risk factors of failure and immediate complications of subclavian venous catheterization (SVC). METHODS: All patients requiring SVC, older than 18 years of age and without past history of operation, scar, and radiation therapy at puncture site were included. After general or regional anesthesia was induced, SVC was done via infraclavicular approach. Patient's age, gender, weight, height, the rank of operator, anesthesia method, the side of venipuncture, the number of puncture attempts, arterial puncture, and success or failure were recorded. After the operation, a chest radiography was evaluated to check the occurrence of pneumothorax, hemothorax and the location of the catheter tip. RESULTS: SVC was performed in 1092 patients. Thirty-nine patients were excluded because a chest radiography was not checked. Successful catheterization without immediate complications was performed in 939 patients (89.2%). Failure occurred in 65 patients (6.2%). Arterial puncture, pneumothorax and misplacement of the catheter tip were reported in 26 (2.5%), 5 (0.5%), and 35 (3.3%) patients, respectively. Misplacement of the catheter tip were observed in 26 patients (2.5%) at ipsilateral internal jugular vein, and in 9 (0.8%) at contralateral subclavian vein. Failure and immediate complications of SVC were associated with the number of puncture attempts. The number of puncture attempts were associated with age, puncture side and anesthetic method. CONCLUSIONS: Failure and immediate complications of SVC occurred in 10.8% of cases and were associated with the number of puncture attempts.
Anesthesia ; Anesthesia, Conduction ; Catheterization ; Catheterization, Central Venous ; Catheters ; Cicatrix ; Hemothorax ; Humans ; Jugular Veins ; Phlebotomy ; Pneumothorax ; Punctures ; Risk Factors ; Subclavian Vein ; Thorax

Circumferential resection by performing endoscopic submucosal dissection (ESD) in the antrum can cause pyloric stenosis. Treatment with balloon dilation usually requires repeated sessions and this may cause bleeding or perforation. There are several studies regarding the treatment of benign pyloric stenosis by the temporary placement of self-expandable metallic stent (SEMS), but these studies did not include any case of pyloric stenosis caused by ESD for treating early gastric cancer (EGC). We experience a case of a man who had EGC encircling the antrum. After ESD, pyloric stenosis occurred and so a SEMS was applied. Eight weeks later, the stent was removed without complications. Stent insertion for benign pyloric stenosis has not been accepted as a standard therapeutic modality. However, continuous dilation of a stenotic lesion can be expected without major complications, except for migration. Therefore, temporary stent insertion can be considered as an alternative treatment option for benign pyloric stenosis. Further study on the long term outcome of this procedure is needed.
Hemorrhage ; Pyloric Stenosis ; Stents ; Stomach Neoplasms

PURPOSE: Leptin may play an important role in the pathophysiology of osteoarthritis. This study investigated whether leptin concentration in synovial fluid is related to the radiographic severity of osteoarthritis. MATERIALS AND METHODS: Synovial fluids were obtained from 29 osteoarthritis patients who underwent knee surgery and 10 who had no abnormality on articular cartilage during arthoscopic examination. The progression of osteoarthritis was classified by Kellgren Lawrence grading scale. The concentrations of leptin was measured with commercial enzyme-linked immnosorbent assay kits. RESULTS: A significant increase in synovial fluid concentrations was observed in osteoarthritis patients (6.7+/-4.1 ng/ml) compared to the control (2.4+/-1.3 ng/ml). Leptin levels were increased with advancing osteoarthritis stage, resulting in the highest level in stage IV patients(10.7+/-4.9 ng/ml; range 4.7-15.8) compared to that of stage I patients (4.0+/-2.0 ng/ml; range 1.2-7.3). In osteoarthritis patients, age showed a significant correlation with leptin concentrations. CONCLUSION: This study shows that synovial fluid leptin concentrations were closely related to the radiographic severity of osteoarthritis, and suggests that the age of patient may influence synovial fluid leptin concentrations during osteoarthritis progression.
Biomarkers ; Cartilage, Articular ; Humans ; Knee ; Leptin ; Osteoarthritis ; Synovial Fluid

To evaluate the hemodynamic changes and the predictive factors of the clinical outcome in pediatric patients with moyamoya disease, we analyzed pre/post basal/acetazolamide stress brain perfusion SPECT with automated volume of interest (VOIs) method. METHODS: Total fifty six (M:F=33:24, age 6.7+/-3.2 years) pediatric patients with moyamoya disease, who underwent basal/acetazolamide stress brain perfusion SPECT within 6 before and after revascularization surgery (encephalo-duro-arterio-synangiosis (EDAS) with frontal encephalo-galeo-synangiosis (EGS) and EDAS only followed on contralateral hemisphere), and followed-up more than 6 months after post-operative SPECT, were included. A mean follow-up period after post-operative SPECT was 33+/-21 months. Each patient's SPECT image was spatially normalized to Korean template with the SPM2. For the regional count normalization, the count of pons was used as a reference region. The basal/acetazolamide-stressed cerebral blood flow (CBF), the cerebral vascular reserve index (CVRI), and the extent of area with significantly decreased basal/acetazolamide-stressed rCBF than age-matched normal control were evaluated on both medial frontal, frontal, parietal, occipital lobes, and whole brain in each patient's images. The post-operative clinical outcome was assigned as good, poor according to the presence of transient ischemic attacks and/or fixed neurological deficits by pediatric neurosurgeon. RESULTS: In a paired t-test, basal/acetazolamide-stressed rCBF and the CVRI were significantly improved after revascularization (p<0.05). The significant difference in the pre-operative basal/acetazolamide-stressed rCBF and the CVRI between the hemispheres where EDAS with frontal EGS was performed and their contralateral counterparts where EDAS only was done disappeared after operation (p<0.05). In an independent student t-test, the pre-operative basal rCBF in the medial frontal gyrus, the post-operative CVRI in the frontal lobe and the parietal lobe of the hemispheres with EDAS and frontal EGS, the post-operative CVRI, and deltaCVRI showed a significant difference between patients with a good and poor clinical outcome (p<0.05). In a multivariate logistic regression analysis, the deltaCVRI and the post-operative CVRI of medial frontal gyrus on the hemispheres where EDAS with frontal EGS was performed were the significant predictive factors for the clinical outcome (p=0.002, p=0.015). CONCLUSION: With probabilistic map, we could objectively evaluate pre/post-operative hemodynamic changes of pediatric patients with moyamoya disease. Specifically the post-operative CVRI and the post-operative CVRI of medial frontal gyrus where EDAS with frontal EGS was done were the significant predictive factors for further clinical outcomes.
Acetazolamide ; Brain ; Follow-Up Studies ; Frontal Lobe ; Hemodynamics ; Humans ; Ischemic Attack, Transient ; Logistic Models ; Moyamoya Disease ; Occipital Lobe ; Parietal Lobe ; Perfusion ; Pons ; Tomography, Emission-Computed, Single-Photon

Our aim was to apply DNA chip technology as a diagnostic tool in infertility research and clinics. Six loci, including a sex-determining region on the Y chromosome and five sequence-tagged sites in azoospermia-factor regions were investigated in infertile male patients. Our method produced a sensitive signal, which showed the presence or absence of the STS regions on the Y chromosome. The results from 93 patients with non- obstructive azoospermia, oligoathenoteratozoospermia, or oligozoospermia were identical when analyzed with either the DNA chip technique or conventional PCR-gel electrophoresis. We have demonstrated its application in the molecular diagnosis of male infertility. This system provides an economic and high-throughput method for detecting the deletion of genomic DNA sequences of large groups of infertile patients, and a completely new approach to male infertility screening. The application of DNA chip technology to identify Yq deletions can also facilitate our understanding of male infertility.
Chromosome Deletion ; Chromosomes, Human, Y/*genetics ; DNA Mutational Analysis/methods ; Electrophoresis, Agar Gel ; Female ; Humans ; Infertility, Male/*diagnosis/*genetics ; Male ; Oligonucleotide Array Sequence Analysis/*methods ; Polymerase Chain Reaction ; Predictive Value of Tests ; Research Support, Non-U.S. Gov't ; Seminal Plasma Proteins/*genetics ; Sensitivity and Specificity ; Sequence Tagged Sites ; *Sex Chromosome Aberrations

PURPOSE: Re-188-Hydroxyethylidene diphosphonate (HEDP) is a new cost-effective agent for systemic radioisotope therapy of metastatic bone pain. We investigated the influence of carrier for labeling and biodistribution of Re-188-HEDP using HEDP kit with or without carrier (KReO4). MATERALS AND METHODS: The kits (HEDP 15 mg, gentisic acid 4 mg and SnCl2.2H2O 4.5 mg) with or without carrier (KReO4 0.1 mg) were labeled with Re-188 solution, made available from an in-house generator by boiling for 15 min. We compared the labeling efficiency and stability of carrier-added and carrier-free preparations of Re-188-HEDP. Biodistribution and imaging studies of each preparation were performed in ICR mice (1.85~3.7 MBq/0.1 ml) and SD rats (74.1~85.2 MBq/0.5 ml). RESULTS: The carrier-added preparation showed high labeling efficiency (95% at pH 5) and high stability in serum (88%, 3 hr). However, the carrier-free preparation showed low labeling efficiency (59% at pH 5) and low stability (43%, 3 hr). The carrier-added preparation showed high uptake in bone and low uptake in stomach and kidneys. However, the carrier-free preparation showed lower uptake in bone and higher uptake in both stomach and kidneys, which is supposed to be due to released perrhenate. The carrier-added preparation also showed better images with higher skeletal accumulation, lower uptake in other organs and lower soft tissue uptake than the carrier-free preparation. CONCLUSION: The results of these studies clearly demonstrate that addition of carrier perrhenate is required for high labeling efficiency, stability, bone uptake and good image quality of Re-188-HEDP.
Animals ; Etidronic Acid ; Hydrogen-Ion Concentration ; Kidney ; Mice ; Mice, Inbred ICR ; Rats ; Stomach

Spinal epidural hematoma is a rare complication of epidural anesthesia and most commonly associated with intraoperative or postoperative anticoagulant administration. We describe the case of an acute thoracolumbar epidural hematoma at the T12-L4 level complicated by cauda equina syndrome, which occurred after placement of spinal epidural catheter for anesthesia and anticoagulant therapy for acute myocardial infarction developed postoperatively. In our experience, the spinal epidural catheterization and anticoagulant therapy may potentially increase the risk of epidural hematoma formation.
Anesthesia ; Anesthesia, Epidural* ; Catheterization ; Catheters ; Cauda Equina* ; Hematoma* ; Hematoma, Epidural, Spinal ; Heparin* ; Myocardial Infarction ; Polyradiculopathy*

Seidel nail provides more advantages for treatment of humeral shaft fracture than other treatment modalities. It enables patients to get high bone union rate, makes surgical technigne less invasive, and allows early mobilization mobilization so that the patients is subjected to more comfortable treatment. But, Seidel nail is apt to injure the rotator cuff and has relatively weak holding power of distal fragment of fracture so that it may result in distraction and rotatory instability, and make nonunion and impaired shoulder function. Thus, in order to the functional and radiological results, complications and technical problems, we evaluated the efficacy of Seidel nail in treatment of 20 cases of hurneral shaft fractures from March l994 to March 1996, retrospectively. The results were as follows. 1. 18 cases(90%) achieved radiological union. 2. The time of union was 12.5 weeks in average. 3. 17 cases achieved satisfactory results according to Neers functional score. 4. The complications included proximal protrusion of nail from the entry site(10%), fracture of greater tuberosity of proximal humerus(5%), loosening of distal spreading screw(10%), and nonunion( l 0%). In conclusion, Seidel nailing is one of good treatment modalities for humeral shaft fracture, but skillful operative technique is needed to obtain the satisfactory functional result. And also, it is necessory to modify the distal locking system of Seidel nail to reinforce the rotational stahility of the fracture site.
Early Ambulation ; Humans ; Humerus ; Retrospective Studies ; Rotator Cuff ; Shoulder

Open tibial pilon fractures present extensive soft tissue disruption and common complications such as sepsis or skin slough, and deserve special cosideration in addition to the challenging reconstructive problems. The purpose of this study is to assess the effectiveness of limited internal fixation and external fixation for the treatment of the open tibial pilon fractures, and to introduce some idea in Ilizarov device use. We reviewed 27 open tibial pilon fractures treated with limited internal fixation and external fixation from Feb. 1992 to Mar. 1996(follow-up range, 1 to 5 years). Fracture classification(Ruedi and Allgower) was type I in 5, type II in 10 and type III in 12, open wound type(Gustilo-Anderson) was II in 8, IIIA in 17 and IIIB in two. Secondary procedures were 16 soft tissue procedures, 13 bone graftings and 2 limb lengthening. Mean time for removal of the external fixators was 3.5 months(range, 6 to 21 weeks), and clinical union averaged 4.3 months(range, 12 to 25 weeks). At the time of last follow-up, radiologic grading(Burwell and Charnley) showed 13 good(48%), 10 fair(37%) and 4 poor results(15%). Objective functional grading(Ovadia and Beals) showed 5 excellent(19%), 15 good(56%), 6 fair(22%) and 1 poor(4%), and subjective grading 2 excellent(7%), 16 good(59%), 7 fair(26%) and 2 poor(7%). Common complications included 10 wound sepsis(37%), 6 posttraumatic arthritis(22%) and 5 malunions(19%). In conclusion, we cosider limited internal fixation and external fixation is an effective treatment modality till bone union for open tibial pilon fractures, and Ilizarov method using tension wires crossed only through the fracture fragments can provide a sufficient early and late stability.
External Fixators ; Extremities ; Follow-Up Studies ; Ilizarov Technique ; Sepsis ; Skin ; Tibia ; Transplants ; Wounds and Injuries