Clinical Manifestations of Symptomatic Spontaneous Dissection of the Celiac and Superior Mesenteric Arteries

Purpose@#Spontaneous isolated dissection of the celiac artery (SID-CA) and superior mesenteric artery (SID-SMA) are rare vascular diseases with similar presentation, yet comparative studies have not been reported. In this study, we compared their characteristics with the aim of providing insights into their etiology. @*Materials and Methods@#Patients diagnosed with symptomatic SID-CA and SIDSMA between July 2009 and December 2018 were included. Demographics, clinical presentation, radiologic findings, treatment strategies, and outcomes were analyzed. @*Results@#Twenty-one patients with SID-CA and 40 patients with SID-SMA were compared. Demographics and initial abdominal pain characteristics were similar, but pain severity was significantly higher and associated mean fasting time was significantly longer in patients with SID-CA than in those with SID-SMA (fasting time 3.2 vs 2.1 days, P=0.001). Most patients were successfully treated conservatively without recurrent pain or aneurysmal dilatation, but 33.3% patients with SID-CA and 17.5% with SID-SMA required endovascular intervention. More favorable remodeling in terms of dissection regression on follow-up computed tomography was found after stenting, where patients with SID-CA showed better remodeling than those with SID-SMA. The overall median follow-up period was 22-31 months, while for patients with stent insertion, it was 55-77 months, and no stent occlusions were found during this period. @*Conclusion@#Patients with SID-CA presented with severer and longer-duration abdominal pain than those with SID-SMA. Stenting in both groups showed good long-term patency and favorable remodeling, with a higher regression rate for SIDCA. Based on our results, patients with SID-CA may benefit more from active endovascular intervention.

Paraplegia after Open Repair of Suprarenal Abdominal Aortic Aneurysm

Spinal cord ischemia after open repair of abdominal aortic aneurysm (AAA) is an unpredictable and devastating complication. We present a case report of a patient who developed paraplegia 6 hours after open repair of suprarenal AAA. A 74-yearold man presented with asymptomatic 5.5-cm suprarenal AAA, for which he underwent open repair under general anesthesia. The paraplegia was identified 6 hours after the operation. Postoperative magnetic resonance imaging showed T2 signal hyperintensity and swelling of the spinal cord, which were consistent findings with subacute spinal cord infarction. Although intravenous steroid was administered and lumbar cerebral spinal fluid drainage was instituted, his neurological outcome did not improve. He was discharged after vigorous rehabilitation but still has paraplegia and requires wheelchair for ambulation.

Clinical Manifestations of Symptomatic Spontaneous Dissection of the Celiac and Superior Mesenteric Arteries

Purpose@#Spontaneous isolated dissection of the celiac artery (SID-CA) and superior mesenteric artery (SID-SMA) are rare vascular diseases with similar presentation, yet comparative studies have not been reported. In this study, we compared their characteristics with the aim of providing insights into their etiology. @*Materials and Methods@#Patients diagnosed with symptomatic SID-CA and SIDSMA between July 2009 and December 2018 were included. Demographics, clinical presentation, radiologic findings, treatment strategies, and outcomes were analyzed. @*Results@#Twenty-one patients with SID-CA and 40 patients with SID-SMA were compared. Demographics and initial abdominal pain characteristics were similar, but pain severity was significantly higher and associated mean fasting time was significantly longer in patients with SID-CA than in those with SID-SMA (fasting time 3.2 vs 2.1 days, P=0.001). Most patients were successfully treated conservatively without recurrent pain or aneurysmal dilatation, but 33.3% patients with SID-CA and 17.5% with SID-SMA required endovascular intervention. More favorable remodeling in terms of dissection regression on follow-up computed tomography was found after stenting, where patients with SID-CA showed better remodeling than those with SID-SMA. The overall median follow-up period was 22-31 months, while for patients with stent insertion, it was 55-77 months, and no stent occlusions were found during this period. @*Conclusion@#Patients with SID-CA presented with severer and longer-duration abdominal pain than those with SID-SMA. Stenting in both groups showed good long-term patency and favorable remodeling, with a higher regression rate for SIDCA. Based on our results, patients with SID-CA may benefit more from active endovascular intervention.

Paraplegia after Open Repair of Suprarenal Abdominal Aortic Aneurysm

Spinal cord ischemia after open repair of abdominal aortic aneurysm (AAA) is an unpredictable and devastating complication. We present a case report of a patient who developed paraplegia 6 hours after open repair of suprarenal AAA. A 74-yearold man presented with asymptomatic 5.5-cm suprarenal AAA, for which he underwent open repair under general anesthesia. The paraplegia was identified 6 hours after the operation. Postoperative magnetic resonance imaging showed T2 signal hyperintensity and swelling of the spinal cord, which were consistent findings with subacute spinal cord infarction. Although intravenous steroid was administered and lumbar cerebral spinal fluid drainage was instituted, his neurological outcome did not improve. He was discharged after vigorous rehabilitation but still has paraplegia and requires wheelchair for ambulation.

Genetic Susceptibilities of Cytochrome P4501A1 and Glutathione S-transferase M1 to the Risk for Korean Head and Neck Squamous Cell Carcinoma Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Individual genetic susceptibilities to chemical carcinogens have been recognized as a major important host factors in human cancers. The cytochrome P450 family (CYPs) and glutathione-S-transferase (GST) have been reported to be associated with risks to the smoking-related human cancers. The purpose of this study is to determine the frequencies of the genotypes of CYP1A1 and GSTM1 genes in healthy control of Koreans and to identify the high-risk genotypes of these metabolic genes in head and neck cancer patients. MAERIALS AND METHODS: Ninety-six healthy controls and 93 head and neck squamous cell carcinoma patients are analysed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: The distributions of CYP1A1 and GSTM1 in healthy controls according to the MspI site and absence or presence of PCR products were as following: m1/m1:m1/m2:m2/m2=39.6%:47.9%:12.5%, GSTM1 (-):GSTM1 (+)=45%:55%. GSTM1 (-) type and CYP1A1 m2/m2 types were more frequent in cancer patients than healthy controls. Among the combined genotypes of CYP1A1 and GSTM1 genes, the relative risk of CYP1A1 m1/m2, GSTM1 (-) genotypes was 2.13 times of relative odds' ratio in head and neck cancer patients. According to the tumor location, CYP1A1 m2/m2, GSTM1 (-) genotypes of larynx and CYP1A1 m1/m2, GSTM1 (-) genotypes of oral and pharynx were the highest risk groups to cancers in their locations. CONCLUSION: These results suggest that the genetic polymorphisms of CYP1A1 and GSTM1 were an important major factor to determine the individual susceptibility to head and neck cancers in Korean. And these polymorphisms and cancers susceptibile genotypes of CYP1A1 and GSTM1 in Korean population are very unique in comparison with the other ethinics.

Study of nasal resistance by rhinomanometry / 대한이비인후과학회지

No abstract available.

Clinical and Histopathological Observation in 34 Patients with Dermatofibroma / 대한피부과학회지

We observed clinical and microscopic features in 34 patients with dermatofibroma. Of these features, peculiar epidermal changes were observed in six (17.6%) cases. These were keratoacanthosis(1 case), acanthosis nigricans-like(2 cases), pseudoepitheliomatous hyperplasia.(1 case), hair follicle-like basal cell proliferation(1 case) and early basalioma-like(1 case) changes.

A Case of Scrotal Eczema with Calcified Nodules / 대한피부과학회지

Cutaneous leishmaniasis (oriental sore) is usually a self-limited infection of the skin caused by the protozoan Leishmania tropica. The disease is endemic to the Mediterranean, Asia, Africa, and the Middle East. It has been seen in this country among many Korean technical experts and labourers working in the endemic areas of the disease. Our patient had acquired cutaneous leishmaniasis in Saudi Arabia and it had remained active for six months. He had been treated with antimony and metronidazole but failed because of severe side effects. And then we treated the patient witb cryosurgery and the skin lesions were followed by resolution with cosmetically acceptable scar in 4 months. The brief review of literature on the treatment of cutaneous leishmaniasis was undertaken.

A Case of Granular Cell Tumor / 대한피부과학회지

We have experienced a patient (4-year-old female) with a granular cell tumor (GCT), Examination of patients skin showed a bean sized asymtomatic firm nodule on the left baek. Exciaional biopsy and histopathologic examination were perforrned under the impression of angiolipoma. The specirnen revealed a distinctive picture of GCT.

Lower Urinary Tract Injuries Associated with Pelvic Bone Fractures / 대한비뇨기과학회지

A clinical study was made on 108 patients with pelvic bone fractures and 37 patients with lower urinary tract injury in the Capital Armed Forces General Hospital during the period of 3 years from January, 1978 to December, 1980. Emphasis was placed on the mechanism of the bladder and urethral injuries. The results were summarized as follows: 1. The most common cause of pelvic bone fractures was traffic accident (88.0%). 2. 37 cases (34.3%) of the pelvic bone fractures were associated with lower urinary tract injuries. These included 17 ruptures of the urethra, 14 bladder injury and 6 bladder and urethral injuries. 3. Among the total bladder injuries (20 cases), we found 14 extraperitoneal ruptures of the bladder. 4 intraperitoneal ruptures and 2 bladder contusion. 4. Among the 23 urethral injuries, membranous urethral injuries were prominent, 19 membranous urethral ruptures and 4 bulbous urethral ruptures.

A Clinical Observation of Urolithiasis / 대한비뇨기과학회지

A clinical observation was made on 148 patients of urolithiasis who admitted to the Department of Urology, C. A. F. G. H. during the 3 years period from January 1977 to December 1979. The results were as follows: 1. During the period, among the total admission (779 cases) those with urolithiasis were 148 cases (19. 0%), being the most common disease of the urinary tract. 2. The great majority of urinary calculi occurred in patients between the ages of 20 and 39(83. 7%). 3. On seasonal distribution, occurrence was prevalent in summer (27. 0%) 4. Locational distributions of urinary tract stones were 89 cases (60. 1%) in the ureter, 47 cases(31. 8%) it the kidney, 9 cases (6.1%) in the bladder and 3 cases (2.0%) in the urethra. 5. In the upper urinary tract stones, mostly the patients complained of flank pain (78. 7%), gastrointestinal symptoms(47. 0%) and gross hematuria(36. 0%), on the other hand in the lower urinary tract stones the chief complaints were stoppage or weakness of urinary stream, bladder irritability and gross hematuria. 6. On urinalysis in most patients pyuria or/and microscopic hematuria were present, and positive urine culture was obtained in 10.2% of the total pyuria cases (108 cases). The identified organisms were E. coli, Proteus, Klebsiella, Pseudomonas and Staphylococcus. 7. On I. V. P. study of the upper urinary tract stones (113 kidneys), moderate hydronephrotic changes were detected it 47 kidneys (32. 8%). non-visualization in 9 kidneys (6.3%) and W. N. L. in 19 kidneys (13. 3%). 8. Managements included surgical intervention (63. 9%), expectant treatments (25. 2%), ureteral catheterization (9.7%) and transurethral litholapaxy (1.3%).

Horseshoe Kidney with Bilateral Stones: Report of A Case / 대한비뇨기과학회지

Horseshoe kidney is the most common fusion anomaly of kidney development, and causes most clinical symptoms by hrdronephrosis and calculi. We report a case of horseshoe kidney with bilateral stone formation it 21 years old male and a brief review of literature is presented.

A Case of Sparganosis in the Scrotum / 대한비뇨기과학회지

Human Sparganosis was one of the main parasitosis and reported over 65 cases in Korea. Sparganum infestation in the scrotum was reported 14 cases. We experienced a cases of Sparganosis in the scrotum. This patient, 45-year-old Master Sergeant, had an episode of in take of raw snakes and frogs for 25 years during survival and ranger training. Life cycle and route of infection of Sparganum mansoni are briefly discussed with review of literatures.