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1.
Annals of Occupational and Environmental Medicine ; : e21-2019.
Artigo em Inglês | WPRIM | ID: wpr-762557

RESUMO

BACKGROUND: Follicle-stimulating hormone (FSH), a gonadotropin secreted by the pituitary gland, is a representative secondary sex hormone and an important indicator of reproductive function. The effects of heavy metals such as lead, cadmium, and mercury on humans have been studied, but reports on their effects on sex hormone levels are lacking. Therefore, we investigated the relationship between heavy metal exposure and FSH levels in Korean men and postmenopausal women. METHODS: A total of 4,689 adults (2,763 men and 1,926 postmenopausal women aged 50 years or over) who participated in the Second Korean National Environmental Health Survey (2012–2014) were included. We compared differences in serum FSH levels by demographic characteristics using the t-test and analysis of variance. Multiple linear regression analysis was used to determine the relationship between the blood levels of lead and mercury and the urine cadmium level, and serum FSH levels. RESULTS: On multiple linear regression analysis, lead exposure was positively associated with serum FSH concentrations in postmenopausal women (β = 2.929, p = 0.019). However, we found no significant association between serum FSH concentration and blood lead and mercury levels, or urine cadmium level, in men. CONCLUSIONS: This study suggests that lead exposure can affect the FSH level in postmenopausal women. Further studies are needed to evaluate the effects of low-dose long-term exposure to heavy metals on sex hormones.


Assuntos
Adulto , Feminino , Humanos , Masculino , Cádmio , Saúde Ambiental , Hormônio Foliculoestimulante , Hormônios Esteroides Gonadais , Gonadotropinas , Modelos Lineares , Metais Pesados , Hipófise
2.
Kidney Research and Clinical Practice ; : 112-117, 2012.
Artigo em Inglês | WPRIM | ID: wpr-174798

RESUMO

BACKGROUND: Few clinical trials have examined the replacement of steroids with other immunosuppressive drugs as a primary treatment modality for minimal change disease (MCD) in adults. We studied the efficacy of tacrolimus to induce complete remission (CR) in adults with MCD. METHODS: We enrolled 14 adults with MCD and nephrotic-range proteinuria. All patients were treated with oral tacrolimus 0.05mg/kg twice daily and prednisolone 0.5mg/kg/day. CR was defined as a urine protein to creatinine ratio of<0.2g protein/g creatinine (g/g cr). The primary outcome was cumulative percentage of CR during 16 weeks. RESULTS: The mean urine protein to creatinine ratio at enrollment was 10.9g/g cr (range: 4.2-18.1g/g cr). The trough tacrolimus level was maintained at 5.99+/-2.63ng/mL. CR was achieved by 13/14 (92.8%) patients within 8 weeks. The cumulative CR rate was 7.7% (1/14), 64.2% (9/14), 71.3% (10/14), and 92.9% (13/14) at 1 week, 2 weeks, 4 weeks, and 8 weeks, respectively. The one remaining patient achieved CR at 20 weeks after treatment, who was followed up for a further 4 weeks. The mean time to achieve CR in the 14 patients was 4.64+/-5.11 (1-20) weeks. Three cases suffered adverse events of abdominal pain, diarrhea, or new-onset diabetes mellitus. CONCLUSION: Tacrolimus and low-dose prednisolone therapy induced CR rapidly (71.3% by 4 weeks and 100% by 20 weeks) and effectively in adult patients with MCD.


Assuntos
Adulto , Humanos , Dor Abdominal , Distrofias Hereditárias da Córnea , Creatinina , Diarreia , Nefrose Lipoide , Projetos Piloto , Prednisolona , Proteinúria , Esteroides , Tacrolimo
4.
Journal of the Korean Fracture Society ; : 113-117, 2010.
Artigo em Coreano | WPRIM | ID: wpr-123316

RESUMO

High-energy injury, as traffic accident or fall down, can cause fracture of femur head and posterior dislocation of hip joint which is accompanied with ipsilateral acetabulum fracture or femur neck fracture. But the case that femur head fracture and posterior dislocation of the hip joint coincide with ipsilateral intertrochanteric fracture of proximal femur is so uncommon that reports of the case is very rare. We hereby are to report the experienced and treated-cases of femur head fracture and posterior dislocation of the hip joint that is accompanied with ipsilateral intertrochanteric fracture.


Assuntos
Acidentes de Trânsito , Acetábulo , Luxações Articulares , Fraturas do Colo Femoral , Fêmur , Cabeça do Fêmur , Cabeça , Quadril , Luxação do Quadril , Articulação do Quadril
5.
Korean Journal of Nephrology ; : 787-791, 2010.
Artigo em Inglês | WPRIM | ID: wpr-85982

RESUMO

This report examines a patient with pulmonary adenocarcinoma that developed on a previous lesion from microscopic polyangiitis. A 59-year-old woman had been diagnosed with microscopic polyangiitis in October of 1988 based on her clinical symptoms and serological tests, which were positive for anti-neutrophil cytoplasmic antibodies. Her glomerulonephritis had been well controlled with low-dose prednisolone. She presented in October of 2005 with vague chest discomfort and dyspnea on exertion. Physical examination was unremarkable. A non-contrast computed tomography (CT) scan of the chest showed patch ground-glass opacity at the right lower lobe of the lung. Because we did not believe the lesion to be a definite malignancy, we decided to follow up with chest images over a short interval. During the 18 months following the images, the lesion did not change. However, the opacity of the lesion increased slightly over the last two months, and a non-contrast CT scan of the chest was therefore performed. A CT scan showed persistent ground-glass opacity with a slightly solid portion. To diagnose the previous finding and possibly to provide treatment, a right lower lobectomy of the lung via video-assisted thoracoscopic surgery was performed. The pathologic review of the resected lung revealed an adenocarcinoma, stage pT1N0. After one year, fluorodeoxyglucose positron emission tomography was performed, and no evidence of a recurrent malignancy was found.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Adenocarcinoma , Anticorpos Anticitoplasma de Neutrófilos , Dispneia , Seguimentos , Glomerulonefrite , Pulmão , Poliangiite Microscópica , Exame Físico , Tomografia por Emissão de Pósitrons , Prednisolona , Testes Sorológicos , Cirurgia Torácica Vídeoassistida , Tórax
6.
Clinics in Orthopedic Surgery ; : 237-243, 2010.
Artigo em Inglês | WPRIM | ID: wpr-46899

RESUMO

BACKGROUND: Patients with chronic lateral ankle instability also have peroneal tendinopathy often. However, preoperative MRIs of these patients are vague in many cases. Our study was performed to see the reliability of MRI findings of peroneal tendinopathy in patients with chronic lateral ankle instability. METHODS: MRI images for 82 patients who had chronic lateral ankle instability, and had received surgical treatment between March 2006 and November 2009 were compared with impressions from operating rooms. The mean age of patients was 36.4 years (range, 15 to 64 years), 82 ankles were studied, and patients with rheumatoid diseases were excluded from the study. RESULTS: Of the 82 cases, 26 were true positives, 38 true negatives, 13 false positives and 5 false negatives. Of 39 cases of peroneal tendinopathy diagnosed from MRI, 14 had peroneal tendon partial tears, 15 tenosynovitis, 3 dislocations, 17 low-lying muscle bellies, and 6 peroneus quartus muscles. Of 31 cases of peroneal tendinopathy observed in surgery 11 had peroneal tendon partial tears, 4 tenosynovitis, 5 dislocations, 12 low-lying muscle belliess, and 1 peroneus quartus muscle. Sensitivity and specificity of peroneal tendinopathy were 83.9% and 74.5%, respectively. Positive predictive value was 66.7%. Negative predictive value was 88.4%. Accuracy rate was 78.0%. CONCLUSIONS: MRI is a useful diagnostic tool for detecting peroneal tendinopathy in patients with chronic lateral ankle instability. However, MRI is vague in many cases. Therefore, a thorough delicate physical examination and careful observation is needed.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Articulação do Tornozelo/cirurgia , Doença Crônica , Instabilidade Articular/complicações , Imageamento por Ressonância Magnética , Variações Dependentes do Observador , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Tendinopatia/diagnóstico , Traumatismos dos Tendões/complicações
7.
Journal of Korean Medical Science ; : S22-S29, 2009.
Artigo em Inglês | WPRIM | ID: wpr-185363

RESUMO

Oxidative stress plays various roles in the development and progression of IgA nephropathy, while bilirubin is known as a potent antioxidant. We therefore hypothesized that serum bilirubin would be associated with renal prognosis in IgA nephropathy. The study subjects comprised 1,458 adult patients with primary IgA nephropathy in Korea. We grouped patients according to the following quartile levels of bilirubin: 0.8 mg/dL (Q4). The outcome data were obtained from the Korean Registry of end-stage renal disease (ESRD). Eighty patients (5.5%) contracted ESRD during a mean follow-up period of 44.9 months. The ESRD incidences were 10.7% in Q1, 8.2% in Q2, 2.8% in Q3, and 2.8% in Q4 (p<0.001). The relative risk of ESRD compared to that in Q1 was 0.307 (95% confidence interval [CI], 0.126-0.751) in Q3 and 0.315 (95% CI, 0.130-0.765) in Q4. The differences of ESRD incidence were greater in subgroups of males and of patients aged 35 yr or more, with serum albumin 4.0 g/dL or more, with normotension, with eGFR 60 mL/min/1.73 m2 or more, and with proteinuria less then 3+ by dipstick test. In conclusion, higher bilirubin level was negatively associated with ESRD incidence in IgA nephropathy.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bilirrubina/sangue , Progressão da Doença , Taxa de Filtração Glomerular , Glomerulonefrite por IGA/sangue , Hipertensão/complicações , Incidência , Falência Renal Crônica/sangue , Risco , Fatores de Risco , Resultado do Tratamento
8.
Journal of Korean Medical Science ; : S30-S37, 2009.
Artigo em Inglês | WPRIM | ID: wpr-185362

RESUMO

The induction of heme oxygenase-1 (HO-1) ameliorates oxidative stress and inflammatory process, which play important roles in IgA nephropathy. We hypothesized length polymorphism in the promoter region of the HO-1 gene, which is related to the level of gene transcription, is associated with disease severity of IgA nephropathy. The subjects comprised 916 patients with IgA nephropathy and gene data. Renal impairment was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) at diagnosis. The short (S: 28) (GT) repeats in the HO-1 gene was determined. The frequencies of S/S, S/M, M/M, S/L, L/M, and L/L genotypes were 7.2%, 6.9%, 3.1%, 30.8%, 22.7%, and 29.4%, respectively. The baseline characteristics were not different. In the S/S genotypic group, the renal impairment rate was 18.2%, which was lower than 32.2% in the group with M/M, L/M, or L/L genotype. The odds ratio of renal impairment in S/S genotype, compared to that in M/M, L/M, or L/L genotype, was 0.216 (95% confidence interval, 0.060-0.774, p=0.019). The HO-1 gene promoter length polymorphism was related to the renal impairment of IgA nephropathy at diagnosis, which is an important risk factor for mortality in IgA nephropathy patients.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Progressão da Doença , Frequência do Gene , Genótipo , Taxa de Filtração Glomerular , Glomerulonefrite por IGA/genética , Heme Oxigenase-1/genética , Razão de Chances , Polimorfismo Genético , Regiões Promotoras Genéticas , Fatores de Risco
9.
Journal of Korean Medical Science ; : S38-S43, 2009.
Artigo em Inglês | WPRIM | ID: wpr-185361

RESUMO

We determined the relationship between the progression of immunoglobulin A nephropathy (IgAN) and the A1818T polymorphism in intron 2 of Angiotensin II type 2 receptor (AT2R) gene, which might play protective roles in the pathogenesis of IgAN. Patients with biopsy-proven IgAN were recruited from the registry of the Progressive REnal disease and Medical Informatics and gEnomics Research (PREMIER) which was sponsored by the Korean Society of Nephrology. A1818T polymorphism of AT2R gene was analyzed with PCR-RFLP method and the association with the progression of IgAN, which was defined as over 50% increase in baseline serum creatinine level, was analyzed with survival analysis. Among the 480 patients followed for more than 10 months, the group without T allele had significantly higher rates of progression of IgAN than the group with T allele (11.4% vs. 3.9%, p=0.024), although there were no significant differences in the baseline variables such as initial serum creatinine level, the degree of proteinuria, and blood pressure. In the Cox's proportional hazard model, the hazard ratio of disease progression in the patients with T allele was 0.221 (95% confidence interval for Exp(B): 0.052-0.940, p=0.041) compared to that of without T allele. In conclusion, A1818T polymorphism of AT2R gene was associated with the progression of IgAN.


Assuntos
Humanos , Alelos , Creatinina/sangue , Progressão da Doença , Genótipo , Glomerulonefrite por IGA/etnologia , Coreia (Geográfico) , Modelos Genéticos , Modelos Estatísticos , Polimorfismo Genético , Polimorfismo de Fragmento de Restrição , Polimorfismo de Nucleotídeo Único , Receptor Tipo 2 de Angiotensina/genética , Fatores de Tempo , Resultado do Tratamento
10.
Korean Journal of Nephrology ; : 94-101, 2007.
Artigo em Coreano | WPRIM | ID: wpr-184514

RESUMO

PURPOSE: Number of patients expecting for kidney transplantation and transplantations in foreign countries are rapidly increasing. However, there was a lack of information about clinical progresses and outcomes of kidney recipients, underwent cadaveric kidney transplantation in China. METHODS: We included 44 patients (China group), received cadaveric kidney transplantation in China and have been managed at our institute from Jan 2002 to Jan 2006 and 33 patients (domestic group), received cadaveric kidney transplantation at our institute from Feb 2000 to Jan 2006. We performed retrospective study based on medical records. RESULTS: Duration of pre-transplantation renal replacement therapy and of post-transplantation follow up was longer in domestic group (China group vs. domestic group; 89.9 months vs. 24.6 months, 31.9 months vs. 13.9 months) (p<0.05, p<0.05). Final GFR of China group was lower than domestic group (China group vs. domestic group; 54.97+/-18.92 mL/min vs. 64.26+/-18.23 mL/min) (p<0.05). Infection and rejection rates of China group were higher than domestic group (Incidences/ Pantients *Yr./1000; China group vs. domestic group; infection; 2.05 vs. 0.76, rejection; 1.34 vs. 0.51) (p<0.05). There was no difference of patient and graft survival between two groups. CONCLUSION: Korean recipients of Chinese cadaveric kidneys showed lower final GFR and higher rates of infection and rejection. We should be aware of the possible rejections and complications of kidney recipients undergoing cadaveric kidney transplantation in China. Mutual exchange of information about current status of patients, transplantation indications, donor status and treatment protocols is needed between foreign transplantation centers and our medical centers.


Assuntos
Humanos , Povo Asiático , Cadáver , China , Seguimentos , Sobrevivência de Enxerto , Transplante de Rim , Rim , Prontuários Médicos , Terapia de Substituição Renal , Estudos Retrospectivos , Doadores de Tecidos
11.
Korean Journal of Physical Anthropology ; : 301-309, 2007.
Artigo em Coreano | WPRIM | ID: wpr-59244

RESUMO

Previous studies showed that whole body vibration could prevent bone resorption and stimulate new bone formation. The aim of this study is to detect and track effect of whole body vibration for osteoporotic bone of OVX rats. 12 Female rats were used and allocated into 5 group, CON, SHAM, WBV 17, WBV 30 and WBV 45. Rats except SHAM group were ovariectomised to induce osteoporosis. Rats in WBV groups were stimulated whole body vibration at magnitude of 1 mm(peak-peak) and frequency 17 Hz, 30 Hz and 45 Hz, repectively, for 8 weeks (20 min, 5 days/week). The 4th lumbar in rats were scanned at a resolution of 35 micrometer at baseline, before stimulation, and 8 weeks by In-vivo Micro-CT. To detect and track changes of morphological characteristics in lumbar trabecuar bone of rats, structural parameters were measured and calculated from acquiring images. In the results, changes of structural characteristics of WBV group were smaller than those of CON group. Loss of quantity of trabecular bone in WBV 45 was the least. In contrast, that in WBV 17 was the biggest. These results showed that reasonable whole body vibration beneficially affected osteoporotic bones. In addition to, whole body vibration was likely to be substituted partly for drug treatment.


Assuntos
Animais , Feminino , Humanos , Ratos , Reabsorção Óssea , Osteogênese , Osteoporose , Vibração
12.
Korean Journal of Nephrology ; : 941-949, 2006.
Artigo em Coreano | WPRIM | ID: wpr-68009

RESUMO

BACKGROUND:CAVI, Cardio Ankle Vascular Index, has been proposed as an independent marker of arterial stiffness regardless of the blood pressure. We measured the CAVI of hemodynamically unstable patients on maintenance hemodialysis and at the same time measured other pulse pressure-related parameters in order to study their correlations with each other. METHODS:We studied 85 patients undergoing maintenance hemodialysis over 3 months. We categorized patients into 4 subgroups: Diabetes+Hypotension (N= 12), Diabetes+Normal blood pressure (N=16), Non- diabetes+Hypotension (N=15), and Non-diabetes+Normal blood pressure (N=42). Using automatic waveform analyzer, we measured CAVI and pulse pressure- related markers twice, before and after the hemodialysis session, and observed the change. RESULTS:After the dialysis, CAVI did not change despite the decreased mean blood pressure. Yet both brachial and ankle pulse pressure dropped significantly (4.34+/-15.22 mmHg, 11.50+/-20.65 mmHg, p<0.01). PEP (Pre-Ejection Period) on the other hand, remarkably increased (12. 13+/-22.18 msec) while ET (Ejection Time) showed considerable decrease (35.86+/-45.68 msec), and PEP/ ET ratio increased as well. Predialysis CAVI was significantly higher in Diabetes group than in Non-diabetes (11.02+/-2.33 vs. 8.20+/-1.87, p<0.001). However, no significant difference of CAVI was observed between Hypotension and Normal blood pressure groups. Diabetes+Hypotension Group displayed reduction in CAVI after dialysis with marginal significance (0.68+/-1.07, p=0.05) whilst PEP, ET and PEP/ET ratio showed no significant change compared to other groups. CONCLUSION:CAVI, a newly developed marker of arterial stiffness, is expected to be useful in prediction of the cardio-vascular risk and prognosis of patients undergoing hemodialysis.


Assuntos
Humanos , Tornozelo , Pressão Sanguínea , Diálise , Mãos , Hipotensão , Prognóstico , Diálise Renal , Rigidez Vascular
13.
The Journal of the Korean Rheumatism Association ; : 121-125, 2005.
Artigo em Coreano | WPRIM | ID: wpr-178146

RESUMO

Juvenile onset ankylosing spondylitis is a chronic inflammatory arthritis showing oligoarthritis and enthesopathy of the peripheral and axial skeleton. This have been shown to have different clinical presentation and outcome from adult onset ankylosing spondylitis. Takayasu arteritis is a uncommon, chronic inflammatory disease of elastic arteries such as the aorta, its larger branches and the pulmonary artery trunk. Although, it has rare report about association between ankylosing spondylitis and Takayasu arteritis, there was no report of juvenile onset ankylosing spondylitis with Takayasu arteritis. Thereby, we report a patient with Takayasu arteritis who had juvenile onset ankylosing spondylitis in the course of his disease.


Assuntos
Adulto , Humanos , Aorta , Artérias , Artrite , Artéria Pulmonar , Doenças Reumáticas , Esqueleto , Espondilite Anquilosante , Arterite de Takayasu
14.
Korean Journal of Nephrology ; : 706-712, 2002.
Artigo em Coreano | WPRIM | ID: wpr-196183

RESUMO

PURPOSE: Hemorrhagic fever with renal syndrome (HFRS) is an acute febrile disease caused by Hantaan virus. It is believed that various kinds of inflammatory mediators and cytokines might be involved in its pathogenesis. METHODS: We studied the expression of adhesion molecules, including ICAM-1 and VCAM-1 on Hantaan virus-infected human umbilical vein endothelial cells (HUVECs) with ELISA. RESULTS: Hantaan antigen increased gradually 48 hours after virus infection, ICAM-1 increased rapidly 3 hours after virus infection and VCAM-1 increased rapidly 4 hours after infection, a little later than ICAM-1. The patterns of the change of reaction were similar between the different concentrations of virus solution that had been adsorbed on HUVECs, but the expression of ICAM-1 or VCAM-1 was greater when HUVECs were infected with stock virus rather than when infected with tenfold diluted virus. CONCLUSION: We report the quantification using ELISA of ICAM-1 and VCAM-1 expression of HUVECs that have been infected by Hantaan virus. Increase of their expression would play an important role in the pathogenesis of HFRS.


Assuntos
Humanos , Citocinas , Células Endoteliais , Ensaio de Imunoadsorção Enzimática , Vírus Hantaan , Febre Hemorrágica com Síndrome Renal , Células Endoteliais da Veia Umbilical Humana , Molécula 1 de Adesão Intercelular , Molécula 1 de Adesão de Célula Vascular
15.
Sleep Medicine and Psychophysiology ; : 77-88, 1997.
Artigo em Coreano | WPRIM | ID: wpr-45426

RESUMO

The purpose of this study was to investigate the prevalence, primary causes, and management of insomnia newly admitted patients in a university hospital. Subjects consisted of 168 adult patients (95 men and 73 women, 88 medical and 94 surgical patients) newly admitted to Gyeongsang National University Hospital from September 7 through September 27, 1996. Sleep patterns of all subjects in the usual nights before admission(UN), the previous night to admission(PN), the night on admission(ON), and the 5th night after admission(5N) were investigated using the Korean version of the St. Mary's Hospital Sleep Questionaire. In addition, all insomnia patients and their doctors and nurses in charge were interviewed by psychiatric residents. Additionally, their medical records were reviewed. Prevalence of insomnia were 22.6% in the UN, 42.9% in PN, 51.8% in ON, and 43.5% in 5N. The prevalence of insomnia was significantly increased immediately before and after admission. There were no significant differences in the prevalence of insomnia by age and sex. The most ammon primary causes of insomnia were somatic symptoms and psychological factors in PN, somatic syptoms and noise in ON and 5n. Only 17 (10.1%) of insomnia patients took medicstions for insomnia control(analgesics in 15, hypnotics in 2). These results shorred that the prevalence of insomnia was significantly increased on hospitalization due to somatic symptoms, environmental factors, and psychological factors, but nearly none were adequately managed.


Assuntos
Adulto , Feminino , Humanos , Masculino , Hospitalização , Hipnóticos e Sedativos , Prontuários Médicos , Ruído , Prevalência , Psicologia , Distúrbios do Início e da Manutenção do Sono , Nações Unidas
16.
Journal of the Korean Radiological Society ; : 647-651, 1995.
Artigo em Coreano | WPRIM | ID: wpr-161732

RESUMO

PURPOSE: The correlation between sonographic findings and clinical symptoms was investigated in the patients with mesenteric lymphadenitis who had recurrent acute abdomen. MATERIALS AND METHODS: Seventy-eight children with recurrent acute abdominal pain without obvious primary disease were evaluated by sonography. The initial and follow-up sonography were performed in 17 children. The abdomen was divided into 3 areas. The number and size of mesenteric lymph nodes were observed in each zone, and was compared with the clinical findings. RESULTS: In 56(71.8%) of 78 cases, good correlation was seen in the area of the greatest size and number of the lymph nodes in the sonography. Most severe symptom, was seen in the right lumbar area(49 cases) and umbilical area(7 cases). In 17 cases of follow up, 14 cases showed decrease size and number of mesenteric lymph nodes while 2 cases showed increase in size and number of the nodes with aggravated symptoms. CONCLUSIONS: Ultrasonography was useful to detect and localize the enlarged mesenteric lymph nodes. Initial and follow-up sonography showed good correlation between the changes in number and size of the lymph nodes and symptoms.


Assuntos
Criança , Humanos , Abdome , Abdome Agudo , Dor Abdominal , Seguimentos , Linfonodos , Linfadenite Mesentérica , Ultrassonografia
17.
Journal of the Korean Radiological Society ; : 505-510, 1994.
Artigo em Coreano | WPRIM | ID: wpr-21684

RESUMO

PURPOSE: We studied to compare computed tomographic(CT) findings of liver injury with management methods in adults and, moreover, to present the CT basis for the management. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 43 adults diagnosed as liver injury during a 66-month period. Thirty-eight patients were hemodynamically stable. Thirty-two of them were managed conservatively, whereas six managed operatively. Five unstable patients underwent emergency operation. We classified CT findings according to the severity of liver injuries(ie, hematoma, laceration, and periportal tracking) and hemperitoneum, ranging from grade 1 to 5 and from 0 to 3+, respectively. Thus, we compared the CT classificafions with their management(ie, operation rate), especially hemodynamically stable patients. RESULTS: Operation rates of all patients and hemodynamically stable patients were 26% and 16%, respectively. Operation rate at each grade of liver injury was low, especially in hemodynamically stable, despite relatively high operation rate in grade 4. Operation rate of 3+ hemoperitoneum was 100%, including hemodynamically stable patients, in contrast to otherwise low operation rate of others. CONCLUSION: Most liver injury in adults, including grade 4, were managed conservatively, especially hemodynamically stable. Though large amount of hemoperitoneum(ie, 3+) required operation, most hemoperitoeum were managed conservatively. Thus, CT findings of liver injury is helpful in the decision for the management method.


Assuntos
Adulto , Humanos , Classificação , Emergências , Hematoma , Hemoperitônio , Lacerações , Fígado , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
18.
Journal of the Korean Radiological Society ; : 405-410, 1994.
Artigo em Coreano | WPRIM | ID: wpr-25276

RESUMO

PURPOSE: The purpose of this study is to correlate CT findings of the patients with chronic subdural hematoma(SDH) showing a sedimentation level with their clinical and operative findings. MATERIALS AND METHODS: We selected 9 patients who showed a sedimentation level within the hematoma after reviewing the CT findings of 55 patients with SDH. We also analyzed their age, initial symptoms, cause of head injury, latent period, the level of consciousness on admission, CT findings, and operative findings. RESULTS: All of the 9 patients were aged persons(over 52 years). They had a history of acute exacerbation of neurologic symptoms. Five of them had an apparent history of head trauma more than one month before the exacerbation. The CT scans showed unilateral, crescent-shaped subdural fluid collection with a sedimentation level except a case of bilateral SDH and 2 cases of planoconvex-shaped SDH. The interface of the sedimentation level was sharp in 3 cases and indistinct in 6 cases. None had bleeding tendency and the hemoglobin level was slightly decreased in 2 patients. All patients revealed membrane of the hematoma during operation. The upper portion of the sedimentation was liquefied blood and the lower portion was fresh blood clots. We could observe fresh RBC's in the hematoma microscopically. CONCLUSION: A sedimentation level in chronic SDH was operatively proved to represent rebleeding, and was clinically manifested as an acute exacerbation of symptoms.


Assuntos
Humanos , Estado de Consciência , Traumatismos Craniocerebrais , Hematoma , Hematoma Subdural Crônico , Hemorragia , Membranas , Manifestações Neurológicas , Tomografia Computadorizada por Raios X
19.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 1307-1314, 1993.
Artigo em Coreano | WPRIM | ID: wpr-645746

RESUMO

No abstract available.


Assuntos
Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço , Cabeça
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