Symptomatic epidural gas cyst treated with epidural block and percutaneous needle aspiration: A case report / 대한마취과학회지

A 68-year-old woman suffered from lower back and radiating pain on her right buttock and posterior calf. Axial magnetic resonance imaging showed a 7 x 7 mm nodular lesion (T1 and, T2 low signal intensity) at the epidural space between the L5-S1 level and computed tomography revealed it was an epidural gas cyst. The authors performed an epidural block and percutaneous needle aspiration of the epidural gas cyst. The patient showed almost complete resolution of symptoms one year later. The authors suggest that an epidural nerve block with needle aspiration of a gas cyst could be an alternative treatment option for patients with a symptomatic epidural gas cyst before surgery.

Percutaneous aspiration of lumbar zygapophyseal joint synovial cyst under fluoroscopic guidance: A case report / 대한마취과학회지

A 51-year-old man with a 1-month history of lower back pain and radiating pain visited to our pain clinic. A magnetic resonance imaging (MRI) scan demonstrated a cyst like mass at the level of the L4-5 interspace and compression of the thecal sac and the nerve root on the right side. We performed percutaneous needle aspiration of the lumbar zygapophyseal joint synovial cyst under fluoroscopic guidance. The patient felt an immediate relief of symptoms after the aspiration, and had no signs or symptoms of recurrence at the follow-up 6 months later. No demonstrable lesion was found in the 6 months follow-up MRI.

Risk Factors for the Failure of Non-operative Reduction of Intussusceptions / 대한소아소화기영양학회지

PURPOSE: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. METHODS: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. RESULTS: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3+/-17.2 months vs. 18.0+/-15.8 months, p=0.03), longer symptom duration before reduction (33.6+/-29.0 hr vs. 21.5+/-20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). CONCLUSION: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.

An Autopsy Case of New Bronchopulmonary Dysplasia / 소아알레르기및호흡기학회지

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects premature babies and contributes to their increased morbidity and mortality. The classic progressive stage with prominent fibroproliferation that first characterized BPD is generally less striking and the disease is currently predominantly defined by a disruption of distal lung growth, thus it has been termed "new BPD." We present here in a case of 5-month-old girl dying from BPD and pulmonary hypertension. Autopsy findings of the lung showed fewer and larger alveoli with less fibrosis, which is consistent with those of "new BPD."

Elbow Arthroscopy for the Stiff Elbow / 대한정형외과학회잡지

Twenty-five consecutive patients who had contracture of the elbow were treated by arthroscopy. The techniques were removal of loose bodies, removal of osteohyte, anterior capsular release, abrasional arthroplasty and excision of the radial head. The type of arthroscopic procedure was determined by the cause of limiting motion which was intra-articular(intrinsic). The mean preoperative arc of total motion was 92°(21°-113°). Re-examination of the elbows after anaverage follow-up of 19 months showed tbat the mean arc of total motion was 116°(14°-130°). Twenty-three out of twenty-five patients (92%) who were followed up were satisfied with the results of the procedure and exhibited improved ability in carrying out daily activities. In conclusion, arthroscopy of the elbow is an effective diagnostic procedure and is also effective in treating certain intra-articular problems with minimal morbidity and rapid recovery to function.

Genetic Polymorphism of Cytochrome P4501A1 Exon 7 and Glutathione S-Transferase M1 in the Head and Neck Squamous Cell Carcinoma Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An individual difference in susceptibility to chemically induced carcinomas is in part ascribed to genetic differences of metabolic activity of environmental procarcinogens. The cytochrome P450 family (CYPs) and glutathione S-transferase (GST) have been reported to be associated with human cancers related with smoking. The purpose of this study was 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. MATERIALS AND METHOD: The genetic polymorphism of CYP1A1 exon 7 and GSTM1 genes were analysed in a group of 115 healthy Koreans and 107 head and neck squamous cell carcinoma patients using allelic-specific polymerase chain reaction. RESULTS: The genotypes of CYP1A1 exon 7 (Ile/Ile, Ile/Val and Val/Val) were 59.1%, 36.5% and 4.4%, respectively, in the healthy control group, and 57.0%, 31.8% and 11.2%, respectively, in the cancer patients . The distributions of GSTM1 [GSTM1 (-), GSTM1 (+)] in healthy control group were 46.1%, 53.9% respectively, and 53.3%, 46.7%, respectively, in the cancer patients. The relative risk (odds ratio) for combination of CYP1A1 Val/Val and GSTM1 (-) genotype was estimated to be 5.17, taking the risk of combined genotype Ile/Ile and GSTM1 (+) as a reference in cancer patients. CONCLUSION: These results suggest that the genetic polymorphisms of CYP1A1 exon 7 and GSTM1 were an important major factor in determining the individual susceptibility to head and neck squamous cell carcinoma in Koreans.