• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.125-129
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• 2016

Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.143-147
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• 2010

Purpose: Nostril stenosis is an uncommon deformity that develops as a consequence of smallpox, chickenpox, tuberculosis, syphilis, congenital malformations etc. There have been several studies on the surgical techniques to treat it. However, it is difficult to maintain the result for a long time. The goal of this study is to evaluate the use of Wplasty, perialar flap as an operative techniques and expansion exercise using Foley catheter as a method to keep the patency of nostril. Methods: This is a retrospective review of the senior surgeon's (Y.L.) patients who underwent W-plasty and a perialar flap. Patients treated from 2005 to 2009 were reviewed and the postoperative results were evaluated. Average patient age was 24 years, ranged from 1 to 61 years, average follow-up period was 27.5 months, ranged from 3 to 77 months. The mild deformity was released with an incision and expansion by the ballooning of a Foley catheter and corrected by W-plasty only. However, a severe deformity required an additional procedure including perialar flap transposition. During the postoperative period, the patients maintained a nasal stent and exercise using a Foley catheter to prevent recurrence. Results: Five cases of nostril stenosis in four patients were treated using this technique. One case was corrected with W-plasty only, but four cases were more severe and were corrected with W-plasty and a perialar flap. There were no perioperative complications. The patients were satisfied with the results and retained a good shape during the follow-up periods. Conclusion: Nostril stenosis can be corrected with W-plasty and a perialar flap. A perialar flap is added if W-plasty is unable to correct the deformity. A postoperative nasal stent and expansion with a Foley catheter can help in preventing recurrences.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.1
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• pp.34-38
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• 2004

We report an unusual case of osteoblastoma in the distal fibula in a 32-year-old man. Radiographs showed a ballooning lesion with internal trabeculation. MR images demonstrated a lobulated expanding lesion of central heterogeneous low signal intensity with enhancement. Curettage specimen was composed of abundant thick, pink osteoid without mineralization. The osteoid seams were lined by plump osteoblasts and a few giant cells. Focally, a fine unmineralized lace-like osteoid was seen.

• Journal of Korean Neurosurgical Society
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• v.57 no.5
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• pp.367-370
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• 2015

Bone cement augmentation procedures have been getting more position as a minimally invasive surgical option for osteoporotic spinal fractures. However, complications related to these procedures have been increasingly reported. We describe a case of bone cement dislodgement following cement augmentation procedure for osteoporotic spinal fracture by reviewing the patient's medical records, imaging results and related literatures. A 73-year-old woman suffering back and buttock pain following a fall from level ground was diagnosed as an osteoporotic fracture of the 11th thoracic spine. Percutaneous kyphoplasty was performed for this lesion. Six weeks later, the patient complained of a recurrence of back and buttock pain. Radiologic images revealed superior dislodgement of bone cement through the 11th thoracic superior endplate with destruction of the lower part of the 10th thoracic spine. Staged anterior and posterior fusion was performed. Two years postoperatively, the patient carries on with her daily living without any significant disability. Delayed bone cement dislodgement can occur as one of complications following bone cement augmentation procedure for osteoporotic spinal fracture. It might be related to the presence of intravertebral cleft, lack of interdigitation of bone cement with the surrounding trabeculae, and possible damage of endplate during ballooning procedure.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.168-174
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• 2015

Purpose: Recent studies have suggested that decreased serum potassium level may contribute to various metabolic disorders in adult patients including nonalcoholic fatty liver disease (NAFLD). We aimed to study the correlation between serum potassium levels and the histologic severity of NAFLD in children. Methods: Pediatric patients with biopsy-proven NAFLD were included in this study. Demographic, clinical, and histopathological data were obtained. Multivariable logistic regression analysis was used to assess whether potassium levels are associated with the presence of nonalcoholic steatohepatitis (NASH) or fibrosis after adjusting for possible confounders. A p-value <0.05 was considered statistically significant. Results: Among 125 biopsies, 49.6% (62) had evidence of NASH while 66.4% (83) had some degree of fibrosis (stage 1-3). Mean serum potassium was significantly lower in NASH group as compared to non-NASH group ($4.4{\pm}0.42mmoL/L$ vs. $4.8{\pm}0.21$, p<0.001). Higher potassium level had negative correlation with presence of steatosis, ballooning, lobular inflammation, fibrosis and NAFLD activity score (p<0.05). On multivariable analysis and after adjusting for the metabolic syndrome and insulin resistance, higher potassium level was significantly associated with lower likelihood of having a histological diagnosis of NASH on biopsy (odds ratio [OR], 0.12; 95% confidence interval [95% CI], 0.05-0.28; p<0.001). Similarly, the likelihood of having fibrosis decreases by 76% for every 0.5 mmoL/L increase in potassium (OR, 0.24; 95% CI, 0.11-0.54; p<0.001). Conclusion: Our study shows an inverse relationship between serum potassium levels and the presence of aggressive disease (NASH and fibrosis) in children with NAFLD.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.85-88
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• 2011

Purpose: Takotsubo cardiomyopathy is a relatively uncommon type of stress-induced cardiomyopathy characterized by transient left ventricular regional wall motion abnormalities. Emotional and physical stresses play a key role in this type of cardiomyopathy in postmenopausal women. The current hypothesis is that the syndrome represents a form of catecholamine surge due to stress or epinephrine-mediated acute myocardial stunning. Methods: A 44-year-old woman had suffered premature ventricular contraction following a cardiogenic shock during a breast augmentation surgery under enflurane anesthesia and tumescent solution infiltration. She was treated with cardiopulmonary resuscitation at a local clinic. Then she was brought to the Emergency Department of the authors' hospital. Results: The woman's echocardiogram showed an ejection fraction of 20~25% with associated basal hyperkinesis and left ventricular apical ballooning. The patient was admitted to the ICU and required inotropic support for two weeks. The patient's condition dramatically improved, and her ejection fraction returned to 70%. Conclusion: It is believed that there were multiple triggering factors of the onset of Takotsubo cardiomyopathy in the woman's social and family history, including infiltration of a large volume of the tumescent solution and VPCs induced by enflurane anesthesia without premedication. The importance of careful history-taking, careful pre-operative consultation on psychological suffering especially for breast surgery, premedication before surgery, patient reassurance, and post-operative psychosocial and emotional assistance was again seen in this case.

• Asian-Australasian Journal of Animal Sciences
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• v.8 no.4
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• pp.325-328
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• 1995

The experiment was conducted to study the comparative pathology of hemic system among three different broiler chicken strains i.e. Hubbard (H), Lohmann (L) and Indian River (IR) suffering from experimentally induced Hydropericardium Syndrome (HPS). For this 50 chicks of each strain were inoculated with HPS inoculum at the age of 21 days and other 50 chicks of each broiler strain were kept as uninoculated control. After slaughtering each bird of both groups was subjected to pathological examination of heart, spleen and aorta and also for determining routine haematological parameters. The maximum values of Total Erythrocyte Count (TEC), heterophils and thrombocytes and the minimum values of Total Leukocyte Count (TLC) and Hemoglobin (Hb) content were found in H broiler strain. Percentage of monocytes, basophils and eosinophils also showed maximum decrease in H broiler chicken strain. Gross pathological lesions in the inoculated birds revealed that the heart showed ballooning due to distention of pericardial sac with pericardial fluid. Haemorrhages on the epicardium and flabbiness of the myocardium. Under the microscope, degenerative changes in myocardial tissue were seen. Lesions in the spleen included splenomegaly and haemorrhagic spots. Aorta showed flabbiness of the wall and disruption of endothelium. It is concluded that there is a marked difference in susceptibility of HPS among three different commercial broiler strains. The Hubbard broiler strain is more susceptible which is followed by the Indian River and Lohmann respectively.

• Natural Product Sciences
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• v.9 no.1
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• pp.13-17
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• 2003

The hepatoprotective effect of the ethanolic extract of Coccinia indica fruits in rats treated with carbon tetrachloride. In hepatotoxic rats, liver damage was studied by assessing parameters such as aspartate aminotransferase (AST), alanine aminotransferase (AlT), alkaline phosphatase (AIP) and gamma glutamyl transpeptidase (GGT) in serum, and concentrations of total proteins, total lipids, phospholipids, triglycerides and cholesterol in both serum and liver. The effect of co-administration of ethanolic extract on the above parameters was further investigated. Histopathological study of the liver in experimental animals was also undertaken. Hepatic damage as evidenced by a rise in the levels of AST, AIT, AIP and GGT in serum, and also changes observed in other biochemical parameters In serum and liver showed a tendency to attain near normalcy in animals co-administered with the extract. The normal values for AST (IU/L), AIP (IU/I), protein (g/100 ml) and total lipids (mg/100 ml) in serum (i.e.,20.24, 70.04, 5.72 and 135.54 respectively) were found to alter towards values 32.61, 127.11, 3.83 and 265.91 in hepatotoxic rats. These parameters Attained near normal values (I.e.,22.82, 79.30, 5.22 and 151.24 for AST, AIP protein and total lipids respectively) in ethanolic extract co-administered rats. Profound steatosis, ballooning degeneration and nodule formation observed in the hepatic architecture of $CCl_4$ treated rats were found to acquire near-normalcy in drug co-administered rats, thus corroborating the biochemical observations. Thus the study substantiates the hepatoprotective potential of ethanolic extract of Coccinia indica fruits.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.227-231
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• 2012

Background : The ankle brachial pressure index (ABI) is a simple, useful method for diagnosing peripheral artery disease (PAD). Although the ABI is an objective diagnostic method, it has limited reliability in certain scenarios. The aim of the present study was to determine the accuracy and reliability of the toe brachial index (TBI) as a diagnostic tool for detecting stenosis in PAD, associated with normal or low ABI values. Methods : ABI and TBI values were measured in 15 patients with diabetic gangrene who were suspected of having lower extremity arterial insufficiency. The ABI and TBI values were measured using a device that allowed the simultaneous measurement of systolic blood pressure in the upper and lower extremities. In addition, the ABI and TBI values were compared pre- and post-angiography. Results : Patients with an ABI of 0.9-1.3 showed almost no difference between the 2 measurements. The patients with TBI >0.6 had no arterial insufficiency. The patients with TBI <0.6 required vascular intervention with ballooning. After the angiography, the gangrenous wounds decreased in size more rapidly than they did prior to the intervention. Conclusions : Our findings suggest that TBI is the method of choice for evaluating lower limb perfusion disorders. This result requires further studies of TBI in a larger number of patients. Future long-term studies should therefore evaluate the utility of TBI as a means of screening for PAD and the present findings should be regarded as preliminary outcomes.

• Nuclear Engineering and Technology
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• v.27 no.5
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• pp.775-783
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• 1995

This study is to assess the effects of increasing wall thickness on the safety margin of pressure tube in operating and of lowering initial hydrogen concentration on the DHC growth in respect to the improvement of the reliability of pressure tube in CANDU reactors. The pressure tube with thicker wall of 5.2 mm shows much higher safety margin for flaw tolerance by 25％ than the current 4.2mmm tube. The thicker pressure tubes have a great benefit in LBB assessment including the initial crack depth at which DHC occurs, the crack length at onset of leaking and the available time for action. The resistance for the pressure tube ballooning at LOCA accident is also increased with the thicker tube. The calculations for Heq concentration after 20 years of operation as a function of wall thickness and initial hydrogen concentration show that the 5.2 mm nil thickness tube with 5 ppm initial hydrogen concentration is the most resistant to DHC. with the lower initial hydrogen concentration, TSS temperature for the precipitation or hydride decreases and the crack growth during cooldown reduces.