In critically ill patients, centeral venous catheterization is a widely used procedure for fluid resuscitation, massive transfusion, total parenteral nutrition, central venous pressure monitoring and hemodialysis. However, many complications are associated with central venous catheterization. Among these complications, hemothorax is rare but fatal. We recently experienced a 32-year-old female diagnosed with hemothorax due to subclavian catheterization who was successfully treated with angiographic intervention. There are no absolute indications of surgery or interventional treatment in such cases. Multicenter studies and consensus are necessary to determine the proper treatment for hemothorax due to central venous catheterization. Angiographic treatment is rarely used for this uncommon complication of subclavian catheterization. We describe a rare case with a review of the literature.
Adult ; Angiography ; Catheterization ; Catheterization, Central Venous* ; Catheters ; Central Venous Catheters* ; Central Venous Pressure ; Consensus ; Critical Illness ; Female ; Hemothorax* ; Humans ; Parenteral Nutrition, Total ; Renal Dialysis ; Resuscitation ; Stents*

No abstract available.
Gyeonggi-do* ; Mental Health*

OBJECTIVE: This study was to determine the effect of different concentration of calcium in medium on the preimplantational development of zygotes and early 2-cell embryos. METHODS: Female mice of ICR strain (5~8 weeks old) were superovulated and mated with fertile males. Zygotes or early 2-cell embryos were collected by flushing the oviducts 31~32 hours after hCG injection. The embryos were cultured in various concentrations of Ca2+ in medium or with EDTA, EGTA and Ni2+. RESULT AND CONCLUSION: Treatment of high concentration of Ca2+ (3.42 mM (2X)~17.1 mM (10X) in medium didn't develop well compared to the control Low concentrations of Ca2+ (0.214 mM (1/8X)~0.855 mM (1/2X)) were deterimental to development beyond 2-cell stage. EDTA, Ca2+ chelating agent was treated with ranged concentrations of eDTA (0.014 mM~0.107 mM) to medium contaning 1.71 mM Ca2+ showed beneficial effect to development to blastocyst compared to the control. EGTA, extracellular Ca2+ chelator, was treated with ranged concentrations of EGTA (0.014~0.107 mM) to the medium contaning 1.71 mM Ca2+. There is no significant difference with the control. Ni2+ (50 micrometer), T-type Ca2+-channel blocker was treated to medium contaning low concentration of Ca2+. It overcame 2-cell block significantly. Rate of degenerated embryos decreased and developmental rate to morula and blastocyst increased more than low Ca2+ concentration alone. Further studies are needed for the overcoming effect of 2-cell block by Ni2+.
Animals ; Blastocyst ; Calcium ; Edetic Acid ; Egtazic Acid ; Embryonic Structures* ; Female ; Flushing ; Humans ; Male ; Mice* ; Morula ; Oviducts ; Zygote

To compare the efficiency, success rate and abortion time of applications of intravaginal misoprostol versus intravenous Sulprostone(Nalador) for mid-trimester pregnancy termination. Eighty three patients between 17-29 weeks of gestation with medical, obstetric, or genetic reasons for termination of pregnancy were randomized to receive either 50 ug tablets of misoprostol placed in the posterior vaginal fomix or 1,000ug sulprostone intravenously diluted I L of isotonic saline solution given as a 12-h infusion. Among eighty three patients recruited, fourty five patients received misoprostol and thirty eight patients received sulprostone intravenously. The average interval from start of induction to vaginal delivery was 13.35+/-3.34 hours in misoprostol group and 21.14+/-6.64 hours in the sulprostone group. The success rate of complete termination within 12 and 24 hours in misoprostol group were 57.7%, 93.3%, respectively, while in sulprostone group were 15.8%, 92.1% respectively. Oxytocin augumentation was 6.7% in misoprostol group and 7.9% in the sulprostone group. No serious complication occurred. Intravaginal misoprostol appears to be acceptably safe and effective agents for second trimester pregnancy termination. Misoprostol has the advantage of being inexpensive, easily stored and readily available. The regimen of 100 ug misoprostol inserted intracervicovaginally every 8 hours is the optimal method for pregnancy termination.
Female ; Humans ; Misoprostol* ; Oxytocin ; Pregnancy ; Pregnancy Trimester, Second* ; Sodium Chloride ; Tablets

BACKGROUND AND OBJECTIVES: Idiopathic restrictive cardiomyopathy is a very rare and poorly recognized disease in children. This study is performed to describe the clinical course and to define potential predictors of outcome. MATERIAL AND METHOD: We reviewed the medical records and diagnostic studies of 11 consecutive patients during the period from Jan.1991 to Aug. 2000. RESULTS: The age at diagnosis was 1.2-13 years (median 7 years) and the duration of follow up was 3-90 months (median 3.6 years). All except one were symptomatic (dyspnea in ten, chest pain in four). The chest pain was associated with significant ST depression on both resting and exercise ECG, suggesting myocardial ischemia. Two had complete heart block as either initial or terminal event. Cardiac catheterization was done in nine ( mean pulmonary arterial wedge pressure 23+/-6mmHg, systolic pulmonary arterial pressure 47+/-14mmHg, mean right atrial pressure 11+/-9mmHg). Echocardiographic dimensional ratio of left atrium and aorta (LA/Ao) was 2.41+/-0.58. Mitral E/A inflow ratio was 2.72+/-1.42, E wave deceleration time was 93.6+/-44.2ms. During follow up, six died. The 2 year and 5 year cumulative survival rates were 54.5% and 18.8% respectively. The predictor for nonsurvivor were pulmonary venous congestion and LA/Ao >2.5(p<0.05). Verapamil was tried in 6 cases without favorable effect in all. CONCLUSION: Considerable numbers of restrictive cardiomyopathy have myocardial ischemia associated with ST depression and chest pain. The patients with pulmonary venous congestion and severe left atrial enlargement (LA/Ao>2.5) were at risk for death, requiring prompt definitive treatment such as cardiac transplantation.
Aorta ; Arterial Pressure ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Restrictive* ; Chest Pain ; Child* ; Deceleration ; Depression ; Diagnosis ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Atria ; Heart Block ; Heart Transplantation ; Humans ; Hyperemia ; Medical Records ; Myocardial Ischemia ; Pulmonary Wedge Pressure ; Survival Rate ; Verapamil

No abstract available.
Breast Neoplasms* ; Breast* ; Drug Resistance, Multiple* ; Genes, MDR*

Angiogenesis is a crucial step in tumor growth and progression. Scarce data is available on angiogensis in gastrointestinal tumors. We studied 16 normal colon, 44 adenomas and 29 carcinomas to evaluate angiogenesis in colorectal tumors and to assess the correlation among p53 protein, proliferative activity and other clinical prognostic parameters. Endothelial cells were immunostained with an anti-Factor VIII mAb; in each case three microscopic fields(x 200) were counted: average number of the three fields was defined as microvessel density (MVD). p53 protein expression was 45.5%(20/44) in adenomas, and 79.3%(23/29) in carcinomas (p<0.01). p53 protein expression of carcinomas was 57.1%(4/7) in diploid tumors, 100%(8/8) in aneuploid tumors (p=0.07), 100%(8/8) in well differentiated tumors, and 50%(2/4) in poorly differentiated tumors (p=0.09). MIB-1 score was 2.3+/-0.7(38) in adenomas, 3.4+/-0.5(29) in carcinomas (p<0.01). There was no significant correlation between p53 protein and MIB-1 score. MVD was 10.4+/-4.1(16) in the normal mucosa, 21.5+/-7.9(39) in the adenomas, 35.3+/-9.7(26) in carcinomas (normal versus adenomas, p<0.01; adenomas versus carcinomas, p<0.01). MVD was 25.8+/-5.4(2) in carcinomas confined to mucosa, and 36.1+/-9.6(24) in carcinomas with transmural invasion. The higher MIB-1 score was in carcinomas the more MVD increased but there was no statistical significance (r=0.38, p=0.055). MVD of carcinomas was not associated with nodal metastasis, p53 expression, and DNA ploidy. p53 protein and MIB-1 expression are useful methods for the evaluation of malignancy, and tumor angiogenesis is an early event in a colorectal tumor but MVD does not correlate with prognostic parameters except for the tumor depth.
Adenoma* ; Aneuploidy ; Colon ; Colorectal Neoplasms ; Diploidy ; DNA ; Endothelial Cells ; Microvessels* ; Mucous Membrane ; Neoplasm Metastasis ; Ploidies

Heat shock protein 70 (HSP70) is a chaperone that binds to mutant p53 and consequently can regulate its accumulation or localization. Its expression is upregulated in tumor cells. We studied 44 adenomas and 29 carcinomas of colorectum to evaluate the expression of HSP70, and to assess the correlation among p53 protein and other clinical prognostic parameters. HSP70 expression was scored according to staining intensity and extent. p53 protein expression was 45.5%(20/44) in adenomas and 79.3%(23/29) in carcinomas(P<0.01). p53 protein expression of carcinomas was 57.1%(4/7) in diploidy tumors, 100.0%(8/8) in aneuploidy tumors(P=0.07), 100.0%(8/8) in well-differentiated tumors, and 50.0%(2/4) in poorly differentiated tumors(P= 0.09). HSP70 expression mainly revealed a fine granular cytoplasmic staining pattern in tumor cells. HSP70 was focally detected in some lymphocyte, ganglion cell and normal mucosa. HSP70 expression was 46.3%(19/41) in adenomas and 93.1%(27/29) in carcinomas. HSP70 score was 0.9+/-1.3 in adenomas(n=41) and 5.5+/-3.5 in carcinomas(n=29)(P<0.0005). Its score was 1.7+/-1.6 in p53 positive adenomas and 0.3+/-0.6 in p53 negative adenomas(P<0.005), and its expression rate was higher in p53 positive carcinomas than p53 negative carcinomas (P>0.05). There was no significant correlation among HSP70, tumor size, Dukes'stage, nodal metastasis, depth of tumor invasion, DNA ploidy and tumor differentiation. In conclusion, HSP70 and p53 protein appear to be correlated to each other, and that HSP70 and p53 protein may play a certain role in the progression of colorectal tumor. Further studies are needed for determining their prognostic factors in colorectal carcinoma.
Adenoma* ; Aneuploidy ; Colorectal Neoplasms ; Cytoplasm ; Diploidy ; DNA ; Ganglion Cysts ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Lymphocytes ; Mucous Membrane ; Neoplasm Metastasis ; Ploidies

No abstract available.
Diabetes Insipidus*

OBJECTIVE: The study was performed to compare the survival rate and the development of day 2 mouse embryos which had freezing procedures done. METHODS: We used three different vitrification solutions (EFS, VS14, DPS) and a ultrarapid freezing solution (UFS) for cryopreservation of day 2 mouse embryo. RESULTS: We tested toxicity by exposing embryos to vitrification solutions and a ultrarapid freezing solution. The survival rates are 100%, 97.8%, 95.6% and 100% (EFS, VS14, DPS and UFS). After cultured for 96 hours, hatching rates of each group are 93.5% (no freezing), 95.6% (EFS), 86.4% (VS14), 93.0% (DPS), and 93.0% (UFS). There is no significant differences among groups. The survival rates after thawing cryopreserved embryos are 80.2%, 91.7%, 69.5%, 0% and 91.8% (slow freezing, EFS, VS14, DPS and UFS). Also cultured for 96 hours, the hatching rates are 93.5% (no freezing), 84.1% (slow freezing), 93.9%) (EFS), 48.5% (VS14) and 70.1% (UFS). CONCLUSION:The survival rates of vitrification in EFS solution and ultrarapid freezing are higher than slow freezing (p<0.05). The hatching rate of vitrification in EFS solution cultured for 96 hours is highest, so vitrification of day 2 mouse embryos in EFS solution considered as more effective for cryopreservation.
Animals ; Cryopreservation ; Embryonic Structures* ; Freezing* ; Mice* ; Survival Rate ; Vitrification*