No abstract available.
Empyema* ; Fistula*

No abstract available.
Neurilemmoma* ; Neurofibromatoses* ; Neurofibromatosis 2*

No abstract available.
Molecular Biology

OBJECTIVE: For the treatment of carotid cavernous fistula(CCF), transarterial detachable balloon occlusion(DBO) is the method of choice. When it has failed to occlude the fistula, various embolization methods are used to treat the fistula. Transvenous embolization through the superior ophthalmic vein(SOV) is another method of treatment. The venous approach through the SOV after surgical dissection and exposure of this vein has been recommended by some delete, but(here) delete delete(an) alternative treatment method by percutaneous puncture of the SOV without surgical dissection(is described). METHODS: A 19-year-old woman admitted to our hospital two months after accident, presented with proptosis, chemosis, occulomotor and abducens nerve palsies, and bruit of the right eye. The authors tried DBO via transarterial route in initial treatment and the fistula was occluded with subsequent disapearance of bruit. However, 2 weeks later, she complained of recurence of bruit. Transarterial approach was attempted again, but the fistula hole was too small for this approach. The venous approach via SOV by percutaneous puncture was then tried. Puncture was made at the medial one third of the superior orbital rim and the fistula was embolized with Guglielmi detachable coils (GDCs). RESULTS: The fistula was completely occluded and no early and late complications noted. The patient's clinical symptoms were improved within a few days. CONCLUSION: Treatment of CCF by percutaneous puncture of the SOV is an alternative and effective method when other approaches are not feasible.
Abducens Nerve Diseases ; Exophthalmos ; Female ; Fistula* ; Humans ; Orbit ; Punctures* ; Veins* ; Young Adult

BACKGROUND: To compare flexible ring with rigid ring for annular remodeling and hemodynamic changes of left ventricle (LV) in mitral valve repair (MVR) at short term interval. METHODS: From January 1998 to March 2001, 35 patients with mitral valve prolapse underwent mitral valve repair with ring annuloplasty. The mean age of these patients was 49 years. Eighteen patients underwent mitral annuloplasty with Carpentier-Edwards Classic-ring (Group A). Seventeen patients underwent mitral annuloplasty with Physio-ring (Group B). LV fun-ction and annulus size were assessed by echocardiography on the day before operation and 2 to 3 months later. Mitral annular motion had been examined by means of the extent of mitral annular systolic excursion (MASE) as measured in two longitudinal LV segments (septal and lateral). RESULTS: 1) In valve pathology, anterior leaflet lesion was 14 cases, posterior was 14, combined lesion was 7 cases. 2) At all, left ventricular end-systolic dimension, left ventricular end-diastolic dimension and LV mass decreased postoperatively. But, no differences existed between the groups. 3) Postoperatively (after 2-3 months), echocardiograms in 35 patients demonstrated no mitral regurgitation (MR) in 16 cases, trace to mild MR in 17 cases, moderate MR in 2 patients. In Classic-ring group, MR was demostrated in 11 cases (61%). In Physio-group, MR was demonstrated in 8 cases (47%). 4) Postoperatively, mitral valve area increased significantly only in patients with Physio-ring (1.93+/-0.33 vs 2.38+/-0.92, p<0.05). 5) No differences existed between the groups in MASE. CONCLUSION: There are the significant reduc-tion in cardiac chambers and annulus size and improvement of LV function after both types of ring annuloplasty at short term result. There are no significant differences between Classic-ring and Physio-ring except 2 cases postrepair SAM (systolic anterior motion) of mitral valve in Classic-ring.
Echocardiography ; Follow-Up Studies* ; Heart Ventricles* ; Hemodynamics* ; Humans ; Mitral Valve Annuloplasty ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pathology

It is difficult to perform Off-pump Coronary Artery Bypass Grafting(OPCAB) for the posterior vessels in patients with cardiomegaly and left ventricular dysfunction due to hemodynamic instability and poor exposure. Right heart supported OPCAB may facilitate posterior vessel approach during OPCAB in those patients, in addition to those advantages of avoiding cardiopulmonary bypass and aortic cannulation. We experienced 2 cases of right heart supported OPCAB for those patients with cardiomegaly and left ventricle dysfunction.
Cardiomegaly ; Cardiopulmonary Bypass ; Catheterization ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Surgical Procedures, Minimally Invasive ; Ventricular Dysfunction, Left

Cervical large cell neuroendocrine carcinoma is rare. We experienced one case of cervical large cell neuroendocrine carcinoma with invasive mucinous adenocarcinoma in 49 years old woman. So we report the case and brief review of literature.
Adenocarcinoma, Mucinous* ; Carcinoma, Neuroendocrine* ; Cervix Uteri* ; Female ; Humans ; Middle Aged ; Mucins*

OBJECTIVE: The safety and effectiveness of Guglielmi Detachable Coil(GDC) embolization for cerebral aneurysm has been well documented. However, domestically there are few reports. The purpose of this study is to analyze procedural complications that occurred during endovascular coilling performed for cerebral aneurysms retrospectively. METHODS: From January 1996 to December 2003, a total of 453 patients (484 aneurysms) who had undergone GDC embolization for cerebral aneurysm were selected. The aneurysms were classified according to rupture history, location, dome and neck size. Procedural complications such as aneurysmal rupture, thrombosis and occlusion of patent vessels due to coil escape were noted. RESULTS: Procedural complications occurred 49 cases (10.1%). Among these, there were 27 of procedure-related aneurysmal rupture (5.6%), 14 of thrombosis (2.9%), 8 of occlusion of patent vessels due to coil escape (1.7%). Death or severe neurological deficit were seen in 18 cases of procedure-related rupture, 9 cases of thrombosis and 4 cases of coil escape. Procedure-related mortality and morbidity rates for endovascular coiling were calculated to be 2.9% and 3.6% respectively. CONCLUSION: The potential complications associated with shape, size and relationship to parent vessels of each specific cerebral aneurysm must be considered carefully before treatment. In order to reduce complications, proper equipment, knowledge on the hemodynamics and vascular anatomy, and operator's expertise are desired.
Aneurysm* ; Hemodynamics ; Humans ; Intracranial Aneurysm ; Mortality ; Neck ; Parents ; Retrospective Studies ; Rupture ; Thrombosis ; United Nations

OBJECTIVE: The author conducts a retrospective study to analyze long-term outcome and complication of LINAC radiosurgery for cerebral arteriovenous malformation(AVM). METHODS: We performed a detailed long-term follow-up study of 31 patients who could be followed up more than 2 years, with AVM treated by LINAC radiosurgery during January, 1996 to July, 2001. At the time of radiosurgery, the mean age was 47 years (range: 13-68). The median follow up period after radiosurgery was 27.2 months (range: 24-36). In all patients, AVM were completely covered with a 50~90% isodose line. The margin dose delivered by the LINAC was 14~28Gy(mean: 20.9Gy) at the periphery. RESULTS: Angiographic complete obliteration rate was 74.2% at 2 years after radiosurgery. Hemorrhage occured in 2cases(6.5%) at 12 and 14months after radiosurgery retrospectively, and 1patient died. Radiation related complication was developed in 1case(3.2%). CONCLUSION: LINAC radiosurgery is safe and effective in the treatment of cerebral arteriovenous malformation.
Arteriovenous Malformations ; Follow-Up Studies ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations* ; Radiosurgery* ; Retrospective Studies

BACKGROUND: Little data is available regarding hospitalized patients with nursing home-acquired pneumonia (NHAP). This is unfortunate because there is an increasing number of elderly persons who are living in nursing homes in Korea. The aim of this study was to compare clinical characteristics and treatment responses of NHAP with community-acquired pneumonia (CAP). METHODS: Patients with pneumonia who were admitted from eight nursing homes or from their own homes were enrolled between May 2007 and April 2009. Their clinical characteristics and treatment responses were reviewed retrospectively, and differences between the two groups were analyzed. RESULTS: Of 110 Patients with pneumonia, 66 (60%) were from nursing homes and their median age was 84. In the NHAP group, functional performance status was significantly poorer, classical symptoms of pneumonia were less severe, and multi-lobe involvement (on chest radiographs) was more frequent than in the CAP group. Patients with NHAP more frequently showed lymphocytopenia, anemia, hypoalbuminemia, hypoxemia, and elevated blood urea nitrogen on admission. The mean CURB-65 score was 2.2 in the NHAP group, higher than 1.7 in the CAP group (p=0.004), and multi-drug resistant pathogens were also highly identified in NHAP group (39% vs. 10%, p=0.036). The mean duration of antibiotic therapy was greater for the NHAP (12.6 days) than for the CAP group (6.6 days) (p<0.001). The mortality rate was 23% in NHAP group, which was significantly higher than 5% in the CAP group (p=0.014). CONCLUSION: NHAP should be more intensively investigated because of the higher frequency of multi-drug resistant pathogens and mortality than the CAP.
Aged ; Anemia ; Anoxia ; Blood Urea Nitrogen ; Humans ; Hypoalbuminemia ; Korea ; Lymphopenia ; Nursing Homes ; Pneumonia ; Pyrenes ; Retrospective Studies ; Thorax