No abstract available.

Kawasaki disease or mucocutaneous lymph node syndrome is an acute inflammatory illness of childhood characterized by systemic panvasculitis. It presents with high fever, dramatic changes of the skin and mucous membranes, and lymphadenopathy. Adult-onset Kawasaki disease is rare and reports on coronary involvement in adult are even rarer. Herein, we report a case of adult-onset Kawasaki disease complicated by splenic infarction and development of coronary aneurysm even despite of treatment with intravenous gamma globulin. A 20-year-old man presented with fever, erytheatous rash, induration and desquamation of hands and feet, pulmonary edema and shock due to cardiomyopathy, splenic infarction, bilateral conjunctivitis, jaundice, and cervical lymphadenopathy. After Kawasaki disease was suspected, intravenous gamma globulin (2 g/kg once) and aspirin (6 g/day) were administered. On the 30th hospital day, transesophageal echocardiography showed one coronary aneurysm and coronary angiography showed three aneurysms. Eight months after the first admission, follow-up coronary angiography showed normalization of the previous coronary abnormalities.
Adult ; Aneurysm ; Aspirin ; Cardiomyopathies ; Conjunctivitis ; Coronary Aneurysm* ; Coronary Angiography ; Echocardiography, Transesophageal ; Exanthema ; Fever ; Follow-Up Studies ; Foot ; gamma-Globulins ; Hand ; Humans ; Jaundice ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome ; Mucous Membrane ; Pulmonary Edema ; Shock ; Skin ; Splenic Infarction* ; Young Adult

No abstract available.
Sterilization, Tubal*

To elucidate the funcion of arachidonic acid as a secondary brain edema facotr, the infusion edema model was constucted using adult cats with studies of somatosensory evoked potentials, regional cerebral blood flow of white matters, brain water contents, magentic resonance images and histological findings. Among 50 cats, 6 cats were used as sham poerated group without infustion and in 45 cats solutions of various concentrations of arachidonic acid and physiologic saline were infused into the left and right frontal white maters respectively. According to the different concentrations of arachidonic acid, three groups were named as group A(0.1mg/ml), group B(1mg/ml), group C(10mg/ml). During 4 hours of slow infusion of the infusates(average 0.5ml in each side totally) central conduction time(CCT) was measured every an hour with contralateral median nerve stimulation bilaterally and cerebral blood flow(CBF) of white matter was measured by hydrogen clearance method every 2 hours. Finally the cats were sacrificed and specimens of edematous white matter obtained bilaterally at the coresponding points. Water contents were measured with vacuum freeze drying method. T2-weighted magnectic resonance images(MRI) and light microscopic studies were performed in a cat of each groups. The results were as followed ; 1) MRI and histologic findings showed that the infusion brain edema technique was efective in inducing interstitial edema, but the differences in the degree of edema formation between the right and the left sides were not siginificant in all groups. 2) There were no statistically significant difference between the water contents of the right and that of left in all groups. 3) Either infusion of arachidonic acid or physiologic saline in the white matter did not change regional white matter CBF in all groups. 4) The I-N1 interpeak latency was labelled as central conduction time(CT), and the baseline CCT was 5.83+/-0.52msec. 5) The differences of CCT between infusion group and noninfusion group were statistically significant in group C at 2, 3, 4hours(p>0.01) and the differerences of cct between arachidonic acid and physiologic saline infustion sites were statistically significant in group B at 4 hors, group C at 1 hour(p>0.05) and group C at 2, 3, 4hours(p>0.01) after eginning of infusion and the differences increased with time in group C(p>0.01). The results indicate that arachidonic acid does not have edemogenic properties during 4 hours infusion but may induce neurologic dysfunction as to increase the CCT in somatosensory evoked potential studies if it exists in the edema fluid of brain white matter.
Adult ; Animals ; Arachidonic Acid* ; Brain Edema ; Brain* ; Cats ; Edema ; Evoked Potentials, Somatosensory* ; Freeze Drying ; Humans ; Hydrogen ; Magnetic Resonance Imaging ; Median Nerve ; Neurologic Manifestations ; Vacuum

No abstract available.
Ectopia Cordis*

No abstract available.
Heart* ; Thoracic Surgery*

Human papillomavirus(HPV) has implicated in the development of cervical cancer. Several studies has suggested a strong correlation between HPV 16, 18 and cervical intraepithelial neoplasia(CIN). For detecting and typing HPV DNA in cervical tissues, recently the chemiluminescent molecular hybridization assay method has been widely used. This study was performed to determine the usefulness of hybrid capture assay for detecting high-risk HPV in cervical epithelial cells, and to compare the correlation among cervical cytology, biopsy finding and HPV infection, and to determine whether the addition of the hybrid capture assay to cytologic test would improve the ability to identify significant lesions. This study included 267 patients who visited the colposcopic clinic of the department of obstetrics and gynecology, Chonbuk University Hospital from May, 1997 to October 199S. Pap smears hybrid capture assays, and colposcopically directed biopsy were performed concurrently on al1 women. The results obtained were as follow; l. Using hybrid capture assay, the detection rate of high-risk HPV of all patients was 37.1%(99/267). There was no statistical significance in the detection rate of HPV between the age groups. 2. The false negative rate of Pap Smear was 53.3% and showed significant discrepancies between the cytologic and histologic diagnosis. 3. According to the cytologic diagnosis, the detection rates of high-risk HPV were 7.1% in normal, 25.3% in ASCUS or LSIL, and 61.6% in HSIL. In each cytologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 4. According to the histologic diagnosis, the detection rates of high-risk HPV were 0.1% in normal, 11.1% in CIN I, and 72.7% in CIN II or CIN III. In each histologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 5. According to the comparison of histologic diagnosis between positive and negative results of high-risk HPV test due to each cytology, there was no statistical significance in the incidence rate of cervical neoplasia, Above results suggest that high-risk HPV test using hybrid capture assay may be a useful method in supplement the pitfalls of cervical cytology. This test might also have prognostic value in the management of patients with CIN.
Biopsy ; Diagnosis ; DNA ; Epithelial Cells* ; Female ; Gynecology ; Human papillomavirus 16 ; Human Papillomavirus DNA Tests* ; Humans ; Incidence ; Jeollabuk-do ; Obstetrics ; Uterine Cervical Neoplasms

In order to observe the changes in left ventricular function during coronary artery occlusion and reperfusion, left anterior descending (LAD) coronary arteries in the anesthetized dogs were occluded for 1 hour and then reperfused for 4 hours. Hemodynamic indexes of global systolic and diastolic function and regional wall thickness changes as a regional contractile index were measured during occlusion and reperfusion. The results were as follows; 1) Indexes of global systolic function (left ventricular peak systolic pressure, peak positive dP/dt) and global diastolic function (peak negative dP/dt, time constant, left ventricular end-diastolic pressure) showed deterioration in early occlusion period (10-30 minutes) but gradually improved even if coronary occlusion persisted. Reperfusion did not induce significant changes except that peak positive dP/dt transiently deteriorated 30 minutes after reperfusion and left ventricular end-diastolic pressure decreased 1.5-2 hours after reperfusion. 2) Indexed of regional function (i.e, end-diastolic thickness and % systolic thickening of anterior left ventricular wall) deteriorated by 10 minutes' occlusion which persisted during the entire occlusion period. Reperfusion induced no significant improvement in regional contractile function compared with occlusion 60 minutes' data, which suggested reperfusion for 4 hours after 1 hour's LAD occlusion may be insufficient for the ischemic region to recover its contractility. 3) Reperfusion arrhythmia (ventricular tachycardia) was noted in most (6/9) of the dogs, one of which deteriorated into ventricular fibrillation and the others spontaneously converted to normal sinus rhythm.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Hemodynamics ; Reperfusion* ; Ventricular Fibrillation ; Ventricular Function, Left*

Situs inversus totalis is a congenital condition in which there is complete right to left reversal of the thoracic and abdominal organ. According to an increase in minimally invasive treatments, laparoscopic surgery for patients with situs inversus totalis has also been increasing. We performed laparoscopy-assisted subtotal gastrectomy on a 60-year-old gastric cancer patient with situs inversus totalis. He was diagnosed with early stage gastric adenocarcinoma at antrum of the anterior wall. We experienced some technical difficulties because of the position and anatomic variation of major vessels. However, the subtotal gastrectomy was completed with D1+ beta lymph node dissection followed by extracorporeal gastroduodenostomy. The patient was discharged six days after operation without any complications. The pathologic report showed that tumor invasion was limited to the submucosa and one lymph node was positive for metastasis. We believe our experience is the first reported case of laparoscopic gastric cancer surgery for situs inversus in Korea.
Adenocarcinoma ; Anatomic Variation ; Gastrectomy ; Humans ; Korea ; Laparoscopy ; Lymph Node Excision ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Situs Inversus ; Stomach Neoplasms

A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.
Adult ; Cauda Equina ; Female ; Gadolinium ; Hip ; Humans ; Leg ; Magnetic Resonance Imaging ; Meningioma ; Recurrence ; World Health Organization