No abstract available.
Ectopia Cordis*

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.

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

No abstract available.
Heart* ; Thoracic Surgery*

PURPOSE: Laparoscopic gastrectomy is a widely accepted surgical technique. Recently, robotic gastrectomy has been developed, as an alternative minimally invasive surgical technique. This study aimed to evaluate the question of whether robotic gastrectomy is feasible and safe for the treatment of gastric cancer, due to its learning curve. MATERIALS AND METHODS: We retrospectively reviewed the prospectively collected data of 100 consecutive robotic gastrectomy patients, from November 2008 to March 2011, and compared them to 282 conventional laparoscopy patients during the same period. The robotic gastrectomy patients were divided into 20 initial cases; and all subsequent cases; and we compared the clinicopathological features, operating times, and surgical outcomes between the three groups. RESULTS: The initial 20 robotic gastrectomy cases were defined as the initial group, due to the learning curve. The initial group had a longer average operating time (242.25+/-74.54 minutes vs. 192.56+/-39.56 minutes, P>0.001), and hospital stay (14.40+/-24.93 days vs. 8.66+/-5.39 days, P=0.001) than the experienced group. The length of hospital stay was no different between the experienced group, and the laproscopic gastrectomy group (8.66+/-5.39 days vs. 8.11+/-4.10 days, P=0.001). The average blood loss was significantly less for the robotic gastrectomy groups, than for the laparoscopic gastrectomy group (93.25+/-84.59 ml vs. 173.45+/-145.19 ml, P<0.001), but the complication rates were no different. CONCLUSIONS: Our study shows that robotic gastrectomy is a safe and feasible procedure, especially after the 20 initial cases, and provides a satisfactory postoperative outcome.
Gastrectomy ; Humans ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Prospective Studies ; Retrospective Studies ; Stomach Neoplasms

This is a case report of systemic lupus erythematosus presented as a transverse myelitis. Central nervous system involvement in systemic lupus erythematosus is a relatively common complication. But the transverse myelitis as a central nervous system involvement in systemic lupus erythematosus is rare and the transverse myelitis as the first manifestation of systemic lupus erythematosus has not been reported in Korea. Thus we report a case of the transverse myelitis as a first manifestation of systemic lupus erythematosus with the literature review.
Central Nervous System ; Korea ; Lupus Erythematosus, Systemic* ; Myelitis, Transverse*

PURPOSE: Although local recurrence rates of stomach cancer after radical surgery have been eported in the range of 30-70%, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. MATERIALS AND METHODS: From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiomyosarcoma. The numbers of patients with stage IB, II, IIIA, IIIB, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion. Minimum and median follow-up periods were 12 months and 18 months, respectively. RESULTS: Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than 15% of their pretreatment weight. But hematemesis, melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/ remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient. Peritoneal seeding occurred in 6, liver metastases in 2, and distant nodes in 2 patients. Four year disease specific survival rate was 40% and disease free survival was 48%. Median survival was 35 months and median disease free survival time was 26 months. Stages and radiation dose were not significant prognostic factors for locoregional failures. CONCLUSION: Although all patients in this study had positive surgical margins, locoregional failure rate was 28%, and 4 year disease specific survival rate was 40%. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences, but we could find a possibility of the role of postoperative radiotherapy in patients with high risk factors.
Adenocarcinoma ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Gastrectomy ; Gastric Stump ; Hematemesis ; Humans ; Intestinal Obstruction ; Leiomyosarcoma ; Liver ; Lymph Nodes ; Melena ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Risk Factors ; Stomach ; Stomach Neoplasms* ; Survival Rate ; Weight Loss