Postinfarction ventricular septal rupture (VSR) is a serious complication following an acute myocardial infarction. We performed repair of a postinfarction posterior VSR; however, the patient developed mitral regurgitation (MR) 2 months later. Geometrical changes caused by ventricular remodeling and recurrent shuntare thought to be the cause of delayed MR.
Humans ; Mitral Valve Insufficiency ; Myocardial Infarction ; Rupture ; Ventricular Remodeling ; Ventricular Septal Rupture

Anomalous origin of right coronary artery from left sinus of valsalva is associated with sudden unexpected death, syncope, arrhythmia and myocardial ischemia. The mechanism that explains the restriction of coronary flow in the anomalous coronary artery is unclear but several surgical methods have been proposed, such as coronary artery bypass graft, coronary reimplantation, translocation of pulmonary artery, and unroofing procedure. We reported the surgical correction of the anomalous origin of right coronary artery from left sinus of valsalva between the aorta and pulmonary trunk using the unroofing procedure.
Aorta* ; Arrhythmias, Cardiac ; Coronary Artery Bypass ; Coronary Vessels* ; Myocardial Ischemia ; Pulmonary Artery ; Replantation ; Sinus of Valsalva* ; Syncope ; Transplants

In June of 1983 authors had investigated the occurrence of the avian malaria in the Humboldt penguins imported from Japan to the Farm-land Zoo in central district of Korea. The disease was characterized by acute course and high mortality. The peripheral blood smears from the affected penguins demonstrated different developmental stages of Plasmodium sp. in the mature erythrocytes. The predominant gross lesions noticed were pulmonary and epicardial edema and hepato-splenomegaly. Microscopically the lesions were characterized by extensive reticuloendothelial cell hyperplasia with striking feature of exoerythrocytic schizogony affecting a variety of tissues. The report also signifies the first description of a disastrous epizootic of avian malaria in Korea.
parasitology-protozoa ; malaria ; penguin ; Plasmodium sp. ; hepatosplenomegaly ; case report

No abstract available.
Adenocarcinoma* ; Neurofibromatoses* ; Pancreas*

One case of giant hydronephrosis associated with staghorn calculus was presented in 65 year old man. It`s containing fluid was about 4,000ml in amount. We reported this cases with a brief review of the literature.
Aged ; Calculi* ; Humans ; Hydronephrosis*

BACKGROUND: Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002. We checked the preoperative factors; sex, age, history of previous serum creatinine over 2.0 mg/dL, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors; IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/dL. RESULT: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/dL in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6.4%) in the patients whose creatinine level have not increased over 2.0 mg/dL. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/dL are diabetes, the history of previous serum creatinine over 2.0 mg/dL and left ventricular ejection fraction. CONCLUSION: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2.0 mg/dL and left ventricular ejection fraction. Postoperative ARF could be the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.
Acute Kidney Injury* ; Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Vessels* ; Creatinine ; Dialysis ; Fluid Therapy ; Humans ; Hypertension ; Medical Records ; Mortality ; Postoperative Complications ; Pulmonary Edema ; Risk Factors ; Stroke Volume ; Thoracic Surgery

BACKGROUND: In the operation for coronary artery stenosis, the procedures for mitral regurgitation are restricted to cases of more than moderate mitral regurgitation or for the lesions in leaflets. This is based on the belief that the less than mild regurgitation are a form of reversible change results from ischemia with coronary artery stenosis. We studied the changes and prognostic factors of mitral regurgitation in patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone. MATERIAL ANDMETHOD: We reviewed the medical records of 90 patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone by a single surgeon from Jan. 1995 to Dec. 2002. We grouped the patients according to the postoperative changes of mitral regurgitation, and then we statistically compared the findings of echocardiogram between preoperative and last follow up. RESULT: There were 24 cases with progression of mitral regurgitation, 12 cases without changes, 54 cases with improvements of mitral regurgitation in total 90 patients. The bypass to LAD was proven as the significant prognostic factor of mitral regurgitation. The preoperative end diastolic left ventricular volume index were higher in aggravated group with 105.38+/-38.89 mL compared to 71.75+/-28.45 mL in improvement group, and 84.00+/-11.66 mL in no change group. The grade of preoperative mitral regurgitation did not show significant differences among the groups. CONCLUSION: The mitral regurgitation in patient with coronary artery stenosis can be improved after the coronary artery bypass surgery alone. However, the expectation of improvements based on the degree of preoperative mitral regurgitation can not be justified, therefore, the procedures for mitral regurgitation should be aggressively considered even in the cases of mild mitral regurgitation. Also, further study should be performed to identify the exact prognostic factors of mitral regurgitation including the left ventricular volume index, and whether the left anterior descending artery has been bypassed.
Arteries ; Coronary Artery Bypass* ; Coronary Stenosis* ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Ischemia ; Medical Records ; Mitral Valve ; Mitral Valve Insufficiency* ; Prognosis* ; Risk Factors*

BACKGROUND: In recent years, a combination of two demographic phenomena, an increased number of older people in the population and an increase in the incidence of lung cancer with age, has made it mandatory to develop therapeutic modalities with less toxicity for the treatment of inoperable elderly patients with lung cancer. Therefore, we investigated the correlation between COX-2 expression and cytotoxicity of Nimesulide, a specific COX-2 inhibitor. MATERIAL AND METHOD: Immunohistochemical staining of COX-2 was performed. After exposure of Nimesulide, XTT analysis, FACS analysis and Hoechst staining were carried out. RESULT: COX-2 protein was expressed in non- treated A549 cells strongly, but not in H1299. Cytotoxicity of Nimesulide against A549 cell and H1299 cell were similar and IC50 of Nimesulide in both cell lines were 70.9 microM in A549 cell line and 56.5 microM in H1299 cell line respectively. FACS analysis showed G0/G1 arrest in both cell lines and the S phase cell fraction was decreased. Morphologic assessment of apoptosis by Hoechst 33258 staining, many apoptotic cells were detected in both cell lines. CONCLUSION: Selective COX-2 inhibitor, Nimesulide, can inhibit the proliferation of non-small cell lung cancer cell lines in vitro. Inhibitory effect of Nimesulide are induction of apoptosis and G0/G1 arrest. There is no correlation between COX-2 expression and cytotoxicity of Nimesulide, a specific COX-2 inhibitor. Therefore, highly selective COX-2 inhibitors such as Nimesulide can be expected to lead to even greater efficacy of their use as adjuncts to various anticancer angents and radiation therapy for the treatment of high-risk patients.
Aged ; Apoptosis ; Bisbenzimidazole ; Carcinoma, Non-Small-Cell Lung* ; Cell Line* ; Cyclooxygenase 2 Inhibitors ; Humans ; Incidence ; Inhibitory Concentration 50 ; Lung Neoplasms ; S Phase

Lingual thyroid is the most common benign ectopic thyroid tissue but is a rare clinical entity. This developmental anomaly is due to the failure of descent of the gland anlage early in the course of embryogenesis. Patients may have symptoms of dysphagia due to obstruction or even hemorrhage. These symptoms can occur at any time from infancy through adulthood. The clinical findings, laboratory tests, and radiographic imaging studies employed in confirming the diagnosis and in planning appropriate treatment have been evaluated. The primary therapeutic goal is to restore thyroid function but surgical excision of the gland is reserved for more advanced cases of gland enlargement resulting in airway compromise, severe dysphagia that limits oral intake, or hemorrhage. We experienced a case of lingual thyroid that was successfully treated by transcervical approach and summarized the principles of current management for this condition.
Deglutition Disorders ; Diagnosis ; Embryonic Development ; Female ; Hemorrhage ; Humans ; Hypothyroidism ; Lingual Thyroid* ; Pregnancy ; Thyroid Dysgenesis ; Thyroid Gland

BACKGROUND AND OBJECTIVES: The majority of nasal bone fractures have been managed by using closed reduction and intranasal packing, leaving rooms for many complaints from patients. But the intranasal Kirschner wire (K-wire) splinting described by Chang in 1994 provided rigid intranasal support and increased less complaints from patients. Although the Kirschner wire splinting can be an alternative method for nasal bone packing that accompanies little complaints from patients, literature regarding the efficiency of Kirshcner wire splinting is rare. We studied the efficiency and clinical outcomes between the K-wire splinting and intranasal packing. MATERIALS AND METHOD: Prospectively, we studied 51 patients with nasal bone fracture who have undergone closed reduction. Of these, 30 patients were immobilized with the Kirschner wire splinting and 21 patients were immobilized with intranasal vaseline packing. On the first prospective day, patients were routinely examined by a visual analogue scale. The degree of satisfaction by both doctors and patients was investigated after a minimum 6 months. Complications were studied. All results were statistically confirmed. RESULTS: Complaints from patients were significantly less when the K-wire was used. There was no statistical difference between satisfaction expressed by doctors and patients, and there were no serious complications in using the K-wire. CONCLUSION: The K-wire is a reliable and useful immobilization method for nasal bone fracture.
Bone Wires ; Humans ; Immobilization ; Nasal Bone* ; Petrolatum ; Prospective Studies ; Splints