BACKGROUND: Impairment of relaxing response and augmentation of contractile response to vasoactive substances have been reported in atherosclerotic arteries. These alterations in vascular reactivity are considered as an underlying mechanism for the development of acute vasospasm in atherosclerotic coronary artery. Recently, it has been reported that lysophophatidylcholine (LPC), an oxidative metabolite of low density lipoprotein causes this functional abnormality. However, the precise mechanism of LPC induced change of vascular reactivity is still uncertain. METHOD: In this study, to elucidate the underlying mechanisms of abnormal vascular reactivity in atherosclerotic coronary artery, we examined the effect of LPC on whole cell K+current using patch clamping technique in rabbit coronary smooth muscle cells. RESULTS: Application of LPC(1microM) showed dual effect on whole cell outward current which depends on the magnitude of test potentials. At relatively high depolarizing test potentials (> 10 mV), LPC increased amplitude of outward current which was blocked by Gd3+ not by iberiotoxin (100 nM) and TEA (1 mM). Reversal potential of this Gd3+sensitive, LPC-induced current was -9.7 +/- 0.6 mV. At less depolarizing test potentials (< 10 mV), LPC decreased whole cell K+currents in a dose dependent manner (from 0.01 to 10 microM) in the range of -30 mV to +0 mV. Half maximal inhibition of K+current was 1.509 microM at 0 mV test potential (n =5). Depolarizing holding potential (0 mV) prevented this LPC-induced inhibition of K+current. Steady state activation and inactivation parameters of K+current were significantly shifted to the positive direction by application of LPC (p < 0.01, n =8). Pretreatment of staurosporine (100 nM), a blocker of protein kinase C partially blocked LPC-induced decrease of K+currents. CONCLUSION: LPC-induced inhibition of voltage dependent K+current may explain abnormal vascular reactivity in atherosclerotic coronary artery.
Arteries ; Constriction ; Coronary Vessels ; Lipoproteins ; Lysophosphatidylcholines* ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Protein Kinase C ; Staurosporine ; Tea

Hand rehabilitation is essential to restore the maximal functional capacity of a patient after the injuries of hand or upper extremity, such as a fracture, tendon tear, crushing, or amputation. To achieve the purpose, hand rehabilitation should begin shortly after the completion of surgery. Especially after the replantation, functional recovery can be achieved by a careful inpatient evaluation providing a proper treatment, detecting problems, and updating treatment programs, and arranging discharge and follow-up cares by a hand rehabilitation team. We report our experience of a successful hand rehabilitation of patient with a replantation surgery after the complete right forearm amputation. A comprehensive approach and systematized treatment programs are important for a hand rehabilitation.
Amputation* ; Follow-Up Studies ; Forearm* ; Hand* ; Humans ; Inpatients ; Rehabilitation* ; Replantation* ; Tendons ; Upper Extremity

OBJECTIVE: Among risk factors associated with cerebral infarction, cardiac factors are well known to be very important. However there were only few studies related to correlation between cardiac risk factors and stroke recurrence. So we tried to evaluate cardiac disease as a risk factor of recurrent cerebral infarction. METHOD: Subjects were 118 patients (62 male, 56 female) with cerebral infarction and were divided into first attack group as a control and recurred group. We evaluated the results of transesophageal echocardiographic study and other major risk factors and the results were compared in two groups using X2 test. RESULTS: Control group was 75 patients (39 male, 36 female), and recurred group was 43 patients (23 male, 20 female) and the mean ages were 62.8 years and 66.7 years, respectively. General transesophageal echocardiographic abnormalities were shown in 63 cases (84%) in control group and 40 cases (93%) in recurred group. Among the abnormal transesophageal echocardiographic findings, atherosclerosis of aorta was significantly higher in recurred group (49%) compared to control group (25%) (p<0.05), but there were no significant difference in aortic valve calcification, mitral calcification etc. Among the major risk factors of cerebral infarction, hypertension, diabetes, hyperlipidemia, and alcohol intake showed tendency of high incidence in the recurred group. Patients with abnormal EKG findings concurrent with abnormal transesophageal echocardiographic findings showed in 33 cases (44%) in control group, and 24 cases (56%) in recurred group, but there's no statistical significance. CONCLUSION: Our results do not support the hypothesis that TEE would be able to diagnose the cardiac risk factor for recurred cerebral infarction. However, the prevalence of atherosclerosis of aorta was significantly higher in recurrent group, so further studies would be needed.
Aorta ; Aortic Valve ; Atherosclerosis ; Cerebral Infarction* ; Echocardiography ; Echocardiography, Transesophageal* ; Electrocardiography ; Heart Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Male ; Prevalence ; Recurrence ; Risk Factors* ; Stroke

OBJECTIVE: Intraoperative monitoring using somatosensory evoked potential (SEP) study has been used increasingly to monitor neurological function during scoliosis surgery and other high-risk spinal surgeries. However, there are few studies related to this intraoperative monitoring, particularly in severe spinal deformity surgery, in Korea. So we evaluated the clinical efficacy of intraoperative SEP monitoring and considered the risk factors related to spinal surgery. METHOD: We performed a posterior tibial nerve somatosensory evoked potential study for intraoperative monitoring during surgical procedures in 101 patients (male 46, female 55). RESULTS: Neurologic damage occurred in 16 patients (10 congenital scoliosis cases, 5 tuberculous kyphosis cases, and 1 degenerative spondylosis case) after surgical procedures. Delayed postoperative neurologic damage occurred in 4 patients (2 mild damage cases, 2 severe damage cases) among 85 cases which showed normal responses during surgical procedures. Sensitivity of this study was 75%, and specificity was 95.3%. CONCLUSION: Somatosensory evoked potential study for intraoperaive monitoring is a sensitive and very useful method to detect iatrogenic lesions during spinal deformity surgery with satisfactory specificity. However, to improve the sensitivity and specificity of the intraoperative monitoring, combination of motor evoked potentials is recommended.
Congenital Abnormalities* ; Evoked Potentials, Motor ; Evoked Potentials, Somatosensory* ; Female ; Humans ; Korea ; Kyphosis ; Monitoring, Intraoperative* ; Risk Factors ; Scoliosis ; Sensitivity and Specificity ; Spondylosis ; Tibial Nerve

BACKGROUND AND OBJECTIVES:Although the various methods of pharyngolaryngeal closure after supraglottic partial laryngectomy(SPL) have been reported, the difference of postoperative function and complications has not been adequately analyzed. Therefore, We investigated the relationship between different pharyngolaryngeal closure methods and postoperative function and complications. PATIENTS AND METHODS: According to the methods of pharyngolaryngeal closure, postoperative complications, decannulation day and postoperative day when to start oral feeding were retrospectively investigated on 22 patients who underwent SPL. We divided the patients into two groups according to the methods of pharyngolaryngeal closure. In cartilage group(13 cases), the closure of pharyngolaryngeal defect was done with direct suture between the thyroid cartilage and base of the tongue. In perichondrial group(9 cases), the closure was done between preserved thyroid perichondrium and base of the tongue. RESULTS: There was no case requiring either a gastrostomy or a persistent tube feeding in our series. Fistula occurred more often in perichodrial group(3 cases) than cartilage group(0 case). In one case of perichondrial group, total laryngectomy was performed because of a fistula. Also, aspiration pneumonia occurred more often in perichodrial group(2 cases) than cartilage group(0 case). Decannulation could be performed relatively earlier in cartilage group than in perichondrial group. Also, oral feeding could be performed relatively earlier in cartilage group than in perichondrial group. CONCLUSION: Direct approximation between cut margin of the thyroid cartilage and base of tongue was safe, time-saving and reliable method of pharyngolaryngeal closure after SPL.
Cartilage ; Enteral Nutrition ; Fistula ; Gastrostomy ; Humans ; Laryngectomy* ; Pneumonia, Aspiration ; Postoperative Complications ; Retrospective Studies ; Sutures ; Thyroid Cartilage ; Thyroid Gland ; Tongue

Turner syndrome is the most common chromosomal disorder in girls. Various phenotypic features show depending upon karyotype from normal female through ambiguous genitalia to male. Usually, Turner girls containing 45,X/46,XY mosaicism, or sex-determining region Y (SRY) gene may have mixed gonadal dysgenesis with various external sexual differentiation. We experienced a short statured 45,X Turner girl with normal external genitalia. Because SRY gene was positive, laparoscopic gonadectomy was performed. The dysgenetic gonads revealed bilateral ovotesticular tissues. The authors report a mixed gonadal dysgenesis case found in clinical 45,X Turner patient with positive SRY gene. Screening for SRY gene should be done even the karyotype is 45,X monosomy and external genitalia is normal.
Chromosome Disorders ; Disorders of Sex Development ; Female ; Genes, sry* ; Genitalia ; Gonadal Dysgenesis, Mixed* ; Gonads ; Humans ; Karyotype ; Male ; Mass Screening ; Monosomy ; Mosaicism ; Sex Differentiation ; Turner Syndrome*

BACKGROUND AND OBJECTIVES: Radical surgery with radiotherapy is regarded as a standard treatment modality of hypopharyngeal squamous cell carcinoma. However, reports on results of treatment and patterns of failure after surgery for hypopharyngeal cancer are lacking. PATIENTS AND METHODS: From July 1992 to December 1998, 39 previously untreated hypopharyngeal carcinoma patients were treated with surgery with or without postoperative radiotherapy at Severance Hospital. Ten were treated with surgery alone, RESULTS: The overall 5-year survival rate was 58.1%, of which 47.2% accounted for the group who received surgery only and 64.6% for the group who received surgery plus postoperative radiotherapy. Survival was best for posterior pharyngeal wall cancer (64.6%) and worst for pyriform sinus cancer (56.1%). Recurrence was noted in 31% (12/39) of the cases. The most common Failure site was the neck, Among the neck failures, three unusual retropharyngeal and paratracheal nodal failures were noted. CONCLUSION: Treatment with radical surgery may improve survival of patients with this notorious cancer. The extent of neck dissection for hypopharyngeal carcinoma may need to be evaluated with future trials. (Korean J Otolaryngol 2000; 43: 528-34)
Carcinoma, Squamous Cell* ; Humans ; Hypopharyngeal Neoplasms ; Hypopharynx* ; Neck ; Neck Dissection ; Pyriform Sinus ; Radiotherapy ; Recurrence ; Survival Rate

Drug hypersensitivity syndrome to both vancomycin and teicoplanin has not been previously reported. We describe here a 50-yr-old male patient with vertebral osteomyelitis and epidural abscess who developed hypersensitivity syndrome to both vancomycin and teicoplanin. Skin rash, fever, eosinophilia, interstitial pneumonitis, and interstitial nephritis developed following the administration of each drug, and resolved after withdrawing the drugs and treating with high dose corticosteroids. The vertebral osteomyelitis was successfully treated with 6-week course of linezolid without further complications. Skin patch tests for vancomycin and teicoplanin was done 2 months after the recovery; a weak positive result for vancomycin (10% aq.,+at D2 and +at D4 with erythema and vesicles; ICDRG scale), and a doubtful result for teicoplanin (4% aq.-at D2 and+/-at D4 with macular erythema; ICDRG scale). We present this case to alert clinicians to the hypersensitivity syndrome that can result from vancomycin and teicoplanin, with possible cross-reactivity, which could potentially be life-threatening.
Vancomycin/*adverse effects ; Teicoplanin/*adverse effects ; Syndrome ; Middle Aged ; Male ; Humans ; Drug Hypersensitivity/*diagnosis/*etiology ; Drug Combinations

OBJECTIVE: To evaluate the cardiopulmonary endurance of subjects with spinal cord injury by measuring the maximal oxygen consumption with varying degrees of spinal cord injury level, age, and regular exercise. METHODS: We instructed the subjects to perform exercises using arm ergometer on healthy adults at 20 years of age or older with spinal cord injury, and their maximal oxygen consumption (VO2max) was measured with a metabolic measurement system. The exercise proceeded stepwise according to the exercise protocol and was stopped when the subject was exhausted or when VO2 reached an equilibriu RESULTS: Among the 40 subjects, there were 10 subjects with cervical cord injury, 27 with thoracic cord injury, and 3 with lumbar cord injury. Twenty-five subjects who were exercised regularly showed statistically higher results of VO2max than those who did not exercise regularly. Subjects with cervical injury showed statistically lower VO2max than the subjects with thoracic or lumbar injury out of the 40 subjects with neurologic injury. In addition, higher age showed a statistically lower VO2max. Lastly, the regularly exercising paraplegic group showed higher VO2max than the non-exercising paraplegic group. CONCLUSION: There are differences in VO2max of subjects with spinal cord injury according to the degree of neurologic injury, age, and whether the subject participates in regular exercise. We found that regular exercise increased the VO2max in individuals with spinal cord injury.
Adult ; Aging ; Arm ; Exercise ; Exercise Test ; Humans ; Male ; Oxygen Consumption ; Spinal Cord Injuries*

Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the novel virus severe acute respiratory syndrome coronavirus 2. The first case developed in December, 2019 in Wuhan, China; several months later, COVID-19 has become pandemic, and there is no end in sight. This disaster is also causing serious health problems in the area of cardiovascular intervention. In response, the Korean Society of Interventional Cardiology formed a COVID-19 task force to develop practice guidelines. This special article introduces clinical practice guidelines to prevent secondary transmission of COVID-19 within facilities; the guidelines were developed to protect patients and healthcare workers from this highly contagious virus. We hope these guidelines help healthcare workers and cardiovascular disease patients around the world cope with the COVID-19 pandemic.