A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.
Acupuncture ; Adult ; Cardiopulmonary Bypass ; Chest Pain ; Dyspepsia ; Female ; Foreign Bodies* ; Heart Ventricles* ; Humans ; Needles* ; Radiography, Thoracic ; Substance-Related Disorders

No abstract available.
Genetic Therapy*

the ineidence of abdominal subcutaneous endometriosis is quite rare we have experienced one case of subcutaneous endometriosis. The typical clinical bistory and local findings of endometriasis enabk us to make the conect diagnosis. the treatment of choice is complete surgical excision of endometrial tissue and post operative medical therapy. This case was reported with a brief review of the comcemed literatures.
Diagnosis ; Endometriosis* ; Female ; Subcutaneous Tissue*

No abstract available.
Apoptosis* ; Female ; Hypertension, Pregnancy-Induced* ; Placenta* ; Pregnancy*

Besides lung transplantation, pulmonary thromboembolectomy is the only effective therapeutic option for chronic thromboembolic pulmonary hypertension. It is however associated with a considerably high hospital mortality between 6.6 to 23%. Proper patient selection is critical when considering a patient for pulmonary thromboembolectomy. And It cannot be overemphasised that the key to the success of the operation is complete endarterectomy of the entire pulmonary arterial tree. We report that pulmonary thromboendarterectomy under total circulatory arrest was an effective and safe method in the surgical correction of the chronic thromboembolic pulmonary hypertension and enabled complete removal of superimposed peripheral organized thrombi in a good operative field.
Endarterectomy* ; Hospital Mortality ; Humans ; Hypertension, Pulmonary ; Lung Transplantation ; Patient Selection ; Pulmonary Embolism

In the present study, the authors investigated the management of mechanical valve thrombosis (MVT). From January 1981 through March 2006, 2,908 mechanical valve replacements were performed in 2,298 patients at our institution. Twenty (0.87%) patients presented with MVT, 14 (70.0%) were women, and the mean age of the patients was 42.0+/-14.0 (27-66) yr. Thrombosis involved mitral in 14 (70.0%), aortic in 2 (10.0%), tricuspid/aortic in 1 (5%), and tricuspid in 3 (15%). The interval from first operation to valve thrombosis was 121.8+/-75.4 (0.9-284.7) months. The most frequent clinical presentation was heart failure (13/20, 65%), and predisposing causes of MVT were: poor compliance with warfarin (7), pregnancy (5), drug interaction (2), and unknown (6). All 20 patients underwent valve replacement: mitral (14, 70.0%), tricuspid (3, 15.0%), aortic (2, 10%) and tricuspid/aortic (1, 5%). One early death occurred due to left ventricular failure, but no late mortality occurred during 63.3+/-49.9 (0.5-165.1) months of follow-up. MVT was treated successfully, and pregnancy and inadequate anticoagulation were found to influence the occurrence of this rare complication.
Adult ; Aged ; Anticoagulants/therapeutic use ; Coronary Thrombosis/drug therapy/*mortality/*surgery ; Drug Interactions ; Female ; Follow-Up Studies ; Heart Valve Prosthesis/*adverse effects/*statistics & numerical data ; Heparin/therapeutic use ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Patient Compliance ; Postoperative Complications/drug therapy/*mortality/*surgery ; Pregnancy ; Pregnancy Complications/mortality ; Recurrence ; Reoperation/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Thrombolytic Therapy ; Warfarin/therapeutic use

OBJECTIVE: To plan the goals of the rehabilitation management after stroke, it was important to know functional prognosis of the patients. The purpose of this article was to predict functional outcomes of stroke patients by means of an analysis of the well-known prognostic factors of function at admission. METHOD: This study was performed retrospectively on 102 patients with acute stroke who were admitted to Department of Rehabilitation Medicine. The inpatients, clinical and functional evaluation were carried out at admission. Functional abilities were measured with the use of the Functional Ambulatory Category (FAC) and the modified Barthel Index (MBI). RESULTS: The significant prognostic factors of FAC improvement rate were age, National Institute of Health Stroke Scale (NIHSS), Morticity Index, MBI, Mini-Mental State Examination (MMSE), aphasia and Trunk Control Test (TCT) (p<0.01). The most valuable single factor of FAC improvement rate was TCT. The significant prognostic factors of MBI improvement rate were age, NIHSS, Morticity Index, MMSE, aphasia and TCT (p<0.01). The most valuable single factor of MBI improvement rate was TCT. CONCLUSION: We concluded that TCT could be the most valuable prognostic factor in rehabilitation management outcome of stroke.
Aphasia ; Humans ; Inpatients ; Prognosis ; Rehabilitation ; Retrospective Studies ; Stroke*

Prostaglandin E1 (PGE-1) is a potent vasodilator, which also inhibits platelet aggregation, affects the blood flow viscosity, and fibrinolysis. The compound also excerts anti-inflammatory effects by inhibiting the monocyte and neutrophil function. PGE-1 has been widely administered following microvascular flap surgery, along with perioperative antithrombotic agents such as low molecular weight heparin or aspirin, showing excellent results. We report a case showing successful salvage recovery from post-traumatic ischemic necrosis of the finger via PGE-1 assisted conservative treatment.
Alprostadil* ; Aspirin ; Fibrinolysis ; Fibrinolytic Agents ; Fingers* ; Heparin, Low-Molecular-Weight ; Ischemia ; Monocytes ; Necrosis* ; Neutrophils ; Platelet Aggregation ; Salvage Therapy* ; Viscosity

We evaluated long-term results of De Vega annuloplasty measured by cylindrical sizers for functional tricuspid regurgitation (FTR) and analyzed the impact of measured annular size on the late recurrence of tricuspid valve regurgitation. Between 2001 and 2011, 177 patients (57.9+/-10.5 yr) underwent De Vega annuloplasty for FTR. Three cylindrical sizers (actual diameters of 29.5, 31.5, and 33.5 mm) were used to reproducibly reduce the tricuspid annulus. Long-term outcomes were evaluated and risk factor analyses for the recurrence of FTR > or =3+ were performed. Measured annular diameter indexed by patient's body surface area was included in the analyses as a possible risk factor. Operative mortality occurred in 8 patients (4.5%). Ten-year overall and cardiac death-free survivals were 80.5% and 90.8%, respectively. Five and 10-yr freedom rates from recurrent FTR were 96.5% and 93.1%, respectively. Cox proportional hazard model revealed that higher indexed annular size was the only risk factor for the recurrence of FTR (P=0.006). A minimal P value approach demonstrated that indexed annular diameter of 22.5 mm/m2 was a cut-off value predicting the recurrence of FTR. De Vega annuloplasty for FTR results in low rates of recurrent FTR in the long-term. Tricuspid annulus should be reduced appropriately considering patients' body size to prevent recurrent FTR.
Adult ; Age Factors ; Aged ; Body Surface Area ; Cardiac Valve Annuloplasty ; Disease-Free Survival ; Echocardiography ; Female ; Humans ; Hypertension/complications ; Male ; Middle Aged ; Postoperative Complications ; Proportional Hazards Models ; Recurrence ; Risk Factors ; Treatment Outcome ; Tricuspid Valve/*physiopathology ; Tricuspid Valve Insufficiency/etiology/mortality/*surgery

PURPOSE: An abridged 5-item version of the 15-item International Index of Erectile Function (IIEF) was developed and its validity has been proven in the western medical community. This study was designed to assess the validity of the abbreviated Korean version of the IIEF as a diagnostic tool for ED. MATERIALS AND METHODS: Patients who visited the Andrology Clinic of the Asan Medical Center with a chief complaint of ED fall into the patient group. Patients who visited the Family Medicine Clinic of the same hospital with chief complaints other than ED, and checked no ED in the self-assessment questionnaire, fall into the control group. Patients, both of the patient group and control group, were asked to fill out the self-administered IIEF-5 and the questionnaire asking the severity of the ED. RESULTS: Collected questionnaires from a total of 309 subjects (the patient group: 149; the control group: 160) were used for statistical analysis. Mean ages were 43 and 52 for the control group and the patient group, respectively. A Receiver Operating Characteristics (ROC) Curve analysis indicated that there is a close correlation between IIEF-5 total scores and the presence of ED (area under the ROC curve=0.961). The most appropriate cutoff score between ED and no ED was 17 (sensitivity=91.3%, specificity=86.3%). Substantial consistency existed between the predicted and the patient-answered ED severity levels (Weighted Kappa=0.681). CONCLUSIONS: The Korean version of IIEF-5 is highly effective in detecting the presence and assessing the severity of ED. The result of our study supports its validity as a diagnostic instrument in the clinical setting.
Andrology ; Chungcheongnam-do ; Diagnosis ; Erectile Dysfunction* ; Humans ; Male ; Surveys and Questionnaires ; ROC Curve ; Self-Assessment