No abstract available.
Cause of Death* ; Korea*

Most insects including the honeybee cause erythema and edema at the site of a sting in non-allergic individuals. This reaction usually resolves within a few days. However, in certain cases, the persistence of inciting materials in the cutaneous tissue may promote a local inflammatory foreign body reaction. Localized nodular lesions were seen in our two patients and erythemstous patches were present in one patient due to rarely encountered complications induced by retained sting materials. In these cases histopathology showed multiple foci of foreign body granuloma containing yellow refraetile material in the center surrounded by histiocytes and foreign body giant cells. The granulomatous skin lesions in these patients were treated with intralesional injections of triamcinolone acetonide and partial excisions of the nodular masses were performed.
Bites and Stings ; Edema ; Erythema ; Foreign-Body Reaction ; Giant Cells, Foreign-Body ; Granuloma* ; Granuloma, Foreign-Body ; Histiocytes ; Humans ; Injections, Intralesional ; Insects ; Skin ; Triamcinolone Acetonide

Anaphylaxis is a life - threatening syndrome elicited in a hypersensitive individual on subsequent exposure to a sensitizing antigen with, reactions ranging widely in severity from mild pruritus and criteria to shock and death. Anaphylaxis occurs in the United States at rates estimated to be as high as one in every 3000 inpatients and may account for more than 500 deaths annually. Preparations of kelp Laminaria digitata are used as tents in gynecologic procedures to dilate the cervix, and the kelp consists principally of a glucagon carbohydrate called laminarin. Laminarin is thought to function as the active ingredient in dilatation by changing osmotic pressure or uterine prostaglandin metabolism. The tent is inserted into the cervix several hours before the procedure. As the cervix desiccates and dilates, the tent develops an hourglass shape. Recently, we experienced one patient with anaphylaxis to laminaria diagnosed by skin test and showing good response to treatment.
Anaphylaxis* ; Cervix Uteri ; Dilatation ; Female ; Glucagon ; Humans ; Inpatients ; Kelp ; Laminaria* ; Metabolism ; Osmotic Pressure ; Pruritus ; Shock ; Skin Tests ; United States

BACKGROUND: In patients with myocardial infarction, one needs to know the location, extent and severity of wall motion abnormalities to assess prognosis and guide therapy. Thus more precise quantatative estimates of regional ventricular function are required. Regional wall motion has generally been assessed by displaying the multiple cardiac images of RVG as endless-loop movie, but the cinematic display was not objective. We used the usefulness of the phase analysis in evaluating the global left ventricular function and regional wall motion abnormalities of patients with myocardial infarction. The accuracy of the RVG cinematic display in detecting regional wall motion abnormalities in patients with myocardial infarction was also evaluated. METHODS: Studied cases were 97 patients with myocardial infarction and 20 normals with low likelihood of coronary artery disease. Coronary angiography and contrast left ventriculography were performed in all patients with myocardial infarction. The regional wall myocardial infarction(presence) is defined when the EKG presented the evidence of myocardial infarction, left ventriculogram showed RWMA(regional wall motion abnormality) along with stenosis of 50% or greater of the regional supplying coronary artery. Each patient was imaged in 45 left anterior oblique(LAO) view, anterior(Ant) view and left lateral(Lt Lat) view. We evaluated Left ventricular ejection fraction(LVEF) from time-activity curve. We constructed the histogram for the left ventricle and both ventricle separately to obtain the global and total phase angle(GPA, TPA), standard deviation of phase angle(GSDPh, TSDPh), full width half maximum(GFWHM, TFWHM). The left ventricle was divided into 7 segments. LAO projection ; septal, apical, basal lateral, apical lateral, Ant projection ; anterolateral, Lt Lat projection ; inferior, posterior, Phase angle(RPA) and full width half maximum(RFWHM) from the histogram (regional 7 segments) were examined. On the RVG cinematic display, the standard 4 grading system was used, normal, hypokinesia, akinesia, dyskinesia. The observer evaluated regional wall motion abnormality of the 7 segments for all cases. The sensitivity of the above parameters and RVG cinematic display was evaluated. We analyzed the regional parameters among the patents with regional wall myocardial infarction(presence), those without regional wall myocardial infarction(absence) and control group using the t-test. The statistical analysis was done by one way ANOVA between regional phase analysis and RVG cinematic display. RESULTS: The sensitivity of LVEF was lowest(70.1%) and the GFWHM was highest among the global parameters(89.1%). But RFWHM showed even higher sensitivity(96.9%), thus regional phase analysis was also required. The RVG cinematic display was also sensitive(92.7%), but less sensitive than the RFWHM. On regional phase analysis the RPA of septal, apical, inferior, posterior walls of the left ventricle was able to separate presence group from absence group and also presence group from control group and the RPA of the apical lateral wall could separate presence group from absence group. The RPA of basal lateral and anterolateral wall was inaccurate in diagnosing the regional wall myocardial infarction, because basal lateral wall was overlapped by adjacent vascular structures, and the area of anterolateral wall dose not correlate completely beteen the RVG & the left ventriculogram, also the anterolateral wall can be supplied by the obtuse marginal branch of left circumflex artery. The RFWHM of all regional walls of left ventricle could separate presence group from absence group and presence group from control group. We found good correlation between regional phase analysis & left ventriculogram for detection of regional wall myocardial infartion. On RVG cinematic display, the RPA of the normal group was different from that of dyskinesia, akinesia and hypokinesia groups. The RPA of the dyskinesia group was also different from that of skinesia and hypokinesia groups by oneway ANOVA(p<0.05). The RFWHM of the dskinesia group was different from that of the normal group and hypokinesia group. RVG cinematic display correlated well with regional phase analysis and also quantitation of wall motion. CONCLUSIONS: Thus RVG cinematic display was useful and can not be replaced by phase analysis. But the regional phase analysis was sensitive and objective in diagnosing the wall motion abnormality in myocardial infarction.
Ants ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Dyskinesias ; Electrocardiography ; Heart Ventricles ; Humans ; Hypokinesia ; Myocardial Infarction* ; Prognosis ; Radionuclide Ventriculography ; Ventricular Function ; Ventricular Function, Left

No abstract available.

The fashion of vascular anastomosis, end-to-end or end-to-side (E-to-S), are depended upon surgeon's preference or surgical situations. In E-to-S anastomosis two different methods of arteriotomy are applicable but it has been suggested the type, either elliptical or slit arteriotomy, play a different role in the flow hemodynamics. We thought that the difference is more considerable in microvascular surgery. This study examines the effects of elliptical versus slit arteriotomy on morphologic vessel patency. Twenty male Sprague-Dawley rats were divided into two groups of ten rats each. Both carotid arteries were selected as a experimental model. During the procedures the rat brain was tolerable to ischemia and all animals were survived after operations. The morphologic analysis of anastomosis site was through resin-casting method with scanning electromicroscopic examination. The results showed notable difference between two groups in three-dimensional morphology at two-month of operation. This difference may affect the flow hemodynamics and long-term vessel patency. In microvascular anastomosis, the mortpologic difference of the elliptical arteriotomy is worse than slit arteriotomy which compromises the vessel circumference.
Animals ; Brain ; Carotid Arteries ; Hemodynamics ; Humans ; Ischemia ; Male ; Models, Theoretical ; Rats ; Rats, Sprague-Dawley

Plain radrographs of thirty nine patients with giant cell tumor of long bone and CT scans of twenty patients among the thirty patients were reviewed retrospectively to evaluate the frequency and significance of sclerosis of the tumor margin. The sclerosis of the tumor margin was observed on plain radiographs in thirteen patients(33.3%) and they were located either on epiphyseal or on both epiphyseal or metaphyseal portion of the tumor. The authors concluded that the giant cell tumor should not be excluded from the differential entities eventhough the tumor has the marginal sclerosis.
Diagnosis, Differential* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Retrospective Studies ; Sclerosis* ; Tomography, X-Ray Computed

No abstract available.
Silver*

A case of supracardiac type of total anomalous pulmonary venous return into the superior vena cava is reported which was successfully diagnosed using spiral CT and three-dimensional image reconstruction. Spiral CT with three-dimensional reconstruction is non-invasive method of visualizing the vascular system and in some instances can replace conventional angiography in pediatric patients.
Angiography ; Humans ; Imaging, Three-Dimensional* ; Scimitar Syndrome ; Tomography, Spiral Computed ; Vena Cava, Superior

An automated percutaneous lumbar discectomy(APLD) have been apphed for contained lumbar disc herniation. But suggested that more exclusion criteria than disc containment was needed to improve success rate. The purposes of this study are to evaluate cIinical outcome of more than 4 years follow up of APLD, to analysis the cause of failure for longer follow up period, and to define prognostic factor of APLD. The l04 patients with contained lumbar disc herniation were treated with APLD from March 1990 to November 1992 in National Medical Center. The surgical candidates were contained focal disc herniation in MRI, sciatica than back pain, failure to conservative management at least 6 weeks and clinical and radiological correlation. And patient were excluded from this data if they had history of previous lumbar surgery and compensation claims. Among them 74 cases were followed up for over 4 years (Mean: 5.3 years). The results were accessed by questionnaire using telephone or OPD follow up. The overall success rate was 84% on 3 months follow up, but 68.9% on more than 4 years follow up by four subjective criterias (Onik, 1987). Causes of decreasing success rate were reoperation, recurrence without specific cause or after sprain and heavy work. 76% of failed cases occurred within 1 year and 40% of them underwent open discectomy. The patient sex, treated level, duration of symptom were not influenced on success rate, but age was factor related to success rate. In this study we can assess the effectiveness of APLD within 3 months in most cases and then change treatment option according to patients status, and it seems that we need more exclusion criteria than disc containment in MRI and refined patient selection in order to decrease the failures.
Back Pain ; Compensation and Redress ; Containment of Biohazards ; Diskectomy* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Patient Selection ; Surveys and Questionnaires ; Recurrence ; Reoperation ; Sciatica ; Sprains and Strains ; Telephone