No abstract available.
Angiotensin II ; Angiotensins ; Endothelial Cells ; Endothelins ; Epoprostenol ; Thrombin ; Umbilical Veins

A 44-year-old man was transferred to our department for mediastinal mass. He had suffered from only an easily fatiguable condition for 1 month. A physical examination and laboratory finding of the patient disclosed no abnormality. A chest radiograph showed a soft tissue tumor in the posterior mediastinum. It was well circumscribed and ovoid. Invasions to adjacent organs were not seen. Therefore it was though the 5th intercostal space. The tumor mass was attached to the visceral pleura of the right upper lobe by a pedicle and this pedunculated tumor laid entirely within the pleural cavity. Excision of the tumor which measured 7x7x3cm was done easily. Pathologic studies confirmed the diagnosis of localized fibrous tumor of the pleura. Localized fibrous tumor of the pleura is rare, This tumor along ith the evidence from ultrastructural and immunohistochemical studies has led most researchers to conclude that localized fibrous tumor is not of the mesothelial origin but arises in the submesothelial connective tissue.
Adult ; Connective Tissue ; Diagnosis ; Humans ; Mediastinum ; Mesothelioma ; Physical Examination ; Pleura* ; Pleural Cavity ; Pleural Neoplasms ; Radiography, Thoracic

In addition to many of the widely accepted risk factors of bronchopulmonary dysplasia (BPD), such as prematurity, oxygen toxicity, barotrauma, and infection, the amount of fluid intake during the early phase of life has recently been reported to be an important factor, especially the amount of colloid. Forty-one premature infants who were admitted to the NICU of Severance Hospital, Yonsei University College of Medicine between Jan. 1990 and Jun. 1992 and treated for respiratory difficulty with mechanical ventilation and restrictive fluid therapy were included in the study. fourteen were diagnosed as BPD and the rest were grouped as Non-BPD. We confirmed prematurity, low birth weight, high oxygen concentration, high ventilator pressures and rates, perinatal asphyxia, acidosis, and low blood pressures as risk factors. However, with restrictive fluid therapy that we have used, there was no difference in the amount of total fluid, of crystalloid, or of colloid between BPD and Non-BPD groups, as were the urine output, serum electrolyte concentrations, and percent body weight change. The amount of colloid when used for the maintenance of adequate blood pressures and for the prevention and treatment of hypovolemia, oliguria, anemia of sepsis under the scheme of restrictive fluid therapy would not influence adversely in the development of BPD. Instead, the amount of colloid used may imply the severity of illness of the patient; that is, the more severe the condition of the patient the more the amount of colloid used.
Acidosis ; Anemia ; Asphyxia ; Barotrauma ; Body Weight Changes ; Bronchopulmonary Dysplasia* ; Colloids ; Fluid Therapy* ; Humans ; Hypovolemia ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Oliguria ; Oxygen ; Respiration, Artificial* ; Risk Factors* ; Sepsis ; Ventilators, Mechanical

A 55-year-old male was admitted to our hospital complaining of chest discomfort, dysphagia and severe pain on swallowing. Esophageal manometry showed that there was no relaxation of lower esophageal sphincter to swallowing. There was double barrelled esophagus or mucosal stripe appearance on esophagogram. Endoscopy revealed an appearance as if an esophago-tracheal fistula had been made at the level of the upper thoracic esophagus. Also, two slit-like mucosal tears was seen on the lower esophagus. There after, fasting and total parenteral nutrition for several weeks failed to bring about any changes in his symptoms. So, as treatment, primary closure of the upper opening of the false lummen was performed under general anesthesia. Soon after the surgical procedure, the patient's symptoms were improved except for mild dysphagia. He was discharged after oral intake had been juduciously commenced with fluids and soft diet subsequently. During follow-up in out-patient department, he had no specific symptoms including fever or dysphagia and massive dissection of the esophagus was improved on esophagogram. We report the experience of a case of spontaneous submucosal dissection of the esophagus which required conservative and surgical management.
Anesthesia, General ; Deglutition ; Deglutition Disorders ; Diet ; Endoscopy ; Esophageal Sphincter, Lower ; Esophagus* ; Fasting ; Fever ; Fistula ; Follow-Up Studies ; Humans ; Male ; Manometry ; Middle Aged ; Outpatients ; Parenteral Nutrition, Total ; Relaxation ; Thorax

BACKGROUND: The purpose of carotid endarterectomy is to prevent stroke regardless of past neurologic events. Major concern in the carotid endarterectomy is the inadequate blood flow of ipsilateral hemisphere during clamping of the carotid artery. It is well known that internal carotid artery back pressure means collateral cerebral blood flow. Our study is intended to determine the guideline of shunt placement according to the carotid back pressure and electroencephalographic finding. MATERIAL AND METHOD: The study population comprised of 16 consecutive patients who underwent carotid endarterectomy for carotid stenosis in our institution between from February 1996 to March 1999. There were 14 men and 2 women between the ages of 56 and 78 years(mean age 66.25+/-6.53 years). The carotid stenosis in the operative site was ranged from 61% to 95%(mean 73.8+/-12.33%) and the mean carotid stenosis of the contralateral side was 60.99+/-25.03%. During the operation, electroencephalographic monitoring was taken in all cases. The internal carotid artery back pressure was measured to estimate the collateral cerebral blood flow, and in all patients with back pressure below 40 mmHg(11 patients) and patients with complete occulusion of contralateral carotid artery(2 patients), an internal shunt was installed. RESULT: One postoperative death occurred in a patient with large evolving cerebral infarction and severe ipsilateral carotid stenosis, who underwent emergent carotid endarterectomy. The cause of death was hemorrhagic infarction in the corresponding cerebral territory. We observed that immediate operation after a major stroke negatively influenced the postoperative outcome. No intraoperative ischemic neurologic complication developed. During the follow-up upto now(mean follow-up 21.5+/-11.85 months), there has been no early or late recurrence of stroke except one patient ,in whom cerebral infarction developed in the contralateral side on the first postoperative day. CONCLUSION: At least 4-6 weeks stabilization after a stroke is recommended for surgical management. The carotid endarterectomy is an effective surgical intervention for prevention of anticipated stroke and can be performed safely if an internal shunt is used in patients whose internal carotid arterial back pressure is below 40 mmHg.
Carotid Arteries ; Carotid Artery, Internal ; Carotid Stenosis* ; Cause of Death ; Cerebral Infarction ; Constriction ; Endarterectomy ; Endarterectomy, Carotid* ; Female ; Follow-Up Studies ; Humans ; Infarction ; Male ; Recurrence ; Stroke

No abstract available.
Bacteremia* ; Female ; Humans ; Pregnant Women*

A-13-urar-old with a history of Alport syndrome had been suffering from progressive dysphagia and postprandial vomiting for over 7 years. Exophagogram and manoemtric studies were consistent with achalasia. Barum study demonstrated marked esophageal dilatation and smooth tapered narrowing of the distal esophagus. However in spite of the medical treatment including the injection of the distal esophagus. However in spite of the medical treatment including the injection of botulinum toxin at the lesion site using an endoscope symptom did not improved and he suffered growth failure and malnutrition. Esophagectomy and esophagogastrostomy were performed to relieve the dysphagia. A firm circumferential intramural mass about 7x5x5 cm was found in the distal esophagus. The lumen of the esophagus was markedly dilated and esophageal wall was hypertrophied. Histologic examination of the neoplasm revealed a rather ill defined tumor tissue consisting of interlacing or whirling spindle cells without significant mitosis and esophageal leiomyo-matosis was confirmed. The patient was discharged uneventfully.
Botulinum Toxins ; Deglutition Disorders ; Dilatation ; Endoscopes ; Esophageal Achalasia ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Humans ; Leiomyomatosis* ; Malnutrition ; Mitosis ; Nephritis, Hereditary* ; Vomiting

No abstract available.
Leiomyoma*

In view of ever rising water pollution problems of river in the vicinity of large urban communities, the author has made an investigation on the pollution of water sampled from Han River (Seoul area) and Nakdong River (Daegu city area) during the period from july to December, 1970. The water samples were taken twice a month during the study period of 6 months from 7 points (locations) along the main stream of Han River at Seoul city and 5 points of Nakdong River at Daegu city. The samples ware measured and analyzed in accordance with the recognized methods in the "Standard Methods or Examination of Water and waste" by American Public Health Association. The obtained results are as follows: I.Han River. 1. Average turbidity was 5.1 units ranging from 1 to 10 units and the turbidity of down stream was higher than that of the upper stream. 2. pH value showed slight alkalinity (mean ; 7.2) except Yunchang-Dong (6.9). 3. The mean value of Dissolved Oxygen contents (D.O) was 7.2 ppm (range of 3.4-10.5ppm). D.O of the upper stream (8.2 ppm. at Walker Hill boating place, 8.0 ppm. at the Gwangzang Bridge and Ddookdo) was higher than that of he downstream (5.6ppm. at Yunchang-Dong. 6.4ppm. at the 2nd Han River Bridge), and D.O in the winter season was higher than that in the summer season, respectively. 4. The mean value of the Biochemical Oxygen Demand (B.O.D.) was 28.3 ppm. (range of 6.2-64.8ppm). The mean value of B.O.D. was 48.7 ppm. at Yunchang-Dong. 42.3ppm. at the 2nd Han River Bridge, 34.0 ppm. at the 1st Han River bridge, 28.5 ppm. at the 3rd Han River Bridge, 19.2 ppm. at Dookdo, 13.2 ppm. at the Gwangzang Bridge, and 10.2 ppm. at the Walker Hill boating place in order of value. B.O.D. in July and August (35.6 and 34.5 ppm.) were the highest and that in November and December (18.6 and 21.2 ppm.) were the lowest. 5. Suspended Solids (SS) were from 15.0 to 667.0 ppm. with the mean of 222.1 ppm "Suspended Solids" of the water samples at Yunchang-Dong and the 2nd Han River Bridge were found to be 378.1 ppm. and 283.9 ppm. respectively which were higher than at the Gwangzang Bridge (134.1ppm.) and at Walker Hill boating place (79.3ppm). 6. Coliform colonies counting of the water samples ranged from 0-2, 500x10/100ml. with the mean value of 205.6x10/100ml. The most contaminated water sample by coliform were from the point of the 2nd Han River Bridge with 640.8x10/100ml while the lowest ones were from Walker Hill boating place with 17.2x10/100ml. There was also a seasonal variation in coliform contamination that is the higher in summer and the lower in winter. II. Nakdong River. 1. The mean value of turbidity was 2.3 units with range of 0 to 9.0 units. The highest point was at Geumho River (7.2 units). and the lowest point was at Gangzung and Moonsan (0.45 and 0.41 units). 2. The mean value of pH was 7.5 (range of 7.1-8.5) and highest point was Geunho River with 8.5. 3. The mean value of D.O was 8.1ppm. (range of 3.4-11.2 ppm.). D.O. of the upper stream showed higher value than that of the down stream, and the winter season than the summer season. 4. B.O.D. ranged from 2.6 to 57.0 ppm. (mean; 20.4 ppm.). The water sample at Geumho River showed the highest value (41.5ppm) while at Moonsan and Gangzung showed the lowest (4.6 and 4.7 ppm.). 5. The mean value of suspended solids was 48.7 ppm. (range of 4.0-182.0 ppm.). The highest month was July (63.7 ppm.) and August (62.1 ppm.) and the lowest month was October (37.0 ppm.) and December (24.4 ppm.). 6. The mean value of the coliform colonies was 22.7x10/100ml. (range of 0-243x10/100ml.). The highest number of the colonies was found in the sample water at the Whawon recreation area (50.5x10/100ml.) followed by the Geumho River (33.9x10/100ml;), the Goryung Bridge (28.3x10/100ml.), Gangzung(0.7x10/100ml), and Moonsan (0.6x10/100ml.).
American Public Health Association ; Daegu ; Hydrogen-Ion Concentration ; Oxygen ; Recreation ; Rivers* ; Seasons ; Seoul ; Ships ; Water Pollution* ; Water*

Myxomas are the most common form of intracardiac tumors and are found primarily in the left atrium. In rare cases, Carney and associates have described a syndrome called "the complex of myxoma" consisting of cardiac myxoma, which characteristically is familial, in assocation with two or more of the follow conditions: myxomatous masses (cardiac myxoma, cutaneous myxosma, and mammary myxoid fibroademoma), spotty pigmented lesions of the skin, and endocrine disorders. We report a case of familial atrial myxoma with Carney's complex in a 19-year old woman who has spotty pigmentations on her face, and left atrial myxomas, and myxoma on the right nipple. Her mother and sister share the left atrial myxoma. The myxomas originated in the septum of the left atrium and the anterior leaflet of the mitral valve were successfully excised. In conclusion, family members of affected patients should be screened periodically with echocardiography in an attempt to identify asymptomatic cardiac myxomas. Complete excision and postoperative follow up are necessary to rule out the muticentricity and high rate of recurrent lesions.
Echocardiography ; Female ; Follow-Up Studies ; Heart Atria ; Heart Neoplasms ; Humans ; Mitral Valve ; Mothers ; Myxoma* ; Nipples ; Pigmentation ; Siblings ; Skin ; Young Adult