BACKGROUND AND OBJECTIVES: Perfluorocarbon exposed sonicated dextrose albumin (PESDA) microbubbles has been suggested to facilitate thrombus disruption under the transcutaneous ultrasound (US). Thus, we investigated whether such a noninvasive approach could augment thrombolytic effect of fibrinolytic agent in an experimental thrombotic model. MATERIALS AND METHODS: Thrombus formation was induced with electrical injury in the rabbit iliofemoral arteries (n=20): Thrombus occlusion was documented by angiography in all arteries. In the control group, only tissue plasminogen activator (t-PA, 3 mg/kg) was administered intrav-enously in five rabbits. In the Group 1 (n=9), injured arteries were exposed to transcutaneous US (20 kHz, 30 W/cm2, continuous mode) with t-PA (3 mg/kg). In the Group 2 (n=6), the same treatment was given while administering PESDA continuously (10 ml/min, intravenous). Angiographic results were evaluated at 10 minute interval for 1 hour respectively. RESULTS: In the control group, two of five iliofemoral arteries (40.0%) were recanalized and one of nine iliofemoral arteries (11.1%) was recanalized in Group 1. In contrast, four of six iliofemoral arteries (66.7%) were recanalized angiographically in Group 2 (p=0.392 vs. control group: p=0.047 vs. Group 1). However, late reocclusion occurred in all iliofemoral arteries of Group 2. CONCLUSION: Although PESDA with transcutaneous US significantly enhanced initial angiographic patency rate of t-PA, it was associated with high rate of reocclusion. Further studies will be necessary for clinical application of this noninvasive method in acute arterial occlusion.
Angiography ; Arteries ; Glucose* ; Microbubbles ; Rabbits ; Thrombolytic Therapy* ; Thrombosis ; Tissue Plasminogen Activator ; Ultrasonography*

Double-orifice mitral valve is a relatively rare congenital abnormality, usually discovered at autopsy or surgery. In most cases, the double-orifice mitral valve causes no hemodynamic effects, sometimes it is regurgitant, and rarely is stenotic. Appreciation of this echocardiographic abnormality is important because double orifice mitral valve is often associated with other congenital anomalies and this echocardiographic findings may be confused with other cardiac abnormalities. The authors report a case of isolated congenital double-orifice mitral valve in a 42-year-old woman. Data from the literature are reviewed and the echocardiographic images of the malformation are described.
Adult ; Autopsy ; Congenital Abnormalities ; Echocardiography ; Female ; Hemodynamics ; Humans ; Mitral Valve*

BACKGROUND: To evaluate depressure effect and safety of delapril, a new ACE inhibitor, in Korea. METHOD: Thirty three patients, aged 37-69, with mild to moderate essential hypertension were first observed for 2 weeks with placebo followed by administration of 15mg of delapril twice daily for 2 weeks, then doubled dosage to 30mg b.i.d. and combined with 25mg of dihydrochlorothiazide if optimal BP were not obtained at the end of 4th week, continued the same dose until the end of 10 week's trial period. RESULT: BP dropped 15/9mmHg inaverage at the end of 10th week rewarding 70% of cumulative effectiveness. Most frequent side reaction was dry cough, occurred in 9% of patients followed by chest tightness, headache, constipation and transient elevation of GPT. CONCLUSION: Delapril 15-30mg twice daily as monotheraphy or combined with diuretics is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Constipation ; Cough ; Diuretics ; Headache ; Humans ; Hydrochlorothiazide ; Hypertension* ; Korea ; Reward ; Thorax

Authors carried out an investigation of the helminthic parasites of the wild birds in Korea. Most wild birds were collected from Kyoung Sang Do, Kyoung Kee Do and Seoul area from September 1970 to March 1973. A total of 70 wild birds, 19 species were examined, which comprised as follows; 10 Anas platyrhynchus, 10 Anas fulicata, 4 Anas poeciolorhyncha zonorhyncha, 8 Anser albifrone albifrone, 5 Anser cygonopsis cygnoid, 10 Aythya fuligula, 6 Gallicrex cinerea, 2 Porgana fusca, 2 Phisianum calichius korponri, 4 Sterptopilla orientalis, Podiceps cristatus, Larus crasirotatus, Malantta fusca, Garis artcus, Buetes buteo, Egretta alba, Starmus philpiens, Bombycilla granulus. Trematode parasites found from six species of the wild birds. Echinostomatidae has been found from intestine of the Anas platyrhynchus platyrhynchus, Anas poeciolorhyncha zonorhyncha, Anas fulcata. Notocatylus attenuatis found from intestine of the Podiceps cristatus, Anas fulcata. Catylurus japonicus was found from rectum of the Anas platyrhynchus platyrhynchus, Anas poeciolorhyncha zonorhyncha.
parasitology-helminth-trematoda ; Notocatylus attenuatus ; Catylurus japonicus ; Echinostoma revolutum ; Echinostoma gotoi ; Echinostoma miyagawai ; Echinoparyphium koizumi ; bird

Hypertrophic scarring is common in burn patients. The treatment of such scarring is difficult, and recurrence of the hypertrophic change after scar revision is not uncommon. It has been done intramarginal excision to diminish the chances of recurrent hypertrophic scarring. Core scars in the auricle are easily separated from auricular cartilage and overlying soft tissue because there is loose areolar tissue between them. We therefore reviewed our experience with core extirpation of post-burn hypertrophic scars in the auricle. Between June 14, 1991, and August 6, 1994, we excised 10 hypertrophic scars in the auricle in 5 burn patients. Core extirpations of hypertrophic scars were performed under local anesthesia with longitudinal incision along long axis of scars. The wounds were closed directly in one layer after marginal trimming. We observed that core extirpation yielded good results in post-burn hypertrophic scars in the auricles.
Anesthesia, Local ; Axis, Cervical Vertebra ; Burns ; Cicatrix ; Cicatrix, Hypertrophic* ; Ear Cartilage ; Humans ; Recurrence ; Wounds and Injuries

A secondary cleft lip nasal deformity can be corrected by many procedures including central lip tissue transfer, forked flap, nasal floor and alar base advancement, nasal skin flaps and composite graft. These procedures have been applied for many years, but each one has some conspicuous residual problems. We propose triple V-Y advancement flaps, which we have performed on 13 secondary cleft lip and nasal deformity patients over the past 6 years. The W-shaped triple reverse V-shaped incision easily exposed the alar cartilages. We made the advancement and rotation of the nasal skin flap to lengthen the columella and project the nasal tip. Postoperatively, the columella length and nasolabial angle were found to be increased by an average of 3.7 mm and 42 degrees, respectively. In lateral view, a relatively natural nasal line was achieved. The scar in the nasal tip posed few problems. This procedure should be useful for the correction of the secondary cleft lip nasal deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Skin ; Transplants

The authors have experienced a case of granulomatous polyp in larynx following endotracheal intubation. The patient had a polyp on the posterior one third of left vocal cord somedays after endotracheal intubation. The microscopic study of the polyp disclosed a granulomatous polyp in larynx.
Humans ; Intubation, Intratracheal* ; Larynx* ; Polyps* ; Vocal Cords

Reconstructive surgeries for old ligament injuries of the knee vary according to the site and nature of injury as well as the age, health, physical demand and cartilage condition of the patients. No single best procedure is present for any old ligament injuries, but the most adaptable technique should be applied according to accurate diagnosis and experiences of surgeon. We reviewed our experiences of several reconstructive surgeries for the 38 cases with chronic ligamentous instabilities and summarized as following. 1) The most prevalent age of the patients was the third decades and males were 5.3 times more common than females. 2) Traffic accidents was the most common cause. 3) Tear of anterior cruciate ligament and medial collateral ligament appeared to be the most common injury. 4) Results at final follow up was not seemed to be affected by severity or location of ligament injury. 5) Intraarticular reconstruction without combined extraarticular reconstruction was not considered to be effective enough for anterior cruciate ligament deficient knee. 6) Although the number of cases was not large enough, we reviewed various reconstructive surgical techniques for comparison and evaluated the effects.
Accidents, Traffic ; Anterior Cruciate Ligament ; Cartilage ; Collateral Ligaments ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Male ; Tears

No abstract available.
Catheterization* ; Catheters* ; Hemothorax* ; Subclavian Vein*

BACKGROUND: Dobutamine echocardiography has been shown to be a valuable tool for determining myocardial viability in both acute and chronic coronary artery disease with left ventricular dysfunction. The purpose of the our study was to identify the role of dobutamine echocardiography in the prediction of improvement of regional left ventricular (LV) dysfunction after revascularization of chronic coronary artery disease. METHODS: Twenty-three patients (mean age 61.2+/-9.0 years;20 men) with chronic LV dysfunction underwent dobuta-mine echocardiography (dobutamine:baseline, 5, 10, 20 microgram/Kg/min) before coronary revascularization (coronary artery bypass graft surgery 16, percutaneous coronary angioplasty 7). The mean LV ejection fraction was 42.9+/-8.8% with ranging from 26% to 58%. Follow-up echocardiography was performed at 2 to 21 months (mean 9.0+/-6.2 months) after revascularization. RESULTS: During dobutamine echocardiography, there was no major complication. Improvement of the dysfunctional myocardium was observed in 12 of 23 patients in dobutamine echocardiography. Among them, 10 patients showed functonal recovery after revascularization. Another 11 patients did not show improvement of dysfunctional myocardium in dobutamine echocardiography, however 3 of them showed functional recovery after revascularization. One hundred fifteen dysfunctional segments were found in 368 segments of 23 patients, and improvement of wall motion abnormality was observed in 46 of 115 segments in dobutamine echocardiography. Among them, 31 segments showed functional recovery after revascularization. Another 69 segments did not show wall motion improvement in dobutamine echocardiography. But among them, 13 segments showed functional recovery after revas-cularization. The sensitivity and specificity of dobutamine echocardiography for the prediction of postoperative improvement of segmental wall motion were 70% and 79%, respectively. The positive and negative predictive value of dobutamine echocardiography were 67% and 81%, respectively. CONCLUSION: In patients with chronic LV dysfunction, dobutamine echocardiography can be used as a predictor of the improvement of dysfunctional segments after revascularization.
Angioplasty ; Arteries ; Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography* ; Follow-Up Studies ; Humans ; Myocardium ; Sensitivity and Specificity ; Transplants ; Ventricular Dysfunction, Left*