No abstract available.
Thoracoscopy*

No abstract available.

Anti-thrombin III deficiency is known as a disease of autosomal dominant trait and relatively common, but in Korea, exact incidence and mortality is not known, In general, Anti-thrombin III deficiency is expressed to venous thromboembolism like deep vein thrombosis or pulmonary embolism. But, arterial embolism is very rare. We experienced a case of Antithrombin III deficiency expressed as myocardial infarction of inferior wall by huge thrombosis in the mid and distal right coronary artery.
Antithrombin III Deficiency ; Coronary Vessels ; Embolism ; Incidence ; Korea ; Mortality ; Myocardial Infarction* ; Pulmonary Embolism ; Thrombosis ; Venous Thromboembolism ; Venous Thrombosis

PURPOSE: Management of major renal injury caused by blunt trauma is still somewhat controversial. We investigated the characteristics of grades IV and V blunt renal injury patients who underwent conservative or operative treatment, and determined the feasibility of conservative treatment of such injury. MATERIALS AND METHODS: We retrospectively reviewed the records of 25 patients who presented our hospital with grades IV or V blunt renal injury. The 10 patients treated conservatively were assigned to group 1, and the 15 patients treated surgically to group 2. Each group was compared with respect to initial evaluation, radiologic findings, associated injuries, duration of hospital and intensive care unit stay, transfusion requirements, complications and follow-up imaging. RESULTS: We found that shock was the only characteristic sign of the surgical treatment group and that the degree of hematuria did not correlate with treatment options. Radiologic findings which differed significantly between the 2 groups were the proportion of devitalized segments to total renal parenchyma and the presence of ureteral opacification despite urinary extravasation. Patients in group 1 had lower transfusion requirements but longer hospitalization, both significantly. Follow-up imaging of group 1 patients revealed functioning renal parenchyma with resolution of retroperitoneal hematoma in 8 of the 10 cases (80%). CONCLUSIONS: This study shows that conservative treatment of blunt grades IV and V renal injury should be considered for patients with hemodynamic stability, no significant associated intra-abdominal organ injuries, devitalized segments less than 25% of renal parenchyma and ureteral opacification despite urinary extravasation on radiologic finding.
Follow-Up Studies ; Hematoma ; Hematuria ; Hemodynamics ; Hospitalization ; Humans ; Intensive Care Units ; Kidney ; Retrospective Studies ; Shock ; Ureter

The purpose of this study is to review the clinical and pathological features of pseudomembranous colitis in Korea. Ten cases of psedomembranous colitis, which were diagnosed by sigmoidoscopy and biopsy at the Seoul National University Hospital from May 1982 to occtober 1985, were analyzed in terms of the age and sex distribution, underlying diseases, presumptive causative antimicrobials, symptomatology, involved site and tratment. 1) The disease was more prevalent above sixth decade with a slight preponderance on the female. 2) The underlying diseases of the patients were the uterine cervix cancer in 3 cases and one case each of the nasal polyp, cataract, degenerative arthritis, tuberculous gradmuloma, SLE with menngitis, CVA and gingival abscess. 3) As for the presumptive causative drugs, cephalosporin were assaciated in 6 cases, aminoglycoside m 7 cases, penlcillin in 3 cases, Bactrim in 3 cases, antituberculosis drugs in 1 case and anticancer drugs in 1 case. 4) As for the anatotmical distribution of the lesion, the rectum was involved in 5 cases, the rectum and sigmoid colon in 4 cases and up to the descending colon in 1 case. 5) All the cases were cured by medical treatment. In 5 cases, discontinuation of the antimicrobial drugs and supportive care only were effective and in other 5 cases, vancamycin and/or metronidazole together vrith cholestyramine were added to the regimen.
Abscess ; Biopsy ; Cataract ; Cervix Uteri ; Cholestyramine Resin ; Colitis ; Colon, Descending ; Colon, Sigmoid ; Enterocolitis, Pseudomembranous* ; Female ; Humans ; Korea ; Metronidazole ; Nasal Polyps ; Osteoarthritis ; Rectum ; Seoul ; Sex Distribution ; Sigmoidoscopy ; Trimethoprim-Sulfamethoxazole Combination ; Trimethoprim, Sulfamethoxazole Drug Combination

Background: Telemetry is a wireless implanted device that measures biological signals in conscious animals and usually requires surgery for its removal when the study is finished. After removing the device, the animals are either used for other studies or euthanatized.Case presentation: Herein, we report the case of a living cynomolgus monkey (Macaca fascicularis) that was used for the entire experimental period, instead of euthanasia, after surgical removal of an implanted telemetry system.Radiography was used to determine the status of the implanted telemetry, following which, a repair surgery was performed for removing the system; clinical signs were used to preserve the life of the cynomolgus monkey. Postoperative clinical signs, food consumption, hematology, and serum biochemistry were examined during the 12-month observational period. No abnormal readings or conditions were observed in the subject after implant removal. Conclusions This study may be a useful case report for living cynomolgus monkeys in telemetry implantations used throughout the study period. We suggest minimizing the suffering and improving the welfare of these animals.

The remaining lung infarction is a rare but life-threatening complication after a thoracic operation and trauma. We report a case of this rare complication after the left upper lobectomy due to pulmonary aspergilloma. The infarction of the remaining left lower lobe occurred due to kinking of the pulmonary vessels after the left upper lobectomy and the completion pneumonectomy was performed in the post-operative second day. Therefore, prompt diagnosis and treatment may be necessary to prevent morbidity and mortality associated with pulmonary infarction from torsion of pulmonary artery and vein.
Diagnosis ; Infarction ; Lung ; Mortality ; Pneumonectomy ; Pulmonary Artery ; Pulmonary Infarction* ; Veins

BACKGROUND: Percutaneous transluminal coronary angioplasty(PTCA) is one of the most widely used therapeutic procedures in the treatment of patients with coronary artery disease. However, acute closure and late restenosis remain a major limitation of PTCA despite extensive efforts to prevent. Coronary artery stents have been proposed as a treatment modality for acute closure and restenosis. We evaluated the initial success rate, complications, the restenosis rate, and the clinical outcomes after coronary artery stenting. METHODS: We implanted 56 stents(Palmaz-Schatz(PS) stent : 38 ; #3.0-14, #3.5-7, #4.0-17, Gianturco-Roubin(GR) stent : 18 ; #2.5-4, #3.0-10, #3.5-1, #4.0-3) in 51 patients(male : 40, mean age : 58+/-1 year). The clinical characteristics of the subjects were unstable angina in 26(51%), stable angina in 2, and myocardial infarction in 23(45%) patients(acute : 18). Follow-up angiography was done at a mean duration of 5.4 month(1-12) after coronary stenting for 34 lesions(61%) of 30 patients. RESULTS: 1) The indications of stenting(n=56) were De novo in 33(59%), bailout procedure in 15(27%), suboptimal result after PTCA in 6, and restenosis after PTCA in 2 stents. The location of lesions were LAD in 24, RCA in 27, and circumflex artery in 5 lesions. Angiographic morphologic characteristics were type B in 38(BI : 3, B2 : 35) and type C in 18 lesions. 2) The angiographic and clinical success rate was 96%(54/56) and 94%(52/56). There were no significant difference in stent modality, lesion site and morphology, and indication of stent. 3) Procedural complications were 1 acute closure which was recanalized by emergency coronary artery bypass graft(CABG), 1 death with subacute closure, 2 dissection, and 5 hemorrhages requiring transfusion. 4) The overall restenosis rate was 26%(9/34). The restenosis rate was reduced significantly in PS stent[PS : 9%(2/22) vs GR : 58%(7/12), P < 0.05], > or =3.5mm of stent size[> or =3.5mm : 6%(1/18) vs 3.5mm : 50%(8/16), p < 0305], and high pressure ballooning group(poststenting adjunct balloon dilation pressure > 12atm) [High pressure(+) : 7%(1/14) vs High pressure(-) : 40%(8/20), p<0.05]. 5) The restenosis sites were managed with re-PTCA in 4, elective CABG in 1, and medical follow-up in 4 patients. CONCLUSION: Coronary stenting is an effective and safe procedure for the management of coronary artery disease. The PS stent and GR stent are considered as a safe means for bail-out, and the PS stent can reduces the restenosis rate especially.
Angina, Stable ; Angina, Unstable ; Angiography ; Arteries ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels* ; Emergencies ; Follow-Up Studies* ; Hemorrhage ; Humans ; Myocardial Infarction ; Stents*

BACKGROUND AND OBJECTIVES: There are relatively few studies that have evaluated the optimal timing, risk of mortality, and outcome for patients with coronary artery bypass graft surgery (CABG) performed in the setting of acute myocardial infarction (AMI). MATERIALS AND METHODS: We reviewed our 18 patients who underwent CABG within 14 days after AMI, between June 1994 and June 1997. Thirteen of the patients were male and 5 were female. Their ages ranged from 41 to 77 years (mean age, 60.6+/-10.4 years), and the amount of time betweenAMIandCABGrangedfrom4hoursto14days (meantime,7.0+/-4.7days).Therewere11 anteroseptal infarctions and 7 inferior wall infarctions. Eleven patients had transmural infarctions and 7 had subendocardial infarctions. Indications of operations were postinfarction angina, cardiogenic shock and intractable ventricular arrhythmia. Six patients required preoperative intra-aortic balloon pump (IABP) support, and 3 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.4+/-0.5 vessels per patient were bypassed. RESULTS: The early mortality rate for these 18 patients was 5.6% and late mortality rate was 5.9%, and 2-year actuarial survival rates were 89.5%. Univariate analysis of mortality showed that an ejection fraction less than 30% was associated with risk factor (p value=0.016 ). Age, sex, time to CABG, emergency operations, locations of infarctions were not significant. CONCLUSION: Although our studies have weak points in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.
Arrhythmias, Cardiac ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Emergencies ; Female ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Myocardial Revascularization ; Risk Factors ; Shock, Cardiogenic ; Survival Rate ; Transplants

BACKGROUND: It has been shown that defects in mitochondrial function are involved in the induction of neuronal cell injury. Prostanoids such as prostaglandin E2 (PGE2) are thought to play an important role in inflammation and neurologic disorders. However, the effect of PGE2 on cholesterol-oxidation-product-induced neuronal cell injury remains uncertain. METHODS: The effect of PGE2 on toxicity of 7-ketocholesterol (7-KCS) was assessed in PC12 cells that were differentiated following treatment with nerve growth factor. The mitochondria-mediated apoptotic process was evaluated by examining the inhibitory effect of PGE2 on 7-KCS-induced toxicity. RESULTS: 7-KCS induced BID cleavage, increased the production of proapoptotic Bax protein, decreased antiapoptotic Bcl-2, increased p53, and promoted cytochrome c release in the cytosolic fraction, which subsequently elicited the activation of caspase-3, DNA fragmentation, and cell death. Treatment with PGE2 inhibited this 7-KCS-induced apoptotic process and cell death. CONCLUSIONS: The results show that PGE2 inhibits 7-KCS-induced toxicity in differentiated PC12 cells by suppressing the mitochondria-mediated apoptotic process. PGE2 may protect against cholesterol-oxidation-product-induced neuronal cell injury.
Animals ; bcl-2-Associated X Protein ; Caspase 3 ; Cell Death ; Cytochromes c ; Cytosol ; Dinoprostone ; DNA Fragmentation ; Inflammation ; Ketocholesterols ; Mitochondria ; Nerve Growth Factor ; Nervous System Diseases ; Neurons ; PC12 Cells ; Prostaglandins