No abstract available.
Mucocutaneous Lymph Node Syndrome*

The congenital pulmonary artery branch stenosis (PABS) was described by Oppenheimer (1) as early as in 1938, but it had attracted very little attention until the last decade. This disease is characterized grossly by single or multiple stenosis of the pulmonary artery and branches and has been described in the literature occasionally under the various designations including supravalvular pulmonary stenosis, coarctation of pulmonary artery, multiple peripheral stenosis of the pulmonary artery and pulmonary artery branch stenosis (3~22). It is known that this defect is no longer a very rare disease and functional problem only. The clinical significance of this disease is to differentiate from other congenital heart diseases such as patent ductus arteriosus, ventricular septal defect and pulmonic stenosis and is a cause of pulmonary hypertension. Nine cases of PABS confirmed by pressure difference in pullback tracing, selective angiography and rate of rise of pulmonary artery pressure are presented. This defect occurred as an isolated cardiovascular anomaly in 3 of the 9 patients. This condition was detected usually in childhood due to exertional dyspnea, frequent upper respiratory infections and heart murmur. Clinically the most significant diagnostic feature was the wide distribution of ejection systolic or continuous murmur, which was seldom louder than grade 4/6. It is also characteristic that the upstroke of the pulmonary artery pressure tracing is similar to the right ventricular tracing with the descending limb of the curve steeper and the dicrotic notch deeper with a low diastolic plateau. This results in a wide pulse pressure. Data are presented which suggest that comparing the rate of rise prestenotic with poststenotic pressure pulse may differentiate organic from functional pressure gradient. The purpose of this paper is to present in detail the clinical features including electrocardioram, chest X-ray, cardiac catherization, angiography, rate of rise of pulmonary artery pressure and diagnostic criteria of PABS. Only two cases of PABS were repoted in Korean literature from our laboratory.
Child ; Male ; Female ; Humans

Verrucous hemangioma is a variant of a capillary, cavernous, or mixed hemangioma which undergoes a reactive proliferative epidermal change. Most verrucous hemangiomas appear on the lower extremities, and most are present at birth or appear during childhood. We observed two patients who showed typical clinical and histopathological findings of verrucous hemangioma. Treatment was done by wide surgical excision and skin graft. The first rnale patient had a good therapeutic result but the second female patient had a recurrence at one month post-operative.
Capillaries ; Female ; Hemangioma* ; Humans ; Lower Extremity ; Parturition ; Recurrence ; Skin ; Transplants

Glioblastoma multiforme (GBM) is a brain tumor notorious for its malignancy. The key reason for the limited efficacy of standard treatment is the high recurrence rate of GBM, even after surgical resection. Hence, intensive postsurgical chemical therapies, such as the systemic delivery of various drugs and/ or drug combinations, are typically followed after surgery. However, overcoming the blood-brain barrier by systemic administration to efficiently deliver drugs to the brain tumor remains a daunting goal. Therefore, various local drug delivery methods showing potential for improved therapeutic efficacy have been proposed. In particular, the recent application of electronic devices for the controlled delivery of chemotherapy drugs to GBM tissue has attracted attention. We herein review the recent progress of local drug delivery strategies, including electronics-assisted strategies, at the research and commercial level. We also present a brief discussion of the unsolved challenges and future research direction of localized chemotherapy methods for GBM.

BACKGROUND AND OBJECTIVES: The prevalence of coronary disease in Korea, with the consequent morbidity and mortality, has rapidly risen during the last two decades. This study aimed to describe the changing pattern in the demographic composition during the 1990s of patients presenting with acute myocardial infarction (AMI) in Korean metropolitan cities. SUBJECTS AND METHODS: Data from the medical record of patients with AMI, admitted to five University Hospitals in Busan and Daegu between January 1990 and December 1999, were sorted according to their age (<30, 3044, 4559, 6074, >75 years) and gender. RESULTS: During the last decade, the number of cases of AMI increased from 283 in 1990, to 988 by 1999 (ratio of AMI/medical patients admitted; 1.68% in 1990 to 2.52% in 1999). The most prevalent age group was 6074 yrs (46.1%), followed by 4559 yrs (34.2%). Generally, the male cases were twice as prevalent as female (68.2% : 31.8%), but the gender ratio was reversed in the highest age group (>75 yrs) (44.6% : 55.4%). During the period in question, the gender ratio and age distribution remained reasonably constant throughout. The proportion of younger AMI patients (<45 yrs) did not increase. CONCLUSION: Admissions due to AMI increased substantially during the 1990s. Almost half the cases were from the 6074 yrs age group, and two third were male. There were little changes in the compositions of age and gender of the AMI cases during this period.
Age Distribution ; Busan ; Coronary Disease ; Daegu ; Female ; Hospitals, University* ; Humans ; Korea ; Male ; Medical Records ; Mortality ; Myocardial Infarction* ; Prevalence

BACKGROUND AND OBJECTIVES: Radiofrequency (RF) catheter ablation of the pulmonary vein (PV) can treat drug refractory focal atrial fibrillation (AF). However, high RF energy (RFE) can cause severe PV damage, and the lower limits of effective RFE in PV have not yet been elucidated. This study attempts to evaluate the changes of PV structure after various modes of RFE delivery. MATERIALS AND METHODS: Right heart and transseptal catheterization were performed in 5 anesthetized mongrel dogs. RFE was delivered at the right superior pulmonary vein (RSPV) with 50 watts and 70degreesC and at the left superior pulmonary vein (LSPV) with 20 watts and 50degreesC. After the procedures, the endocardiums of the left atrium and both superior PVs were examined. RESULTS: Total applied RFE in both PVs was 14.2+/-.2 vs. 13.5+/-.6 watts, 46.6+/-.1 vs. 64.5+/-.2degreesC (p<0.05), in LSPV vs. RSPV, respectively. Follow up pulmonary venograms showed that total occlusions of PV branches and severe stenosis of proximal PV (>70% luminal narrowing) developed in 4 dogs with high RFE. Mild stenosis (<50% luminal narrowing) of PV developed in 1 dog with low RFE. Histological examination of the 5 dogs revealed coagulation necrosis over the whole PV layer, including the adventitia and some portion of the myocardial sleeve, and severe hemorrhage and destruction of PVs from high energy treatment, in contrast to intimal damage and swelling of subintimal PV layers in low energy treatment. CONCLUSION: High RF current may result in severe damage of pulmonary veins and sub-structures whereas low RF current may cause suboptimal pulmonary vein damage such as intimal only damage.
Adventitia ; Animals ; Atrial Fibrillation ; Catheter Ablation ; Catheterization ; Catheters ; Constriction, Pathologic ; Dogs ; Endocardium ; Follow-Up Studies ; Heart ; Heart Atria ; Hemorrhage ; Necrosis ; Phenobarbital ; Pulmonary Veins*

In this study, the rate of bone formation and the pattern of bone to implant contact surface around HA coated implant and pure Ti implant inserted into the irradiated tibia of rabbit were compared. Sixteen mongrel mature male rabbits were used as experimental animal. Each rabbit received 15 Gy of irradiation. Four weeks after irradiation, two holes were prepared on the tibia of each rabbit for placement of HA coated type and pure Ti type implants. Prior to implant placement, one group received steroid irrigation and the control group was similarly irrigated with normal saline. This was immediately followed by placement of the two different types of implants. Postoperatively, tetracycline was injected intramuscularly for 3 days. For fluorescent labelling, 3 days of intramuscular alizarine red injection was given. 2 weeks before sacrifice, followed by intramuscular calcein green on the last 3 days before specimen collection. Each rabbit was sacrificed on the second, fourth, sixth and eighth week after the implantation. The specimens were observed by the light microscope and the fluorescent microscope. The results were as follows; 1. All implants inserted into the irradiated tibia of rabbit were free from clinical mobility and no signs of bony resorption were noted around the site of implant placement. 2. Under the light microscope, new bone formation proceeded faster around implants that received steroid irrigation compared to the control group irrigated with saline. Bone to implant contact surface was greater in the steroid irrigated group than the saline irrigated group. Therefore, better initial stabilization was observed in the group pretreated with steroid irrigation. 3. Under the light microscope. HA coated implants showed broader bone to implant contact surface than pure Ti implants, and HA coated implants had better bone healing pattern than pure Ti implants. 4. In the steroid pretreated group, acceleration of bone formation was demonstrated by fluorescent microscopy around the 2, 4 weeks group and the 6 weeks HA coated implant group. The difference in the rate of bone formation proved to be statistically significant (P<0.05). Faster bone formation was noted in the saline irrigated group in the 6 weeks pure Ti implants and 8 weeks group. The difference was not statistically significant(P<0.05). 5. For the rabbits that were sacrificed on the second and fourth week after the implant placements, the rates of bone formation around HA coated implants proceeded faster than those around pure Ti implants under the fluorescent microscopy. For the rabbits that were sacrificed on the sixth week after the implant placements, the rates of bone formation around pure Ti implants proceeded faster than those around HA coated implants under the fluorescent microscopy. But this result did not show statistical significance (P<0.05) For the rabbits that were sacrificed on the eighth week after the implant placements, the rates of bone formation around HA coated implants proceeded faster than those around pure Ti implants under the fluorescent microscopy. This result was statistically significant (P<0.05).
Acceleration ; Animals ; Humans ; Male ; Microscopy ; Osteogenesis* ; Rabbits ; Specimen Handling ; Tetracycline ; Tibia*

BACKGROUND: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4microgram/ml) and to find any sexual differences. METHODS: Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4microgram/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation. RESULTS: The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 microgram/ml) in male group and 1.05 microgram/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups. CONCLUSIONS: Relatively small dosages of remifentanil (0.68-1.81 microgram/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences.
Anesthesia, General ; Anesthesia, Intravenous* ; Arterial Pressure ; Blood Pressure* ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Male ; Propofol ; Sex Characteristics

BACKGROUND: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4microgram/ml) and to find any sexual differences. METHODS: Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4microgram/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation. RESULTS: The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 microgram/ml) in male group and 1.05 microgram/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups. CONCLUSIONS: Relatively small dosages of remifentanil (0.68-1.81 microgram/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences.
Anesthesia, General ; Anesthesia, Intravenous* ; Arterial Pressure ; Blood Pressure* ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Male ; Propofol ; Sex Characteristics

Necrotizing fasciitis is an uncommon severe infection involving the subcutaneous soft tissue, particularly the superficial and often deep fascia. It is usually associated with systemic toxicity, rapid progression and a mortality rate which varies between 20 and 60%. It can affect any part of the body but is most common on the extremities, especially the leg. Predisposing factors include diabetes mellitus, alcoholism, intravenous drug abusers, abdominal surgery, perineal infection. The prognosis for necrotizing fasciitis depends so heavily on early recognition and determination of the extent of necrosis. Whilist there are reports of acute renal failure occuring in the presence of necrotizing fasciitis, descriptions of the condition in patients with chronic renal failure are rare in the literature. Hence we report a case of necrotizing fasciitis, diagnosed by MRI(Magnetic Resonance Imaging) in chronic renal failure patient.
Acute Kidney Injury ; Alcoholism ; Causality ; Diabetes Mellitus ; Drug Users ; Extremities ; Fascia ; Fasciitis, Necrotizing ; Humans ; Kidney Failure, Chronic* ; Leg ; Magnetic Resonance Imaging ; Mortality ; Necrosis ; Prognosis