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

PURPOSE: We report clinical charateristics of percutaneous central venous catheteriza- tion(PCVC) that is performed commonly as a vascular access procedure in the neonatal intensive care unit(NICU) including comparision between the success rate and com- plication rate of groups performed by a doctor and by nurses who were accustomed to the IV procedure. METHODS: We evaluated a total of 158 PCVC cases performed in the NICU of Soonchunhyang Chunan hospital over 2 years 5 rnonths from May, 1995 to September, 1997. The 24 cases of PCVC were performed by doctors and 134 cases of this proce- dures were performed by well trained nurses. We have compared success rates, clinical characteristics, insertion sites, indwelling time, causes of removal of the catheters, and associated complication of both doctor performed group (D) and nurse performed group (N) retrospectively. RESULTS: The mean gestational age, birth weight, weight at the time of insertion were significantly lower in the doctor performed group than in the nurse group(P<0.001). There were significant differences in postnatal age and mean duration per catheter in both groups. The overall success rate of insertions was 89.9%(142/158), the success rate of doctor performed group was 54.2%(13/24) and nurse group was 96.3%(129/134) and there was significant difference(P<0.001). In the doctor performed group, 100% were axillary however in the nurse group 43.4% were axillary, 38.8% were antecubital, 9.4% were temporal, and 5.4% were hand. The most common cause of the removal of the catheter was elective in both groups but there was also substantial spontaneous removal by the patients and mechanical complication. Cultures of catheter tips were done after removal in 110 cases, among then were positive in 36 cases(33.6%), the most common causes were Staphylococcus aureus and Candida albicans. CONCLUSION: In this report, the authors emphasize that percutanous central venous catheterization performed by well trained nurses has a higher success rates than the doctor performed group and can be considered safe. We would also like to emphasize that more attention should be paid to the maintanace of PCVC.
Birth Weight ; Candida albicans ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Chungcheongnam-do ; Gestational Age ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Retrospective Studies ; Staphylococcus aureus

No abstract available.
Lung* ; Oxygen* ; Rabbits* ; Ventilation*

Neonatal infective endocarditis is fatal and rare disease but recently there is a trend of an increase in incidence even without congenital heart disease when there are high risk as prematurity, central vein catheterization and neonatal cardiopulmonary resuscitation. Symchych reported that in about 3% of autopsy cases of an year, the findings of infective endocarditis were noted. In Korea, there was a case report but it was case of a premature infant who had umbilical vein catheterization and respiratory ventilator treatment. We experienced a case of neonatal infective endocarditis in a female infant who was delivered at 34 weeks gestational age without receiving central vein catheterization or neonatal cardiopulmonary resuscitation. Although she received intensive antibiotic therapy for staphylococcus cultured in blood, she died necessarily. We reported a case of neonatal infective endocarditis without cardiac anomaly with brief review of related literature.
Autopsy ; Cardiopulmonary Resuscitation ; Catheterization ; Catheters ; Endocarditis* ; Female ; Gestational Age ; Heart Defects, Congenital ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Korea ; Rare Diseases ; Staphylococcus ; Staphylococcus aureus ; Umbilical Veins ; Veins ; Ventilators, Mechanical

2 Cases of primary lymphoma of brain are reported with brief review of literatures. Preoperative CT scans were performed and the correct diagnoses were made by operative biopsy. Initially the tumor masses were located in the periventricular white matter, in both cases. CT scans showed slightly high density areas with homogenous contrast enhancement. After local irradiation, these lesions disappeared completely. But soon after, well circumscribed homogenous contrast enhancing mass lesions recurred in the cerebellum.
Biopsy ; Brain ; Cerebellum ; Diagnosis ; Lymphoma ; Tomography, X-Ray Computed ; White Matter

No abstract available.

No abstract available.
Pregnancy* ; Statistics as Topic*

No abstract available.
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

Hypersensitivity myocarditis is an inflammatory disease of the myocardium usually related to drug allergy. The clinical manifestation may be nonspecific, and the diagnosis is seldom suspected or established during the life. So in most of the reported patients, the diagnosis was made at autopsy. Although, retrospectively, more than 90% of the patients described have had clinically recognizable cardiac involvement before death, tole clinical suspicion of hypersensitivity myocarditis is rare. The presence of nonspecific cardiac finding in a patient receiving any drug associated with hypersensitivity should alert the clinician to the possibility of drug related myocarditis. We experienced a case of hypersensitivity myocarditis accompanying allergic skin lesion in a 58 years old man with a history of taking cefadroxil. Fortunately, the outcome was favorable, therefore we do not have histologic confirmation of the diagnosis.
Autopsy ; Cefadroxil ; Diagnosis ; Drug Hypersensitivity ; Humans ; Hypersensitivity* ; Middle Aged ; Myocarditis ; Myocardium ; Retrospective Studies ; Skin

BACKGROUND: Bronchial asthma is classically defined as a reversible obstruction and hypsrresponsiveness of the airway attributed to an inflammatory process. However, some individuals with asthma show an irreversible component of airflow obstruction. It may be associated with structural changes in the airway resulting from severe or long standing air- way inflammation and remodelling. OBJECTIVE: The study was undertaken to compare the clinical characteristics of patient and airway remodelling as shown in bronchial wall thickness in HRCT according to the duration of asthma. MATERIALS AND METHODS: A retrospective clinical study was done on 119 patients with bronchial asthma, who had been admitted to Ewha Womans University Mokdong Hospital. Patients were divided to three groups according to disease duration and, clinical characteristics, pulmonary function test and HRCT were done. RESULTS: Basal FEV, and FVC was significantly lower in patient with longer duration. (p<0. 05) However pulmonary function was improved regardless of disease duration after 2 weeks steroid and bronchodilator therapy, and there was no significant difference in level changes according to the disease duration. The inner diameter of the bronchi and thickness of the bronchial wall at segmental and subsegmental bronchi increased significantly in patient with longer duration of asthma(p<0.05). Conclusion: These findings showed that airway remodelling was more extensive in patients with longer duration of disease resulting in decreased pulmonary function. These facts suggested that early anti-inflammatory therapy would be helpful for prevention of airway remodelling.
Airway Remodeling* ; Asthma* ; Bronchi ; Female ; Humans ; Inflammation ; Respiratory Function Tests ; Retrospective Studies