As the average age of the general population increases, a growing number of elderly patients are presenting for cardiac operations. Although aortic valve replacement in patients aged 80 years and older has been shown to have excellent outcomes with good long-term survival rates, some physicians are still hesitant to refer elderly patients for surgical intervention. A 95-years old female was admitted to our hospital with cardiogenic shock and an emergency operation was required. She was successfully treated with emergency aortic valve replacement. We report here on a case of successful emergency surgical treatment for aortic stenosis in a 95 years old woman.
Aged ; Aortic Valve ; Aortic Valve Stenosis ; Emergencies ; Female ; Humans ; Shock, Cardiogenic ; Survival Rate

OBJECTIVE: The authors attempted to confirm the risk factors for recurrent chronic subdural hematoma(CSDH) after simple burr-hole drainage. METHODS: A total of 302 patients with CSDH who were treated at our hospital between January 1998 and May 2005 were studied. Various parameters considered for analysis of factors associated with CSDH recurrence; demographic and clinical findings (age, sex, history of seizures, diabetes, vascular diseases), initial and perioperative CT findings (hematoma density, location of catheter tip, post operative intracranial air, intracranial hematoma extension, hematoma width, hematoma site). RESULTS: Twenty-four patients (7.9%) experienced recurrence, whereas 278 patients (92.1%) did not. Five major risk factors should be considered : 1) layered type by hematoma density, 2) type I, II by location of catheter tip, 3) presence of postoperative intracranial air, 4) cranial base type of intracranial hematoma extension, 5) greater hematoma width. CONCLUSION: In this study, we report that the incidence of postoperative CSDH recurrence can be reduced by the examination of the hematoma chracteristics on initial and perioperative CT findings and by preventing subdural air accumulation during operation. In addition, the location of the catheter tip can be used as a helpful factor in reducing the recurrence.
Catheters ; Drainage ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Recurrence ; Risk Factors ; Seizures ; Skull Base

BACKGROUND AND OBJECTIVES: Nicorandil has pharmacologic effects similar to nitroglycerin and potassium in respect to the channel opening action in vascular smooth muscle cells. We examined hemodynamic changes in patients following nicorandil infusion. We investigated the action mechanism of nicorandil, and whether nicorandil affects hemodynamic changes in patients receiving antianginal medication. SUBJECTS AND METHODS: A total of 17 patients (11 normal control group, 6 coronary artery disease group) undergoing cardiac catheterization for investigation of chest pain participated in this study. During cardiac catheterization, nicorandil was infused into the pulmonary artery at a dose of 80 microgram/kg over a period of 1 min. Hemodynamic parameters were measured before and at 5, 10 and 20 minutes after nicorandil infusion. RESULTS: Five minutes after nicorandil infusion, the maximal changes in preload and afterload hemodynamic parameters were observed in both the coronary artery disease and control group. Changes of preload parameters were sustained longer than those of afterload parameters, and were maintained until 20 minutes after the infusion. Afterload parameters (heart rate and cardiac output), were slowly normalized five minutes after the infusion. In the coronary artery disease group with antianginal medication, additive hemodynamic changes were also seen after the infusion, although the degree of changes were small. CONCLUSION: Following nicorandil infusion, both the preload and afterload hemodynamic parameters decreased, and the preload parameters showed a larger decrease for a longer period than the afterload parameters. In the coronary artery disease group with antianginal medication, additive hemodynamic changes were also seen following nicorandil infusion.
Angina Pectoris ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Artery Disease* ; Coronary Vessels* ; Hemodynamics* ; Humans ; Muscle, Smooth, Vascular ; Nicorandil* ; Nitroglycerin ; Potassium ; Pulmonary Artery*

No abtract available.

BACKGROUND: To evaluate whether Staphylococcus aureus is actually the leading cause of infective endocarditis in Korea, investigation on updated clinical pictures, treatments, and prognosis was performed. This study also aims to describe differences in clinical characteristics of infective endocarditis in patients undergoing maintenance hemodialysis. MATERIALS AND METHODS: Fifty five patients who were diagnosed with infective endocarditis, using modified Duke criteria, at 4 Soon Chun Hyang University Hospitals (located in Seoul, Bucheon, Cheonan, and Gumi) from January of 2000 to June of 2007 were enrolled. Patients were separated into two groups; those on hemodialysis and those who were not on hemodialysis (control group). Medical records and laboratory results of each patient were reviewed retrospectively. RESULTS: The positive rate of blood culture was 72.7%. Staphylococcus aureus was isolated in 38.2% of the patients, making it the most common causative organism of infective endocarditis. It was also the most common organism in both hemodialysis group and non-hemodialysis group. Six patients (10.9%) died while admitted to the hospital and the in-hospital death rate for hemodialysis group was significantly higher. CONCLUSION: In most parts of the world, S. aureus is increasingly becoming the principal causative organism of infective endocarditis. To our knowledge, this is the first study that shows S. aureus to be the most common causative organism of infective endocarditis in Korea, and that Korea is not except from this global epidemiology.
Endocarditis ; Hospitals, University ; Humans ; Korea ; Medical Records ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus

BACKGROUND: To evaluate whether Staphylococcus aureus is actually the leading cause of infective endocarditis in Korea, investigation on updated clinical pictures, treatments, and prognosis was performed. This study also aims to describe differences in clinical characteristics of infective endocarditis in patients undergoing maintenance hemodialysis. MATERIALS AND METHODS: Fifty five patients who were diagnosed with infective endocarditis, using modified Duke criteria, at 4 Soon Chun Hyang University Hospitals (located in Seoul, Bucheon, Cheonan, and Gumi) from January of 2000 to June of 2007 were enrolled. Patients were separated into two groups; those on hemodialysis and those who were not on hemodialysis (control group). Medical records and laboratory results of each patient were reviewed retrospectively. RESULTS: The positive rate of blood culture was 72.7%. Staphylococcus aureus was isolated in 38.2% of the patients, making it the most common causative organism of infective endocarditis. It was also the most common organism in both hemodialysis group and non-hemodialysis group. Six patients (10.9%) died while admitted to the hospital and the in-hospital death rate for hemodialysis group was significantly higher. CONCLUSION: In most parts of the world, S. aureus is increasingly becoming the principal causative organism of infective endocarditis. To our knowledge, this is the first study that shows S. aureus to be the most common causative organism of infective endocarditis in Korea, and that Korea is not except from this global epidemiology.
Endocarditis ; Hospitals, University ; Humans ; Korea ; Medical Records ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus

PURPOSE : Several lines of evidence have indicated that deregulation of apoptosis is involved in the mechanism of cancer development. Caspase-8 activation plays a central role in the initiation phase of apoptosis, while caspase-7 is one of the main execution phase caspases of apoptosis. The aim of this study was to explore the possibility that genetic alterations of the caspase-8 and caspase-7 genes are involved in the development of human non-small cell lung cancer (NSCLC). MATERIALS AND METHODS : We have analyzed the entire coding region of both the caspase-7 and caspase-8 genes to detect the somatic mutations in 100 NSCLCs by using polymerase chain reaction (PCR)- single strand conformation polymorphism (SSCP). RESULTS : The PCR-SSCP analysis detected no mutations in the entire coding regions of both the caspase-7 and caspase-8 genes in the NSCLCs. CONCLUSION : The data presented here suggests that both the caspase-7 and caspase-8 genes may not be somatically mutated in human NSCLCs
Apoptosis ; Carcinoma, Non-Small-Cell Lung* ; Caspase 7* ; Caspase 8 ; Caspases ; Clinical Coding ; Humans ; Polymerase Chain Reaction

Background Kidney renal clear cell carcinoma (KIRC) is one of the most common renal malignancies with a high mortality rate. Cuproptosis, a novel form of cell death, is strongly linked to mitochondrial metabolism and is mediated by protein lipoylation, leading to a proteotoxic stress response and cell death. To date, few studies have ellucidated the holistic role of cuproptosis-related genes (CRGs) in the pathogenesis of KIRC.Methods We comprehensively and completely analyzed the RNA sequencing data and corresponding clinical information from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. We screened for differentially expressed CRGs and constructed a prognostic risk model using univariate and multivariate Cox proportional regression analyses. Kaplan-Meier analysis was performed and receiver operating characteristic (ROC) curves were plotted to predict the prognosis of KIRC patients. Functional enrichment analysis was utilized to explore the internal mechanisms. Immune-related functions were analyzed using single-sample gene set enrichment analysis (ssGSEA), tumour immune dysfunction and exclusion (TIDE) scores, and drug sensitivity analysis.Results We established a concise prognostic risk model consisting of four CRGs (DBT, DLAT, LIAS and PDHB) to predict the overall survival (OS) in KIRC patients. The results of the survival analysis indicated a significantly lower OS in the high-risk group as compared to the patients in the low-risk group. The area under the time-dependent ROC curve (AUC) at 1, 3, and 5 year was 0.691, 0.618, and 0.614 in KIRC. Functional enrichment analysis demonstrated that CRGs were significantly enriched in tricarboxylic acid (TCA) cycle-related processes and metabolism-related pathways. Sorafenib, doxorubicin, embelin, and vinorelbine were more sensitive in the high-risk group.Conclusions We constructed a concise CRGs risk model to evaluate the prognosis of KIRC patients and this may be a new direction for the diagnosis and treatment of KIRC.
Humans ; Carcinoma, Renal Cell/genetics* ; Immunotherapy ; Kidney ; Kidney Neoplasms/genetics* ; Prognosis ; Copper ; Apoptosis