In the Dept. of Thoracic Surgery, Korea University Hospital, Preoperative diagnosis as Ebstein anomaly was made on the 11-year old female through the preoperative examination including right cardioangiography and the Glenn Operation was performed to this patients as palliative treatment. During closure of the thoracic wall just after the anastomosis of S.V.C. and right pulmonary artery, sudden cardiac arrest developed. One day later after death, autopsy was performed in order to confirm the pathologic anatomy of the cardiac anomaly and to clarify the cause of death. Pathologic anatomy of the heart revealed the huge dilatation of right atrium, Patent Foramin Ovale, and the deformed and descended posterior and the septal leaflets of tricuspid value by which right ventricle was devided into the atrialized and the functional portion. The diagnosis of the autopsy showed (1) Ebstein Anomaly (2) bilateral total atelectasis of the lung, (3) multiple petechial hemorrhage and edema of the myocardium, brain and liver due to acute hypoxia, (4) fibrocaseous tuberculosis of the liver and tuberculous pericholangitis.
Anoxia ; Autopsy ; Brain ; Cause of Death ; Child ; Death, Sudden, Cardiac ; Diagnosis ; Dilatation ; Ebstein Anomaly* ; Edema ; Female ; Heart ; Heart Atria ; Heart Ventricles ; Hemorrhage ; Humans ; Korea ; Liver ; Lung ; Myocardium ; Palliative Care ; Pulmonary Artery ; Pulmonary Atelectasis ; Thoracic Surgery ; Thoracic Wall ; Tuberculosis

We present a rare case demonstrating successful endovascular management of an arterioureteral fistula involving the abdominal aorta. Arterioureteral fistulas are rare but life-threatening, with mortality rates ranging from 7% to 23%. Early recognition and prompt management are essential for preventing catastrophic consequences, including hypovolemic shock. However, recognition of an arterioureteral fistula requires a high index of clinical suspicion due to its rarity and the lack of a sensitive diagnostic method. Arterioureteral fistulas could be induced by traumatic events in patients who have a history of pelvic surgery, radiation, and prolonged placement of a ureteral stent. Endovascular stent graft placement could be a valid treatment option for arterioureteral fistulas involving the abdominal aorta.

PURPOSE: The purpose of this study was to investigate the degree of the gender role identity and quality of life of women applying hormone replacement therapy with hysterectomy and to identify the relation among these variables.The purpose of this study was to investigate the degree of the gender role identity and quality of life of women applying hormone replacement therapy with hysterectomy and to identify the relation among these variables. METHODS: The subjects were 121 outpatients applying hormone replacement therapy with hysterectomy at a university hospital in Busan province. The data were collected using self-reported questionnaire and medical record, from September to October 2008. RESULTS: There were statistically significant differences in the degree of quality of life according to the age, educational level, occupation, family economic status, Body Mass Index (BMI), menopause state, duration to restarting intercourse from hysterectomy, discomfort from intercourse, satisfaction from intercourse and duration, sources, and formulation of hormone replacement therapy (HRT). The femininity identity group occupied the largest proportion (31.4%), and then the masculinity identity group (28.1%), the undifferentiated identity group (26.4%), and finally the androgyny identity group (14.1%). There was a positive correlation between femininity and quality of life (r=.276, p=.002). CONCLUSION: These results indicate that HRT helps the women's sense of loss caused by hysterectomy to be reduced, the postmenopausal symptom after hysterectomy to be relieved and the quality of life to be improved.
Body Mass Index ; Female ; Femininity ; Gender Identity ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Masculinity ; Medical Records ; Menopause ; Occupations ; Outpatients ; Quality of Life ; Surveys and Questionnaires

No abstract available.
Carbon Dioxide* ; Carbon* ; Lasers, Gas* ; Vulva*

Human epidermal cells were obtained from suction blisters of 14 healthy individuals, and were cultured for 24-96 hours st a concentration of 1x 10(7)/ml, 5 x 10(6)/ml, 1 x 10(6)/ml, 5 x 10(5)/ml. Cells were also cultured with or without stimulants such as phorbol myristic acetate(PMA), muramyl dipeptide(MDP), and endotoxin. Then, cell-free supernatants of cultured epidermal cells were tested for ETAF by a thymocyte prolifera.tiom assay. The results were as follows : 1, The highest activity of ETAF was produced by fresh epidermal cells(EC) at a concentration of 1 x10(7)ml. Its highest 3H-TdR was 4928+/-2480cpm. The highest activity of ETAF was produced by cultured EC at a concentration of 5 x10(6)/ml. Its highest 3H-TdR was 13983+/-8045 cpm. 2. The highest activity of ETAF was produced by fresh EC with n culture time of 24 hours. Its highest 3H-TdR was 5357+/-3760cpm. The highest activity of ETAF was produced by cultured EC with a culture time of 72 hours. Its highest 3H-TdR was 11905+/-5327cpm. 3. The highest activity of ETAF was produced by both fresh and cultured EC at a titer of 1: 8 dilution of cell-free supernatants. 1ts highest 3H-TdR was 4928 +/-2480cpm in the fresh EC, and 11905+/-5327cpm in the cultured EC. 4. Alhen fresh EC was stimulated with PMA, MDP and endotoxin, higher activity of ETAF was found in the group stimulated with PMA or MDP compared with its control group. But lower activity of ETAF was found in the group stimulated with endotoxin compared with its control group. The 3H-TdR was 6000+/-1936 cpm in the group stimulated with PMA, 6945+/-3182 cpm in the group stimulated with MDP, and 36943+/-36861cpm in the group stimulated with endotoxin.
Blister ; Humans* ; Suction ; Thymocytes

No abstract available.
Aneurysm ; Aneurysm, Ruptured* ; Cerebral Veins* ; Veins*

PURPOSE: The purpose of this study was to explore ways to define the concept of health inequality. METHODS: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. RESULTS: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.
Delivery of Health Care ; Education ; Human Rights ; Mortality ; Occupations ; Quality of Life ; Social Discrimination ; Socioeconomic Factors*

PURPOSE: We conducted this study to evaluate the efficacy of Doppler study by examining obstruction at the site of anastomosis in patients with total anomalous pulmonary venous return(TAPVR). METHODS: Retrograde analysis of the postoperative echocardiography results was done in 14 patients with simple TAPVR, who were operated at Dong-A University Hospital from January 1993 to July 1998. The peak systolic velocities, peak diastolic velocities and flow patterns of the 14 patients were compared with those of 9 control cases. Among the 14 patients, 2 cases showed evidence of obstruction at the anastomosis site. RESULTS: Pulmonary venous flow patterns of normal infants were biphasic, varying with the cardiac cycle. The peak velocities during systole and diastole were 40 to 60cm/sec(mean 51+/-9cm/sec) and 45 to 78cm/sec(mean 59+/-9cm/sec), respectively. The flow patterns of patients without postoperative stenosis were also biphasic. The peak velocities during systole and diastole was 38 to 115cm/sec(mean 71+/-27cm/sec) and 55 to 140cm/sec(mean 111+/-28cm/sec), respectively. The diastole peak velocity was significantly higher than normal(P=0.0002). The flow patterns of patients with postoperative stenosis was continuous, non-phasic or increased peak velocity even though it was phasic. CONCLUSION: Postoperative Doppler echocardiographic evaluation of pulmonary venous return in patients with TAPVR is useful in examining obstruction at the site of anastomosis. But a study on the Doppler echocardiographic normal range of postoperative patients will be needed.
Constriction, Pathologic ; Diastole ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Infant ; Reference Values ; Scimitar Syndrome* ; Systole

PURPOSE: We conducted this study to evaluate the efficacy of Doppler study by examining obstruction at the site of anastomosis in patients with total anomalous pulmonary venous return(TAPVR). METHODS: Retrograde analysis of the postoperative echocardiography results was done in 14 patients with simple TAPVR, who were operated at Dong-A University Hospital from January 1993 to July 1998. The peak systolic velocities, peak diastolic velocities and flow patterns of the 14 patients were compared with those of 9 control cases. Among the 14 patients, 2 cases showed evidence of obstruction at the anastomosis site. RESULTS: Pulmonary venous flow patterns of normal infants were biphasic, varying with the cardiac cycle. The peak velocities during systole and diastole were 40 to 60cm/sec(mean 51+/-9cm/sec) and 45 to 78cm/sec(mean 59+/-9cm/sec), respectively. The flow patterns of patients without postoperative stenosis were also biphasic. The peak velocities during systole and diastole was 38 to 115cm/sec(mean 71+/-27cm/sec) and 55 to 140cm/sec(mean 111+/-28cm/sec), respectively. The diastole peak velocity was significantly higher than normal(P=0.0002). The flow patterns of patients with postoperative stenosis was continuous, non-phasic or increased peak velocity even though it was phasic. CONCLUSION: Postoperative Doppler echocardiographic evaluation of pulmonary venous return in patients with TAPVR is useful in examining obstruction at the site of anastomosis. But a study on the Doppler echocardiographic normal range of postoperative patients will be needed.
Constriction, Pathologic ; Diastole ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Infant ; Reference Values ; Scimitar Syndrome* ; Systole

Failure of a glaucoma filtering operation mainly results from scarring at the filtering wound, and postoperative proliferation and migration of fibroblasts play an important role histologically in the formation of scar tissue. As an inhibitory agent for fibroblast proliferation, gamma-interferon has been introduced, and the application of gamma-interferon following filtering surgery is now being made on a trial basis. We studied the effect of gamma-interferon histologically on the fibroblast proliferation and collagen synthesis occurring at the filtering site by comparing the effect of gamma-interferon on the experimental group with that of 5-fluorouracil on the control group, using 10 rabbits (20 eyes) after posterior lip sclerectomy. Both groups showed similar flat and diffused bleb grossly and also showed a similar inhibitory effect on fibroblast proliferation and collagen fiber synthesis histologically. Our findings seem to justify the clinical use of gamma-interferon. Further studies on adequate dosage, method of administration, and local and systemic complications would be desired.
Animals ; Anterior Chamber/drug effects ; Cell Division/drug effects ; Collagen/*biosynthesis ; Fibroblasts/drug effects ; Fluorouracil/pharmacology ; Glaucoma/pathology/*surgery ; Interferon-gamma/*pharmacology ; Rabbits ; Sclera/pathology ; *Sclerostomy