BACKGROUND: With the recent development in arterial reconstructive procedure such as percutaneous transluminal coronary angioplasty or atherectomy, the incidence of vascular complications involving femoral artery is increasing due to greater use of larger percutaneous instruments(including arterial sheath) and periprocedural anticoagulant therapy. Femoral pseudoaneurysm requires rapid diagnosis and management to prevent limb ischemia, worsening of the arterial injury or repair of the arterial defect. Recently, accurate diagnosis of these injuries can be made nonivasively with duplex sonography and Doppler color flow imaging, and nonsurgical treatment may be possible by using external compression guided by ultrasound even in patients requiring prolonged anticoagulant therapy. METHOD: Three patients, one undergoing coronary angiography and two undergoing percutaneous transluminal coronary angioplasty, developed expansile groin masses at the vascular access sites diagnosed as femoral artery pseudoaneurysm s by Doppler ultrasound. All patients were hypertensives, taking aspirin and two patients who underwent PTCA received intravenous heparin after procedure. After diagnosis of femoral pseudoaneurysm, all patients underwent mechanical(C-clamp) external compression guided by ultrasound for 3 hours. RESULT: Follow up color flow scans were obtained after 24 hours and in one patients, blood flow in the tract was eliminated but persistent blood flow was observed in two patients who underwent PTCA. Before closure of pseudoaneurysm, one patient needed another 6 hours of ultrasound guided compression and the other needed more 12 hours. All patients were discharged without complication or recurrence of pseudoaneurysm. CONCLUSION: These cases suggest that nonsurgical closure of femoral pseudoaneurysms is feasible even in patients requiring prolonged antiplatelet and anticoagulant therapy.
Aneurysm, False* ; Angioplasty, Balloon, Coronary ; Aspirin ; Atherectomy ; Cardiac Catheterization* ; Cardiac Catheters* ; Coronary Angiography ; Diagnosis ; Extremities ; Femoral Artery ; Follow-Up Studies ; Groin ; Heparin ; Humans ; Incidence ; Ischemia ; Recurrence ; Ultrasonography

PURPOSE: We studied the attitudes of general population and medical personnels toward premature infants to establish basic data about prematurity. METHODS: Ten students from Yeungnam University College of Medicine conducted field surveys on the general population at residential and commercial districts, and on medical personnels at private local clinics and hospitals in Taegu with a prepared questionaire from July 25, 1996 to August 20, 1996. Statistical analysis was done by Chi square test using SPSS computerized program. RESULTS: The respondents who have never heard about premature babies are 4.6% of 502 total respondents. Sixty percent of the respondents acquired information about prematurity from mass media (television, newspaper, radio), and television was the most frequentl among them (60%). Because the percentage of respondents who know the correct meaning of prematurity is lower in those who acquired information from mass media than those from medical personnels or books on childcare, it was observed that information about prematurity is delivered inaccurately through mass media. Fifty percent of the respondents regard premature babies as handicapped or retarded babies, sixty-five percent of the respondents want their babies, not to be treated not because of economical burden but possibilities of residual handicap or death. CONCLUSION: Delivery accurate information about recent advances in intensive care for premature babies through mass media, i.e. television, newspaper and radio, is necessary to inform the general population and to help parents or family members of a premature baby participate in making a decision on whether to continue treatment for the baby or not.
Daegu ; Surveys and Questionnaires ; Disabled Persons ; Ethics ; Humans ; Infant, Newborn ; Infant, Premature* ; Critical Care ; Mass Media ; Periodicals ; Parents ; Television

No abstract available.
Humans ; Microsporum* ; Siblings* ; Tinea Capitis* ; Tinea*

It is well known that the murine T helper cell clones are divided by their lymphokine secretory activities. One is the Th-1 cell, producing IL-2 and IFN after stimulation and the other is the Th-2 cell, producing the IL-4 and IL-5. This study was undertaken to evaluate the immunomodulatory properties of the bacterial lipopolysaccharide(LPS) on the lymphokine production in vivo and in vitro. The results were as follows: There were no effects on the lymphokine secretion by the in vitro treatment of the LPS. The in vivo treatment of the LPS decreases the capability of the production of IL-2 and IFN , whereas it increases the capability of IL-4 production. The altered capacity of the lymphokine production was recovered about 2 weeks after the treatment of the LPS. There were no differences on the lymphokine production between E-coli LPS and salmonella LPS. The capacity of the lymphokine production was the same in the treatment of a non-heated LPS or heated-LPS. The lymphokine production of the mice which were desensitized by the long term treatment of the LPS was not different from the control mice. The in vitro treatment of RU486 can block the alterations of the lymphokine production after the treatment of the LPS. In summary, one can tell that the LPS increases the secretion of the IL-4 through the endogenous secretion of the glucocorticoids.
Animals ; Clone Cells ; Glucocorticoids ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Mice ; Mifepristone ; Salmonella ; T-Lymphocytes* ; T-Lymphocytes, Helper-Inducer

We present a patient with spinal epidural arteriovenous fistula presented with subdural hematoma and progressive myelopathy. Transarterial embolization using NBCA results in complete obliteration of fistula without complication. The pathophysiology, angioarchitexture of the lesion and strategy for its cure would be discussed.
Arteriovenous Fistula* ; Fistula ; Hematoma, Subdural* ; Humans ; Spinal Cord Diseases ; Spine

No abstract available.
Emergencies ; Humans

In patient with Zollinger-Ellison syndrome, it is difficult to localize gastrinoma because the tumor is frequently small and multiple. However, accurate localization of the tumor is important for the treatment. Among various imaging modalities, somatostatin receptor scintigraphy (SRS) has been recognized to be the most sensitive tool for the detection of neuroendocrine tumors such as gastrinomas based on the presence of high-affinity binding sites for somatostatin. Recently, we experienced a case of Zollinger-Ellison syndrome caused by gastrinomas which was localized by SRS. This is the first case report of gastrinoma detected by SRS in Korea. SRS can facilitate tumor detection in patient with Zollinger-Ellison syndrome and should be considered as the first-line diagnostic method in the early course of the disease.
Binding Sites ; Gastrinoma* ; Humans ; Korea ; Neuroendocrine Tumors ; Radionuclide Imaging ; Receptors, Somatostatin ; Somatostatin ; Zollinger-Ellison Syndrome*

PURPOSE: The standard treatment for aortic aneurysms is surgical replacement with a prosthetic graft. Currently there is great interest in endoluminal intervention for treatment of aortic aneurysm. The purpose of this study was to evaluate the safety and effectiveness of endoluminally placed Stent-graft for the treatment of aortic aneurysms. MATERIALS AND METHODS: Transluminal endovascular Stent-graft placements were attempted in 9 patients with infra-renal aortic aneurysms(n=6), thoracic aortic aneurysm(n=l), and aortic dissection(n=2). The endovascular Stent-grafts were custom-designed for each patient and were constructed of self-expandable modified Gianturco Stents covered with polytetrafluroethylene. The Stent-grafts were introduced through a 16-18 french sheath and expanded to 17-30mm in diameter. The endovascular therapy was performed using a common femoral artery cutdown with local anesthesia. RESULTS: The endovascular Stent-graft deployment was achieved in 7 of 9 patients. Two cases failed deployment of the Stent-graft due to lilac artery stenosis and tortousity. There were complete thrombosis of the thoracic and infra-renal aortic aneurysm surround the Stent-graft in 3 patients, and persistent leak with partial thrombosis in 2. Two patients with aortic dissection were successfully treated by obliteration of entry tears. There were no major complication associated with Stent-graft placement. CONCLUSION: These preliminary results show that transluminal endovascular Stent-grafts offer great promise and good results. Further investigation is needed to establish its long-term safety and efficacy.
Anesthesia, Local ; Aortic Aneurysm ; Arteries ; Constriction, Pathologic ; Femoral Artery ; Humans ; Stents ; Thrombosis ; Transplants

Langerhans cell histiocytosis (LCH) is related diseases characterized by proliferation of Langerhans cell with involvement of bone, skin, lung and other organs. LCH usually occurs in childhood and are presented as multiple small papules or eczematoid lesion mostly. We report a 50-year-old man with 3 brown lichenoid patches on left dorsal foot. He was diagnosed pulmonary LCH 5 years ago. Typical LC cells on skin lesion and CD1 complex positive staining confirm the diagnosis of LCH. We consider brown lichenoid patches may be a previously unreported cutaneous presentation in cutaneous or multisystem LCH.
Foot ; Histiocytosis, Langerhans-Cell ; Humans ; Lung ; Middle Aged ; Skin

A brief period of cerebral ischemia produces neuronal damage in the vulnerable regions of the brain, such as the CA1 area of the hippocampus. However, mild ischemic episodes may limit damage from subsequent ischemic insults, the phenomenon known as ischemic tolerance or preconditioning. We used hippocampal slices as an experimental model to investigate the possible utilization of ischemic tolerance, and to determine the effects of various drugs acting on glutamate and adenosine receptors following a conditioned ischemic insult. Preconditioning ischemic insult was induced in hippocampal slices of 450nm thickness for 60-70 seconds. Glutamate and adenosine receptors were pretreated 1 hour later with D,L-2-amino-5-phosphonovaleric acid(AP-5, 50nM), propentofylline(PPF, 200nM), 6-cyano-7-nitroquinoxaline-2,3-dione(CNQX, 10nM), 8-cyclopentyl-3,7-dihydro-1,3-dipropyl-1H-purine-2,6-dione(DPCPX, 1, 10nM) and 2-chloro-N6-cyclopentyl-adenosine (CCPA, 1, 10, 50nM). The slices were reoxygenated for 3 hours, after then a second ischemic insult was induced by substituting 95% O2, 5% CO2 and glucose for 95% N2, 5% CO2 and sucrose for 10 minutes. Population spikes(PS) were estimated from extracellular electrophysiological recordings of the hippocampal CA3-CA1 synaptic conduction 1 hour following the second ischemic insult. The PS(mV) was 2.69+/-0.06 in the normal hippocampal slice, while it was reduced to 1.21+/-0.05 in the hippocampal slice induced with 10 minutes of ischemia. The effects of the A1 selective agonist CPPA revealed a reduction of PS to 0.98+/-0.06 with low concentration(1nM), similar PS as the control group with a concentration of 10nM, and an increase in ischemic tolerance of 1.78+/-0.05 at a higher concentration(50nM). The selective A1 antagonist DPCPX(1nM) showed minimal reduction in PS of 1.10+/-0.04, while the NMDA antagonist AP-5(5nM) had a more profound weakening effect(1.05+/-0.04). The adenosine uptake inhibitor profentophylline(200nM) augmented the PS to 1.56+/-0.06; this effect was not influenced by 1nM DPCPX(1.60+/-0.07), but was abolished by a higher concentration of 10nM(1.36+/-0.05). These results confirmed ischemic tolerance in the hippocampal experimental model. We conclude that adenosine plays an important role in ischemic tolerance as activation of adenosine receptors or adenosine uptake inhibition enhances ischemic tolerance.
Adenosine ; Brain ; Brain Ischemia ; Glucose ; Glutamic Acid ; Hippocampus ; Ischemia* ; Models, Theoretical ; N-Methylaspartate ; Neurons ; Receptors, Purinergic P1 ; Sucrose