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BACKGROUND: Cold blood cardioplegic solution has been used to protect myocardium during open heart surgery with the hypothesis stating that it provides more oxygen supply to myocardium compared to crystalloid caridoplegic solution. We repeatedly infused cold blood cardioplegic solution to achieve myocardial protection. We biopsied a small portion of papillary muscle of patients with mitral valve replacement or double valve replacement during aortic cross-clamp time and evaluated the method of myocardial protection through the observation of changes in ultrastructure. We then analysed the relationship between changes in ultrasructure and peak postoperative CK-MB value and SGOT value. MATERIAL AND METHOD: We report observation on changes of myocardial ultrastructure, postoperative CK-MB and SGOT, and electrocardiogram in 31 patients who underwent cardiac operation. There were 11 males and 20 females, and they ranging in age from 28 to 69 years (mean score was 2.08+/-0.560, it was 2.37+/-0.558 at 40 minutes, and it was 2.36+/-0.523 at 70minutes. Mitochondrial score increased significant at 40 minutes. Mean value of postoperative peak CK-MB and SGOT were 37.3+/-17.061IU, 144.5+/-125.5IU respectively. We were not able to find any new Q were in EKG after the operation. There was no significant relationship between myocardium mitochondrial score and mean value of postoperative peak CK-MB and SGOT. CONCLUSION: In conclusion, with this study the cold blood cardioplegic solution was incomplete in preserving ultrastructure of myocardium even with satisfactory results in serum enzyme and EKG evaluation.
Aspartate Aminotransferases ; Cardioplegic Solutions ; Electrocardiography ; Female ; Heart* ; Humans ; Male ; Mitral Valve ; Myocardium ; Oxygen ; Papillary Muscles ; Thoracic Surgery*

The purpose of this study is to evaluate the change of mucosal immunity in gastric diseases. A quantative analysis of IgA and secretory component(SC) in gastric diseases by immunohistochemical method was performed in 110 specimens. The results are as follows: 1) In normal gastric mucosa, all of 10 cases revealed a negative reaction to antihuman SC but 4 cases were positive for IgA. 2) In chronic superficial gastritis and chronic atrophic gastritis with intestinal metaplasia, the metaplastic cells except for the goblet cells were positive for both IgA and SC. 3) The dysplastic cells were also positive for both IgA and SC, and the regenerating cells in ulcer as well. 4) All of the well differentiated or moderately well differentiated adenocarcinomas showed positive reactions to antihuman IgA and antihuman SC, and the intensity appeared to be stronger in the former. However, among 10 cases of poorly differentiated adenocarcinoma SC was not demonstrated in 5 cases, and no IgA was present in one case. In 10 cases of signet ring cell carcinoma, 6 cases revealed a negative reaction to antihuman IgA and 6 cases to antihuman SC. The above results suggest that the secretory immunity is not essential in normal gastric mucosa. The intestinal metaplasia in chronic gastritis is considered as an adaptive response to chronic inflammation. The degree of differentiation in adenocarcinoma may be related to the mucosal immunity.
Adenocarcinoma

Clinical investigation of 20 cases of brain abscess has been done at the dept of Pediatric Yonsei Medical Center, who had been treated during the period of 8 years from January 1977 through Jun 1985. Following results has been obtained: 1. Of 20 patients, 14 patient was male and the rest 6 was female rating M:F ratio 2.3:1 and the youngest patient was undler 1 year, the oldest one was 15 years old. 2. The chief complaints at admission were headache, fever, vomiting in order of frequency, while neurologic signs were neck stiffiness, hemiparesis, papilledema etc. 3. The preceeding causative diseases of brain abscess were diseases involving ENT 15%, congenital heart disease 20%, head trauma 35% and the rest 20% the etiology of brain abscess was not determined. The abscess tended to occure at temporoparietal area in the cases associated with otitis media while abscess originating from congenital heart diseases tended to occure multiple area. 4. 10 cases out of 20 had lumbar puncture under the suspision of meningitis, 2 cases manifested normal CSF finding. Patients who has focal neurologic finding associated with OMPC or congenital heart disease should suspect for brain abscess, which can be easily conform by brain C-T scan as well as patient who manifested unusual clinical course. 5. Factor relating prognosis were mental state and duriation between onset of clinical symptom and time starting treatment; clear mental state and short duration reflect better prognosis. 6. The motality rate was 33%, and the neurologic sequelas were hemiparesis (36.4%), mental deficit (18.2), dysarthria, epilepsy, hydrocephalus and blindness.
Abscess ; Adolescent ; Blindness ; Brain Abscess* ; Brain* ; Child* ; Craniocerebral Trauma ; Dysarthria ; Epilepsy ; Female ; Fever ; Headache ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Hydrocephalus ; Male ; Meningitis ; Neck ; Neurologic Manifestations ; Otitis Media ; Papilledema ; Paresis ; Prognosis ; Spinal Puncture ; Vomiting

A rate com;lication of hysterectomy is complete prolapse and inversion of vagina. This can occur whether the hysterectomy was abdominal or vaginal and cystocele and/or enterocele is often associated with this condition. Traditionally, prolapse has been treated by surgery, the types of operation for prolapse are generally but not always, carried out through the vaginal rather than through the abdominal surgical route. We experienced five cases who had repair of posthysterectomy vaginal vault prolapse by transabdominal sacral colpopexy and report with brief review of literatures.
Cystocele ; Hernia ; Hysterectomy* ; Pelvic Organ Prolapse* ; Prolapse ; Vagina