No abstract available.
Korea*

BACKGROUND: The diagnosis of intraabdominal solid organ injuries is easy for accuracy of the imaging studies, but that of hollow viscus perforations is sometimes relatively difficult. And some of gastrointestinal perforations can be missed and their diagnosis may be delayed. This can result in high morbidity and mortality. So, I studied the incidence and causes of each gastrointestinal tract perforation. METHOD: Four hundred eighty four patients were reviewed, who visited the Emergency Center of Seoul Red Cross Hospital for their gastrointestinal perforations from January, 1987 to December, 1998. Medical records were reviewed in a retrospective manner. The incidence and causes of each hollow viscus perforation, the preferability of each perforation from the pattern of trauma, age and sex distribution in each perforation and associated injuries with trauma were analyzed. RESULTS: The most common perforations were in duodenum(254cases, 52.4%) due to mainly peptic ulcer. The incidence was in order of small bowel(32.6%), stomach(7.4%), colorectum(6.6%) and esophagus(0.8%) after that. Trauma induced perforations were 164 cases(33.9%) and the ratio between blunt and penetrating trauma was 3.9 : 1. Small bowel was most vulnerable site of perforation from both trauma. Duodenum and esophagus were relatively stable from trauma. There were no cases from blunt trauma in stomach and esophagus. The male to female ratio was 5.1 : 1. CONCLUSION: Each hollow viscus has each preferred cause of perforation. It's diagnosis was not easy everytime, sometimes it was really difficult. But pattern of causes in perforations will be helpful to decision making process. In difficult cases, suspicion is very important. And in suspicious perforation of hollow viscus, diagnosis and the decision to operate will be made by frequent physical examination and proper investigating tests.
Decision Making ; Diagnosis ; Duodenum ; Emergencies ; Esophagus ; Female ; Gastrointestinal Tract* ; Humans ; Incidence* ; Male ; Medical Records ; Mortality ; Peptic Ulcer ; Physical Examination ; Red Cross ; Retrospective Studies ; Seoul ; Sex Distribution ; Stomach

No abstract available.

No abstract available.

Tumor angiogenesis has been found to have prognostic significance in many tumor types for predicting an increased risk of metastasis. We assessed tumor vascularity in 28 cases of borderline malignancy and 71 cases of carcinoma of the ovary which had been resected and diagnosed, using the highly specific endothelial cell marker CD34. The numbers of microvessels were counted in 200 magnification in three highly vascularised areas. The numbers of microvessels in carcinomas were higher than that in the borderline malignancy of serous and mucinous tumors. The number of microvessels of mucinous carcinomas was significantly higher than that of serous carcinomas. There were neither significant differences in the number of microvessels according to histological tumor types (p=0.075) nor significant differences in the number of microvessels according to FIGO stages (p=0.072). But in serous carcinomas, the number of microvessels was higher in the FIGO III-IV stage than in the FIGO I-II stage (p=0.017). This study showed higher neovascularization in malignant tumor than borderline malignancy, and in the advanced stage (FIGO III-IV) than less advanced stage (FIGO I-II) of serous carcinomas.
Adenocarcinoma, Mucinous ; Endothelial Cells ; Female ; Microvessels ; Mucins ; Neoplasm Metastasis ; Ovary

Eleven magnetic resonance(MR) and CT imagings were performed in nine patients with mild to moderate degree oddelayed neuropsychiatric symptoms following acute carbon monoxide(CO) poisoning, to evaluate the capability of MRin demonstrating any additional finding to CT. The MR images were obtained using 0.15 Tesla resistive system withvariuos combination of three pulse sequences, including partial saturation recovery, T2-weighted spine echo andinversion recovery. Bilateral white matter abnormalities suggesting demyelination were demonstrated in 4 patientswith MR and in only 2 patients wtih CT. The contrast discrimination between normal and abnormal white matterproved to be better with T2-wieghted spin echo and inversion recovery than with partial saturation recovery andCT. But necrosis of the globus pallidus(1 patient) and diffuse atrophy(3 patients) were equally demonstrated onboth MR and CT. It is suggested that MR be used as a initial imaging method in the evaluation of the delayedencephalopathy following acute CO poisoning, especially for the detection of the possible white matter lesions.
Brain Diseases ; Carbon Monoxide Poisoning ; Carbon Monoxide ; Carbon ; Demyelinating Diseases ; Discrimination (Psychology) ; Humans ; Methods ; Necrosis ; Poisoning ; Spine ; White Matter

Generally, exposure and the operative technique are common difficulty encountered in the total knee arthroplasty of ankylosed knee due to old infection sequelae. Also the postoperative range of motion and relief of pain is poor due to deformity and excessive soft tissue contracture around knee. There have heen few reports, however, that address the reconstructive challenge of total knee arthroplasty in a previously infected ankylosed knee. We perfoined TKA in thirty six patients who had ankylosed knee between July l986 and Dec. 199S. After follow up of average five years and one month, we analysed the results. The definition of ankylosis was a knee ROM less than 90 degree. Average age of patients were 36.7 years old. Twelve patients were meii and twenty four patients were women. Sixteen patients of partial ankylosis and twenty patients of complete ankylosis were performed operation. There were nineteen cases of healed tubercuiosis knees and seventeen cases of healed pyogenic knees. For the release of soft tissue contracture in 9 cases, we lengthened quadrceps tendon with the method of modified V-Y advancement technique. Patella tendon was proximally reattached with staples and suture in 6 cases and tibial tubercle was proximally transferred in 3 cases. As results, the postoperative average range of motion was 79.3 (30 - l21') in complete ankylosis, 107 (60 - 135 ) in partial ankylosis. The average Hospital for Speciai Surgery knee rating score improved from 56.3 points preoperatively to 84.8 points postoperatively. Radiolucent line was observed in two Knees with less than 2mm width in three years and four months, and four years postoperatively, hut the patient had no pain. In five patients who had poor gain of range of motion after operation, we perfonned arthroscopic adhesiolysis. In conclusion, regarding patient selection, reasonable hony development, relative]y healthy extensor mechanism and adequate soft tissue condition are important for success of TKA in old intection sequelae. TKA of ankylosed knee in old infection sequelae is a successful procedui which can ohtain the restoration of function of the ankylosed knee.
Ankylosis ; Arthroplasty* ; Congenital Abnormalities ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee* ; Patellar Ligament ; Patient Selection ; Range of Motion, Articular ; Sutures ; Tendons

BACKGROUND: Ischemic preconditioning enhances the tolerance of myocardium against ischemia/reperfusion injury, with the enhancement of the recovery of post-ischemic myocardial function. This study was disigned to assess whether the protective effect of ischemic preconditioning could provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rate heart. MATERIAL AND METHOD: Fourty four Spargue-Dawley rats, weighing 300-450gm, were divided into four groups. Group 1(n=7) and group 3 (n=12) were subjected to 30 minutes of aerobic Langendorff perfusion without ischemic preconditioning and then preserved in saline solution at 2-4 degree C for 4 hours and 5 respectively. Group 2 (n=7) and group 4 (n=18) were perfused in the same way for 20 minutes, followed by 3 minutes of global mormothermic ischemia and 10 minutes of perfusion and then preserved in the same cold saline solution for 4 hours and 5 hours respectively. Heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured at 15 minutes during perfusion as baseline. Spontaneous defibrillation time was measured after reperfusion. Heart rate, LVDP, and coronary flow were also recorded at 15 minutes, 30 minutes, and 45 minutes during reperfusion. Samples of the apical left ventricular wall were studied using a transmission electron microscope. Time of spontaneous defibrillation (TSD) was significantly longer in group 4 than in group 1 (p<0.001), and TSD in group 1 was significantly longer in comparision to that of group 2 (p<0.05). Heart rate at 45 minutes was significantly higher in group 1 than in group 4 (p<0.05). Heart rate at 15 min was significantly higher in group 2 than in group 1(p<0.001) and in group 4 than in group 3 (p<0.05). Left ventricular developed pressure (LVDP) at 30 minutes and 45 minutes was higher in group 1 than in group 4 (p<0.01), LVDP at 45 minutes was higher in group 4 than in group 3 (p<0.05). Rate-pressure product (RPP) at 30 minutes and 45 minutes was higher in group 1 than in group 4 (p<0.05). RPP at 15 minutes was higher in group 2 than in group 1 (p<0.01). RPP at 30 minutes and 45 minutes was higher in group 4 than in group 3 (p<0.05). Group 2 showed relatively less sarcoplasmic edema and less nuclear chromatin clearance than group 1. Group 4 showed less myocardial cell damage than group 3, group 4 showed less myocardial cell damage than group 3, group 4 showed more myocardial cell edema than group 1. CONCLUSION: Ischemic preconditioning enhanced the recovery of postischemic myocardial function after 4 hours and 5 hours preservation. However, it was not demonstrated that ischemic preconditioning could definitely provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rat heart.
Animals ; Chromatin ; Edema ; Heart Rate ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Myocardial Ischemia ; Myocardium ; Perfusion ; Rats* ; Reperfusion ; Sodium Chloride

PURPOSE: The neuophils contribute as an important defence mechanism against bacterial infection. In neonates with infection, not only the number of neutrophils are decreased due to inhibited production but also phagocytic function is impaired resulting in high mortality rate. The purpose of this study is to establish the effectiveness of exogenous granulocyte-macrophage colony-stimulating factor (GM-CSF) in infected neonates by comparing the serum levels of GM-CSF and various hematologic paratmeters in non-infected and infected neonates. METHODS: The study included 50 neonates without infection and 23 neonates with infection who were admitted to neonatal intensive care unit of Chungnam National University Hospital in between May 1998 and February 1999. The total number of white blood cell (WBC) counts, absolute granulocyte counts (AGC) and the serum GM-CSF concentration at birth were measured in non-infected neonates and they were stratified according to birth weight and gestational age. The total number of WBC counts, AGC and the serum GM-CSF concentration at postnatal 7th and 14th day were measured and compared with that of infected neonate's. Neonates with infection were divided either to receive exogenous GM-CSF & antibiotics or antibiotics only; The total number of WBC counts, AGC and the serum GM-CSF concentration at post-treatment 2nd and 7th day were measured and compared. RESULTS: Decreased total number of WBC counts, AGC and the serum GM-CSF concentration at birth were observed with lower birth weight and gestational age. In infected neonates, the total number of WBC counts, AGC and the serum GM-CSF concentration increased more when compared with that of non-infected neonates. Tendency towards increased total number of WBC counts, AGC and the serum GM-CSF concentration were observed after exogenous GM-CSF treatment. CONCLUSION: We recommend the use of GM-CSF in neonates with infection, especially those without increasing total WBC counts, and absolute granulocyte count as a norrnal physiological response.
Anti-Bacterial Agents ; Bacterial Infections ; Birth Weight ; Chungcheongnam-do ; Gestational Age ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes* ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Leukocytes ; Macrophages* ; Mortality ; Neutrophils ; Parturition

No abstract available.
Edema* ; Hemoptysis* ; Lower Extremity*