No abstract available.
Hyperaldosteronism*

We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.
Cardiomyopathies ; Extracorporeal Membrane Oxygenation* ; Extremities ; Heart Transplantation* ; Heart* ; Humans ; Mediastinitis* ; Myocardial Infarction ; Perfusion ; Shock ; Transplantation ; Wound Infection

No abstract available.
Keratinocytes* ; Transplants*

No abstract available.
Keratoacanthoma*

No abstract available.
Intercellular Adhesion Molecule-1* ; Interleukin-6* ; Keratinocytes*

Objective: A suicide attempt by self-poisoning is a common cause of admissions to the emergency department (ED). Management of such intentiona poisoning often requires complicated medical procedures, resulting in a longer length of stay (LOS) as compared to other cases that require treatment in the ED. This study aimed to determine the factors affecting a longer LOS in self-poisoning patients. Methods: This was a retrospective study wherein all the medical charts of patients who visited the ED of one hospital, from August 2016 to July 2019, because of intentional self-poisoning, were reviewed. Results: Most of the patients visited the ED involuntarily and there were almost twice as many female patients as males. Almost half of the patients were referred to the psychiatry department. A comparison of various factors within the LOS groups revealed significant differences in mental status, guardian co-visitation, patient gender, psychiatric referral, and poisoning substance. Moreover, the LOS had a stronger association with the pre-consultation period than the consultation to decision-making period. Conclusion To reduce the LOS, it seems important to make a rapid decision on whether to observe the patient in the ED and wait until the workup is completed or to admit and then evaluate the patient in the ward. If the clinicians cannot obtain enough information to evaluate the patient for appropriate management, short-term admission may be an option to reduce the LOS and to provide a stable evaluation.

A clinicopathological study was made on 17 case with leukemia cutis diagnosed in a period of 10 years frorn 1980 to 1989 in Seoul Xational University I-lospital. The results were summarized as follows : 1. There were 4 cases with acute lyrnphocytic leukernia, 7 with acute myelocytir. leukemia (AML), 5 with chronic myelocytic leukemia (CML), 1 with eosinophilic leukemia. 2. The clinical appearance of leukemia cutis included nodules (88.2%), papules, macules, plaques and ulcerative lesions. Leukemia cutis dis not show any discernible clinical qppearance with each different type of leukemia. 3. Leukemia cutis showed a wide spectrum of histopathologic features, diffuse infiltration, patchy infiltration with linear infiltration between collagen bundles, perivascular and peridnexal involvement, perivascular involvement, and mainly subcutaneous tissue involvement. There was no distinctive histopathologic pattern with each different type of leukemia. 4. The demonstration of intracytoplasmic chloroacetate esterase and lysozyme was helpful to refine the diagnosis of leukemia cutis.
Collagen ; Diagnosis ; Hypereosinophilic Syndrome ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Muramidase ; Seoul ; Subcutaneous Tissue ; Ulcer

We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.
Cardiomyopathies ; Extracorporeal Membrane Oxygenation ; Extremities ; Heart Transplantation ; Heart ; Humans ; Mediastinitis ; Myocardial Infarction ; Perfusion ; Shock ; Transplantation ; Wound Infection

OBJECTIVE: To evaluate the efficacy and safety of concurrent chemotherapy of paclitaxel and carboplatin with standard pelvic radiotherapy as adjuvant therapy after primary surgery in high-risk cervical cancer. METHODS: Twenty-eight patients with FIGO stage IB1-IIB cervical cancer who received adjuvant concurrent chemoradiotherapy with paclitaxel and carboplatin from February 2000 to November 2001 were analyzed retrospectively in this study. Adjuvant chemoradiotherapy was done if there were lymph node involvement or at least 2 positive findings among following risk factors; lymphovascular space invasion, full- thickness involvement of cervix and tumor size larger than 4 cm in diameter. Two cycles of paclitaxel 135 mg/m2, followed by carboplatin with AUC of 4.5 were administered intravenously with an interval of at least 4 weeks. The radiotherapy was initiated concurrently at the first day of chemotherapy. The therapeutic results were evaluated by pelvic examination, Pap smear, SCCA (Squamous cell carcinoma antigen) and computed tomography (CT). The toxicities of the treatment were evaluated and graded by NCI-CTC version 2.0. RESULTS: Total 56 cycles of paclitaxel/carboplatin chemotherapy with concomitant pelvic radiotherapy was delivered. None of the patients had a progressive or recurrent disease during the follow-up period ranging from 6 to 33 months (median: 12.5 months). Neutropenia was the most common and concerned toxicity. Fifteen cases of grade 3 and 4 neutropenia (26.8%) were observed. Non-hematologic toxicities were mild and mainly related to neurologic or gastrointestinal symptoms. Eight cases of grade 1 and 2 neurotoxicity were observed (14.3%). CONCLUSION: The adjuvant chemoradiotherapy with paclitaxel and carboplatin seems to be effective and well-tolerated for the treatment of high risk group cervical cancer after primary surgical therapy. But a large randomized study with longer duration of follow-up is needed to justify this conclusion.
Area Under Curve ; Carboplatin* ; Cervix Uteri ; Chemoradiotherapy* ; Chemoradiotherapy, Adjuvant ; Drug Therapy ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Lymph Nodes ; Neutropenia ; Paclitaxel* ; Radiotherapy ; Retrospective Studies ; Risk Factors ; Uterine Cervical Neoplasms*

BACKGROUND: We evaluated the efficacy of the cardiopulmonary exercise test as an objective indicator of functional status and as a pre-operative prognostic indicator in patients with mitral regurgitation (MR) and aortic regurgitation (AR). METHODS: Cardiopulmonary exercise tests and echocardiography were performed in 47 patients (MR: 30, AR: 15, MR + AR: 2) before surgery and repeated one year after surgery. We compared the New York Heart Association (NYHA) functional class, peak oxygen consumption rate (VO2peak), exercise duration, left ventricular dimension and ejection fraction, before and after surgery. RESULTS: Initial VO2peak and exercise duration were significantly different according to NYHA class. A year later, NYHA functional class improved from 2.1+/-0.1 to 1.4+/-0.1 (p< 0.001). The VO2peak was significantly increased (21.7+/-1.0 to 23.7+/-1.0 mL/kg per min, p=0.008) and exercise duration also increased (521.7+/-35.9 to 623.3+/-35.7 seconds, p< 0.001). When patients were analysed according to their post-operative NYHA functional class, those with class I showed significantly different pre-operative VO2peak (class I: 23.7+/-1.1, II: 18.3+/-1.5 mL/kg per min, p=0.005) and exercise durations (class I: 587.5+/-43.2, II: 415.6+/-55.7 seconds, p=0.02). Patients with higher pre-operative VO2peak (19.0 mL/kg per min) more frequently became NYHA functional class I than those with a lower pre-operative VO2peak (76.7% vs. 35.3%, p=0.02). But baseline left ventricular dimension and ejection fraction by echocardiography were not different between post-operative class I and II group. CONCLUSION: VO2peak and exercise duration are excellent parameters to evaluate the subjective functional class and to predict the post-operative functional class of patients with MR and/or AR. Patients with a pre-operative VO2peak of 19.0 mL/kg per min or more will have a better functional status one year after surgery.
Adult ; Aortic Valve Insufficiency/diagnosis/*surgery ; Chi-Square Distribution ; Cohort Studies ; Exercise Test ; Exercise Tolerance ; Female ; Follow-Up Studies ; Heart Valve Prosthesis Implantation/*methods ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency/diagnosis/*surgery ; Oxygen Consumption ; Postoperative Period ; Preoperative Care ; Probability ; Prospective Studies ; Pulmonary Gas Exchange ; Severity of Illness Index ; Statistics, Nonparametric ; Stroke Volume ; Treatment Outcome