No abstract available.
Esophageal Perforation* ; Intubation, Intratracheal*

To clarify possible causes, pathogenesis, and appropriate prevention method of remote intracerebral hemorrhage (RICH), we analyzed the clinical findings and the possible predisposing factors of six cases who developed RICH among the 206 surgical series of cerebral aneurysm operated in our hospital over recent 5-year period. The locations of aneurysm were anterior communicating artery in three cases and internal carotid artery in three other cases. The sites of RICH were dependent regions considering the operative position in five of six cases, con-tralateral cerebellum in three cases, bilateral cerebellum in one case, and contralateral occipital area in one case. Peripheral low density around the RICH, suggesting hemorrhagic infarction, was observed on computed tomography in four cases. No patient had preoperative hypertension; however, significant elevation of blood pressure was observed intraoperatively or postoperatively in three cases. The factors which could have induced brain shift(large amount of removed or drained cerebrospinal fluid, large amount of infused mannitol, too low PaCO2) were observed in all cases except one case. There was no case with coagulopathy or underlying occult lesion. Two patients in whom detection of RICH was delayed showed poor outcomes. The possible underlying mechanisms involved in such complication seem to be shifting of brain due to sudden decreased intracranial pressure and excessive removal of cerebrospinal fluid, and subsequent injury of blood vessels such as compression or breakdown of vein. Moreover, the sudden elevation of blood pressure may have played a role as contributing factor. Therefore, consideration should be given to the maintenance of an adequate volume of intracranial cerebrospinal fluid and the appropriate blood pressure to prevent this complication. Early detection and immediate treatment with awareness of the possibility of this complication should be borne in mind when treating these patients to prevent such complications and to obtain good results.
Aneurysm* ; Arteries ; Blood Pressure ; Blood Vessels ; Brain ; Carotid Artery, Internal ; Causality ; Cerebellum ; Cerebral Hemorrhage* ; Cerebrospinal Fluid ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Intracranial Aneurysm ; Intracranial Pressure ; Mannitol ; Veins

BACKGROUND AND OBJECTIVES: Mitral valve repair is the main procedure for the treatment of mitral valve insufficiency. The aims of this study were to review the applied techniques. and to evaluate postoperative residual mitral valve insufficiency, to compare preoperative and postoperative cardiac functions and dimensions, to compare the effects of rigid and flexible ring annuloplasty, and to assess overall freedom from valve failure-related reoperation. SUBJECTS AND METHODS: From March 1996 to September 1999, 34 patients underwent mitral valve repair for the treatment of mitral valve insufficiency at our department. This group comprised ten males and twenty four females, aged 8 to 65 years. The causes of mitral valve insufficiency were of degenerative origin in 12 patients, rheumatic in 10, congenital in 9, cardiomyopathic in 2, and ischemic in 1. The applied valve repair techniques included annuloplasty, quadrangular resection, leaflet slicing, cleft repair, chordae shortening, chordae transfer, secondary chordae resection, new chordae formation, papillary muscle splitting, commissuroplasty, and commissurotomy. RESULTS: There was no early or late mortality. We encountered 8 residual mitral valve insufficiencies (more than grade II), 2 of which worsened and eventually required correction by valve replacement. There were no statistical differences seen between the effects of rigid and flexible ring annuloplasty on left ventricular function either before or 1 year following annuloplasty. The cardiac dimensions decreased significantly. The actuarial freedom from valve failure-related reoperation was 93.01% at 43 months. CONCLUSION: Mitral valve repair with preserved valvular apparatus showed that the repaired valves functioned well and cardiac dimensions recovered satisfactorily. There were no statistical differences between the effects of rigid and flexible ring annuloplasty on cardiac functions and dimensions either before or 1 year following annuloplasty.
Female ; Freedom ; Humans ; Male ; Mitral Valve Insufficiency* ; Mitral Valve* ; Mortality ; Papillary Muscles ; Reoperation ; Ventricular Function, Left

Parricide, the crime of murdering a parent, accounts for about 5% of all homicides. Filicide is the crime of murdering one's own child. This study aimed to review demographic features and criminal characteristics of individuals who committed parricide and filicide in Republic of Korea (ROK). This study is based on data from the Korea Police Crime Analysis System, from 2006~2013. We assessed the diverse characteristics of both victims and perpetrators. Over the selected period, 381 parents were killed by their children and 230 children were killed by parents in the ROK. Parricides caused by schizophrenic murders accounted for 39.6% of all cases. Moreover, approximately 44.4% of the perpetrators attempted suicide following the maternal filicide. In our findings, psychiatric illness was a very important predictor in parricide, and these further suggest that young mothers with severe mental illness require careful monitoring by mental health support service.
Child ; Crime ; Criminals ; Homicide ; Humans ; Korea ; Mental Health ; Mothers ; Parents ; Police ; Republic of Korea ; Schizophrenia ; Suicide, Attempted

No abstract available.
Angioplasty*

No abstract available.
Heart Atria*

Microcornea is a condition characterized by a small cornea in an otherwise normal eye and can be defined when corneal diameter is less than 11.00mm. Microcornea may occur as an isolated abnormality or accompany other anterior segment anomalies like aniridia and anterior chamber cleavage abnormalities. Microcornea is part of nanophthalmos, a condition in which a reduction in global dimensions is the only structural abnormality, as well as microphthalmos, a term generally, used to signify a small, abnormal globe. Microcornea is a rare anomaly and its etiology is probably a primary aberration of the growth of the ectoderm of the optic cup. Both autosomal dominant and autosomal recessive patterns of inheritance occur, but it may appear sporadically. Cornea plana is usually seen in association with microcornea wherein the corneal curvature is less than normal. It is often associated with diffuse opacities of the cornea stroma. Cornea plana might be caused by a deep developmental arrest in the fourth month, at which time the cornea begins to increase its curvature relative to the sclera. The authors experienced a case of bilateral microcornea with cornea plana in a family which seemed to transmit as the dominant trait.
Aniridia ; Anterior Chamber ; Cornea* ; Ectoderm ; Humans ; Microphthalmos ; Sclera ; Wills

Microcornea is a condition characterized by a small cornea in an otherwise normal eye and can be defined when corneal diameter is less than 11.00mm. Microcornea may occur as an isolated abnormality or accompany other anterior segment anomalies like aniridia and anterior chamber cleavage abnormalities. Microcornea is part of nanophthalmos, a condition in which a reduction in global dimensions is the only structural abnormality, as well as microphthalmos, a term generally, used to signify a small, abnormal globe. Microcornea is a rare anomaly and its etiology is probably a primary aberration of the growth of the ectoderm of the optic cup. Both autosomal dominant and autosomal recessive patterns of inheritance occur, but it may appear sporadically. Cornea plana is usually seen in association with microcornea wherein the corneal curvature is less than normal. It is often associated with diffuse opacities of the cornea stroma. Cornea plana might be caused by a deep developmental arrest in the fourth month, at which time the cornea begins to increase its curvature relative to the sclera. The authors experienced a case of bilateral microcornea with cornea plana in a family which seemed to transmit as the dominant trait.
Aniridia ; Anterior Chamber ; Cornea* ; Ectoderm ; Humans ; Microphthalmos ; Sclera ; Wills

Deep sternal wound infection (with or without acute mediastinitis) is a serious complication of open heart surgery, with high rates of associated morbidity and mortality, and prolonged hospitallization. The result of treatment largely depends on timely diagnosis and appropriate surgical management. Postoperative deep sternal wound infections in 4 cases were successfully treated with extensive debridement, pressurized jet irrigation with antibiotic solution, sternal refixation by Robicsek method, and dilute antibiotic irrigation via irrigation-suction system. We report 4 cases with review of articles.
Debridement ; Diagnosis ; Heart* ; Mediastinitis ; Mortality ; Sternotomy ; Thoracic Surgery* ; Wound Infection* ; Wounds and Injuries*

Since introduction of magnetic resonance imaging(MRI), six cases of multiple intracranial meningiomas without signs of neurofibromatosis were found among the forty eight cases of meningiomas. The incidence of multiple intracranial meningiomas in our series was 12.5% of all meningiomas. We analyzed six cases of multiple intracranial meningiomas that were evaluated by MRI. Two tumors were found in five patients, whereas the other one patient had more than ten tumors at different sites. The tendency of unihemispheric distribution was not seen and two cases had bilaterally located tumors and other two cases had tumors above and below the tentorium without tentorial involvement. Relatively high occurrence of meningioma in posterior fossa was observed. Half of the six cases had posterior fossa tumors and 6 tumors(28.6%) of the total 21 tumors were located in the posterior fossa. All the cases were female. Mean age on admission was 61.3 years, ranged from 44 to 77 years. All six patients were treated surgically and three of them underwent multiple staged operations. Histologically, of the 12 tumors removed, 5 were transitional, 4 were fibroblastic, 3 were meningothelial. The histological subtypes of tumors in each case were different in two cases, but identical in other three cases. The surgical results, although the follow-up periods(ranged 3 months to 2.5 years) were not long enough in some cases, were favorable.
Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Incidence ; Infratentorial Neoplasms ; Magnetic Resonance Imaging ; Meningioma* ; Neurofibromatoses