No abstract available.

No abstract available.
Candida albicans* ; Candida* ; Ecthyma* ; Giant Lymph Node Hyperplasia* ; Humans ; Proteus vulgaris* ; Proteus*

An anomalous left coronary artery from the pulmonary artery(Bland-White-Garland syndrome) is a rare congenital malformation and sometimes fatal. It is caused by an abberant endothelial budding from or an anomalous division of the truncus arteriosus. Echocardiography (transthoracic and transesophageal) and angiographical imaging are essential for the diagnosis of this anomaly. Corrective Surgery is recommended due to its fatal natural course. A case was diagnosed in a 45-year-old man who presented with intermittent palpitation. This patient was successfully treated with closure of anomalous left coronary artery orifice combined with right saphenous vein graft anastomosis.
Bland White Garland Syndrome ; Coronary Vessels* ; Diagnosis ; Echocardiography ; Humans ; Middle Aged ; Pulmonary Artery* ; Saphenous Vein ; Transplants ; Truncus Arteriosus

A 47-years-old woman presented with a 2-month history of a dry mouth and dry cough. The patient had been taking medication for Sjogren's syndrome for approximately 7 years. The chest radiography showed multiple cystic lesions and a hazy density in both lower lung fields. The HRCT showed a diffuse ground glass like appearance and multiple variable sized cystic lesions in both lung fields. After medication, the symptoms were aggravated. Bronchoscopy was preformed with a transbronchial lung biopsy. The biopsies showed an infiltration of lymphocytes, neutrophils, monocytes and histiocytes through the interstitial space of the alveola and a widening of the alveolar septa. However, the histological findings of the cysts were not obtained. Sjogren's syndrome is a slowly progressive inflammatory autoimmune disease, which is characterized by lymphocyte mediated destruction of the exocrine glands, with pulmonary involvement in approximately 19-65%, High-resolution CT is a sensitive technique for assessing the pulmonary involvement in patients with Sjogren's syndrome. Although a lung biopsy is not always necessary for establishing a diagnosis of an interstitial lung disease in Sjogren's syndrome. A lung biopsy may reveal a wide spectrum of changes ranging from a mild inflammatory response to end stage fibrosis with honeycombing. Because of the predominantly peribronchiolar inflammatory infiltration and inspissated secretions the cysts were suspected to have been formed by the ballvalve phenomenon. However, no definite evidence was obtained.
Autoimmune Diseases ; Biopsy ; Bronchoscopy ; Cough ; Diagnosis ; Exocrine Glands ; Female ; Fibrosis ; Glass ; Histiocytes ; Humans ; Lung Diseases* ; Lung Diseases, Interstitial* ; Lung* ; Lymphocytes ; Monocytes ; Mouth ; Neutrophils ; Radiography ; Sjogren's Syndrome* ; Thorax

Iatrogenic suclavian artery aneurysm is a rare disease which requires surgery because of the dangers of a rupture. We report a case of an aneurysm of the right subclavian artery developed by an iatrogenic trauma in a 43-year-old male. The preoperative diagnosis was made by an angiography and Doppler ultrasonogram. After the resection of a 6x7 cm sized aneurysm, an end to end anastomosis was done with a 6 mm Gore-Tex vascular graft. The post-operative course was uneventful and has been followed up from 3 months after discharge.
Adult ; Aneurysm* ; Angiography ; Arteries ; Diagnosis ; Humans ; Male ; Polytetrafluoroethylene ; Rare Diseases ; Rupture ; Subclavian Artery* ; Transplants ; Ultrasonography

We present three neuropathologically-verified and two clinically-probable cases of Creutfeldt Jakob disease. All five had nonspecific prodromal complaints or symptoms prior to overt neurological signs and showed striking progressive neurologic deterioration, especially cognitive decline and cerebellar dysfunction. Myoclonic involuntary movements and complete decapitated states followed in one or two months. The characteristic even pathognomonic in proper clinical settings, features of electroencephalography, magnetic resonance imaging and positron emission tomography and pathologic findings are presented.
Cerebellar Diseases ; Creutzfeldt-Jakob Syndrome* ; Dyskinesias ; Electroencephalography ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Strikes, Employee

BACKGROUND: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. MATERIAL AND METHOD: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean+/-standard deviation. RESULT: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8+/-7.4, 82.1+/-21.1, 59.9+/-7.7 and 46.5+/-6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6+/-4.1, 17.5+/-5.8, 36.3+/-7.3, and 41.5+/-2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5+/-8.2, 12.3+/-3.5, 17.9+/-4.6, and 15.5+/-3.4ml. Blood norepinephrine level was 133.3+/-60.0pg/dL at the baseline and 479.4+/-327.3pg/dL at the heart failure stage(p=0.008). CONCLUSION: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.
Animals ; Blood Pressure ; Capillaries ; Cardiomyopathy, Dilated ; Catheterization, Swan-Ganz ; Depression ; Dilatation ; Dogs ; Heart Failure* ; Heart Rate ; Heart Ventricles ; Heart* ; Hemodynamics ; Models, Theoretical ; Mortality ; Myocardial Ischemia ; Norepinephrine ; Pulmonary Artery ; Stroke Volume ; Tachycardia* ; Thermodilution ; Veins ; Ventricular Function, Left

PURPOSE: The visual analogue scale (VAS) pain score is widely and frequently used to evaluate the severity of pain. However, statistically significant differences in the VAS scores may not always mean differences in pain severity. This study is to determine clinically meaningful reductions in pain severity as measured by the VAS and by a verbal categorical rating of pain. METHODS: Three hundred adult patients presenting to the emergency department (ED) with acute pain resulting from trauma or non-traumatic diseases were enrolled in this prospective, descriptive study. A 100-mm non-hatched, horizontal visual analogue scale was used to measure pain severity. The VAS measurements were obtained two times 1 minute apart at admission, 30 minutes after admission, and 1 hour after treatment. At each VAS measurements, patients also gave verbal ratings of their pain as "more pain,""the same pain," or "less pain." Data from the groups reporting "the same pain" or "less pain" were compared with their preceding descriptions and yielded a VAS difference. The mean VAS change was calculated, from which a grand means and 95% confidence intervals (95% CI) were determined. RESULTS: At 30 minutes after admission and 1 hour after treatment, 256 and 31 patients, respectively described their pain as "the same pain,"and 33 and 269 patients described it as "less pain." The mean reduction in VAS for the group reporting that pain was "the same pain" was 13 to 16 mm (95% CI, 8 to 20 mm) instead of 'zero.'For the group reporting that pain was "less pain," the mean reductions in VAS score were 24 mm (95% CI, 20 to 28 mm) at 30 minutes after admission and 44 mm (95% CI, 42 to 46 mm) at 1 hour after treatment. CONCLUSION: When evaluating management for acute pain in the ED, a difference in VAS score of less than 20 mm without regard to the presence or absence of treatment is unlikely to signify a clinically meaningful reduction in pain severity. This study provides guidance to those who design and interpret clinical studies of the acute pain experience in the ED.
Acute Pain ; Adult ; Emergency Service, Hospital ; Humans ; Pain Management ; Prospective Studies

BACKGROUND AND OBJECTIVES: The recovery of the vestibular sensory epithelia of guinea pigs after gentamicin (GM) induced hair cell injury was assessed both quantitatively and qualitatively with a functional study of the vestibular system using animal rotatory chair. MATERIALS AND METHOD: Evaluations were made via calculating the number of utricle cells bearing hair bundles using scanning electron microscopy (SEM). The number of ampullar hair cells and supporting cells were calculated by toluidine blue staining. Animal rotatory chair test was performed for the evaluation of functional recovery of vestibular system after gentamicin damage in guinea pigs. RESULTS: The initial loss of hair cells in utricle and ampulla were followed by the recovery of hair cell number. The quantitative analyses indicated that the lost hair cells were replaced or regenerated after the end of GM administration, or at 3 months. SEM revealed the morphological recovery of the damaged hair cells and new hair cell regeneration in utricle. In animal rotatory chair test, the gain in slow harmonic acceleration were decreased immediate after GM application, and the gain increased over 3 months. The value of bias off the vertical axis rotation also decreased immediatly after the GM application, and the decreased value of bias were partially recovered. CONCLUSION: We find guinea pig vestibular hair cell regeneration after gentamicin damage with morphologic and functional study.
Acceleration ; Animals ; Axis, Cervical Vertebra ; Bias (Epidemiology) ; Cell Count ; Gentamicins* ; Guinea Pigs* ; Guinea* ; Hair ; Hair Cells, Vestibular* ; Microscopy, Electron, Scanning ; Regeneration* ; Saccule and Utricle ; Tolonium Chloride

The result of a series of thirteen translabyrinthine removals of acoustic neurinomas are reported. From 1990 March to 1993 May, thirteen patients with acoustic neuromas underwent translabyrinthine removal at Seoul National University Hospital with cooperation of Department of Neurosurgery and Otolaryngology. In four patients with the medium-sized(11-20 mm) tumors, complete removal with preservation of the facial nerve was possible. In nine patients with the large(21-40 mm) tumors, complete removal of the tumor was possible in seven. Preservation of the facial nerve was possible in all but one, whose facial nerve was incidentally transected at the distal intracanalicular portion and was anastomosed end-to-endly. In one, postoperative leakage of cerebrospinal fluid required reoperation. The results of translabyrinthine approaches were compared with those of suboccipital approaches performed during the same period. In medium-sized or large acoustic tumors, translabyrinthine approach was comparable with suboccipital approach in the rate of total tumors removal, preservation of the facial nerves, and complication.
Acoustics* ; Cerebrospinal Fluid ; Facial Nerve ; Humans ; Neuroma, Acoustic* ; Neurosurgery ; Otolaryngology ; Reoperation ; Seoul