No abstract available.
Edema* ; Humans ; Hydrops Fetalis* ; Infant, Newborn*

OBJECTIVE: It is well known that X-ray induces follicular atresia, but the exact mechanism of atresia is not still unveiled completely. In addition, the role of macrophage related with clean-up the dead granulosa cells and other functions within the ovarian follicle is emphasized recently. The aim of this study is to assess the radiation-induced morphological changes of ovarian follicles and follicular macrophages. METHODS: 8 Gy X-ray irradiated on the 3-week old rats (Sprague-Dawley strain), sacrificed at 6, 12, and 24 hours after irradiation, and performed morphological studies with light and transmission electron microscopy, TUNEL, and macrophage immunohistochemistry. RESULTS: Follicular atresia increased significantly (p<0.01) at 6 hours after X-irradiation, and it was decreased significantly (p<0.01) at 12 and 24 hours after irradiation. X-ray induced chromatin condensation in the nucleus and nuclear fragmentation of granulosa cells, which were the typical features of apoptosis. Apoptotic granulosa cells were phagocytosed by the neighboring normal granulosa cells and the macrophages. During atresia of follicles, radioresistant granulosa cells were found in some follicles, which showed similar features morphologically with the granulosa cells of normal follicles. Macrophages were found both within the antrum and at the follicular granulosa layer. CONCLUSION: X-radiation induced follicular atresia by means of granulosa cell apoptosis, and radioresistant granulosa cells which have similar features morphologically with the granulosa cells of normal follicles were observed in some follicles. And the macrophages which phagocytose the apoptotic granulosa cells were located within the follicular antrum and at the follicular granulosa layer.
Animals ; Apoptosis ; Chromatin ; Female ; Follicular Atresia* ; Granulosa Cells ; Immunohistochemistry ; In Situ Nick-End Labeling ; Macrophages* ; Microscopy, Electron, Transmission ; Ovarian Follicle ; Radiation, Ionizing ; Rats

PURPOSE: To determine the electronic spin relaxation times, T1e, of three commercially available Gd-chelated MR contrast agents, Gd-DTPA, Gd-DTPA-BMA and Gd-DOTA, using Electron Paramagnetic Resonance(EPR) technique. Material and Methods: The paramagnetic MR contrast agents, Gd-DTPA(Magnevist), Gd-DTPA-BMA(OMNISCAN) and Gd-DOTA(Dotarem), were used for this study. The EPR spectra of these contrast agents, which were prepared 2:1 methanol/water solution, were obtained at low temperatures, from-160degrees C~-20degrees C. The glassy-state EPR spectra for these contrast agents were then fitted by the simulation spectra generated with different zero-field splitting (ZFS) parameters by a computer simulation program 'GE N', which generates the EPR powder spectrum using a given ZFS in 3X3 tensor. Finally, the spin relaxation times of the contrast agents were then determined from the T2e, D, and E values of the best simulation spectra using the McLachlan's theory of average relaxation rate. Results: The electronic transverse spin relaxation times, T2e's, of Gd-DTPA, Gd-DTPA-BMA and Gd-DOTA were 0.113ns, 0.147ns and 1.81ns respectively. The g-values were 1.9737, 1.9735 and 1.9830 and the electronic spin relaxation times, T1e's, were 18.70ns, 33.40ns and 1.66micros, respectively. Conclusion: The results of these studies reconfirm that the paramagnetic MR contrast agents with larger ZFS parameters should have shorter T1e's. Among three contrast agents used for this study, Gd-DOTA chelated with cyclic ligand structure shows better electronic property then the others with linear structure. Thus, it is concluded that the exact determination of ZFS parameters is the important factor in evaluating relaxation enhancement effect of the agents and in developing new contrast agents.
Computer Simulation ; Contrast Media* ; Gadolinium DTPA ; Magnetic Resonance Imaging* ; Relaxation*

PURPOSE: We wanted to assess the short term clinical outcomes and the effectiveness of reverse total shoulder replacement for massive rotator cuff tears with cuff tear arthropathy in elderly patients. MATERIALS AND METHODS: Between September 2007 and January 2009, 17 reverse total shoulder arthroplasties were performed on patients with an average age of 69.3 (58-80) years. The follow up period was an average of 17.9 (12-32) months. The outcomes were evaluated using the visual analogue scale, the range of motion, the muscle strength, the Constant score, the UCLA score and the Korea shoulder score. We performed radiological measurements of medialization of the center of rotation, distalization of the humerus, and tilting of the inferior glenoid on the preoperative and postoperative radiographs. RESULTS: The VAS improved from 7.2+/-3.6 preoperatively to 1.6+/-1.0 postoperatively. The average preoperative active forward fl exion was 51.5+/-28.4 degrees, which improved to 131.5+/-20.7 degrees at the final follow-up. The internal rotation was deteriorated from L2 to L5 (p<0.001, 0.001, 0.011). The average Constant score improved from 23.9+/-5.1 points before surgery to 62.2+/-9.1 points at the time of follow-up and the UCLA score and KSS score also rose from 7.6+/-2.4 and 27.0+/-7.5 points to 26.3+/-3.6 and 69.2+/-10.4 points respectively, which were statistically significant. For the radiological measurements, the medialization of rotation of the center was a mean of 20.6 mm+/-4.3 and the distalization of the humerus was a mean 22.8 mm+/-5.56. The glenoid inferior tilting increased a mean of 12.1+/-4.3 degrees. Inferior scapular notching was observed in two cases. CONCLUSION: The reverse total shoulder arthroplasty produced good results when used for the treatment of massive rotator cuff tear and cuff tear arthropathy. Forward fl exion was significantly improved, but on the contrary internal rotation was deteriorated. Considering the technical difficulties and the possibility of complications, the reverse total shoulder arthroplasty should be judiciously used by expert surgeons.
Aged ; Arthroplasty ; Follow-Up Studies ; Humans ; Humerus ; Korea ; Muscle Strength ; Range of Motion, Articular ; Rotator Cuff ; Shoulder

PURPOSE: We wanted to evaluate the clinical results of the Latarjet procedure for treating anterior shoulder instability combined with a glenoid bone defect. MATERIALS AND METHODS: Between Oct. 2006 and May. 2007, fourteen patients underwent a Latarjet operation to treat their anterior shoulder instability combined with a glenoid bone defect. The mean follow-up period was 15 months (range: 12 to 19 months), and the average age at the time of surgery was 29.9-years-old (range: 19 to 44 years). There were 13 males and 1 female. Eight patients exhibited involvement of the right shoulder. The dominant arm was involved in 8 patients. Six patients had undergone a previous arthroscopic Bankart repair before their Latarjet operation and 2 patients had a history of seizure. RESULTS: The average Rowe score improved from 51.8 to 80.2 with 9 excellent, 4 good, and 1 fair results. The average Korean shoulder score for instability improved from 61.6 to 82.1 postoperatively. The active forward flexion and external rotation at the side of the involved shoulder was an average of 8degrees and 16degrees less than that of the uninvolved shoulder. The muscle strength of the involved shoulder measured 78.7% in forward flexion and 82.5% in external rotation, as compared with that of the uninvolved shoulder. There was 1 case of dislocation, 1 transient subluxation, 2 fibrotic unions, 1 resorption of the transferred coracoid process, 1 intraoperative broken bone, 1 transient musculocutaneous nerve injury and 1 case of stiffness. CONCLUSION: The Latarjet procedure for treating anterior shoulder instability combined with a significant glenoid defect effectively restores function and stability through extending the articular arc at the expense of external rotation. We should be cautious to avoid or detect complications when performing coracoid transfer.
Arm ; Dislocations ; Female ; Follow-Up Studies ; Fractures, Bone ; Humans ; Male ; Muscle Strength ; Musculocutaneous Nerve ; Shoulder

A femoral artery pseudoaneurysm (FAP) is one of the most troublesome complications following invasive procedures related to the femoral arterial access. Post-procedure FAP rarely occurs; however, its occurrence tends to increase with the more frequently antiplatelet agents, anticoagulants, and larger-sized catheter used for interventional procedures. Traditionally, surgical repair has been considered as the standard treatment modality for FAP; however, less invasive methods currently exist such as blind manual or ultrasound-guided compression repair (UGCR) as well as percutaneous thrombin injection, both of which have replaced the need for surgery. We report a case of a giant pseudoaneurysm in a femoral artery, which had developed as a complication of stenting in a patient with carotid artery stenosis and ischemic heart disease, and was subsequently successfully treated using percutaneous thrombin injection.
Aneurysm, False ; Anticoagulants ; Carotid Stenosis ; Catheters ; Femoral Artery ; Humans ; Myocardial Ischemia ; Platelet Aggregation Inhibitors ; Stents ; Thrombin

Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65–0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72–1.36; p=0.94). Conclusion Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.

BACKGOUND/AIMS: Gastrointestinal (GI) bleeding remains a common medical problem, with morbidity and mortality rates of GI bleeding in intensive care unit (ICU) believed to have remained unchanged. There has been no report about the etiology and clinical manifestation of GI bleeding in ICU in Korea. Therefore, we performed this study to determine the frequency, etiology, risk factors, and outcome of clinically significant GI bleeding that occurred after admission to ICU. METHODS: We reviewed medical records of 1829 patients admitted to medical ICU in Samsung Medical Center from October 1994 to May 1999. Cases were enrolled the patients who developed GI bleeding more than 24 hours after admission to the medical ICU. The cases were compared with control populations: a set of ICU patients without GI bleeding matched with cases for age, gender, and length of ICU stay to evaluate the risk factors of GI bleeding. RESULTS: Clinically significant GI bleeding, confirmed by endoscopy, occurred in 71 patients of 1,829 patients (3.9%) after a mean ICU stay of 14+/-2.6 days. Gastric ulcer bleeding was the most common source of GI bleeding, accounting for 29.6% of cases overall. There were no statistical differences in underlying disease, mechanical ventilator use, heparin or steroid use, prothrombin time, prophylactic drug use such as H2 blocker and antacid use between cases and controls. However, thrombocytopenia (<50,000/mm3) was more common in cases who had GI bleeding than controls (P<0.05). CONCLUSIONS: Gastric ulcer was the most common cause of GI bleeding in ICU and careful attention was necessary to patients with thrombocytopenia (<50,000/mm3) in ICU.
Endoscopy ; Hemorrhage* ; Heparin ; Humans ; Intensive Care Units* ; Critical Care* ; Korea ; Medical Records ; Mortality ; Prothrombin Time ; Risk Factors ; Stomach Ulcer ; Thrombocytopenia ; Ventilators, Mechanical

Gastric tuberculosis is quite rare and usually combined with pulmonary tuberculosis. Its diagnosis is so difficult as it is often unsuspected. We report a patient with gastric tuberculosis who presented with hematemesis in Korea. Upper endoscopy showed large, deep penetrating ulcer containing an exposed vessel and adherent clot in the body. Gastric biopsies revealed only chronic inflammation and no evidence of granuloma or malignancy. Diffuse mural thickening was noted on abdominal CT. The diagnosis was made postoperatively following gastrectomy for bleeding gastric ulcer. Microscopic examination of resected stomach showed peptic detritus and noncaseating granulomas. However, multiple caseating granulomas with Lagerhan's giant cells were found on the examination of lymph nodes. The patient was treated with antituberculous therapy for 12 months without any complications.
Biopsy ; Diagnosis ; Endoscopy ; Gastrectomy ; Giant Cells ; Granuloma ; Hematemesis* ; Hemorrhage ; Humans ; Inflammation ; Korea ; Lymph Nodes ; Stomach ; Stomach Ulcer ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

Duplication of the alimentary tract is an unusual congenital anomaly which may occur at any level, from the oral cavity to the rectum. Jejunal duplication cyst is quite rare and most of them are presented in infancy with the symptoms of abdominal mass, obstruction, hemorrhage and perforation. But some cases has not been diagnosed till adult if duplication cyst was too small enough to cause symptoms. We report a case of a 28-year-old woman who presented with recurrent gastrointestinal hemorrhage as a result of an ulceration without ectopic mucosa in jejunal duplication cyst and was successfully treated with surgery.
Adult* ; Female ; Gastrointestinal Hemorrhage* ; Hemorrhage ; Humans ; Jejunum ; Mouth ; Mucous Membrane ; Rectum ; Ulcer