Six cases of congenital coronary arteriovenous fistulae were diagnosed radiographically and confirmed afteroperation at Seoul National University Hospital in recent three and a quarter years since 1979. The clinical andradiological findings with the emphasis on the cinecardiographic findings were analysed. The summaries of theanalysis are as follows; 1. Among 6 cases, 2 cases were male and 4 cases were female. Age dsitribution was from 3months to 19 years. 2. In chest x-ray findings, 5 cases had cardiomegaly. Among these 5 cases, increase ofpulmonary vascularity was in 3 cases. Chest X-ray finding of the rest 1 case was within normal limit. 3. Thecoronary arteriovenous fistula orginated from the right coronary artery in 5 cases and from the single left coronary artery in 1 case. In 5 cases, a coronary arteriovenous fistula drained into the right ventricle and in 1case, a fistula from a SA node branch of the right coronary artery into the right atrium. 4. In 5 cases, a mainright coronary artery was dilated. Among these 5 cases, aneurysmal dilatation of main right coronary artery was in2 cases, saccular aneurysmal dilatation of distal portion of right coronary artery was in 2 cases and in 1 case,diffuse dilatation without aneurysm formation of a main right coronary artery. In 1 case, SA node branch of theright coronary artery was dilated with aneurysm formation. 5. For accurate diagnosis of congenital coronaryarteriovenous fistula, biplane cinecardiography is an essential procedure.
Aneurysm ; Arteriovenous Fistula ; Cardiomegaly ; Coronary Vessels ; Diagnosis ; Dilatation ; Female ; Fistula ; Heart Atria ; Heart Ventricles ; Humans ; Male ; Seoul ; Thorax

There are some effective methods for removing layers of skin to improve aging face and dermatologic defects : chemabrasion (chemical peeling), dermabrasion(surgical removal), laserabrasion. Chemabrasion, generally performed with a chemical solution, is most useful for removal of fine facial wrinkles and abnormal pigmentation. The application of chemical caustics, especially TCA (trichloroacetic acid), is known to be an effective and is now commonly practiced to improve the surface of the facial skin that has been blemished by pigmentation, wrinkles, solar damage and certain scars. Trichloroacetic acid is a colorless melting crystal and derivatives of acetic acid which das protein precipitating properties. It has specific odor but there is not systemic toxic effect like a phenol. It has heavy caustic effect on skin and mucosa and cause the coagulation necrosis of the skin and therefore, it must be handled carefully and stored in the proper condition. Especially, moderate to high concentrated TCA solution must be treated by well-trained persons. A 46-year-old woman visited a private clinic for removal of fine wrinkles around the lip. She was refered to our department because of acute upper lip coagulation necrosis which was caused by injection of 35% TCA solution mistaken for lidocaine, which was supposed to be used for anesthesia. At her arrival, cental half of upper lip showed severe coagulation necrosis. The lesion was well discriminated in a few days, then debridement and immediate reconstruction was done using an Abbe flap. Chemical peeling is a relatively effective procedure for improvement of aging skin lesion in a lower cost with a short time operation, if the practitioner has much experience and optimal indication is properly selected. But not so as, side effect and complication may be often ocurred in a mistake and as a result irreversible scars are remained. We experienced a rare case of upper lip necrosis which was caused by TCA injection mistaked for lidocaine in a private clinic and so, We report this case with the results of experiment of rabbit model which was observation of macroscopic and microscopic changes of the abdominal skin of the rabbit injected with serially diluted TCA solution.
Acetic Acid ; Aging ; Anesthesia ; Caustics ; Cicatrix ; Debridement ; Female ; Freezing ; Humans ; Lidocaine ; Lip* ; Middle Aged ; Mucous Membrane ; Necrosis* ; Odors ; Phenol ; Pigmentation ; Skin ; Trichloroacetic Acid

No abstract available.
Masticatory Muscles* ; Spasm* ; Tetanus*

HIV-1 p24 was cloned into multiple cloning site of pMV261, extrachromosomal expression vectors carrying BCG replication origin and BCG-specific heat-shock promoter, and then introduced into BCG and E. coli. Western blot experiments showed that the p24 efficiently expressed in recombinant BCG (rBCG), but not in E. coli. Recombinant p24 expression induced by a single heat-shock of rBCG was maintained longer than 3 weeks. Immunoblot experiments with intact rBCG did not show any distinctive positive signal, suggesting that the recombinant protein was not secreted or exposed at the surface of BCG. The guinea pigs immunized with live rBCG showed delayed type hypersensitivity (DTH) by the systemic area as well as an effective humoral immunity, suggesting that tbis rBCG is believed to elicit eKcient immune responses against p24, even though the expression is restricted only in the cytoplasm as reported previously with other antigen. These results demonstrate that BCG can be developed as a live recombinant vaccine vector against a broad spectrum of infectious disease.
Animals* ; Blotting, Western ; Clone Cells ; Cloning, Organism ; Communicable Diseases ; Cytoplasm ; Guinea Pigs ; HIV* ; HIV-1 ; Hypersensitivity ; Immunity, Humoral ; Mycobacterium bovis* ; Replication Origin

A case of right-sided infective endocarditis in a 22-year-old male with ventricular septal defect of perimembranous type, right ventricular(RV) infundibular and pulmonic valve stenosis was reported. The vegetations were found on the mural endocardium of RV infundibulum and pulmonic valve. Streptococcus viridans was identified in 5 consecutive blood cultures, Pulmonary embolism and septic infarction in the lung was associated with systemic embolization, which was manifested by left renal infarction. The RV infundibular stenosis was due to anomalous muscle bundle at the proximal portion. Therefore, we thought that the mechanism of RV infundibular vegetation was probably due to 'Venturi effect and turbulence'. Several clinical features which were found in this case were also reviewed.
Constriction, Pathologic ; Endocarditis* ; Endocardium ; Heart Septal Defects, Ventricular ; Humans ; Infarction ; Lung ; Male ; Pulmonary Embolism ; Viridans Streptococci ; Young Adult

BACKGROUND: To evaluate the role of free fatty acids on the ischemic myocardium, influences of various free fatty acids upon transmembrane action potential and ATP-sensitive K+(KATP) channel activity were examined in the ventricular myocardium and single cardiac myocytes. METHODS: KATP channel activities were measured in the enzymatically (collagenase) isolated single rat ventricular cardiac myocytes by the method of the excised inside-out and the cell-attached patch clamp, and transmembrane action potentials were recorded using the conventional 3M-KCl microelectode techniques in the rat ventricular myocardium. RESULTS: Free fatty acids [FFAs; arachidonic acid (AA), linoleic acid (LA) and lysophosphatidylcholine (LPC)] reduced the KATP channel activity in a dose-dependent manner in the inside-out patch, and 50%-inhibition concentrations (IC50) were 88 +/- 11.2, 49 +/- 12.5, and 188 +/- 17.4 M respectively. Both frequency of channel opening and the mean open-burst duration were markedly decreased, but the amplitude of single channel currents were not changed by the FFAs. AA (50 micrometer) and LPC (50 micrometer) did not affect the dinitrophenol (DNP, 50 micrometer)-induced KATP channel activity, whereas LA (50 micrometer) had a tendency to reduce the activity. The channel inhibition effects by 10 micrometer AA in the inside-out patch were significantly augmented by diclofenac (10 micrometer), but was not changed by nordihydroguaiaretic acid. FFAs never stimulated KATP channel activity, even in the inside-out patch where KATP channel activity reduced in the presence of internal ATP (100 micrometer). Time for 90% repolarization (APD90) significantly increased during superfusion of the FFAs, to 22 (50 micrometer AA), 24 (50 micrometer LA), and 18 (50 micrometer LPC) % from those of the contol at the time of 10 min superfusion, but the other action potential characteristics were not changed by the FFAs. AA (10 micrometer) attenuated cromakalim (10 micrometer)-induced APD90 shortening effects. CONCLUSION: It was inferred that FFAs inhibit the KATP channel activity directly by themselves and/or indirectly by their metabolites in the rat ventricular cardiomyocytes, and therefore, duration of action potential lengthens to be a burden over the ischemic myocardium accounting for the injury of myocardium at the late stage of ischemia.
Action Potentials* ; Adenosine Triphosphate ; Animals ; Arachidonic Acid ; Cromakalim ; Diclofenac ; Fatty Acids, Nonesterified* ; Ischemia ; Linoleic Acid ; Lysophosphatidylcholines ; Masoprocol ; Myocardium* ; Myocytes, Cardiac ; Potassium Channels* ; Potassium* ; Rats*

Sudden hearing deterioration may occur in our population, but it is difficult to explain the exact pathophysiology and the cause. Magnetic resonance imaging (MRI) in sudden sensorineural hearing loss (SSNHL) is usually useful to evaluate neural lesions such as acoustic schwannoma and hemorrhage in labyrinth. Recently some cases of SSNHL caused by intralabyrintine hemorrhage were reported by the advance of MRI. In the case of intralabyrintine hemorrhage, MRI showed a hyperintense signal in the labyrinth on the pre-contrast and contrast enhanced T1-weighted image and relatively weak intensity on T2-weighted image. The prognosis SSNHL by intralabyrintine hemorrhage is generally known to be poor. We report a case of sudden deafness with intralabyrintine hemorrhage who has a history of anticoagulant administration, with a review of literature.
Ear, Inner ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Hemorrhage* ; Magnetic Resonance Imaging ; Neuroma, Acoustic ; Prognosis

Diabetic nephropathy is characterized by one or a combination of the following lesions: (1) glomerular involvement with three distinctive patterns: diffuse glomerulosclerosis, nodular glomerulosclerosis, and exudative lesions; (2) arteriolo sclerosis; (3) urinary tract bacterial infection with pyelonephritis and sometimes emphysematous pyelonephritis. Emphysematous pyelonephritis is an uncommon life-threatening and acute suppurative infection of the kidney, and usually occurs in diabetic female patients. It is characterized by the production of intraparenchymal gas. Glucose fermentation has been considered the main cause of the gas formation. We presented two illustrative nephrectomy cases of emphysematous pyelonephritis in addition to the typical pathologic features of diabetic nephropathy.
Bacterial Infections ; Diabetic Nephropathies* ; Female ; Fermentation ; Glucose ; Humans ; Kidney ; Nephrectomy ; Pyelonephritis* ; Sclerosis ; Urinary Tract

Neonatal and obstetrical problems related to the low birth weight infants were evaluated by a retrospective review of the medical records of the 186 low birth weight infants born at Yeungnam University Hospital during 3 years and 8 months from May 1, 1983 to February 28, 1987. The results were as follows: 1. The incidence of the low birth weight infants was 4.98% among 3,803 live births. 2. Male to female ratio was 1.02:1. 3. The incidence of the low birth weight infants was lowest in mothers of 25 to 29 years, increased in mothers of 19 years of less and 30 to 39 years significantly. 4. There was no difference in the incidence of low birth weight infants between primiparous and multiparous mothers. 5. Common obstetrical complications associated with low weight infants were multiple pregnancy, toxemia and premature rupture of membrane in order of frequency. 6. Common neonatal problems in low birth weight infants were jaundice, idiopathic respiratory, distress syndrome, asphyxia and metabolic derangement such as hypocalcemia and hypoglycemia in order of frequency.
Asphyxia ; Clinical Study* ; Female ; Humans ; Hypocalcemia ; Hypoglycemia ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Jaundice ; Live Birth ; Male ; Medical Records ; Membranes ; Mothers ; Pregnancy ; Pregnancy, Multiple ; Retrospective Studies ; Rupture ; Toxemia

No abstract available.
Adult* ; Humans