A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the traumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the posttraumatic tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.
Dilatation ; Dyspnea ; Edema ; Emergencies ; Humans ; Middle Aged ; Motor Vehicles ; Rupture ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Background : It has been suggested that thrombospondin (TSP) is a p53-dependent negative regulator of tumor angiogenesis. TSP expression and localization in hepatocellular carcinomas (HCCs) and its association with overexpression of p53 protein were investigated. Methods : TSP-1 and -2 expressions were examined in 40 HCC specimens by immunohistochemical staining and in 4 HCC cell lines by Western blotting. In addition, p53 protein expression and microvessel density (MVD) were correlated with the TSP expression. Results : Strong immu- nopositivity for TSP-1 was observed in fibroblasts, vascular endothelial cells, and some vas- cular smooth muscle cells of the stroma in 18 cases (45%), and in tumor cells in 3 cases (7.5%) of 40 cases of HCC. Immunoreactivity for TSP-2 was observed in only the sinusoidal lining cells of the tumor in 15 cases (46%), and in tumor cells in 2 cases (6%) of 32 cases of HCC. TSP-1 expression was inversely correlated with MVD (p=0.028), but TSP-2 expression did not show any correlation with MVD. Although p53 was overexpressed in 17 cases, there was no significant correlation between TSP and p53 expressions. None of the HCC cell lines expressed TSP-1 or -2. Conclusions : These findings indicate that TSP-1 is mainly derived from nonparenchymal cells, and may decrease tumor angiogenesis in HCC.
Angiogenesis Inhibitors ; Blotting, Western ; Carcinoma, Hepatocellular* ; Cell Line ; Endothelial Cells ; Fibroblasts ; Microvessels ; Myocytes, Smooth Muscle ; Thrombospondin 1 ; Thrombospondins

Many kinds of different treatment options for fecal incontinence such as biofeedback therapy, anterior or posterior sphincteroplasty, pelvic floor repair, gracilis or gluteus muscle transposition have been introduced. However, appropriate indications for these treatment options have not yet been delineated up to now. PURPOSE: The aim of this study was to access the preoperative severity of fecal incontinence by physiologic tests to give an idea that indications of appropriate selection criteria and parameters for assess the outcome could be simultaneously considered by preoperatively objective physiologic data. MATERIALS AND METHODS: From January 3, 1997 to, August 1, 1997 all patients with fecal incontinence who visited colorectal clinic in the Department of Surgery, Korea Veterans Hospital, were classified into two groups according to the severity of fecal incontinence (0~20): Group I (1~9), Group II (10~20) and compared them with the results of physiologic tests: anorectal manometry, endorectal ultrasound (ERU), cinedefecography, and pudendal nerve terminal motor latency (PNTML). Statistical analysis was performed by Student's-t test, and Chi-square test and p<0.05 was considered significant. RESULTS: The number of GI was 25, and GII was 22. There were no differences between the two groups in terms of age (GI: 57.7+/-14.5, GII: 61.4+/-14.0years), gender (male: female, 19:6, 16:6), cause (neurogenic; 11/25 (GI),7/22(GII), postanal surgery; 6/25,6/22) obstetric trauma (2/25, 2/22), anal trauma (1/25, 1/22) diabetes melitus (1/25, 2/22), rectal prolapse (2/25, 1/22), and others (2/25, 3/22), duration of fecal incontinence (64.4+/-82.2, 48.7+/-65.3 months), high pressure zone (3.3+/-1.7, 3.5+/-1.4 cm), mean resting pressure (50.5+/-27.0, 51.9+/-18.7 cm H2O), maximal resting pressure (88.4+/-50.6, 89.4+/-41.8 cm), maximal squeezing pressure (150.6+/-71.0, 129.7+/-59.5 cm H2O), rectoanal inhibitatory reflex (13/21, 8/21 positive), sensitivity (37.5+/-15.2, 41.8+/-29.0 cc), compliance (19.0+/-14.5, 21.4+/-39.4 cc/cm H2O) in anorectal manometric findings, anal sphincter defect (13/21, 15/22 positive), size of defect (60+/-26.30degrees, 71 +/-30.8degrees/360degrees), thickness of the external anal sphincter (3.46+/-0.78, 3.84 +/-1.02 cm), thickness of internal anal sphincter (1.58+/-0.79, 1.74+/-0.81 cm) in ERU, anorectal angle in rest (85.2+/-28.0degrees, 97+/-22.9degrees), squeeze (72+/-27.1degrees, 82 +/-19.7degrees), push (100+/-43.9degrees, 117.9+/-34.5degrees), length of perineal descent in rest (3.7+/-1.2, 3.6+/-1.7 cm), squeeze (2.9+/-1.5, 2.7+/-1.5 cm), push (7.9+/-3.5, 6.6+/-2.6 cm) in cinedefecography. However, rectal capacity in manometry (212.5+/-99.9, 155+/-51.5 cc, p<0.05), right PNTML (1.73+/-0.39, 2.71+/-0.83 ms, p<0.001), and left PNTML (1.83+/-0.43, 2.94+/-0.80 ms, p<0.001) were significantly increased in GII compare to those of GI. CONCLUSION: As the severity of fecal incontinence was increased, rectal capacity, right and, left PNTML were increased.
Anal Canal ; Biofeedback, Psychology ; Compliance ; Fecal Incontinence* ; Female ; Hospitals, Veterans ; Humans ; Korea ; Manometry ; Patient Selection ; Pelvic Floor ; Pudendal Nerve ; Rectal Prolapse ; Reflex ; Ultrasonography

The proposed factors that affect the prognosis of osteosarcoma are the patient's age, site and size of the primary lesion, pathologic features(type and grade), duration of symptoms, spread of disease (local or regional extension, distant metastasis) at diagnosis, the patient's sex, serum alkaline phos- phatase(ALP) and lactic dehydrogenase(LDH) levels, chromosomal number or DNA index, response to initial chemotherapy, location of the lesion on the bone, presence or absence of pathologic fracture, and mode of therapy. The purpose of this study is to analyze the factors that affect the 5-year survival rates of osteosarcoma. Total 25 patients were included in this study who had treated form Jan. 1988 to Apr. 1994. The overall 5-year survival rate of 25 patients was 65.43%, and the 5-year survival rates were sig- nificantly higher(P < 0.1) in the groups in which limb salvage operation with neoadjuvant chemothera- py were performed(66.67%), with longer duration of symptoms(>2 months; 83.33%), with lower serum level of LDH( < 300 U/L; 100%), and with smaller mass size( < 10cm; 72.92%). However there were no significant differences in the 5-year survival rates according to age and sex of the patients. We also suggest that the better prognosis will be observed in the patients with the favorable radiologic response to the preoperative chemotherapy.
Diagnosis ; DNA ; Drug Therapy ; Fractures, Spontaneous ; Humans ; Limb Salvage ; Osteosarcoma ; Prognosis ; Survival Rate

Osteoporosis is a disease characterized by excessive bone loss or osteopenia particulary in the axial skeleton at the site of fracture, such as the spine and proximal femur. Since the strength of both spine and femur is directly proportional to the bone mass, this osteoporosis always increases the risk of fracture. In this study, to evaluate whether a simple measurement of femoral geometry and BMD value are related with hip fracture, we obtained DEXA Scan (Lunar Expert-XL) of hip by retrospective study. DEXA scan was measured on 70 control people and 17 hip fracture patients aged 50 or older. The result is I. The mean Ward BMD value of hip fracture group is significantly lower than control group (Hip fracture group: 0.52g/cm2, Control group: 0.67g/cm2 P=0.0001) 2. The mean L-spine BMD value of hip fracture group is significantly lower than control group (Hip fracture group: 0.81g/cm, Control group: 0.97g/cm2 P=0.0002) 3. The mean femur axis length of hip fracture group is longer than control group (Hip fracture group: 6.77g/cm2, Control group: 6.57g/cm2 P=0.006) As a conclusion, the measurement of BMD and hip axis length in DEXA scan is an effective method for screening the hip fracture risk patient and BMD value of femur, hip axis length and L- spine BMD value are strongly associated with hip fracture.
Absorptiometry, Photon ; Axis, Cervical Vertebra* ; Bone Density* ; Bone Diseases, Metabolic ; Femur ; Hip* ; Humans ; Mass Screening ; Osteoporosis ; Retrospective Studies ; Skeleton ; Spine

Computerized Tomography is now well established and important noninvasive method of diagnosting mediastinal mass lesions because of its superior imaging of their size, location and internal composition. Authors analyzed and present CT findings of 30 surgically proven mediastinal tumors and cysts that were studied and treated at the Yeungnam University Hospital during recent 6 years. The most common tumor was thymoma (9 cases), and teratoma (6 cases), lymphoma (6 cases), bronchogenic cyst (4 cases), neurogenic tumor (4 cases), pericardial cyst (1 case) were next in order of frequency. There were 5 cases of thymoma showing homogenous solid density mass, 2 cases were malignant thymoma and myasthenia gravis was present in 2 cases. A case of thymolipoma and a case of thymic carcinoma were included. All teratomas were cystic masses but pathognomonic fat, and calcified density were seen only in 4 cases. 5 cases were located in anterior mediastinum and 1 case was in posterior mediastinum. Lymphoma (3 Hodgkin's and 3 non-Hodgkin's) appeared as irregular lobulated mass in anterior mediastinum. Neurogenic tumor (2 ganglioneuroma and 2 neurilemmoma) appeared as homogenous density mass located in posterior mediastinum. Among the 4 bronchogenic cysts, 2 were located in retrotracheal area, 1 was located in subcarinal and 1 was in parathoracic area. One case of pericardial cyst was oval shaped cystic mass located in left pericardiac border.
Bronchogenic Cyst ; Ganglioneuroma ; Lymphoma ; Mediastinal Cyst ; Mediastinum ; Methods ; Myasthenia Gravis ; Teratoma ; Thymoma

The antigenic domain of the major surface protein (Nc-p43) of Neospora caninum was examined by polymerase chain reaction of its gene fragments and recombinant expression as GST fusion proteins. The fragments of Nc-p43 were as follow: a total open reading frame (OFR), T; OFR without signal sequence and C-terminal hydrophobic sequence, S; N-terminal 2/3 parts of S, A; C-terminal 2/3 parts, P; N-terminal 1/3 part, X; middle 1/3 part, Y; and C-terminal 1/3 part, Z, respectively. The DNA fragments were cloned into pGEX-4T vector. Recombinant plasmids transformed into Escherichia coli of BL21 pLysS (DE3) strain were induced to express GST or GST fused fragments of Nc-p43 such as 69 kDa protein for T, 66 kDa for S, 52 kDa for A, 53 kDa for P, and 40 kDa proteins for X, Y, and Z, respectively in SDS-PAGE. The Nc-p43 fragments of T, S, and P reacted with a bovine serum of neosporosis while those of A, X, Y, and Z together with GST did not in the western blot. These findings suggest that the antigenic domain of Nc-p43 of N. caninum may be localized in the C-terminal 2/3 parts. Together with A19 clone in SAG1 of Toxoplasma gondii (Nam et al., 1996), the P fragment of Nc-p43 could be used as efficient antigens to diagnose and differentiate those infections with both species.
Amino Acid Sequence ; Animals ; Base Sequence ; Biological Markers/analysis ; Blotting, Western ; Cells, Cultured ; Cercopithecus aethiops ; Coccidiosis/diagnosis ; Neospora/*immunology ; Protozoan Proteins/*analysis/genetics/immunology ; Reverse Transcriptase Polymerase Chain Reaction ; Support, Non-U.S. Gov't ; Vero Cells/parasitology

From Nov. 7. 1988 to Nov. 21. 1988, we visited 20 universities' opticians and contact lens stores affiliated with them, and surveyed contact lens wearing process. We found that in all 14 stores, fitting was done by non-ophthalmologists and in 11 stores, wearing was processed without consulting on ophthalmologists.

The authors carried out various treatment modalities in 74 consecutive patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage and were admitted to the Department of Neurosurgery. Konkuk University Hospital, from Jan. 1991 to Dec. 1993. A variety of prognostic factors that influence mortality were observed. The locaton of hematoma was at the basal ganglia in 47 cases and at the thalamus in 27 cases. The prognosis gets poorer as the hematoma extended wider and deeper. The prognosis was unfavorable when the hematoma was over 30cc(P<0.001). The mortality rate was higher in cases with IVH than in cases without IVH(P<0.005). In cases with IVH, 19 cases(26%) showed dilated 4th ventricular hemorrage and higher mortality rate(P<0.001). Cases in which the GCS were less than 9 on admission showed higher mortality rate(P<0.0001). The mortality rate was also higher if the midline shift was more than 10mm on the initial brain CT scan(P<0.005). THe group where the unilateral or bilateral pupillary light reflex was unreactive(35cases) showed poorer prognosis than the group where the bilateral pupillary light reflex was reactive(P<0.0001). The ventriculocranial ratio(VCR), hydrocephalus, surrounding edema edema around the heamtoam, and treatment modality were not related to the prognosis. The significant prognostic factors in patients with hypertensive basal ganglionic-thalamic intracerebral hemorrhage were location and type of hematoma, whether or not the volume of hematoma is more than 30cc, IVH, dilated 4th ventricular hemorrhage, Graeb's score of more than 7, GCS of less than 9, midline shift of more than 10mm, and reactivity of pupillary light reflex.
Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Edema ; Ganglion Cysts* ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Prognosis ; Reflex ; Thalamus

No abstract available.
Heart Diseases* ; Heart*