The Gerbode shunt, known as the left ventricle to the right atrial communication, is a rather rare finding, following surgical closure of septal defects. Even though the surgical closure is accepted as a treatment of choice, we report a successful percutaneous transcatheter closure of the Gerbode shunt in a 3-months old baby who weighed 3 kilograms.
Heart Septal Defects ; Heart Ventricles ; Humans ; Septal Occluder Device

PURPOSE: Colonoscopy is a safe and commonly used method for the screening of colon cancer, but sometimes major complications, such as, colonic perforation or hemorrhage occur during the procedure. The aim of this study was to compare the surgical outcomes of laparoscopic and open surgery for colon perforation after colonoscopy. METHODS: A retrospective review of patient records was performed on 25 patients with iatrogenic colon perforation during colonoscopy during the 7-year period from January 2005 to June 2012. Demographic data, operative procedures, operation times, postoperative complications, hospital course, and morbidities in the laparoscopic surgery group (LG) and open surgery group (OG) were compared. RESULTS: Seventeen of the 25 patients underwent laparoscopic surgery (68%) and 8 patients open surgery (32%). The most common surgical methods were primary repair in the LG, and Hartmann's operation in the OG. Average time to first flatus was 2.9 days in the LG and 4.5 days in the OG, and average times to first meals were 4.5 days and 5 days, respectively. Mean hospital stays were 10.8 days in the LG and 17 days in the OG. After surgery, complications occurred in two patients in the LG, but no complication occurred in the OG. CONCLUSION: Laparoscopic repair for iatrogenic colonic perforation during colonoscopy seems to be useful and safe surgical method in early period after perforation. However, open surgery is also needed for the delayed cases after perforation.
Colon* ; Colonic Neoplasms ; Colonoscopy* ; Flatulence ; Hemorrhage ; Humans ; Intestinal Perforation ; Laparoscopy ; Length of Stay ; Mass Screening ; Meals ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

PURPOSE: This study was done to know the usefulness of fractal analysis when evaluating the radiologic changes after decompression on jaw bone cystic lesions using fractal analysis. MATERIALS AND METHODS: 30cases of cystic lesions were followed up after decompression. Panoramic image was used to observe radiologic changes around the cystic lesion. The part of the panoramic image which showed radiologic change was defined as region of interest(ROI); The fractal dimension of the ROI was calculated using box-counting method. RESULTS: Using sign-rank test, there was a statistically significant difference in fractal dimensions after decompression therapy(P<;0.0001). The fractal dimensions statistically increased after decompression(the median of D:0.12). CONCLUSIONS: The ROI after decompression showed higher fractal dimensions which offer the objective proof of the bone healing around cystic lesions after decompression treatment.
Bone Cysts* ; Decompression* ; Fractals* ; Jaw*

Intrabronchial nerilemmoma is very rare disease. Neurilemmoma has been thought to arise from schwann cell, has been reported to occur in almost any anatomic location. The incidence of primary neurogenic tumors of the lung has been estimated to be 0 to 2 percent of all lung tumors. These tumors are predominantly(75%) associated with neurofibromatosis of von Recklinghausen's disease. To our knowledge, no case of benign solitary endobronchial neurilemmoma has been reported in Korea. This paper presents a case of benign solitary endobronchial neurilemmoma with a brief review of the pertinent literature. A 19 year old female visited our medical hospital with the symptoms of chest discomfort and pain. Bronchoscopy and chest CT scan revealed a mass on the left upper 1obar bronchus. Left upper lobectomy was performed successfully and histological section revealed a neurilemmoma.
Bronchi ; Bronchoscopy ; Female ; Humans ; Incidence ; Korea ; Lung ; Neurilemmoma* ; Neurofibromatoses ; Neurofibromatosis 1 ; Rare Diseases ; Thorax ; Tomography, X-Ray Computed ; Young Adult

PURPOSE: We performed this study to evaluate the incidence and clinical significance of antiphospholipid antibodies (aPL Ab) in Korean children with Henoch-Schonlein purpura (HSP). METHODS: The medical records of 62 patients (31 boys and 31 girls) aged 6.0+/-3.1 (1-16) years with a clinical diagnosis of HSP based on the EULAR/PReS criteria were reviewed retrospectively. From the years 2007 to 2009, the sera from children with acute HSP were tested for aPL Ab such as LA, anti-cardiolipin antibody and anti-beta2 glycoprotein I antibody. RESULTS: LA was positive in 18 (29%) of the 62 patients with HSP and We divided the patients into the two groups LA positive group (N=18) and LA negative group (N=44). There were no significant differences between the two groups with regard to abdominal pain, arthralgia and renal involvement, but LA positive group had significantly higher C-reactive protein (4.3+/-7.2 mg/dL vs. 1.3+/-1.8 mg/dL, P=0.035), erythrocyte sedimentation rate (37.5+/-26.2 mm/hr vs. 25.1+/-22.6 mm/hr, P= 0.039), IgM (148.1+/-48.4 mg/dL vs. 114.9+/-41.5 mg/dL, P=0.024), C3 (143.1+/-21.9 mg/dL vs. 129.7+/-24.5 mg/dL, P=0.048) and C4 levels (30.9+/-6.3 mg/dL vs. 24.9+/-7.8 mg/dL, P=0.002) compared with LA negative group. CONCLUSION: We found that the incidence of positive aPL Ab tests was relatively higher in Korean children with HSP and the presence of aPL Ab was associated with acute inflammatory process of HSP. These results suggest that the aPL Ab are involved in the pathogenesis of HSP in children.
Abdominal Pain ; Aged ; Antibodies, Antiphospholipid ; Arthralgia ; Blood Sedimentation ; C-Reactive Protein ; Child ; Glycoproteins ; Humans ; Immunoglobulin M ; Incidence ; Lupus Coagulation Inhibitor ; Medical Records ; Purpura, Schoenlein-Henoch ; Retrospective Studies

PURPOSE: To evaluate and analyse the operative results of percutaneous iliosacral screw fixation in displaced posterior pelvic ring injuries. MATERIALS AND METHODS: Fourteen consecutive patients with displaced posterior pelvic ring injuries (August 1995-June 1998) treated by percutaneous iliosacral screw fixation were reviewed. We analysed the pattern of fracture, associated injury and method of operation including patient's position, complication and functional result. RESULTS: Seventeen iliosacral screws under fluoroscopic guidance were applied in fourteen patients. During the operations various positions of patients were possible, and all cases were treated with closed reduction and percutaneous iliosacral screw fixation except in one case (open reduction and percutaneous screw fixation). Fixation of associated anterior pelvic ring injury was undertakes in eight cases. Screw-related neurovascular injury and other complications such as breakage, loosening, misplacement and redisplacement, nonunion and screw site infection during follow-up period were not found. Satisfactory clinical and radiologic results were achieved during follow-up period except in one case (limping due to leg length discrepancy, malreduction) in this study. CONCLUSION: Precise understanding of iliosacral anatomy and its variants, proper patient positioning and appropriate intraoperative interpretation of fluoroscopic iliosacral image are mandatory. We believe percutaneous iliosacral screw fixation is a useful addition to treatment options for unstable posterior pelvic ring injury.
Follow-Up Studies ; Humans ; Leg ; Patient Positioning

Resveratrol is a polyphenolic compound in red wine that has anti-oxidant and cardioprotective effects in animal models. Reactive oxygen species (ROS) and monocyte chemotactic protein-1 (MCP-1) play key roles in foam cell formation and atherosclerosis. We studied LPS-mediated foam cell formation and the effect of resveratrol. Resveratrol pretreatment strongly suppressed LPS-induced foam cell formation. To determine if resveratrol affected the expression of genes that control ROS generation in macrophages, NADPH oxidase 1 (Nox1) was measured. Resveratrol treatment of macrophages inhibited LPS-induced Nox1 expression as well as ROS generation, and also suppressed LPS-induced MCP-1 mRNA and protein expression. We investigated the upstream targets of Nox1 and MCP-1 expression and found that Akt-forkhead transcription factors of the O class (FoxO3a) is an important signaling pathway that regulates both genes. These inhibitory effects of resveratrol on Nox1 expression and MCP-1 production may target to the Akt and FoxO3a signaling pathways.
Antioxidants/*pharmacology ; Cells, Cultured ; Chemokine CCL2/genetics/*metabolism ; Enzyme Activation/drug effects ; Foam Cells/*drug effects/physiology ; Forkhead Transcription Factors/metabolism ; Humans ; Lipopolysaccharides/pharmacology ; NADH, NADPH Oxidoreductases/genetics/*metabolism ; Proto-Oncogene Proteins c-akt/metabolism ; RNA, Messenger/metabolism ; Reactive Oxygen Species/*metabolism ; Signal Transduction ; Stilbenes/*pharmacology

Atrial Septal Defect(ASD) is usually suspected clinically but requires a confirmative diagnostic procedure before surgical repair. Conventional transthoracic echocardiography has relatively high sensitivity and specificity for ASD, but difficulty in visualizing the ASD occasionally. Transesophageal echocardiography has special advantages for investigating the posteriorly located cardiac structures, including the atrial septum, which is imaged perpendicularly at a relatively short distance. We describe a case in which ostium secundum ASD was not visualized by conventional transthoracic echocardiography, but was diagnosed confidently by transesophageal echocardiography. It is concluded that transesophageal echocardiography appears to be a promising diagnostic tools for the evaluation of ASD on the basis of its ability to provide excellent imaging of the entire atrial septum and related posterior cardiac structures.
Atrial Septum ; Echocardiography ; Echocardiography, Transesophageal* ; Heart Septal Defects, Atrial* ; Sensitivity and Specificity

There has been a dramatic increase in the number and type of procedures performed in the field of cardiac intervention in the past decade. Percutaneous intervention is becoming an increasingly recognized modality for the management of prosthetic paravalvular leakages (PVLs) in severely symptomatic non-surgical candidates. Herein, we report our experience of percutaneous closure using the Amplatzer duct occluder for a PVL in a patient who underwent tricuspid valve replacement.
Heart Valve Prosthesis ; Humans ; Septal Occluder Device ; Tricuspid Valve ; Tricuspid Valve Insufficiency

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in Korea. The overall rate of MRSA in hospitals in Korea was estimated over 60%. Recently hospital infections caused by MRSA are getting increased and problematic in Korea, Our hospital Seoul Paik Hospital, has been trying to solve this problem. We had not applied exact methods for hospital infection control. Therefore, we adapted strict methods under the control of hospital infection control committee (HICC) and assessed the effectiveness of these methods. METHODS: Every month, the number of MRSA isolates was collected and analyzed; the results of the analysis were reported to every ward. All wards were supplied with Microshild(R) (Johnson & Johnson, Australia), Clean N' Fresh(R) (Carroll, USA), and standard paper towels. Health care workers were regularly educated for hospital infection control. The use of antibiotics was controlled by the HICC. We compared MRSA isolation rate between before and after applying the strict infection control methods under the regulation of HICC. Mann-Whitney U test, one-way ANOVA, and Chi-square test were used for statistical analysis of the results. RESULTS: After restricting the uses of antibiotics, glycopeptides and carbapenems were prescribed 15% less (20.3 vs 17.3 DDD /1000 patient-days) and 35% less (9.3 vs 6.0 DDD /1000 patient-days) respectively, compared to before restricting antibiotics. Methicillin resistance rate was decreased from 78% to 69% compared to before the methods(p=0.02). The isolation rate of MRSA was reduced by 31-42% from 2.33 to 1.35-1.60/1000 patient-days compared to before adapting strict infection control methods (p=0.04-0.07). CONCLUSION: This study showed that applying the strict infection control methods in the hospital can be effective to reduce the isolation rate of MRSA.
Anti-Bacterial Agents ; Carbapenems ; Cross Infection* ; Delivery of Health Care ; Dichlorodiphenyldichloroethane ; Glycopeptides ; Infection Control ; Korea ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Seoul ; Staphylococcus aureus* ; Staphylococcus*