The 8 cases of left ventricular thrombus detected by the 2 D echocardiography or left ventriculography, after acute transmural anterior myocardial infarction were effectively lysed by the thrombolytic agents and heparin therapy. The thrombolytic agents were either urokinase or tissue plasminogen activator. Urokinase was infused intravenously at a dose of 1.0 million unit for three days. And tissue plasminogen activator was infused at a dose of 100mg for a day. In all cases, the thrombi were completely lysed. At follow up, no recurrence of left ventricular thrombus was found. We have experienced 2 cases of peripheral embolization in which, left ventricular thrombi were protruding nonmobile type. The one was the embolic cerebral infarction, the other was transient hoarseness and paresthesia on the left foot, which may be transient ischemic attack. These results show that left ventricular thrombi can be treated by intravenous thrombolytic agents without life-threatening complication. However, for the better establishment of the risk and benefit of therapy further investigation is needed.
Cerebral Infarction ; Echocardiography ; Fibrinolytic Agents ; Follow-Up Studies ; Foot ; Heparin ; Hoarseness ; Ischemic Attack, Transient ; Myocardial Infarction* ; Paresthesia ; Recurrence ; Thrombolytic Therapy* ; Thrombosis* ; Tissue Plasminogen Activator ; Urokinase-Type Plasminogen Activator

No abstract available.
Vasovasostomy*

BACKGROUND: Despite extensive investigation, the clinical features and prognostic significance of the non-Q wave myocardial infarction, when compared with Q wave myocardial infarction, remain controversial. And no definite relationship between EKG findings and infarct related arteries has been reported. METHOD: A retrospective analysis was done on 205 patient with acute myocardial infarction who were undergone coronary angiography and left ventriculography. Among them, 30 patient with non-Q wave myocardial infarction and 175 patients with Q wave myocardial infarction. RESULTS: 1) There was no significant difference between the two groups in risk factors, prevalence of preinfarct angina and preinfarct heart failure. 2) The faction of patients with non-Q wave myocardial infarction who received thromobolytic therapy was significantly less, compared to patient with Q wave myocardial infarction(p<0.0001). 3) The patients with non-Q wave myocardial infarction had a smaller infarct size estimated by peak creatine phosphokinase(p<0.01). But there was no difference in Killip's classification and left ventricular ejection fraction. 4) In patients with non-Q wave myocardial infarction, 87% of the patients had one or more abnormal EKG finding other than Q wave, and the most frequent abnormal finding was primary T wave change. 5) The location of infarct-related artery was significantly different between group(p<0.0001). The most frequently involved coronary artery in non-Q wave myocardial infarction was left circumflex coronary artery, especially in patients with normal EKG findings. 6) There was no significant difference between the two groups in the prognosis. CONCLUSION: There were significant differences between non-Q wave and Q wave myocardial infarction in the infarct size and the location of infarct related arteries. but not in the risk factors, the prevalence of previous coronary artery disease and prognsis. Further prospective and collaborative studies should be performed to define conclusion.
Arteries* ; Classification ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Creatine ; Electrocardiography* ; Heart Failure ; Humans ; Myocardial Infarction* ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke Volume

OBJECTIVE: We hypothesize that the effect of aging on memory is mediated by executive function. METHODS: Two hundred and thirty healthy adults (101 male, 129 female) were recruited for the study. We used a promising, newly developed, computerized neuropsychological test for the measurement of executive function and memory. The data were analyzed using structural equation modeling and path analysis. RESULTS: The full mediation model showed a good fit to the data. However, chi-squared (chi2) tests for model comparison indicated that the partial mediation model better fits our data. Thus, the partial mediation model was used as the final model. In terms of auditory-verbal memory, the effect of aging on memory was fully mediated by executive function. However, visuo-spatial memory was significantly affected both indirectly (through executive function) and directly (by aging). Gender differences were not significant in this model. CONCLUSION: This study demonstrated the importance of executive function in the memory functioning of normal aging adults. It is noteworthy that modality differences were found between auditory-verbal and visuo-spatial memory. Aging is not the only factor that drives memory decline, and its direct, adverse effect on memory was more prominent in the visuo-spatial memory task than auditory-verbal memory task. Since performance in both modalities is fully or partially mediated by executive function, it is important to train normal aging adults in executive control skills, such as planning, strategy formation, and rapid decision making.
Adult ; Aging ; Decision Making ; Executive Function ; Humans ; Male ; Memory ; Negotiating ; Neuropsychological Tests ; Trail Making Test

Cavernous hemangioma is the venous malformation that most frequently involves the orbit, And in orbital venography, the injection of contrast medium(conray) is made into a branch of frontal vein. The films are taken after delivery of 5 ml and immediately prior to the end of the injection. A preliminary control film is also obtained for this subtraction studies. Recently, authors experienced a case of orbital hemangioma which is caused unilateral proptosis of right eye(6 yr, old boy) and confirmed this patient as an orbital cavernous hemangioma by the technical aid of orbital venography under general anesthesia. Subtraction technique of R. orbital venograms following catheterization of one of the frontal veins revealed that 3rd segment of R. superior ophthalmic vein including 1st and 2nd segments is slightly displaced medially and superiorly of the frontal projection. They were somewhat dilated in caliber. Some dilated and tortuous vessels were filled with contrast media in the inferomedial aspect of the R. oribit from possible Srd segment of SOV. on the R. down lateral projection, there were abnormaly abundant dilated and tortuous vessels in the lateral portion of the orbit. It is fed from the R. angular vein, and CM are drained from the lesion to the dilated IOV at its posterior portion. R transfemoral arteriograms(AP, Lat) showed mild elevation of 3rd portion of the ophthalmic artery superiorly on the lateral projection, but it appeared normal caliber. The supraorbital and muscular branches as well as choroid crescent were not remarkable in this case. R. external carotid angiogram(LAT) showed within normal patterns. Angiographic diagnosis was a large venous malformation involving the lateral and posterior portions of the R. orbit, most likely cavernous hemangioma. Final diagnosis was confirmed by histopathological study of an excised hemangioma. After surgical removal the visual acuity was improved to normal without any disability of the eye.
Anesthesia, General ; Catheterization ; Catheters ; Choroid ; Contrast Media ; Diagnosis ; Exophthalmos ; Hemangioma ; Hemangioma, Cavernous* ; Humans ; Ophthalmic Artery ; Orbit* ; Phlebography* ; Subtraction Technique ; Veins ; Visual Acuity

No abstract available.
Gelatin* ; Hemorrhagic Fever with Renal Syndrome*

To attempt a rigorous definition of the structure of the accessory spleen (AS) in the Chinese hamster, we examined twenty-one animals, and found AS in 5 animals (23.8%), which were over 7-month-old. The AS had no connection with the main spleen and was seen as a dark red oval organ (0.7 mm x 1.5 mm), which was embedded in the adipose tissue near the tail of the pancreas. It was demarcated from the adipose tissue and some pancreatic tissue. The organ was encapsulated by thin collagenous connective tissue and smooth muscle fibers, and contained lymphatic nodules, reticular fibers, nodular central arterioles, macrophages and megakaryocytes. Notably the incidence of AS appeared to increase with age in the Chinese hamsters.
Adipose Tissue/anatomy & histology ; Age Factors ; Animals ; Connective Tissue/anatomy & histology ; Cricetinae ; Cricetulus/*anatomy & histology ; Erythrocytes/cytology ; Lymphocytes/cytology ; Muscle, Smooth/anatomy & histology ; Pancreas ; Spleen/*anatomy & histology/cytology

BACKGROUND: Critical care physician staffing is a crucial element of the intensive care unit (ICU) organization, and is associated with better outcomes in ICUs. Adult ICUs in Korea have been suffering from inadequate full-time intensivists and nurses because of insufficient reimbursement rates (<50% of the original critical care cost) from the National Health Insurance System. Recently, full-time intensivists have been introduced as a prerequisite for adult ICUs of tertiary hospitals in Korea. The purpose of this study was to examine the perception of intensivist staffing among critical care program directors regarding the barriers and solutions when implementing an intensivist model of critical care in Korea. METHODS: An email survey of critical care program directors in designated teaching hospitals for critical care subspecialty training by the Korean Society of Critical Care Medicine was performed. The survey domains included vision, culture, resources, barriers, and potential solutions to implementing intensivist physician staffing (IPS). RESULTS: Forty-two critical care program directors were surveyed. A total of 28 directors (66.7%) responded to email queries. Of these, 27 directors (96.4%) agreed that IPS would improve the quality of care in the ICU, although half of them reported a negative perception of relevant clinical colleagues for the role of full-time intensivists and poor resources for IPS in their hospitals. Increased financial burden due to hiring full-time intensivists and concerns regarding exclusion from the management of their critically ill patients in the ICU, together with loss of income for primary attending physicians were stated by the respondents to be major barriers to implementing IPS. Financial incentives for the required cost from the health insurance system and enhancement of medical law relevant to critical care were regarded as solutions to these issues. CONCLUSIONS: Critical care program directors believe that intensivist-led critical care can improve the outcome of ICUs. They indicated the financial burden due to IPS and underestimation of a full-time intensivist's role to be major barriers. The program directors agreed that a partnership between hospital leaders and the Ministry of Health and Welfare was needed to overcome these barriers.
Adult* ; Critical Care ; Critical Illness ; Electronic Mail ; Hospitals, Teaching ; Humans ; Insurance, Health ; Intensive Care Units ; Jurisprudence ; Korea ; Motivation ; National Health Programs ; Personnel Staffing and Scheduling ; Surveys and Questionnaires ; Tertiary Care Centers

BACKGROUND: The aim of this study was to evaluate the sensitivity of a clinicians' self-report method for the detection of nosocomial infections (NIs) in comparison with a total surveillance method in a neonatal intensive care unit (NICU). METHODS: Two surveillance methods were concurrently performed in the NICU of a university hospital during 5 months in 2003. Clinicians' self-report surveillance (CSRS) was based on the retrospective verification of monthly reports of positive bacteriologic results by NICU clinicians. Total surveillance (TS) was done prospectively by an infection control nurse based on chart review and laboratory data. RESULTS: One hundred fifty nine patients accounting to 2759 patient-days were included in the study. Twenty-seven NIs among 26 patients were identified by TS. The sensitivity of CSRS compared to TS was 14.8% (4 of 27 NIs). The specificity was 98.5% (131 of 133 non-NIs). Kappa measures of agreement were -0.309. CONCLUSIONS: Our results confirm that the retrospective review of charts and laboratory data by clinicians lacks sensitivity and agreement for the surveillance of nosocomial infections.
Cross Infection* ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care, Neonatal* ; Prospective Studies ; Retrospective Studies ; Sensitivity and Specificity

We found an error in this article. The author's name should be corrected as following: from "Younsuk Koh" to "Younsuck Koh".