A 63 Year-old-lady has had substernal chest pain on exertion for 8 years. The chest pain has been increased over the last 3 years. A continuous murmur was heard at the left second to third inercostal spaces along the left sternal border. The electrocardiogram showed the inverted T-waves in the precordial leads. The right heart catheterization revealed 5% oxygen step up between RV and PA. The right sided pressures were normal. The coronary arteriography revealed markedly tortuous vessels starting shortly after the left main stem coronary artery was normally originated. One of the large vessel was shown to be drained into the pulmonary artery. In the operation room, without using heart-lung machine this abnormally drained vessel was simply ligated at it's draining site into pulmonary artery. After the operation the patient is feeling well with little symptoms and the continuous murmur is no longer heard.
Angiography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Vessels* ; Electrocardiography ; Heart-Lung Machine ; Humans ; Middle Aged* ; Oxygen ; Pulmonary Artery*

OBJECTIVES: There are a lot of studies that analyze the interaction between the emotion of disgust and the functional brain images using fMRI and PET. But studies using sLORETA (standardized low resolution brain electromagnetic tomography) almost do not exist. The aim of this research is to explore the relationship of the emotion of disgust and the cortical activation using sLORETA analysis. METHODS: Forty five healthy young adults (27.1+/-2.6 years) participated in the study. While they were watching 4 neutral images and 4 disgusting images associated with mutilation selected from the international affective picture system (IAPS), participants' EEGs were taken for 30 seconds per one picture. Through these obtained EEG data, sLORETA analysis was performed to compare EEGs associated with neutral and negative images. RESULTS: During looking for visual disgusting stimulus, all participants reported unpleasantness, arousal and stress. In sLORETA analysis, the decrease of current density in theta wave was shown at left frontal superior gyrus (BA10) and middle gyrus (BA10, 11). This voxel cluster consists of a total of 11 voxels and the threshold of t value indicating statistically significant decreases in the current density (p<0.05) was -1.984. There were no differences between male and female in the degree of being disgusted by the stimuli. CONCLUSION: This finding may suggest that the activation of dorsolateral prefrontal cortex might be associated with regulating disgust emotion.
Arousal ; Brain ; Electroencephalography ; Female ; Humans ; Magnetic Resonance Imaging ; Magnets ; Male ; Prefrontal Cortex ; Young Adult

BACKGROUND: Solvents play an immense role in the industria sector. Irritant dermatitis which is more common than allergic contact dermatitis can be caused by solvents. OBJECTIVE: Our purpose was to compare the skin irritancy of several solvents using human and guinea pig skin models. METHODS: The skin responses to short contact with etharol, acetone, dimethylsulfoxide (DMSO) and xylene were measured by visual scoring of erythm, transepidermal water loss and laser doppler flowmetry. RESULTS: The results are summarized as follows . 1. Guinea pig and human skin responses to normal saline, ethanol, and acetone were nearly negligible. 2. Guinea pig skin responses to 99.9% DMSO under occlusion for 0.5 min were assessed by visual scoring system, TEWL, and LDF. They are measured 3+0.(0,1+21.70, 45+12.70 at 5 min after removal of 99.9% DMSQ, and 0.83+0.41, 10.5+3.83, 36+4.0, to 120 min after removal. 3. Guinea pig skin responses to 97% xylene under occlusion for 5 nin were assessed by visual scoring system, TEWL and LDF. They are measured 3+0.00, 1. 5.82, 77+11.7 at 5 min after removal of 97% xylene, and 1.83+0.75, 5.5+3.21, 39.17+11.53 at l2 min after removal. 4. Human skin responses to 75% DMSO under occlusion for 1 min were assessed by visual scoring system, TEWL and LDF. They are measured 2,5+0.5, 63+25.8, 51+13.7 at 5 min after removal of 75% DMSO, and 0.17+0.41, 14.67+15.87, 21.17-8. 1 at 120 min after removal. 5. Human skin responses to 97% xylene under occlusion for 12 min were assessed by visual scoring system, TEWL and LDF. They are measured 2.7+0.52+4.22, 76+14.30 at 5 min after removal of 97% xylene, and 0+0, 2.5+0.55, 3.17+0.98, 120 emOVBI. CONCLUSION: Short contact vrith DMSO and xylene cause visib erythema and an increase in TEWL and cutaneous blood flow. The reaction patterns in hurr an and guinea pig skin models were similar.
Acetone ; Animals ; Dermatitis, Allergic Contact ; Dermatitis, Irritant* ; Dimethyl Sulfoxide ; Erythema ; Ethanol ; Guinea Pigs ; Humans ; Laser-Doppler Flowmetry ; Lichen Planus ; Skin ; Solvents* ; Xylenes

To know the causes and visual prognosis of ectopia lentis in children, medical records of 41 patients (82 eyes) were retrospectively analysed.The patients were divided into systemic disease-associated, simple, and familial types according to the causes and directions of lens deviation were compared.Surgical methods, pre-and post-operative corrected vision, and complications were investigated. The mean age at diagnosis was 45/12 years old. The decreased vision (87%) and the presence of family history (7.3%) werethe chief complaints on the first examination. According to the causes, 19patients had Marfan syndrome, 14 simple type, and 8 familial type respectively. The directions of lens deviation in Marfan syndrome were different from in simple and familial types. Surgical management have been per-formed in twenty-six patients (44 eyes) on the average 6years of age, and all but one showed an improvement of postoperative corrected vision. One eye presented a dyscoria as a complication. These results are the first report in Korea about the causes and the visual prognosis of ectopia lentis in children and may give us a reference for further management of these patients.
Child* ; Diagnosis ; Ectopia Lentis* ; Humans ; Korea ; Marfan Syndrome ; Medical Records ; Prognosis ; Retrospective Studies

OBJECTIVE: To investigate how differences in oxygen saturation between non-REM (NREM) and REM sleep in patients according to the severity of sleep apnea. METHODS: We studied 396 male patients diagnosed with simple snoring or obstructive sleep apnea syndrome (OSAS) on nocturnal polysomnography. Patients were divided into groups by the OSAS severity. We compared the average oxygen saturation between REM and NREM sleep in each group. RESULTS: In the simple snoring group, average oxygen saturation was significantly greater during REM than during NREM sleep. In the severe OSA group alone, average oxygen saturation was greater in NREM than in REM sleep. The difference of NREM-REM average oxygen saturation correlated significantly with AHI in the severe OSA group. CONCLUSION: More severe hypoxemia was seen in REM than NREM sleep in the severe OSAS group. The differential oxygen decrease between REM and NREM sleep is likely due to the differentially occurring sleep breathing events in each sleep stage according to the SDB severity. The more AHI increases in the severe OSAS patients, the more prominent the hypoxemia of REM sleep compared with NREM sleep is likely to appear. This suggests that the pressure of continuous positive airway pressure should be increased to control the hypoxemia of REM sleep in extremely severe OSAS.
Anoxia ; Continuous Positive Airway Pressure ; Eye Movements* ; Humans ; Male ; Oxygen* ; Polysomnography ; Respiration ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Sleep Stages ; Sleep, REM* ; Snoring

Carpal tunnel syndrome, compression of the median nerve in the carpal tunnel at the wrist, is the most common entrapment syndrome of peripheral nerve. It is characterized by sensory and motor symptoms and signs in the distribution of the median nerve. Radiofrequency thermocoagulation is a neuroablative treatment for various chronic pain disorders, but is associated with neural injury, neuritis, and occasional neuroma. Unlike RF, pulsed radiofrequency, the use of the high current intensity and electrical fields, has been proposed for the modulation of the excited nervous system pathway of pain without neuro-destruction and other potential complications. We report a case of bilateral carpal tunnel syndrome that was relieved after PRF lesioning of both median nerves.
Carpal Tunnel Syndrome ; Chronic Pain ; Electrocoagulation ; Humans ; Median Nerve ; Nervous System ; Neuritis ; Neuroma ; Peripheral Nerves ; Wrist

PURPOSE: To determine whether the maximum standardized uptake value (SUV) of [18F] fluorodeoxyglucose uptake by positron emission tomography (FDG PET) ratio of lymph node to primary tumor (mSUVR) could be a prognostic factor for node positive non-small cell lung cancer (NSCLC) patients treated with definitive radiotherapy (RT). MATERIALS AND METHODS: A total of 68 NSCLC T1-4, N1-3, M0 patients underwent FDG PET before RT. Optimal cutoff values of mSUVR were chosen based on overall survival (OS). Independent prognosticators were identified by Cox regression analysis. RESULTS: The most significant cutoff value for mSUVR was 0.9 with respect to OS. Two-year OS was 17% for patients with mSUVR > 0.9 and 49% for those with mSUVR < or = 0.9 (p = 0.01). In a multivariate analysis, including age, performance status, stage, use of chemotherapy, and mSUVR, only performance status (p = 0.05) and mSUVR > 0.9 (p = 0.05) were significant predictors of OS. Two-year OS for patients with both good performance (Eastern Cooperative Oncology Group [ECOG] < or = 1) and mSUVR < or = 0.9 was significantly better than that for patients with either poor performance (ECOG > 1) or mSUVR > 0.9, 23% (71% vs. 23%, p = 0.04). CONCLUSION: Our results suggested that the mSUVR was a strong prognostic factor among patients with lymph node positive NSCLC following RT. Addition of mSUVR to performance status identifies a subgroup at highest risk for death after RT.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lymph Nodes ; Multivariate Analysis ; Positron-Emission Tomography ; Prognosis

We describe a patient with isolated inferior rectus palsy due to midbrain infarction. A 68-year-old-man developed vertical diplopia of sudden onset which was maximal with a right lower side gaze. Neurological examination revealed weakness of the right inferior rectus muscle. Magnetic resonance imaging of the brain showed a focal infarction in the dorsomedial portion of the right midbrain tegmentum. The sole involvement of fascicular fibers of the inferior rectus muscle in the midbrain was accountable as the cause of this isolated inferior rectus palsy. We think that this is a case supporting the three-dimensional model of somatotopic fascicular arrangement of oculomotor nerve in the midbrain.
Brain ; Diplopia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Mesencephalon ; Muscles ; Neurologic Examination ; Oculomotor Nerve ; Paralysis

BACKGROUND: As in vivo models such as animal and human tests have many potential problems the keratinocyte culture model has previously been used as an in vitro model for testing skin irritancy for common skin irritants. OBJECTIVE: To determine the skin irritant potency of several solvents, we employed cultured human keratinocytes as an in vitro model. METHODS: To evaluate the cytotoxicity of solvents, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT) test, lactic dehydrogenase(LDH) release test, and tritiated thymidine incorporation test were used. RESULTS: Dose dependent decrease of cell viability and DNA synthesis, and dose dependent increase in leakage of LDH liberation were observed in normal cultured human keratinocytes after exposure to several solvents. The cytotoxicity potency of several solvents measured by each method were slightly different. CONCLUSION: These observations suggest that the cultured human keratinocyte model would be useful in evaluating the cytotoxicity of solvents.
Animals ; Cell Survival ; DNA ; Humans* ; Irritants ; Keratinocytes* ; Skin ; Solvents* ; Thymidine

BACKGROUND: As in vivo models such as animal and human tests have many potential problems the keratinocyte culture model has previously been used as an in vitro model for testing skin irritancy for common skin irritants. OBJECTIVE: To determine the skin irritant potency of several solvents, we employed cultured human keratinocytes as an in vitro model. METHODS: To evaluate the cytotoxicity of solvents, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT) test, lactic dehydrogenase(LDH) release test, and tritiated thymidine incorporation test were used. RESULTS: Dose dependent decrease of cell viability and DNA synthesis, and dose dependent increase in leakage of LDH liberation were observed in normal cultured human keratinocytes after exposure to several solvents. The cytotoxicity potency of several solvents measured by each method were slightly different. CONCLUSION: These observations suggest that the cultured human keratinocyte model would be useful in evaluating the cytotoxicity of solvents.
Animals ; Cell Survival ; DNA ; Humans* ; Irritants ; Keratinocytes* ; Skin ; Solvents* ; Thymidine