Between December 1993 and March 1996, 75 patients had undergone subannular procedures in mitral valve reconstruction. Their mean age was 45 years and they consisted of 28 males and 47 females. The cause of mitral disease in 75 patients were classified as follow : 29 cases were degenerative, 40 cases were rheumatic, 3 cases were congenital, 2 cases were infectious and 1 case was ischemic. Average number of mitral anatomical lesion per patient was 3.1 and we used average 1.5 procedures on subannular structure in mitral valve per patient. Subannular procedures were chordae shortening 21, chordae transfer 22, new chordae formation 20, papillary muscle splitting 33, shortening of papillary muscle 2. Intraoperative transesophageal echocardiography was carried out for providing an immediate and accurate assessment of the adequacy of the reconstruction. There was no operative death. Patients have been followed up from 2 to 29months, mean 12.5. There were two failures that necessitated reoperation. The mean functional class(NYHA) was 3.19 preoperative and improved to 1.12. postoperatively. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data. In conclusion, subannular procedure in mitral valve repair when feasible is stable and safe with a low prevalence of reoperation.
Echocardiography ; Echocardiography, Transesophageal ; Female ; Heart Valve Diseases ; Hemodynamics ; Humans ; Male ; Mitral Valve* ; Papillary Muscles ; Prevalence ; Reoperation

Primary cardiac tumors in infancy and childhood are rare, with fibromas being the second most common tumor after rhabdomyomas. Although cardiac fibromas are characteristically benign intramural tumors, they may exhibit exhibit expansile growth resulting in obstruction, valvular dysfunction, as well as other problems so early diagnosis and successful surgical excision are important. We report a case of cardiac fibroma in a 2 month-old male infant. He presented with generalized cyanosis from birth. Echocardiography showed oval round large mass filing the right atrium and ventricle which infiltrated into the lateral wall of the ventricle. Partial excision of the tumor was done after another echocardiogram showed a pericardial effusion and restriction of blood flow to the right ventricle due to the tumor. The resected tumor was ovoid, gray-tan, slightly firm and measuring 5x3x2.5 cm. Histologically, the tumor was composed of spindle-shaped fibroblasts and hyalinized fibrous tissue interdigitating with the surrounding myocardium.
Infant ; Child ; Male ; Female ; Humans

In the past two decades, open reduction and internal fixation has been the preferred treatment of posterior pelvic ring disruption with instability. Despite of rigid fixation, it can induce bleeding, wound infection, wound necrosis and prolong operation time in the patient with combined injuries. To compensate for these disadvantages, we have implemented closed reduction and percutaneous iliosacral fixation under fluoroscopy in reducible posterior pelvic ring disruption. In spite of anatomical risk during screw insertion, the percutaneous iliosacral screw technique after closed reduction of the posterior pelvic ring disruption minimally violates the soft tissue envelope and reduces both the operative blood loss and infection rate. We are reporting the early results of our 6 patients treated between Aug. 1995 to Aug. 1996. The operation time was shorter than open reduction and internal fixation. There was no significant bleeding, wound infection and nerve injury by screws.
Fluoroscopy ; Hemorrhage ; Humans ; Necrosis ; Wound Infection ; Wounds and Injuries

BACKGROUND/AIMS: Ischemic colitis is a vascular condition of inadequate blood flow in the colon which leads to colonic inflammation and can cause significant morbidity and mortality. Oxidative stress is an early initiating event in ischemia and reperfusion injury. Heme oxygenase (HO) is considered to be an antioxidant enzyme that catabolizes heme to carbon monoxide, free iron and biliverdin. The aim of this study was to evaluate the expression patterns of HO-1, inducible form of HO, in ischemic colitis. METHODS: We analyzed the twelve cases of clinically and pathologically diagnosed ischemic colitis without surgical intervention compared with normal colon (n=10) and psedomembranous colitis (n=5). Immunohistochemical stainings for HO-1 were performed in paraffin-embedded tissues. RESULTS: The age of the patients ranged from 56 to 84 years (mean: 67 years) in ischemic colitis. Eight patients (66.7%) were female. The most common presenting symptom was bloody stool (66.7%) and rectosigmoid area (91.7%) of the large intestine was the most common ischemic site. Expression of HO-1 in ischemic colitis was high in contrast to normal colonic mucosa or psedomembranous colitis. CONCLUSIONS: Ischemic colitis usually involves the rectosigmoid area in elderly female patients with a history of bloody stool. High expression of HO-1 in ischemic colitis may be responsible for a protective mechanism to ischemia or heme injury.
Aged ; Aged, 80 and over ; Colitis, Ischemic/*enzymology ; Colon/*enzymology ; Female ; Heme Oxygenase (Decyclizing)/*metabolism ; Humans ; Immunohistochemistry ; Intestinal Mucosa/*enzymology ; Male ; Middle Aged

Fibroblast growth factor-4 (FGF-4) has various functions, affecting many signaling pathways, and leading to cellular proliferation and differentiation and to the regulation of cell migration, invasion, and angiogenesis. However, there are few reports of the relationship between TS cells and FGF-4 even if FGF-4 is located in inner cell mass of embryo and Fibroblast growth factor receptor (FGFR) is located in TS cells. Therefore the physiologic effects of FGF-4 on TS cells were investigated for identifying the effects of FGF-4 on TS ell differentiation. FGF-4 was involved in early stage development of the trophoblast via upregulation of eomesodermin mRNA expression. In addition, FGF-4 suppressed the differentiation of TS cells through activation of extracellular-signal regulated kinase (Erk) and suppression of focal adhesion kinase (FAK) activation, which in TS cells is an important indicator of early trophoblast cell differentiation, migration and invasion. FGF-4 was involved in angiogenesis in the trophoblast through the activation of p38 and the induction of Dlx-3 mRNA expression in TS cells. In addition, TS cells cultured with FGF-4 for 4 days in a thrombinfibrinogen gel culture system, a specific culture system for endothelial cells, showed a healthy appearance, while TS cells cultured without FGF-4 were severely damaged. Taken together, these data suggest that FGF-4 is closely involved in differentiation of TS cells for development of placenta.
Cell Differentiation ; Cell Movement ; Cell Proliferation ; Embryonic Structures ; Endothelial Cells ; Fibroblasts ; Focal Adhesion Protein-Tyrosine Kinases ; Phosphotransferases ; Placenta ; Receptors, Fibroblast Growth Factor ; RNA, Messenger ; Trophoblasts* ; Up-Regulation

BACKGROUND: Rhus verniciflua Stokes (RV) has traditionally been used in Korea as an indigenous food (Rhus chicken soup) and as an herbal medicinal plant. While the anticancer, antimicrobial, and anti-inflammatory properties of RV have been actively studied in the medical field, its antioxidant effects in the skin that resist the reactive oxygen species in keratinocytes and fibroblasts is less understood. OBJECTIVE: We designed to evaluate the effects of R. verniciflua Stokes extract (RVE) on the photo-aged skin by an in vitro experiment using human fibroblasts and an in vivo experiment using a photo-aged murine model. METHODS: For the in vitro experiments, human fibroblasts irradiated with ultraviolet (UV) B were treated with RVE or vehicle, and the growth levels and the expression level of type 1 procollagen were compared. For the in vivo experiment, photo-aged mice irradiated with UVB and UVA were administered drinking water with or without RVE, and histological changes and the expression level of type 1 procollagen and matrix metalloprotease (MMP)-13 were compared. RESULTS: In vitro experiments using fibroblasts irradiated with UVB showed that RVE promoted growth and significantly increased the expression of type 1 procollagen as compared to the control group. In the photo-aged mice, RVE increased collagen content in the dermis and promoted the synthesis of type 1 procollagen without any visible decrease in MMP-13 as compared to control group. CONCLUSION: In addition to the previously reported antioxidant effects of RVE, oral intake of RVE effectively inhibited photo-aging in hairless mice by enhancing collagen synthesis.
Aging ; Animals ; Antioxidants ; Chickens ; Collagen ; Dermis ; Drinking Water ; Fibroblasts ; Humans ; In Vitro Techniques ; Keratinocytes ; Korea ; Mice* ; Mice, Hairless ; Plants, Medicinal ; Procollagen ; Reactive Oxygen Species ; Rhus* ; Skin*

BACKGROUND: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited small vessel disease caused by mutations in the Notch3 gene. Lacunes may reflect occlusive type microangiopathy. However, cerebral microbleeds (CMBs) may reflect bleeding-prone microangiopathy. In the present study, we aimed to determine whether hypertension influence the distribution and severity of lacunes and CMBs in patients with CADASIL. METHODS: The study population comprised 85 patients who underwent brain MRI, including T1-weighted image, susceptibility weighted image (SWI), and fluid attenuated inversion recovery (FLAIR) image. The patients were divided into two groups depending on the presence or absence of hypertension. In the first, demographic factors, and MRI findings were compared between CADASIL patients with and without hypertension. In the second, we undertook a region by region comparison of number of patients with lacunes or CMBs. RESULTS: The hypertensive group showed a higher incidence of CMBs in lobar area (p<0.001) and basal ganglia (p=0.014). CMBs tend to be observed more frequently in the thalamus (p=0.058), brainstem (p=0.057), and cerebellum (p=0.052) in the hypertensive group. However, hypertensive group demonstrated a higher incidence of lacunes just in lobar area (p=0.040). CONCLUSIONS: Our findings suggest that CMBs may be a more sensitive neuroimaging marker of hypertensive arteriopathy in patients with CADASIL.
Basal Ganglia ; Brain ; Brain Stem ; CADASIL* ; Cerebellum ; Demography ; Humans ; Hypertension* ; Incidence ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Neuroimaging ; Thalamus

Encephalopathy is a term for any diffuse disease of brain that alters brain function or structure with very different etiologies and prognoses. There are some reports that steroids have good effects on some encephalopathies with nonvasculitic autoimmune causes. We describe a 63-year-old woman with a 3-month history of progressive gait disturbance, cognitive decline and increasing confusion in whom steroid treatment resulted in dramatic clinical recovery.
14-3-3 Proteins ; Brain ; Female ; Gait ; Humans ; Middle Aged ; Prognosis ; Steroids

No abstract available.
Gyeongsangbuk-do* ; Quality Control*

Myxoma, a rare primary tumor occurring in cardiac chamber, has been shown to cause various neurologic complications such as embolic infarction, neoplastic aneurysm and metastasis. Recently we experienced a patient with cardiac myxoma who presented with behavioral changes. Brain MRI showed lesions suggestive of metastasls and embolic infarctions. Aneurysm was also documented in cerebral angiogram. The case illustrates diverse spectrum of neurologic complications of cardiac myxoma.
Aneurysm ; Brain ; Humans ; Infarction ; Magnetic Resonance Imaging ; Myxoma* ; Neoplasm Metastasis