No abstract available.
Nephrectomy*

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

No abstract available.
Humans ; Rectus Abdominis* ; Tissue Donors*

OBJECTIVES: The purpose of this study was to investigate the neurocognitive and psycho-physiological effects of total sleep deprivation by using the objective and quantifiable methods of Vienna Test System (Reaction Unit, Cognitrone, Vigilance) and P300 event-related potential. METHODS: Thirty healthy medical students(22 men, 8 women) participated in this study. Subjects remained awake for 38 hours under continuous surveillance. In the morning and the evening of two consecutive study days, the Vienna tests and P300 were performed. RESULTS: In Vigilance test of the Vienna Test System, a significant functional impairment occurred as a result of total sleep deprivation(p<.001). In Reaction unit, reaction time significantly increased (p<.01). However, in Cognitrone, a functional improvement was revealed. The P300 latency was significantly prolonged(p<.001) and amplitudes decreased(p<.01) as a consequence of total sleep deprivation. Comparing the results of Vigilance and Reaction unit each taken in the morning and evening, the performance decrements were prominent in morning sessions. In Cognitrone, evening session result showed the improvemed performance. CONCLUSIONS: The cognitive impairment resulting from 38 hours of sleep deprivation are considerable in alertness and reaction time tests, but not in higher complex cognitive functions such as fine perceptual analyses, visual discrimination, and short term memory. Considering the results with P300 latency and amplitudes, it may be concluded that the P300 changes as a result of total sleep deprivation are due to the decrement in the alertness which prolongs reaction time. More deterioration of cognitive performance shown in the morning, could be explained by considering circadian rhythm.
Circadian Rhythm ; Discrimination (Psychology) ; Event-Related Potentials, P300 ; Humans ; Male ; Memory ; Reaction Time ; Sleep Deprivation*

No abstract available.
Nocardia Infections*

PURPOSE: To evaluate the outcome after Ahmed valve implantation in patients with neovascular glaucoma when using intraoperative mitomycin C (MMC) and postoperative 5-fluorouracil (5-FU). METHODS: A total of 40 eyes of 40 patients with neovascular glaucoma who received antiglacomatous medication without previous glaucoma surgery were included in the present study. The patients received Ahmed valve implantation and intraoperative MMC and postoperative 5-FU. Failure was defined as the first occurrence of any of the following: 1) the first of three consecutive visits where intraocular pressure (IOP) was >18 mmHg or 20% IOP reduction from baseline and the final number of topical medication did not reduce by at least two from baseline, 2) the need for additional surgery, or 3) the occurrence of a serious complication. RESULTS: The cumulative success rate was 77.5% at 12 months. The final number of topical medication after Ahmed valve implantation was 0.73+/-0.78, and the change in the number of medication from baseline was -2.18+/-0.84. Serious complications such as endophthalmitis, valve exposure or prolonged hypotony were not observed. CONCLUSIONS: The adjunctive use of intraoperative MMC and postoperative 5-FU with Ahmed valve implantation results in a high success rate and good IOP control and did not show serious complications within the postoperative period.
Endophthalmitis ; Eye ; Fluorouracil ; Glaucoma ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Mitomycin ; Postoperative Period

OBJECTIVE: Diurnal preference is an attribute reflecting whether people are alert and preferring to be active either early or late in the day. It also referred to as chronotype or morningness-eveningness trait. The PER3 genes have been known to influence diurnal preference. In this study, we have investigated the associations between the PER3 gene polymorphisms and diurnal preference in a healthy young population, controlling for the social and environmental confounding factors. METHODS: The participants in this experiment included 299 unrelated medical college students (M=191, F=108), with a mean age of 22.9 years. Diurnal preference was measured by a single administration of the 13-item Composite Scale for Morningness (CSM). Genotyping of the PER3 VNTR (rs57875989) was performed using polymerase chain reaction. A two-tailed alpha of 0.05 was chosen. RESULTS: The mean+/-SD score on the CSM scale for all subjects was 31.90+/-6.39. There was no significant difference in total CSM score between gender groups, although females showed a trend towards higher morningness score. Although PER3 5R/5R showed the tendency towards high CSM scores, there were no significant differences on CSM scores among genotypes and allele status of PER3 VNTR (rs57875989). CONCLUSIONS: We could not confirm that the PER3 VNTR is associated with diurnal preference in a Korean healthy young population. The future studies need to investigate the association between diurnal preference and other polymorphisms of PER3 gene in larger sample of Korean young healthy population.
Alleles ; Female ; Genotype ; Humans ; Polymerase Chain Reaction

As advance care planning is taking center stage in the field of end-of-life care, various tools have been developed to aid in the often emotional and difficult decision-making process. Video decision support tools are one of the most promising means of assistance, of which the modus operandi is to provide more comprehensive and precise information of medical procedures to patients and their families, allowing them to make better informed decisions. Despite such value, some are concerned about its potential negative impact. For example, video footages of some procedures may be shocking and unpalatable to non-medical professionals, and patients and families may refuse the procedures. One approach to soften the sometimes unpleasant visual of medical procedures is to show less aggressive or more relaxing scenes. Yet another potential issue is that the objectivity of video decision support tools might be vulnerable to the very stakeholders who were involved in the development. Some might argue that having multiple stakeholders may function as checks and balances and provide collective wisdom, but we should provide more systematic guarantee on the objectivity of the visual decision aids. Because the decision of the modality of an individual's death is the last and most significant choice in one's life, no party should exert their influence on such a delicate decision. With carefully designed video decision support tools, our patients will live the last moments of their lives with dignity, as they deserve.
Advance Care Planning* ; Decision Making ; Decision Support Systems, Clinical ; Decision Support Techniques ; Hope* ; Humans ; Lifting* ; Nimodipine ; Palliative Care ; Shock ; Terminal Care ; Videotape Recording

LPS and IFN-r induce nitric oxide synthase in macrophages and the resultant NO causes apoptotic cell death in the activated macrophages. NO production and apoptosis were inhibited by N-monomethyl L-arginine (NMMA), a competitive inhibitor of NO synthase. To study the role of BCL-X proteins, RAW 264.7 cells were transfected with the expression vectors with human bcl-Xl or bcl-Xs cDNAs, respectively. Stable transfectants were selected and confirmed by RT-PCR. NO production in response to LPS and IFN-r caused apoptosis in RAW 264.7 cells and vector transfected control cells within 24 hr. Both NO production and apoptosis were inhibited by N(G)-monomethyl L-arginine (NMMA). In contrast, bcl-Xs transfectant appeared slightly susceptible and bcl-X(L)< transfectant appeared slightly resistant, although NO production was similar to control cells. These results suggest that bcl-X proteins play roles in both positive and negative regulation of apoptosis induced by NO.
Apoptosis* ; Arginine ; bcl-X Protein* ; Cell Death ; DNA, Complementary ; Humans ; Macrophages* ; Nitric Oxide ; Nitric Oxide Synthase