PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty ; Arteries ; Cardiac Output ; Catheters ; Coronary Artery Disease ; Endarterectomy ; Femoral Artery* ; Follow-Up Studies ; Humans ; Popliteal Artery* ; Punctures ; Stethoscopes

The spleen is the most common intraabdominal organ injured in blunt trauma, Although physical signs andsymptoms, coupled with abdominal paracentesis & peritoneal lavage confirm intraabdominal injury, but isolatedsplenic injury especially delayed rupture, the diagnosis and clinical course is variable. We are reevaluation ofplain roentgenologic findings for the light of early diagnosis of isolated splenic injury. 24 patiens of theautopsy and surgically proven isolated splenic injury at Chosun University Hospital in the period from 1980January to 1986 June were analyzed plain roentgenogram retrospectively. The results were as follows: 1. Malepatients predominate, constitution 87.5%. Incidence has been greatest in second to fourth decade. 2. Mode oftrauma causing isolated splenic injury is most common in motor vehicle accident and others are fall down, struckby fist, blow to object, uncertain blunt trauma. 3. Delayed rupture of spleen occured in 2 cases(8.3%). 4. Commonpatterns of splenic injury is simple laceration that involves both the capsule and the parenchyma and a lacerationthat involves the splenic pedicle. 5. Plain chest roentgenographic findings were abnormal in 4 cases (16.7%). Themost common plain abdominal roentgenographic findings was the evidence of intraabdominal fluid in 21 cases(87.5%).The others are included in order of frequency: gastric dilatation, prominent mucosal folds on greater curvature ofthe stomach, evidence of pelvic fluid, displacement of stomach to the right or downward, mass density in theregion of spleen. 6. No relationship can be shown between patterns of injury, time lapse after trauma and plainroentgenological findings. But the evidence of intraabdominal fluid is most important in the light of earlydiagnosis. 7. Diagnosis of splenic injury may be most helpul that in combination with clinical history, clinicalsymptoms & signs and plain film findings. In delayed rupture, diagnostic value of serial examination and surgicalobservation is emphasized.
Constitution and Bylaws ; Diagnosis ; Early Diagnosis ; Gastric Dilatation ; Incidence ; Lacerations ; Motor Vehicles ; Paracentesis ; Peritoneal Lavage ; Retrospective Studies ; Rupture ; Spleen ; Stomach ; Thorax

Pulmonary Embolism, one of the causes of maternal death, is a life threatening disease that needs early and accurate diagnosis. We have exprerienced a case of a fatal pulmonary embolism which was diagnosed by lung perfusion scan on the postoperative 1 day after cesarean delivery and was managed with heparin therapy. We present this case with a brief review of literatures.
Diagnosis ; Heparin ; Lung ; Maternal Death ; Perfusion ; Pulmonary Embolism*

BACKGROUND: Terminology is a good index of reflections in conceptional imaginations, trends and technological advances in the field of their own. The goal of this study was to compare the similarity and difference of terms in anesthesiology to evaluate the communicability between South and North Korea. These results may be particularly helpful during the next step of making glossary, academic communication and the searching of social unity at the time of reunion. METHODS: Several books and indexes written in South and North Korea and data from seminars were obtained. Multiple terms were then drawn from these data. These terms were used to make a comparison between South and North side. RESULTS: Both side does not use a Chinese character in their books and indexes, even though many terms stem from a Chinese character. North side had more terms of native language than South side. There were some different terms because of each others rules of grammar. Several terms were confusedly used in both side. In some of combined terms, words were reversed in their orders. CONCLUSIONS: We conclude that terminology using in South and North Korea in the field of anesthesiology is not so far way and both side can be capable of communication without any difficulty. But both have many areas to be filled with terms of native language to have identity.
Anesthesiology* ; Asian Continental Ancestry Group ; Democratic People's Republic of Korea* ; Humans ; Imagination ; Reunion

PURPOSE: The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CT with multiplanar reformation in patients with extrahepatic biliary obstruction. MATERIALS AND METHODS: Helical CT was performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasive cholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). The cause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, three pancreatitis) and 18 malignant diseases(seven common bile duct carcinomas, seven pancreatic head carcinomas, three ampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bile duct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained with multiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level and the cause of the obstruction. We compared findings of the CT cholangiogram with that of operation or invasive cholangiography. RESULTS: In 100%(36/36) of cases, CT cholangiography could be obtained successfully. The accuracy of the CT cholangiography in determinating the level of the obstruction was 100%(11 cases of suprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and the accuracy in determinating the cause of the obstruction was 91.7%(all cases of 18 benign diseases, and 15 cases of 18 malignant diseases). CONCLUSION: In evaluating the obstruction of extrahepatic bile ducts, the CT cholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinating the level.and the cause of biliary obstruction and therefore could replace t~e invasive cholangiography.
Bile Ducts, Extrahepatic ; Cholangiography* ; Choledochal Cyst ; Common Bile Duct ; Head ; Humans ; Retrospective Studies ; Tomography, Spiral Computed*

Orientia tsutsugamushi, a causative agent of scrub typhus, is an obligate intracellular parasite and usually propagates in the cytoplasm of host endothelial cells and macrophages. Macrophages are the first defense line against bacterial infection and NF-kappaB is activated upon contact with bacteria, resulting in the transcription of inflammatory cytokine to control bacterial infection. In this study, we investigated whether O. tsutsugamushi modulates NF-kappaB activation in the macrophages. We examined the changes of NF-kappaB proteins upon infection with O. tsutsugamushi and found that NF-kappaB is activated at a slow rate as judged with EMSA and immunoblot analysis. Interestingly, we found that p65 was cleaved generating a 45 kDa fragment. In addition, fragment of p65 is generated only by the virulent serotype strain of O. tsutsugamushi, suggesting this cleavage may be associated with the mouse virulence. It is still unknown whether this is a direct result of O. tsutsugamushi proteins or enzymes of host cell. Further exploration of the mechanism that modulates NF-kappaB activity by O. tsutsugamushi could contribute to a better understanding of the molecular pathogenesis of O. tsutsugamushi infection.
Animals ; Bacteria ; Bacterial Infections ; Cytoplasm ; Endothelial Cells ; Macrophages ; Mice ; NF-kappa B ; Orientia tsutsugamushi ; Parasites ; Proteins ; Scrub Typhus ; Sprains and Strains

The common arterial trunk is a congenital cardiovascular malformation in which one arterial trunk gives origin to the aortic arch, pulmonary and coronary arteries. Other cardiovascular malformations are often associated, such as ventricular septal defect, aortic arch interruption, patent arterial duct and so on. During the early period of life, the persistence of the increased pulmonary arteriolar resistance results in cyanosis. As the pulmonary vascular resistance decreases, the cyanosis disappears but signs of congestive heart failure become the main problems. We report five cases of common arterial trunk that was confirmed by autopsy at Chungnam National University Hospital, Seoul National University Hospital, and Yonsei University Severance Hospital between 1983 and 1995. The ages of these patients at autopsy were 8-28 days and four of them were male. Pulmonary arteries arose as a pulmonary trunk in two cases but three cases showed two arteries arising separately from the posterior wall of the common trunk. The type of ventricular septal defect was juxtatruncal in every case. All five cases had three leaflet truncal valves but three cases showed dysplasia of the leaflets. Interruption of aortic arch was associated in two cases. The cause of death was renal failure in two cases, cardiac failure after corrective surgery in two cases, and pulmonary edema and failure in one case.

OBJECTIVE: To characterize perioperative biomechanical changes after thoracic spine surgery. METHODS: Fifty-eight patients underwent spinal instrumented fusions and simple laminectomies on the thoracolumbar spine from April 2003 to October 2008. Patients were allocated to three groups; namely, the laminectomy without fusion group (group I, n = 17), the thoracolumbar fusion group (group II, n = 27), and the thoracic spine fusion group (group III, n = 14). Sagittal (ADS) and coronal (ADC) angles for adjacent segments were measured from two disc spaces above lesions at the upper margins, to two disc spaces below lesions at the lower margins. Sagittal (TLS) and coronal (TLC) angles of the thoracolumbar junction were measured from the lower margin of the 11th thoracic vertebra body to the upper margin of the 2nd lumbar vertebra body on plane radiographs. Adjacent segment disc heights and disc signal changes were determined using simple spinal examinations and by magnetic resonance imaging. Clinical outcome indices were determined using a visual analog scale. RESULTS: The three groups demonstrated statistically significant differences in terms of angle changes by ANOVA (p < 0.05). All angles in group I showed significantly smaller angles changes than in groups II and III by Turkey's multiple comparison analysis. Coronal Cobb's angles of the thoracolumbar spine (TLC) were not significantly different in the three groups. CONCLUSION: Postoperative sagittal balance is expected to change in the adjacent and thoracolumbar areas after thoracic spine fusion. However, its prevalence seems to be higher when the thoracolumbar spine is included in instrumented fusion.
Humans ; Laminectomy ; Magnetic Resonance Imaging ; Prevalence ; Spine

PURPOSE: To evaluate characteristic MR findings of craniocerebral anomaly and its relationship with neurologic manifestations. MATERIALS AND METHODS: We retrospectively reviewed MR images of 36 patients with craniocerebral anomaly diagnosed by MRI and clinical courses. We correlated the characteristic MR findings in 41 lesions with neurologic manifestastions focusing on seizures and developmental delay. RESULTS: Twenty-three patients with seizures consisted of 14 patients(60%) with neuronal migration disorders and seven(30%) with phakomatosis, among which 18 patients(78%) had generalized type of seizures. Locations of the lesions were the parietal lobes in 11 patients(52%) and the subependymal or periventricular regions in seven(33%). Two patients with tuberous sclerosis had the lesions in both parietal and subependymal areas. Nine patients had the signs of developmental delay that were seen in the four(44%) with schizencephaly, two (22%) with tuberous sclerosis, two(22%) with heterotopia, and one(ll %) with pachygyria. CONCLUSION: Neuronal migration anomaly was relatively common lesion that presented neurologic manifestations such as seizures and developmental delay. Generalized type of seizures was common. We were able to diagnose these anomalies using the MRI that helped establish therapeutic plans.
Humans ; Lissencephaly ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Neurocutaneous Syndromes ; Neurologic Manifestations ; Neuronal Migration Disorders ; Neurons ; Parietal Lobe ; Rabeprazole ; Retrospective Studies ; Seizures* ; Tuberous Sclerosis

BACKGROUND: We evaluated the antihypertensive effect, safety and effect on serum lipids of terazosin, second generation alpha1-blocker. METHODS: Terazosin 1-4mg was adminstered once daily in 20 patients for 12 weeks with dose titration every 2 weeks. RESULTS: 1) The systolic and diastolic blood pressure were decreased from 170.0+/-13.0/104.0+/-6.0mmHg to 144.0+/-13.3/88.0+/-5.6mmHg(p<0.01), but the heart rate and body weight were independant of terazosin administration. 2) Total cholesterol was decreased significantly from 209.9+/-33.5mg/dL to 194.6+/-30.1mg/dL after 12 weeks treatment(p<0.05), triglyceride was decreased significantly from 185.4+/-37.0mg/dL to 168.9+/-35.0mg/dL(p<0.05). and LDL-cholesterol was decreased significantly from 134.5+/-31.9mg/dL to 122.7+/-29.9mg/dL(p<0.05), but HDL-cholesterol was increased significantly from 37.8+/-5.6mg/dL to 40.6+/-5.5mg/dL(p<0.05). 3) The adverse effects of terazosin were dizziness in 2, headache in 2, asthenia in 1, peripheral edema in 1 and skin rash in 1 patient, but were not troublesome enough to stop medication. CONCLUSIONS: Terazosin 1-4mg once daily regimen was effective and safe as an antihypertensive agent, and moreover terazosin has favorable effects on serum lipids.
Asthenia ; Blood Pressure* ; Body Weight ; Cholesterol ; Dizziness ; Edema ; Exanthema ; Headache ; Heart Rate ; Humans ; Hypertension* ; Triglycerides