BACKGROUND: As surgical techniques and postoperative care are improving, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other types of pulmonary resection. However, a postpneumonectomy complication is a serious life-threatening problem if it occurrs. The purpose of this study is to evaluate determinants for postoperative mortality after pneumonectomy. METHODS: Patients were divided for study as follows: the Dead group versus the Alive group. To determine whether age, operation site, operation time, intraoperative fiuid intake, urine output, blood loss, complications, preoperative and intraoperative arterial blood gas analyses, and preoperative pulmonary function tests influence the determinants for postoperative mortality after pneumonectomy, a rettospecive analysis was performed on 71 patients who had undergone pneumonectomy from 1990to 1994 in Kosin Medical COLLEGE hOSPITAL. RESULTS: Operation time and blood loss were longer and greater respectively in the Dead group. The intraoperative PaO2 was lower and incidence of complications was more frequent in the Dead group.Otherwise there were no significant differences between two groups. CONCLUSION: We concluded that operation time, blood loss, incidence of complications and intra-operative PaO2 were closely related with postoperative mortality.
Blood Gas Analysis ; Humans ; Incidence ; Mortality* ; Pneumonectomy* ; Postoperative Care ; Respiratory Function Tests

Some circulating cancer cells in the blood play a central role in the metastatic process and may have a major influence on patient progress. Their numbers can be very small and techniques for their detection need to be both sensitive and specific. Polymerase chain reaction (PCR) has been successfully used to detect small numbers of tumor cells in cancer. We used a reverse transcriptase-polymerase chain reaction (RT-PCR) to detect circulating breast cancer cells in venous blood samples before operations and assessed cytokeratin-19 (CK-19) and cytokeratin-20 (CK-20) as target mRNA markers in the blood of healthy donors (n=6) and breast cancer patients (n=30) with American Joint Committee on Cancer stages 0 to IIIa. CK-19 mRNA was expressed in all blood samples of healthy donors and patients. But CK-20 was the only mRNA marker not detected in the blood from healthy donors. Seven of 30 (23%) venous blood isolates of breast cancer patients yielded a CK-20 mRNA with positive results. There was no correlating CK-20 mRNA expression with stage and axillary lymph node status. In conclusion, CK-19 showed no diagnostic value as a mRNA marker in the detection of circulating cancer cells by RT-PCR assay because this was expressed in the blood of healthy donors. CK-20 mRNA was an useful marker to detect circulating cancer cells in breast cancers.
Breast Neoplasms/pathology* ; Breast Neoplasms/genetics* ; DNA Primers ; Female ; Gene Expression Regulation, Neoplastic ; Genetic Markers ; Human ; Intermediate Filament Proteins/genetics ; Keratin/genetics ; Neoplasm Circulating Cells* ; RNA, Messenger/analysis ; RNA, Neoplasm/analysis* ; Reverse Transcriptase Polymerase Chain Reaction/methods* ; Sensitivity and Specificity ; beta 2-Microglobulin/genetics

PURPOSE: To assess the CT and histological findings after cryoablation in the normal lung of rabbits. MATERIALS AND METHODS: After performing chest CT on rabbits, we inserted a cryoneedle toward the lower lobe of the right lung. We performed percutaneous cryoablation that was composed of freeze-thaw-freeze cycles (25 minutes) for group 1 animals and one cycle of variable freezing time (10-20 minutes) for group 2 animals. We measured the longest (Dl) and shortest diameter (Ds) of the ablated zones that were determined after cryoablation for all of the CT images. After cryoablation, we performed a pathological examination. RESULTS: The mean Dl and Ds of the ablated zone was 28.1+/-3.9 mm and 16+/-1.6 mm, respectively, for group 1 rabbits. For group 2 rabbits, the mean Dl and Ds was 28.7+/-6.3 mm and 14.4+/-3.8 mm, respectively, for one cycle of 20 minutes freezing time. Based on the histological findings, the ablated zone was composed of a necrotic, hemorrhagic, and inflammatory area, in order from the center to the outside. Although each area was well differentiated in group 1 rabbits, only freezing for one cycle of 20 minutes for the group 2 rabbits gave the same results as for the group 1 rabbits. CONCLUSION: A total freezing time of at least 20 minutes and two more freeze-thaw-freeze cycles might be important factors for providing a sufficient area of the ablated zone and uniform necrosis during cryoablation.
Animals ; Catheter Ablation ; Cryosurgery ; Cryotherapy ; Freezing ; Lung ; Lung Neoplasms ; Necrosis ; Rabbits ; Thorax

Purpose: To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice. Methods: A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). Results: A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%–91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results—according to which, 20% of the respondents tended to use brimonidine more often—affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%). Conclusions Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.

Purpose: To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice. Methods: A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS). Results: A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%–91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results—according to which, 20% of the respondents tended to use brimonidine more often—affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%). Conclusions Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.

No abstract available.
Brain Abscess* ; Brain* ; Vancomycin-Resistant Enterococci*

PURPOSE: Acute renal failure (ARF) is one of the common complications after liver transplantation (LT) and could be fatal unless promptly treated. Identification of risk factors is needed to prevent ARF and to attenuate the unfavorable outcomes of ARF after LT. The aim of this study was to analyze risk factors for development of postoperative ARF (between day 0 and day 30 after LT). METHODS: Total 72 LTs were performed between 1996 and 2005. Sixty six patients' records, excluding 6 patients with preoperative serum creatinine level more than 2.5 mg/dl, were reviewed retrospectively for preoperative, intraoperative, and postoperative variables to compare patients presenting ARF with the remaining patients. RESULTS: Postoperative ARF occurred in 36 transplants (54.5%) after LT. Preoperative serum sodium, bilirubin and BUN, creatinine level were higher in ARF group. ARF group had more child-pugh class C, and more episodes of preoperative hepatic encephalopathy. During intraoperative period, anhepatic time was longer and total doses of intraoperative furosemide was larger in ARF group. Also, postoperative blood immunosuppressant level was higher, and postoperative episodes of bleeding and hypotension were more common in ARF group. In multivariate analysis, preoperative child-pugh class C (P=0.041), preoperative serum creatinine level (> or =1.0 mg/dL, P=0.032), and postoperative episodes of hypotension and bleeding (P=0.045, P=0.03 respectively) were identified as risk factors for postoperative ARF. CONCLUSION: This study showed that preoperative renal and liver function, and postoperative hemodynamic condition were independent risk factors for development of ARF after LT.
Acute Kidney Injury* ; Bilirubin ; Creatinine ; Furosemide ; Hemodynamics ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Hypotension ; Intraoperative Period ; Liver Transplantation* ; Liver* ; Multivariate Analysis ; Retrospective Studies ; Risk Factors* ; Sodium

No abstract available.
Aged ; Angina Pectoris/diagnosis/etiology ; Coronary Angiography ; Coronary Artery Disease/*complications/diagnosis/therapy ; Coronary Stenosis/*complications/diagnosis/therapy ; Coronary Vessel Anomalies/*complications/diagnosis ; Humans ; Male ; Percutaneous Coronary Intervention/instrumentation ; Stents ; Treatment Outcome

BACKGROUND: Intravenous lipid emulsion has been used to treat systemic toxicity of local anesthetics. The goals of this in vitro study were to determine the ability of two lipid emulsions (Intralipid(R) and Lipofundin(R) MCT/LCT) to reverse toxic dose local anesthetic-induced vasodilation in isolated rat aortas. METHODS: Isolated endothelium-denuded aortas were suspended for isometric tension recording. Vasodilation was induced by bupivacaine (3 x 10(-4) M), ropivacaine (10(-3) M), lidocaine (3 x 10(-3) M), or mepivacaine (7 x 10(-3) M) after precontraction with 60 mM KCl. Intralipid(R) and Lipofundin(R) MCT/LCT were then added to generate concentration-response curves. We also assessed vasoconstriction induced by 60 mM KCl, 60 mM KCl with 3 x 10(-4) M bupivacaine, and 60 mM KCl with 3 x 10(-4) M bupivacaine plus 1.39% lipid emulsion (Intralipid(R) or Lipofundin(R) MCT/LCT). RESULTS: The two lipid emulsions reversed vasodilation induced by bupivacaine, ropivacaine, and lidocaine but had no effect on vasodilation induced by mepivacaine. Lipofundin(R) MCT/LCT was more effective than Intralipid(R) in reversing bupivacaine-induced vasodilation. The magnitude of lipid emulsion-mediated reversal of vasodilation induced by high-dose local anesthetics was as follows (from highest to lowest): 3 x 10(-4) M bupivacaine-induced vasodilation, 10(-3) M ropivacaine-induced vasodilation, and 3 x 10(-3) M lidocaine-induced vasodilation. CONCLUSIONS: Lipofundin(R) MCT/LCT-mediated reversal of bupivacaine-induced vasodilation was greater than that of Intralipid(R); however, the two lipid emulsions equally reversed vasodilation induced by ropivacaine and lidocaine. The magnitude of lipid emulsion-mediated reversal of vasodilation appears to be correlated with the lipid solubility of the local anesthetic.
Amides ; Anesthetics, Local ; Animals ; Aorta ; Bupivacaine ; Emulsions ; Lidocaine ; Mepivacaine ; Rats ; Solubility ; Vasoconstriction ; Vasodilation

The authors report a case of a 16-year-old girl with pituitary hyperplasia and primary hypothyroidism caused by Hashimoto's thyroiditis. She presented with growth arrest, and hormonal studies showed decreased level of free thyroxine (T4), and increased levels of thyroid-stimulating hormone (TSH) and prolactin. A pituitary magnetic resonance imaging (MRI) showed a suprasellar mass. After 2 months of thyroxine replacement, thyroid function and high prolactin levels normalized, and the pituitary hyperplasia disappeared. This case represents relatively rapid normalization of pituitary hyperplasia, compare to the previous studies.
Adolescent ; Female ; Humans ; Hyperplasia ; Hypothyroidism ; Magnetic Resonance Imaging ; Pituitary Gland ; Prolactin ; Thyroid Gland ; Thyroiditis ; Thyrotropin ; Thyroxine