BACKGROUND: Desmopressin acetate (DDAVP) may improve hemostasis in congenital or acquired disorders of coagulation and reduce operative blood loss in patients undergoing surgical procedures. The effects of DDAVP on coagulation in hemorrhagic shock were studied in rabbits subjected to severe hemorrhage. METHODS: 20 rabbits were bled to shock and infused lactated Ringer's solution simultaneously so that the mean arterial pressure were maintained above 50 mmHg. Animals were randomly received DDAVP 0.3 ug/kg (group Dl), 3 ug/kg (group D10) or saline (group S) over 15 minutes. Bleeding time and factor VIII coagulant activity (FVIII:C) were measured before, after shock and 45 minutes after DDAVP or saline infusion. RESULTS: After shock, bleeding time was not changed but FVIII:C was decreased significantly in all groups. After saline or DDAVP infusion, bleeding time was not changed in group S and group Dl, whereas shortened in group D10 from 107.5+/-11.3 second to 87.5+/-17.5 second (P<0.05). After saline or DDAVP infusion, FVIII:C was decreased in group S and group Dl (P<0.05), but not changed in group D10. CONCLUSIONS: Infusion of DDAVP 3 ug/kg shortens bleeding time and causes an increase of FVIII:C than other groups in rabbits resuscitated from hemorrhagic shock.
Animals ; Arterial Pressure ; Bleeding Time ; Deamino Arginine Vasopressin* ; Factor VIII ; Hemorrhage ; Hemostasis ; Humans ; Pharmacology ; Rabbits* ; Shock ; Shock, Hemorrhagic*

PURPOSE: The purpose of this study was to identify effects of 'mental illness education using movies' on the perceptions and attitudes toward mental illness held by middle and high school teachers. METHODS: The participants were 66 middle and high school teachers, 33 in the experimental group and 33 in the control group. The 'mental illness education using movies' was given to the experimental group twice a week for two weeks. The perceptions and attitudes toward mental illness were measured using the Knowledge and Attitude toward Mental Illness Questionnaire developed by Park, Paik, and Kwack (1995). RESULTS: After the mental illness education, there was a significant difference between the experiment and control group for psychological and environmental concepts toward mental illness (t=7.10, p<.001). CONCLUSION: 'Mental illness education using movies' has limited effects on the perceptions and attitudes of middle and high school teachers toward mental illness. The results of this study indicate that further research is needed with a revised contents of 'the mental illness education using movies' if perceptions and attitudes are to be changed.
Education* ; Humans ; Mental Health ; Surveys and Questionnaires

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

Although diseases of the parotid gland are relatively uncommon in children, a variety of benign and malignant lesions may occur and the use of imaging is essential for accurate diagnosis and treatment. Ultrasonography (US) is the initial imaging modality utilized for suspected parotid lesions, and its use may suggest a correct diagnosis in an adequate clinical setting. The use of computed tomography (CT) and magnetic resonance imaging (MRI) are useful for the assessment of large and atypical lesions. These modalities also allow the ability to image the deep parotid lobe and to better define the nature of a lesion. CT is the preferred imaging modality for inflammatory processes, including suspected sialolithiasis, abscesses and salivary duct obstructions, whereas MRI is usually used to evaluate tumors due to excellent anatomic resolution and a lack of ionizing radiation exposure, especially in children. This report describes the imaging findings of various parotid gland lesions in children. Familiarity with these findings will aid in lesion characterization and should facilitate optimal clinical management.
Abscess ; Child ; Humans ; Magnetic Resonance Imaging ; Parotid Gland ; Radiation, Ionizing ; Recognition (Psychology) ; Salivary Ducts ; Salivary Gland Calculi ; Tomography, X-Ray

We reported a 32-year-old man diagnosed as Bickerstaff's brainstem encephalitis with Guillian-Barre syndrome. After plasmapheresis, his consciousness and respiratory function and motor strength improved. He was discharged without rehabilitation treatment and could perform activities of daily living independently on wheel chair level. For reducing cocontraction of lower extremity muscles, neuromuscular reeducation using EMG biofeedback was performed after admission. After a month of treatment, gait pattern was improved. He received rehabilitative managements such as pool therapy with gait training and improved to 4/5 grade at proximal lower extremities, but the endurance and the quality for his walking was poor because of the cocontraction of muscles in lower extremities. EMG biofeedback for the neuromuscular reeducation leading to each muscle's isolated movements was done. After 2-month rehabilitation, he could walk over 20 meters even level independently without walking aids. This case could be a good model for the effective neuromuscular reeducation.
Activities of Daily Living ; Adult ; Biofeedback, Psychology ; Brain Stem* ; Consciousness ; Encephalitis* ; Gait ; Guillain-Barre Syndrome* ; Humans ; Lower Extremity ; Muscles ; Plasmapheresis ; Rehabilitation* ; Walking ; Wheelchairs

A meandering pulmonary vein (MPV) is a rare pulmonary vascular anomaly characterized by an abnormal course of the pulmonary vein draining into the left atrium. We report the case of a 55-year-old female who was diagnosed with a right MPV on pulmonary angiography. Enhanced chest CT revealed a vascular structure with an abnormal course that drained into the right superior pulmonary vein in the right upper lobe, which resembled a pulmonary arteriovenous malformation (AVM). Pulmonary angiography performed to discriminate between an MPV and pulmonary AVM showed no feeding artery, normal parenchymal staining, and drainage to the left atrium via the culprit vessel. Thus, the patient was diagnosed with MPV. When an MPV is difficult to differentiate from other vascular anomalies on enhanced chest CT, pulmonary angiography can be helpful. By recognizing the angiographic findings of an MPV, unnecessary treatment can be prevented.

A meandering pulmonary vein (MPV) is a rare pulmonary vascular anomaly characterized by an abnormal course of the pulmonary vein draining into the left atrium. We report the case of a 55-year-old female who was diagnosed with a right MPV on pulmonary angiography. Enhanced chest CT revealed a vascular structure with an abnormal course that drained into the right superior pulmonary vein in the right upper lobe, which resembled a pulmonary arteriovenous malformation (AVM). Pulmonary angiography performed to discriminate between an MPV and pulmonary AVM showed no feeding artery, normal parenchymal staining, and drainage to the left atrium via the culprit vessel. Thus, the patient was diagnosed with MPV. When an MPV is difficult to differentiate from other vascular anomalies on enhanced chest CT, pulmonary angiography can be helpful. By recognizing the angiographic findings of an MPV, unnecessary treatment can be prevented.

Melanotic oncocytic metaplasia of the nasopharynx is a rare condition which is characterized by the presence of usually a small, brown to black colored pigmented lesion around the Eustachian tube opening. Although it is a benign lesion, it may be clinically misdiagnosed as malignant melanoma. Microscopically, melanotic oncocytic metaplasia is a combination of oncocytic metaplasia of the epithelium of the gland and melanin pigmentation in its cytoplasm. In our present study, we report three cases of melanotic oncocytic metaplasia of the nasopharynx. All the three cases occurred in men and were presented as multiple black pigmented lesions around the torus tubarius. Microscopically, mucous glands with diffuse oncocytic metaplasia and numerous black pigments were observed. No cellular atypia was observed. Immunohistochemically, the scattering of S-100 protein-positive, and human melanoma black 45-negative dendritic melanocytes was evident. This is the first report of cases of melanotic oncocytic metaplasia of the nasopharynx in Korea.
Cytoplasm ; Epithelium ; Eustachian Tube ; Humans ; Korea ; Male ; Melanins ; Melanocytes ; Melanoma ; Metaplasia ; Nasopharynx ; Oxyphil Cells ; Pigmentation

PURPOSE: To report the expression of decorin and TGF-beta in partial myotomy of the extraocular muscle in rats. METHODS: Partial myotomy of the superior rectus muscle was performed on the right eye of 10 Sprague-Dawley rats followed by exposure of the left superior rectus muscle and a simple suture of the conjunctiva. The bilateral superior rectus muscle was obtained from all rats at 2 weeks postoperatively. The tissues were observed under light microscopy with hematoxylin-eosin, Masson's trichrome staining and immunohistochemistry. RESULTS: Histological examinations of the surgical area at 2 weeks after postoperatively showed irregularly concentrated fibrosis on light microscopy with hematoxylin-eosin and Masson's trichrome staining of the experimental eyes. Immnohistochemistry showed that expression of decorin was in the same location as TGF-beta in the experimental group. CONCLUSIONS: The expression of decorin was found in the healing process after partial myotomy of the extraocular muscle in rats. Immunohistochemistry showed that expression of decorin was in the same location as with TGF-beta.
Animals ; Conjunctiva ; Decorin* ; Fibrosis ; Immunohistochemistry ; Microscopy ; Rats* ; Rats, Sprague-Dawley ; Sutures ; Transforming Growth Factor beta*

PURPOSE: To report the case of a child with triple X syndrome presenting with exotropia and chorioretinal coloboma. CASE SUMMARY: A one-year-old female infant presented with 35PD exotropia in the primary position. The patient had poor fixation of the right eye, and a fundus examination showed chorioretinal coloboma in the inferior region of her right eye. The patient also exhibited syndactyly of the right hand. Brain magnetic resonance imaging revealed a well-defined 2 cm cyst in the right cerebellum. Upon chromosomal study, the patient's karyotype was found to be 47, XXX. CONCLUSIONS: When infants or children present with ophthalmologic findings such as strabismus and coloboma, systemic conditions and congenital problems should be considered.
Brain ; Cerebellum ; Child ; Chromosomes, Human, X ; Coloboma ; Exotropia ; Eye ; Female ; Hand ; Humans ; Infant ; Karyotype ; Magnetic Resonance Imaging ; Sex Chromosome Aberrations ; Sex Chromosome Disorders of Sex Development ; Strabismus ; Syndactyly ; Trisomy