A total of 3,119 cardiac valves were replaced in 2,471 patients with acquired valvular heart diseases at Seoul National University Hospital during a period of 26 years from 1968 to 1994. Mechanical valves including St. Jude, Carbomedics, Bjork-Shiley and Duromedics were used in 1,609 cases(52%) and bioprosthetic valves including Lonescu-Shiley, Hancock and Angell Shiley were implanted for the rest of the patients(1,510 cases, 48%). A total of 308(12.5%) redo valve replacement was performed during the same period, and 10 of 308 patients underwent second redo valve replacements. The single valve replacement was done in 1,846 cases, double valve replacement in 602 cases and triple valve replacement in 23 cases. Among the single valve replacement, the mitral valve replacement was performed most frequently(1,377 cases). The male to female ratio was almost equal(1.223 : 1,248) and the mean age was 37.9+/-10.5 years old. But the mean age has been increasing year by year and it reached to 44.8 years old in the 1990's. The overall hospital mortality was 5.3%, and 6.8% in redo valve replacement. However, the hospital mortality for the recent 10 years dropped to 1 to 4%. The number of redo valve surgery has been increasing since the mid-1980's because of structural deterioration of bioprostheses that were replaced during the late-1970's and early 1980's. Redo valve surgery comprised 34% for all valve replacement in 1994. The causes of the redo valve operation were structural deterioration(81.5%), prosthetic valve endocarditis(11.7%), paravalvular leakage(5.6%), and valve thrombosis(0.9%). The actuarial freedom from overall valve failure in Ionescu-Shiley were 81.0+/-7.1%(5 year) in mitral position, 89.1+/-1.8%(7 year) in aortic position and 88.9+/-7.6% in double valve replacement. The 5 year actuarial freedom from all complications in Carbomedics were 90.1+/-3.1% in mitral position, 84.9+/-4.2% in aortic position and 81.7+/-5.1% in double valve replacement. The 10 year actuarial freedom from all complications in St. Jude were 80.9+/-3.8%, 81.4+/-6.1%, 72.4+/-10.7% in each positions. In conclusion, the mean age of patients was younger than that of western countries, but it showed increasing tendency year by year. Bioprosthetic valves were used during the initial period until mid-1980's when mechanical valves were used instead of bioprosthetic valves, mainly because of the structural deterioration of the bioprostheses. In terms of thromboembolism, both bioprostheses and mechanical valves seems to be almost comparable although the comparison of both valves was impossible because of the different period of operation, various surgeon and level of the prothrombin time and so on. Recently the number of valve replacement has been decreased since the 1990's and the number of redo valve surgery and valve repair has been increased.
Bioprosthesis ; Female ; Freedom ; Heart Valve Diseases ; Heart Valves* ; Hospital Mortality ; Humans ; Male ; Mitral Valve ; Prothrombin Time ; Seoul* ; Thromboembolism

Objective: To identify, for the first time, the prevalence and impact of Boosepivirus (BooV) on calf diarrhea in the ROK. Methods: Here, the unknown cause of calf diarrhea was determined using metagenomics We then explored the prevalence of certain pathogens, including BooV, that cause NCD. Seventy diarrheal fecal samples from Hanwoo (Bos taurus coreanae) calves were analyzed using reverse transcriptase and quantitative real-time polymerase chain reaction for pathogen detection and BooV isolate sequencing. Results: The complete genome of BooV was detected from unknown causes of calf diarrhea.And also, BooV was the most frequently detected pathogen (35.7%) among 8 pathogens in 70 diarrheic feces from Hanwoo calves. Co-infection analyses indicated that most BooV-positive samples were solely infected with BooV, indicating its significance in NCD in the ROK. All isolates were classified as BooV B in phylogenetic analysis. Conclusions and Relevance: This is the first study to determine the prevalence and molecular characteristics of BooV in calf diarrhea in the ROK, highlighting the potential importance of BooV as a causative agent of calf diarrhea and highlighting the need for further research on its epidemiology and pathogenicity.

PURPOSE: This study was undertaken to compare the initial micromotion and stress shielding of a "fit and fill" stem to a "proximal fitting and distal tapered" stem in the early postoperative period using the load simulating single leg stance and stair climbing. MATERIALS AND METHODS: Using the data from 3-D human CT scan, authors developed two types of 3-dimensional finite element total hip replacement model of proximal femur, which were inserted with a "fit and fill" stem and a "proximal fitting and distal tapered" stem. The constructions of stems were based on the OmnifitTM stem (about 13,000 element & 20,000 nodes). We compared micromotion, maximal principal stress and strain energy of each stems. RESULTS: The results indicate that micromotion in a fit and fill stem were slightly lower than that of a tapered stem, especially in stair climbing over that in the single leg stance. The maximum principal stress on the cortex of femur was slightly higher in a tapered stem in the case of single leg stance, and 2 times higher in the case of stair climbing. Strain energy also was much higher in a tapered stem in both single leg stance and stair climbing gait. CONCLUSION: These findings indicate that a tapered stem design could provide more favorable biomechanical benefits rather than a fit & fill stem after cementless total hip replacement.
Arthroplasty, Replacement, Hip ; Femur ; Gait ; Hip Prosthesis* ; Hip* ; Humans ; Leg ; Postoperative Period ; Tomography, X-Ray Computed

BACKGROUND: Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in additon to evaluating any problems related to patients' home care in our country. METHODS: A register of 92 patients with home ventilators in Seoul and Kyunggi province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. RESULTS: There were 26 males (90%) and their mean age was 48.0(±20.1 years. The underlying diseases were: 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT;n=20, 69%) was more frequently used than the pressure targeted type(PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000(±3,290,000) won for a PTT, and 14,280,000(±3,130,000) won for a VTT. Total cost for the equipment was 11,430,000(±634,000) won. The average cost required for home care per month was 1,120,000(±1,360,000) won. CONCLUSION: The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.
Caregivers ; Education ; Europe ; Gyeonggi-do* ; Home Care Services ; Humans ; Intensive Care Units ; Korea ; Lung Diseases ; Male ; Motor Activity ; Neuromuscular Diseases ; Nurses, Community Health ; Nutritional Status ; Organization and Administration ; Oxygen ; Quality of Life ; Seoul* ; Spinal Cord Injuries ; Spouses ; Tidal Volume ; Tracheostomy ; United States ; Ventilation ; Ventilators, Mechanical*

Basal cell carcinoma (BCC) is the most common skin cancer in humans. It usually develops on sun-exposed areas of the head and neck but can occur anywhere on the body. The various clinical features include nodules, ulcers, bleeding, crust, or scale. Thus, it is important to distinguish BCC from other diseases with similar clinical features. The umbilicus is one of the sun-protected sites where BCC rarely develops. Herein, we describe 71-year-old woman with umbilical BCC initially misdiagnosed as pyoderma.
Aged ; Carcinoma, Basal Cell ; Female ; Head ; Hemorrhage ; Humans ; Neck ; Pyoderma ; Skin Neoplasms ; Ulcer ; Umbilicus

The superficial peroneal nerve is vulnerable to damage from ankle sprain injuries and fractures as well as surgery to this region. And it is also one of the most commonly involved nerves in complex regional pain syndrome type II in the foot and ankle region. We report two cases of ultrasound-guided pulsed radiofrequency treatment of superficial peroneal nerve for reduction of allodynia in CRPS patients.
Ankle ; Ankle Injuries ; Causalgia ; Foot ; Humans ; Hyperalgesia* ; Neuralgia ; Peripheral Nerves ; Peroneal Nerve* ; Pulsed Radiofrequency Treatment* ; Ultrasonography

No abstract available.
Pneumoconiosis* ; Welding*

No abstract available.

BACKGROUND AND OBJECTIVES: The Deiters' cell is one of the supporting cells in the organ of Corti and is known to possibly regulate the signal transduction pathway in the organ of Corti. The signal transduction process can be modulated by ATP and acetylcholine, the so-called neurotransmitters, in Deiters' cells. Intracellular Ca2+ concentration can be also increased by these neurotransmitters and the control mechanism on the organ of Corti is highly suggested in Deiters' cells. Potassium ion (K+) is known to be important both in hair cells and supporting cells. Through K+ channel, the membrane potential may be controlled and the signal transduction pathway can be regulated. Furthermore, the motility of outer hair cell and the signal transduction from the apical stereocilia are considered to be regulated by this channel. The aim of this study is to record the K+ current in the isolated Deiters' cells from guinea pig cochlea. MATERIALS AND METHODS: Deiters' cells were isolated from the organ of Corti of guinea pig by using collagenase and a pipet. A whole cell patch clamp was performed under the inverted microscope and the current was measured with List-7 amplifier and pClamp 8.0.2 software. RESULTS: The resting membrane potential was -15.02+/-2.66 mV (n=6). When the cell membrane was hyperpolarized into -110 mV from the -40 mV holding potential, the peak current was -227+/-39.9 pA (n=15). After having depolarized to the maximum, (50 mV), the peak current was 7123+/-737 pA, and the reversal potentials of different external K+ concentration changed in the K+-dependent manner. About 80% of this current was inhibited by TEA. When K+ was substituted by Cs+, the peak current was 1788+/-231 pA at 50 mV step pulse. Activation curve of this outward current showed two different Vh (half activation voltage) and K (slope factor). CONCLUSION: Outward rectifying K+ channels exist in Deiters' cells and they can be inhibited by TEA and permeable to Cs+. More than two types of K+ current can exist and they may play a role in the recovery of membrane potential after depolarization,
Acetylcholine ; Adenosine Triphosphate ; Animals ; Cell Membrane ; Cochlea* ; Collagenases ; Guinea Pigs* ; Guinea* ; Hair ; Labyrinth Supporting Cells ; Membrane Potentials ; Neurotransmitter Agents ; Organ of Corti ; Patch-Clamp Techniques ; Potassium ; Potassium Channels ; Signal Transduction ; Stereocilia ; Tea

Staphylococcus schleiferi has been infrequently reported as a human pathogen. We experienced the case of vascular access infection by Staphylococcus schleiferi in a 65-year-old hemodialysis patient. Metastatic infection occurred despite the removal of infected focus and appropriate antibiotic therapy. This case highlights the importance of considering Staphylococcus schleiferi as a true pathogen in vascular access infection with hemodialysis patients.
Aged ; Humans ; Renal Dialysis* ; Staphylococcus*