BACKGROUND: Brief episode of coronary artery occlusion (i.e., ischemic preconditioning) makes the heart more resistant to injury from a subsequent ischemic insult. Although a great deal of effort has been made in studying ischemic preconditioning, the underlying mechanism of ischemic preconditioning and its effect on hypothermic insult has not been elucidated. This study was performed to see whether ischemic preconditioning protects against the depression of cardiac contractility induced by hypothermic cardioplegic arrest/reperfusion. And recently, adenosine was known to have some correlation with the mechanism of preconditioning. If so, does this effect remain after the blockade of adenosine receptor by 8-phenyl theophylline? METHOD: Twenty-four Sprague-Dawley rat weighed 250-350g were used and divided into three groups. Rat hearts were removed rapidly, and each isolated heart paced with a rate of 180/min was perused by modified Krebs-Hensleit buffer(KHB) solution on a Langendorff apparatus far an hour. After obtaining baseline data including left ventricular pressure(LVP), dp/dt, and coronary flow, cardiac arrest was induced by perfusion of 0degrees C crystalloid cardioplegic(St Thomas) solution. After that, all hearts were stored in the same St Thomas solution at salute temperature far 2 hours. In group I (control group), the hear was reperfused by KHB solution. In group II(preconditioning group), the heart was subjected to two 2-minute episode of global ischemia followed by 5 minute reperfusion with KHB solution(preconditioning) before cardiac arrest. In group III(phenyl theophylline group), the heart was subjected to preconditioning procedure and 8-phenyl theophylline at 10muM in concentration was added to KHB solution at time of reperfusion. Observing parameter was obtained in each group at 10, 20, 40 and 60 minutes after starting reperfusion and compared statistically by use of one way ANOVA test(STASTICA, release 4.5). P-value less than 0.05 was considered significant. RESULTS: Although depressed LVP, dp/dt, and Coronary flow were seen in all groups during the reperfusion period, the preconditioned group showed more effective recovery of LVP than that of the control group, especially at 10, 20 and 40 minutes(p<.05). We failed to demonstrate the difference between the phenyl theophylline group and the control group(p=NS). CONCLUSION: These results suggest that ischemic preconditioning has protective effect on recovery state of hypothermic cardioplegic arrest/reperfusion. Its protective effect was limited during early reperfusion stage and was blocked by adenosine blocker.
Adenosine ; Animals ; Coronary Vessels ; Depression ; Heart Arrest ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Myocardium* ; Perfusion ; Rats ; Rats, Sprague-Dawley ; Receptors, Purinergic P1 ; Reperfusion ; Theophylline

Aortic transection or interruption is a rare condition which developed after an acute deceleration injury. Its occurrence depends on the location and direction of the force applied and is usually from motor vehicle accident or falling down. The exact incidence of aortic transection in trauma is not known but, when develops, only about 10-15% of the victims can furtive and be transported to the hospital. Even in the survivors, majority of them will be fatal within a few days if a prompt diagnosis and surgical treatments are not made. Aggressive diagnostic work-up is recommended for the patients with high suspicious index, which would salvage the victims with this fatal condition. We report the experience of two cases of aortic transection or interruption following motor vehicle accidents.
Deceleration ; Diagnosis ; Early Diagnosis* ; Humans ; Incidence ; Motor Vehicles ; Survivors ; Thorax* ; Wounds and Injuries*

Traditionally, the Rhododendron species has been used in gastrointestinal disorder or hypertension. Grayanotoxin exists in honey, flowers, pollen, and the nectar of the Rhododendron species. We experienced 3 cases of Grayanotoxin intoxication. The symptoms of intoxication were nausea, vomiting, hypotension, bradycardia, diplopia, dizziness, and chest discomfort. Generally, the treatment for Grayanotoxin intoxication is fluid resuscitation and injection of atropine sulfate. The patients who were intoxicated with Grayanotoxin were discharged without complication after supportive care.
Atropine ; Bradycardia ; Diplopia ; Dizziness ; Flowers ; Honey ; Humans ; Hypertension ; Hypotension ; Nausea ; Plant Nectar ; Pollen ; Resuscitation ; Rhododendron ; Thorax ; Vomiting

BACKGROUND: In Korea, Trichophyton (T.) rubrum is occupied more than 80% of causative fungi of dermatophytosis. Strain differentiation of T. rubrum is essential for epidermiologic study. OBJECTIVE: The aim of this study is to develope the primers for amplification of rDNA intergenic spacer (IGS) to detect polymorphism of T. rubrum. METHODS: The primers were designed from 25S and 18S of rDNA, and were applied to 20 strains of T. rubrum, which included 1 standard strain and 19 clinical isolates. RESULTS: Primers for amplification of polymorphic rDNA IGS were designed from the 3'end of the 25S (primer ANID25-3, 5'-GACAGGTTAGTTTTACCCTACTGA-3') and the 5'end of the 18S (TR18-2R, 5'- ATCTAATAAATACACCCCTTCCGA-3'). PCR condition was adjusted for detecting polymorphism. Best results were obtained at 55degrees C for annealing temperature and 3 minutes for extension time. Eight bands sized as 1.1, 2.4, 2.7, 2.9, 3.2, 3.8, 5 kb were amplified with PCR using the primers. With 4 bands sized 2.7, 2.9, 3.2 and 3.8 kb, 20 strains of T. rubrum could be grouped into 6 subtypes. CONCLUSION: The PCR fingerprinting with the primers for rDNA IGS was able to differentiated strains of T. rubrum, and it can be applied in clinical and epidemiologic studies. The primer could be applied to other fungi with unknown sequences.
Dermatoglyphics ; DNA, Ribosomal* ; Fungi ; Korea ; Polymerase Chain Reaction ; Tinea ; Trichophyton*

BACKGROUND: Carotid cavernous fistula (CCF) is an abnormal communication between the carotid artery and the cavernous sinus. The pathogenesis of spontaneous CCF remains unclear, although sinus thrombosis is known to be a predisposing factor for dural arteriovenous fistula. Because spontaneous CCFs are mainly of the dural type, we considered that thrombogenic conditions, such as, protein S deficiency might be associated with CCF. CASE REPORT: A 42-year-old woman complained of conjunctival injection and retro-orbital pain that first appeared 1-month before visiting our hospital. She had no history of head trauma or intracranial surgery. Exophthalmos and chemosis were observed in her left eye, which also had lower visual acuity and higher intraocular pressure than the right eye. Magnetic resonance images and cerebral angiography revealed a left dural CCF. Her protein S was low, at 41% (normal range: 70-140%), but other hematologic values related to coagulation were normal. Her symptoms were relieved after initial transvenous coil embolization. However, a newly developed sixth-nerve palsy was detected 4 days after initial embolization. Follow-up angiography revealed a minimal shunt, and thus transvenous coil embolization was repeated. Two days later, the ophthalmoplegia started reducing, and 1-month later it had almost disappeared. CONCLUSIONS: To the best of our knowledge, this is the first report of spontaneous dural CCF in a Korean patient with concurrent protein S deficiency. Interestingly, transient sixth-nerve palsy developed after transvenous coil embolization in this patient. This additional symptom caused by the residual fistula was relieved after additional transarterial embolization.
Adult ; Angiography ; Carotid Arteries ; Cavernous Sinus ; Caves ; Central Nervous System Vascular Malformations ; Cerebral Angiography ; Craniocerebral Trauma ; Exophthalmos ; Eye ; Female ; Fistula ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Magnetic Resonance Spectroscopy ; Ophthalmoplegia ; Paralysis ; Protein S ; Protein S Deficiency ; Sinus Thrombosis, Intracranial ; Visual Acuity

A primary sarcoma of the pulmonary artery is a rare disease. The symptoms of the disease are nonspecific, so it is very difficult to get an exact diagnosis in an emegency situation. A 48-year-old man was admitted to our emergency center with the history of syncope. The patient had no symptoms of a chest problem. During the diagnostic work up, we found an increased density in the left upper lung field on the chest PA, which was the only diagnostic clue to the patient 's illness. A chest CT, a chest MRI, and other studies were done to diagnose the undelying cause of syncope. We found a large intraluminal mass in the pulmonary artery and anterior mediastinal lymph node enlargement. A firm tumor, which arose from the main pulmonary artery and caused a near total obstruction of the left main pulmonary artery, was found during operation, and a partial resection of the tumor mass was done. Histologic and immunohistochemical staining revealed the tumor to be poorly differentiated spindle cell sarcoma. We report the case of a pulmonary artery sarcoma patient, along with a brief review of related literature.
Diagnosis ; Emergencies ; Hemangiosarcoma* ; Humans ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Pulmonary Artery* ; Rare Diseases ; Sarcoma ; Syncope ; Thorax ; Tomography, X-Ray Computed

A case is presented of an amnionic rupture sequence which led to massive fetal ventral herniation and lordoscoliosis. Characteristic ultrasonographic findings of an omphalocele, fetal attachment to the placenta, and the absence of free-floating umbilical cord were observed.
Abnormalities, Multiple/*etiology/ultrasonography ; Adult ; Amnion ; Female ; Fetal Membranes, Premature Rupture/*complications ; Gestational Age ; Hernia, Umbilical/etiology ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Umbilical Cord/abnormalities

The malignant neoplasm of thyroglossal duct cyst (TGDC) is a rare tumor and is mostly revealed accidently in the course of histologic examinations after surgery. The most common histopathologic type is a papillary carcinoma. We experience a 25-year-old young woman of papillary carcinoma in thyroglossal duct cyst and the position of pyramidal lobe was unusual. She was treated by Sistrunk's operation with total thyroidectomy. We report this case with a review of literature.
Adult ; Carcinoma, Papillary ; Female ; Humans ; Thyroglossal Cyst ; Thyroidectomy

The malignant neoplasm of thyroglossal duct cyst (TGDC) is a rare tumor and is mostly revealed accidently in the course of histologic examinations after surgery. The most common histopathologic type is a papillary carcinoma. We experience a 25-year-old young woman of papillary carcinoma in thyroglossal duct cyst and the position of pyramidal lobe was unusual. She was treated by Sistrunk's operation with total thyroidectomy. We report this case with a review of literature.
Adult ; Carcinoma, Papillary ; Female ; Humans ; Thyroglossal Cyst ; Thyroidectomy

No abstract available.
Antibodies, Monoclonal* ; Humans* ; Interleukins*