No abstract available.
Colonoscopy* ; Tuberculosis*

An accurate and relatively simple method for estimating the amount of acute blood loss is essential in the hemorrhagic shock patients. Conventional physiologic parameters, blood pressure, pulse rate and CVP, could not serve for evaluation of the adequate oxygen transport in the tissue. Pulmonary artery catheter is a best tool for evaluating the cardiopulmonary function and the oxygen transport system, and mixed venous oxygen saturation(SvO2) monitoring have made a great advances for early detection of cardiovascular dysfunction and the changes in peripheral tissue oxygenation. But pulmonary artery catheterization is complicated procedure in emergency setting. Although the central venous oxygen saturation(ScvO2) cannot completely replace the SvO2 value, it has a close relation with SvO2 change in variable clinical situations. We testify the usefulness of ScvO2 monitoring in 24 patients of the hemorrhagic shock. Initial resuscitation was performed with ATLS standard and continuous ScvO2 was monitored. Systolic blood pressure and pulse rate were recorded for one hour from initial resuscitation in each 15 minutes. Nineteen patient was traumatic hemorrhagic shock and five was non traumatic. Twelve of 19 patients was blunt trauma, and remains were stab in injury mechanism. Mortality rate was 29.2%. Initial ScvO2 of nonsurvivor was 43.6%, and 51.3% in survivor groups(p>0.05). In the group of stab wound and non-traumatic hemorrhage, the ScvO2 was gradually increase by time. But ScvO2 in survivors of blunt trauma was increased first 30 minutes and decrease afterthen. Continuous monitoring of ScvO2 may by partly useful in resuscitation for hemorrhagic shock. It is more valuable in the blunt trauma than in the penetrating injury or non-traumatic hemorrhage.
Blood Pressure ; Catheterization, Swan-Ganz ; Catheters ; Emergencies ; Heart Rate ; Hemorrhage ; Humans ; Mortality ; Oxygen* ; Pulmonary Artery ; Resuscitation ; Shock, Hemorrhagic* ; Survivors ; Wounds, Stab

BACKGROUND: The stratum corneum presents a significant barrier to transdermal drug delivery. Approaches to improve percutaneous absorption of drugs have included iontophoresis and skin penetration enhancers. Oleic acid has been studied as a skin penetration enhancer for drugs, primarily via its action mainly on the stratum corneum lipid structure. OBJECTIVE: The purpose of this study was to assess the interaction between oleic acid and stratum corneum lipids in vivo. METHODS: Male hairless mice were treated topically with oleic acid. Barrier function was assessed by transepidermal water loss measurement and ultrastructural observation with ruthenium tetroxide (RuO₄) staining. RESULTS: Oleic acid in propylene glycol had a profound effect on epidermal barrier function and was found to be concentration dependent. Moreover, ultrastructural examination with RuO4 post-fixation demonstrated that there were marked alterations in the stratum corneum lipid structure. CONCLUSION: This study provides direct evidence that oleic acid increases the epidermal permeability through a mechanism involving the stratum corneum lipid membrane perturbation via the lacunae formation within the stratum corneum.
Animals ; Humans ; Iontophoresis ; Male ; Membranes ; Mice ; Mice, Hairless ; Oleic Acid* ; Permeability ; Propylene Glycol* ; Ruthenium ; Skin ; Skin Absorption ; Water

No abstract available.
Animals ; Interleukin-4* ; Mice*

No abstract available.

PURPOSE: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. MATERIALS AND METHODS: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). RESULTS: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. CONCLUSION: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.
Chondrosarcoma ; Curettage ; Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Tumor Burden

Congenital absence of the major salivary glands, especially of the parotid gland, is a rare disorder whose etiopathogenesis is poorly understood. Aplasia of the parotid glands may be unilateral or bilateral and may occur alone or in association with the absence of other salivary glands or with other developmental anomalies of the first branchial arch, such as hypoplasia or aplasia of the lacrimal glands, hemifacial microsomia, mandibulofacial dysostoses, and multiple congenital anomalies. Various degree of xerostomia and dental caries with early loss of teeth may occur due to decreased salivary production. The authors experienced a case of unilateral parotid aplasia in a 22-year old female who had painless swelling in the right parotid region. We present this case with review of literature.
Branchial Region ; Dental Caries ; Female ; Goldenhar Syndrome ; Humans ; Lacrimal Apparatus ; Mandibulofacial Dysostosis ; Parotid Gland ; Parotid Region ; Salivary Glands ; Tooth ; Xerostomia ; Young Adult

To evaluate the diagnostic accuracy of two-dimensional echocardiogrphy(2-D echo) in ventricular septal defect, location and size of the defects, estimated right ventricular systolic pressure and associated cardiac anomaly were compared to the operative findings in 139 children operated for correction of ventricular septal defect at Severance Hospital from Jan. 1983 to June 1987. In addition, postoperative complications and mortality cases were anlysed. The following results were obtained; 1) Perimembranous defects were 82 cases(66.1%), subarterial infundibular defects 33 cases(26.6%), and muscular defect was found in only 1 case(0.8%). The accuracy of 2-D echo in localizing the defects was 84.2%. 2) In 79.2% of the patients, the defects were moderate to large in size, and actual size measured at operation was larger than that obtained by echocardography in general. 3) The estimated right ventricular systolic pressure was correlated(r=0.650) with that measured at the operating field. 4) Combined cardiac anomalies were patent ductus arteriosus(22 cases), atrial septal defect(3 cases), valvular pulmonic stenosis(2 cases) and interventricular septal aneurysm(2 cases). The sensitivity of 2-D echo in detecting these anomalies was 65.5% and the specificity was 96.4%. 5) Among 32 patients who had postoperative complications, in two thirds, there were pulmonary complication including lung atelectasis(16 cases), pleural effusion(5 cases)and pneumonia(5 cases). 6) Operative mortality was 2.9%(4 cases). The causes of death were low cardiac output state due to left ventricular myocardial failure in 3 patients and respiratory failure from asphyxia in one case. In conclusion, with close cooperation with cardiac surgeons, there will be few problems in diagnosing and operating patients with ventricular septal defect on the basis of two-dimensional echocardiographic findings without invasive procedures, such as cardiac catheterization, even with pulmonary hypertension, unless Eisenmenger syndrome is complicated.
Asphyxia ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output, Low ; Catheterization* ; Catheters* ; Cause of Death ; Child* ; Echocardiography* ; Eisenmenger Complex ; Heart Failure ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Lung ; Mortality ; Postoperative Complications ; Respiratory Insufficiency ; Sensitivity and Specificity

A 25-year-old woman with focal seizure, intermittent morning headache and vomiting for 2 years showed microcytic hypochromic anemia on peripheral blood smear and a 6x7.5cm sized intracranial mass with cystic and solid portions at the right temporoparietal convexity on brain CT and MRI which was hypervascular on cerebral angiography. Histopathologic findings on light microscopy suggested chordoma, but it was confirmed as a chordold meningioma by immunohistochemical study. The present case suggests that the diagnosis of chordold meningioma shoud be considered in a juvenile or young adult who is presented with an extra-axial mass with typical location of meningiomas, findings of chordomas on light microscopy, and clinical findings of Castleman syndrome.
Adult ; Anemia, Hypochromic ; Brain ; Cerebral Angiography ; Chordoma ; Diagnosis ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Microscopy ; Seizures ; Vomiting ; Young Adult

No abstract available.