We tried to analyze the status of 10 units of frozen thawed apheresis platelet concentration by 6% DMSO method for the evaluation of practical applicability. The platelet concentrations were transferred to PL-732(Baxter, USA) cryopreservation bag, and DMSO is added to those bag at slow rate until expected final 6% concentration is achieved, thereafter those were directly placed to -80 degrees C refrigerator for freezing. Someday later from I week to 1 month, those were thawed at 37 degrees C water bath, and then washed by same volume of ABO matched plasma. In the course of cryopreservation, about 7% of platelets were lost and the mean recovery rate of platelet was 93% compared with those of unfrozen status. LDH, the values of platelet lysis, and pH were within normal limits, whereas platelet aggregation test shows decreased aggregation to collagen and ristocetine compared with those of unfrozen status(p<0.05) but they were clinically acceptable. We suggest that the frozen platelets may be useful in a some clinical situation such as hematologic malignancy and solid tumor by autologous transfusion.
Baths ; Blood Component Removal ; Blood Platelets* ; Collagen ; Cryopreservation* ; Dimethyl Sulfoxide* ; Freezing ; Hematologic Neoplasms ; Hydrogen-Ion Concentration ; Plasma ; Platelet Aggregation ; Ristocetin ; Water

No abstract available.
Foreign Bodies* ; Skull Base* ; Skull*

No abstract available.
Sinusitis*

BACKGROUND AND OBJECTIVES: Allergic rhinitis (AR) and rhinitis medicamentosa (RM) have different mucosal color and pathophysiology. To investigate whether the mucosal color and nasal blood flow are different between the diseases in spite of same symptoms, we designed this study. Materials and Methods: 20 patients with allergic rhinitis and 21 patients with rhinitis medicamentosa were compared with 20 normal volunteers using mucosal color grading and Laser Doppler flowmetry. The Laser Doppler flowmetry was performed with a Periflux 4001 (Perimed, Jrtlla, Sweden) and perfusion unit (PU), velocity unit (VU), and concentration Unit (CU) were measured. The Laser Doppler flowmetry data in AR and RM were compared with those of the normal subjects, and between AR and RM. RESULTS: The perfusion score of AR and RM were lower than the control (p<0.05) and it was statistically significant that the mucosal color of AR were pale and of RM were reddish, comparing to the control group (p<0.05). CONCLUSION: The nasal blood flow was decreased with AR and RM compared to control but the mucosal color of AR and RM were different because of the difference of pathophysiology of diseases. When diagnosing RM, observation of mucosal color and measurement of nasal blood flow will be helpful besides the history of long-term use of nasal decongestant.
Healthy Volunteers ; Humans ; Laser-Doppler Flowmetry* ; Perfusion ; Rhinitis*

We evaluated CT findings of bronchial carcinoid and accuracy of preoperative pathological diagnosis according to two subtypes. The subjects were 10 cases (typical;5, atypical;5), confirmed by surgery and tissue pathology. Sputum cytology (n=10), percutaneous aspiration (n=1) and bronchoscopic biopsy (n=8) were performed, preoperatively. The CT findings were analysed according to two subtypes. Typical carcinoid shows central location in all, and bronchial lumens just proximal to tumor were widened in two, whereas atypical carcinoid presented as peripheral leison in two. Among central atypical carcinoid, two cases showed flat meniscus appearance of lumen. Remaining one showed diffuse wall thickening. Intratumoral low density by necrosis was noted in one. Both subtypes show contrast enhancement. For preoperative diagnosis, sputum cytology & percutaneous aspiration were not conclusive at all. As for bronchoscopic biopsy, only 3 cases were accurately diagnosed as typical carcinoid. Typical carcinoid presented as endobronchial mass in all, whereas atypical carcinoid presented in various appearance. In all atypical & some typical carcinoid were misdiagnosed as primary lung cancer, preoperatively. However, in typical carcinoid, conservative surgery was possible. In conclusion, if there is discrepancy between CT findings & preoperative pathological diagnosis, full understanding of CT findings of bronchial carcinoid is imperative to choose appropriate surgical modality.
Biopsy ; Carcinoid Tumor* ; Diagnosis* ; Lung Neoplasms ; Necrosis ; Pathology ; Sputum

BACKGROUND: Head injury is one of the most common causes of emergency department visits and hospital admission in the pediatric populations, and most injuries are mild. In mild head injury, grading of severity and decision of hospital admission are difficult in the emergency department. Recent studies have suggested that patients with a normal head CT scan and neurologic exam following head injury can be safely discharged from the emergency department. However, previous studies have relied on incomplete patient follow-up and been limited for the most part to adult population. So we performed this study to assess clinical course and the incidence of significant CNS sequelae in children with a normal head CT scan and no focal neurologic sign after mild head injuries during hospital admission and follow-up for 1 month. METHODS: We reviewal the records of children(n=209) admitted to the department of emergency medicine with closed head injuries from Jan. 1, 1996 to Dec. 31, 1996, who's initial Glasgow Coma Scale was 13 to 15, and have no focal neurologic sign and a normal head CT scan. RESULT: 209 patients were studied with a mean age of 6.8(range 3 months to 15years), and 66.5% were male. The most common mechanisms of injury were pedestrian T.A(50.2%) and fall(11.5%). Patients had a mean Glasgow coma scale of 14.8 and mean Abbreviated Injury Score of 1.3. Patients had clinical symptoms of headache(49.3%), vomiting(44.5%), loss of consciousness(LOC)(29.6%), amnesia(10.0%), sleepiness(8.6%), irritability(8.6%), confusion(2.9%) and seizure(1.9%). The mean duration of admission was 4.3 days(range: 6 hours-20 days) and the mean duration of symptom was 36.4 hours. No child developed significant CNS sequelae during hospital admission. However, during hospital admission, aye children(all were preschooler) had psychologic complication ; one child developed post-traumatic stress disorder requiring psychologic treatment for 3 months. Three children developed enuresis and two children developed night terror. During 1 month fallow-up, one child developed a symptomatic hemorrhagic contusion 5 days after the head injury, not requiring neurosurgical treatment. CONCLUSION: Among children with an initial Glasgow Coma Scale of 13 to 15, a normal head CT scan and no focal neurologic sign after mild head injuries, delayed intracranial sequelae are extremely uncommon. So these patient may be discharged home with parental supervision and education for dose observation.
Adult ; Child* ; Contusions ; Craniocerebral Trauma* ; Education ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Enuresis ; Follow-Up Studies ; Glasgow Coma Scale ; Head Injuries, Closed ; Head* ; Humans ; Incidence ; Male ; Neurologic Manifestations ; Organization and Administration ; Parents ; Stress Disorders, Post-Traumatic ; Tomography, X-Ray Computed

A K+-channel blocker, 4-aminopyridine(4-AP) increases neurotransmitter release from motor nerve terminals and has been shown to restore neuromuscular transmission in the myasthenic syndrome. It has been reported that the intravenous injection of 4-AP in the myasthenic patients caused many central adverse effects including anxiety and restlessness, but did not affect the blood pressure. The aim of this study was to observe the effect of intracerebroventricularly administered 4-AP on the blood pressure and to elucidate the mechanism of the action in urethane-anesthetized rabbits. Intracerebroventricular(icv) 4-AP produced pressor effects in a dose-dependent fashion, but intravenous(iv) 4-AP of the same dose did not altered the blood pressure. Tetraethylammonium, a K+-channel blocker which differs from 4-AP structurally, had little effect on the blood pressure, but 3,4-diaminopyridine, another derivative of the aminopyridine, produced pressor effect similar to 4-AP. The pressor effect of icv 4-AP was not affected by the treatment with iv phenoxybenzamine and chlorisondamine, and in bilateral adrenalectomized rabbits. These results suggest that the 4-AP pressor effect is not related to the periphral sympathetic nerve nor adrenal gland. The pretreatment with icv phentolamine and prazosin did not altered the 4-AP pressor. However, the icv 4-AP pressor effect was significantly attenuated by the treatment with icv yohimbine, and significantly potentiated by the treatment with icv clonidine. The treatment with icv diltiazem markedly inhibited the icv 4-AP pressor effect. It is concluded that 4-AP-sensitive K+-channels in rabbit brain might play a role in the regulation of blood pressure and that the 4-AP pressor effect is closely related to the central alpha2-adrenoceptors and L-type calcium channels.
4-Aminopyridine* ; Adrenal Glands ; Anxiety ; Arterial Pressure* ; Blood Pressure ; Brain ; Calcium Channels, L-Type ; Chlorisondamine ; Clonidine ; Diltiazem ; Humans ; Injections, Intravenous ; Neurotransmitter Agents ; Phenoxybenzamine ; Phentolamine ; Prazosin ; Psychomotor Agitation ; Rabbits ; Tetraethylammonium ; Yohimbine

OBJECT: Object of this study is to study which factors affect the prognosis in spontaneous thalamic hemorrhage treated with conservative method, stereotactic surgery and extraventricular drainage. MATERIAL AND METHODS: We analyzed 127 patients with spontaneous thalamic hemorrhage for evaluating the factors affecting prognosis. Various factors such as age, sex, location of hematoma, Glasgow coma scale(GCS) on admission, intraventricular hemorrhage(IVH), ventricular dilatation, CT classification, hematoma diameter, 4th ventricle dilatation, and treatment modality. RESULTS: The results were as follows: 1) Of the 40 patients with GCS of 3 to 8, 15 patients(37.5%) died. Of the 34 patients with GCS of 13-15, 33 patients(97%) survived 2) The 99 patients had intraventricular hemorrhage and 25 patients(25.2%) died. The 28 patients had no intraventricular hemorrhage and they all survived. 3) Of the 24 patients in whom the cerebrocaudate index(CCI) was more than 0.25, 10 patients(41.6%) died and only 2 patients had good prognosis. The 35 patients had no ventricular dilatation and all 35 patients survived 4) Of the 23 patients extending to hypothalamus or midbrain with ventricular hemorrhage, 11 patients(47.8%) died and 12 patients(52.1%) survived. 5) Of the 10 patients in whom hematoma diameter was more than 45mm, 4 patients(40%) died and 6 patients(60%) had a poor prognosis. 6) The 31 patients had hemorrhagic dilatation of the fourth ventricle and 16 patients(51.6%) died. Of the 29 patients with ventricular hemorrhage and no dilatation, 6 patients(20.6%) died. CONCLUSION: Multiple logistic regression analysis showed prognostic factors: GCS score(p<1/20.0001), extending to hypotahalamus or midbrain with ventricular hemorrhage(p<1/20.0001), thalamic hematoma with IVH(p<1/20.0001), dilated 4th ventricle hemorrhage(p<1/20.0012), hematoma diameter(p<1/20.0001), CCI(p<1/20.0001).
Classification ; Coma ; Dilatation ; Drainage ; Fourth Ventricle ; Hematoma ; Hemorrhage* ; Humans ; Hypothalamus ; Logistic Models ; Mesencephalon ; Prognosis

Pulmonary Aspergillomas usually arise from proliferation of Aspergillus in preexisting parenchymal cavities.202 college students (99 men, 103 women) aged 18% 26 years. Fasting blood samples were. The most common symptom in this disorder is hemoptysis, which may be minimal in amount or it may be massive & life threatening. The optimum therapy for pulmonary aspergilloma is controversial. The major options available include surgical resection of the lesion, a number of medical therapies, or simple observation of the patient for a time. Surgery is the most effective treatment but it is limited to some patient because most patients haute underlying pulmonary disease. Thus the various form of medical therapy was available with successful result. The authors present a case of percutaneous intracavitary amphoterician B injection for the treatment of pulmonary aspergilloma & its successful effect for the repetitive hemoptysis.
Amphotericin B* ; Aspergillus ; Fasting ; Hemoptysis* ; Humans ; Lung Diseases ; Male

PURPOSE: The aim of this study was to determine whether liver resection treated by using laparoscopy is equally safe for patients who have benign liver mass, hepatolithiasis, hepatocellular carcinoma (HCC), or metastatic liver cancer. METHODS: We performed our study in 32 patients with the following conditions: 17 patients with IHD stones, 7 with HCC, 1 with cholangiocarcinoma, and 7 patients who had colon cancer with liver metastasis. On a retrospective bases, these patients were investigated for clinical history, type of operation, time for the operation, hospital stay, and post operative complications. RESULTS: The target age range was from 37 to 80 years and the mean age was 61.2 years old. The percentage of patients over 60 years old was 68.7%. According to their past history, 8 patients had experienced an upper abdominal operation. In our study there were 9 cases of left hepatectomy (28.1%), 9 cases of left lateral segmentectomy (28.1%), 2 cases of sectionectomy, and 12 cases of wedgeresection. The average operation time was 364+/-148 mins, the average bleeding amount was 417 cc, and the average hospital stay was 13.2 days. There were 8 cases (25%) of postoperative complications developed (2 bile leak, 1 intrabdominal abscess, 1 acute renal failure, 2 wound infection). All cases were improved with conservative management. And there was one case of remnant IHD stone, which had surgical treat and one patient had peritoneal carcinomatosis, who had laparoscopic liver resection for HCC. CONCLUSION: Our study showed that laparoscopic liver resection has advantages; it is less painful, causes a small operative scar, a the short period of hospital stay and has cosmetic benefits. In the future, laparoscopic liver resection could be an important option for the treatment of hepatolithiasis and HCC through improved surgical instrument and skill of operation.
Abscess ; Acute Kidney Injury ; Bile ; Carcinoma ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cicatrix ; Colonic Neoplasms ; Cosmetics ; Hemorrhage ; Hepatectomy ; Humans ; Laparoscopy ; Length of Stay ; Liver ; Mastectomy, Segmental ; Neoplasm Metastasis ; Postoperative Complications ; Retrospective Studies ; Surgical Instruments