No abstract available.

High output heart failure due to congenital arteriovenous fistula is a rare disease and is difficult to treat. A 27 year old man, suffering from dyspnea, palpitation, lower extremity edema, and abdominal distension admitted May, 1987. At admission there were continuous thrill and bruit at left supraclavicular and infraclavicular area. The heart sound was irregular and rapid, and grade IV/VI pansystolic murmur was audible at the apex. Chest PA showed marked cardiomegaly with pleural effusion and notching at superior aspect of left 2nd rib. Selective left subclavian artery angiogram showed extensive congenital arteriovenous fistula at the area of left subclavian artery and its branches. After setrial feeding artery embolization and palliative operation, the fistula size decreased much with clinical improvement.
Adult ; Arteries ; Arteriovenous Fistula* ; Cardiomegaly ; Dyspnea ; Edema ; Fistula ; Heart Failure ; Heart Sounds ; Humans ; Lower Extremity ; Pleural Effusion ; Rare Diseases ; Ribs* ; Subclavian Artery* ; Thorax

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. The injuries to the ankle joint result in a severe functional disturbance because of complex anatomical characteristics around the ankle joint. 284 patients of the ankle fracture that were treated in orthopedic Dept. Capital Armed Forced General Hospital from march 1985. to march 1988. were analized in clinical and radiological aspects. The following results were obtained: 1. The main cause of the injuries was falling from a height and the other were sports injury and slipping down in order. 2. The most common type by Lauge-Hansen classification was supination-external rotation type(122 case, 42.9%). 3. 211 case(74.3%) were treated with open reduction and internal fixation, and 73 case(25.7%) were treated with closed reduction. Poor outcome seemed closely related to the severity of the injury and degree of fracture displacement. 4. Accurate reduction and rigid internal fixation of the lateral malleolus with shortening was important factor. 5. Classification of Lauge-Hansen was useful in the diagnosis and treatment of the ankle fractures.
Accidental Falls ; Ankle Fractures ; Ankle Joint ; Ankle ; Arm ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Hospitals, General ; Humans ; Musculoskeletal System ; Orthopedics ; Walking

No abstract available.
Tuberculosis, Meningeal*

Anomalous origin of one pulmonary artery from the ascending aorta is a rare congenital malfomation. To date, there have been 60 reported cases in the literature. Usually the right pulmonary artery arises form the ascending aorta and other malformations such as patent ductus arteriosus are commonly associated. Early diagnosis is essential because congestive heart failure develops in early life and operation is contraindicated if severe pulmonary vascular changes have occurred. We report a case of anomalous origin of right pulmonary artery from the ascending aorta, which is associated with patent ductus arteriosus and severe pulmonary hypertension. She was diagnosed by digital subtractional angiography and cardiac catheterization.
Angiography ; Aorta* ; Cardiac Catheterization ; Cardiac Catheters ; Ductus Arteriosus, Patent ; Early Diagnosis ; Heart Failure ; Hypertension, Pulmonary ; Pulmonary Artery*

The nutcracker phenomenon consists in the compression of the left renal vein between the superior mesenteic artery and the aorta, and this syndrome is an infrequent cause of left-sided hematuria. We present a case of the nutcracker syndrome with intermittent gross hematuria to increase the awareness of this possible cause of hematuria.
Aorta ; Arteries ; Hematuria ; Renal Veins

BACKGROUND: Lidocaine is a well known antiarrhythmic agent. However, recent reports indicate that indocaine has myocardial protective effects on acute myocardial ischemia and reperfusion. The exact mechanism of myocardial protection of lidocaine is still not clearly understood. In this study we intended to assess the effects of lidocaine on high energy phosphate metabolism in cats subjected to myocardial ischemia-reperfusion by using 31P MR spectroscopy. Effect of lidocaine on size of infarct will also be evaluated by 2, 3, 5-triphenyltetrazolium chloride(TTC) staining. METHODS: Twenty-seven cats were used for this study. The animals were divided into three groups : for group 1(n=10) and group 2(n=7), animals were subjected to a 90 min of LAD occlusion followed by a 90 min of reperfusion ; for group 3(n=10), a 20 min of occlusion followed by a 90 min of reperfusion. In group 2 and group 3, lidocaine(5mg/kg/hr) was infused continuously during the occlusion and reperfusion periods with an initial bolus injection(1mg/kg) before ligation of LAD. In-vivo MR spectroscopy was performed on a 4.7T Biospec System(Bruker, Switzerland). A home-made surface coil(diameter : 1.5cm) was used to receive31p signals from the myocardium underwent ischemic and reperfusion damage. RESULTS: Decrease of PCr during ischemic period was not different between each groups : PCr showed less than 30% of the baseline value at L-30 in group 1 and group 2 and at L-20 in group 3. More than 90% recovery of PCr was achieved at R-30 in group 2 and group 3, whereas less than 50% of PCr was recovered in group 1. Decrease of ATP during ischemic period was less pronounced in group 2 than in group 1 : in group 2 ATP depleted down to 25% of the baseline at L-90, whereas in group 1 ATP decreased to 50% of the baseline. Recovery of ATP during reperfusion period was not signiflcant in all three groups. On TTC staining, evidence of infarct was seen in all cases of group 1 : the area of infarct was 12.3+/-2.7% of the left ventricular mass and 23.9+/-6.1% of the area at risk. On the contrary, there was no evidence of infact in any case of group 2 and group 3. CONCLUSION: In this study, we found that lidocaine has myocardial protecitve effects on ischemia-reperfusion in cats. Lidocaine improves high energy phosphorous metabolism during ischemia and reperfusion as well as reduces infarct size.
Adenosine Triphosphate ; Animals ; Cats* ; Ischemia ; Lidocaine* ; Ligation ; Magnetic Resonance Spectroscopy ; Metabolism ; Myocardial Ischemia ; Myocardium ; Polymerase Chain Reaction ; Reperfusion ; Reperfusion Injury

Implant overdenture exhibits higher retention, masticatory function, and patient's satisfaction compared to conventional dentures. Particularly, in treatment of severe alveolar bone resorption, implant overdenture can be considered as the first treatment option. The types of attachments used for implant overdenture can be classified into solitary type, which implants are not connected to each other, and bar type in which implants are connected. In the case of solitary type commonly used in clinical practice, parallel relationship is important. When it is not established, there is a higher risk of attachment wear, retention loss, and frequent visits for maintenance. In this case, satisfactory results have been obtained with implant overdentures using milled bar on two unparallel implants placed on the mandible.
Bone Resorption ; Denture, Overlay* ; Dentures ; Mandible

PURPOSE: To compare the CT findings of mycobacterial infection other than tuberculosis (MOTT) with those of tuberculosis (TB). MATERIALS AND METHODS: The chest CT scans of 30 immunocompetent patients with culture-proven pulmonary MOTT (M:F=11:19; mean age, 51.2 yrs.) and of 24 patients with active tuberculosis (M:F=12:12; mean age, 42.5 yrs.) were analyzed by two radiologists; decisions were reached by consensus. RESULTS: Common findings for both MOTT and TB included bronchogenicaly-spread bronchogenic spread nodular lesion (93.3% for MOTT, 100 % for TB), bronchiectasis (90%, 83.3%), bronchial wall thickening (66.7%, 54.2%), granuloma (63.3%, 75%), parenchymal scarring (53.3%, 54.2), and mediastinal lym-phadenopathy (50%, 37.5 %). Less commonly observed findings were emphysema (46.7%, 29.7%), atelectasis (36.7%, 29.2%), narrowing of a major airway (23.3%, 25%), consolidation (23.3 %, 29.2 %), and pleural disease (16.7%, 29.2%). Except for cavity (30%, 53.3%; p< .05), the frequencies of each finding were not right middle lobe (40%, 16.7%), right lower lobe (63.3%, 33.3%) and lingula division (53.3 %, 25%) was sig-nificantly more common in MOTT than in TB (p < .05). The number of lobes in which bronchiectasis and bronchial wall thickening were involved was greater in MOTT(3.20) than in TB(2.04) (p=.011). CONCLUSION: Although the CT findings of MOTT and TB overlap considerably, cavities are more common in TB, while in MOTT, bronchiectasis in the lower lung zone is more common and bronchiectasis tends to be more extensive.
Bronchiectasis ; Cicatrix ; Consensus ; Emphysema ; Granuloma ; Humans ; Lung ; Pleural Diseases ; Pulmonary Atelectasis ; Tomography, X-Ray Computed ; Tuberculosis*

We evaluated the relationship between preoperative risk factors[gestational age, birth weight, postconceptual age and weight at operation, duration of operation, duration of anesthesia, abnormalities in neurosonogram, bronchopulmonary dysplasia]and apnea with or without bradycardia, for which mechanical ventilation was necessary after general anesthesia in the surgical treatment of retinopathy of prematurity[ROP]. Thirty-eight patients [21%]developed apnea and thirteen patients[7%]had bradycardia out of 183 patients. Retrospective study was performed and risk factors were analyzed by logistic regression. Gestational age, birth weight, postconceptual age and weight at operation and bronchopulmonary dysplasia showed the positive correlation with postanesthetic apnea and bradycardia. Duration of operation showed the positive correlation with postanesthetic apnea but not with postanesthetic bradycardia. In logistic regression without confoundings, weight at operation and bronchopulmonary dysplasia were correlated with postanesthetic apnea. Receiver operating characteristic curve analysis revealed that patients with weight under 2, 600gm at operation suffered from apnea more frequently than those with weight over 2, 600gm. In conclusion, patients with weight under 2600gm or bronchopulmonary dysplasia are at greater risk for postanesthetic apnea and optimal pre-and postanesthetic management should be prepared for these patients.
Anesthesia ; Anesthesia, General* ; Apnea* ; Birth Weight ; Bradycardia ; Bronchopulmonary Dysplasia ; Gestational Age ; Humans ; Infant, Newborn ; Logistic Models ; Respiration, Artificial ; Retinopathy of Prematurity* ; Retrospective Studies ; Risk Factors* ; ROC Curve