No abstract available.
Cardiomyopathy, Dilated* ; Estrogens, Conjugated (USP)*

No abstract available.
Diagnosis* ; Infant, Newborn ; Meconium Aspiration Syndrome* ; Meconium*

No abstract available in English.
Plasmacytoma

BACKGROUND: Although surgical angioplasty for isolated coronary ostial stenosis is assumend as an alternative approach to CABG, the clinical features of isolated coronary ostial stenosis, postoperative complications and follow-up angiographic results would have not been well studied. METHODS: We retrospectively studied 24 patients (female : male = 20 : 4, mean age 50.0 +/- 12.3 yr) who underwent surgical angioplasty for isolated coronary ostial stenosis using patch ( 22 fresh autologous pericardium, 2 saphenous vein) during the period of March 1990 through February 1998. Repeat coronary angiography (16 patients) and echocardiography (24 patients) were performed. Aortic regurgitation was evaluated semiquantitatively (Grade I - Grade IV). RESULTS: There were 3 deaths after surgical angioplasty. One death was due to acute coronary dissection perioperatively, the second due to low cardiac output syndrome 2 weeks post-surgery, and the third due to traumatic panperitonitis 10 months post-procedure. Angina recurred in 4 patients and the remaning 18 patients were symptom-free. Repeat angiography (19.3 +/- 20.7 Mo) showed widely patent ostium with excellent run-off except 2 patients (1 distal patch stenosis, 1 ostial restenosis in Takayasu's arteritis). The third symptomatic patient was proven to have coronary spasm by ergonovine test. AR increased in the fourth patient (Grade II -> III) with patent ostium. CONCLUSION: Surgical angioplasty may be feasible and alternative operative method to CABG for isolated coronary ostial stenosis. It should however be noted that postop AR can develop and/or increase. Further investigation is needed to evaluate the clinical significance of the AR.
Angiography ; Angioplasty* ; Aortic Valve Insufficiency ; Cardiac Output, Low ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Male ; Pericardium ; Postoperative Complications ; Retrospective Studies ; Spasm

BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

No abstract available.
Hernia* ; Pneumoperitoneum*

No abstract available.
Emergencies* ; Emergency Service, Hospital*

PURPOSE: Various surgical approaches have been used for stress urinary incontinence. We used a suburethral patch sling operation using fascia lata for all patients with stress urinary incontinence and report our experience. MATERIALS AND METHODS: From November, 1996 to May, 1997, a total of 25 female patients with stress urinary incontinence underwent the sling procedure, and 22 patients were followed up postoperatively. A 1.5- x 3.5- cm rectangle of fascia lata was used with 1-0 prolene sutures attached to allow suspension and the fascia lata patch was fastened at the level of the bladder neck in the anterior vaginal wall. We used the Stamey needle to transfer the suspension sutures in a fashion identical to that used for bladder neck suspension. Median followup was 22 months(range 20 to 26). RESULTS: Mean age was 47.1 years and mean parity was 3.1. According to the symptom grading system by Stamey, grade I was 77.3%(17), grade II 18.2%(4), and grade III 4.5%(1). Valsalva leak point pressure was 60cmH2O or less in 27.3%(6), 61 to 90cmH2O in 27.3%(6), and more than 90cmH2O in 45.4%(10). Mean operation time was 124.0minutes and mean duration of postoperative indwelling catheter was 4.2 days. Among 22 patients, 18 patients(81.8%) were cured, 3(13.6%) improved, and 1(4.5%) failed. No statistically significant relationship existed between either symptom grade or VLPP and success rate, but maybe it would be due to low number of patients to be compared. Two patients(9.1%) with grade I suffered from prolonged voiding difficulty and they catheterized intermittently for 30 days and 64 days respectively before normal voiding. De novo urge incontinence developed in 1 patients(4.5%). Other minor complications were urinay tract infection(4 cases), weak stream(3 cases), bladder irritative symptom(2 cases), deviation of urine stream(2 cases), prolonged suprapubic pain(1 case), prolonged thigh pain(1 case), and dyspareunia(1 case). CONCLUSIONS: The suburethral patch sling operation using fascia lata was considered another useful option for the patients with stress urinary incontinence who want autologous tissue for sling material but can not use rectus fascia due to medical condition or previous abdominal operation or irradiation.
Catheters ; Catheters, Indwelling ; Fascia Lata* ; Fascia* ; Female* ; Follow-Up Studies ; Humans ; Neck ; Needles ; Parity ; Polypropylenes ; Sutures ; Thigh ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge

No abstract available.
Tachycardia*

No abstract available.
Neck*