No abstract available.
Humans ; Kidney Transplantation* ; Living Donors*

Vasodilatory shock has been implicated in life-threatening complications after cardiac surgery. This syndrome may result from the vasopressin deficiency following cardiopulmonary bypass (CPB), which do not respond to fluids or usual intravenous inotropes. We used arginine-vasopressin in adults with vasodilatory shock coming off cardiopulmonary bypass. Therefore, we report these cases with a review of articles.
Adult ; Arginine Vasopressin* ; Arginine* ; Cardiopulmonary Bypass* ; Diabetes Insipidus, Neurogenic ; Humans ; Shock* ; Thoracic Surgery ; Vasodilation ; Vasopressins

No abstract available.

We present the case of a 7 year-old child who underwent angioplasty with a stent for anastomosis site stenosis between a left subclavian artery free graft and the left main coronary artery in an arterial switch operation.
Angioplasty* ; Child* ; Constriction, Pathologic ; Coronary Vessels ; Humans ; Stents* ; Subclavian Artery ; Transplants ; Transposition of Great Vessels

BACKGROUND: Large abdominal wall defect resulting from trauma, invasive infection, tumor resection, or other causes continue to be major problems for patients and surgeons. The lack of sufficient tissue may require the insertion of prosthetic materials. This study compares the results of PPM mesh and e-PTFE patch for repairs of abdominal wall defects. METHODS: The anterior abdominal walls of Sprague-Dawley rats, including fascia, muscle, and peritoneum were removed. The defects were repaired with a PPM mesh or an e-PTFE patch. Animals were killed at 1, 2, 6, and 12 weeks after the operation, and the implant were excised along their margins and evaluated for gross and microscopic differences. RESULTS: Histological examination showed that PPM was progressively infiltrated by whorled disorganized collagen fiber, which became densely adherent to the mesh. In contrast, the e-PTFE was infiltrated by fine fibrils of collagen, which progressively penetrated the interstices of the material, binding it firmly to the tissue. One of the most serious complications associated with fascial closure with PPM was the development of visceral adhesions. CONCLUSIONS: e-PTFE patch material has a lower foreign body reaction, a lower infectability, and a lower rate of adhesion formation than PPM mesh.
Abdominal Wall* ; Animals ; Collagen ; Fascia ; Foreign-Body Reaction ; Humans ; Peritoneum ; Polypropylenes* ; Polytetrafluoroethylene* ; Rats* ; Rats, Sprague-Dawley

This prospective study was performed to determine the effective antibiotics for use in treating acute appendicitis patients during the perioperative period. To identify the sensitive antibiotics, the peritoneal fluid was cultured during operation. Also, wound infection was defined as pus or serous discharge in the wound or when we opened the wound under suspicious of a wound problem. The results were obtained as follows: 1) A total of 138 cases treated during the two years from January 1995 to December 1996 were examined; 84 of them (60.87%) were found to have positive peritoneal fluid cultures, of which 29 (34.52%) were monomicrobial and 55 (65.48%) were polymicrobial. 2) The most common species were Escherichia coli (73.81%), Bacteroides (32.14%), Klebsiella (16.67%), Pseudomonas (9.52%), and Streptococcus (9.52%). 3) In the sensitivity test, the most sensitive drugs were aminoglycosides and cefotaxime. 4) Infectious complications, which developed in 27 (19.6%) patients, were wound infection and intraabdominal abscess. 5) The average length of stay for all patients 9.9 days (range: 3 to 32 days). 6) The common organisms curtured from the complication cases were E. coli and Bacteroides.
Abscess ; Aminoglycosides ; Anti-Bacterial Agents* ; Appendicitis* ; Ascitic Fluid ; Bacteroides ; Cefotaxime ; Escherichia coli ; Humans ; Klebsiella ; Length of Stay ; Perioperative Period ; Prospective Studies ; Pseudomonas ; Streptococcus ; Suppuration ; Wound Infection ; Wounds and Injuries

OBJECTIVE: A constituent of green tea, (-)-epigallocatechin-3-gallate (EGCG), has been known to possess anti-diabetes, anti-hypertension and anti-cancer properties. In this study, we investigated the anticancer effects of EGCG on human ovarian cancer cell lines. The growth inhibitory mechanism(s) and regulation of cell cycle-related proteins by EGCG were also evaluated. METHODS: To carry out cell counting assay to observe the anti-proliferative effects, we treated 25, 50, and 100 uM EGCG to both ovarian cancer cell lines SKOV-3 and OVCAR-3, respectively. Also, we treated EGCG to PA-1 cells with 6.25, 12.5 and 25 uM, respectively. Six days later, we examined the characteristics of apoptosis and changes in cell cycle regulation by cell counting assay, Annexin V-FITC staining and DNA fragmentation assay, and FACS analysis. In addition, protein and gene expression patterns in SKOV-3 cell were investigated by using cell cycle cDNA chip, RT-PCR, and Western blot analyses. RESULTS: Inhibition of cell growth by cell counts showed in SKOV-3 cells with 48.8%, 82.5%, 99.2% after six days of the treatment with 25, 50, 100 uM of EGCG, respectively. OVCAR-3 cells showed 53.9%, 84.8%, and 97.7% growth inhibition patterns. And PA-1 cells showed 17.1%, 48.4%, and 74.1%, as compared to control. When SKOV-3 cells were tested for EGCG-induced apoptosis, apoptotic cells were observed with 8.6, 11.4, and 23.3-fold at 25, 50, 100 uM EGCG, respectively. And PA-1 cells showed 1.7, 2.4, and 4.2-fold, as compared to control. In contrast, OVCAR-3 did not show EGCG-induced apoptosis. When SKOV-3 cells were tested for their gene expression using cell cycle cDNA chip after treatment with 24.5 uM of EGCG, up-regulations of p21, Bax and cyclin G were shown, while down-regulations of CDK6, E2F-4, and cyclin A were shown. In Western blot assay, up-regulations of Bax and p21 proteins were shown, while down- regulations of cyclin D1, Bcl-XL, Rb, CDK2, E2F-1, E2F-4, PCNA proteins were shown. CONCLUSION: These data support that EGCG can inhibit ovarian cancer cell growth through induction of apoptosis and cell cycle arrest as well as regulation of gene and protein expressions. Thus, EGCG likely provides an additional option for a new and potential drug approach for ovarian cancer.
Apoptosis ; Blotting, Western ; Cell Count ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Line* ; Cyclin A ; Cyclin D1 ; Cyclin G ; DNA Fragmentation ; DNA, Complementary ; Gene Expression ; Humans ; Ovarian Neoplasms* ; Proliferating Cell Nuclear Antigen ; Social Control, Formal ; Tea*

BACKGROUND: Vasodilatory shock has been implicated in life-threatening complications after open heart surgery, where the systemic inflammatory reaction is attributed to the cardiopulmonary bypass (CPB). The secretion of arginine vasopressin (AVP) has been found to be defective in a variety of vasodilatory shock states and administration of AVP markedly improves vasomotor tone and blood pressure. So we reviewed our experience of AVP therapy in patients with vasodilatory shock following heart surgery using CPB. MATERIAL AND METHOD: From January 2004 to July 2006, we reviewed the records of patients who received AVP therapy for vasodilatory shock following heart surgery using CPB. Vasodilatory shock was defined as a mean arterial pressure lower (MAP) than 70 mmHg, a cardiac index greater than 2.5 L/min/m2, peripheral vascular resistance lower than 800 dyn/s/cm5, and vasopressor requirements. The hemodynamic responses of patients who received AVP therapy for vasodilatory shock after cardiac surgery were analyzed retrospectively. RESULT: One hundred ninety nine open cardiac surgery patients were consecutively included in this study. Twenty two patients (11.1%) met criteria for vasodilatory shock. Despite the administration of high dose catecholamine vasopressor, all patients were hypotensive with a mean arterial pressure less than 70 mmHg. AVP therapy increased MAP from 53.3+/-7.4 to 82.0+/-12.0 mmHg at 1 hour (p <0.001) and decreased other vasopressor requirements from 25+/-7 to 18+/-6 at 1 hour (p <0.001) and individually maintained it for 12 hours. CONCLUSION: Our date suggest that AVP may be a safe and an effective vasopressor in patients with vasodilatory shock. In patients exhibiting vasodilatory shock after heart surgery, replacement of AVP increases blood pressure and reduces catecholamine vasopressor requirements.
Arginine Vasopressin* ; Arginine* ; Arterial Pressure ; Blood Pressure ; Cardiopulmonary Bypass ; Hemodynamics ; Humans ; Retrospective Studies ; Shock* ; Thoracic Surgery* ; Vascular Resistance ; Vasodilation ; Vasopressins

BACKGROUND/AIMS: Tuberculous peritonitis is still a very important cause of exudative ascites in Korea. We analized the clinical features and laparoscopic findings in patients with tuberculous peritonitis diagnosed by laparoscopy. METHODS: We studied 51 patients who had tuberculous peritonitis confirmed by laparoscopic biopsy from 1980 to 2000, in retrospective method. RESULTS: The ratio of male to female was 1:2. The peak incidence was between 21 and 40 years of age. The mean duration of symptoms is 60 days. The most frequent chief complaints and physical findings was abdominal fullness (88.2%) and shifting dullness (94.1 %). Involvement of other organs included pulmonary tuberculosis (27.4%), cervical tuberculous lymphadenitis (3.9%). The mean ascitic fluid protein concentration was 4.9 gm/dL, mean WBC count 1,240/mm3 and lymphocyte dominant exudate 88.2%. AFB smear was positive only one patient (2.0%). Tuberculous nodules on laparoscopy were noted in all of the patients. Histolologic findings were caseating granuloma (72.6%), non-caseating granuloma (19.6%) and nonspecific inflammation (7.8%). Tissue AFB stain was positive 10 patients (19.6%). CONCLUSIONS: Tuberculous peritonitis shows nonspecific clinical features. Therefore, laparoscopic examination with biopsy is the most useful method to make differential diagnosis of patients who are suspected tuberculous peritonitis.
Ascites ; Ascitic Fluid ; Biopsy ; Diagnosis, Differential ; Exudates and Transudates ; Female ; Granuloma ; Humans ; Incidence ; Inflammation ; Korea ; Laparoscopy* ; Lymphocytes ; Male ; Peritonitis, Tuberculous* ; Retrospective Studies ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary

OBJECTIVES: One hypothesis of obstructive sleep apnea syndrome (OSAS) is that long-standing snoring vibrations and hypoxia of the nerves cause a local neuropathy in the upper airway during sleep. The aim of this study was to investigate olfactory function in subjects comprising snorers and untreated subjects with OSAS, and to correlate data with polysomnographic parameters. METHODS: Sixty-nine patients were evaluated for snoring from January 2010 to December 2013. The mild group (apneahypopnea index [AHI]<15) consisted of 19 subjects, and the moderate-severe group (AHI≥15) consisted of 50 subjects. Exclusion criteria were conductive olfactory dysfunction, previous tonsil or soft palatal surgery, central sleep apnea, and medications that are known to affect peripheral nerves. Nocturnal polysomnography and olfactory function test such as Korean version of Sniffin’s stick test I, II (KVSS I, II) were performed. RESULTS: There was a significant difference in body mass index, average oxygen saturation (SaO2), lowest SaO2, average snoring duration, and KVSS I, II between the two groups. AHI was related to odor threshold score, and average SaO2 was related to odor discrimination score. But, odor identification score showed no relation with AHI and average SaO2 except for age. Average SaO2 and AHI were closely related to the function of smell. CONCLUSION: Hypoxia and low nasal airflow caused by OSAS may have an effect on the olfactory function. On comparison between the two groups, patients with a high AHI, especially those with OSAS, had an olfactory dysfunction. Also, low average oxygen is the main risk factor in determining the olfactory function. In people with OSAS, the possibility of olfactory dysfunction should be considered and an olfactory function test should be performed.
Anoxia ; Body Mass Index ; Discrimination (Psychology) ; Humans ; Odors ; Olfaction Disorders ; Oxygen ; Palatine Tonsil ; Peripheral Nerves ; Polysomnography ; Risk Factors ; Sleep Apnea Syndromes* ; Sleep Apnea, Central ; Sleep Apnea, Obstructive ; Smell ; Snoring ; Vibration