No abstract available.

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.
Adult ; Aneurysm* ; Aorta, Thoracic* ; Aortic Valve ; Brain Ischemia ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Male ; Middle Aged ; Perfusion ; Sternotomy ; Thoracotomy ; Transplants

No abstract available.
Sinusitis*

No abstract available.
Lung* ; Tracheoesophageal Fistula*

OBJECTIVE: This study was designed to evaluate the efficiency of tumor markers level for early diagnosis of ovarian malignancy and for differentiation between benign and malignant ovarian tumors. MATERIALS AND METHODS: We determined preoperative serum tumor markers level in patients who were going to have an operation due to ovarian tumor in OB & GY Dept. of Chonnam University Hospital from April 1993 to September 1999. RESULTS: 1) The average values of serum tumor markers in patients with malingnant ovarian tumors were statistically higher than those of benign ovarian tumors. among malignant ovarian tumors, positive rate of all serum tumor markers was highest in epithelial ovarian carcinoma group. and among ovarian tumor markers, and positive rate of CA 125 was highest in epithelial ovarian carcinoma. 2) Dermoid cyst and endometioma were correlated to CA 19-9, CA 125 levels respectively. for malignant tumors, mucinous ovarian adenocarcinoma and non-mucinous ovarian adenocarcinoma were CA 19-9, CA 125 levels respectively. 3) Among ovarian tumor markers, CA 125 was the most in sensitivity and CA 72-4 was the most in specificity and diagnostic efficiency. 4) For postmenopausal women with ovarian tumors, elevated levels of at least one of the 4 tumor markers were present in the serum in 85.7% of the women who developed cancer, 62.5% of women with borderline, 27.8% of women with benign ovarian tumors. Conclusion; It is suggested that determination of serum tumor markers in patient suspected of ovarian tumor may be helpful to clinician for early diagnosis, differentiation between malignant and benign ovarian tumors.
Adenocarcinoma ; Dermoid Cyst ; Early Diagnosis ; Female ; Humans ; Jeollanam-do ; Mucins ; Sensitivity and Specificity ; Biomarkers, Tumor*

S-100 protein is a mixture of three proteins, that is, S-100 ao(aa), S-100 a(ab) and, S- 100 b(bb). Twenty-two case, of sweat gland tumors were stained with immunoperoxidase technique (ABC method) for the presence of S-100a and b-subunit. Four syringomas, four eccrine poromas, two eccrine porocarcinomas, two ecerine spirdeiomas, one papillary eccrine adenoma, three clear cell hidradenomas, three mixed tumr rs of the skin, two papillary syringocystadenomas, and one cylindroma were included. All specimens were formalin-fixed and paraffin-embedded. The results were as follows : 1) The staining patterns of anti-S-100a and b-protein antibodies we e simillar to those of anti-S-100 protein antibody except in eccrine poroma and porocare nomal. 2) In eccrine poroma and porocarcinoma, scattered S-100-positive dendritic cells within tumor cell nests were stained by S-100-protein antibody (3/6), but not by anti-S-100a protein antibody. S-100p is present in normal Langerhans cells. Therefore this finding suggests that these cells niay be Langerhans cells
Acrospiroma ; Adenoma ; Antibodies ; Antibodies, Monoclonal* ; Carcinoma, Adenoid Cystic ; Dendritic Cells ; Eccrine Porocarcinoma ; Immunoenzyme Techniques ; Langerhans Cells ; Poroma ; S100 Proteins ; Skin ; Sweat Glands* ; Sweat* ; Syringoma

PURPOSE: Considering that renal biopsy is not routinely indicated in nephrotic syndrome in children and the risk of the procedure, we studied that it is possible to predict steroid responsiveness in nephrotic syndrome and the difference in responsivenss is related with the histopathologic type using urinary beta2-microglobulin and N-Acetyl-beta-D-Glucosaminidase activity as a safe and noninvasive method. METHODS: We measured serum creatinine, albumin, cholesterol and urinary creatinine, protein, B2M, NAG at the time of admission and after 2 weeks of treatment in 37 cases of primary nephrotic syndrome in children who were admitted to the Pediatric department of Chung-Ang Medical Center between March 1, 1994 and June 30, 1996. RESULTS: The results were as follows : 1) When urinary B2M value of less than 1000microgram/g creatinine was used as the cut-off value, the test identified steroid responsiveness with a sensitivity of 100%, a specificity of 80%. When urinary NAG activity of less than 100U/hr/mg creatinine was used as the cut-off value, the test identified steroid responsiveness with a sensitivity of 100%, a specificity of 81.8%. 2) Pretreatment urinary B2M levels in Good-response and Poor-response group were 559.8+/-718.5microgram/g creatinine, 3599.1+/-4956.7microgram/g creatinine, respectively. There was statistical significance between the two groups (P<0.05). 3) Pretreatment urinary NAG activity in Good-response and Poor-response group were 42.6+/-23.6U/hr/mg creatinine, 79.6+/-80.1U/hr/mg creatinine, respectively. There was statistical significance between the two groups (P<0.05). CONCLUSIONS: In conclusion, measurement of urinary B2M level and NAG activity for early detection of renal tubular damage is helpful in prediction of steroid responsiveness of primary nephrotic syndrome. If the urinary B2M level and NAG activity are elevated, the patient is suspected to steroid resistance. Therefore, prolonged steroid therapy should be avoided in such patients because of their greater chance of not responding. This approach would reduce the many serious side effects of prolonged treatment in patients who are unlikely to benefit.
Acetylglucosaminidase* ; Biopsy ; Child ; Cholesterol ; Creatinine ; Humans ; Nephrotic Syndrome* ; Sensitivity and Specificity

This study investigated the stress of community residents in Kwang-Ju and Chonnam areas by using the General Health Questionnaire(GHQ-60) as a instrument of stress measurement. The number of subject were 445 residents who lived in three areas (large city, middle city, and rural area) and they were individually interviewed in March, 1994. The result of study showed that the degrees of stress measured by GHQ-60 were statistically significant in the residents' area, age. sex variables: (a) the residents in middle city among three area had the highest level of stress: (b) the resident who were more than 60 in age had the highest level of stress: (c) the female resident had more stress than male residents: (d) particularly, the residents who were more than 60 years old in the middle city had the highest level of stress. Further, the results of factor analysis showed that there were three factors of social dysfunction, depression and anxiety, and psychosomatic symptom. The social dysfunction factor was statistically significant in both age and resident area variables. The depression and anxiety factor was statistically significant in the residents' area, age. sex variables. The psychosomatic symptom factor was statistically significant in both age and sex variables. The study suggested that they should give a special attention to solve the old people's stress because stress was closely related to residents age.
Anxiety ; Depression ; Factor Analysis, Statistical ; Female ; Gwangju ; Humans ; Jeollanam-do ; Male ; Mass Screening* ; Middle Aged ; Surveys and Questionnaires*

OBJECTIVE: To investigate the response of hyperplastic endometrium to Medroxyprogesterone acetate according to the histologic types such as simple typical, complex typical and atypical hyperplasia. METHODS: A total of 79 patients with histologically proved endometrial hyperplasia were enrolled into this prospective study between March 1996 and May 1998. Patients without atypia were placed on a regimen of cyclic therapy with 10mg MPA orally, each day for 14days per month for 3 months. In the cases in which hyperplasia did not regress , MPA was increased to 20mg. Patients with atypical hyperplasia received continuous MPA therapy, 20mg orally each day for 3 month. All patients were followed up for a minimum of 3 months and a maximum of 1 year(mean 7 months). RESULTS: In patients with simple typical hyperplasia, 45 patients(80.4%) had regression, 11 patients(19.6%) had persistence and none had progression. In patients with complex typical hyperplasia, 10 patients(83.3%) had regression, 2 patients(16.7%) had persistence and none had progression. But, in patients with atypical hyperplasia 5 patients(45.4%) had regression, 4 patients(36.4%) had persistence and 2(18.2%) patients had well differentiated endometrial adenocarcinoma. There was no recurrence during the follow up. CONCLUSION: This data suggest that most women with typical hyperplasia respond to progestin therapy, but there is high failure rate of response to progestin therapy and risk of endometrial cancer in patients with atypical hyperplasia. If the young patient desires to preserve her fertility, then progestin therapy may be considered as primary treatment in patients with atypical hyperplasia. But older patients in whom fertility is not an issue, hysterectomy should be selected as treatment of choice for atypical lesion.
Adenocarcinoma ; Endometrial Hyperplasia* ; Endometrial Neoplasms ; Endometrium ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hyperplasia ; Hysterectomy ; Medroxyprogesterone Acetate ; Medroxyprogesterone* ; Prospective Studies ; Recurrence

No abstract available.
Azithromycin* ; Pregnancy* ; Scrub Typhus*