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.
Adenocarcinoma* ; Scrotum* ; Stomach Neoplasms*

No abstract available.
Biopsy*

A healthy 12-year-old girl had noted over 2 years a gradual-growing painless nodule on the area below the right axilla. The lesion measuring approxima:;ely 1.2 x 1.2 x 0.4cm in size, had a reddish-blue colored ulcerative papule raised on its cente with mucous discharge to compression. Histopathelogically, a circumscribed solid tumor located in the deep dermis, revealed the predominnntly epidermoid features of polyhedral cells, with the mucous cells within and at the peripiiery of the tumor. The mucous cells exhibited diastase-resistant PAS -positive, alcian-blue reactive at pH 2.5 and mucicarmine-positive reactions. Results of irnmunoperoxidase staining for cytokeratin and carcinoernbryonic antigen were focally cytoplasmic-positive, while negative for S-100 protein and epithlial membrane antigen. She has remained free of disease one year following excision.
Acrospiroma* ; Axilla ; Child ; Dermis ; Female ; Humans ; Hydrogen-Ion Concentration ; Keratins ; Membranes ; S100 Proteins ; Ulcer

Arnold-Chirai malformation type II is congenital disorder which consists of downward displacement into upper cervical spinal canal of parts of the cerebellum, 4th ventricle, and medulla oblongata. We experienced two cases of Arnold-Chiari malformation with lumbar meningomyelocele, hydrocephalus. We confirmed the cases by brain C-T and report with brieft review of the lilterature.
Arnold-Chiari Malformation* ; Brain ; Cerebellum ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Hydrocephalus ; Medulla Oblongata ; Meningomyelocele ; Spinal Canal

No abstract available.
Sinusitis*

We report a case of epidermolysis bullosa simplex occurred in a 12-year-old girl, who presented with intractable bullous lesions of the hands and feet after minor traumas ever since her early neonatal period. The bullous lesions were noted on the 2nd and 4th webs of the fingers and dorsum of the hands as well as on the skin of the ankle. The lesions were healed without scar formation. Family history was not contributary and seasonal pattern was not noted. Histologic sections revealed intraepidermal bullae just above the well preserved basement membrane. Electron microscopic findings revealed cytolysis of basal cells with preservation of the basement membrane, indicating the epidermal type of epidermolysis bullosa simplex.
Infant, Newborn ; Humans

No abstract available.
Myoepithelioma* ; Trachea*

PURPOSE: We examined the relationship between BIS, sedation score and plasma midazolam concentration to verify the usefulness of BIS to assess the patient's consciousness during sedation. PATIENTS AND METHODS: Twenty-five young, healthy adult volunteers participated in this clinical study. Midazolam was administered intravenously up to 0.08 mg/kg to induce unconsciousness and we monitored the patient's physiological and conscious status until complete recovery from sedation. BIS and sedation score were measured before sedation, 10, 20, 30 minutes after midazolam administration. Plasma midazolam concentration was measured 10 minutes after midazolam administration. BIS was measured using A-2000 BISTM monitor (Aspect Medical Systems, USA) and the degree of sedation was evaluated with the sedation score. RESULTS: The BIS score correlated with the sedation score (r = 0.676, P < 0.05). With the decreased plasma midazolam concentration, the correlation was better with sedation score(r = -0.656).Although BIS values did not correlate with calculated plasma concentration of midazolam (r = 0.467) at 10 minutes after midazolam administration, values after sedation were well distinguished from those before sedation. CONCLUSIONS: BIS is known for an effective predictor of patient's hypnotic state, and it is correlated with the sedation score. But, it doesn't always coincide with the clinical parameters of depth of sedation. So more attention is needed using BIS only during sedation, and it is advisable that the patient's consciousness is monitored with variable sedation score systems every several minutes.
Adult ; Consciousness ; Humans ; Midazolam* ; Plasma* ; Unconsciousness ; Volunteers