Pulmonary artery aneurysms are very rare. They are usually associated with congenital cardiac defect. We present one case of pulmonary artery aneurysm associated with patent ductus arterious with the review of the literatures.
Aneurysm* ; Ductus Arteriosus, Patent* ; Pulmonary Artery*

No abstract available.
Colorectal Neoplasms*

PURPOSE: This study aimed to develop a systematic career-coaching program (SCCP) that can be used by medical teaching schools to address a growing need for career-coaching. The program objectives were to help students (1) develop a comprehensive self-understanding of their aptitudes, interests, and personality traits; (2) explore possible career choices and decide on a career path; and (3) develop the competencies needed to prepare for their future careers. METHODS: The SCCP was based on the ADDIE (analysis, design, development, implementation, and evaluation) model and decision-making questioning model. Medical professionals, medical education and career counseling experts, and students participated in designing the program. RESULTS: The SCCP describes coaching content, tools, operational methods, and appropriate timing, and identifies the professionals and specialists who can offer their expertise in the different coaching phases. It is designed to allow medical schools to offer the program in segments or in its entirety, depending on the curriculum and environment. CONCLUSION: The SCCP represents a viable career-coaching program for medical students that can be applied in part or in its entirety, depending on a medical school’s curriculum and educational environment.
Aptitude ; Career Choice ; Counseling ; Curriculum ; Education, Medical ; Humans ; Professionalism ; Schools, Medical ; Specialization ; Students, Medical* ; Vocational Guidance

One family with asymmetric septal hypertrophy was reported. The propositus of this family was 31 years old man who was admitted because of transient syncope. His father and one brother were affected but asymptomatic. His sister was suddenly died at age 21 years. The interventricular septal thickness to left ventricular posterior wall thickness ratios were measured using M-mode echocard ogram. In the affected family, echocardiogram revealed asymmetric septal hypertrophy (1.5:1, 2:1, 1.9:1 respectively). In the propositus, cardiac catheterization and simultaneous biventricular cineangiography were performed. Pressure study revealed mild peak systolic pressure gradient within left ventricular apex and left ventricular outflow tract (4mm Hg respectively). Biventricular cineangiogram showed the septal width increased inferiorly, and left ventricular endocardial surface of the septum was straight, while the right ventricular border convex toward the right ventricle.
Adult ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Cineangiography ; Fathers ; Heart Ventricles ; Humans ; Siblings ; Syncope

Reconstruction of the male urethra is required for a multitude of congenital anomalies, such as hypospadias and epispadias, as well as fort acquired lesions such as stricture disease and trauma. No method is appropriate for all types of repair of the urethra. A successful surgical reconstruction of the urethra is the result of a proper operative selection that depends on the site and length of the disrupted urethra and also depends on, as well as the experience of the surgeon. Reconstruction of the urethra has been performed by the use of homografts, silicone tubes, grafts taken from the bladder mucosa. But serious postoperative problems, such as urinary fistula, urethrostenosis, stricture of the site of urethral anastomosis, and diverticulum formation, are not uncommon. Especially, reconstruction of Proximal urethra is very difficult because of limitations of operation field exposure and flap transfer. However, the hairless median scrotal skin flap with the scrotal septum attached, rich in neurovascular plexus, is ideal material for creating a new urethra without interference to its blood supply and other complications. We experienced a successful reconstruction of the proximal urethral defect in about 8cm length and perineal sore with pedicled scrotal septal flap and gracilis musculocutaneous flap, respectively.
Allografts ; Constriction, Pathologic ; Diverticulum ; Epispadias ; Female ; Humans ; Hypospadias ; Male ; Mucous Membrane ; Myocutaneous Flap ; Silicones ; Skin ; Transplants ; Urethra ; Urinary Bladder ; Urinary Fistula

PURPOSE: We reviewed the results of endoureterotomy and balloon dilation for benign ureteral strictures to determine the efficacy of these procedures. MATERIALS AND METHODS: We treated 19 patients who had benign ureteral stricture by retrograde endoureterotomy or balloon dilation followed by placement of a 6-8Fr stent for 6 weeks. Mean follow up period was 14 months (6-27 months). Eight patients were treated by endoureterotomy using cold knife under direct vision and 11 patients were treated by balloon dilation. The causes of ureteral strictures were abdominal surgery in 8 patients, urinary tuberculosis in 6 patients, radiation therapy in 2 patients, rigid ureteroscopy in 2 patients and periureteral abscess in 1 patient. The length of strictures was shorter than 1cm in 14 patients and over 1cm in 5 patients. The etiology of strictures was ischemic origin in 11 patients and nonischemic in 8 patients. One patient had poor ipsilateral renal function (<25%). RESULTS: The overall success rate was 78.9% (15/19). The success rate of balloon dilation was 81.8% (9/11) and that of endoureterotomy was 75% (6/8). No significant complication such as high fever or sepsis was observed. Strictures shorter than 1cm had 92.9% (13/14) success rate while strictures over 1cm had 40% (2/5) success rate (p <0.05). The nonischemic strictures had better success rate (87.5%) compared to ischemic strictures (72.7%) without statistical significance. CONCLUSIONS: We would suggest the use of balloon dilation or endoureterotomy as the initial treatment of benign ureteral stricture regarding the safety and efficiency. The better outcome would be expected in the strictures shorter than 1cm in length.
Abscess ; Constriction, Pathologic* ; Fever ; Follow-Up Studies ; Humans ; Sepsis ; Stents ; Tuberculosis ; Ureter* ; Ureteroscopy

PURPOSE: To evaluate the changes in break-up time (BUT) and corneal sensitivity following LASIK surgery for refractive error correction with presbyopia in patients older than 45 years. METHODS: The authors of the present study measured the BUT and corneal sensitivity of 92 eyes that received LASIK surgery for correcting refractive error with presbyopia. The eyes were divided into groups according to gender and preoperative refractive error before surgery and 1, 3, 6 and 12 months after LASIK. RESULTS: The mean age of patients was 52.01 +/- 5.51 years, and the male to female eye distribution was 31:61. The value of BUT before surgery and 1, 3, 6, and 12 months postoperative was 5.31 +/- 2.03 sec, 4.47 +/- 1.67 sec, 4.04 +/- 1.58 sec, 4.53 +/- 1.51 sec, and 4.87 +/- 1.46 sec, respectively; corneal sensitivity was 56.35 +/- 5.94 mm, 40.07 +/- 14.21 mm, 46.42 +/- 10.41 mm, 50.75 +/- 8.04 mm, and 52.92 +/- 7.51 mm, respectively. BUT was not significantly different relative to refractive error and was significantly shorter in the female group than the male group at 1 month postoperative. Corneal sensation of myopia at 12 months postoperative was statistically higher than at other time points; however, there was no difference between genders. BUT and corneal sensitivity at 12 months postoperative recovered to 91.6% and 93.9% of the preoperative value, respectively. CONCLUSIONS: BUT and corneal sensitivity after LASIK for presbyopia were decreased until 12 months postoperative and recovered slowly, but did not return to preoperative levels.
Eye ; Female ; Humans ; Keratomileusis, Laser In Situ ; Male ; Middle Aged ; Myopia ; Presbyopia ; Refractive Errors ; Sensation ; Tears

The purpose of this study was to evaluate the effects of EDTA and pulsed Nd:YAG laser on apical leakage of canal obturation. Forty-eight single-rooted teeth were used in this study. The teeth were instrumented up to a size 40 K-file and irrigated with 2.5% NaOCl between each file size. And the teeth were divided into 4 groups. In group A, the root canals were irrigated with a final flush of 5ml 2.5% NaOCl as a control group. The teeth in group B were irrigated with a final flush of 5ml 17% EDTA. The teeth in group C and D were irradiated by pulsed Nd:YAG laser(laser parameters were set at 1W, 100mJ, 10Hz, and 2W, 100mJ, 20Hz respectively). The results were as follows: 1. Apical leakage was observed in 50% of samples in group A, 30% of samples in group B, 20% of samples in group C, and 10% of samples in group D. 2. The teeth in group B had less leakage than group A, but there was no statistically significant differences(p>0.05). 3. The teeth in group C, D had less leakage than group A, and there was statistically significant differences(p<0.05). 4. The teeth in group C, D had less leakage than group B, but there was no statistically significant differences(p>0.05). 5. There was no significant differences in apical leakage between group C and group D(p>0.05).
Dental Pulp Cavity ; Edetic Acid* ; Smear Layer ; Tooth

Deregulation of G1 cyclins has been reported in several human and rodent tumors including colon cancer. To investigate the expression pattern of G1 cyclins in 1,2- dimethyl-hydrazine dihydrochloride (DMH)-induced rat colon carcinogenesis, we studied the expression of cyclin D1 and cyclin E by quantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis and immunohistochemistry (IHC). The mRNA level of cyclin D1 was increased 1.2-fold in adenocarcinomas but not significantly in adenomas, when compared with normal rat colonic mucosa (p<0.05). The cyclin E mRNA level was increased 2.7-fold in adenomas and 3.3-fold in adenocarcinomas (p<0.05). The PCNA mRNA level was also increased 1.9-fold in adenomas and 1.8-fold in adenocarcinomas (p<0.05). Immunohistochemical staining revealed exclusive nuclear staining of the neoplastic cells for cyclin D1, cyclin E and PCNA. Cyclin D1 expression was detected in 56.3% of the adenomas and in 61.5% of the adenocarcinomas examined, whereas cyclin E expression was detected in 87.5% of the adenomas and in 92.3% of the adenocarcinomas. Overall, cyclin D1, cyclin E and PCNA expression was significantly increased at both the mRNA and protein levels in normal colonic mucosa, adenomas and adenocarcinomas, but there was no significant difference in the degree of expression of these genes in adenomas and adenocarcinomas. Our results indicate that the overexpression of cyclin D1 and cyclin E may play an important role during the multistage process of rat colon carcinogenesis, at a relatively early stage, and may disturb cell-cycle control in benign adenomas, and thereafter, participate in tumor progression.
1,2-Dimethylhydrazine/toxicity ; Adenocarcinoma/*chemically induced/metabolism ; Adenoma/*chemically induced/metabolism ; Animals ; Carcinogens/toxicity ; Cell Cycle/drug effects/physiology ; Colon/metabolism ; Colonic Neoplasms/*chemically induced/metabolism ; Cyclin D1/*biosynthesis/genetics ; Cyclin E/*biosynthesis/genetics ; Gene Expression Regulation, Neoplastic ; Immunohistochemistry ; Male ; Proliferating Cell Nuclear Antigen/biosynthesis/genetics ; RNA, Messenger/metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUND: Mitral regurgitation is a valvular heart disease that produce complex hemodynamic alternations and myocardial dysfunction occurs subclinically, so result in a high incidence of left ventricular dysfunction that might affect postoperative result. In order to assess preoperative factors affecting the outcome of mitral valve replacement in patients with chronic mitral regurgitaion, we evaluated prognostic factors from preoperative clinical, laboratory, and echocardiographic findings in 71 patients with chronic mitral regurgitation who received mitral valve replacement. METHODS: From 1985 to 1994, 71 patients with chronic mitral regurgitation, who received mitral valve replacement, were included in this study. The patients were defined as group I who had improved symptom and / or decreased left ventricular end-diastolic dimension after operation, and group II who had persistent symptom and / or over 60mm of left ventricular end-diastolic dimension after operation. RESULTS: 1) In clinical findings, preoperative systolic blood pressure was higher in Group I patients(p<0.05). 2) Hemoglobin, serum creatinine, and blood urea nitrogen level were not significantly different in both groups. 3) In echocardigraphic findings, left atrial dimension, left ventricular end-systolic / end-diastolic dimension, and left ventricular volume index of Group II were much higher than those of Group I patients(p<0.05). 4) In the discriminant analysis, left ventricular end-diastolic dimension, age, NYHA functional class, and left ventricular mass index were defined as important prognostic factors. CONCLUSION: According to the above results, preoperative age, NYHA functional class are significant prognostic factors in clinical and laboratory findings. And left atrial dimension, left ventricular end-systolic and end-diastolic dimensions, left ventricular volume index, and left ventricular mass index are significant prognostic factors in echocardiographic findings.
Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Echocardiography ; Heart Valve Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Insufficiency* ; Mitral Valve* ; Ventricular Dysfunction, Left