The clinical studies were performen on 304 patients with heart disease who had been received corrective heart surgery at Kosin Medical Center from July, 1984 to December, 1991. The results were as follows: 1) Out of 304 patients, 162 cases (53.3%) were male and 142 cases (46.7%) were female and sex ratio was 1.15:1. 35 cases (11.5%) had clinical cyanosis and 269 cases (88.5%) had no evidence of cyanosis. 2) As age distribution of patients, under 2 years, 3~5 years, 6~10 years, 11~15 years, 16~18 years consist of 22.0%, 26.0%, 29.0%, 16.1% and 6.9%, respectively. 3) As disease distribution, out 304 patients, ventricular septal defect (57.9% of all) was the most common disease, and then atrial septal defect (13.2%), tetralogy of Fallot (11.2%), patent ductus arteriosus (9.9%) and pulmonic stenosis (5.3%), in their order. 4) As sex distribution of each disease, ventricular septal defect, atrial septal defect and tetralogy of Fallot were more common in male and patent ductus arteriosus and pulmonic stenosis were more common in female. 5) The most frequent cardiac anomaly associated with ventricular septal defect and atrial septal defect was pulmonic stenosis. In the case of subarterial ventricular septal defect, aortic insufficiency was associated in 13.3%. 6) Respiratory problems (11.3%), tricuspid regurgitation (9.5%), arrhythmia (6.2%) and congestive heart failure (5.8%) were the major complications after surgery. 7) Case fatality reat was 4.4%. Mortality rate in ventricular septal defect, tetralogy of Fallot and tricuspid atresia were 1.7%, 20.6% and 100%, respectively, Majority (75.0%) of expired patients were died within 24 hours after sugery and the cause of death was hypoxia due to low cardiac output syndrome.
Age Distribution ; Anoxia ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Cause of Death ; Cyanosis ; Ductus Arteriosus, Patent ; Female ; Heart Diseases* ; Heart Failure ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Male ; Mortality ; Pulmonary Valve Stenosis ; Sex Distribution ; Sex Ratio ; Tetralogy of Fallot ; Thoracic Surgery ; Tricuspid Atresia ; Tricuspid Valve Insufficiency

No abstract available.
Pre-Eclampsia* ; Proteinuria*

BACKGROUND: Meicillin-resistant Staphylococcus aureus(MRSA) is a common cause of nosocomial infections worldwide. Identification of strains by molecular typing facilitates epidemiological studies and improves disease control This study was performed to determine the usefulness of mecA-associated hypervariable region(HVR) polymerase chain reaction (PCR) and random amplified polymorphic DNA(RAPD) analysis in the investigation of a nosocomial MRSA infections. METHODS: Methicillin-resistance was identified by NCCLS disk diffusion method using the oxacillin disk. And PCR was done for detection of mecA gene. Antimicrobial susceptibility test, HVR-PCR and RAPD using 3 primers were performed for epidemiological analysis on isolates of MRSA. RESULTS: During the period from 1997 Dec. to 1998 May, 120 strains of S. aureus were isolated from clinical specimens. Among them, 78 strains were MRSA, and 72 strains were mecA positive. The strains of mecA positive MRSA were classified into four types by antibiogram, six genotypes by HVR-PCR, and 29 groups by RAPD using three primers. The combination of HVR genotypes and RAPD analysis showed 43 different types in 72 mecA positive MRSA isolates The five strains which were repeatedly isolated from the same patients showed the same HVR genotypes and RAPD analysis. CONCLUSIONS: Antibiogram, HVR-PCR, and RAPD could classify MRSA isolates into only 4-6 types, respectively, but combination of these methods could improve the typability. And combination of results of RAPD analysis using three primers were better than that using one primer in epidemiological studies of MRSA because of same reasons. It can be concluded that molecular typing of MRSA using HVR-PCR and RAPD assay is useful in epidemiolgical investigation of nosocomial infections caused by MRSA, because of its simplicity and reproducibility.
Cross Infection ; Diffusion ; Epidemiologic Studies ; Genotype ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Microbial Sensitivity Tests ; Molecular Typing ; Oxacillin ; Polymerase Chain Reaction ; Staphylococcus

Global aphasia without other focal neurologic lateralizing signs (GWLS) is an uncommon stroke syndrome. The pathogenesis of GWLS has been thought as the result of multiple cardioembolism. However, a few cases of GWLS with a single lesion have been reported. We report an unusual case of GWLS with a single left superior temporal infarction. A 73-year-old right handed man was admitted with receptive and expressive language impairment without other focal neurologic lateralizing signs. The patient's global aphasia symptom has being 4 weeks after symptom onset. Brain CT showed only one lesion of left superior temporal lobe. Our case notes that the multiple lesions of the speech area are not only necessary to produce GWLS, and it is not necessarily imply a double lesion or an embolic causes.
Aged ; Aphasia* ; Brain ; Hand ; Humans ; Infarction ; Stroke ; Temporal Lobe

No abstract available.
Diagnosis* ; Polycystic Kidney Diseases*

Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors that arise in the wall of the gastrointestinal tract. We report a case of obscure gastrointestinal bleeding due to a GIST of the jejunum successfully documented by videocapsule endoscopy (VCE) and single-balloon enteroscopy (SBE). A 36-year-old man with hematochezia was referred for further evaluation of no evidence of bleeding focus on esophagogastroduodenoscopy and colonoscopy. A VCE showed a suspicious ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion. SBE revealed a nonbleeding 4x2 cm mass with an ulcer at the proximal jejunum. The patient underwent laparoscopic resection without complication. Histological examination revealed a well circumscribed, dumbbell-shaped firm mass comprised of spindle cells. Immunohistochemical staining for CD 117 was diffusely positive, whereas staining for S-100, CD 34 and MIB-1 was all negative. It was confirmed to be a low-grade GIST at the proximal jejunum.
Capsule Endoscopy ; Colonoscopy ; Endoscopy ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Jejunum ; Ulcer

1. Evaluation of the Neural Injury For evaluation of neural injury from the thoracolumbar spine fracture, we should know the type and extent of injury. In case of the complete Spinal Cord Injury( SCI - Frankel classification A), they will not only lose the spinal cord function permanently distal to the injury site, but also show the probability 0~9% from Frankel A to D or E. But in case of the incomplete SCI, they will show sacral sparing and some kind of function will be recovered. The anticipation of recovery from the SCI depend on the results of neurologic examination after the spinal shock. If they have motor sparing, 86% of patients show the recovery of motor function during the first 6 month. The factor that influence to neurologic recovery are the initial kyphosis angle and canal compromising pattern, and do not influenced by treatmet methods. 2. The Factor of the Neural Injury Recovery 1) Conservative treatment in acute stage The inital pathophysiology of SCI is the mechanical injury, but secondary injury will be occur by impairment of blood supply and biochemical alteration, formation of free radial, release of glutamic acid, calcium influx, lipid peroxidation. Immediate methylprednisolone could minimize the spinal cord inury during the first 8 hours, and other GM-1 ganglioside, naloxone, TRH, spinal cord cooling, hyperbaric theraphy will be helpful. 2) Surgical treatment The factor influence the recovery of SCI (1) time interval injury to operation, (2)decompression of neural element, (3) reduction of fractured fragment. 3) Management of the Residual chronic stage Most common cause of death in SCI is urinary complication. We always should consider the improvement bladder function in SCI and the maintenance of low bladder pressure and feel free a bladder symptom.
Calcium ; Cause of Death ; Classification ; Glutamic Acid ; Humans ; Kyphosis ; Lipid Peroxidation ; Methylprednisolone ; Naloxone ; Neurologic Examination ; Shock ; Spinal Cord ; Spine* ; Urinary Bladder

OBJECTIVE: We evaluate the cerebral protective effect of thiopental, propofol and dantrolene in middle cerebral artery occlusion(MCAO) model of rats, which ventilated spontaneously and showed definitely decreased EEG activities which is compatible with cerebral focal ischemia. METHODS: Sprague-Dawley rats were anesthetized with halothane. In control group, halothane(1-1.3 vol%) was inhaled by mask. In thiopental and propofol group, halothane was switched to each drug about 20 minutes before MCAO. In dantrolene group, dantrolene was administered 20 minutes before MCAO with halothane inhalation. Middle cerebral artery was occluded for 120 minutes. The focal ischemic proess was confirmed by ipsilateral suppression of EEG, expressed by compressed spectral array. The volume percentage of infarcted brain was measured. RESULTS: The percentage of infarct volume in thiopental group(13.7+/-4.6%) was significantly smaller than other groups(control group : 28.4+/-4.2%, propofol group:32.3+/-6.7%, dantrolene group : 31.9+/-5.4%). But, there was no statistically meaningful difference between control group, propofol group, and dantrolene group. CONCLUSION: The results of this study indicate that only thiopental has brain protective effect against focal cerebral ischemia.
Animals ; Brain ; Brain Ischemia* ; Dantrolene* ; Electroencephalography ; Halothane ; Infarction, Middle Cerebral Artery* ; Inhalation ; Ischemia ; Masks ; Middle Cerebral Artery* ; Propofol* ; Rats* ; Rats, Sprague-Dawley ; Thiopental*

No Abstract Available.
Humans ; Interleukin-12* ; Interleukin-18* ; Tuberculosis, Pleural*

Medullary respiratory centers are composed of two respiratory groups: dorsal and ventral. A dorsal respiratory group consists primarily of inspiratory neurons. A ventral respiratory group consists both of inspiratory and expiratory neurons. A direct infarction of their structure may lead to a complete loss of respiratory drive involving both automatic and voluntary components. A 78-year-old man was admitted with sudden dysarthria, dizziness, and bilateral ophthalmoplegia. On the second and third hospital day, he nearly had a complete loss of respiratory drive involving both automatic and voluntary components. He did not get the respiratory drive during CO2 retention while consciousness and motor were preserved. Brain MRI showed unilateral lesions involving the medullary reticular formation, nucleus tractus solitarius, nucleus ambiguus, and nucleus retroambiguus but sparing the corticospinal tract. Unilateral medullary infarction may lead to severe respiratory failures not limited to automatic responses, which differentiates it from Ondine's curse.
Aged ; Brain ; Cerebral Infarction ; Consciousness ; Dizziness ; Dysarthria ; Humans ; Infarction ; Magnetic Resonance Imaging ; Medulla Oblongata ; Neurons ; Ophthalmoplegia ; Pyramidal Tracts ; Respiratory Center ; Respiratory Insufficiency* ; Reticular Formation ; Solitary Nucleus