Torsades de pointes is characterized by paroxysms of ventricular tachycardia at rates typically greater than 200 beats/min in which QRS morphology shows alternating polarity in an undulating pattern so that the complexes appear to be twisting about the beseline;this arrhythmia is virtually always associated with prolongation of the QT interval. Its importance lies not in its unusual structure but in the potentially fatal outcome if conventional treatment is administred. Torsades de pointes was diagnosed in 4 patients;the first with hypokalemia, the second with congenital QT prolongation syndrome, the third with amiodarone, the fourth with organophosphorous and hypokalemia. Treatment of these patients consisted of potassium supply, isoproterenol, lidocaine, phenobarbital, tenormin, phenytoin, cardioversion, atropine. Three patients improved successfully, but one patient died, as a direct result of the ensuing ventricular fibrillation and cardiac arrest on one hour after admission.
Amiodarone ; Arrhythmias, Cardiac ; Atenolol ; Atropine ; Electric Countershock ; Fatal Outcome ; Heart Arrest ; Humans ; Hypokalemia ; Isoproterenol ; Lidocaine ; Phenobarbital ; Phenytoin ; Potassium ; Tachycardia, Ventricular ; Torsades de Pointes* ; Ventricular Fibrillation

Anomalous origin of one pulmonary artery from the ascending aorta is a rare congenital malfomation. To date, there have been 60 reported cases in the literature. Usually the right pulmonary artery arises form the ascending aorta and other malformations such as patent ductus arteriosus are commonly associated. Early diagnosis is essential because congestive heart failure develops in early life and operation is contraindicated if severe pulmonary vascular changes have occurred. We report a case of anomalous origin of right pulmonary artery from the ascending aorta, which is associated with patent ductus arteriosus and severe pulmonary hypertension. She was diagnosed by digital subtractional angiography and cardiac catheterization.
Angiography ; Aorta* ; Cardiac Catheterization ; Cardiac Catheters ; Ductus Arteriosus, Patent ; Early Diagnosis ; Heart Failure ; Hypertension, Pulmonary ; Pulmonary Artery*

Chronic ruptures of the patellar tendon are uncommon injuries. They are technically difficult to repair because of scar formation, poor quality of the remaining tendon, and quadriceps muscle atrophy and contracture. We report a case on the reconstruction of a chronic patellar tendon rupture. The reconstruction was performed 18 months after the injury, using an Achilles tendon allograft and reinforcing suprapatellar wire. At four weeks postoperative, the patient had attained 70degrees C flexion and 10degrees C extension lag. Nine months after the index procedure, the patient regained 130degrees C flexion and 5degrees C extension lag, and 85% quadriceps strength. The technique accomplished the preoperative goals of restoring quadriceps function and anatomic position of the patella as well as allowing early mobilization after surgery. Although this reconstructive procedure is technically demanding, the functional results obtained can be excellent. We recommend the use of this technique for chronic patellar tendon ruptures that cannot be primarily repaired.
Achilles Tendon ; Allografts* ; Atrophy ; Cicatrix ; Contracture ; Early Ambulation ; Humans ; Patella ; Patellar Ligament* ; Quadriceps Muscle ; Rupture* ; Tendons

BACKGROUND: Chronic suppurative otitis media is one of the most common disease in the otolaryngologic field. It is important to choose of antibiotics in the management of chronic suppurative otitis media. OBJECTIVES: Bacteriologic studies can make it possible to use appropriate antibiotics. MATERIALS AND METHODS: The bacteriologic study was made on 98 cases of chronic suppurative otitis media who visited the department of otolaryngology, Dae Dong Hospital in Pusan from Nov. 1989 to Dec. 1995 and the following results were obtained. RESULTS: 1) In 90 cases in which pathogenic organism was isolated, single infection was 81 cases(90%) and mixed infection was 9 cases(10%). 2) The most frequent pathogenic organism was Staphylococcus(46.5%) and Proteus(16.1%), Pseudomonas(14.1%), Providencia(10.1%) were the next. 3) In the aspect of the sensitivity to antibiotics, Ciprofloxacin, Ceftriaxon and Amikacin were sensitive drug generally. 4) Staphylococcus was sensitive to Vancomycin and Ciprofloxacin. 5) Proteus was sensitive to Amikacin, Ciprofloxacin, and Ceftriaxon. 6) Pseudomonas was sensitive to Ciprofloxacin, Amikacin and Piperacin. 7) Providencia was sensitive to Ciprofloxacin, Ceftriaxon, Amikacin and Piperacin. 8) Methicillin Resistant Staphylococcus Aureus(MRSA) was 19 Strains(45.5%). CONCLUSION: Recently, pathologic strain and it's sensitivity to antibiotics has changed. So, we recommand that periodic bacteriologic study and sensitivity test should be done for effective management of chronic otitis media.
Amikacin ; Anti-Bacterial Agents ; Bacteriology ; Busan ; Ceftriaxone ; Ciprofloxacin ; Coinfection ; Methicillin Resistance ; Otitis Media ; Otitis Media, Suppurative* ; Otolaryngology ; Proteus ; Providencia ; Pseudomonas ; Staphylococcus ; Vancomycin

No abstract available.
Pregnancy*

Drug-induced liver injury (DILI) is the serious and fatal drug-associated adverse effect, but its incidence is very low and individual variation in severity is substantial. Acetaminophen (APAP)-induced liver injury accounts for >50% of reported DILI cases but little is known for the cause of individual variations in the severity. Intrinsic genetic variation is considered a key element but the identity of the genes was not well-established. Here, pre-biopsy method and microarray technique was applied to uncover the key genes for APAP-induced liver injury in mice, and a cause and effect experiment employing quantitative real-time PCR was conducted to confirm the correlation between the uncovered genes and APAP-induced hepatotoxicity. We identified the innately and differentially expressed genes of mice susceptible to APAP-induced hepatotoxicity in the pre-biopsied liver tissue before APAP treatment through microarray analysis of the global gene expression profiles (Affymetrix GeneChip® Mouse Gene 1.0 ST for 28,853 genes). Expression of 16 genes including Gdap10, Lpl, Gabra3 and Ccrn4l were significantly different (t-test: FDR <10%) more than 1.5 fold in the susceptible animals than resistant. To confirm the association with the susceptibility to APAP-induced hepatotoxicity, another set of animals were measured for the expression level of selected 4 genes (higher two and lower two genes) in the liver pre-biopsy and their sensitivity to APAP-induced hepatotoxicity was evaluated by post hoc. Notably, the expressions of Gabra3 and Lpl were significantly correlated with the severity of liver injury (p<0.05) demonstrating that these genes may be linked to the susceptibility to APAP-induced hepatotoxicity.
Acetaminophen ; Animals ; Drug-Induced Liver Injury ; Genetic Variation ; Incidence ; Lipoprotein Lipase* ; Lipoproteins* ; Liver ; Methods ; Mice ; Microarray Analysis ; Real-Time Polymerase Chain Reaction ; Receptors, GABA-A* ; Toxicogenetics ; Transcriptome

BACKGROUND/AIMS: Liver cirrhosis is an end-stage liver disease. Ito cell is known to have central role in fibrogenes is of liver cirrhosis. But collagen content and Ito cell activity in liver cirr hosis have received little attention. So Ito cell activity and hepatocyte proliferation activity according to collagen content was investigated. WAF-1 and c- met were studied to evaluate the effect of cell cycle. METHODS: We analyzed 56 cases of liver cirrhosis ( viral:41, biliary:11, alcoholic:2, Wilson' s disease:2). Collagen content was measured by spectrophot ometry. Ito cell activity and prolifer ation index was measured by-SMA and Ki- 67 immunohistochemistry. RESULTS: In viral cirrhosis, high collagen group showed increased Ito cell activity compared to low collagen group. There was no difference in hepatocyte prolifer ation activity bet ween high and low collagen group in viral cirrhosis. In biliary cirrhos is, high collagen group showed increased Ito cell activity in septal zones compared to low collagen group. WAF- 1and c- met were negative in most of cases. CONCLUSION: Collagen content of liver cirrhosis is closely related to increment of activated Ito cells . Ito cell activity was prominent in septal zones than in parenchymal areas of viral cirrhosis and that was only significant in septal zones of biliary cirrhosis. There is no correlation bet ween collagen content and hepatocyte proliferation activity.
Cell Cycle ; Collagen* ; Fibrosis ; Hepatic Stellate Cells ; Hepatocytes* ; Immunohistochemistry ; Liver Cirrhosis* ; Liver Cirrhosis, Biliary ; Liver Diseases ; Liver*

BACKGROUND: In primary total hip replacements (THRs), the dissected femoral heads (FHs) are commonly used to make the bone-chips for the reconstruction in the orthopaedic surgery. The donated FHs are routinely microbiologically cultured to identify and contaminated FHs are discarded. This study examines whether a positive FH culture predicts an infection and prosthetic failure after primary THR. METHODS: The study sampled 274 donated FHs from patients with osteonecrosis (ON), hip joint osteoarthritis (OA), and femoral neck fracture (FNF) in THR to culture the microbes. The FH contamination rates were analyzed for ON, OA, and FNF groups. Proportion of the postoperative infection or prosthetic failure in the group of donors with a positive FH culture were compared to the proportion in the group of donors with a negative FH culture. RESULTS: The rates of the positive culture in the ON, OA, and FNF groups were 7.1%, 3.8%, and 4.0%, respectively. The infection rate was found to be non-significantly greater in the ON group than in the OA and FNF groups. In the negative culture group, one patient (0.63%) had a postoperative superficial infection, and five patients (3.2%) experienced additional surgeries including a fixation for a periprosthetic fracture, within a minimum follow-up of two years. However, no postoperative infection was encountered, and no revision surgery was required in the positive culture group. CONCLUSIONS: A positive FH culture is not always associated with elevated risks of infection or prosthetic failure after THR. Therefore, such finding cannot be used as a prognostic factor of THR. The FHs that return a positive culture may not lead to the orthopaedic assessment of an infection or other postoperative complication risks in primary THR.
Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip/adverse effects/*methods ; Female ; Femoral Neck Fractures/surgery ; Femur Head/*microbiology ; Humans ; Male ; Middle Aged ; Osteoarthritis, Hip/surgery ; Osteonecrosis/surgery ; Prognosis ; Prosthesis-Related Infections/*microbiology ; Staphylococcus/isolation & purification

This study aimed to explore the use of three-dimensional reconstructed computed tomography images of the adult humerus for forensic anthropological sex estimation in the Korean population. In forensic anthropology, the skull and pelvic bone show high accuracy in sex estimation; however, when they are impaired, other bones should be available for sex estimation. Six hundred images of the right and left humerus pair were used. A logistic regression analysis was performed by measuring the volumes of 500 images and the remaining 100 images were used in the metric sex estimation. Both the logistic regression and metric measurements were performed separately on three regions of the right and left humerus: the head, mid-shaft, and digital regions, The accuracy of sex estimation in the right humerus was 93% (91% for men and 96% for women), 92% (93% for men and 91% for women), and 87% (85% for men and 89% for women) for the head, mid-shaft, and digital regions, respectively. Sex estimation accuracy in the left humerus was 92% (89% for men and 96% for women), 93% (96% for men and 89% for women), and 91% (91% for men and 91% for women) for the head, mid-shaft, and digital regions, respectively. These results contribute to high accuracy and reliability in sex estimation using three-dimensional images of the humerus in Koreans, whereas the two-dimensional metric method provided limited information on bone measurements.