Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.
Aorta ; Arteries ; Bradycardia ; Cause of Death ; Chest Pain ; Diagnosis ; Emergencies ; Heart Rupture* ; Hematoma ; Humans ; Infarction ; Myocardial Infarction ; Rupture ; Shock ; Transplants

Craniopharyngioma is one of the most challenging, Frustrating, and humbling benign intracranial tumors of childhood. Its behavior is a clinical malignancy even though it is benign tumor in microscopically. There is no single treatment of craniopharyngioma and there must be a plan customized for eacg patient. This decision may, be made from diagnostic studies alone, but in most cases exploration of the tumor and the testing of its adherence to its surroundings will be the only thorough and fair way to determine whether it can be totally excised or not. So the choice of treatment is "individualize". We experienced one case of giant cystic craniopharyngioma and performed combined operaion whih were percutaneous intermittent drainage of cystic fluid through Ommaya reservoir and following microsurgical radial excision. There was no complication and marked intellectual and psychological improvement until todays for 20 months.
Craniopharyngioma ; Drainage* ; Humans

Sixty five patients of lumbar spondylolisthesis were treated with pedicle screw fixation during last 3-years. Roy-Camille plate system has been used in 17 patients, steffee system in 41 and Puno/Winter/Byrd(PWB) system in 7. We analysed the changes of symptoms and radiological findings during follow-up observation(average 15 months). After surgery the average time for low back pain reduction was 7 months, Twenty patients(3%) complained a graft donor site pain initially, but almost except one were alleviated after 7.3 months later on an average. Radiologically the reducton degree of the displacement was from 24% on preoperative state to 12% on last follow-up and pseudoarthrosis rate was 8%. Surgical result was evaluated by our score rating system, according to that system 64.5% of the patients had satisfactory result.
Follow-Up Studies* ; Humans ; Low Back Pain ; Pseudarthrosis ; Spondylolisthesis* ; Tissue Donors ; Transplants

Roberts syndrome is an autosomal recessive disorder accompanied by limb defects, craniofacial abnormalities, pre-and postnatal growth retardation. Patients with Roberts syndrome have characteristic premature separation of heterochromatin of many chromosomes and abnormalties in celldivision cycle. We have experienced a case of Roberts syndrome in an immature neonate The patients showed characteristic clinical features of multiple, severe facial mid-line clefts, and tetraphoco-amelia. The brief review of the literlature was made.
Craniofacial Abnormalities ; Ectromelia ; Extremities ; Heterochromatin ; Humans ; Infant, Newborn

The development of CT scan and stereotaxic surgery with urokinase irrigation made possible early diagnosis and improved survival in the patients of spontaneous intraparenchymal hemorrhage. We had clinically reviewed and analyzed 30 patients of stereotactically treated spontaneous intraparenchymal hemorrhage, according to the hematoma volume, ICP, wital signs, GCS and prognosis. The results were summarized as follows: 1) As the hematoma volume increasing, ICP was also increased(p<0.05). 2) The systolic arterial pressure was increased as the hematoma volume increasing(p<0.05). 3) Mean ADL was 55(26% and ADL level were decreased in cases of large hematoma(p<0.05). 4) As the hematoma volume increasing, the level of verbal GCS and total GCS was low(p<0.1). 5) No significant correlation was noted between the hematoma volume and complications(T test).
Activities of Daily Living ; Arterial Pressure ; Blood Pressure* ; Early Diagnosis ; Hematoma* ; Hemorrhage* ; Humans ; Intracranial Pressure ; Prognosis* ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator

PURPOSE: Chemical lights, also called Luminous Sticks, consist of a solution of diphenyl oxalate (C14H10O4) and hydrogen peroxide (H2O2). Human tissue can be damaged when the mixed solution contacts the human body. The authors report a single case of chemical injury of keratoconjunctiva by exposure to chemical lights. CASE SUMMARY: A 47-year-old man's right eye accidentally contacted the fluorescent material when breaking a Luminous Stick 7 days before being referred to our clinic. He had pain in the right eye and experienced visual loss. The patient's best corrected visual acuity in the right eye was 20/50. An ulcerative lesion with edema at the inferior bulbar and palpebral conjunctiva and coneal epithelial defect was observed upon biomicroscopic examination. The patient was hospitalized and antibiotics, steroids, mydriatic and artificial tear eye drops were applied for treatment. After 9 days of treatment, the best corrected visual acuity of the patient recovered to 20/20, and the conjunctiva and cornea were mostly healed. No complication was observed. CONCLUSIONS: Chemical lights are commonly used in concerts and festivals. If the contents contact the eyes when breaking he chemical lights, various chemical burns can occur and cause ophthalmologic complications. Since no regulations have been passed regarding chemical lights, safety education and supervision are considered to be necessary for children.
Anti-Bacterial Agents ; Biphenyl Compounds ; Burns, Chemical ; Child ; Conjunctiva ; Cornea ; Edema ; Eye ; Holidays ; Human Body ; Humans ; Hydrogen Peroxide ; Light ; Middle Aged ; Ophthalmic Solutions ; Organization and Administration ; Social Control, Formal ; Steroids ; Tears ; Ulcer ; Visual Acuity

No abstract available.
Cadaver* ; Kidney Transplantation* ; Kidney*

Fourty one cases with coronary occlusive disease were anesthetised for aortocoronary bypass graft from May 1977 to December 1983 st Severance Hospital, Yonsei University Medical Center. The main anesthetic agents were diazepam-morphine-pancuronium-O2-N2O in most cases, and supplemented with halothane, enflurane of methoxyflurane in some cases. Nitroglycerin, nitroprusside, triflupromasine, and dopamine were used for keeping the hemodynamic stability before, during and after anesthesia depending on the needs. Two operative death occured in our early years. The mortality rate was 4.87% and no late deaths. The overall anesthetic management for aortocoronary bypass graft surgery is disscussed.
Academic Medical Centers ; Anesthesia* ; Anesthetics ; Coronary Artery Bypass ; Dopamine ; Enflurane ; Halothane ; Hemodynamics ; Methoxyflurane ; Mortality ; Nitroglycerin ; Nitroprusside ; Transplants*

No abstract available.
Cadaver* ; Kidney Transplantation* ; Kidney*

OBJECTIVES: Cholesterol interacts with serotonin and it has been found to be associated with some clinical symptoms of mood disorders. There is a paucity of data on first onset bipolar patients and from Asian population. In this study, we compared the total choelsterol (TC) level between the bipolar I patients with a single manic episode (BPSM) and the normal controls, and investigated the relationship between the TC level and treatment response in the BPSM. METHODS: Twenty-five BPSM and thirty normal controls were enrolled in this study. The pretreatment and posttreatment TC levels in the BPSM were measured and comapred to that of normal controls. Young Mania Rating Scale (YMRS) was used for assessing symptom severity in the BPSM. RESULTS: The TC level was significantly lower in the BPSM than in the controls. There were negative correlations between the YMRS scores and the pretreatment TC level in the BPSM. The posttreatment TC level was significantly higher than the pretreatment TC level in the BPSM. CONCLUSION: This study suggests that the TC level can be changed after treatment in bipolar manic patients, although more studies involving different ethnic groups will be needed. Further longitudinal studies will be needed to examine the change of total cholesterol level according to the clinical course of bipolar disorder.
Asian Continental Ancestry Group ; Bipolar Disorder ; Cholesterol* ; Ethnic Groups ; Humans ; Mood Disorders ; Serotonin