The rupture of a renal artery aneurysm is a rare disease that is difficult to diagnose. Although we usually consider the appropriate treatment to be open laparotomy with aortic aneurysm surgery or stenting with graft insertion through intravascular intervention, thus far, there is no general consensus on the treatment protocol for renal artery aneurysm. Notably, ruptured renal artery aneurysm is a true critical emergency that may result in a fatal outcome. We are reporting two renal artery aneurysm patients who had ruptured and underwent emergency laparotomy.
Aneurysm* ; Aortic Aneurysm ; Clinical Protocols ; Consensus ; Emergencies ; Fatal Outcome ; Humans ; Laparotomy ; Rare Diseases ; Renal Artery* ; Rupture ; Stents ; Transplants

Stent entrapment is a very rare complication of percutaneous coronary intervention. The interventional approach could be a treatment strategy. However, if it does not work, surgical treatment should be considered. Here, we report a case of surgical treatment of stent entrapment in the left coronary sinus of a 53-year-old male patient.
Coronary Sinus* ; Humans ; Male ; Middle Aged ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Stents*

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.
Catheters ; Chest Tubes ; Female ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Pleural Effusion ; Stress, Psychological ; Thorax

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.
Catheters ; Chest Tubes ; Female ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Pleural Effusion ; Stress, Psychological ; Thorax

BACKGROUND: TRAIL (TNF-related apoptosis inducing ligand) is a newly identified member of the TNF gene family which appears to have tumor-selective cytotoxicity due to the distinct decoy receptor system. TRAIL has direct access to caspase machinery and induces apoptosis regardless of p53 phenotype. Therefore, TRAIL has a therapeutic potential in lung cancer which frequently harbors p53 mutation in more than 50% of cases. However, it was shown that TRAIL also could activates NF-kappaB in some cell lines which might inhibit TRAIL-induced apoptosis. This study was designed to investigate whether TRAIL can activate NF-kappaB in lung cancer cell lines relatively resistant to TRAIL-induced apoptosis and inhibition of NF-kappaB activation using proteasome inhibitor MG132 which blocks I kappa B alpha degradation can sensitize lung cancer cells to TRAIL-induced apoptosis. METHODS: A549 (wt p53) and NCI-H1299 (null p53) lung cancer cells were used and cell viability test was done by MTT assay. Apoptosis was confirmed with Annexin V assay followed by FACS analysis. To study NF-kappaB-dependent transcriptional activation, a luciferase reporter gene assay was used after making A549 and NCI-H1299 cells stably transfected with IgGkappa-NF-kappaB luciferase construct. To investigate DNA binding of NF-kappaB activated by TRAIL, electromobility shift assay was used and supershift assay was done using anti-p65 antibody. Western blot was done for the study of I kappa B alpha degradation. RESULTS: A549 and NCI-H1299 cells were relatively resistant to TRAIL-induced apoptosis showing only 20~30% cell death even at the concentration 100 ng/ml, but MG132 (3microM) pre-treatment 1 hour prior to TRAIL addition greatly increased cell death more than 80%. Luciferase assay showed TRAIL-induced NF-kappaB transcriptional activity in both cell lines. Electromobility shift assay demonstrated DNA binding complex of NF-kappaB activated by TRAIL and supershift with p65 antibody. I kappa B alpha degradation was proven by western blot. MG132 completely blocked both TRAIL-induced NF-kappaB dependent luciferase activity and DNA binding of NF-kappaB. CONCLUSION: This results suggest that inhibition of NF-kappaB can be a potentially useful strategy to enhance TRAIL-induced tumor cell killing in lung cancer.
Annexin A5 ; Apoptosis ; Blotting, Western ; Cell Death ; Cell Line ; Cell Survival ; DNA ; Genes, Reporter ; Homicide ; Humans ; I-kappa B Proteins ; Leupeptins ; Luciferases ; Lung ; Lung Neoplasms ; NF-kappa B ; Phenotype ; Proteasome Endopeptidase Complex ; Proteasome Inhibitors ; Transcriptional Activation

A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.
Adenocarcinoma ; Aged ; Anemia ; Angina, Unstable ; Chest Pain ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Gastrectomy* ; Hemorrhage ; Humans ; Male ; Physical Examination ; Stomach Neoplasms ; Transplants

INTRODUCTION: In traditional society, the roles of housewives were to do housework, to look after her children and to give her family emotional stability. With rapid social and economic change, the traditional sense of value changes and the concepts of sexual roles, too. However, they are in a transition period yet. These discord and tension followed by role change appeared as the form of psychological instability or social pathological problem in modern family. Thus, this study aimed to avaluate the effect of employment on depression of housewives who play importent roles in family and their commumity. METHODS: From May to July 1996, the questonnaires were distributed to 179 housewives who have university education background(including community college), and have one or more children and live in Bundang-Ku of Sungnam city, making a distinction between working housewives and nonworking housewives. Regarding the subjects of this study, the non-working housewives are restricted to full-time housewives who have no job, and working housewives who have full-time job. As tools of measurement, we used BDI questionnaires consisted of 15 items in Korean. We performed statistical analysis among the data by means of SPSS/PC+. We analyzed statistical data for significance using one-way ANOVA and analyzed categorical data for significance using S-test. RESULTS: The average score on BDI for working housewives was 12.22(standard deviation 7.42) and this is rather higher than that of non-working housewives(10.80, standard deviation : 7.42). But the number of children increased, the BDI score were higher significantly in both groups. And the BDI score was high in working Housewives groups whose husbands had professional job or dommerce job, whose family system is a multi-generation family, and who feel a lot of fatigue after work. In case of non-working housewives, the BDI score was high with age(especially between 50-59), duration of marriage, lower income and Duvalls family life cycle 6, 7. CONCLUSIONS: There is no difference in depression tendency between working housewives and nonworking housewives. But in case of working housewives, some factors have influence on their depression tendency, the number of children, husbands job, family type, degree of fatigue after work. And in case of non-working housewives, the factors are the number of children, age, duration of marriage, income, family life cycle.
Child ; Depression* ; Education ; Employment ; Fatigue ; Gyeonggi-do ; Housekeeping ; Humans ; Marriage ; Seoul* ; Spouses ; Surveys and Questionnaires

Multiple primary lung cancer is not common and classified as a synchronous primary lung cancer and a metachronous primary lung cancer. We experienced one case of the triple synchronous primary lung cancer of different cell types. We conducted right pneumonectomy for preoperative diagnosed neuronendocrine tumor of the RUL and adenocarcinoma of the RLL. Pathologic examination revealed the carcinoid tumor of RUL bronchus, the squamous carcinoma of the RML and the adenocarcinoma of the RLL.
Adenocarcinoma ; Bronchi ; Carcinoid Tumor ; Carcinoma, Squamous Cell ; Lung Neoplasms* ; Lung* ; Pneumonectomy

A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up.
Diaphragm ; Emergencies ; Follow-Up Studies ; Hemodynamics ; Hemorrhage ; Humans ; Liver ; Middle Aged ; Multiple Trauma ; Rehabilitation ; Resuscitation ; Scapula ; Steel* ; Thoracic Injuries ; Thoracic Wall ; Trauma Centers

BACKGROUND: Tapered grafts, which have a smaller diameter on the arterial side, have been increasingly used for arteriovenous fistula (AVF) formation. We compared the outcomes of 4–6-mm tapered and 6-mm straight forearm loop arteriovenous grafts. METHODS: A total of 103 patients receiving forearm loop arteriovenous grafts between March 2005 and March 2015 were retrospectively analyzed and separated into 2 groups (group A, 4- to 6-mm tapered grafts, n=78; group B, 6-mm straight grafts, n=25). In each group, complications and patency rates after surgery were assessed. RESULTS: Clinical characteristics and laboratory results, except for cerebrovascular disease history (group A, 7.7%; group B, 28.0%; p=0.014), were similar between the groups. No significant differences were found for individual complications. Kaplan-Meier survival analysis revealed no significant differences in 1-year, 3-year, and 5-year patency rates between groups (61.8%, 44.9%, and 38.5% vs. 62.7%, 41.1%, and 35.3%, respectively). CONCLUSION: We found no significant differences in complication and patency rates between the tapered and straight graft groups. If there are no differences in complication and patency between the two graft types, tapered grafts may be a valuable option for AVF formation in light of their other advantages.
Arteriovenous Fistula* ; Cerebrovascular Disorders ; Forearm* ; Humans ; Polytetrafluoroethylene* ; Retrospective Studies ; Transplants*