We report a cace of 69-year-old man who developed massive pulmonary hemorrhage and subsuquent adult respiratory distress syndrome following intravenous urokinase for acute myocardial infarction. Pulmonary hemorrhage is a rare but a potentially life-threatening complication after thrombolytic therapy and should be considered in the differential diagnosis of pulmonary infiltrates of falling hemoglobin after thrombolytic therapy for acute myocardial infarction with no obvious site of bleeding.
Adult* ; Aged ; Diagnosis, Differential ; Hemorrhage* ; Humans ; Myocardial Infarction* ; Respiratory Distress Syndrome, Adult* ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

Adult polycystic kidney disease is a genetic disease characterized by bilateral multiple renal cysts and is transmitted as an autosomal dominant traits. The disease usually manifests in the fourth decade of life. The affected patients usually die with end stage renal failure, cardiovascular assaults and infection etc. Cardiovascular assaults include ruptured berry aneurysm, spontaneous intracranial hemorrhage, acute myocardial infarction, dissecting aortic aneurysm and hypertensive heart failure. Fatal intracranial hemorrhage and hypertensive heart failure occur in 15% and 2% of patients, respectively. Genetically-determined structural weakness in the arterial wall have been suggested as a possible factor in the genesis of berry aneurysm. We have experienced three autopsy cases with cardiovascular causes of sudden death. Two cases have intracranial hemorrhage (1 berry aneurysm and 1 intracerebral hemorrhage) and the remaining one is dead with hypertensive cardiomyopathy. All of them are aged over 40 years and associated with polycystic liver disease. Histologically, myriad cysts of enlarged bilateral kidney are lined by single layer of cuboidal cells with focal hyperplastic epithelial configuration. Diffusely scattered liver cysts are also lined by flat to cuboidal epithelium and often associated with portal fibrosis.
Adult* ; Aortic Aneurysm ; Autopsy ; Cardiomyopathies ; Cerebral Hemorrhage ; Death, Sudden ; Epithelium ; Fibrosis ; Heart Failure ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Kidney ; Liver ; Liver Diseases ; Myocardial Infarction ; Polycystic Kidney, Autosomal Dominant* ; Renal Insufficiency

BACKGROUND: There are several ways to treat for recurrent pericardial effussion and cardiac tamponade due to malignancy. They are repeated pericardiocentesis, pericardial instillation of sclerosing and chemotherapeutic agents, surgical creation of a pericardial window and transthoracic pericardiectomy. Surgical techniques are usually effective but bear a significant morbidity and mortality especially in chronic debilitating cancer patients. So percutaneous balloon pericardial window as an alternative to surgery in these patients. METHODS: After pericardiocentesis was performed, a 0.035 inch J-tip guidewire was advanced into the pericardial space. And a pigtail catheter was advanced over the wire. A moderate amount of pericardial fluid were removed. A nd then the pigtail catheter was withdrawn and 8F sheath was inserted. A20mm diameter, 4cm long(Single balloon method) or two 10mm diameter, 4cm long balloon dilating catheter(Double balloon medium) was advanced over the wire to straddle the parietal pericardial border though the sheath. Several inflations of the balloon with a solution containing 50% radiographic contrast medium were performed until disappearance of the balloon waist. After balloon dilation, contrast medium from the pericardial space to subcutaneous tisse suggesting successful PBPWF. Single ballon method was employed in 4 patients and Dould balloon method in 2 patients. RESULT: We performed percutaneous balloon pericardial window formation in 6 patiemts with malignant pericardial effusion. We did percutaneous balloon pericardial window formation successfully in 5 patients and failed due to adhesion of parietal pericardium in 1 patient. One patient developed recurrent pericardial effusion with tamponade at a mean follow-up of 11.49.6 months(1.5-26 months). Conclusion: These results suggest that PBPWF is an alternative method less invasive than subxiphoid surgical windowing, espesially in critically ill patients with recurrent malignant pericardial effussion. It carries less risks and has more constant effect than repeated pericardiocentesis.
Cardiac Tamponade ; Catheters ; Critical Illness ; Follow-Up Studies ; Humans ; Mortality ; Pericardial Effusion* ; Pericardiectomy ; Pericardiocentesis ; Pericardium ; Rabeprazole

Pulmonary masses were observed in the thoracic cavity of a 9-year-old female Korean native cattle (Hanwoo) encountered at a Jeju, Korea slaughterhouse. Grossly, the thoracic cavity was filled with pulmonary masses. Histologically, the neoplastic masses were composed of many abnormal papillary structures lined by single to double columnar neoplastic cells and formed arborizing fronds supported by significant fibrovascular stroma. The neoplastic cells showed strong destructive and infiltrative growth to adjacent tissues and were strongly positive for pan-cytokeratin (CK), CK 7 and sporadically positive for CK MNF116. The masses in the female Hanwoo were diagnosed as a papillary pattern of pulmonary adenocarcinoma.
Abattoirs ; Adenocarcinoma ; Animals ; Cattle ; Child ; Female ; Humans ; Korea ; Lung ; Thoracic Cavity

No abstract available.
Neurofibromatoses* ; Neurofibromatosis 1*

A patient (Hellman dental age IIIA) who had anterior cross bite due to functional factor was treated with activator. Following results were obtained: 1) Anterior cross bite was crorrected 3 months after the initial application of the appliance. 2) Comparing pretreatment records with posttreatment, the main effects were labioversion of upper incisors, increase of upper arch length and downward-backward rotation of the mandible. 3) There was no damage on teeth and periodontal tissues and the patient had normal occlusion 1 year after the treatment.
Humans ; Incisor ; Malocclusion ; Mandible ; Prognathism* ; Tooth

Pulmonary masses were observed in the thoracic cavity of a 9-year-old female Korean native cattle (Hanwoo) encountered at a Jeju, Korea slaughterhouse. Grossly, the thoracic cavity was filled with pulmonary masses. Histologically, the neoplastic masses were composed of many abnormal papillary structures lined by single to double columnar neoplastic cells and formed arborizing fronds supported by significant fibrovascular stroma. The neoplastic cells showed strong destructive and infiltrative growth to adjacent tissues and were strongly positive for pan-cytokeratin (CK), CK 7 and sporadically positive for CK MNF116. The masses in the female Hanwoo were diagnosed as a papillary pattern of pulmonary adenocarcinoma.

A large number of viruses belonging to Genus Hantavirus in Family Bunyaviridae are etiologic agents for hemorrhagic fever with renal syndrome (HFRS), or hantavirus pulmonary syndrome (HPS). Hantaan (HTN), Seoul (SEO), Belgrade (BEL), Puumala (PUU) serotype viruses are well known causative agents for HFRS in Eurasian continent. Among those viruses Hantaan and Seoul serotypes are well known to cause HFRS in Korea, but there are some sporadic incidence by other than Hantaan or Seoul viruses. Recently we have developed the combined Hantaan-Puumala virus vaccine to prevent world-wide occurring HFRS. This combined vaccine is formalin inactivated, suckling mouse and suckling hamster brain extracts for Hantaan and Puumala viruses, respectively. Protein contents of this purified candidate vaccine is 27 microgram/ml, which contains 1,024 ELISA antigen units to each virus, but content of myelin basic protein which is causing experimental allergic encephalomyelitis is legs than 0.1 ng/ml. Thirty hamsters were given twice at one month interval intra-muscularly and bled on 30 days after each vaccination from retro-orbital sinus vein. Antibody titers were tested against 5 major serotype viruses, Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses by IFA and PRNT. The mean IF antibody titers on 30 days after primary shot were 78.4, 68.8, 68.8, 37.9, and 15.6; mean neutralizing antibody titers were 65.4, 12, 6.1, 65.6 and 0.5 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively. The mean IF antibody titers on 30 days after booster shot were 686.9, 567.5, 550.4, 516.3, and 430.9; and neutralizing antibody titers were 710.8, 41.9, 24.3, 409.9, and 1.6 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively.
Animals ; Antibodies, Neutralizing ; Brain ; Bunyaviridae ; Cricetinae* ; Encephalomyelitis, Autoimmune, Experimental ; Enzyme-Linked Immunosorbent Assay ; Formaldehyde ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Incidence ; Korea ; Leg ; Mice ; Myelin Basic Protein ; Puumala virus ; Seoul ; Seoul virus ; Sin Nombre virus ; Vaccination ; Veins

During the exhumation of victims of Korean War, among the memorial activities of Korean War, we found a dead body in a tomb in Kyung-Ju city. With the testimony of natives we could find the family related with the body. Using bone and teeth of it we determined that it was male and about 20 years old or more and the result was unite with the insistence of the bereaved family. With the photography offered by the family and the skull we did the photographic superimposition and according to the result we could not exclude that it was the same person with him. We performed mitochondrial DNA(mtDNA) sequencing and it reveals that the dead body and the family have same maternal inherited mtDNA. Finally, We could identify the dead body. At present it is very difficult thing to collect much data of victims of Korean War because it passed over 50 years. But if we find the bereaved family of them we can identify them more accurate and more objective with the forensic identification method like sex determination, age estimation, superimposition and mtDNA sequencing and so on.
DNA, Mitochondrial ; Exhumation ; Gyeongsangbuk-do ; Humans* ; Korean War* ; Male ; Photography ; Population Groups ; Skull ; Tooth ; Young Adult

PURPOSE: The purpose of this study was to determine whether the multiple mini-interview (MMI) predicts academic achievement for subjects in a medical school curriculum. METHODS: Of 49 students who were admitted in 2008, 46 students finished the entire medical education curriculum within 4 years. We calculated the Pearson correlation coefficients between the total MMI score of the 46 graduates and their academic achievements in all subjects of the curriculum. RESULTS: The correlation coefficients between total MMI score and academic achievement in Medical Interview and History Taking, Problem-Based Learning, Doctoring I, and Clinical Practice of Surgery ranged from 0.4 to 0.7, indicating that they were moderately related. The values between total MMI score and achievement in Research Overview, Technical and Procedural Skills, Clinical Performance Examinations 1 and 3, Clinical Practice of Laboratory Medicine and Psychiatry, Neurology, and Orthopedics ranged from 0.2 to 0.4, which meant that they were weakly related. CONCLUSION: MMI score can predict medical student' academic achievement in subjects in the medical humanities and clinical practice.
Clinical Competence ; Curriculum ; Education, Medical ; Humanities ; Humans ; Neurology ; Orthopedics ; Problem-Based Learning ; Schools, Medical*