Therapeutic plasma exchange is used in almost every condition in which there is a plasma factor thought possibly to the etiology or pathogenesis of a disease or one of its manifestations. In order to evaluate plasma exchange using fresh frozen plasma as replacement solution, eighty four therapeutic plasma exchanges were carried out in eighteen patients. In standardized procedures, 1.5 times the calculated plasma volume was replaced with a Hartman's solution and fresh frozen plasma. Anticoagulation was achieved using a whole venous blood to 2.5% trisodium citrate in the ratio of 10 to 1. Total calcium, phosphorus, glucose, urea nitrogen, creatinine, bilirubin, alkaline phosphatase, amylase, creatine kinase, IgG, C3, total white and red blood cell count, hemoglobin, and differential count were not significantly affected by the procedure. In contrast, serum cholesterol, total protein, albumin, aspartate aminotransferase, alanine aminotransferase, ionized calcium, IgM, C4 and platelet were significantly decreased by the plasma exchange. All these measurements had returned to the first pre-exchange level within 24 hours, while the C4 and platelet count took between 24 and 72 hours, and the IgM level, between 72 hours and 1 week. These data indicated that in an isovolemic plasma exchange there was a transient but rapidly reversible effect on all the components studied, with C4 and platelet count, returning more slowly to pre-exchange level than the others, and IgM levels responding the slowest. In summary, plasma exchanges using fresh frozen plasma as replacement solution were assumed to be not significantly affected the function of various organs.
Alanine Transaminase ; Alkaline Phosphatase ; Amylases ; Aspartate Aminotransferases ; Bilirubin ; Blood Platelets ; Calcium ; Cholesterol ; Citric Acid ; Creatine Kinase ; Creatinine ; Erythrocyte Count ; Glucose ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Nitrogen ; Phosphorus ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Platelet Count ; Urea

No abstract available.
Chromosome Aberrations*

Ganglion cyst of the spinal facet joint is rare. It is believed that ganglion cysts on the dorsal aspect of the facet joints are asymptomatic and therefore are not clinically appreciated. But we have experienced a patient who had severe low-back and buttock pain and diagnosed as ganglion cyst located on the dorsal aspect of the right side facet joint between the fourth and fifth lumbar vertebrae. The treatment was surgical excision of the cyst and resulted in a satisfactory recovery. The differential diagnosis involving herniated lumbar intervertebral disc should not exclude ganglion cyst of the dorsal aspect of the lumbar facet joint.
Buttocks ; Diagnosis, Differential ; Ganglion Cysts* ; Humans ; Intervertebral Disc ; Lumbar Vertebrae ; Zygapophyseal Joint*

No abstract available.
Survival Rate* ; Uterine Cervical Neoplasms*

PURPOSE: Colonic diverticulitis was rare in Korea in the past. However, it is progressively increasing probably because of a prolonged life span and a westernized diet pattern. Especially, right-sided colonic diverticulitis is difficult to differentiated from acute appendicitis. The purpose of this study was to verify the usefulness of laparoscopic-assisted surgery for the diagnosis and treatment of colonic diverticulitis. METHODS: We retrospectively reviewed 65 patients with colonic diverticulitis who underwent surgery from January 1998 to December 2002. RESULTS: The mean age of the patients was 36.3 years. Males were more prevalent than females (1.6:1). Abdominal ultrasonography (USG) was used as a diagnostic tool in 40 cases (61.5%), abdominal USG with colon enema in 8 cases (12.3%), and abdominal USG with abdominal CT in 4 cases (6.2%). The preoperative diagnosis was acute appendicitis in 52 patients (80.0%), perforated diverticulitis in 10 patients (15.4%), peritonitis in 2 patients (3.5%), and peptic ulcer perforation in 1 patient (1.5%). The postoperative diagnosis was simple diverticulitis in 47 cases (72.3%). The cecum was the most commonly involved area (55 cases, 84.6%). The types of open surgery were an appendectomy in 17 cases (26.1%), a right hemicolectomy in 17 cases (26.1%), a cecectomy in 6 cases (9.2%). The types of laparoscopic- assisted surgery were an appendectomy in 17 cases (26.1%), a laparoscopic-assisted right hemicolectomy in 4 cases (6.2%), and an anterior resection in 1 case (1.5%). The postoperative complication rate was 11.9% (5 cases). All of these occurred with the open technique, but no statistically significant difference existed between the complication rates for the two operative procedures (P=0.158). The mortality rate was zero for both operative procedures. The length of hospital stay (4.72+/-4.3 vs 10.1+/-6.2)(P=0.001) was significantly shorter in the laparoscopic-assisted group than in the open group. CONCLUSIONS: Preoperative diagnosis is sometimes difficult in patients with colonic diverticulitis. We consider laparoscopic-assisted surgery to be a useful diagnostic and therapeutic modality in such cases. The laparoscopic technique offers particular advantages to diverticulitis patients because of the short hospital stay and the low morbidity and mortality rates.
Appendectomy ; Appendicitis ; Cecum ; Colon* ; Diagnosis ; Diet ; Diverticulitis ; Diverticulitis, Colonic* ; Enema ; Female ; Humans ; Korea ; Length of Stay ; Male ; Mortality ; Peptic Ulcer Perforation ; Peritonitis ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative ; Tomography, X-Ray Computed ; Ultrasonography

A clinical analysis was carried out retrospectively with 54 cases of severe head injured patients(Glasgow Coma Scale score 3 to 8) to identify prognostic factors. Unawareness for over 1 month, abnormal papillary reaction, abnormal motor response pattern, and diffuse head injury with basal cisternal compression prove to be the most reliable predictors. Individual predictions of outcome provide a powerful too for assessing the relative efficacy of alternative treatments.
Coma ; Craniocerebral Trauma ; Head* ; Pupil ; Retrospective Studies

We report 3 cases of multiple myeloma showing ABO discrepancy with missed reaction in serum typing. They showed markedly decreased immunogolobulin level except for monoclonally increased abnormal immunoglobulin. Their blood group was confirmed by saliva test and addition of anti-globulin reagent. As serum immunoglobulin level is raised, the reactivity in serum typing showed improving tendency and ABO discrepancy appeared when immunoglobulin was markedly decreased.
Immunoglobulins ; Multiple Myeloma* ; Saliva

The Rastelli operation has been a standard procedure for repairing complete transposition of the great arteries combined with a ventricular septal defect and pulmonary stenosis. Yet this procedure has several shortcomings, including the risk of incurring left ventricular outflow tract obstruction on long-term follow-up. In this regard, aortic translocation has recently been regarded as a potent alternative to Rastelli's operation. We report here on a case of complete transposition of the great arteries that was combined with an inlet-extended perimembranous ventricular septal defect and pulmonary stenosis in a 2-year-old boy. All the problems were successfully repaired using the aortic translocation technique. Postoperative echocardiography showed a straight and wide left ventricular outflow tract.
Arteries ; Echocardiography ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; Preschool Child ; Pulmonary Valve Stenosis ; Transposition of Great Vessels

A 74-year-old woman who had paroxysmal atrial fibrillation without mitral stenosis was hospitalized for syncope and right-sided weakness. Echocardiography revealed a large free-floating thrombus in the left atrium, sometimes prolapsing partially into the left ventricle in diastole. Because of her poor neurological status, she was managed with anticoagulation. On the 12th day, the thrombus had disappeared on the follow-up echocardiography, and aortoiliac embolization was later detected on computed tomography. Unfortunately, she developed various complications of stroke and limb infarction, and died after 4 months of hospital care. In addition to this case report, we reviewed a total 70 cases of left atrial free-floating thrombus. Atrial fibrillation and mitral pathology were two major causative factors. All the cases, except 1, were confirmed on echocardiography. The most common presentation that led to echocardiography was systemic embolization, followed by heart failure. Others were acute hemodynamic decompensation from mitral obstruction, chest pain, palpitation, and bacteremia. Cardiac thrombectomy was the preferred treatment modality with favorable outcomes.
Aged ; Atrial Fibrillation ; Bacteremia ; Chest Pain ; Diastole ; Echocardiography ; Extremities ; Female ; Follow-Up Studies ; Heart Atria ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Humans ; Infarction ; Mitral Valve Stenosis ; Pathology ; Stroke ; Syncope ; Thrombectomy ; Thrombosis*

OBJECTIVES: Glide path preparation is recommended to reduce torsional failure of nickel-titanium (NiTi) rotary instruments and to prevent root canal transportation. This study evaluated whether the repetitive insertions of G-files to the working length maintain the apical size as well as provide sufficient lumen as a glide path for subsequent instrumentation. MATERIALS AND METHODS: The G-file system (Micro-Mega) composed of G1 and G2 files for glide path preparation was used with the J-shaped, simulated resin canals. After inserting a G1 file twice, a G2 file was inserted to the working length 1, 4, 7, or 10 times for four each experimental group, respectively (n = 10). Then the canals were cleaned by copious irrigation, and lubricated with a separating gel medium. Canal replicas were made using silicone impression material, and the diameter of the replicas was measured at working length (D0) and 1 mm level (D1) under a scanning electron microscope. Data was analysed by one-way ANOVA and post-hoc tests (p = 0.05). RESULTS: The diameter at D0 level did not show any significant difference between the 1, 2, 4, and 10 times of repetitive pecking insertions of G2 files at working length. However, 10 times of pecking motion with G2 file resulted in significantly larger canal diameter at D1 (p < 0.05). CONCLUSIONS: Under the limitations of this study, the repetitive insertion of a G2 file up to 10 times at working length created an adequate lumen for subsequent apical shaping with other rotary files bigger than International Organization for Standardization (ISO) size 20, without apical transportation at D0 level.
Dental Pulp Cavity ; Silicones ; Transportation