No abstract available.
Emergencies* ; Emergency Medical Services*

BACKGROUND: The purpose of this study was to investigate the mechanism of endothelium-dependent and independent responses to endothelins (ETs) in porcine coronary artery. METHODS: The vascular rings of left anterior descending artery or left circumflex artery from 7 pigs were suspended in conventional organ chambers for the measurement of isometric force. To evaluate relaxation responses, vascular rings with endothelium were exposed to ET-1 and ET-3. To evaluate contraction responses, vascular rings with and without endothelium were exposed to ET-1 and ET-3 in the presence or absence of BQ 123 (ET(A) receptor antagonist) or TAK-044 (ET(A) and ET(B) receptor antagonist). RESULTS: Transient relaxation responses of vascular rings occurred after exposure of ET-1 and ET-3. These transient responses disappeared after preincubation with N-nitro-L arginine. There was an increased contractions of vascular rings according to increasing concentration of ET-1 and ET-3. The initial responses were enhanced in vascular rings without endothelium in ET-1 and ET-3. In vascular rings with endothelium, the contraction responses were more reduced in vascular rings with preincubation of BQ 123 than in vascular rings without BQ 123 in ET-1. In vascular rings without endothelium, the contraction responses were more reduced in vascular rings with preincubation of TAK-044 than in vascular rings without TAK-044 in ET-1. CONCLUSION: ET(B) receptor on the endothelium might mediate the transient vasodilator responses to ET-1 and ET-3 through release of nitric oxide in porcine coronary artery. ET(A) and ET(B) receptor on vascular smooth muscle cells might mediate vasoconstrictor responses to ETs.
Arginine ; Arteries ; Coronary Vessels* ; Endothelins* ; Endothelium ; Muscle, Smooth, Vascular ; Nitric Oxide ; Receptors, Endothelin ; Relaxation ; Swine

Diaphragmatic eventration and spontaneous rupture of the diaphragm are not common. Authors experienced a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome, visited emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic cavity. She underwent exploratory laparotomy. Reduction of the herniated abdominal viscera, trimming of the ruptured diaphragm and plication of the diaphragm were done. Postoperative course was uneventful. In the English literature there is only one reported case of spontaneous rupture of eventrated diaphragmatic.
Abdominal Pain ; Child* ; Diaphragm* ; Diaphragmatic Eventration ; Emergency Service, Hospital ; Female* ; Humans ; Laparotomy ; Nephrotic Syndrome* ; Rupture, Spontaneous* ; Thoracic Cavity ; Thorax ; Ultrasonography ; Viscera ; Vomiting

No abstract available.
Adult* ; Fistula* ; Humans

Discoid meniscus is a congenital morphological variable anomaly of meniscus which is often asymptomatic. Arthroscopic surgeries on 91 symptomatic lateral discoid menisci of 84 patients were performed at the Department of Orthopedic Surgery, Seoul National University Hospital during the period of Jan. 1987 to Jan. 1994, which equals 19.2% of arthroscopic meniscectomies performed. Follow up was done from minimum of 1 year to maximum of 8 years, with an average period of 3 years and 10 months. Retrospective study was done with the review of clinical records, roentgenograms, MRI, and arthroscopic findings on recorded videotapes to evaluate the clinical and radiological features, results of arthroscopic treatment and possible prognostic factors. The followings are the results: 1. The lateral discoid meniscus encompassed 19.2% of arthroscopic meniscectomies performed at the same period, which was relatively high incidence. Arthroscopic partial and subtotal menis- cectomy resulted in satisfactory results. 2. Since 8 (11%) knees were not diagnosed preoperatively as discoid meniscus due to type being incomplete or torn meniscus displacement, these points should be considered with clinical findings at diagnosis of discoid meniscus. 3. 34.9% of 83 menisci with tear had previous trauma history which showed high vulnerability to tear. Discoid menisci without tears but with grade II intrasubstance increased signal and symptoms were treated with arthroscopic meniscectomy and showed good results. Therefore discoid menisci without tears should be considered of arthroscopic meniscectomy in the presence of clinical symptoms and MRI findings. 4. Lysholm total and pain scores were significantly improved at postop. 1 year and at the final follow up with p<0.05. Factors such as degenerative changes, sex, age, duration of preoperative symptoms, presence of tears and types of meniscectomy gave no significant influence on the results and the prognosis.
Arthroscopy ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Knee* ; Magnetic Resonance Imaging ; Orthopedics ; Prognosis ; Retrospective Studies ; Seoul ; Videotape Recording

Hemorrhagic cystitis is potentially life-threatening sequellae of chemotherapy using oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide). Mesna contains a sulfhydryl group that is believed to bind acrolein within the urinary collecting system and reduce the hemorrhagic cystitis without affecting the chemotherapeutic potential. To date, about thirty cases of hypersensitivity or allergic reactions of the delayed and urticarial type associated with mesna have been reported. We reported two patients with systemic lupus erythematosus who developed facial rash and flushing associated with mesna which imitate malar rash.
Acrolein ; Alkylating Agents ; Cyclophosphamide ; Cystitis ; Drug Therapy ; Exanthema* ; Flushing ; Humans ; Hypersensitivity* ; Lupus Erythematosus, Systemic ; Mesna*

Neurocristopathy is characterized as having a common origin in aberrant neural crest development. Congenital central hypoventilation syndrome (Ondine's curse) is characterized by marked depression of respiratory drive during sleep and normal ventilation while awake because of no response to both hypercapnea and hypoxia. The girl was full-term, weighing 3020 grams. The girl had poor respiratory effort at birth, but improved with oxygen supply and stimulation. abdominal distention and calcification were noted. During laparotomy transitional zone was found at distal jejunum; a jejunostomy was constructed. Numerous attempts at extubation failed because of apnea. The results of an apnea work-up, including brain sonography, echocardiogram, were normal. The girl died of sepsis at 37 days of age. para-aortic ganglioneuroblastoma was found on autopsy. We experienced a newborn with congenital central hypoventilation syndrome, Hirschsprung's disease and congenital ganglioneuroblastoma representative of neurocristopathy.
Anoxia ; Apnea ; Autopsy ; Brain ; Depression ; Female ; Ganglioneuroblastoma* ; Hirschsprung Disease* ; Humans ; Hypoventilation* ; Infant, Newborn* ; Jejunostomy ; Jejunum ; Laparotomy ; Neural Crest ; Oxygen ; Parturition ; Sepsis ; Ventilation

Ventriculoperitoneal shunt (VP shunt) for hydrocephalus is thought to inhibit the closure of processus vaginalis by increasing intraabdominal pressure, thus it promotes the inguinal hernia. We reviewed the incidence and characteristics of the inguinal hernia in VP shunted patients, and tried to estimate the patency rate of processus vaginalis in early childhood. A reprospective review of patients undergone insertion of VP shunt between January 1980 and May 1998 at Seoul National University Children Hospital was done. 262 patients were included in this study. Among them, 28 patients developed inguinal hernia (10.7%). Six patients developed inguinal hernia before the insertion of VP shunt. According to the age of VP shunt, the inguinal hernia developed in 16.2% (12/74) of patients who had undergone VP shunt before 6 months old, 12.4% (11/89) between 6 months and 2 years old and 5.1% (5/99) after 2 years old. Among 22 patients excluding 6 patients who developed hernia before VP shunt, the incidence of inguinal hernia after VP shunt was 8.6% (22/256) with male predominance (M:F=18:4). 8 patients developed inguinal hernia bilaterally (36.4%). It is suggested that at least 14% of processus vaginalis is patent until 2 years old.
Child ; Child, Preschool ; Hernia ; Hernia, Inguinal* ; Humans ; Hydrocephalus ; Incidence ; Infant ; Male ; Seoul ; Ventriculoperitoneal Shunt*

No abstract available.
Child* ; Humans

In order to reinforce the role of primary care physician and to improve doctor-patient relationship, the Korean government tried to introduce 'Family Doctor Registration Program' into Seocho-Gu in Seoul, Ansung-Gun and Paju city in Kyunggi-Do in Oct. 1996. Community residents and doctors in those area did not show much interest in this project because of low incentives. We have done this study to see how much people know 'Family Doctor Registration Program' and what is people's real needs about 'Family Doctor Registration Program. We selected l,800 telephone numbers in Seoul, Chongju city, and Ansung-Gun by multi-stage stratified random sampling. Three trained survey personnels called them and got answers to the premade questionnaire until they completed the questionnaires of 200 persons in each community. The calling time was 7-9 p.m. from Monday to Friday, 3-9 p.m. on Saturday, and 9 a.m. to 9 p.m. on Sunday. We dropped out the persons who did not respond 3 times. The subjects consisted of 222 male and 367 female residents. Their ages ranged from 20 to 78: 24.8% in their 30s, 23.4% in their 20s, 22.5% in their 40s in male, and 35.2% in their 30s, 22.5% in their 40s, 18.5% in their 20s in female. 9.9% of male and 13.2% of female had their Family Doctors. The specialties of their Family, Doctors were internists in 56.2%, general surgeons in ll.0%. The persons who did not have their family, doctors were asked which doctors they would prefer if they had choices of family doctor. The results were internists in 50.3%, family physicians in 13.0%, pediatricians in 4.8%. Only 16.0% residents knew that government tried to introduce Family Doctor Registration Program. The 'Family Doctor Registration Program' was not well known to people. The results of our study showed that more effective incentives and public notifications are needed to activate this program.
Female ; Gyeonggi-do ; Humans ; Male ; Motivation ; Physicians, Family ; Physicians, Primary Care ; Primary Health Care ; Surveys and Questionnaires ; Research Personnel ; Seoul ; Telephone*