BACKGROUND: Coronary arterigraphy has been used as a tool to assess the degree of coronary artery narrowing and the result of balloon angioplasty, which frequently underestimates the degree of atherosclerosis. Intravascular ultrasound(IVUS) can give more delicate information about plaque morphology and the result of coronary intervention. We compared qualitaive and quantitative measurement between IVUS and coronary angiography after coronary intervention. METHODS: We used 30 or 20 MHz intravascular ultrasound catheter which was connected to Hewlett Packard Sonos 1500 Intravasscular equiment in 5 coronary balloon angiopasty and 3 Palmaz-Schatz stent implantation cases. Sites of intervention were at the left anterior descending coronary artery in 7 patients and at the left circumflex artery in one patient. Quantitative coronary angiography(QCA) was done by CAAS II system. We measured referenc diameter(RD), minimal lumen diamter(MLD), Lumen and vessel cross sectional areas(LCSA,VCSA) obstraction area(OA) and plaque area(PA) and also analysed plaque morphology. RESULTS: 1) IVUS is more sensitive in the detection of eccentricity, Calcification and dissection. 2) Before intervention, the mean reference diameter was 2.87+/-0.42mm,3.07+/-0.39mm,% diameter stenosis was 52.4+/-11.6%,65.3+/-9.22% and MLD was 1.32+/-0.24mm, 1.07+/-0.23mm in IVUS and QCA, respectively, which were no statistical significance between these parameters(p>0.05). After intervention, MLD and OA increased significantly(p<0.01) com pared with basal values but there were no significant difference between MLD and OA between 2 measurements(p>0.05). Plaque area measured by IVUS decreased from 9.84 to 7.26mm2 without statistical significance(p>0.05). 3) There was a good correlation in the measurement of the reference segments before intervention but this correlation was much lower after intervention in the reference and stenosis segments between 2 methods(r=0.8723 vs 0.6538, p<0.01). CONCLUSION: IVUS is considered as a sensitive tool in the detection of calcification, eccentricity and dissection and in evaluationg the results of the coronary intervention.
Angioplasty, Balloon ; Arteries ; Atherosclerosis ; Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Humans ; Stents ; Ultrasonography*

Branchial cleft cysts and branchial anomalies develop from the branchial cleft apparatus that persists after fetal development. The most common anatomical site for the occurrence of branchial cleft cysts is in the cervical area, generally anterior to the sternomastoid muscle in the upper or middle portion of the neck. A mediastinal branchial cleft cyst is extremely rare and few cases have been reported. We report the case of branchial cleft cyst found in the anterior mediastinum with literature review.
Branchial Region ; Branchioma ; Fetal Development ; Mediastinal Cyst ; Mediastinum ; Muscles ; Neck ; Thorax ; Tomography, X-Ray Computed

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.
Anti-Bacterial Agents ; Child ; Communicable Diseases ; Drainage ; Epidural Abscess* ; Fever ; Humans ; Lateral Sinus Thrombosis ; Masks ; Mastoid* ; Mastoiditis* ; Otitis Media ; Streptococcus pneumoniae*

The present study comprehensively evaluated lower urinary tract function prospectively using urodynamic study to delineate and quantify changes that take place in the lower urinary tract subsequent to radical abdominal hysterectomy. This report is follow-up investigation of 36 women treated for cervical carcinoma FIGO stages Ib (27), IIa (5) and IIb (4) from January, 1995, to March, 1996 at the Department of Gynecology, All patients were operated on by the same surgeon. The mean age of the study patients was 46 years with ages ranging from 31 to 60. The mean follow up period was 9 months (2-14 month). The urodynamic study was obtained using a Jupiter-8000 F/M Wiest. A 12Fr. three-way catheter (Porges) was placed on the bladder, and a 22Fr. rectal manometry balloon catheter was located 10cm from the anus in the supine position. Normal saline was infused continuously into the bladder through a three-way catheter with a infusion pump at a medium rate of 30ml per minute. Urethral pressure profiles were recorded with the same 12Fr. three-way catheter during withdrawal of catheter in a stepwise fashion (l mm/sec), and then uroflowmetry was recorded during voiding in the sitting position. Compared with preoperative status, in postoperative 3rd week and postoperative 6ih week, changes of following parameters were statistically significant: 1) average flow rate decreased, 2) residual urine volume increased. 3) bladder capacity and 4) detrusor pressure decreased in postoperative 3rd week (.p<0.05). Voiding volume, bladder compliance, maximal urethral pressure and functional urethral pressure were also decreased, but those were not statistically significant. We have obtained a functional recovery of the urodynamic parameters at about 6 weeks after operation. The voiding dysfunction developed in 4 cases (9%) after postoperative 6th week. The urodynamic classification of lower urinary tract dysfunction (1988, ICS) showed 2 in normal/normal, 1 in underactivity/normal and 1 underactivity/hyposensitivity. In conclusion, postoperative voiding dysfunction after cervical carcinoma operation, where urologic care is necessary, is considered to be a temporary change.
Anal Canal ; Catheters ; Classification ; Compliance ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy* ; Infusion Pumps ; Manometry ; Prospective Studies* ; Supine Position ; Urinary Bladder* ; Urinary Tract ; Urodynamics*

Leiomyomas of the appendix are rare and most are encountered incidentally during exploration of the abdomen for some other disease, during postmortem examination, or in the course of routine pathologic examinations of surgical specimens. We report here the findings of ultrasonography, CT and surgery of a case of leiomyoma that arose from the appendix; this lesion was pathologically confirmed.
Abdomen ; Appendix* ; Autopsy ; Leiomyoma* ; Ultrasonography

The purpose of this study was to evaluate the effects of magnetic field on cellular activity of MC3T3-El cells. The celular activity was monitored by alkaline phosphatase and DNA synthetic activity in control, static magnetic field and pulsed electromagnetic field groups. A static magnetic field was applied to the cell by placing one, two, three, four, and five samarium-cobalt magnets above and below each cell plate for 24hours per day. A pulsed electromagnetic field with a frequency of 100 herz was applied for 10 hours per day. After 10 days of magnetic field exposure, there were increase of alkaline phosphatase activity in static magnetic field groups consisted of one, two and three magnetic groups, Alkaline phosphatase activities were not significantly increased in four and five magnetic groups, Application of pulsed electromagnetic field did not result in significant increase in alkaline phosphatase activity compared to control. DNA synthetic activity in both static and pulsed electromagnetic field group were not significantly different from that in control group, The result of this study suggest that magnetic field could have effect on the metabolism of bone cells related to the cellular metabolic process,
Alkaline Phosphatase* ; DNA* ; Electromagnetic Fields* ; Magnetic Fields* ; Magnets* ; Metabolism

PURPOSE: This study identifies the optimal incision site by describing the relationship between McBurney's point and the base of appendix using the coronal view of abdominal multi-detector computed tomography (MDCT) in patients with acute appendicitis. METHODS: We reviewed the records of 206 patients with positive MDCT findings who were histologically diagnosed with acute appendicitis after appendectomy between January 2014 and September 2015. The outer 1/3 point between two points, the umbilicus and the right anterior superior iliac spine, was marked as McBurney's point on the coronal view. The superoinferior, mediolateral and radial distances between the base of appendix and McBurney's point were measured and recorded. RESULTS: The average age was 35.1±20.3 years. There were 34 patients below the age of 15-years-old (children), and 172 patients over 15-years-old (adults). In 35.4% of patients, the base of appendix was located within a radius of 2 cm from the McBurney's point, in 39.8% it was within 2~4 cm, and in 24.8% was over 4 cm. The average center coordinate of the base of inflamed appendix in our patients is 9.32 mm, 8.31 mm and the distance between two points is 12.5 mm. CONCLUSION: The location of appendix has wide individual variability; therefore the McBurney's point has limitations as an anatomic landmark. If we choose to customize appendectomy incisions considering the base of appendix by using an abdominal MDCT coronal view, additional incision site extension can be reduced.
Anatomic Landmarks ; Appendectomy ; Appendicitis* ; Appendix ; Humans ; Radius ; Spine ; Umbilicus

No abstract available.
Forearm* ; Humerus*

BACKGROUND: Measurement of coronary flow velocity in clinical caes contributes to understanding the pathophysiology of coronary circulation. To evaluate the coronary hemodynamics, we analyzed the pattern of coronary flow velocity with a new device consisting of 15Mhz piezoelectric transducer integrated into the tipped 0.018 inch or 0.014 inch flexible, steerable angioplasty guidewire. METHOD: A low profile(0.018 in. or 0.014 in.) Doppler angioplasty guidewire was used to measure the basal blood flow velocity in proximal coronary artery after intracoronary infusion of 200µg nitroglycerine, hyperemic blood flow velocity after intracoronary infusion of adenosine(12µg for LCA, 6µg for RCA). We measured several parameters such as APV (average peak velocity, cm/sec), DSVR(diastolic systolic velocity ratio), MPV(maximal peak velosity, cm/sec), PVI(peak velocity integral, cm), SPVI(systolic peak velocity integral, cm), DSIR(diastolic systolic integral ratio), ASPV(average systolic peak velocity, cm/sec) in basal and hyperemic states. This measurements were made in 17 patients undergoing coronary angiography. RESULTS: 1) APV, ADPV, MPV, in the basal state were higher in LCA than in RCA(32.1±16.6, 40.0±23.6, 57.1±29.0/15.8±9.1, 17.1±10.2, 24.5±20.9cm/sec) and DSVR was also higher in LCA(2.7±2.1/1.4±0.6). But ASPV and SPVI was not different(p>0.05). Significant increases in APV were noted in LCA(32.1±16.6→60.6±17.6cm/sec) and in RCA (15.8±9.1→42.1±15.5cm/sec) after adenosine infusion compared with basal state. DSVR measured in basal state were not statistically different from values in hyperemic state in LCA and RCA(2.7±2.1→2.3±1.7, 1.4±0.6→1.4±0.5, p>0.05). CONCLUSION: The blood flow patterns in both coronary arteries showed different biphasic flow patterns and this finding might be due to the pressure gradient during diastolic phase of both ventricles.
Adenosine ; Angioplasty ; Blood Flow Velocity ; Coronary Angiography ; Coronary Artery Disease ; Coronary Circulation ; Coronary Vessels ; Hemodynamics ; Humans ; Methods ; Nitroglycerin ; Transducers

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS. METHODS: We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group. RESULTS: From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock. CONCLUSIONS: In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.
Acute Kidney Injury ; Aged* ; Extracorporeal Membrane Oxygenation ; Humans ; Intensive Care Units ; Medical Records ; Patients' Rooms ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Shock, Septic ; Ventilator-Induced Lung Injury