Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

BACKGROUND: Acute idiopathic thrombocytopenic purpura(ITP) in children has a low morbidity and mortality, and most of cases are self limited illness. But some of them are not responsive to treatment and finally progress to chronic disease. The purpose of this study is to evaluate the factors which influence the outcome in childhood idiopathic thrombocytopenic purpura. METHOD: From January 1990 to December 1995, patients with ITP who were admitted to the Pediatric department of Pusan National University Hospital were divided into acute and chronic form depending on whether the platelet count had returned to normal(150 x 10(9)/1) by six months after diagnosis. Between two groups, the clinical and laboratory characteristics, response to treatment were compared. RESULT: 1) Out of 55 patients with ITP, 36 cases(65.5%) were acute and 19 cases(34.5%) were chronic ITP. 2) Sex, previous viral infection history, clinical manifestations were not significantly different between two groups, but the chronic ITP was rare in less than 1 year of age. 3) The duration of symptoms over >2 weeks at presentation was strongly predictive of chronic ITP. 4) Most of chronic disease (87.5%) showed platelet counts below 150 x 10(9)/1 at 28 days after diagnosis as compared with acute disease(25.0%). 5) Among 19 cases of chronic disease, 6 cases responded completely to treatment, but 11 cases(57.9%) did not respond to any treatments, 2 cases improved spontaneously. CONCLUSION: A history of symptoms over 2 weeks at presentation and platelet counts below 150 x 10(9)/1 at 28 days after diagnosis were strong predictors of chronic ITP in children.
Busan ; Child ; Chronic Disease ; Diagnosis ; Humans ; Mortality ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*

The tibial pilon fracture has been described as difficult fracture to manage. We have reviewed 23 cases of tibial pilon fractures from Mar. 1987 to Feb. 1993 at our hospital. 1. The fractures were classified into five types according to the system of Ovadia and Beals and the methods of treatment were divided into two groups; 9 cases were treated with Ilizarov device(Group I). 6 cases out of Group I were type 3, 4 and 5. Other methods were performed in 14 cases(Group II). 8 cases out of Group II were type 3, 4, and 5. 2. In type 3, 4 and 5 fractures, there were 86 per cent good and fair radiographic results in Group I and 63 per cent good and fair results in Group II. 3. Satisfactory results were obtained by the treatment of Ilizarov method especially in type 3, 4 and 5 fractures. The advantages of Ilizarov device were its primary reduction with ligamentotaxis, easy open reduction due to proximal and distal stabilization, minimal soft tissue injury and minimal internal fixation.
Ilizarov Technique ; Soft Tissue Injuries

BACKGROUND: Free radical reactions are a part of normal human metabolism. When produced in excess, radicals can cause tissue injury. The present study was aimed to investigate neurotoxic effect of oxygen free radicals and neuroprotective effect of antioxidant(glutathione). METHODS: Neurotixic effect of oxygen radicals was evaluated by MTT[3-(4,5-dimethylthiazol-2,5- diphenyltetrazolium bromide] assay and neurofilament enzyme-immunoassay after culturing of spinal motor neuron cell line of mouse(NSC-34). Then these cells were exposed to various concentrations of xanthine oxidase(XO) and hypoxanthine(HX). In addition, neuroprotective effect of antioxidant against oxidant-induced neurototoxicity on these cultures was examined. RESULTS: Exposure of neurons to 25mU/ml XO and 0.2mM HX for 3 hours resulted in a significant cell death and also glutathione(GSH) blocked the neurotoxicity induced by oxygen radicals in cultured mouse spinal motor neurons. CONCLUSION: From the above results, it is suggested that oxygen radicals are toxic in NSC-34. Selective antioxidants such as GSH are effective in blocking oxidant-induced neurotoxicity on these cultures.
Animals ; Antioxidants ; Cell Death ; Cell Line ; Free Radicals ; Glutathione* ; Humans ; Metabolism ; Mice ; Motor Neurons* ; Neurons ; Neuroprotective Agents ; Oxygen ; Reactive Oxygen Species ; Xanthine

No abstract available.
Rho(D) Immune Globulin*

A 30 years old female patient was diagnosed valvular heart disease and double valve replacement was ndertaken. After operation, mediastinitis developed and we had done continuous mediastinal irrigation and had used IV antibiotics for 3 weeks. During outpatient follow-up, infection signs developed, so she readmitted and was reoperated because CT revealed mediastinal abscess. No infected material was observed at the operation. Infection signs continued for 3 weeks. Chest CT revealed giant pseudoaneurysm of ascending aorta. We resected the pseudoaneurysm and performed an aortoplasty with bovine pericardium under deep hypothermia and total circulatroy arrest. She recovered well and was discharged without any complication.
Abscess ; Adult ; Aneurysm, False ; Anti-Bacterial Agents ; Aorta* ; Female ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Hypothermia ; Mediastinitis* ; Outpatients ; Pericardium ; Thoracic Surgery* ; Tomography, X-Ray Computed

The objective of this study is to define optimal diagnosis and treatment strategies for patients with urachal anomalies in the pediatric age group. The medical records of 21 children who had undergone surgery for urachal anomalies at Severance Hospital, Yonsei University College of Medicine from January 1990 to April 2005 were reviewed. The subjects included 14 males and 7 females (M:F 2:1). The four types of urachal anomalies confirmed were a urachal cyst in 10 patients (47.6%), a patent urachus in 6 (28.6%), a urachal sinus in 4 (19.0%) and a urachal diverticulum in 1 (4.8%) patient. The most common presenting complaint was umbilical discharge (n = 10, 40.0%), followed by abdominal mass (n = 9, 36.0%). Urachal anomalies were diagnosed by ultrasonography in 18 patients, and 7 of them were additionally examined by computed tomography. The remaining patients were diagnosed solely by surgical exploration. Excision was performed in all patients and was supplemented by partial cystectomy in three. Umbilical discharge was the most common clinical manifestation in our patients, suggesting that ultrasonography should be performed in patients with umbilical discharge to differentiate urachal anomalies. We found the most common anomaly to be the urachal cyst, and all patients were successfully treated by surgical excision.
Urachus/*abnormalities/surgery ; Urachal Cyst/*diagnosis/surgery ; Male ; Infant, Newborn ; Infant ; Humans ; Hospitals, University ; Female ; Child, Preschool ; Child ; Abnormalities/diagnosis/surgery

Fertility preservation (FP) is an effort to retain the fertility of cancer patients, and as an emerging discipline, it plays a central role in cancer care. Because of improvement in diagnostic and therapeutic strategies, an increasingly large number of patients are surviving with cancer. FP specialists should make an effort to spread the significance of FP among reproductive women with cancer and provide appropriate education both for associated physicians and for cancer patients who wish to preserve their fertility. Physicians who take part in the initial diagnosis and management of cancer should consider the importance of early referral of young cancer patients to FP specialists and take care of those patients by providing timely information and appropriate counseling. Individualized treatment strategies should be delivered depending on the patient's situation with appropriate team approach.
Counseling ; Female ; Fertility ; Fertility Preservation ; Humans ; Referral and Consultation ; Specialization

PURPOSE: In the current study, the relation between the clinicopathological parameters and levels of the amplification of the c-met and E-cadherin genes were investigated in patients with an advanced gastric carcinoma. METHODS: The levels of amplification of the c-met and E-cadherin genes in 44 advanced gastric carcinoma patients were retrospectively investigated using RT-PCR. The relationships between the levels of amplification of these genes and the clinicopathological parameters were evaluated using univariate and multivariate analyses. RESULTS: Seventeen (38.6%) and 13 (29.5%) of the 44 advanced gastric carcinoma patients were evaluated as having amplification of the c-met gene and down-regulation of the E-cadherin gene, respectivly. The amplification of c- met gene was significantly correlated with serosal invasion, lymph node metastasis and neural invasion, whereas the down-regulation of the E-cadherin gene was significantly correlated with the diffuse type of gastric carcinoma by Lauren's calssification, and neural invasion. CONCLUSION: The levels of the c-met and E-cadherin gene amplifications may be a powerful aids in evaluating the metastatic potential and prognosis in patients with advanced gastric cancer.
Cadherins* ; Down-Regulation ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms*

Adult ; Animals ; Bone Density ; Calcium Sulfate ; Depression ; Dogs ; Golgi Apparatus ; Humans ; Organelles ; Osteoblasts ; Osteogenesis ; Secretory Vesicles ; Transplants ; Wounds and Injuries