The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

PURPOSE: This study was to investigate the age and sex differences of the fractal dimension of the normal parotid glands in the digitized CT images. MATERIALS AND METHODS: The six groups, which were composed of 42 men and women from 20`s, 40`s and 60`s and over were picked. Each group contained seven people of the same sex. The normal parotid CT images were digitized, and their fractal dimensions were calculated using Scion ImagePC program. RESULTS: The mean of fractal dimensions in males was 1.7292(+/-0.0588) and 1.6329(+/-0.0425) in females. The mean of fractal dimensions in young males was 1.7617, 1.7328 in middle males, and 1.6933 in old males. The mean of fractal dimensions in young females was 1.6318, 1.6365 in middle females, and 1.6303 in old females. There was no statistical difference in fractal dimension between left and right parotid gland of the same subject(p>0.05). Fractal dimensions in male were decreased in older group(p<0.05) and larger than female in same age group(p<0.05). But fractal dimensions in female had a tendency to decrease in older group but no statistical difference between ages(p>0.05). CONCLUSIONS: The fractal dimension of parotid glands in the digitized CT images will be useful to evaluate the age and sex differences.
Female ; Fractals* ; Humans ; Male ; Parotid Gland* ; Sex Characteristics

PURPOSE: Thallium (TI+) autometallography is often used for the imaging of neuronal metabolic activity in the rodent brain under various pathophysiologic conditions. The purpose of this study was to apply a thallium autometallographic technique to observe changes in neuronal activity in the forebrain of rats following acute carbon monoxide (CO) intoxication. METHODS: In order to induce acute CO intoxication, adult Sprague-Dawley rats were exposed to 1100 ppm of CO for 40 minutes, followed by 3000 ppm of CO for 20 minutes. Animals were sacrificed at 30 minutes and 5 days after induction of acute CO intoxication for thallium autometallography. Immunohistochemical staining and toluidine blue staining were performed to observe cellular damage in the forebrain following intoxication. RESULTS: Acute CO intoxication resulted in significant reduction of TI+ uptake in major forebrain structures, including the cortex, hippocampus, thalamus, and striatum. In the cortex and hippocampal CA1 area, marked reduction of TI+ uptake was observed in the cell bodies and dendrites of pyramidal neurons at 30 minutes following acute CO intoxication. There was also strong uptake of TI+ in astrocytes in the hippocampal CA3 area following acute CO intoxication. However, there were no significant histological findings of cell death and no reduction of NeuN (+) neuronal populations in the cortex and hippocampus at 5 days after acute CO intoxication. CONCLUSION The results of this study suggest that thallium autometallography can be a new and useful technique for imaging functional changes in neural activity of the forebrain structure following mild to moderate CO intoxication.

BACKGROUND AND OBJECTIVES: Normal angiogenesis occurs as a part of the body's repair processes like the healing of wounds and fractures. By contrast, uncontrolled angiogenesis can often be pathological. Vascular remodelling could therefore play an important role in the growth process of solid tumors. The aim of this study was to detect the expression of platelet-derived endothelial cell growth factor (PD-ECGF), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF), and investigate the correlation between these factors. Also, we studied the relationships between the expressions of these factors and the clinical stage, nodal involvement, and histologic grade in the squamous cell carcinoma of larynx. MATERIALS AND METHOD: The authors examined the expression of three angiogenic factors in specimens of laryngeal squamous cell carcinoma (n=17). The mRNA expressions of angiogenic factors were detected by the semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Statistics were analysed using the Fisher's exact test, the Wilcoxon signed rank test, and the Spearman correlation coefficiency. RESULTS: PD-ECGF and bFGF were significantly higher in the stages III and IV cancers than in the stages I and II cancers, and thus shows that bFGF was related to severity of the nodal involvement. The expression of more than one factor was significantly related with stages III and IV cancer. PD-ECGF and VEGF were related with each other. CONCLUSION: The authors suggest that angiogenic factors, especially, PD-ECGF and bFGF, may be used as prognostic factors for the squamous cell carcinoma of larynx.
Angiogenesis Inducing Agents ; Carcinoma, Squamous Cell* ; Endothelial Cells* ; Fibroblast Growth Factor 2 ; Fibroblasts* ; Larynx* ; RNA, Messenger ; Thymidine Phosphorylase ; Vascular Endothelial Growth Factor A ; Wounds and Injuries

Uterine fibroid, or leiomyoma, is a common benign neoplasm in women, but serious complications are rarely reported. We present the case of a 48-year-old woman with acute onset of abdominal pain. She was hemodynamically unstable, and computed tomography revealed abundant fluid collection in the peritoneal cavity, suggesting hemoperitoneum. During emergency exploratory laparotomy, the subserosal vein overlying a uterine fibroid was identified as the source of bleeding. Hemostasis was accomplished with fibroid excision. Spontaneous hemorrhage originating from a uterine fibroid is extremely rare, but may lead to life-threatening conditions. Therefore, in female patients with acute abdominal pain and hemoperitoneum, uterine fibroid may be a potential etiology and emergency exploratory laparotomy should be considered.

Uterine fibroid, or leiomyoma, is a common benign neoplasm in women, but serious complications are rarely reported. We present the case of a 48-year-old woman with acute onset of abdominal pain. She was hemodynamically unstable, and computed tomography revealed abundant fluid collection in the peritoneal cavity, suggesting hemoperitoneum. During emergency exploratory laparotomy, the subserosal vein overlying a uterine fibroid was identified as the source of bleeding. Hemostasis was accomplished with fibroid excision. Spontaneous hemorrhage originating from a uterine fibroid is extremely rare, but may lead to life-threatening conditions. Therefore, in female patients with acute abdominal pain and hemoperitoneum, uterine fibroid may be a potential etiology and emergency exploratory laparotomy should be considered.

PURPOSE: This study was designed to compare the wound healing effect of silk fibroin, alginate and fibroin/ alginate blend sponge with clinically used Nu gauze in a rat skin defect model. METHODS: Two full thickness excisions were made on the back of Sprague-Dawley rat. The excised wound was covered with either of the silk fibroin(SF), alginate (SA), or fibroin/alginate blend sponge(SF/SA). On the postoperative days of 3, 7, 10 and 14, the wound area was calculated by image analysis software. At the same time, a skin wound tissue was biopsied. RESULTS: Healing time 50% (HT(50)) of SF/SA sponge treated group was dramatically reduced as compared with that of control treatment. We also found that the HT50 of SF/SA sponge was significantly decreased as compared with either those of SF or SA treatment. Furthermore, SF/SA treatment significantly increased the size of epithelialization and collagen deposition as well as the number of PCNA positive cells on epidermal basement membrane as comapred with those of control treatment. CONCLUSION: Our results suggest that the wound healing effect of SF/SA blend sponge is the best among other treatments including SF and SA during the whole wound healing period.
Animals ; Basement Membrane ; Collagen ; Fibroins ; Porifera* ; Proliferating Cell Nuclear Antigen ; Rats ; Rats, Sprague-Dawley ; Silk* ; Skin ; Skin, Artificial* ; Wound Healing ; Wounds and Injuries*

BACKGROUND: The role of ultrasound in the thoracic spine has been underappreciated, partly because of the relative efficacy of the landmark-guided technique and the limitation of imaging through the narrow acoustic windows produced by the bony framework of thoracic spine. The aim of this study was to make a comparison between the 12th rib and the spinous process of C7 as a landmark for effective ultrasound-guided target segment identification in the thoracic spine. METHODS: Ultrasonography of 44 thoracic spines was performed and the same procedure was carried out 1 week later again. The target segments (T3–4, T7–8, and T10–11) were identified using the 12th rib (group 1) or the spinous process of C7 (group 2) as a starting landmark. Ultrasound scanning was done proximally (group 1) or distally (group 2) toward the target transverse process and further medially and slightly superior to the target thoracic facet. Then, a metal marker was placed on the T3–4, T7–8, and T10–11 and the location of each marker was confirmed by fluoroscopy. RESULTS: In the total 132 segments, sonographic identification was confirmed to be successful with fluoroscopy in 84.1% in group 1 and 56.8% in group 2. Group 1 had a greater success rate in ultrasound-guided target segment identification than group 2 (p = 0.001), especially in T10–11 (group 1, 93.2%; group 2, 43.2%; p = 0.001) and T7–8 (group 1, 86.4%; group 2, 56.8%; p = 0.002). The intrarater reliability of ultrasound-guided target segment identification was good (group 1, r = 0.76; group 2, r = 0.82), showing no difference between right and left sides. Ultrasound-guided target segment identification was more effective in the non-obese subjects (p = 0.001), especially in group 1. CONCLUSIONS: Ultrasound-guided detection using the 12th rib as a starting landmark for scanning could be a promising technique for successful target segment identification in the thoracic spine.
Acoustics ; Fluoroscopy* ; Nerve Block ; Ribs ; Spine* ; Ultrasonography

Modern capacity for high-resolution brain imaging has facilitated studying the clinicoanatomic correlations of small lesions in subcortical nuclear structures. Several recent reports have convincingly demonstrated that there were particular clinical syndromes associated with specific distributions of thalamic lesions. Thalamic dysfunction due to diveres casues, particularily in the left side has been associated with memory impairment, speech disturbance, cognitive deficits, and behavioural changes. Simplified bedside behavioral examinations were performed in six patients with the left tuberothalamic infarcts. We found severe neuropsychological deficits considered as dementia meeting the DSM III criteria, leaving few focal motor and sensory deficits. The disturbance of attention, speech, cognition and behavior after the left tuberothalamic infarcts are probably related not only to intrinsic thalamic dysfunction itself, but also to the disruption of the regular function of motor, sensory, and integrative cortical stuctures connecting with the thalamus.
Cognition ; Dementia* ; Humans ; Memory ; Neuroimaging ; Thalamus

OBJECTIVE: The aim of this study is to evaluate of the significance of intraoperative electrophysiologic monitoring and follow up electrophysiologic study at seven days after microvascular decompression(MVD) for hemifacial spasm(HFS). METHODS: Thirty nine patients with hemifacial spasm were included in this study and were treated with MVD of the facial nerve from Jun 1990 to May 2001. The patients were divided into a monitoring group and a non-monitoring group. We compared the surgical outcomes, operation related complications between two groups. The abnormal muscle response(AMR) of preoperative electromyographic recording appeared on the mentalis muscle during stimulation of the zygomatic branch of the facial nerve was compared with those of changed during operation, immediately after operation and at postoperative 7th day(POD 7). The relationship between degree of AMR disappearance and surgical outcome was analyzed. RESULTS: There was no difference in surgical outcomes but significant difference in the incidence of operation-related complications between two groups. The results of electrophysiologic study at POD 7 were significantly correlated with surgical outcome in the monitoring group. CONCLUSION: The electrophysiologic study is helpful for identifying the offenders, determining the adequacy of vascular decompression and decrease of operation-related complications. The clinical and electrophysiologic status of HFS after MVD has continuously changed, and therefore the results of eletrophysiologic study at POD 7 are useful for predicting the surgical outcome.
Criminals ; Decompression ; Electromyography* ; Facial Nerve ; Follow-Up Studies* ; Hemifacial Spasm* ; Humans ; Incidence ; Microvascular Decompression Surgery*