No abstract available.
Hemoperitoneum*

No abstract available.
Infection Control*

BACKGROUND: Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. MATERIAL AND METHOD: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. RESULT: After surgical correction peak aortic gradient fell from 58.4+/-17.6, to 23.7+/-17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6+/-24.3 to 143.7+/-27.1 mmHg and from 1.78+/-0.4 to 1.76+/-0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10+/-0.2, to 1.27+/-0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2+/-24.9 to 57.1+/-27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. CONCLUSION: We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.
Aorta ; Aortic Valve Stenosis* ; Blood Pressure ; Child ; Equidae ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardium ; Oxygen Consumption ; Reoperation ; Stroke Volume

BACKGROUND AND OBJECTIVES: The purpose of this research was to evaluate physiological significances of expression of immediate early gene proteins in the vestibular nuclear complex by change of arterial pressure (AP) in adult Sprague-Dawley rats. MATERIALS AND METHOD: Record AP and inject either sodium nitroprusside (SNP) or phenylnephrine to change AP. Either fast or slow removal of blood from the femoral artery was made to induce different rapidity in reduction of AP. Blood supply to the inner ear was temporally blocked by clamping anterior inferior cerebellar artery (AICA). Immunohistochemical staining and image analysis for cFos, FosB, Krox, and JunB proteins were performed 2, 6, 12 hours after change of AP. RESULTS: The selective expression of cFos protein was observed in the medial vestibular nucleus (MVN) following reduction of AP. The number of cFos positive neurons peaked at 2 hours and then rapidly reduced, returning to the normal value 24 hours after SNP injection. And cFos protein expression was also well correlated with that of AP reduction at 2 hours of SNP injection. The rapid falling of AP caused a significant expression of cFos protein but slow withdrawal of blood did a minimal change of cFos protein expression. In addition, there was a significant expression of cFos protein following the increase of AP by single injection of phenylnephrine. Unilateral occlusion of AICA resulted in the significant expression of cFos protein in bilateral MVN. Furthermore, bilateral ablation of vestibular endorgans resulted in significant reduction of cFos expression by AICA occlusion in MVN. CONCLUSION: These results suggest that cFos protein is a marker for neuronal excitation in vestibular complex in response to rapid changes in the arterial blood pressure and that medial vestibular nuclei plays an important role in signaling the process of cardiovascular information coming from the peripheral vestibular apparatus.
Adult* ; Animals ; Arterial Pressure* ; Arteries ; Blood Pressure ; Constriction ; Ear, Inner ; Femoral Artery ; Humans ; Neurons ; Nitroprusside ; Proteins ; Rats* ; Rats, Sprague-Dawley ; Reference Values ; Vestibular Nuclei ; Vestibule, Labyrinth

Diving is a perilous activity. Long exposure to the subaquatic environment results in many troubles to divers. In Korea, the number of divers, especially recreational ones, is soaring up and the incidence of diving related accidents and illnesses is also increasing rapidly. Consequently, diving medicine which approaches underwater medical problems is getting more important to doctors as well as divers. Decompression sickness (DCS) is one of the most typical diseases in diving medicine, and divers who breathe compressed air or mixed gas always have a risk of suffering from it. DCS is caused by bubbles from dissolved inert gas as a result of decompression. The diagnosis of DCS is based completely on clinical manifestations, but it is not easy to make a correct diagnosis due to various symptoms. In general, DCS needs prompt recompression chamber treatment with trained medical and paramedical staff, but few doctors are trained to handle diving related diseases like DCS and most people in Korea are not aware of diving medicine. Additionally, lack of recompression facilities hinders DCS patients from taking treatment timely. To deal with these problems, Korean government as well as doctors needs to show deep concern at this field.
Compressed Air ; Decompression ; Decompression Sickness ; Diving ; Humans ; Hyperbaric Oxygenation ; Incidence ; Korea ; Stress, Psychological

The treatment of massive bone and soft tissue defect in the lower leg has a high complication rate of nonunion, chronic infection, and amputation without well-vascularized tissue coverage of the open fracture. Despite adequate free soft tissue coverage, massive skeletal defect may result in segmental bone defects, angulation deformity, and limb length discrepancies. In the last decade, major advances have occurred in the Ilizarov method of distraction osteogenesis in lower leg salvage as a delayed procedure or simultaneous distraction after free-tissue transfer. The authors have performed Ilizarov transport in conjunction with muscle and musculocutaneous flap coverage in nine cases of lower leg salvage. The flaps consist of rectus, gracilis, latissimus dorsi, parascapular, and serratus muscle or musculocutaneous fashioning using ipsilateral or contralateral pedicle in consideration of vessel condiation. Revision, recorticotomy and flap elevation were also used as a secondary procedure for satisfactory results. The conclusions, were as follows: 1) Multidisciplinary team approach with conjoining departments at the time of preoperative evaluation, postoperative care and rehabilitation care; 2) Muscle flap covered with split-thickness skin graft was preferred to musculocutaneous flap; 3) To reduce the total reconstructive period, simultaneous free tissue transfer with Ilizarov distraction should be considered.
Amputation ; Congenital Abnormalities ; Extremities ; Fractures, Open ; Ilizarov Technique ; Leg* ; Myocutaneous Flap ; Osteogenesis* ; Osteogenesis, Distraction ; Postoperative Care ; Rehabilitation ; Skin ; Superficial Back Muscles ; Transplants

This study was performed to evaluate the effect of topical and intravenous heparin on thrombosis and patency in the microvascular anastomosis of the traumatized veins. Nine white rabbits weighing about 2kg were used. After exposure of both femoral veins, the veins were crushed by the jaws of smooth needle holder in order to create a thrombosis model. Transectional incision was made in the vein. The animals were then divided into 3 groups based on the administration method of heparin: 1) Experimental Group I, topical irrigation of lumen with heparin saline solution (n=6); 2) Experimental Group 2, topical irrigation of lumen with heparin saline solution and intravenous injection of heparin (0.75 mg/kg) via the marginal ear vein for 3 days; 3) Control Group, topical irrigation of lumen with saline solution (n=6). The patency was evaluated with empty-and-refill test and thrombus formation was judged by surgical microscope. The results were as follows: 1. Thirty minutes after microvascular anastomosis, the patency fall Experimental Groups was better than Control group. However, there was no significant difference among groups. 2. Three days after anastomosis, the patency of all Experimental Groups was much more improved than that of Control Group (P<0.05). There was no significant difference between Experimental Group 1 and 2. 3. Three days after anastomosis, the amount of thrombus in all Experimental Groups was much less than that of Control Group (P<0.05). 4. In histologic findings a lot of luminal thrombus were observed around sutured area in Control Groups. Few luminal thrombus was observed in all Experimental Groups. Mild necrosis in the vessel wall was observed around sutured area in all specimens. These results indicate that topical irrigation of heparin may improve the patency and inhibit the formation thrombus in the microvascular anastomosis of the traumatized veins.
Animals ; Ear ; Femoral Vein ; Heparin* ; Injections, Intravenous ; Jaw ; Necrosis ; Needles ; Phenobarbital ; Rabbits ; Sodium Chloride ; Thrombosis* ; Veins

No abstract available.
Cross Infection ; Foot* ; Pseudomonas aeruginosa

No abstract available.
Lipomatosis*

An unusual case of embryonal rhabdomyosarcoma of the bladder in a 77 year old man, who presented with difficult urination, gross hematuria and vague lower abdominal pain. Herein, we report a case of rhabdomyosarcoma. which revealed early recurrence and rapid growing up after partial cystectomy.
Abdominal Pain ; Adult* ; Aged ; Cystectomy ; Hematuria ; Humans ; Recurrence ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Embryonal ; Urinary Bladder* ; Urination