BACKGROUND: In sudden cardiac arrest, the effective maintenance of coronary artery blood flow is of paramount importance for myocardial preservation as well as cardiac recovery and patient survival. The purpose of this study was to directly compare the effects of pulsatile and non-pulsatile circulation to coronary artery flow and myocardial preservation in cardiac arrest condition. MATERIAL AND METHOD: A cardiopulmonary bypass circuit was constructed in a ventricular fibrillation model using fourteen Yorkshire swine weighing 25~35 kg each. The animals were randomly assigned to group I (n=7, non-pulsatile centrifugal pump) or group II (n=7, pulsatile T-PLS pump). Extracorporeal circulation was maintained for two hours at a pump flow of 2 L/min. The left anterior descending coronary artery flow was measured with an ultrasonic coronary artery flow measurement system at baseline (before bypass) and at every 20 minutes after bypass. Serologic parameters were collected simultaneously at baseline, 1 hour, and 2 hours after bypass in the coronary sinus venous blood. The Mann-Whitney U test of STATISTICA 6.0 was used to determine intergroup significances using a p value of <0.05. RESULT: The resistance index of the coronary artery was lower in group II and the difference was significant at 40 min, 80 min, 100 min and 120 min (p <0.05). The mean velocity of the coronary artery was higher in group II throughout the study, and the difference was significant from 20 min after starting the pump (p <0.05). The coronary artery blood flow was higher in group II throughout the study, and the difference was significant from 40 min to 120 min (p <0.05) except at 80 min. Serologic parameters showed no differences between the groups at 1 hour and 2 hours after bypass in the coronary sinus blood. CONCLUSION: In cardiac arrest condition, pulsatile extracorporeal circulation provides more blood flow, higher flow velocity and less resistance to coronary artery than non-pulsatile circulation.
Animals ; Cardiopulmonary Bypass ; Coronary Sinus ; Coronary Vessels* ; Death, Sudden, Cardiac ; Extracorporeal Circulation* ; Heart Arrest ; Humans ; Pulsatile Flow ; Regional Blood Flow ; Swine ; Ultrasonics ; Ventricular Fibrillation

PURPOSE: Morel-Lavallee lesions is post-traumatic effusion at subcutaneous layer. Early management of Morel-Lavallee lesion is percutaneous drainage and compression. Surgical excision is recommended for cases that are chronic. METHODS: A 41-year old male patient had slow growing, painful mass on left thigh, which has been present for 3 years. He had a history of blunt trauma 3 years ago. Computed tomography presented 10 x 10 x 5 cm sized cystic mass on left thigh, between subcutaneous fat layer and muscle fascia layer. The mass was surgically removed and biopsy was performed. RESULTS: Histopathological examination shows chronic inflammation and fibrotic change. After 6 month follow-up period, postoperative course was uneventful. CONCLUSION: We performed surgical excision of Morel-Lavalle lesion in a patient who had trauma 3 years ago. We report a case of Morel-Lavallee lesion with the review of the literatures.
Biopsy ; Drainage ; Fascia ; Follow-Up Studies ; Humans ; Inflammation ; Male ; Muscles ; Postoperative Period ; Subcutaneous Fat ; Thigh

PURPOSE: To describe technical methods for functional magnetic resonance imaging (fMRI) study with arterial spin labeling (ASL) compared to blood oxygenation level-dependent (BOLD) technique and discuss the potential of ASL for research and clinical practice. MATERIALS AND METHODS: Task-based (n = 1) and resting-state fMRI (rs-fMRI) (n = 20) were performed using ASL and BOLD techniques. Results of both techniques were compared. RESULTS: For task-based fMRI with finger-tapping, the primary motor cortex of the contralateral frontal lobe and the ipsilateral cerebellum were activated by both BOLD and ASL fMRI. For rs-fMRI of sensorimotor network, functional connectivity showed similar results between BOLD and ASL. CONCLUSION: ASL technique has potential application in clinical and research fields because all brain perfusion imaging, CBF measurement, and rs-fMRI study can be performed in a single acquisition.
Brain ; Cerebellum ; Frontal Lobe ; Magnetic Resonance Imaging* ; Motor Cortex ; Oxygen ; Perfusion Imaging

PURPOSE: To describe technical methods for functional magnetic resonance imaging (fMRI) study with arterial spin labeling (ASL) compared to blood oxygenation level-dependent (BOLD) technique and discuss the potential of ASL for research and clinical practice. MATERIALS AND METHODS: Task-based (n = 1) and resting-state fMRI (rs-fMRI) (n = 20) were performed using ASL and BOLD techniques. Results of both techniques were compared. RESULTS: For task-based fMRI with finger-tapping, the primary motor cortex of the contralateral frontal lobe and the ipsilateral cerebellum were activated by both BOLD and ASL fMRI. For rs-fMRI of sensorimotor network, functional connectivity showed similar results between BOLD and ASL. CONCLUSION: ASL technique has potential application in clinical and research fields because all brain perfusion imaging, CBF measurement, and rs-fMRI study can be performed in a single acquisition.
Brain ; Cerebellum ; Frontal Lobe ; Magnetic Resonance Imaging* ; Motor Cortex ; Oxygen ; Perfusion Imaging

BACKGROUND AND AIMS: Abdominal distension from the insufflation of air can create more troublesome discomfort after colonoscopy (CFS) than after upper endoscopy. Many patients report difficulty in expelling insufflated air after CFS. One previous study demonstrated that insertion of rectal tube at the conclusion of CFS significantly improves patient satisfaction with the procedure. The aim of this study was to compare the effectiveness of rectal tube placement for abdominal decompression after CFS in an effort to limit patient discomfort by carefully applying air suction during CFS. METHODS: We conducted a prospective trial in 103 consecutive patients undergoing elective CFS. Patients were randomized to receive rectal tube placement at the end of the procedure or simple air suction during the procedure. Patients were evaluated by clinical symptoms and signs 10 minutes after completion of CFS. RESULTS: All 103 patients had a complete examination of the colon to the cecum. No specific complications occurred during and a day after examination. The two groups were well matched with respect to age, sex, height, weight, chief complaints. There were no significant differences between the two groups for bowel preparation, duration of examination, abdominal pain during procedure, abdominal disten-sion 10 minutes after CFS, and abdominal pain 10 minutes after CFS (p >0.05). CONCLUSIONS: Meticulous air suction during CFS reduces abdominal discomfort and distension after CFS and is as effectively as the placement of a rectal tube at the con-clusion of CFS.
Abdominal Pain ; Cecum ; Colon ; Colonoscopy* ; Endoscopy ; Humans ; Insufflation ; Lower Body Negative Pressure ; Patient Satisfaction ; Prospective Studies ; Suction

In reconstructing a defect of the mandible after removing tumor of an oral cavity or facial region, various musculocutaneous flaps are used. Among those, SCM musculocutaneous flaps are clinically frequently used due to its near donor site and it can be done without an additional operation. Because the SCM muscle is supplied by many vessels of the external carotid artery and subclavian artery, it is essential to the figure out its distribution to the SCM muscle, clavicle and the skin before making an osseomusculocutaneous flap including the clavicle. Especially, understanding the distribution status of the origin of superior thyroid artery and SCM branch is very important in making a SCM musculocutaneous flap including the clavicle and deciding the rotation arc of the musculocutaneous flap. The authors have dissected SCM muscles and arteries distributed to the SCM muscle of 50 cadavers and found the following results. The average distance from the origin of superior thyroid artery to SCM branch entering to SCM muscle was 30.1 mm (16.0 ~37.7 mm), and some were to have 2 ~3 branches inserted simultaneously into the SCM muscle. The average distance from the origin of superior thyroid artery to clavicular head of SCM muscle was 87.6 mm (57.7 ~123.8 mm), and to sternal head of SCM muscle was 131.2 mm(99.7 ~166.8 mm). After the SCM branch of superior thyroid artery distributed to the SCM muscle, the bifurcation point into clavicular branch and sternal branch is located at an average 58.8 mm(28.4 ~130.4 mm) above the clavicle. All of the nutrition artery distributed to the clavicle were branches of the thoracoacromial artery, and the SCM branch of superior thyroid artery distributed throughout the SCM muscle and downwards to the periosteal artery of the clavicle. The pattern of the superior thyroid artery was divided into 6 types. Among the branches of superior thyroid artery such as laryngeal, SCM and thyroid branch, The type I (36%) that the laryngeal branch arised first was most common. Next, the incidence of type II that all three branches arised at one point was 16%. In addition, the incidence of the case that SCM branch arised directly from the external carotid artery was 26%. In conclusion, because the origin of superior thyroid artery from the external carotid artery is located relatively close to the mandible above the neck, the length of SCM musculocutaneous flap including the SCM branch of superior thyroid artery is sufficient to reconstructing the mandible and the SCM osseomusculocutaneous flap including the clavicle is useful in reconstruction of the mandible.
Arteries* ; Cadaver ; Carotid Artery, External ; Clavicle ; Head ; Humans ; Incidence ; Mandible ; Mouth ; Muscles ; Myocutaneous Flap ; Neck ; Skin ; Subclavian Artery ; Thyroid Gland ; Tissue Donors

PURPOSE: The aim of this study was to assess the expression of VEGF-C (vascular endothelial growth factor-C) and LYVE-1 (lymphatic vessel endothelial HA receptor-1) mRNA in human breast cancer, and to compare the expression of VEGF-C protein and VEGF-C, LYVE-1 mRNA with the clinico-pathological outcomes. METHODS: RT-PCR was carried on the VEGF-C, LYVE-1 mRNA drawn from three samples of adjacent normal breast tissues, the MCF-7 breast cancer cell line and 39 breast cancer tissues. Immunohistochemical staining was done to detect the expression of VEGF-C protein in 39 cancer tissues and in 5 benign tissues with using well preserved, paraffin embedded tissues. The clinico-pathological findings were retrospectively reviewed for menopausal status, lymphatic invasion, hormonal status, the expression of p53 and c-erbB2. RESULTS: RT-PCR analysis revealed the expression of VEGF-C mRNA in 22 of 39 (56.4%) and LYVE-1 mRNA in 19 of 39 breast cancer tissues (48.7%). The expression of VEGF-C mRNA was positive in all cases except for one in LYVE-1 mRNA positive case, this revealed good correlation between the two molecules. Immunohistochemical analysis revealed that VEGF-C protein was expressed only in the breast cancer cells, with specific VEGF-C staining evident in 10 of 39 (25.6%). There was no significant correlation between VEGF-C, LYVE-1 mRNA expressions and the other pathologic variables. However, VEGF-C protein expression was negative in the group with a postmenopausal status, positive estrogen receptor and negative c-erbB2 significantly. CONCLUSIONS: VEGF-C mRNA seems to be related to the lymphangiogenetic marker-LYVE-1 mRNA and the amplification of the VEGF-C may be correlated with some clinico-pathological factors in the breast cancer.
Breast Neoplasms* ; Breast* ; Cell Line ; Estrogens ; Humans ; Paraffin ; Retrospective Studies ; RNA, Messenger ; Vascular Endothelial Growth Factor C*

PURPOSE: The aim of this study was to assess the expression of VEGF-C (vascular endothelial growth factor-C) and LYVE-1 (lymphatic vessel endothelial HA receptor-1) mRNA in human breast cancer, and to compare the expression of VEGF-C protein and VEGF-C, LYVE-1 mRNA with the clinico-pathological outcomes. METHODS: RT-PCR was carried on the VEGF-C, LYVE-1 mRNA drawn from three samples of adjacent normal breast tissues, the MCF-7 breast cancer cell line and 39 breast cancer tissues. Immunohistochemical staining was done to detect the expression of VEGF-C protein in 39 cancer tissues and in 5 benign tissues with using well preserved, paraffin embedded tissues. The clinico-pathological findings were retrospectively reviewed for menopausal status, lymphatic invasion, hormonal status, the expression of p53 and c-erbB2. RESULTS: RT-PCR analysis revealed the expression of VEGF-C mRNA in 22 of 39 (56.4%) and LYVE-1 mRNA in 19 of 39 breast cancer tissues (48.7%). The expression of VEGF-C mRNA was positive in all cases except for one in LYVE-1 mRNA positive case, this revealed good correlation between the two molecules. Immunohistochemical analysis revealed that VEGF-C protein was expressed only in the breast cancer cells, with specific VEGF-C staining evident in 10 of 39 (25.6%). There was no significant correlation between VEGF-C, LYVE-1 mRNA expressions and the other pathologic variables. However, VEGF-C protein expression was negative in the group with a postmenopausal status, positive estrogen receptor and negative c-erbB2 significantly. CONCLUSIONS: VEGF-C mRNA seems to be related to the lymphangiogenetic marker-LYVE-1 mRNA and the amplification of the VEGF-C may be correlated with some clinico-pathological factors in the breast cancer.
Breast Neoplasms* ; Breast* ; Cell Line ; Estrogens ; Humans ; Paraffin ; Retrospective Studies ; RNA, Messenger ; Vascular Endothelial Growth Factor C*

Menetrier's disease is a rare, characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss, and edema due to gastric protem loss. A 64 year old male patient was admitted with the chief complaint of epigastric discomfort. Endoscopic, radiologic and histologic examination, revealed characteristic findings of Menetrier's disease. A case of Menetrier's disease is reported with a brief review of literature.
Edema ; Gastritis, Hypertrophic* ; Humans ; Male ; Middle Aged ; Stomach ; Weight Loss

BACKGROUND: Abnormalities of the left ventricular diastolic function can be classified by pulsed Doppler echocardiography, but sometimes it may be difficult to differentiate normal diastolic function from pseudonormalization. Heart failure caused by increased left ventricular filling pressure is rather associated with pseudonormalization or restrictive pattern than normal pattem or relaxation abnormality. We investigated the usefulness of color M-mode Doppler echocardiographic indexes in differentiating normal relaxation from pseudonormalization after acute myocardial infarction. METHOD: Echocardiographic examination including color M-mode Doppler was performed in 44 patients with acute myocardial infarction between 10 and 14 days after attack. 34 patients without in-hospital congestive heart failure(CHF) were assigned as group I, and 10 patients with in-hospital CHF as group II. Flow propagation slope(FPS), time difference(TD) between the occurrence of peak flow velocity in the apical region and at the mitral tip, and normalized time difference(nTD) by mitral and apical distance were measured with color M-mode Doppler echocardiography. RESULTS: FPS was lower in group II(group I, 42.0+/-20.6cm/sec vs group II, 27.8+/-8.0cm/ sec , p=0.065). Both groups had similar TD and nTD. FPS was compared in patients with E/ A ratio of mitral inflow greater than 1(22 patients of group I and 7 patients of group II). Patients with E/A) 1 in group II had significantly lower FPS(group I, 52.1+/-17.5cm/sec vs group II, 31.0+/-7.4cm/sec ; p(0.01). CONCLUSION: FPS was significantly decreased after acute myocardial infarction in patients with in-hospital CHF compared with patients without in-hospital CHF, even when E/A ratio of mitral inflow was greater than 1. Therefore, FPS was an useful index in differentiating normal relaxation from pseudonormalization.
Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Humans ; Myocardial Infarction* ; Relaxation