We report unusual 3 cases of adult coronary arteriovenous fistula(CAVF) diagnosed by coronary arteriography in Soonchunhyang University Hospital. In one patient with mitral stenoinsufficiency, multiple CAVFs originated from left anterior descending and left circumflex coronary areries. In another patient with significant stenosis(90%) in distal right coronary artery, new CAVF was seen in mid right coronary artery during consecutive coronary arteriography. In the remaining one, it was arose from contus branch of right coronary artery. Surgical correction was performed in two cases.
Adult* ; Angiography ; Arteriovenous Fistula* ; Coronary Vessels ; Humans

Ninety-one cases of genitourinary tract injuries which were admitted to Severance Hospital during the period from Jan. 1960 to Aug. 1968 were analyzed clinically and statistically. And it was investigated compared with previous papers 1) The rate of genitourinary injuries accounted for 7.3 per cent to the total admission patients during eight years sixty-nine per cent of all injuries were in men and thirty-one per cent in women. The age distribution was much the same as that found in previous literature. Most favorable age was in from 20 to50 years for 72.5 percent 2) The meet common involvement site was in urethra for32.9 per cent while external genitalia showing most common site in war wound Also iatrogenic ureteral injuries was relatively high in spite of most less commonest incidence in previous paper 3) Thirty-six per cent of all injuries weredue to traffic or vehicular accident and twenty-four per cent 'due to iatrogenic. Majority of these iatrogenic injuries occurred in pelvic operation. Falls kick and blow were listed not less frequently. 4) On observation of kidney injuries. predisposed hydronephrotic kidney was injured more frequently due to mild external forces and three cases of sixteen kidney injuries had hydronephrosis dueto stone and congenital ureteral stricture in this series 5) An incidence of ureteral injury during radical hysterectomy was variable in literature. but it was noted around 10 percent generally. In reviewing 197 cases of radical hysterectomy for carcinoma of cervix, incidence of ureteral injuries was 12 cases(7.3 per cent) and it was listed 9.3 percent including bladder injuries. 6) In investigating bladder injuries, 53 percent of injuries were associated with pelvic bone fracture And 87 per cent was extraperitoneal type and 13 per cent wasin intraperitoneal rupture. 7) Also majority of urethral injuries were associatedwith pelvic bone fracture especially in car accident cases and then involved posterior urethra for 85 per cent. And bulbous urethra was injured by straddle injury for 70 per cent.
Age Distribution ; Cervix Uteri ; Constriction, Pathologic ; Female ; Genitalia ; Humans ; Hydronephrosis ; Hysterectomy ; Incidence ; Kidney ; Male ; Pelvic Bones ; Rupture ; Ureter ; Urethra ; Urinary Bladder ; Wounds and Injuries

BACKGROUND: Studies of human coronary plaque specimens have shown that T lymphocytes and macrophages are present in all types of lesions, from fatty streaks to advanced plaques. There is growing evidence for a pathogenic role for immune response in progression of atherosclerosis. This study was designed to investigate cytokine production by mononuclear leukocytes from patients with myocardial infarction. METHOD: We measured the kinetics of secretion of tumor necrosis factor-alpha (TNF-alpha) and interferon-r (IFN-r) by mononuclear leukocytes from 8 control subjects and 12 patients with acute myocardial infarction. Mononuclear leukocytes were isolated and incubated with plant lectin mitogen concanavalin-A for 24 and 48 hours. TNF-alpha and IFN-r secretions were measured by ELISA. RESULTS:There were no significant differences between TNF-alpha and IFN-r secretions by mononuclear leukocytes at and before 24 hours of incubation from both patients and control subjects, but TNF-alpha and IFN-r secretions at 48 hours of incubation were higher (p<0.005, p<0.05) in patients when compared with control subjects. TNF-alpha and IFN-r secretions by mononuclear leukocytes after incubation correlated with the peak level of creatine phosphokinase (CK) and CK-MB. CONCLUSION: Increased cytokine secretory capacity of mononuclear leukocytes may be due to the acute inflammatory response of myocardial infarction. Further trials may be needed to determined the effects of increase in secretory capacity of mononuclear leukocytes before myocardial infarction.
Atherosclerosis ; Creatine Kinase ; Enzyme-Linked Immunosorbent Assay ; Humans ; Kinetics ; Leukocytes, Mononuclear* ; Macrophages ; Myocardial Infarction* ; Plants ; T-Lymphocytes ; Tumor Necrosis Factor-alpha*

No abstract available.
Fibrin* ; Transplants*

BACKGROUND: Hemodynamic derangements of cardiac tamponade are generally believed to result from compression of the cardiac chambers, which limits diastolic filling. The character and magnitude of the alternation are determined by the compliance characteristics of the pericardium and the total pericardial fluid volume. During serial pericardial fluid withdrawal, improvement of hemodynamic alternations is expected in patients with pericardial effusion. Method : Hemodynamic study was performed before and during serial fluid drainage in 11 patients with chronic moderate to severe pericardial effusion. RESULTS: 1) Intrapericardial pressure was elevated and equal to mean right atrial ventricular diastolic, and pulmonary capillary wedge pressure. Pulmonary arterial and right ventricular systolic pressure were also midly elevated equal to one another. 2) Pericardial fluid was gradually removed in 50ml aliquots in all patients. The most significant hemodynamic improvement occured during intial 50mL withdrawal. Futher drainage of intrapericardial fluid was accompanied by slight hemodynamic improvement. 3) There were significant correlations between total pericardial fluid volume and intrapericardial and right atrial pressure (r=0.75 (p<0.005), r=0.71(p<0.01)). Correlations between intrapericardial pressure and right atrial, right ventricular diastolic and pulmonary capillary wedge pressure were also significant. 4) Two groups of patient could be distinguished based upon intrapericardial pressure as 7mmHg. More significant hemodynamic changes were in 6 patients with higher intrapericardial pressure after withdrawal of 200mL fluid. CONCLUSION: In chronic moderate to severe pericardial effusion, the most significant hemodynamic improvement occurred during initial fluid drainage. Early pericardiocentesis is important in management of pericardial effusion with high intrapericardial pressure.
Atrial Pressure ; Blood Pressure ; Cardiac Tamponade ; Compliance ; Drainage* ; Hemodynamics* ; Humans ; Pericardial Effusion* ; Pericardiocentesis ; Pericardium ; Pulmonary Wedge Pressure

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin* ; Transplants*

No abstract available.
Osteoarthritis*

BACKGROUND: Laser resurfacing has beneficial effects for the treatment of several skin conditions. Recently, the pulsed erbium:YAG laser has been shown to be a highly effective treatment for several kinds of pitted facial scars. OBJECTIVE: The purpose of this study was to assess the efficacy and safety of pulsed erbium:YAG laser skin resurfacing at the setting of low or high energy for pitted acne scars. METHODS: 65 patients with pitted acne scars were included in this study. All patients had skin types III or IV. All patients were instructed to use tretinoin cream 0.05% nightly for 2-4 weeks prior to the laser treatment. The pulsed erbium:YAG laser with a 2 mm handpiece at the setting of 500 mJ/pulse, 3.5-5 W in 45 patients and 1,000 mJ/pulse, 7-10 W in 20 patients was used. Two weeks after laser treatment, topical application of hydroquinone 4%, tretinoin 0.05%, and hydrocortisone 1% cream was recommended for 2-4 weeks. Facial photographs were obtained at baseline and 2 week intervals postoperatively. The results of treatment were evaluated for the changes of skin texture and color at 1 month, 3 months, and 6 months. RESULTS: In 45 cases treated with 500 mJ/pulse energy, pitted acne scars were improved about 46.7 % on average and no erythema and postinflammatory hyperpigmentation was observed after 6 months. In 20 cases treated with 1,000 mJ/pulse energy, pitted acne scars were improved about 64% on average and erythema in two patients and postinflammatory hyperpigmentation in one patient were observed after 6 months. CONCLUSION: The results of laser treatment for pitted facial acne scars at the setting of high energy are better than those of laser treatment at the setting of low energy.
Acne Vulgaris* ; Cicatrix* ; Erbium* ; Erythema ; Humans ; Hydrocortisone ; Hyperpigmentation ; Lasers, Solid-State* ; Skin ; Tretinoin

Acute Febrile Neetrophilic Dermatosis(AFND, Sweet's syndrome) ia characterixed by painful erythematous plaquea aaaociatcd with arthralgia, fever and leukocytoeis, We preagented a case of acute febrice neutrophilie denmatoeis in acutemyelogenous leukemia which occurred in a 55-year-old man. After 10 days of treatment with prednisolone, the skin lesion disapceared, but he die of pneumonia in spite of anticancer therapy.
Arthralgia ; Fever ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Middle Aged ; Pneumonia ; Prednisolone ; Skin ; Sweet Syndrome*

BACKGROUND: The distribution of Malassezia yeasts on normal human skin was varied according to the age and race of the volunteers and the methodologies used. In Korea, most reports of Malassezia yeast distribution have relied on direct skin smears rather than culture methods. OBJECTIVE: The aim of this work was to perform a comprehensive survey of the distribution of Malassezia yeasts on normal human skin to provide a base line for a companion study of Malassezia yeasts in patients with various dermatoses. METHODS: Malassezia yeasts were cultured using the swabbing technique from the scalp, forehead, chest, upper back, upper arm and upper thigh in 137 subjects, infancy to 80 years of age. RESULTS: Malassezia yeasts were present in the lowest incidence(0-30%) on six sites of infants and present in 60.0-66.7% on the sebum-rich sites (scalp, forehead, chest, upper back) of children aged 1-9. Malassezia yeasts were present in 80.0-86.7% on the sebum-rich sites of the elderly group(over 60 years of age), about the same frequency as in the middle-aged groups. The population density of these organisms was significantly higher on the upper back than on the forehead, chest, upper arm and upper thigh in all age groups except the infant group and the group aged 1 to 9 (p<0.05). There were no regular quantitative variations in the distribution of Malassezia yeasts on a given site between age groups. On Leeming and Notman media, besides three morphotypes of Malassezia yeasts reported by Cunningham et al(1990), one additional type was identified. CONCLUSION: The results showed regional variations in the distribution of Malassezia yeasts in all ages except infancy and no regular age variations on a given site. Additionally, four colony types of Malassezia yeasts were found. The findings of our study coold help to investigate the role of Malassezia yeasts in related disorders.
Aged ; Arm ; Child ; Continental Population Groups ; Forehead ; Friends ; Humans* ; Infant ; Korea ; Malassezia* ; Population Density ; Scalp ; Skin Diseases ; Skin* ; Thigh ; Thorax ; Volunteers ; Yeasts*