BACKGROUND: Hyperinflation during lung ischemia has been known to improve pulmonary functions after reperfusion which may be exerted through a pulmonary vasodilation and avoidance of atelectasis by an increased surfactant release and been known whether the improvement of pulmonary function was the effect of hyperinflation itself or the oxygen content in inflation gas. Therefore we attempted to clarify the effect of hyperinflation with oxygen in pulmonary inflation gas during warm ischemia on pulmonary function after reperfusion to solve the problem of ischemia-reperfusion injury after lung transplantation. MATERIAL AND METHOD: sixteen mongrel dogs were randomly divided into two groups: the left lung was inflated to 30-35 cm H2O with 100% oxygen in oxygen group and 100% nitrogen in nitrogen group. The inflated left lung was maintained with warm ischemia for 100 minutes. Arterial and mixed venous blood gas analysis and hemodynamics were measured before ischemia and 30, 60, 120, 180 and 240 minutes afer reperfusion. Lung biopsy was taken for the measurement of lung water content after the end of reperfusion. RESULT: In oxygen group arterial oxygen tension the difference of arterial and mixed venous oxygen tension and the difference of alveolar-arterial oxygen tension at 30-minute after reperfusion were not significantly different from those before ischemia and were stable during the 40hour reperfusion. However in nitrogen group these values were significantly deteriorated at 30-minute after reperfusion. there was no significant difference between two groups in hemodynamic data peak airway pressure and lung water content. CONCLUSION: The results indicated that the oxygenation one of the most important pulmonary functions was improved by pulmonary inflation with 100% oxygen during warm ischemia but the hemodynamics were not. Oxygen as a metabolic substrate during warm ischenia was believed to make the pulmonary tissues to maintain aerobic metabolism and to prevent ischemic damage of alveoli and pulmonary capillary.
Animals ; Biopsy ; Blood Gas Analysis ; Capillaries ; Dogs* ; Hemodynamics ; Inflation, Economic* ; Ischemia ; Lung Transplantation ; Lung* ; Metabolism ; Nitrogen ; Organ Preservation ; Oxygen* ; Pulmonary Atelectasis ; Reperfusion ; Reperfusion Injury* ; Vasodilation ; Warm Ischemia

PURPOSE: The purpose of the present study was to determine the risk factors for predicting the recurrence in first-time urinary stone formers. MATERIALS AND METHODS: A total of 121 patients, who presented at our hospital with first-time urinary stone episodes, between 1996 and 2005, and followed up for at least 3 years, were retrospectively evaluated. Of these, 65 patients (41 males, 24 females) recurred (R group) and 56 (38 males, 18 females) not (NR group) during the follow-up period. The blood chemistry and urinary analytes values, as well as the clinical characteristics between the NR and R groups were compared by gender. p-values less than 0.05 were used to indicate statistical significance. RESULTS: There were no differences in the clinical characteristics between the NR and R groups. A comparison of the blood chemistry showed differences in the phosphate and calcium in men and women (p=0.047 and 0.034), respectively. Greater urinary excretion of phosphates were found in the R group than in the NR group (p=0.018), but was more prominent in men (p=0.006). No significant differences were found between the two groups with regard to metabolic abnormalities. A multivariate analysis revealed that urinary phosphates excretion was the sole predictor for stone recurrence (Exp beta=8.347, p=0.033). CONCLISIONS: Our results suggested that the increased excretion of urinary phosphates was a significant risk factor for stone recurrence, which might be useful as a prognostic marker.
Calcium ; Chemistry ; Female ; Follow-Up Studies ; Humans ; Male ; Multivariate Analysis ; Phosphates ; Recurrence* ; Retrospective Studies ; Risk Factors ; Urinary Calculi

The authors report the surgical results of thalamotomy and pallidotomy, performed at our hospital between 1983 and 1993 for the treatment of Parkinson's disease. The series included a retrospective analysis of 156 patients with this condition by stereotactic ventrolateral(VL) thalamotomy(126 patients, 138 thalamotomies) and posterolateral pallidotomy(30 patients, 30 pallidotomies). Each patient was followed up postoperatively, for one year. Among those who underwent the stereotactic VL thalamotomy, 136/138 procedures(99%) led to improvement of tremor, and 83/138(60%) resulted in reduced rigidity. Stereotactic posterolateral pallidotomy, led to improvement of bradykinesia after 27/30 procedures(90%), of rigidity after 22/30(73%) and of tremor after 13/30(43%). Drug-induced dyskinesia showed a 42% improvement in the thalamotomy series and a 93% improvement in the pallidotomy series; the difference between the two series was significant(p<0.001). The patients themselves and their relatives used the Hoehn & Yahr staging scale to assess postoperative improvement in disability, and according to the results, 91/126 patients(72%) in the thalamotomy series and 26/30(87%) in the pallidotomy series showed improvement. In the thalamotomy series, there was a significantly higher improvement in disability for preoperative groups I and II(Hoehn & Yahr staging scale) than for groups III and IV(p<0.029), while in the pallidotomy series, there was no statistically significant difference in postoperative improvement between these same groups(p>0.557). In addition, for groups with greater preoperative disability(Hoehn & Yahr staging, groups III and IV), improvement was more likely after pallidotomy than after thalamotomy. In the pallidotomy series, dysphasia was the only serious complication and this was seen after 20% of procedures. In the thalamotomy series, however, complications included hypotonia(24%), transient confusion(19%), transient dysphasia(11%), permanent dysarthria(7%), subjective numbness(4%) and epileptic seizure(3%). The authors believe that posterolateral pallidotomy is much more effective than VL thalamotomy for the control of Parkinsonian bradykinesia and rigidity, but that thalamotomy is still a useful surgical option for the control of Parkinsonian tremor.
Aphasia ; Dyskinesia, Drug-Induced ; Humans ; Hypokinesia ; Pallidotomy* ; Parkinson Disease* ; Retrospective Studies ; Tremor

Thoracoscopic thoracic sympathectomy for primary palmar hyperhidrosis has been known to be effective and to have cosmetic merits compared to conventional open sympathectomy. In spite of its cosmetic advantages over thoracotomy, VATS using 5 mm or 10 mm instruments still has the problem of operative wound as well as pain on trocar sites. Recently, 2 mm thoracoscopic instruments have been used. The purpose of this study was to examine the results of thoracoscopic sympathectomy for palmar hyperhidrosis with 2 mm thoracoscopic instruments. From January 1997 to April 1997, 46 patients underwent bilateral thoracoscopic sympathectomy with 2mm instruments at Seoul National University Hospital. T-2 ganglion was carefully dissected and resected out in all patients. In one patient, the lower third of T-1 ganglion was inadvertently resected together with T-2 ganglion due to poor anatomical localization. In 4 patients who also complained of excessive axillary sweating, T-3 ganglion was resected as well. The instruments were removed without leaving any chest drain after reexpansion of the lung. Trocar sites were approximated with sterile tapes. All patients were relieved of excessive sweating in their upper extremities immediately after the operation. Nine patients (19.6%) showed incomplete reexpansion of the lung, and two of them required needle aspiration. Complications related to the surgical procedures, such as Horner's syndrome, hemothorax, and brachial plexus injury, were not detected in any cases. Most patientsdid not complaine of pain. All patients were discharged from the hospital on the day of operation. Despite a narrow operative viewfield, thoracic sympathectomy with 2 mm thoracoscopic instruments can be performed without increasing any severe complications. We recommend 2 mm instruments for thoracoscopic sympathectomy because they make as the more cosmetic, less painful, and equally effective compared to thoracoscopic sympathectomy using 5 mm or greater instruments.
Brachial Plexus ; Ganglion Cysts ; Hemothorax ; Horner Syndrome ; Humans ; Hyperhidrosis* ; Lung ; Needles ; Seoul ; Surgical Instruments ; Sweat ; Sweating ; Sympathectomy* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy ; Thorax ; Upper Extremity ; Wounds and Injuries

BACKGROUND: Thoracoscopic sympathetic block in palmar hyperhidrosis has merits in its immediate responsiveness and recovery. In palmar hyperhidrosis, the level of sympathetic chain to be blocked has been somewhat obscure. MATERIALS AND METHODS: To compare the results of T2 with T2,3 sympathetic block, we retrospectively studied 192 patients (T2 group: 84, T23 group: 108) operated on at SNUH with palmar hyperhidrosis between April 1994 and July 1997. We reviewed medical records and recently interviewed the patients by telephone call. Sex and age distribution between two groups showed no significant differences. We performed sympathectomy at the early phase of the syudy until April 1997, and after then, we adopted sympathicotomy rather than sympathectomy. RESULTS: All patients showed symptomatic improvement after the operation. Mean operation times of T2, T23 groups were 61.3+/-22.5min, 82.7+/-24.8min, respectively (p<0.01). Early postoperative complications, such as Horner's syndrome or chest tube insertion, were not different in two groups. There were no statistical differences of late complications such as compensatory truncal hyperhidrosis, gustatory sweating, and phantom sweating. No patient experienced recurrence of palmar hyperhidrosis during the study period. The only difference was the extent of compensatory truncal hyperhidrosis. The compensatory sweating occurred from axilla to suprapatella in T2 group whereas its extent was from nipple to suprapatella in T23 group. CONCLUSIONS: We concluded that T2 thoracic sympathetic block is mandatory for the treatment of primary palmar hyperhidrosis.
Age Distribution ; Axilla ; Chest Tubes ; Horner Syndrome ; Humans ; Hyperhidrosis* ; Medical Records ; Nipples ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Sweat ; Sweating ; Sweating, Gustatory ; Sympathectomy ; Telephone

Methotrexate (MTX) has been widely used in the treatment of psoriasis and rheumatoid arthritis. But prolonged use of MTX can induce hepatic fibrosis and even cirrhosis. To date, in Korea, there have been very few reports on hepatotoxicity due to MTX, and no report on biopsy-proven chronic active hapatitis. We report one patient who developed chronic acitve hepatitis while taking long-term daily dose of MTX(10mg per day) for psoriasis for a prolonged period.
Arthritis, Rheumatoid ; Fibrosis ; Hepatitis ; Hepatitis, Chronic* ; Humans ; Korea ; Methotrexate* ; Psoriasis*

A 67-Year-old male patient was adimitted due to aggravation of long-standing left moter weakness. Past history revealed weakness of left extremity for 20 years caused by CVD attack. On adimission, his mental state was drowsy and brain CT scan showed a round mass mimicking a brain tumor in the frontal horn of right lateral ventricle with asymmetric dilatation of lateral ventricles. After failed carotid angiography due to vascular tortuosity, his mental state was progressively deteriorated and left hemiparesis aggravated. A right external ventricular drainage was done, and 5 days later a craniotomy was performed under the impression of the intraventricular tumor causing obstruction of right foramen of Monro, but a large thrombosed aneurysmal sac was found intraoperatively. Retrial of carotid angiography revealed a large anterior communicating artery aneurysm. After second operation, maningoencephalitis with wound infection was complicated. Twenty days after second operation, clipping of the aneurysmal neck with removal of partially thrombosed aneurysmal sac was performed successfully.
Aged ; Aneurysm ; Angiography ; Animals ; Brain ; Brain Neoplasms ; Cerebral Ventricles ; Craniotomy ; Dilatation ; Drainage ; Extremities ; Horns ; Humans ; Hydrocephalus* ; Intracranial Aneurysm* ; Lateral Ventricles ; Male ; Neck ; Paresis ; Tomography, X-Ray Computed ; Wound Infection

The present study was undertaken to evaluate in vitro activities of following drugs against adult worms of Clororchis sinensis: i.e., stibnal, chloroquine diphosphate, Hetol (1,4-bis-trichloromethylbenzol), dehydroemetine 'Roche' (Ro 1-9334), niridazole (Ambilhar), bisbendazole, gentian violet, dithiazanine iodide, hexachlorophene, bithionol, niclofolan (Bilevon, Bayer 9015) and praziquantel (Embay 8440, Biltricide). After isolation from bile ducts of experimentally infected rabbits (3 months infection), the parasites were rinsed in sterilized Tyrode's solution and incubated for 24 hours at 37 C in TC 199 medium with Earle's balanced salt solution containing 0, 0.01, 0.1, 1.0, 10 and 100 microgram/ml concentrations of each above drugs. The activities of each concentrations with each drugs were evaluated by the motility of the worms in culture tubes observing at 15, 30, 60 minutes and 2, 4, 6, 12, 18 and 24 hours by stereomicroscope. In the results, no effect was found at the adult worms of C. sinensis in all concentrations with stibnal, chloroquine diphosphate, Hetol, dehydroemetine, niridazole and bisbendazole. However, moderate activities were observed in the concentrations of 1.0 and 0.1 microgram/ml of gentian violet, dithiazanine iodide, hexachlorophene and bithionol. The highest activities were observed in all concentrations of niclofolan and praziquantel.
parasitology-helminth-trematoda ; Clonorchis sinensis ; chemotherapy ; in vitro ; stibnal ; chloroquine diphosphate ; Hetol(1,4-bis-trichloromethylbenzol) ; dehydroemetine ; 'Roche'(Ro 1-9334) ; niridazole(Ambilhar) ; bisbendazole ; gentian violet ; dithiazanine iodide ; hexachlorophene ; bithionol ; niclofolan ; praziquantel

PURPOSE: We investigated whether the expression levels of Transforming growth factor beta1 (TGF-beta1) and its receptors were related to the development, recurrence, progression and disease-free survival in the patients with bladder cancer. MATERIALS AND METHODS: The mRNA levels of TGF-beta1 and its receptors were examined in 102 tumor specimens from patients with primary bladder cancer, 29 corresponding normal bladder mucosae specimens surrounding these tumors and 15 normal bladder mucosae specimens by performing quantitative competitive PCR (QC-PCR). The protein levels of TGF-beta1 and its receptors were investigated by performing immunohistochemical staining on sections cut from 86 archival bladder tissue paraffin blocks. RESULTS: QC-PCR analysis showed that expressions of TGF-beta1, TGF-beta receptor I (TGF-betaRI) and receptor II (TGF-betaRII) in the superficial and low-grade bladder cancers were significantly higher than those in both the corresponding normal bladder mucosae surrounding the cancer (p= 0.0069, 0.0022 and 0.0046, respectively) and the control's normal bladder mucosae (p=0.0014, 0.0125 and 0.0089, respectively). Expressions of TGF-beta1 and its receptors were enhanced in the non-recurred and non-progressed patients compared to the recurred cases (p=0.0022, 0.0003 and 0.0001, respectively) and the progressed cases (p=0.0002, <0.0001 and <0.0001, respectively). Patients with high expression of TGF-beta and its receptors had a significantly higher disease-free survival rate than those patients with low expressions (p=0.0129, 0.0121 and 0.0132, respectively). CONCLUSIONS: The enhanced expression of TGF-beta1 and its receptors was correlated not only with superficial and low-grade bladder cancer, but also with enhanced patient survival. In conclusion, our findings suggest that the expressions of TGF-beta1 and its receptors are useful prognostic markers for a patient's resistance to disease recurrence and/or progression.
Disease-Free Survival ; Humans* ; Mucous Membrane ; Paraffin ; Polymerase Chain Reaction ; Receptors, Transforming Growth Factor beta ; Recurrence* ; RNA, Messenger ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Carcinosarcoma is a tumor compromised of malignant epithelial and mesenchymal elements It is a well known uterine malignancy but is seen very rarely in the bladder. We report a case of carcinosarcoma of the bladder in 49 year-old male.
Carcinosarcoma* ; Humans ; Male ; Middle Aged ; Urinary Bladder*