Aneurysms of the ascending aorta are relatively uncommon disorders which are located in ascending portion of the thoracic aorta. The commenest cause of aneurysms of the ascending aorta is arteriosclerosis, but syphilis, marfan syndrome, cystic medial necrosis, trauma, and aging of the aorta must also be noted as causes. We report a case with a aneurysm of the ascending aorta, 23 years old female, who was performed the open heart surgery because of ventricular septal defect with aortic insufficiency about 10 years ago.
Aging ; Aneurysm* ; Aorta* ; Aorta, Thoracic ; Arteriosclerosis ; Female ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Marfan Syndrome ; Necrosis ; Syphilis ; Thoracic Surgery* ; Young Adult

Blind nasotrscheal intubation with preformed tube has been attempted in 20 conscious young male scheduled for surgical reduction of mandibular fracture. The patient was premedicated in the usual fashion with glycopyrrolate -midszolam- fentanyl. Airway anesthesia was performed with topical lidocaine ; Nasopharyngeal and translaryngeal. Of the 20 patients in whom intubation was performed, 12 (60%) required one to three attempts, 6 (30%) required four to six, and only two failures occurred. Contrary to our expectation, this procedure met with almost positive acceptance by the patients in the series, and the surgical staff had no adverse criticism. In addition to the effectiveness and ease of learning, this technique is simple and free from major morbidity.
Anesthesia ; Fentanyl ; Glycopyrrolate ; Humans ; Intubation* ; Learning ; Lidocaine ; Male ; Mandibular Fractures

The endemic status of clonorchiasis and metagonimiasis along the Geum-gang (River) in Okcheon-gun (County) in Korea was examined. From February to December 2000, stools of total 1,081 inhabitants living in 5 villages were examined. Each stool specimen was examined by both the cellophane thick smear method and the formalin-ether sedimentation technique. Egg-positive cases were further analyzed by Stoll's egg-counting technique, and praziquantel was administered to positive cases. The egg-positive rates for Clonorchis sinensis and Metagonimus species were 9.3% and 5.5%, respectively, and the double infection rate was 3.5%. The numbers of eggs per gram (EPG) of feces of C. sinensis and Metagonimus sp. were 918 +/-1.463 and 711+/-947, respectively. The egg-positive rates for C. sinensis and Metagonimus sp. in the riverside area were 14.2% and 8.4%, respectively, which were significantly higher than those of the inland area (3.2% and 1.7%, respectively). The egg-positive rates of C. sinensis and Metagonimus sp. in males (16.7% and 10.0%) were significantly higher than those of females (3.5% and 1.8%). However, there were no significant differences of EPG values between localities and sexes. The prevalence of clonorchiasis and metagonimiasis in this survey was significantly lower than that in the previous reports. However, there is still a high prevalence of infection with C. sinensis and Metagonimus sp. in this region, especially in the riverside area.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Child ; Clonorchiasis/*epidemiology/parasitology ; Clonorchis sinensis/isolation & purification ; Feces/parasitology ; Female ; Heterophyidae/isolation & purification ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Parasite Egg Count ; Prevalence ; Rural Population ; Sex Factors ; Time Factors ; Trematode Infections/*epidemiology/parasitology

BACKGROUD: Fatigue is one of the most common problems encountered in family practice but its diagnosis and management are neither standardized nor simphfied. This basehne study was conducted to find out the clinical characteristics, dinical courses, and outcomes of fatigued patients. METHODS: This study included 163 fatigued patients who visited a department of a university hospital based family practice due to fatigue as their primary or secondary complaint. We dassified fatigue which persisted for more than 6 months as acute fatigue, less than 6 months as acute fatigue. Retrospective review of medical record was used to collect all rehted dinical characteristics and telephone interview was done to follow the course and outcomes of fatigue. RESULTS: Of the total 163 fatigued patients, 105 patients(64.4%) were men. Fifty two patients(31.9 %) visited the dinic for complete health check up due to fatigue. The rate of response to telephone interview was 62.6%. Fifty five patients(33.7%) were acute fatigue, 75 patients(46.0%) chronic fatigue, and 33 patients (20.2%) unknown duration of fatigue. Accordirg to the causes of fatigue, 11.7% of patients corresponded to organic cause, 60.7% psychiatric cause, 27.6% unknown cause. Specified organic causes of fatigue, chronic hepatitis was the most common disease followed by alcohol liver disease, arthritis, anemia, viral syndrome and hyperthyroidism As psychiatric causes af fatigue, stress was the most common cause followed by overwork, alcohol abuse, depression, and anxiety. Reassurance and observation(71.8%), drug tberapy(17.8%) were the mast common treatments. Those who felt their function decreased below 50% were 7.6% of total 102 patients. On the survival analysis, 58.2% of acute fatigue patients, 62.4% of chronic fatigue patients, 67.0% of unknown patients had fatigue for 2 years since the initial visit. CONCLUSIONS: As the cause af fatigue in a family practice, psychiatric causes were more frequent than organic causes. As psychiatric causes of fatigue, stress was the most common cause followed by overwork and alcohol abuse. Only one third of the fatigued patients had improved two years later.
Alcoholism ; Anemia ; Anxiety ; Arthritis ; Depression ; Diagnosis ; Family Practice* ; Fatigue ; Hepatitis, Chronic ; Humans ; Hyperthyroidism ; Interviews as Topic ; Korea* ; Liver Diseases ; Male ; Medical Records ; Retrospective Studies

PURPOSE: Hepatic resection is generally considered as the most satisfactory treatment for patients having intrahepatic stones. Yet for cases of right-sided intrahepatic stones, role of hepatic resection is still ambiguous because of the higher operative risks that are entailed when performing surgery at that location. This report presents the results of hepatic resection for the treatment of right-sided intrahepatic stones. METHODS: Seventy-one patients with right-sided intrahepatic stones were operated on during a period of 14 years. The operative procedures executed in the patients were 40 hepatic resections and 31 biliary lithotomies. We analyzed the operative findings and the results of treatment were then compared between the two treatment groups. RESULTS: The intrahepatic bile duct changes associated with stones were cholangitis (n=16), biliary stricture (n=31), biliary dilatation (n=13), and liver atrophy (n=11). Biliary dilatation and liver atrophy were more frequently observed in patients with hepatic resection (p< 0.05). Operative complications occurred in 6.5% of patients after biliary lithotomy and in 25.0% of patients after hepatic resection. There was no operative mortality in both groups. Retained stones were found in 51.6% of patients after biliary lithotomy. There were no retained stones in patients undergoing hepatic resection. After biliary lithotomy, the rate of retained stones was higher for patients having associated bile duct strictures and dilatations (cholangitis; 18.2%, stricture; 64.7%, dilatation; 100%, p< 0.05). Recurrent stones were found to have developed in 10 patients (14.2%), yet the rates for the recurrent stones were not different in both groups. CONCLUSION: Hepatic resection is an effective and safe treatment for right-sided intrahepatic stones. For intrahepatic stones associated with definite bile duct strictures, hepatic resection is the most suitable procedure for the complete removal of stones.
Atrophy ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangitis ; Cholelithiasis ; Constriction, Pathologic ; Dilatation ; Hepatectomy ; Humans ; Liver ; Mortality ; Surgical Procedures, Operative

Background and Objectives: Toxoplasmosis is a disease caused by an intracellular parasite, Toxoplasma gondii. There has been only a few studies done on cervical toxoplasma lymphadenitis, and this study was performed to evaluate its clinical characteristics and outcomes.Subjects and Method We retrospectively reviewed the patients diagnosed with cervical toxoplasma lymphadenitis from January 2010 to December 2019. We investigated clinical pathologic findings, treatment and clinical outcomes. Results: Enrolled in the study were 21 patients who were confirmed with typical pathologic findings in an excisional biopsy (16/21) and core needle biopsy (5/21). Nine patients were male and 12 patients were female, with the mean age of 46.1±13.59 (19-70). All patients complained of neck masses and 5 (23.8%) patients showed pain or tenderness. Only one (4.8%) patient had mild fever. Fine needle aspiration cytology was performed in 5 patients, with no resulting pathognomonic outcomes in any one of the patients. CT scan was performed in 15 patients, with 8 (53.3%) patients showing multiple nodal enlargements but 7 (46.6%) patients showing a single enlarged lymph node. The most frequently involved location was level I (53.3%), followed by level II (46.6%), level V (46.6%), level III (40.0%), and level IV (20.0%). The serologic test for toxoplasma revealed positive IgG (100%) and IgM (85.7%). Treatments were excision only (61.9%) and excision with pharmacologic treatment using sulfonamide or pyrimethamine (38.1%). There was no case of recurrence after treatment. Conclusion Cervical toxoplasma lymphadenitis can be diagnosed by biopsy but needle aspiration has little role. It shows favorable clinical outcomes after treatment.

We aimed to evaluate structural dynamic changes of neurons in the auditory cortex after visual deprivation. We longitudinally tracked dendritic spines for 3 weeks after visual deprivation in vivo using a two-photon microscope. GFP-labeled dendritic spines in the auditory cortex were serially followed after bilateral enucleation. The turnover rate, density, and size of the spines in the dendrites were evaluated 1, 2, and 3 weeks after visual deprivation. The turnover rate of the dendritic spines in the auditory cortex increased at 1 week (20.1±7.3%) after bilateral enucleation compared to baseline (12.5±7.9%); the increase persisted for up to 3 weeks (20.9±11.0%). The spine loss rate was slightly higher than the spine gain rate. The average spine density (number of spines per 1 μm of dendrite) was significantly lower at 2 weeks (2W; 0.22±0.06 1/μm) and 3 W (0.22±0.08 1/μm) post-nucleation compared to baseline (0.026±0.09 1/μm). We evaluated the change of synaptic strength in the stable spines at each time point. The normalized spine size in the auditory cortex was significantly increased after bilateral blindness at 1 W postoperatively (1.36±0.92), 2 W postoperatively (1.40±1.18), and 3 W postoperatively (1.36±0.88) compared to baseline. Sensory deprivation resulted in remodeling of the neural circuitry in the spared cortex, via cross-modal plasticity in the direction of partial breakdown of synapses, and enhanced strength of the remaining synapses.

PURPOSE: Gingko biloba extract (GBE), a natural product extracted from Gingko leaves, is known to increase the radiosensitivity of tumors. This radiosensitization probably arises from the increase in the peripheral blood flow by decreasing the blood viscosity and relaxing the vasospasm. The influence of a GBE on the metabolic status in fibrosarcoma II (FSaII) of a C3H mouse was investigated using 31P magnetic resonance spectroscopy (MRS). MATERIALS AND METHODS: Eighteen C3H mice with fibrosarcoma II (from 100 mm3 to 130 mm3) were prepared for this experiment. The mice were divided into 2 groups; one (9 mice) without a priming dose, and the other (9 mice) with a priming dose of GBE. The GBE priming dose (100 mg/kg) was administered by an intraperitoneal (i.p.) injection 24 hours prior to the measurement. First 31P MRS spectra were measured in the mice from each group as a baseline and test dose of GBE (100 mg/kg) was then administered to each group. One hour later, the 31P MRS spectra were measured again to evaluate the change in the energy metabolic status. RESULTS: In the group without the priming dose, the mean pH, PCr/Pi, PME/ATP, Pi/ATP, PCr/(Pi+ME) values 1 hour after the test dose were not changed significantly compared to the values at the baseline. However, in the group with the priming dose, the mean PCr/Pi, Pi/ATP, PCr/(Pi+PME) values 1 hour after the test dose changed from the baseline values of 0.49, 0.77, 0.17 to 0.74, 0.57, 0.28 respectively. According to the paired t-test, the differences were statistically significant. CONCLUSION: The above findings suggest that the metabolic status is significantly improved after administering GBE if the priming dose is given 24 hours earlier. This shows that the radiosensitizing effect of GBE is based on the increase of tumor blood flow and the improvement in the metabolic status.
Animals ; Blood Viscosity ; Energy Metabolism ; Fibrosarcoma* ; Ginkgo biloba* ; Hydrogen-Ion Concentration ; Magnetic Resonance Spectroscopy* ; Mice ; Mice, Inbred C3H* ; Radiation Tolerance ; Radiation-Sensitizing Agents

The purpose of this paper is to develop an efficient method for the quick determination of multiple isocenters plans to provide optimal dose distribution in stereotactic radiosurgery. A Spherical dose model was developed through the use of fit to the exact dose data calculated in a 18cm diameter of spherical head phantom. It computes dose quickly for each spherical part and is useful to estimate dose distribution for multiple isocenter. An automatic computer search algorithm was developed using the relationship between the isocenter move and the change of dose shape, and adapted with a spherical dose model to determine isocenter separation and collimator sizes quickly and automatically. A spherical dose model shows a comparable isodose distribution with exact dose data and permits rapid calculation of 3-D isodoses. The computer search can provide reasonable isocenter settings more quickly than trial and error types of plans, while producing steep dose gradient around target boundary. A spherical dose model can be used for the quick determination of the multiple isocenter plans with a computer automatic search. Our guideline is useful to determine the initial multiple isocenter plans.
Head ; Radiosurgery*

BACKGROUND AND OBJECTIVES: Rapamycin has been shown to inhibit the vascular smooth muscle cell migration and proliferation that contributes to neointimal formation. We investigated whether the perivascular delivery of rapamycin in Pluronic gel could inhibit neointimal hyperplasia in a rat carotid artery model, and we tested the usefulness of carotid arteriography. MATERIALS AND METHODS: To assess the kinetics of rapamycin's release from Pluronic gel, a [3H] thymidine incorporation assay was performed with using the media exposed to rapamycin in Pluronic gel for 10, 20, 60 and 120 min. We applied 100 microgram of rapamycin in Pluronic gel to the perivascular space of the carotid artery after the balloon injury (n=9), whereas only gel was applied in a control group (n=9). We performed the carotid arteriography and the morphometric analysis 14 days after injury. RESULTS: The [3H] thymidine incorporation assay showed a reduction of uptake in a time-dependent manner (86%, 48%, 45% and 40% of the control, respectively, at 10, 20, 60 and 120 minutes). The inhibiting effect of rapamycin on neointimal hyperplasia was identified on the carotid arteriography (mean luminal diameter; 0.75+/-0.11 vs. 0.60+/-0.12 arbitrary units, respectively, p< 0.05) and on the morphometric analysis (neointima area: 0.09+/-0.03 vs. 0.17+/-0.06 mm(2), respectively, p< 0.05). CONCLUSION: This study demonstrated that perivascular delivery of rapamycin in Pluronic gel inhibits neointimal hyperplasia in a rat carotid injury model. This animal model combined with arteriography can be used for developing new drugs to treat restenosis. In addition, this technique might be useful for vascular surgery such as coronary artery bypass grafting, arteriovenous fistula formation and peripheral vascular bypass graft insertion.
Angiography ; Animals ; Arteriovenous Fistula ; Carotid Arteries ; Carotid Artery Injuries ; Cell Movement ; Coronary Artery Bypass ; Drug Delivery Systems ; Hyperplasia ; Kinetics ; Models, Animal ; Muscle, Smooth, Vascular ; Phenobarbital ; Rats ; Sirolimus ; Thymidine ; Transplants