A clinical review was made on 48 cases with cor pulmonale who were admitted to medical department, National Medical Center, between 1973 and 1982, and the results were as follows : 1) Teh age of subjects ranged from 26 to 88, and their mean was 51. male to female ratio was 1.6:1 and majority of them were in their 6th and 7th decade. 2) COPD was the most common cause of cor pulmonale but pulmonary tuberculosis had also a considerable portion. Less commonly it was caused by chest deformity which was mainly from spine tuberculosis and kyphoscoliosis. 3) Almost all patients were admitted with over heart failure. 4) Laboratory features showed indirect evidence of heart failure and pulmonary hypertension in chest X-ray films, RVH patterns in EKG and hypoxia and hypertcapnea with metabolic compensation in arterial gas analysis. 5) The case fatality rate was one-forth and that from kyphoscoliosis was especially high(80%).
Anoxia ; Compensation and Redress ; Congenital Abnormalities ; Electrocardiography ; Female ; Heart Failure ; Humans ; Hypertension, Pulmonary ; Male ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Heart Disease* ; Spine ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary ; X-Ray Film

PURPOSE: We examined changes in the corneal curvature and recurrence rate following pterygium surgery with relation to pterygium size and morphology. METHODS: One hundred eyes with primary nasal pterygia were graded as atrophic(Group 1), intermediate (Group 2), or fleshy(Group 3) according to morphology and grouped as small area group or large area group according to an assessment of pterygium length from and along the limbus. Corneal curvature was measured with autokeratometer at 3 days, 1 week, 1 month, and 6months preoperatively and postopera-tively as well. Recurrence was evaluated at the same periods. RESULTS: Each group had no significant difference(p>0.05) to preoperative corneal curvature when pterygia were divided according to morphology. Large area group had significantly smaller corneal curvature than the preoperative one(p<0.05), but small area group didn't(p>0.05). The angle of astigmatism had the tendency of against-the-rule at 3 days postoperatively(163.3degrees), more strikingly in small area group(159.1degrees). The recurrence rate was 10% totally with no significant difference among each group(p>0.05). CONCLUSIONS: The magnitude of the corneal curvature following pterygium surgery was smaller than the preoperative one and the change of angle had the tendency of against-the-rule astigmatism. Surgically induced changes in the corneal curvature and recurrence rate related to morphology had no significant difference, but preoperative corneal curvature and postoperative changes were related to pterygium size.
Astigmatism ; Pterygium* ; Recurrence*

We report a case of coronary artery-pulmonary artery fistula in 53-year-old man with review of literature. He complained of anterior chest pain with tightness, but all physical findings were normal. Routine laboratory findings in cluding EKG and chest PA were normal. For evaluation of angina, we performed the coronary arteriogram and established the diagnosis of coronary artery-pulmonary artery fistual incidentally. There was no hemodynamic significance.
Angina Pectoris* ; Arteries* ; Chest Pain ; Diagnosis ; Electrocardiography ; Fistula* ; Hemodynamics ; Humans ; Middle Aged ; Thorax

This study assessed the dynamics of morphological and immunophenotypic properties of activated microglia in a 6-hydroxydopamine (6-OHDA) induced Parkinsonian animal model. Neurodegeneration in the substantia nigra pars compacta (SNc) was induced by unilateral injection of 6-OHDA into the medial forebrain bundle. Parkinsonian animal model were sacrificed at 1, 2, 4 and 8 weeks after 6-OHDA injection. Changes in the functional activity of activated microglia were identified using different monoclonal antibodies: OX6 for major histocompatibility complex (MHC) class II, ED1 for phagocytic activity. Phagocytic microglia, characterized by ED1- or OX6-immunoreactivity, appeared in the SNc at 1 week after 6-OHDA injection, activated microglia selectively adhered to degenerating axons, dendrites and dopaminergic neuron somas in the SNc. This was followed by significant loss of these fibers and nigral dopaminergic neurons. Activation of microglia into phagocytic stage was most pronounced at 2 week after 6-OHDA injection and gradually subsided, but phagocytic microglia persisted until 8 weeks after 6-OHDA injection. Taken together, our results indicate that activated microglia is lead to persistently neuron cell death and promotes loss of dopaminergic neuron by degeneration of the dopaminergic neurons.
Animals ; Axons ; Carisoprodol ; Cell Death ; Dendrites ; Dopaminergic Neurons ; Major Histocompatibility Complex ; Medial Forebrain Bundle ; Microglia ; Models, Animal ; Neurons ; Oxidopamine ; Substantia Nigra

The shoulder injury was resulted from muscle imbalance between acceleration and deceleration during the throwing. The agonist-antagonist muscle strength relationship for throwing was formerly described as functional ratios of eccentric external rotator to concentric internal rotator moments and eccentric internal rotator to concentric external rotator moments. The purpose of this study was to measure the ratio of concentric and eccentric strength of the shoulder rotators by isokinetic muscle performance in Korean throwing college athletes for descriptive data. On 10 dominant shoulders of asymptomatic throwing college athletes applying Cybex II isokinetic dynamometer, concentric and eccentric muscle strength of the rotators were measured at the speed of 90degrees/s, 180degrees/s, 240degrees/s. Maximal torque ratio of the eccentric strength of the external rotator against the concentric strength of the internal rotator was 1.25, 1.13, 1.21 at the each speed. The functional external eccentric-to-internal concentric ratio was similar with previous published studies. There was no significant difference between each speed. Eccentric strength of the external rotator was higher than concentric strength of the internal rotator during internal and external rotation at all speeds. This functional assessment of strength testing that reflected the importance of eccentric external rotation strength for the dynamic shoulder joint stability during the throwing. Therefore, the increase of the eccentric strength of the external rotator would be helpful to prevent the shoulder injury and to treat for rehabilitation of injured shoulder.
Acceleration ; Athletes ; Deceleration ; Humans ; Muscle Strength ; Muscles ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Torque

PURPOSE: To evaluate the effect of portal hypertension on the tumor recurrence in patients with hepatocellular carcinoma (HCC) and without hepatic decompression following radiofrequency ablation (RFA). MATERIALS AND METHODS: Treatment-naïve HCC patients within the Milan criteria and with Child-Pugh class A were included in this study, who had performed RFA in our hospital between January 2010 and March 2017. Univariate and multivariate analyses using the Cox proportional hazard model were performed to find the predictors of local or distant tumor recurrence. RESULTS: Overall, 178 patients were included in this study. Median follow-up period was 40.2 months. The difference in the local tumor progression rates depending on the absence or presence of portal hypertension was not statistically significant (p = 0.195). The 1-, 3-, and 5-year distant intrahepatic tumor spread rates were 6.6%, 29.5%, and 537% in patients without portal hypertension, and 23.4%, 51.9%, and 63.6% in patients with portal hypertension, respectively. The difference was statistically significant (p = 0.011). Univariate and multivariate analysis showed that portal hypertension was an independent predictor for distant intrahepatic tumor spread (p = 0.008). CONCLUSION For HCC patients with Child-Pugh class A, portal hypertension adversely affected distant intrahepatic tumor progression.

Ciliated hepatic foregut cysts are uncommon lesions of the liver. They arise from remnants of the embryonic foregut, and are usually asymptomatic and benign. They are lined with a layer of ciliated columnar cells and contain mucoid material and debris. Ciliated hepatic foregut cysts are not malignant neoplasms and must be differentiated from cystic neoplasms and hypovascular solid tumors. We experienced a case of ciliated hepatic foregut cyst, which was successfully removed by laparoscopic excision, so we report the case with review of the literature.
Laparoscopy ; Liver

BACKGROUND/AIMS: The rate of laparoscopic appendectomy has been gradually increasing. The following studies were conducted to compare laparoscopic appendectomy (LA) with open appendectomy (OA). METHODS: We compared retrospectively 48 patients in the LA group with 135 patients in the OA group, all of whom were operated at Anam hospital, Korea University, from January 1996 to January 1997. Documentation included information such as age, sex, diagnostic method, postoperative diagnosis, misdiagnosis rate, operative time, conversion to open appendectomy, analgesics injection, hospital stay, and complicatians. RESULTS: 1) The mean age and male to female ratio were 28.5 years and 1: 2.4 in LA group, and 34.1 years and 1: 1.1 in OA group, respectively. 2) An abdominal sonogram was perfomed in 18.8% of the LA group and 28.9% in OA group (p < 0.05). 3) The operative time was 68.4 minutes in the LA group and 53.7 minutes in the OA group (p<0.05). 4) The number of analgesic injections was 1.23 in the LA group and 2.65 in the OA group (p<0.05). 5) The postoperative hospital stay was 3.38 days in the LA group and 3.84 days in the OA group (p > 0.05). 6) The complication rate was 10.9% in the LA group and 15,5% in the OA group (p >0.05), but the wound infection rate was 2.2% in the LA group and 8.5% in the OA group (p<0.05). CONCLUSIONS: LA is a safe and effective operation for acute appendicitis, and is particularly superior to OA in regard to diagnosis, postoperative pain, wound infection, and cosmetic benefits.
Analgesics ; Appendectomy* ; Appendicitis ; Diagnosis ; Diagnostic Errors ; Female ; Humans ; Korea ; Length of Stay ; Male ; Operative Time ; Pain, Postoperative ; Retrospective Studies ; Wound Infection

PURPOSE: This study aimed to evaluate the epidemiology of bicycle injuries in Korea. It analyzed the injury severity of bicycle accidents by making a comparison between accidents that originated from bicycle lanes and accidents that originated in other sites since the inception of the Korea Promoting Bicycle Usage Act in 2011. METHODS: We performed a retrospective study on 23,038 cases from January 2011 to December 2014, utilizing the data from the emergent department-based, in-depth injury surveillance system. The main analysis of death was conducted by a multivariate logistic regression, using SPSS statistics ver. 18.0. We also classified bicycle accidents in accordance with the sites of accident bicycle lane and other sites, accident year, age, gender, injury location, activity, helmet use, and alcohol consumption. RESULTS: The entire study population of 23,038 patients were divided into two groups depending on accident site: 4045 from bicycle lane and 18,993 from other accident sites. According to the analysis, the percentage of accidents involving female was significantly higher in bicycle lane than in other accident sites (75.8% vs. 79.3% p<0.001). The highest bicycle accident occurred alone (77.3%) in bicycle lane and 57% in other accident sites. However, motor vehicle crash was significantly higher in other accident sites than in bicycle lane (32.9% vs. 10.2%). The result from a multivariate logistic regression demonstrates that bicycle lanes significantly decreases the severity of mortality on average (odd ratio, 0.46; 95% confidence interval 0.24-0.91). CONCLUSION: We found that bicycle lanes have a significant impact on decreasing not only general accidents caused by bicycles, but also mortality.
Alcohol Drinking ; Bicycling ; Epidemiology ; Female ; Head Protective Devices ; Humans ; Korea* ; Logistic Models ; Mortality ; Motor Vehicles ; Retrospective Studies

Cardiac contusion is an increasingly recognized entity in patients with nonpenetrating chest injury. Unifortunately, the diagnosis of cardiac trauma, particularly cardiac contusion, is imprecise and may be confounded by the presence of associated injuries, hypoxia, shock, and metabolic abnormalities. Symptomatic cardiac injury follwing blunt chest trauma is relatively rare, and valvular injury is even rarer. The valves most commonly affected are mitral and tricuspid. Although tricuspid regurgitations are usually asymptomatic and can resolve spontaneously, recent developments in echocardiography made possible the precise diagnosis of valvular injuries noninvasively, The authors report the case of tricuspid regurgitation incidentally detected by echocardiography in a construction worker who had suffered multiple fractures.
Anoxia ; Contusions ; Diagnosis ; Echocardiography* ; Humans ; Shock ; Thoracic Injuries ; Thorax ; Tricuspid Valve Insufficiency ; Tricuspid Valve*