The tricuspid valve is not a simple but a complex structure, tricuspid valve complex. This complex is composed of tricuspid orifice, annulus, valve leaflet, chordae tendineae and papillary muscles. There are flew articles about these structures. The authors studied tricuspid valve complex in 53 cases of normal korean adults, such as circumference of tricuspid annulus, the maximum diameter of the tricuspid orifice, height and breadth of the cusps, including commissures, the ratio of rough to clear zone, the number of scallops of posterior cusp, the number, length and pattern of arrangement of the several types of chordae, the number and morphological characteristics of papillary muscles.
Adult* ; Chordae Tendineae ; Heart* ; Humans ; Papillary Muscles ; Pectinidae ; Tricuspid Valve*

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Acneiform Eruptions ; Bevacizumab

BACKGROUND: The renin angiotensin syaimstem plays an important role in hypertension. Therefore, the purpose of this study was to investigate the comparison of responsiveness to angiotensin II (ANG II) in isolated renal proximal convoluted tubules of spontaneously hypertensive (SHR) and Wistar Kyoto (WKY) rats. METHODS: Intracellualr calcium concentration ([Ca2+i) was measured using Fura- 2/AM, inositol trisphosphate (IP3) accumulation was determined by radioimmuno assay and cellular ATP content measured using the microchemilunescene method in renal proximal tubule suspension or isolated renal proximal tubules. RESULTS: When measured the ANG II-induced [Ca2+i, the young rats showed a greater response to ANG II than adult rats in both strains. The ANG II (10-7 M)-induced [Ca2+i transient in the cortical tubule suspension from adult SHR was significantly lower than that in age-matched WKY. In isolated proximal tubule segments, ANG II-induced [Ca2+i increment was only observed in S1 segments. Comparing responsiveness to ANG II in SHR and WKY, similar phenomenon was observed as experiment using tubule suspension. IP3 accumulation by ANG II also attenuated in adult SHR. The 20-minutes incubation without any exogenous substrate in proximal convoluted tubule (S1) significantly decreased cellular ATP content and ANG II (10-7 M) inhibited decrement of cellular ATP level. The effect of ANG II on cellular ATP restoration was disappeared by the treatment with losartan. CONCLUSION: From these results, the responsiveness of ANG II to AT1A receptor is attenuated in the proximal convoluted tubules of adult SHR comparing the age- mached WKY.
Adenosine Triphosphate ; Adult* ; Angiotensin II ; Angiotensins ; Animals ; Calcium ; Humans ; Hypertension ; Inositol ; Losartan ; Rats ; Renin

The most common fracture about the elbow joint in chilren is a supracondylar fracture. The displaced fracture is difficult to manage due to the potential danger of Volkmann's ischemia, nerve injury, and malunion, During the period of 6 years from June, 1979 to June, 1985, 63 children with supracondylar fractures of the humerus were treated at Pusan Paik Hospital, Inje Medical College, and analyzed. The results are summarized as follows: 1. The average age was 7.1 years, ranged from 1 year to 14 years, and the male and female ratio was 2.5: l. 2. In type of fracture, extension type was 92% and flexion type was 8%. In displacement of fracture, Grade I was only 2 cases, Grade III and IV were 87.3%. Posteromedial displacement was 42.8% (27 cases). 3. At the time of admission, 15cases(23.8%) accompanied nerve injury, of these median nerve injury (9 cases) was most common. All the patient with nerve injury were completely recovered within 14 months after reduction. 4. Severe cubitus varus was 14.2%, and severe limitation of elbow motion was 1.6%. 5. Of 61 displaced fractures, 37 patients were treated with closed reduction and percutaneous pin fixation. By Flynn's criteria, satisfactory results were obtained in 36 of the 37 patients(97.3%) treated with percutaneous pinning. 6. In the displaced fractures, closed reduction and percutaneous pinning is a satisfactory method for obtaining and maintaining reduction while preserving vascular function, if acute flexion is necessary for stable reduction.
Busan ; Child ; Clinical Study ; Elbow ; Elbow Joint ; Female ; Fractures, Closed ; Humans ; Humerus ; Ischemia ; Male ; Median Nerve ; Methods

Objectives: This study compared the buckling resistance of 3 nickel-titanium (NiTi) retreatment file systems and the torque/force generated during retreatment. Materials and Methods: The buckling resistance was compared among the D-RaCe (DR2), HyFlex Remover, and Mtwo R25/05 retreatment systems. J-shaped canals within resin blocks were prepared with ProTaper NEXT X3 and obturated by the single-cone technique with AH Plus. After 4 weeks, 4 mm of gutta-percha in the coronal aspect was removed with GatesGlidden drills. Retreatment was then performed using DR1 (size 30, 10% taper) followed by DR2 (size 25, 4% taper), HyFlex Remover (size 30, 7% taper), or Mtrwo R25/05 (size 25, 5% taper) (15 specimens in each group). Further apical preparation was performed with WaveOne Gold Primary. The clockwise torque and upward force generated during retreatment were recorded. After retreatment, resin blocks were examined using stereomicroscopy, and the percentage of residual filling material in the canal area was calculated. Data were analyzed using 1-way analysis of variance with the Tukey test. Results: The HyFlex Remover files exhibited the greatest buckling resistance (p < 0.05), followed by the Mtwo R25/05. The HyFlex Remover and Mtwo R25/05 files generated the highest maximum clockwise torque and upward force, respectively (p < 0.05). The DR1 and DR2 files generated the least upward force and torque (p < 0.05). The percentage of residual filling material after retreatment was not significantly different between file systems (p > 0.05). Conclusions NiTi retreatment instruments with higher buckling resistance generated greater clockwise torque and upward force.

Dieulafoy's lesion is a rare distinetive arterial malformation that can cause massive gastrointestinal henorrhage. Although in most cases the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction, similar lesions have been described in the antrum, duodenum, jejunum, colon, and rectum. We report 3 unusually located Dieulafoy-like lesion, two gastric antrum and one jejunum in patient who had gastrojejunostomy for pancreatic caneer. After a year follow up there was no bleeding episode in patient after endoscopic treatment.
Colon ; Duodenum ; Esophagogastric Junction ; Follow-Up Studies ; Gastric Bypass ; Hemorrhage ; Humans ; Jejunum* ; Pyloric Antrum* ; Rectum ; Stomach

Cryosupernatant which is the residual plasma fraction after removing cryoprecipitate has been used for plasma exchange in thrombotic thrombocytopenic purpura and hemolytic uremic syndrome replacing the fresh frozen plasma. Recently, the unusually large yon Willebrand factor multireefs (ULvWFM) has been observed in patients with refractory or chronic relapsing hemolytic uremic syndrome as well as thrombotic thrombocytopenic purpura which disappeared by infusion or plasma exchange with cryosupernatant, and infusion of fresh frozen plasma, the largest multimers of yon Willebrand factor were replenished that it might be a cause of refractoriness. This study was conducted to investigate the characteristics of home-made cryosupernatant from thawed fresh frozen plasma and its thehrapeutic effect in a hemolytic uremic syndrome patient. The level of fibrinogen, coagulation factor VIII, vWF antigen, and ristocetin cofactor activity was decreased and yon Willebrand factor multimers were barely seen in cryosupernatant than those of in fresh frozen plasma. A hemolytic uremic syndrome patient tried with exchange and infusion of cryosupernatant showed excellent recovery. It is concluded that home-made cryosupernatant shares many of the features of fresh frozen plasma except factor VIII, especially von Willebrand factor multimers, and thus it could be a useful alternative to fresh frozen plasma in case of refractory hemolytic uremic synydrome.
Factor VIII ; Fibrinogen ; Hemolytic-Uremic Syndrome ; Humans ; Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic ; von Willebrand Factor

We underwent 3 cases of laparoscopic splenectomy in pediatric patients of hereditary spherocytosis and had excellent outcome. Average operation time was 100 minutes and it was longer than average operation time of traditional open splenectomy in pediatric patients of hereditary spherocytosis (83 minute), but average hospitalization day was 3 days and it was shorter than compared group (6.2 days). Advantages of laparoscopic surgery were appeared in this study. Excellent outcome of these cases will help further performance of laparoscopic splenectomy in children.
Child* ; Hospitalization ; Humans ; Laparoscopy ; Splenectomy*

Transforaminal lumbar interbody fusion (TLIF) is commonly used procedure for spinal fusion. However, there are no reports describing anterior cage dislodgement after surgery. This report is a rare case of anterior dislodgement of fusion cage after TLIF for the treatment of isthmic spondylolisthesis with lumbosacral transitional vertebra (LSTV). A 51-year-old man underwent TLIF at L4-5 with posterior instrumentation for the treatment of grade 1 isthmic spondylolisthesis with LSTV. At 7 weeks postoperatively, imaging studies demonstrated that banana-shaped cage migrated anteriorly and anterolisthesis recurred at the index level with pseudoarthrosis. The cage was removed and exchanged by new cage through anterior approach, and screws were replaced with larger size ones and cement augmentation was added. At postoperative 2 days of revision surgery, computed tomography (CT) showed fracture on lateral pedicle and body wall of L5 vertebra. He underwent surgery again for paraspinal decompression at L4-5 and extension of instrumentation to S1 vertebra. His back and leg pains improved significantly after final revision surgery and symptom relief was maintained during follow-up period. At 6 months follow-up, CT images showed solid fusion at L4-5 level. Careful cage selection for TLIF must be done for treatment of spondylolisthesis accompanied with deformed LSTV, especially when reduction will be attempted. Banana-shaped cage should be positioned anteriorly, but anterior dislodgement of cage and reduction failure may occur in case of a highly unstable spine. Revision surgery for the treatment of an anteriorly dislodged cage may be effectively performed using an anterior approach.
Decompression ; Follow-Up Studies ; Humans ; Leg ; Middle Aged ; Pseudarthrosis ; Spinal Fusion ; Spine ; Spondylolisthesis