A total of 23 human fetal hearts from 18 to 40 weeks of gestation were provided for histologic and morphometric studies. The fetuses were the products of spontaneous or artificial abortions and were found to have no congential anomalies or associated lesions at autopsy. Maxima thickness of the left anterior, left lateral, left posterior, right anterior, right lateral, right posterior ventricular wall, and of the interventricular septal wall were measured and the left / right wall thickness ratio was calculated. The cross-sectional area of each ventricle parallel to the base of the heart at about 3-5mm below from the origin of the aorta was measured under drawing attachment-equipped light microscope with the application of point counting or cut-and-weigh method. Data were analyzed by the Anderson-ell ABSTAT dBASE ll statistical package program. The ventricular wall consisted of endocardium, myocardium and epicardium. The myocardium showed epithelial character by stratification of barrel-shaped myocardial cells, but the epithelial character progressively changed to as in adult myocardial tissue from the myocardial area close to the epicardium with increasing fetal age. However, any significant histologic difference between the left and the right ventricular wall at the same fetal age was not found. The growth pattern of both ventricular wall, the interventricular septal wall, and of the cross sectional area were linear (p<0.01). However, there was no significant difference in the wall thickness between the left and right ventricle at the same fetal age, and the left / right thickness ratio was nearly constant with increasing fetal age. The cross sectional area was greater in the right than in the left ventricle in the fetuses after 18 weeks of gestation (p<0.01), and there was no significant difference in the morphometric values between point counting and cut-and-weigh method (p>0.1).
Adult ; Aorta ; Autopsy ; Endocardium ; Fetal Heart* ; Fetus ; Gestational Age ; Heart ; Heart Ventricles ; Humans* ; Methods ; Myocardium ; Pericardium ; Pregnancy

A case of Korean hemorrhagic fevery confirmed by fluorescent antibody technique in a 8years old boy was reported with a brief review of references.
Fluorescent Antibody Technique* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Male

Acquired nasolacrimal duct obstruction may result from chronic infection, lacrimal stones, anatomical variations such as aberrant ethmoid cells, facial fractures, or complications following nasal surgery. In Korea, there has been no reported case of secondary nasolacrimal duct obstruction due to a retention cyst in the lacrimal sac. Recently, the authors encountered a 65-year-old female patient who presented with epiphora, was diagnosed with a lacrimal sac retention cyst, and was successfully treated with endoscopic marsupialization.

Epiphora is usually caused by nasolacrimal duct obstruction. The nasolacrimal duct obstruction is related with facial trauma, other nasal or paranasal sinus diseases, or recurrent dacryocystitis. We describe a case of iatrogenic nasolacrimal duct obstruction that occurred secondary to midfacial autologous fat injection. In our case, mal positioned fat tissue was detected on the dacryocystogram to be present in the lacrimal sac and the nasolacrimal duct. They were safely removed during dacryocystorhinostomy.
Dacryocystitis ; Dacryocystorhinostomy ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Paranasal Sinus Diseases

Carcinogens ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2E1 ; Cytochrome P-450 Enzyme System ; Cytochromes ; DNA Repair ; Exons ; Genes, Suppressor ; Genetic Predisposition to Disease ; Genotype ; Head and Neck Neoplasms ; Head ; Humans ; Metabolism ; Neck ; Negotiating ; Oncogenes ; Polymorphism, Genetic ; Xenobiotics

Carotid body tumor is a manifestation of paraganglioma, a systemic disease, in the head and neck region. Bilateral presentation is rare, and it may or may not be functional. In symptomatic cases, it is important to evaluate the patient thoroughly through the whole body for the causative lesion. We experienced an unusual patient who had a history of resection for a carotid body tumor presenting with fluctuating hypertension. Work up revealed contralateral carotid body tumor and increased levels of catecholamine. He underwent resection of the contralateral carotid body tumor, but his symptoms persisted. Further studies led to detection of extraadrenal retroperitoneal paraganglioma with liver infiltration, for which he had an operation. His hypertension and catecholamine levels returned to normal.
Carotid Body Tumor* ; Carotid Body* ; Head ; Humans ; Hypertension ; Liver ; Neck ; Paraganglioma*

OBJECTIVES: Postoperative bleeding and adhesion formation are the two most common complications after endoscopic sinus surgery (ESS). The former sometimes can be life threatening and the latter is the most common reason requiring revision surgery. This study was designed to evaluate the effect of newly developed chitosan gel (8% carboxymethyl chitosan, Surgi shield) on hemostasis and wound healing after ESS. METHODS: A prospective, randomized, double-blind controlled trial was conducted in 33 patients undergoing symmetric ESS. At the conclusion of the operation, Surgi shield was randomly applied on one side of the nasal cavity, with the opposite side acting as control and the bleeding quantity of the surgical field was evaluated every 2 minutes. And then, Merocel was placed in the ethmoidectomized areas of the both sides. Five milliliters of Surgi shield was applied to the Merocel of intervention side and saline was applied to the other side. Merocel in both nasal cavities was removed and 5 mL of Surgi shield was applied again to the intervention side on the second day after surgery. The nasal cavity was examined using a nasal endoscope and the degree of adhesion, crusting, mucosal edema, infection, and granulations were graded at 1, 2, and 4 weeks after surgery. RESULTS: Complete hemostasis was rapidly achieved in the Surgi shield applied side compared with the control side at 2, 4, 6, 8, and 10 minutes after application of Surgi shield (P#x0003d;0.007, P#x0003d;0.004, P<0.001, P#x0003d;0.001, and P<0.001, respectively). There were significantly less adhesions on the Surgi shield applied side at postoperative 1, 2, and 4 weeks (P#x0003d;0.001, P<0.001, and P<0.001, respectively). The degree of mucosal edema, infection, crusting, or granulation formation assessed by the endoscopic features in the Surgi shield applied side was not significantly different from that of the control side (P>0.05). No adverse effects were noted in the patient series. CONCLUSION: Surgi shield containing chitosan can be used safely to achieve rapid hemostasis immediately after ESS and to prevent adhesion formation.
Chitosan* ; Edema ; Endoscopes ; Endoscopy ; Hemorrhage ; Hemostasis* ; Humans ; Nasal Cavity ; Prospective Studies ; Wound Healing

BACKGROUND: Following several decades of decline, the incidence of tuberculosis has recently begun to increase in many countries and the control of this disease has been impeded by the emergence of multi-drug resistant tuberculosis (MDR-TB). The development of rapid diagnostic methods and effective new drugs are needed to control MDR-TB. One of the new drugs for MDR-TB is rifabutin (RBU) which has been known to be effective in some patients with MDR-TB. A few reports showed that some types of mutaitions of the rpoB gene, which were known to be present in 96-98% of rifampicin-resistant M. tuberculosis, were associated with the rifampicin-resistant but RBU-susceptible phenotype. This study was performed to investigate the correlation between RBU susceptibility and the patterns of rpoB gene mutations in Korean MDR-TB. METHODS: Sixty-five clinical isolates of multi-drug resistant Mycobacterium tuberculosis, gathered from patients two visited the Asan Medical Center from July 1997 to June 1999, were investigated. Clinical responses to rifabutin-containing regimen were evaluated. An RBU susceptibility test and sequencing analysis of rpoB gene were performed, and the result were analyzed to confirm which mutations correlated with RBU-susceptible MDR-TB. RESULTS: Fifty-three of 56 (95%) clinical isolates of MDR-TB had 60 mutations of the rpoB gene. The most frequent mutations were found at codon 531 (43%), and two mutations were combined in seven clinical isolates. Five of 53 (10%) clinical isolates showed the RBU-susceptible phenotype, and in them the characteristic patterns of point mutations were found at codon 509, 516, and 526. CONCLUSION: The frequency and pattern of mutations of the rpoB gene of Korean MDR-Tb isolates were similar to those in western countries, where the prevalence of tuberculosis is low, but some show RBU-susceptible phenotypes. RBU-susceptible MDR-TB isolates showed the characteristic pattern of mutations of the rpoB gene which could be used to rapidly diagnose RBU susceptibility.
Chungcheongnam-do ; Codon ; Humans ; Incidence ; Mycobacterium tuberculosis* ; Mycobacterium* ; Phenotype ; Point Mutation ; Prevalence ; Rifabutin* ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

Parathyroid adenoma usually manifests with symptoms related to hypercalcemia, such as urinary stone and bone fracture. It may also present with asymptomatic hypercalcemia. However, spontaneous cervical hematoma may occur very rarely as a result of extracapsular hemorrhage of a cervical parathyroid adenoma causing acute painful cervical swelling, bruising, dyspnea, hoarseness and dysphagia. We report a 44-year-old woman who manifested as a spontaneous cervical hematoma without any clinical evidence of hyperparathyroidism.
Acute Pain ; Adult ; Deglutition Disorders ; Dyspnea ; Female ; Fractures, Bone ; Hematoma ; Hemorrhage ; Hoarseness ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Neck ; Parathyroid Neoplasms ; Urinary Calculi

The toxic effect of azalea extract, especially on cardiovascular system, in relatively unclear. The purpose of this study is to study the possible underlying mechanism and effect of toxic ingredient of azalea on cardiovascular system. The 71 healthy rabbits were divided into 10 groups: In group as preliminary study; 4 cc of normal saline was administered intravenously (N); 0.7 gm/kg and 1.0 gm/kg of azalea extract was administered respectively in the same route, volume (A1, A2); atropine was administered intravenously (A); after pretreatment with atropine (0.04 mg/kg) to block parasympathetic system, azalea extract was injected like the above groups (AA1, AA2); normal saline, 0.7 gm/kg and 1.0 gm/kg of azalea extract were administered respectively with 0.2 cc (1:1000) epinephrine (E0, E1, E2). We measured the following indices at I minute interval during first 10 minutes and then 10 minute interval during next 30 minutes: RR interval, QTc interval, maximal systolic and diastolic pressure drop with occurring time and presence of significant arrhythmia. The results were as follows: 1. The changes of RR interval, QTc interval were significantly increased in groups by Azalea extract. The blood pressure change was significantly decreased in groups by Azalea extract. There were no significant differences according to dosage of Azalea extract. 2. The changes of RR interval, blood pressure were significant differences between administration of atropine and Azalea extract after pretreatment with atropine, but not in the change of QTc interval. 3. There were no significant differences in the change of RR interval, ATc interval, blood pressure drop according to pretreatment with atropine. 4. The interaction between epinephrine and Azalea extract was not noted by the effect of epinephrine itself. 5. The ST change by 0.7 gm/kg, 1.0 gm/kg of Azalea extract was revealed in 1 case (14.0%), 7 case (100%), respectively. 6. Most of all cases with arrhythmia, ventricular tachycardia, ventricular fibrillation, were noted in the group by epinephrine, except on case by Azalea extract (1.0 gm/kg). It was idioventricular rhythm. In conclusion, azalea extract has negative inotropic and chronotropic effect with arrhythmogenic potential possibly through direct myocardial ischemia or injury but we can't be absolutely exclusive of actions of autonomic nervous system, especially parasympathetic nervous system.
Arrhythmias, Cardiac ; Atropine ; Autonomic Nervous System ; Blood Pressure ; Cardiovascular System* ; Epinephrine ; Myocardial Ischemia ; Parasympathetic Nervous System ; Rabbits ; Tachycardia, Ventricular ; Ventricular Fibrillation