Post-traumatic tricuspid insufficiency is a rare condition and may be clinically silent and imprecise. The diagnosis may be difficult when it progreses slowly and other acute lesions exist concomittantly. Two-dimenstional Doppler echocardiography appears to be an essential procedure in diagnosting the rupture of chordae tendineae or papillary muscle following traumatic injury. We report a case of tricuspid insufficiency of which symptom developed 8 years later following a blunt chest trauma. The patient was operated by tricuspid vlave repair with chordal replacement and ring annuloplasty successfully. We would like to emphasize that patients sustaining major thoracic trauma should be carefully examine for possible blunt chest trauma including cardiac valve rupture or tear.
Chordae Tendineae ; Diagnosis ; Echocardiography, Doppler ; Heart Valves ; Humans ; Papillary Muscles ; Rupture ; Thorax*

PURPOSE: We evaluated the severity of olfactory disturbance (OD) in the murine model of allergic rhinitis (AR) and local allergic rhinitis (LAR) in mice. We also investigated the therapeutic effect of an intranasal steroid on OD. METHODS: Forty BALB/c mice were divided into 5 groups (n = 8 for each). The control group was sensitized intraperitoneally (i.p.) and challenged intranasally (i.n.) with saline. Mice in the AR group got i.p. and i.n. ovalbumin (OVA) administration for AR induction. The LAR group was challenged i.n. with 1% OVA for inducing local nasal allergic inflammation, without inducing the systemic allergy. The OD group got an i.p. methimazole administration (75 mg/kg) to induce total destruction of olfactory mucosa. Mice in the intranasal budesonide group received i.n. budesonide (12.8 μg per time, 30 minutes after the i.n. OVA challenge) while using OVA to cause systemic allergies. We conducted a buried-food pellet test to functionally assess the degree of OD in each group by measuring the time taken until finding hidden food. We evaluated the damage to olfactory epithelium using histopathologic evaluation and compared the degree of olfactory marker protein (OMP) expression in olfactory epithelium using immunofluorescent staining. RESULTS: Mice of the AR (81.3 ± 19.8 seconds) and LAR groups (66.2 ± 12.7 seconds) spent significantly more time to detect the pellets than the control group (35.6 ± 12.2 seconds, P < 0.01). After treatment, the intranasal budesonide group exhibited significantly better results (35.8 ± 11.9 seconds) compared with the AR and LAR groups (P < 0.01). The AR and LAR groups showed considerable olfactory epithelial damage and suppression of OMP expression compared with the control group. In the intranasal budesonide group, the olfactory lesions and OMP expression had improved substantially. CONCLUSIONS: OD may be caused by olfactory epithelial damage and suppression of OMP expression in nasal allergic inflammation and could be reversed using an intranasal steroid.
Animals ; Budesonide ; Hypersensitivity ; Inflammation ; Methimazole ; Mice ; Olfaction Disorders ; Olfactory Marker Protein ; Olfactory Mucosa ; Ovalbumin ; Ovum ; Quality of Life ; Rhinitis, Allergic ; Steroids

Thalidomide, a potent teratogen, is Known as an angiogenic inhibitor. This study was performed to examine the effect of thalidomide on corneal angiogenesis in rabbit cornea induced by chemical cauterization. We applied Whatman filter paper disc soaked in 30% silver nitrate (AgNO3) application on corneas of 12 white rabbits. After 5days, we administered oral dose of 100mm2 thalidomide to the 6 animals everyday and examined the length and extent of neovascularization to evaluate the area of neovascularization. After 2 days of oral administration, the increase of neovascularization is 14.3+/-11.7mm2in thalidomide-treated group and 27.9+/-14.6mm2 in cotrol grop. The area of neovascularization reached to its maximum at day 9 in thalidomide-treated group compared to day 11 in control group and decreased thereafter in both groups. The increase of the area of vascularized cornea revealed 28.0+/-13.5mm2 in thalidomide-treated group and 44.4+/-12.7mm2 in control group at the day 9 (p=0.04, Wilkoxon Matched-pairs signed-rank test). This fact means that treatment with thalidomide resulted in an inhibition of the area of vascularized cornea with the median inhibition of 37.3%. On light micrographs, there were infiltration of inflammatory cell and capillary lumens in corneal stroma in both animals. Electron micrographs of thalidomide-treated animals showed loss of vascular endothelial cell junction, mitochondrial swelling and loss of cristae which were not found in control animals. This results suggest that orally-administered thalidomide has a direct effect on the growing vasculature and an inhibitory effect on corneal angiogenesis.
Administration, Oral ; Animals ; Capillaries ; Cautery ; Cornea ; Corneal Neovascularization* ; Corneal Stroma ; Endothelial Cells ; Mitochondrial Swelling ; Rabbits ; Silver Nitrate ; Thalidomide*

No abstract available.
Bone Density* ; Female ; Lactation* ; Postpartum Period*

PURPOSE: The purpose of this study was to conceptualize and clarify a concept of "preparatory grief" in terminal cancer patients. METHOD: A hybrid model of concept development was applied to develop a concept of preparatory grief, which included a field study carried out in Busan, Korea. Participants of this study were 8 cancer patients. RESULTS: On the basis of our literature, research and clinical experience, the concept of preparatory grief emerged as a complex phenomenon playing an important role in five areas; physical, emotional, interpersonal, religious, and transcendental dimensions. Two new attributes were defined through a field phase; trust of the post-mortal world and a serene state of mind. Indicators reflected attitudes of sadness, worry, regret, capability to adapt and hope. The results of preparatory grief were loss of energy and interest, emotional chaos, contemplation, taciturnity and restoration. CONCLUSIONS: Differentiating among preparatory grief and other symptoms in cancer patients is essential because of therapeutic implications. Understanding preparatory grief is necessary in order to manage cancer patients for promoting quality of life so that its application may have a positive impact on the patient's life.
Adaptation, Psychological ; Aged ; *Concept Formation ; Counseling/*methods ; Female ; *Grief ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms/nursing/*psychology ; Quality of Life ; *Terminal Care

Multiple minute digitate hyperkeratosis (MMDH) is a rare disorder of keratinization characterized clinically by multiple, tiny, spiky, keratotic papules. Herein, we report a new case of MMDH. There was no family history of similar lesions or a personal history of underlying disease. The lesions were limited to the face and associated with acne vulgaris. We consider this case as a postinflammatory type of MMDH.
Acne Vulgaris ; Humans

PURPOSE: The purpose of this paper was to investigate whether the reflected synovio-capsular flap, covering one-third of the remaining peripheral after partial removal of two-thirds of the central medial meniscus of rabbit knee, contributes to the regeneration of meniscus. MATERIALS AND METHODS: Forty rabbits were used in this study. In each rabbit the right knee was used for the experimental group in which the synovio-capsular flap was reflected after a partial meniscectomy, while the left knee, with only a skin incision, was used for the control group. The width and thickness of the regenerated menisci were measured with the Vernier calliper, and evaluated grossly by Hematoxylin-Eosin (H-E) staining, histochemically by safranin-O staining, and subcellularly by transmission electron microscopy at 4, 8, 12 and 16 weeks after the operation. RESULTS: The width and thickness of reflected synovio-capsular flaps gradually decreased until reaching a normal size. After eight weeks, there was no statistical difference between the experimental and control group. Twelve weeks after the operation, immature fibrocartilage cells appeared in the central portion of the reflected synovio-capsular flaps in 7 out of 8 rabbit knees. Sixteen weeks after the operation, more mature cartilage cells and their halos, stained very deeply with safranin-O, appeared in 6 out of 8 rabbit knees. In electron microscopic examination of cell shape, normal cell process and nuclear shape were observed with the passage of time. Rough endoplasmic reticulum and chromatin transparence peaked at 12 weeks and gradually returned to normal shape at 16 weeks. CONCLUSIONS: The results showed that the reflected synovio-capsular flap in rabbit was incorporated with the remaining peripheral portion of the meniscus and became a normal meniscus-like structure.
Cartilage ; Cell Shape ; Chromatin ; Endoplasmic Reticulum, Rough ; Fibrocartilage ; Knee ; Menisci, Tibial ; Microscopy, Electron, Transmission ; Rabbits ; Regeneration ; Skin

Takayasu's arteritis is generally recognized as a chronic, idiopathic, inflammatory disease, which affects the aorta and the proximal portions of its major branches. We experienced a patient with Takayasu's arteritis who was presented with main pulmonary artery stenosis and right coronary ostial occlusion without involvement of aorta nor its major branches. She was managed with pulmonary arterioplasty and coronary artery bypass graft. This case emphasize that the disease cannot affect the aorta.
Aorta ; Constriction, Pathologic* ; Coronary Artery Bypass ; Coronary Vessels* ; Humans ; Pulmonary Artery* ; Takayasu Arteritis* ; Transplants

Chondromyxoid fibroma is the least common benign bone tumor, accounting for less than 1% of all bone tumors. Pathologically, it is composed of varying proportions of chondroid, myxoid and fibrous elements. The most common anatomical site is the metaphyseal region of the long bone, and the typical radiologic appear-ance is a cortical expansile osteolytic lesion with a lobulated sclerotic margin, and septa. We report the plain and MRI findings of a relatively typical chondromyxoid fibroma occuring in the proximal fibula.
Bone Neoplasms ; Fibroma* ; Fibula* ; Magnetic Resonance Imaging

Sodium azide (NaN3) is a white to colorless, crystalline powder that is highly water soluble, tasteless, and odorless. It is used mainly as a preservative in aqueous laboratory reagents and biologic fluids and also as an automobile airbag gas generant. Although it has caused deaths for decades, the toxic properties and effects of sodium azide in humans remains unknown. A 31-year-old comatose female was transported to the emergency department with an empty bottle labeled sodium azide. She developed cardiac arrest 15 minutes after arrival and expired in spite of 30 minutes of resuscitative effort. Subsequently, resuscitation team members incidentally suffered from sodium azide's exposure and developed eye discomfort, skin rashes parasthesias, pruritus, sore throat, and headache.
Adult ; Air Bags ; Automobiles ; Coma ; Crystallins ; Eating ; Emergencies ; Exanthema ; Eye ; Female ; Headache ; Heart Arrest ; Humans ; Indicators and Reagents ; Pharyngitis ; Pruritus ; Resuscitation ; Sodium ; Sodium Azide