Extensive laceration of the lung itself has relatively little attention as a threat to life compared with other intrathoracic organ injuries. The incidence of pulmonary laceration extensive enough to require thoracotomy is rare, but is higher than expected. The diagnosis of extensive pulmonary laceration may be difficult, but this injury should be suspected with attention and early thoracotomy can be carried out in indicated cases. Recently, thoracoscopy has assumed a major role in the management of a variety of surgical diseases of the chest. We experienced a case of extensive pulmonary laceration caused by nonpenetrating trauma, which underwent lobectomy by thoracoscopic surgery. A 21-year-old man who was injured in a motocycle accident was brought to Emergency Room from the scene by an ambulance, and complained of chest pain and dyspnea. A chest roentgenogram showed a hemothorax and fractures of the posterior ends of the right seventh, eighth, and ninth ribs. A chest tube was inserted. Thirteen hundred ml of blood was drained through the chest tube during the next one hour. Emergency right mini-thoracotomy revealed extensive laceration of the lower lobe extending to the pulmonary hilum. The lower lobe was the most badly torn. A lower lobectomy was done by video-assisted thoracic surgery (VATS). He complained less postoperative pain and the postoperative course was uneventful.
Ambulances ; Chest Pain ; Chest Tubes ; Diagnosis ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Hemothorax ; Humans ; Incidence ; Lacerations* ; Lung ; Pain, Postoperative ; Ribs ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy ; Thorax ; Young Adult

OBJECTIVES: Sleep problems has been consistently reported as a suicidal risk factor in adults and, recently, also in adolescents. In this study, dividing study subjects by the previous suicidal behaviors (suicidal vs non-suicidal), we compared the group differences of suicidal risk factors, and examined the possibility of sleep as a suicidal risk factor. METHODS: Study subjects were 561 (271 boys and 290 girls) from a community sample of high school students. Suicidal Risk Behavior Checklist, Center for Epidemiological Study-Depression (CES-D), Symptom Checklist-90-Revision (SCL-90-R) Anxiety and Aggression subscale, Pittsburg Sleep Quality Index (PSQI) were done. RESULTS: Forty six students (8.1%) reported previous actual self-harm behavior as a suicidal attempt, 181 students (32.4%) reported having suicidal thought only. Three hundred thirty four students (59.5%) reported no previous suicidal behavior (thought and attempt, both). Suicidal behavior group showed higher score on risk behaviors such as school violence, substance use and internet addiction. CES-D, SCL-90-R, PSQI showed significant group difference. Logistic regression analysis showed suicidal risk were significantly associated with depression, stress in suicidal risk factors and sleep latency, daytime dysfunction in PSQI. Analysis of variance (ANOVA) shows the most prolonged sleep latency and increased index of all PSQI components except sleep efficiency in suicidal attempt group. CONCLUSIONS: Sleep Problems had a strong association with the suicidal risk behavior in adolescents. Sleep problems, especially, prolonged sleep latency, daytime dysfunction might be important markers for suicidal behavior. Screening for sleep problems in adolescents are encouraged for the parents, school teachers, and related medical physicians.
Adolescent ; Adult ; Aggression ; Anxiety ; Checklist ; Depression ; Humans ; Internet ; Logistic Models ; Mass Screening ; Parents ; Risk Factors ; Risk-Taking ; Suicide ; Violence

Some cases of renal malignancy associated with adult (autosomal dominant) polycystic kidney disease have been reported. Most of these malignancies were diagnosed as renal cell carcinoma. But the case of transitional cell carcinoma has not been reported. We report a case of renal pelvic and urethral transitional cell carcinoma associated with adult polycystic kidney.
Adult* ; Carcinoma, Renal Cell ; Carcinoma, Transitional Cell* ; Humans ; Kidney ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Dominant*

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

This is the report of 98 cases in renal allograft, which were treated at Yeungnam University Hospital from January 1994 to July 1996 and compared the significance of changes of TNF alpha, IL-2R, IL-6 in blood and urine as an early diagnostic tool of acute rejection in renal allograft. The aim of this study was to investigate the value of plasma and urinary TNF alpha, IL-2R, IL-6 in patients with renal allografts. Renal allografts patients were divided into four groups (control, acute rejection, acute tubular necrosis, systemic infection) according to their postoperative diagnostic methods. Blood and urine samples in four groups were obtained: control group (2 days before transplantation, at the day of transplantation and every other day after transplantation), acute rejection group (everyday sampling from 2 days before therapy to the end of therapy), acute tubular necrosis and systemic infection group (everyday sampling from the day of diagnosis to the end of therapy). In acute rejection group, there were significant elevation of cytokines; plasma TNF alpha (68.4%, p<0.01), IL-2R (73.6%, p<0.01), and IL-6 (89.5%, p<0.01), urinary TNF-alpha (42.1%, p<0.01), IL-2R (89.5%, p<0.01) and IL-6 (94.7%, p<0.01). In systemic infection group, all cytokines except urinary TNF-alpha were significantly elevated. The results suggested that plasma and urinary TNF-alpha, IL-2R, and IL-6 may play a complementary early diagnostic tool of acute rejection in renal allograft patients although the differential diagnosis is difficult with systemic infection. Urinary TNF-alpha was not elevated in systemic infection group, so it may be used in differential diagnosis between acute rejection and systemic infection.
Allografts* ; Cytokines ; Diagnosis ; Diagnosis, Differential ; Humans ; Interleukin-6* ; Necrosis ; Plasma* ; Tumor Necrosis Factor-alpha*

This is the report of 98 cases in renal allograft, which were treated at Yeungnam University Hospital from January 1994 to July 1996 and compared the significance of changes of TNF alpha, IL-2R, IL-6 in blood and urine as an early diagnostic tool of acute rejection in renal allograft. The aim of this study was to investigate the value of plasma and urinary TNF alpha, IL-2R, IL-6 in patients with renal allografts. Renal allografts patients were divided into four groups (control, acute rejection, acute tubular necrosis, systemic infection) according to their postoperative diagnostic methods. Blood and urine samples in four groups were obtained: control group (2 days before transplantation, at the day of transplantation and every other day after transplantation), acute rejection group (everyday sampling from 2 days before therapy to the end of therapy), acute tubular necrosis and systemic infection group (everyday sampling from the day of diagnosis to the end of therapy). In acute rejection group, there were significant elevation of cytokines; plasma TNF alpha (68.4%, p<0.01), IL-2R (73.6%, p<0.01), and IL-6 (89.5%, p<0.01), urinary TNF-alpha (42.1%, p<0.01), IL-2R (89.5%, p<0.01) and IL-6 (94.7%, p<0.01). In systemic infection group, all cytokines except urinary TNF-alpha were significantly elevated. The results suggested that plasma and urinary TNF-alpha, IL-2R, and IL-6 may play a complementary early diagnostic tool of acute rejection in renal allograft patients although the differential diagnosis is difficult with systemic infection. Urinary TNF-alpha was not elevated in systemic infection group, so it may be used in differential diagnosis between acute rejection and systemic infection.
Allografts* ; Cytokines ; Diagnosis ; Diagnosis, Differential ; Humans ; Interleukin-6* ; Necrosis ; Plasma* ; Tumor Necrosis Factor-alpha*

Angiogenesis is a fundamental biological process including endothelial cell adhesion, migration, invasion and tube formation. Integrin receptors of endothelial cells play important roles in angiogenesis. They mediate cell-cell contact and cell adhesion to extracellular matrix. Roles of integrins have been described for a number of cell types. ECV304 endothelial cells were known to overexpress alpha3beta1 integrin and to form tube like structure in 3-D Matrigel culture. However the function of alpha3beta1 integrin in endothelial cells remains to be determined. Therefore, we have investigated morphological characteristics of ECV304 cells and roles of alpha3beta1 integrin in angiogenesis. To elucidate several characteristics, ECV304 endothelial cells were compared with HUVEC in the aspect of morphology, localization of integrins, angiogenesis pattern. In addition, role of alpha3beta1 integrin were analyzed in the aspect of endothelial cell binding, migration, invasion and tube formation on Matrigel. The result showed that alpha3beta1 integrin overexpressed ECV304 endothelial cells showed strong adhesiveness to extracellular matrix proteins, and high migration and invasion activities. Furthermore, expression of alpha3beta1 integrin was increased according to time course during in vitro culture and was continuously strong in ECV304 cells on 3-D Matrigel culture. These results indicate that alpha3beta1 integrin is able to be a critical component in control of angiogenesis by regulation of cell adhesion, migration, invasion and tube formation of ECV304 endothelial cells.
Adhesiveness ; Biological Processes ; Cell Adhesion ; Endothelial Cells* ; Extracellular Matrix ; Extracellular Matrix Proteins ; Integrin alpha3beta1* ; Integrins

PURPOSE: The pericentric inversion of chromosome 9 is one of the most common structural balanced chromosomal variations and has been found in both normal populations and patients with various abnormal phenotypes and diseases. The aim of this study was to re-evaluate the clinical impact of inv(9)(p11q13). MATERIALS AND METHODS: We studied the karyotypes of 431 neonates with congenital anomalies at the Pediatric Clinic in Ajou University Hospital between 2004 and 2008 and retrospectively reviewed their clinical data. RESULTS: Chromosomal aberrations were detected in 60 patients (13.9%). The most common type of structural abnormality was inv(9)(p11q13), found in eight patients. Clinical investigation revealed that all eight cases with inv(9)(p11q13) had various congenital anomalies including: polydactyly, club foot, microtia, deafness, asymmetric face, giant Meckel's diverticulum, duodenal diaphragm, small bowel malrotation, pulmonary stenosis, cardiomyopathy, arrhythmia, and intrauterine growth restriction. The cytogenetic analysis of parents showed that all of the cases were de novo heterozygous inv(9)(p11q13). CONCLUSION: Since our results indicate that the incidence of inv(9)(p11q13) in patients with congenital anomalies was not significantly different from the normal population, inv(9)(p11q13) does not appear to be pathogenic with regard to the congenital anomalies. Some other, to date unknown, causes of the anomalies remain to be identified.
Adult ; Chromosome Inversion/*genetics ; Chromosomes, Human, Pair 9/*genetics ; Congenital Abnormalities/*genetics ; Female ; Humans ; Infant, Newborn ; Male ; Retrospective Studies

No abstract available.
Animals ; Metaphase* ; Mice* ; Oocytes*