Airway Management ; Aorta ; Drainage ; Edema ; Esophagus ; Heart ; Lung ; Mediastinitis ; Mediastinum ; Neck ; Thorax ; Tongue ; Vagus Nerve

BACKGROUND: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. MATERIAL AND METHOD: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. RESULT: There were 21 male and 6 female patients. Mean birth weight was 2.62+/-.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). CONCLUSION: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.
Birth Weight ; Cause of Death ; Colon ; Constriction, Pathologic ; Empyema ; Esophageal Atresia* ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mortality ; Retrospective Studies ; Tracheoesophageal Fistula

The authors analyzed ultrasonographic findings of 112 cases of trophoblastic disases which were confirmed byD&E or hysterectomy at Wallace Memorial Baptist Hospital from September 1980 to December 1984. The results were asfollows; 1. Of all 112 cases, hydatidiform moles were 99 cases, invasive moles were 3 cases and choriocarcinomas were 10 cases. 2. 81 cases (72%) occurred in 3rd decades. 3. The sized of uterus was large for gestational weeksin 65 cases(56%) and smaller in 13 cases(13%). 4. The contour of uterus was globular in 59 cases(53%), diffuse in49 cases(44%) and nodular in 4 cases(3%). 5. The internal echopatterns of uterus revealed numerous small vesicular snowstorm patterns in all cases, and revealed internal degeneration in 67 cases(60%). 6. Uterine walls in 89 cases(79%) were well delineated but uterine walls in 23 cases(21%) were poor delineated. 7. Multiseptated ovarian thecalutein cysts were seen in 36 cases (32%). 8. Invasive trophoblastic disease(invasive moles 3 cases andchoriocarcinomas 10 cases) revealed similiar ultrasonographic findings with H-mole, but more irregular internalechoes and irregular echoes in uterine wall. 9. Diagnostic accuracy was diagnostic in 98 cases (88%) , nonspecificin 11 cases (10%) and error in 3 cases(2%).
Choriocarcinoma ; Female ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Hysterectomy ; Pregnancy ; Protestantism ; Trophoblasts ; Uterus

Humans ; Maxillary Sinus ; Prognosis ; Survival Rate ; Transplantation, Heterologous ; Transplantation, Homologous ; Transplants

Airway Obstruction ; Arteries ; Cellulose, Oxidized ; Hemorrhage ; Hemostasis ; Humans ; Male ; Mandible ; Postoperative Hemorrhage

Myristoylated alanine-rich C kinase substrate (MARCKS) is a widely distributed protein kinase C (PKC) substrate and has been implicated in actin cytoskeletal rearrangement in response to extracellular stimuli. Although MARCKS was extensively examined in various cell culture systems, the physiological function of MARCKS in the central nervous system has not been clearly understood. We investigated alterations of cellular distribution and phosphorylation of MARCKS in the hippocampus following kainic acid (KA)-induced seizures. KA (25 mg/kg, i.p.) was administered to eight to nine week-old C57BL/6 mice. Behavioral seizure activity was observed for 2 h after the onset of seizures and was terminated with diazepam (8 mg/kg, i.p.). The animals were sacrificed and analyzed at various points in time after the initiation of seizure activity. Using double-labeling immunofluorescence analysis, we demonstrated that the expression and phosphorylation of MARCKS was dramatically upregulated specifically in microglial cells after KA-induced seizures, but not in other types of glial cells. PKC alpha, beta I, beta II and delta, from various PKC isoforms examined, also were markedly upregulated, specifically in microglial cells. Moreover, immunoreactivities of phosphorylated MARCKS were co-localized in the activated microglia with those of the above isoforms of PKC. Taken together, our in vivo data suggest that MARCKS is closely linked to microglial activation processes, which are important in pathological conditions, such as neuroinflammation and neurodegeneration.
Up-Regulation/drug effects ; Time Factors ; Seizures/chemically induced/*metabolism ; Protein Kinase C-delta/analysis ; Protein Kinase C-alpha/analysis ; Protein Kinase C/*analysis ; Protein Biosynthesis/drug effects ; Phosphorylation/drug effects ; Microscopy, Confocal ; Microglia/cytology/drug effects/*metabolism ; Mice, Inbred C57BL ; Mice ; Membrane Proteins/*analysis/metabolism ; Kainic Acid/*toxicity ; Isoenzymes/analysis ; Intracellular Signaling Peptides and Proteins/*analysis/metabolism ; Immunohistochemistry ; Animals

We have experienced a case of idiopathic erythrocytosis developed in a patient with end stage renal disease who had switched to CAPD from hemodialysis. Hemoglobin levels gradually increased from 8 to 19.0 mg/dl, resulting in various symptoms from hyperviscosity during the first 2 months after the initiation of CAPD. There were no other possible causes of secondary erythrocytosis, such as hypoxia, erythropoietin -producing tumor or acquired cyst. Serum level of IGF-1 was above the normal range in contrast with low serum levels in CAPD patients with anemia. Increased IGF-1 levels may possibly influence on the development of erythrocytosis in this case.
Anemia ; Anoxia ; Erythropoietin ; Humans ; Insulin-Like Growth Factor I ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Polycythemia* ; Reference Values ; Renal Dialysis

We report a case of trichoblastic fibroma involving the scrotum in a 60-year-old man. Trichoblastic fibroma is very rare and benign trichogenic tumor that has both epithelial and mesenchymal components and histologically recount the embryologic development of the hair follicle. The diagnosis was confirmed by histopathologic examination.
Diagnosis ; Fibroma* ; Hair Follicle ; Humans ; Middle Aged ; Scrotum*

We report a non-obese patient suffering from spastic gait and right leg paresis caused by thoracic spinal cord compression secondary to spinal epidural lipomatosis. Although spinal epidural lipomatosis is most often associated with the administration of exogenous steroid or endogenous Cushing syndrome, obesity also has been reported as a possible cause. However, idiopathic(non-glucocorticoid induced) spinal epidural lipomatosis in non-obese healthy man is an extremely rare disease and dose not have any good explanation for the abnormal fat deposition in spinal epidural space. We recently experienced a patient with idiopathic thoracic epidural lipomatosis in whom MRI and histopathology established the specific diagnosis. With a case report, brief review of the disease including clinical feature, diagnostic procedure and therapeutic considerations is described.
Cushing Syndrome ; Diagnosis ; Epidural Space ; Gait Disorders, Neurologic ; Humans ; Leg ; Lipomatosis* ; Magnetic Resonance Imaging ; Obesity ; Paresis ; Rare Diseases ; Spinal Cord Compression

No abstract available.
Angina Pectoris* ; Electrocardiography* ; Pheochromocytoma*