This study was undertaken to investigate the morphologic changes following flushing, preservation and reperfusion procedures in a canine lung allotransplantation model. Donor lungs were flushed with modified Euro-Collins (MEC) solution, low potassium dextran glucose (LPDG) solution or University of Wisconsin (UW) solution, then stored at 10oC for 20 hours. Light microscopic and electron microscopic features of the lungs were examined after flushing, preservation and 2 hours after reperfusion. After flushing light microscopy showed focal mild alveolar collapse and interstitial edema. After preservation the lung tissue showed multiple foci of alveolar collapse, consolidation, and alveolar epithelial cell damage. After reperfusion the lung tissue showed diffuse alveolar collapse, consolidation and many destroyed cellular debris in the alveolar lumina. After flushing electron microscopy showed focal alveolar collapse and mild swelling of type I epithelial cells. After preservation both type I epithelial cells and endothelial cells were swollen and destroyed focally. Some type I epithelial cells were detached from the basal lamina. The endothelial cells showed luminal protrusion of tactile-like structure and vacuoles of the cytoplasm. After reperfusion the lung tissue showed fibrin material in the alveoli, prominent type I epithelial cell swelling with fragmented cytoplasmic debris and marked endothelial cell swelling with vacuoles or tactile-like projections. The alveolar macrophages showed active phagocytosis. After preservation scanning electron microscopic examination of the pulmonary arteries showed multiple patchy areas of swelling or conglomerated lesions in the inner surface of the pulmonary arteries. In conclusion, the ultrastructural changes associated with flushing were mild in severity, the donor lungs were injured during the preservation, and further damage occurred during the reperfusion.
Basement Membrane ; Cytoplasm ; Dextrans ; Edema ; Endothelial Cells ; Epithelial Cells ; Fibrin ; Flushing ; Glucose ; Humans ; Lung Transplantation* ; Lung* ; Macrophages, Alveolar ; Microscopy ; Microscopy, Electron ; Perfusion* ; Phagocytosis ; Phenobarbital ; Potassium ; Pulmonary Artery ; Reperfusion* ; Tissue Donors ; Vacuoles ; Wisconsin

Neurilemmoma reprsents a benign nerve sheath tumor derived from Schwann cells. Lesions almost always are solitary, although multiple lesions may occur in association with multiple neurofibromatosis. We report a case of multiple neurilemmomas not in asaociation with neurofibromatosis. The patient was a 28-year-old male who had multiple tender nodules along the course of peripheral nerves on the palmar aspect of the right hand. A local excision of all lesions was performed and the microscopic diagnosis of neurilernmoma was established.
Adult ; Diagnosis ; Hand ; Humans ; Male ; Neurilemmoma* ; Neurofibromatoses ; Peripheral Nerves ; Schwann Cells

No abstract available.
Humans ; Infant* ; Intussusception*

Aortopulmonary septal defect is a rare congenital cardiac anomaly. A 15 year old boy was admitted to Department of Internal Medicine of Seoul National University Hospital because of exertional dyspnea. Aortopulmonary septal defect was confirmed by cardiac catheterization demonstrating severe pulmonary hypertension and patent foramen ovale, and retrograde aortogram showing contrast material passing from the ascending aorta just above the aortic valve into the pulmonary trunk. We present a case of aortopulmonary septal defect with a review of literatures.
Adolescent ; Aorta ; Aortic Valve ; Aortopulmonary Septal Defect* ; Cardiac Catheterization ; Cardiac Catheters ; Dyspnea ; Foramen Ovale, Patent ; Humans ; Hypertension, Pulmonary ; Internal Medicine ; Male ; Seoul

PURPOSE: The admission rates for pediatric asthma are increasing annually and are partially responsible for the increased rates of readmission. Selections of children with a high-risk of readmission and aggressive treatments of them may improve treatment outcome and cost- effectiveness. The purpose of this study is to evaluate the risk factors affecting readmission in cases of bronchial asthma in children. METHODS: We reviewed the medical records of 95 cases under 14 years of age who were admitted to the Department of Pediatrics, Kyung-Hee University, from March 1996 to February 1997 and divided them into readmission and first admission group. RESULTS: Readmission cases were 52 (55%). Age, sex, duration of admission, duration of oxygen therapy, serum IgE concentration, duration of symptoms prior to admission and severity of asthma were not statistically significant compared with those of the control group (t-test) (P>0.05). Use of prophylactic agents, family history of allergic diseases and past history of bronchiolitis were significant (P<0.05), but age under 4 years and sex were not significant (X2-test). Age under 4 years, history of bronchiolitis, and history of previous hospital admission for asthma were significant (P<0.05), but sex, severity of asthma, history of frequent upper respiratory tract infection, family history, and the use of prophylactic agents were not statistically significant (P>0.05) as independent risk factors. CONCLUSION: Age under 4 years, past history of bronchiolitis, and history of previous hospital admission for asthma were significant risk factors for hospital readmission. Further study needs to be done to decrease the readmission rates.
Asthma* ; Bronchiolitis ; Child ; Humans ; Immunoglobulin E ; Medical Records ; Oxygen ; Patient Readmission ; Pediatrics ; Respiratory Tract Infections ; Risk Factors* ; Treatment Outcome

Nevus lipomatosus cutaneus superficialis is a very rare skin disease which appears at birth or within the firat two decades of life. This uncommon condition is due to collections of ectopic fat cells within the upper and mid-dermis. There are two clinical forms. The first form is a lesion of zonal distribution, present from birth or childhood, usually on the buttocks or the lower back. The second form, a dome or sessile, papule, begins in adult life and is less restricted in distribution, and occurs also on the limbs Coalescence of soft, yellowish papules tends to form cerebriform plaques. The authors experienced two cases of typical nevus lipomatosus cutaneus superficialis. The first case was a 23-year male who had asymptomatic, soft, skin colored, and pea sized confluent nodules on the right lower back area since at birth. The second case was a 35-year female who had asymptomatic, multiple, soft, skin colored from rice to walnut sized confluent nodules on the coccygeal area which developed at the age of 27. Diagnosis was confirmed by clinical and histopathological findings.
Adipocytes ; Adult ; Buttocks ; Diagnosis ; Extremities ; Female ; Fluconazole ; Humans ; Juglans ; Male ; Nevus* ; Parturition ; Peas ; Skin ; Skin Diseases

Epidermolytic hyperkeratosis is a rare disease which is extremely variable in its severity. In some patients it may be so severe and generalized during the neonatal period as to be lifethreatening, in others, it is relatively inconspicuous. A bullous eruption is the characteristic finding of the epidermolytic hyperkeratosis The bullous episodes soon become less frequent and more localized and may eventually cesse, but continue into adult life after the age of 20 years in at least 20% of cases. A case of epidermolytic hyperkeratosis is represented. The patient was a 25-year-old male who had ichthyosiform erythroderma and the frequent episades of bullous eruption. The bullous eruption had been subsided under the treatment with oral penicillin administration. The histopathological features of the bullous lesion on his abdomen revealed the features of epidermolytic hyperkeratosis.
Abdomen ; Adult ; Blister ; Dermatitis, Exfoliative ; Humans ; Hyperkeratosis, Epidermolytic* ; Male ; Penicillins ; Rare Diseases

No abstract available.

Between January 1982 and September 1986, at the Department of Orthopaedic Surgery of Kyung Hee University Hospital, 82 total knee arthroplasties were performed in 57 patients. We studied 25 patients (50 Knees) who had been operated by bilateral total knee arthroplasties to compare one stage and two stage operations. The follow-up ranged from 10 months to 5 years and 7 months (average 1 year and 8 months). All operations were performed by one of the authors (D.K.B.), but the follow-up study and the entire medical record were independently evaluated by another authors. The clinical results of preoperative and postoperative assessments and rehabilitation processes are as follows; 1. Group I (10 patients) had both kness replaced by one stage simultaneous operation under same anesthesia, and Group II(15 patients) had replaced by two stage operation at the intervals of 2 weeks. 2. The periods required to do bilateral weight bearing were 10.3 days for Group I, 23.6 days for Group II. 3. Complications in one stage operation was no more than the in two stage operation. 4. The postoperative pain and ROM were not significantly different in both groups. 5. Using the hospital for special surgery rating system, we found the clinical results to be similar in both groups. 6. Comparing to two stage operation, the advantages of one stage operation were shorter operative and tourniquet time, lesser use of antibiotics, reduced medical cost and hospital stay. In conclusion, if patient conditions do not prevent prolonged anesthetic time and surgeons have good surgical techniques, we recommend one stage simultaneous operation in bilateral total knee replacement.
Anesthesia ; Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Length of Stay ; Medical Records ; Pain, Postoperative ; Rehabilitation ; Surgeons ; Tourniquets ; Weight-Bearing

Purpose: To measure the level of reflection, this study analyzes diaries written by third-year nursing students before and after the debriefing stage in simulation training. A qualitative study using diary entries from 15 nursing students to explore reflection depth. Methods: Students engaged in simulation training and the debriefing stage, documenting their reflections in diaries. Before and after debriefing, reflections were rated from Level 1 (reflectivity) to Level 7 (theoretical reflectivity). Results: The total number of reflection levels rose significantly from 545 to 829 post-debriefing, enhancing higher-order reflection.The shift signifies a move from superficial to deep reflection, highlighting debriefing's role in fostering critical thinking. Conclusion The findings underscore the critical role of debriefing in enhancing reflective thinking in nursing education. There is a demonstrated need for further research into the specific elements of debriefing that are most effective at promoting deep reflection. Future studies should conduct comparative analyses of different debriefing methods and approaches across various educational settings. This research could lay the foundation for designing more effective debriefing strategies that foster critical thinking and improve learning outcomes in nursing education.