A 59-year-old man presented for possible durable ventricular assist device (VAD) implantation. He had previously been diagnosed with congenitally corrected transposition of the great arteries, a ventricular septal defect, an atrial septal defect, pulmonary valve stenosis, and aortic valve regurgitation. In the previous 22 years, he had undergone palliative cardiac surgery 3 times. VAD implantation as a bridge to transplantation was planned. Owing to severe adhesions, mesocardia, a left ascending aorta, and moderate aortic regurgitation, we performed VAD implantation and aortic valve closure via a dual left thoracotomy and partial sternotomy.

BACKGROUND: Skin grafting is a relatively simple and thus widely used procedure. However, the elastic and structural quality of grafted skin is poor. Recently, various dermal substitutes have been developed to overcome this disadvantage of split-thickness skin grafts. The present study aims to determine the feasibility of RapiGraft as a new dermal substitute. METHODS: This prospective study included 20 patients with partial- or full-thickness skin defects; the patients were enrolled between January 2013 and March 2014. After skin defect debridement, the wound was divided into two parts by an imaginary line. Split-thickness skin grafting alone was performed on one side (group A), and RapiGraft and split-thickness skin grafting were used on the other side (group B). All patients were evaluated using photographs and self-questionnaires. The Manchester scar scale (MSS), a chromameter, and a durometer were used for the scar evaluation. The average follow-up period was 6 months. RESULTS: The skin graft take rates were 93% in group A and 89% in group B, a non-significant difference (P=0.082). Statistically, group B had significantly lower MSS, vascularity, and pigmentation results than group A (P<0.05 for all). However, the groups did not differ significantly in pliability (P=0.155). CONCLUSIONS: The present study indicates that a simultaneous application of RapiGraft and a split-thickness skin graft is safe and yields improved results. Therefore, we conclude that the use of RapiGraft along with skin grafting will be beneficial for patients requiring reconstructive surgery.
Cicatrix ; Debridement ; Follow-Up Studies ; Humans ; Pigmentation ; Pliability ; Prospective Studies ; Skin Transplantation* ; Skin* ; Transplants ; Wounds and Injuries

PURPOSE: The objective of this study was to examine the psychological features and coping strategies of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). MATERIALS AND METHODS: The participants consisted of 55 military personnel suffering from CP/CPPS and 58 military personnel without CP/CPPS symptoms working at the Military Capital Hospital. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was used to assess CP/CPPS symptoms. The Responses to Hospital Anxiety and Depression (HAD) scale, Social Readjustment Rating Scale, and Global Assessment of Recent Stress (GARS) scale were compared between the two groups. The Weisman Coping Strategy Scale was used to assess coping ability with CP/CPPS. RESULTS: The NIH-CPSI score of the CP/CPPS group was significantly higher than that of the control group for all domains including pain, urinary symptoms, quality of life, and summed score. The Anxiety and Depression domain of the HAD showed significant differences between the two groups. There were no significant differences in the Social Readjustment Rating Scale between the two groups, but the sum of the GARS score was higher in the CP/CPPS group than in the control group. These were correlated with the pain, quality of life, and sum domains of the NIH-CPSI. The Weisman Coping Strategy Scale showed that intellectualization, redefinition, and flexibility were higher in frequency in descending order, and that fatalism, externalization, and self-pity were lower in frequency. CONCLUSIONS: The CP/CPPS patients had depression, anxiety, and higher perception of stress. In particular, these were closely related to the pain and quality of life of the patients.
Adaptation, Psychological ; Anxiety ; Depression ; Humans ; Military Personnel ; National Institutes of Health (U.S.) ; Pelvic Pain ; Pliability ; Prostatitis ; Quality of Life ; Stress, Psychological

DA-8159, a selective inhibitor of phosphodiesterase type 5, was developed as a new drug for erectile dysfunction. The effect of DA-8159 on the electroretinogram (ERG) and the retinal histopathology were evaluated in rabbits. The ERG was performed prior to, and 1 and 5 hr after DA-8159 (5 to 30 mg/kg) administration. The plasma concentration of DA-8159 was determined at each time point, and retinal microscopic examination was also performed. There was no statistically significant ERG change at any dose or at any time. Though the 30 Hz flicker showed a prolongation of the implicit time at 5 hr after the administration of either DA-8159 15 mg or 30 mg/kg (p<0.05), but concurrent amplitude decreases were not statistically significant. At a dose of 5 mg/kg, no test drug was detected in the blood after either 1 or 5 hr. At either 15 mg/kg or 30 mg/kg, there was a dose-dependent increase in the blood concentration after 1 hr of drug administration, which decreased with time. In light and electron microscopic examinations of the retina, there was no remarkable change at any dose. These results suggest DA-8159 has a low risk potential to the retina, but further evaluation on the visual functions in human is needed.
3',5'-Cyclic-GMP Phosphodiesterase/*antagonists & inhibitors ; Animals ; Dose-Response Relationship, Drug ; Electroretinography/*drug effects ; Humans ; Male ; Phosphodiesterase Inhibitors/blood/*pharmacology ; Pyrimidines/blood/*pharmacology ; Rabbits ; Retina/*cytology/*drug effects

Small cell carcinoma of the colon and rectum is a rare primary epithelial malignancy at this location. Histologically, this tumor represents a spectrum of neuroendocrine differentiation. The neuroendocrine cancers of the colon manifest a highly aggressive behavior, even more than their adenocarcinoma counterpart of the same stage. Small cell carcinoma in the colon has early metastasis and the prognosis is extremely poor. We report a case of small cell carcinoma of the rectum manifesting as femur neck fracture during sleep.
Adenocarcinoma ; Carcinoma, Small Cell* ; Colon ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Neoplasm Metastasis ; Prognosis ; Rectum*

BACKGROUND: An increase in total body water and the systemic inflammatory response occurs during cardiopulmonary bypass (CPB) which has resulted in the release of inflammatory mediators, including tumor necrosis factor-alpha (TNFalpha), interleukin-1beta, interleukin-6,and interleukin-8. These substances were suggested to be responsible for postoperative organ dysfunction and morbidity. Conventional ultrafiltration (cUF) and modified ultrafiltration (mUF) were used in cardiac operations to reduce volume overload and total body water. The purpose of this study was to estimate the value of these techniques in removing inflammatory mediators during CPB. METHODS: Serial plasma samples were taken before CPB,after 1 hour of CPB, just before cUF, after cUF, after mUF and 24 hrs after bypass. Cytokines were detected using highly specific double-ligand enzyme-linked immunosorbent assays. The data were analyzed using the repeated measurement ANOVA. RESULTS: TNFalpha, interleukin-1beta, interleukin-6, and interleukin-8 were increased during CPB and peaked just before cUF. After cUF, all four cytokines had been significantly decreased. After mUF,interleukin-6 and interleukin-8 had significantly been decreased, but TNFalpha and interleukin-1beta did not change significantly. After 24 hours of CPB , TNFalpha and interleukin-8 returned to preCPB values, but interleukin-1beta and interleukin-6 did not. CONCLUSIONS: We conclude that ultrafiltration has the potential to remove cytokines from the circulation. The ultrafiltration technique may be a useful technique in the management of patients undergoing bypass, particularly in patients at high risk of accumulating fluids and inflammatory reactions.
Body Water ; Cardiopulmonary Bypass* ; Coronary Vessels* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-1beta ; Interleukin-6 ; Interleukin-8 ; Plasma ; Tumor Necrosis Factor-alpha ; Ultrafiltration*

No abstract available.
Child ; Male ; Female ; Humans

Although many reseraches have been persued to detect the molecular tumor marker to define the cancer, ideal tumor marker which speak for the characteristics of malignancy and has high sensitivity and specificity is not known. One of the characteristics of the malignant cells is indefinite proliferative potential, in other word, immortality. The expression of telomerase and stabilization of telomeres are concomitant with the attainment of immortality in tumor cells; thus the measurement of telomerase activity in clinically obtained tumor samples may provide important information which would be useful as a diagnostic marker to detect immortal cancer cells. Telomerase activity was analyzed in 12 non-small cell lung cancer cell lines and 41 primary non-small cell lung cancers with the use of a PCR-based assay. All the cell lines and the majority of tumors displayed telomerase activity, but telomerase was not detectable in most of the corresponding pathologically-normal tissues. Telomere length was not correlated with telomerase activity. The present study indicate that measurement of telomerase activity may be useful as a molecular tumor marker in non-small cell lung cancer.
Carcinoma, Non-Small-Cell Lung* ; Cell Line ; Lung Neoplasms ; Sensitivity and Specificity ; Telomerase* ; Telomere

Cardiopulmonary bypass in children is associated with capillary leak, which results in an increase in total body water after open heart surgery. The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery. Study A: Twenty-six consecutive children aged 0.1~10 years(median 7 months) underwent cardiac operation incorporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~150l/min for 3~14 min. After modified ultrafiltration, elevation of hematocrit(28.3%+/-3.6% vs. 33.8%+/-4.0%, p<0.001), increased systolic blood pressure(66.7+/-11.2mmHg vs. 76.2+/-11.8mmHg, p<0.02), and decreased central venous pressure(7.8+/-3.7mmHg vs. 6.9+/-2.9mmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n=14) or modified ultrafiltration(n=12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0+/-2.4 cmH2O vs. 22.4+/-2.3cmH2O, p< 0.03). Modified ultrafiltration after cardiopulmonary bypass in children improves early hemo- dynamics and pulmonary mechanics, and represents an excellent option for perioperative management of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.
Body Water ; Capillaries ; Cardiopulmonary Bypass ; Child ; Diagnosis ; Filtration ; Heart* ; Hemodynamics ; Humans ; Mechanics ; Thoracic Surgery* ; Ultrafiltration*

No abstract available.
Clone Cells* ; Humans* ; Influenza, Human* ; Polysaccharides*