Use of fibrin-based thromboelastometry for cryoprecipitate transfusion in cardiac surgery involving deep hypothermic circulatory arrest during cardiopulmonary bypass.

We aimed to assess the predictive value of fibrin-based thromboelastometry performed before weaning from cardiopulmonary bypass (CPB) for cryoprecipitate administered to correct the bleeding diathesis after CPB involving deep hypothermic circulatory arrest. Eleven patients undergoing aortic surgery were enrolled. The arterial blood was withdrawn before skin incision, 30 min before CPB weaning (Cweaning), 5 min after protamine reversal (Preversal) and at closure of the sternum to run intrinsically activated INTEM, heparinase-treated HEPTEM, extrinsically activated EXTEM and platelet-inhibited FIBTEM analysis, platelet count, fibrinogen, prothrombin time (international normalized ratio) and activated partial thromboplastin time.

Analgesic effects of ketamine infusion therapy in korean patients with neuropathic pain: A 2-week, open-label, uncontrolled study.

Background: The overexcitation of the N-methyl-D-aspartate receptor complex appears to play a critical role in the development of neuropathic pain, and ketamine acts as an antagonist to that receptor. Some publications have reported on the prominent relief of neuropathic pain with intravenous or subcutaneous ketamine infusions or a single-dose intravenous ketamine injection despite adverse effects.

Objectives: The primary objective of this study was to determine the analgesic effect of intravenous ketamine infusion therapy for neuropathic pain refractory to conventional treatments.

Ovarian preservation during the surgical treatment of early stage endometrial cancer: a nation-wide study conducted by the Korean Gynecologic Oncology Group.

Objectives: The objective of this study was to determine whether ovarian preservation is feasible in younger endometrial cancer patients.

Methods: Endometrial cancer patients who underwent ovary-saving surgery were recruited from the tumor registries of 14 tertiary hospitals under the influence of the Korean Gynecologic Oncology Group (KGOG). Information regarding patient age, preoperative and intraoperative evaluations, pathologic reports, and follow-up results was abstracted from medical records.

Serum adipocyte fatty acid-binding protein levels are associated with nonalcoholic fatty liver disease in type 2 diabetic patients.

Objective: Adipocyte fatty acid-binding protein (A-FABP) is a major cytoplasmic protein in adipocytes and macrophages and is closely associated with metabolic syndrome, type 2 diabetes, and atherosclerosis. Here, we investigated whether A-FABP was associated with nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes.

Research Design And Methods: We enrolled 181 type 2 diabetic patients.

Intravascular injection in lumbar medial branch block: a prospective evaluation of 1433 injections.

Background: The successful outcome and validity of lumbar medial branch block (MBB) are largely dependent on technique accuracy. Intravascular uptake of injectate causes a false-negative response to block and is associated with various possible complications. In the current study, we prospectively evaluated the incidence of, and the factors associated with, intravascular injection during block.

The influence of neck flexion and extension on the distribution of contrast medium in the high thoracic epidural space.

Background: For safe and effective thoracic epidural analgesia (TEA), it is important to control the level of TEA and to identify factors that influence its spread. In this study, we observed the distribution of contrast injected into the high thoracic epidural space during neck flexion and extension.

Methods: An epidural catheter was inserted into the epidural space until its tip was located at the T1-2 intervertebral level.

Histopathologic changes of acellularized xenogenic carotid vascular grafts implanted in a pig-to-goat model.

Introduction: The present study was designed to determine the in vivo patency and recellularization pattern of acellularized small-diameter xenogenic arterial grafts. We implanted acellularized porcine carotid arteries in bilateral carotid arteries of goats and microscopically analyzed the recellularization pattern of these grafts with the recipient's cells over time.

Material And Methods: Carotid arteries of pigs weighing 30-40 kg were harvested and decellularized with hypertonic saline followed by sodium dodecyl sulfate.

Transcatheter closure of fenestration with detachable coils after the Fontan operation.

We report our experience in 13 patients who underwent transcatheter closure of Fontan fenestration with the Cook detachable coils. These patients underwent the extracardiac type Fontan operation with a short conduit fenestration (n=7) or lateral tunnel type with a punch-hole fenestration (n=6). Fenestration closure was done at the mean age of 5.

Comparison of clinical efficacy of Newfactan versus Surfacten for the treatment of respiratory distress syndrome in the newborn infants.

Newfactan is a domestically developed, bovine lung-derived, semi-synthetic surfactant. The aim of this study was to compare the clinical efficacy of Newfactan with that of Surfacten in the treatment of respiratory distress syndrome (RDS). Newfactan or Surfacten was randomly allocated to 492 newborn infants who were diagnosed as RDS and required surfactant instillation in four participating hospitals.

Management of deep sternal infection in infants and children with advanced pectoralis major muscle flaps.

Background: Advanced pectoralis major muscle flaps can be used to treat deep sternal wound infections in children; however, the long-term outcomes have not been widely reported.

Methods: We retrospectively reviewed 11 patients (median age, 3.8 months), who had developed deep sternal wound infections following median sternotomy, among 1380 consecutive pediatric cardiac procedures from January 1995 to July 2001.

Serum ethanol levels after alcohol sclerotherapy of arteriovenous malformations.

We analyzed the effects of several factors on the serum ethanol levels after alcohol sclerotherapy in the arteriovenous malformations (AVMs) retrospectively. Blood ethanol level, amounts of given alcohol, location of lesions, methods of flow control, and Doppler resistive index (RI) were analyzed. The results of linear regression analysis showed that the amount of alcohol administered was the predictor of serum ethanol level (r2=0.

Full sternotomy with minimal skin incision for congenital heart surgery.

Purpose: The purpose of this paper is to analyze the feasibility of the full sternotomy with minimal skin incision and its related complications and risks.

Methods: A total of 405 patients with simple congenital heart disease underwent open heart surgery exclusively under full sternotomy with minimal skin incision. We reviewed the available medical records of the patients retrospectively.

Homologous monocuspid valve patch in right ventricular outflow tract reconstruction.

Background: In the surgical repair of tetralogy of Fallot or pulmonary atresia, pulmonary regurgitation may be detrimental in the postoperative period. We have used homograft monocuspid valve patch to prevent pulmonary insufficiency.

Methods: From September 1996 to December 1998, twenty-five patients, 4 months to 8 years of age (median 10.

Different expressivity of a ventricular essential myosin light chain gene Ala57Gly mutation in familial hypertrophic cardiomyopathy.

Background: Familial hypertrophic cardiomyopathy (HCM) is a clinically and genetically heterogeneous disease of the sarcomere. Molecular genetic studies have shown that familial HCM involves mutations in 8 different genes that encode proteins of the myofibrillar apparatus.

Methods: We thoroughly searched these genes to find the mutations in 38 probands of unrelated families with familial HCM.

Clinical characteristics of acute viral lower respiratory tract infections in hospitalized children in Seoul, 1996-1998.

This study was performed to investigate the etiologic agents, age distribution, clinical manifestations and seasonal occurrence of acute viral lower respiratory tract infections in children. We confirmed viral etiologies using nasopharyngeal aspirates in 237 patients of the ages of 15 years or younger who were hospitalized for acute lower respiratory tract infection (ALRI) from March 1996 to February 1998 at Samsung Seoul Hospital, Seoul, Korea. The overall isolation rate was 22.

The effect of dialysate dwell on gastric emptying time in patients on continuous ambulatory peritoneal dialysis.

Methods And Patients: We evaluated gastric emptying time (GET) with a technetium (Tc) 99m-sulfur colloid gastric emptying scan in 11 patients on continuous ambulatory peritoneal dialysis (CAPD) (6 males, 5 females) and in 14 controls. We investigated the effect of dialysate dwell on GET by studying the subjects twice: once without dialysate in the abdomen (drained) and once with 2 L of dialysate in the abdomen (full). We also investigated the relationship between body surface area (BSA) and delayed gastric emptying.

Anaplastic large cell lymphoma presenting as an endobronchial polypoid mass.

We present a case of CD30+ anaplastic large cell lymphoma (ALCL) with a unusual endobronchial polypoid mass. There was para-aortic lymphadenopathy on the CT scan. This case illustrates that ALCL should be included in the differential diagnosis of endobronchial mass lesions.

Cleaved variant of plasmacytoma with myelomonocytic differentiation--immunohistochemical and ultrastructural studies.

Although plasma cells are terminally differentiated B cells, neoplastic plasma cells frequently express not only pre-B cell antigen, but also megakaryocytic, myelomonocytic, or erythroid markers. Since morphologic diagnosis of plasmacytoma is based on the recognition of neoplastic cells closely resembling normal plasma cells, unusual morphologic variants of neoplastic cells associated with these aberrant immunohistochemical features frequently cause diagnostic difficulty. The authors report a case of plasmacytoma with cleaved nuclei and myelomonocytic features occurring in the clavicle.

Pseudopapillary neurocytoma of temporal lobe with glial differentiation.

We present a case of cerebral neurocytoma with unusual pseudopapillary pattern, which was a predominant feature in the tumor and was characterized histologically by hyalinized vascular cores surrounded by a single or multilayered small round cells. Vascular hyalinization was also evident in the linear arborizing capillary networks in the cellular mass of the tumor. Immunohistochemically, the tumor cells were strongly positive for synaptophysin and neuron-specific enolase except some cells lining the pseudopapillae, which showed immunoreactivity for glial fibrillary acidic protein, vimentin and S-100 protein.