BACKGROUND: In order to evaluate the prevalence of enterovirus and cytomegalovirus infections to terminally failing hearts, the presence of enteroviral RNA and cytomegaloviral DNA was screened in the explanted hearts of transplantation recipients. METHODS: RNA and DNA extractions were performed from explanted failing hearts (N=22) and normal hearts (N=5). Reverse transcription-polymerase chain reaction (RT-PCR) of enterovirus and polymerase chain reaction (PCR) of cytomegalovirus were performed. In situ RT-PCR and in situ PCR were performed with positive nucleic acids of viruses. RESULTS: The positivity of enterovirus in failing hearts was 4.4% (1/22) and 0% (0/5) in normal hearts in nested RT-PCR. There was no significant difference in positivity of enteroviral RNA between failing and normal hearts. Nuclei of myocardium was stained in dark-violet color with in situ RT-PCR. The positivity of cytomegalovirus in failing hearts was 45% (10/22) and 40% (2/5) in nested PCR. There was no significant difference in positivity of cytomegaloviral DNA between failing and normal hearts. Nuclei of myocardium was stained in dark-violet color with in situ PCR. Positive chambers of cytomegalovirus were in decreasing tendency according to increasing patient's age. CONCLUSION: Enterovirus was very rarely observed in explanted terminally failing hearts and cytomegalovirus was frequently found both in explanted failing hearts and normal. These viruses have little direct causal relationship with the development of heart failure.
Cardiomyopathy, Dilated ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Enterovirus* ; Heart Failure ; Heart* ; Humans* ; Mass Screening* ; Myocardium ; Nucleic Acids ; Polymerase Chain Reaction ; Prevalence ; RNA

Gardner's syndrome is a familial disease consisting of gastrointestinal adenomatous polyposis, osteomas of the mandible, skull, and long bones, and a variety of sol tissue lesions, including sebaceous cysts, fibromas, lipomas, and desmoid tumors. The colon is the most common site for polyposis, but the stomach, duodenum, small bowel, and periampullary area may also be involved. The diagnostic evaluation, malignant potential, and management is identical to that for familial adenomatous polyposis. The extracolonic manifestations of Gardner's syndrome are frequent and varied. Gardner's syndrome is inherited as autosomal dominant traits. Authors experienced one case that is a 32 year old female patient who had colonic and duodenal multiple polyposis, desmoid tumor in abdominal wall and right mesocolon and odontoma on mandible.
Abdominal Wall ; Adenomatous Polyposis Coli ; Adult ; Colon ; Duodenum ; Epidermal Cyst ; Female ; Fibroma ; Fibromatosis, Aggressive ; Gardner Syndrome* ; Humans ; Lipoma ; Mandible ; Mesocolon ; Odontoma ; Osteoma ; Skull ; Stomach

No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Incidence*

Due to unknown safety concerns, sugammadex should not be administered to patients withend-stage renal disease (ESRD). However, because the supply of benzylisoquinolinium-typeneuromuscular blocking agents (NMBAs) has been discontinued, rocuronium is the onlynon-depolarizing NMBA that can be used in clinical settings in some countries, includingSouth Korea. The administration of sugammadex cannot be avoided to achieve rapid andcomplete neuromuscular recovery in patients with ESRD or renal transplantation after rocuronium administration. Although there has been a limited number of clinical studies involving the use of sugammadex in patients with ESRD, studies have shown that sugammadexcan effectively and safely reverse rocuronium-induced neuromuscular blockade (NMB) inpatients with ESRD, however recovery of neuromuscular function in patients with ESRD isslower than in patients with normal renal function. Nonetheless, safety-concerns are yet tobe addressed. Considering the small number of clinical studies, high heterogeneity amongstudies, and insufficient safety information, more extensive data on the efficacy and safetyof sugammadex in patients with ESRD are needed. In particular, it is important to securedata on safety, including residual NMB after surgery, recurarization and cardiorespiratorycomplications, anaphylactic reactions, and long-term morbidity and mortality. Furthermore,anesthesiologists should remember that performing proper quantitative neuromuscularmonitoring and neuromuscular management based on the monitoring signs are the mostessential requirements when using sugammadex in patients with ESRD.

Takayasu's arteritis(TA) is a nonspecific areritis of unknown etiology affecting segmentally the aorta and its main branches, which result in stenosis, occlusion or aneurysm of involved arteries. The clinical manifestations present with a variety of symptoms such as headache, dyspnea on exertion, pain and weakness of extremities, pulse deficit, and hypertension according to involves arteries. Usually it can be managed by medical or surgical treatment, and recently by percutaneous transluminal balloon angioplasty. The type III classified by Lupi-Herrena and associates is the most frequent variety of TA. However the case of type III involving both subclavin arteries and both renal arteries has rarely been reported. We experienced a case of TA involving both subcalvian arteries, and both renal arteries presented with paroxysmal hypertension and right flank pain, in which the stenosis of both subclavian arteries were managed by percutaneous transluminal balloon angioplasty and the stenosis and occlusion of both renal arteries were successfully managed by aorto-renal bypass surgery with autogenous right iliac artery and synthetic vessel(Gortex). The patient was discharged uneventfully.
Aneurysm ; Angioplasty, Balloon ; Aorta ; Arteries* ; Constriction, Pathologic* ; Dyspnea ; Extremities ; Flank Pain ; Headache ; Humans ; Hypertension ; Iliac Artery ; Renal Artery* ; Subclavian Artery ; Takayasu Arteritis*

No abstract available.
Aeromonas hydrophila* ; Aeromonas* ; Animals ; Histamine Release* ; Histamine* ; Mast Cells* ; Rats*

Differences of usual relationship between aortic and radial artery pressure was evaluated in 14 patients at pre-and post cardiopulmonary bypass (CPB) period, post-CPB, 5 min and10 min after open heart surgery. Radial arterial systolic pressure were lower, (range 0-44 mmHg, mean 17 mmHg) relative to aortic preasure, after CPB than before CPB in all 14 patient studied. In 9 patients post-CPB radial mean arterial pressure were lower than mean aortic pressure in the range of 5-25 mmHg. These data indicate that the low radial pressure measured at post-CPB did not represent the true aortic pressure in the immediate postbypaas period. In conclusion, we recommend direct measurement of the aortic pressure following CPB whenever radial arterial pressure is low enough that treatment is contemplat-ed, since aortic pressure may in fact be adequate.
Aorta* ; Arterial Pressure ; Blood Pressure* ; Cardiopulmonary Bypass* ; Humans ; Radial Artery* ; Thoracic Surgery

No abstract available.

In contrast to younger patients, geriatric patients are generally considered to be a poor risk for anesthesia and surgery and greater care should be taken in anesthetic management, because many have chronic systemic diseases in addition to a decrease in physiologic function. To evaluate geriatric anesthetic experiences, we received clinical records of 1,062 patients aged over 65 out of 21,656 surgical cases performed at Korea University Hye-Wha Hospital from January 1980 to December 1986. The cases were analysed according to age, sex, department, preoperative physical status, anesthetic techniques and agents, duration of anesthesia, operation site, length of hospital stay, laboratory data(Chest X-ray, EKG), associated diseases, postoperative complications and mortality. The results are as follows: 1) Of the 1,062 geriatric surgical patients, 516 cases(48.6%) were 65~69 years of age. 2) The number of geriatric surgical cases was 1,062 of which 672(63.3%) were male and 390(36.7%) were female. 3) Most surgical cases were general surgery(401 cases, 37.8%). 4) The rate of elective and emergency surgery was 78.0%(829 cases) and 22.0%(233 cases), respectively. The ratio of insurance patients (737 cases, 69.4%) versus noninsurance patients(325 cases, 30.6%) was approximately 2:1. 5) The number of general anesthesia cases was 777 (73.2%), spinal anesthesia 244( 23.0%), epidural anesthesia, 21(.20%), and brachial plexus block, 5( 0.5%). The anesthetics were thalamonal and meperidine hydrochloride(238 cases, 22.4%), halothane(204 cases, 19.2%) and tetracaine(244 cases, 23.0%). 6) The duraion of anesthesia was within 1hour in 88 cases( 8.3%), 1~2 hours in 421 cases(39.6%), and 2~3 hours in 291 cases(27.4%). 7) The number of lower abdominal surgery cases was 497 (46.8%) and the number of upper abdominal surgery cases was 188(17.7%). 8) Preoperative laboratory findings were as follows: The findings of preoperative chest X-rays revealed that 219 cases(21.4%) were within normal mits. 182 cases(17.8%) had hypertensive heart, and 208 cases(20.4%) had atherosclerosis. The EKG, which was done on 90.8% of the patients, revealed that 333 cases (34.5%) were within normal limits, 77 cases(8.0%) showed left ventricular hypertrophy, 65 cases(6.7%) showed sinus bradycardia, and 27 cases(2.8%) showed myocardial ischemia. 9) Hypertension(88cases, 49.4%) was the most commonly associated disease. 10) The total number of postoperative complication cases was 73(6.9%). Seventeen cases showed wound infection and delayed skin closure, 19 cases showed pneumonia, and 7 cases showed atelectasis. 11) The total number of postoperative deaths was 18 cases(1.7%).
Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Anesthetics ; Atherosclerosis ; Brachial Plexus ; Bradycardia ; Electrocardiography ; Emergencies ; Female ; Heart ; Humans ; Hypertrophy, Left Ventricular ; Insurance ; Korea ; Length of Stay ; Male ; Meperidine ; Mortality ; Myocardial Ischemia ; Pneumonia ; Postoperative Complications ; Pulmonary Atelectasis ; Skin ; Thorax ; Wound Infection