Balloon dilatation angioplasty was performed in a 15 months old child with isolated discrete unoperated coarctation of the aorta. The peak systolic pressure gradient across the coarctation before balloon angioplasty was 80 mmHg, and immediately after balloon angioplasty it decreased to 19 mmHg. No significant complications were encountered during the procedure. No evidence of aneurysm formation and restenosis was seen on 6 months follow-up examination. Balloon dilatation angioplasty seems to be a safe and effective nonsurgical alternative for relieving the obstruction associated with discrete coarctation of the aorta.
Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aortic Coarctation* ; Blood Pressure ; Child ; Dilatation ; Follow-Up Studies ; Humans ; Infant

No abstract available.
Craniosynostoses* ; Humans ; Infant, Newborn*

BACKGROUND: Constriction or banding of the pulmonary artery to create pulmonary artery stenosis is a palliative procedure designed to limit pulmonary blood flow in congenital cardiac malformation with unrestricted left to right shunt. Activation of sensory endings such as the arterial baroreceptors results in an inhibitory endings in the heart. The purpose of this study is to test the hypothesis that acute pulmonary artery constriction(PAC) results in an enhanced cardiopulmonary inhibition of the arterial baroreflex. METHODS: Baroreflex control of renal sympathetic nerve activity(RSNA) were examined in rabbits before and during reversible PAC. New Zealand white rabbits were instrumented with an occluder around the main pulmonary artery, a right ventricular catheter, femoral artery and venous catheters, and recording electrodes around renal sympathetic nerves. Baroreflex mediated changes in RSNA were monitored during decreases and increases in mean arterial pressure. RESULTS: Acute PAC produced significant([<0.05) changes in mean arterial pressure(76.3+/-1.9 vs. 59.8+/-3.0mmHg), right ventricular systolic pressure(23.1+/-4.2 vs. 42.3+/-7.4mmHg), and resting RSNA(100 vs. 71+/-6.3%). The effect of acute PAC on the arterial baroreflex was characterized by decreases in RSNA range(103.0+/-1.3 vs. 83.8+/-3.8%) and gain (-3.5+/-0.2 vs. -2.6+/-0.2). CONCLUSION: Acute PAC significantly attenuates arterial baroreflex control of RSNA in rabbits. The attenuated arterial baroreflex regulation of RSNA may be result of an enhanced inhibitory influence from activated cardiac receptors.
Arterial Pressure ; Baroreflex* ; Catheters ; Constriction ; Constriction, Pathologic ; Electrodes ; Femoral Artery ; Heart ; Pressoreceptors ; Pulmonary Artery* ; Rabbits*

No abstract available.
Constriction* ; Heart Ventricles* ; Pulmonary Artery* ; Rabbits*

No abstract available.
Doxorubicin* ; Membrane Potentials* ; Membranes* ; Purkinje Fibers* ; Sodium*

Congenital tricuspid stenosis is an uncommon congenital heart anomaly. Tricuspid stenosis is usually associated with other anomalies, most commonly severe pulmonary stenosis or atresia with secondary hypoplasia of the right ventricle. Clinically it may be difficult to distinguish from tricuspid atresia. A case of congenital tricuspid stenosis in a 32 day-old-girl is presented. The patient had cyanosis and dyspnea. Echocardiographic study revealed tricuspid stenosis with right ventricular hypoplasia, atrial septal defect and pulmonary stenosis.
Constriction, Pathologic* ; Cyanosis ; Dyspnea ; Echocardiography ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Ventricles ; Humans ; Pulmonary Valve Stenosis ; Tricuspid Atresia

No abstract available.
Balloon Valvuloplasty* ; Child* ; Constriction, Pathologic* ; Humans

PURPOSE: Simple instructional systems design (ISD) model is based on a fast development, usability test, and continuos feedback, which are necessary for educational program development in medical school. This study aims to figure out the usability of Simple ISD model for a medical ethics education program by describing a developmental details of each phase and its evaluation results. METHODS: Research has been conducted in two steps. First, while researchers participated in the program development by using Simple ISD model, we collected empirical data of each development activities. Second, the developed program was evaluated by students' web-based usability test, a 8-students' focus group interview and 5 faculty members' individual interviews in 4 domains; learning contents, instructional methods and strategies, achievement evaluation, and self-evaluation. RESULTS: Following the circular process of analysis, design, development, and usability test of Simple ISD model, a 10-week medical ethics program covering 9 instructional topics was developed. The average points of response on the developed medical ethics program in 2008 and 2009 are increased from 3.96 to 4.59 and 4.41, respectively. The prospects and limitations of the program are discussed. CONCLUSION: From a development study of the medical ethics program by using Simple ISD model, we could implement a more usable medical ethics program, and found 4 different usability of the Simple ISD model; the rapid development of educational program, program improvement by continuous feedback, faculty members' engagement in instructional design, and professional development of the faculty members.
Achievement ; Ethics, Medical ; Focus Groups ; Learning ; Program Development ; Schools, Medical

No abstract available.
Adolescent* ; Adult* ; Child* ; Heart Defects, Congenital* ; Humans ; Rehabilitation*

BACKGROUND: Bupivacaine is a potent, and commonly used, long acting local anesthetic. If accidentally injected into the systemic circulation, bupivacaine can cause lethal dysrhythmias and circulatory collapse. Attempts to treat bupivacaine induced cardiac toxicity have been varied and controversial, and they have not been very successful. The aim of this study was to investigate the electrophysiologic effects of bupivacaine in Purkinje fibers. METHODS: Effects of bupivacaine on the membrane potential were studied in 12 isolated canine Purkinje fibers. Purkinje fibers from ventricle were dissected and mounted in a tissue chamber perfused with Tyrode's solution. Transmembrane potentials recorded through glass microelectrodes filled with 3M KCI in the beating or quiescent Purkinje fibers during infusions of bupivacaine at concentratons of 3*10/-7M,10/-6M, 3*10/-6M,10/-5M, and 3*10/-5M. RESULTS: Bupivacaine reduced action potential druation in a dose-dependent manner. Bupivacaine produced a decrease in intracelullar sodium ion activity in driven(1Hz) and quiescent canine Purkinje fibers. Bupivacaine-induced hyperpolarizaton of diastolic membrane potential in quiescent Purkinje fibers was dose dependent, and the hyperpolarization by bupivacaine was attenuated by depolarization induced by high potassium extracellular concentration in part. CONCLUSIONS: These results suggest that bupivacaine decreases the fast inward sodium current, and inhibits pacemaker current in canine Purkinje fibers.
Action Potentials ; Bupivacaine* ; Glass ; Membrane Potentials* ; Membranes* ; Microelectrodes ; Potassium ; Purkinje Fibers ; Shock ; Sodium ; Sodium Channels