A case of generalized primary amyloidosis with a reveiw of the literatures is reported. The 38 year old patient suffered from malabsorption syndrome for a year and was presented chronic renal failure with renal enlargment, myxedema and hemorrhagic gastritis. Biopsy of kidney and stomach revealed characteristic findings of amyloidosis by congo red stain and electronmicroscopy.
Adult ; Amyloidosis* ; Biopsy ; Congo Red ; Gastritis ; Humans ; Kidney ; Kidney Failure, Chronic ; Malabsorption Syndromes* ; Myxedema ; Stomach

No abstract available.
Child* ; Heart Septal Defects, Ventricular* ; Humans

BACKGREOUND: Acute normovolemic hemodilution (ANH) is one of the methods of autologous transfusion drawing much attention recently. It is economical and easy to apply to many surgeries requiring multiple transfusions. When used as a drug for induced hypotension, esmolol can avoid many drawbacks of sodium nitroprusside and reduce the amount of intraoperative bleeding with better operative field. Considering recent trend of combining ANH and induced hypotension to increase the success rate of autotransfusion, esmolol-induced hypotension with ANH will be used more frequently in the future. However, tissue oxygen balance may be in danger because of decreased tissue perfusion pressure by induced hypotension and reduced arterial oxygen content by ANH. Thus it is necessary to evaluate effects of induced hypotension combined with ANH on cardiovascular system and systemic oxygen balance. METHODS: In 8 mongrel dogs anesthetized with N2O-O2-enflurane and paralyzed with vecuronium, ANH was performed up to half of initial level of hemoglobin with isovolemic pentastarch infusion, and then mean arterial pressure (MAP) was lowered by 30% of the initial value by intravenous administration of esmolol. Various hemodynamic parameters were measured before and after ANH and 15, 30, 60 and 90 minutes after induction of hypotension and 30 minutes after the end of hypotension. RESULTS: Heart rate began to decrease after ANH and showed significant decrease at 60 and 90 minutes after hypotension compared with initial value. Central venous pressure increased significantly after ANH and hypotension. Pulmonary arterial pressure showed significant increase at 15 and 90 minutes after hypotension. Cardiac output was increased markedly by ANH but began to decrease after hypotension and showed significant decrease at 60 minutes after hypotension. Systemic vascular resistance showed significant decrease after ANH, 15 minutes after hypotension and 30 minutes after discontinuation ofesmolol. Pulmonary capillary wedge pressure and pulmonary vascular resistance showed no significant change. Oxygen flux was decreased markedly by esmolol but recovered after discontinuation of esmolol. Oxygen consumption was maintained throughout the study. Oxygen extraction ratio was increased dly after hypotension. There were no acidemia and hypoxemia throughout the study. CONCLUSION: In conclusion, the results of this study suggest that tissue oxygen delivery might be decreased by anemia but that systemic oxygen balance might be preserved by ANH and induced hypotension within the range used in this study.
Administration, Intravenous ; Anemia ; Animals ; Anoxia ; Arterial Pressure ; Blood Transfusion, Autologous ; Cardiac Output ; Cardiovascular System* ; Central Venous Pressure ; Dogs* ; Heart Rate ; Hemodilution* ; Hemodynamics ; Hemorrhage ; Hydroxyethyl Starch Derivatives ; Hypotension* ; Nitroprusside ; Oxygen Consumption ; Oxygen* ; Perfusion ; Pulmonary Wedge Pressure ; Vascular Resistance ; Vecuronium Bromide

BACKGROUND: Thoracic epidural anesthesia(TEA) is not commonly used for the purpose of pure regional anesthesia. To investigate the usefulness of TEA as a method of regional anesthesia, we performed TEA in patients(n=20) with breast mass. METHODS: After placement of thoracic epidural catheter at one of the 3rd, 4th, 5th or 6th thoracic intervertebral space according to the position of the mass, we injected 8ml of 2% plain lidocaine solution as initial dosage and 2~4 ml as additional dosage if necessary. Blood pressure and heart rate were measured before and at 5, 10, 15, 20, 25, 30, 60 and 90 minutes after epidural injection. Fifteen minutes after epidural injection, the extent of sensory block was measured at cephalad and caudad directions. Two-dermatome regression time was recorded postoperatively. We also investigated whether surgeon used lidocaine locally and anesthetist used intravenous analgesics or sedatives. And we observed the occurrence of complications associated with TEA. RESULTS: The induction dose of 2% lidocaine was 10.1+/-2.1 ml and total dose used was 11.4+/-2.1 ml. The extent of sensory block was T1.1+/-1.1 to T9.1+/-2.3 and two-dermatome regression time was 73+/-24 minutes. Blood pressure and heart rate showed stable pattern of change perioperatively. In two of the subjects, the surgeon used 4 ml of 1% lidocaine locally and in one of the subjects, 50 microgram of fentanyl was used intravenously. Another one of the subjects developed Horner's syndrome postoperatively, which soon disappeared without specific treatment. CONCLUSIONS: Above results suggest that TEA is suitable for breast mass excision as a method of regional anesthesia.
Analgesics ; Anesthesia, Conduction ; Anesthesia, Epidural* ; Blood Pressure ; Breast* ; Catheters ; Fentanyl ; Heart Rate ; Horner Syndrome ; Hypnotics and Sedatives ; Injections, Epidural ; Lidocaine ; Tea

No abstract available.
Cerebral Hemorrhage* ; Mucormycosis*

No abstract available.
Humans ; Spondylolisthesis*

No abstract available.
Hematoma* ; Orbit*

No abstract available.

No abstract available.

No abstract available.
Animals ; Brain* ; Corpus Striatum* ; Neurons* ; Neuropeptides* ; Rats*