Vascular leak syndrome(VLS) is characterized by endothelial damage, which causes extravasation of plasma proteins and fluid from capillaries into the extravascular space. It has been suggested that the increased vascular permeability is the result of an IL-2-induced suppression of endothelin-1 secretion by endothelial cells, an IL-2-induced activation of the complement cascade or TNF-alpha release from IL-2-activated T-cells. A 13-year-old male patient visited our hospital with abdominal pain. He was diagnosed with acute lymphoblastic leukemia(T cell type) by bone marrow study on his 2 nd day in hospital. On the 3 rd day of induction chemotherapy(prednisone, L-asparaginase, vincristine, intrathecal methotrexate), pulmonary edema and pleural effusion, ascites and generalized edema developed and lasted for 53 days without responding to supportive care. The laboratoy finding was that TNF-alpha was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.
Abdominal Pain ; Adolescent ; Ascites ; Blood Proteins ; Bone Marrow ; Capillaries ; Capillary Permeability ; Complement System Proteins ; Edema ; Endothelial Cells ; Endothelin-1 ; Humans ; Hypoalbuminemia ; Induction Chemotherapy* ; Male ; Pleural Effusion ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pulmonary Edema ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Vincristine

No abstract available.
Lymphadenitis* ; Parotid Gland* ; Tuberculosis, Cutaneous* ; Tuberculosis, Lymph Node

The intravenous pyelograms of 126 cases of ureteral stones were analized for study on changes in size,renocortical idex(RCI) and function of the affected kidney. The following results were obtained. 1. The size ofaffected kidney was increased in 45% of cases and decreased in 40% of cases. 2. The affected kidney showed anelevated RCI value as compared to the normal side. The mean value of RCI of the affected kidneys was 0.44 andnormal kidneys was 0.35. 3. The cases of upper ureteral stones most frequently showed urinary stasis. Theincidence of urinary stasis: hydronephrosis 61%, hydroureter 48%, nonvisualization 10%, and combinedhydronephrosis and hydroureter in 54% of the all cases.
Humans ; Hydronephrosis ; Kidney ; Ureter

Conegenital anomalies of the ribs are common but rarely result in shadow which might be mistaken forpathological lesions. Careful inspection of the bony parts, which should be a routine, will usually be sufficientto avoid mistakes. Authors reviewed 6,921(5,865 male, 1,056 female) chest P-A films in adult (older than 16years), and radiolographic findings of congenital anomalies of the ribs were analized. The result were as follows;1. Congenital anomalies of the ribs were present in 193 patients. The incidence of congenital anomalies of theribs were 2.7% in male, 3.3% in female. 2. Among the 193 cases of congenital rib anomalies, 7 cases(0.1%) ofcervical ribs, 31 cases (0.4%) of underdeveloped ribs, 81 cases (1.2%) of anterior bifurcation, 34 cases (0.5%) ofbroadned ribs, 19 cases (0.3) of complete fusion and 21 cases (0.3%) of pseudathrosis were included. 3. 11.4% ofthe cases were bilateral, and right to left was 4:3 in unilateral involvement. 4. The location of the ribanomalies were as follows; (1) Underdeveloped ribs; 1st rib 31 case (79.5%), 2nd rib 3 cases(7.7%), 4th rib 3cases(7.7%), 5th rib 2 cases(5.1%). (2) Anterior bifurcation; 3rd rib 37 cases. 4th rib 29 cases, 5th rib 12cases, 6th rib 6cases, 2nd rib 2 cases. (3) Broadened ribs; 3rd 17 cases, 4th rib 15 cases, 5th rib 4 cases, 2ndrib 1 case. (4) Complete fusion; 1st-2nd rib 13 cases (68.4%), 5-6th ribs 4 cases (21.0%), 4-5th ribs 1case(5.3%), 6-7 ribs 1case(5.3%). The fusion occur in the posterior portion of 1st-2nd and 4-5th ribs,and in theposterior portion of 5-6th and 6-7ribs. (5) Pseudarthrosis; 1st-2nd and 2nd-3rd ribs, and in the posterior portionof 3-4th, 4-5 and 5-6th ribs. 5. In the cases of anterior bifurcation, the rib bifurcates almost in its anterior2.1-5.0 cm and most common in 3.1-4.0cm. 6. The characteristic radiographic findings in anterior bifurcation wereas follow;
Adult ; Female ; Humans ; Incidence ; Male ; Pseudarthrosis ; Ribs ; Thorax

We experienced a case of aeute cerebral infaretion after operation. A 74 year old female patient slipped down and received left femoral neck fracture. Preoperatively, orthopedist, internist and anesthesiologist visited and evaluated her but could not find any suspicious symptoms related to cerebral infarction. She have suffered from hypertension and diabetes mellitus for 1Q yrs. She underwent bipolar endoprosthesis under general anesthesia. Postoperatively, she became deep drowsy and revealed respiratory depression, abnormal neurological sign and was diagnosed as acute cerebral infartion on cranial computed tomography and ultimately expired.
Aged ; Anesthesia, General* ; Cerebral Infarction* ; Diabetes Mellitus ; Female ; Femoral Neck Fractures ; Humans ; Hypertension ; Respiratory Insufficiency

No Abstract Available.
Clone Cells* ; Cloning, Organism* ; Mycobacterium tuberculosis* ; Mycobacterium*

BACKGROUND: An adequate uteroplacental and fetal blood flow during labor and cesarean delivery is of prime importance for fetal well-being and neonatal outcome. METHODS: Using the vascular smooth muscle of the human isolated umbilical arteries, this study was performed to see whether commonly used local anesthetics (bupivacaine, lidocaine and 2-chloroprocaine) and opioids (morphine,fentanyl and meperidine) could induce contracion or relaxation of these resting and precontracted vessels. Rings from human umbilical arteries were prepared by microdissection. The vessel rings were mounted in tissue baths for an isometric recording of the contractile activity. For resting muscles, the reactivity to drugs is expressed as a percentage of a maximal KCl-induced contraction, and for precontracted muscle, it is expressed as a percentage of a submaximal KCl-induced contraction. RESULTS: Bupivacaine, lidocaine and 2-chloroprocaine all induced contractions. Bupivacaine showed a maximal contraction (46.7 +/- 10.5%) at concentrations of 43 micrometer, lidocaine 19.7 +/- 4.8% at 0.11 mM. and 2-chloroprocaine showed 14.6 +/- 2.9% at 0.65 mM. Morphine, fentanyl and meperidine all induced contractions. Morphine showed a maximal contraction (19.6 +/- 7.1%) at a concentration of 10 4 M, meperidine at 17.2 +/- 8.4% at 3 x 10 5 M, and fentanyl at 1.7 +/- 2.0% at 3 x 10(-6)M. When umbilical arteries were induced to contract with a submaximal concentration of KCl, bupivacaine and lidocaine showed an ability to increase the magnitude of the sustained contraction, but 2-chloroprocaine showed a relaxation of the sustained contraction. Morphine, fentanyl and meperidine showed no change in the sustained contraction. CONCLUSIONS: This study demonstrates these local anesthetics and opioids as vasoactive on human umbilical arteries. If applicable in vivo, these drugs might have some influence on umbilical vessel tone and thus might reduce umbilical blood flow.
Analgesics, Opioid* ; Anesthetics, Local* ; Baths ; Bupivacaine ; Fentanyl ; Fetal Blood ; Humans* ; Lidocaine ; Meperidine ; Microdissection ; Morphine ; Muscle, Smooth, Vascular ; Muscles ; Relaxation ; Umbilical Arteries*

No abstract available.
Kidney ; Tuberculosis ; Tuberculosis, Renal

No abstract available.
Bone Density* ; Child* ; Humans

OBJECTIVE: The purpose of this study was to evaluate how the friction that occurs during the sliding movement of the archwire through esthetic brackets is differently affected by bracket materials, slot designs, and tip angulations of the archwire. METHODS: Eight types of brackets with 0.018 inch slots (composite: Brillant (BR); composite with metal slot: Spirit MB (SP); ceramic: Inspire (IN), Signature (SI), Cristaline V (CR); ceramic with metal slot: Clarity (CL), Luxi II (LU); and metal bracket: Integra (IT)), and placed into groups of 20 brackets in each group, were tested in artificial saliva with 0.018 inch stainless steel wire. The wire tip angulations were given as 0, 4 and 8 degrees. RESULTS: CR group significantly showed the lowest frictional force with all wire tip angulations of 0, 4, and 8 degrees. IN significantly showed the highest frictional force (p < 0.001). BR (polyoxymethylene) had significantly less frictional force than SP (polycarbonate) (p < 0.001) and showed no significant difference between metal brackets. Friction was increased as the wire tip angulations were increased, but no notches were observed on any parts of the archwire. CONCLUSIONS: According to the results of this study, esthetic brackets are superior or similar to SS brackets from a frictional point of view.
Ceramics ; Friction* ; Saliva, Artificial ; Stainless Steel