We had experienced a case of congenital lobar emphysema in a 3 months old male infant. Chief symptoms included tachypenea, respiratory difficulty, cyanosis, Chest X-ray or chest CT scan revealed extensive emphysematous changes of the right upper and middle lobes, compression of the right lower lobe and shifted of mediastinum to the left side. This condition was appeared in the absence of infection and foreign body in the bronchus and its failure to respond to conservative treatment. This patient was treated by the right upper and right middle lobes pneumonectomy. A brief review of literature was made.
Bronchi ; Cyanosis ; Emphysema* ; Foreign Bodies ; Humans ; Infant ; Male ; Mediastinum ; Pneumonectomy ; Thorax ; Tomography, X-Ray Computed

No abstract available.
Pneumonia*

No abstract available.
Smoke* ; Smoking Cessation* ; Smoking*

BACKGROUND: The atrial repolarization waves might contribute to ST segment depression during the exercise loading test. As atrial repolarization waves are opposite in direction to P waves, they could shift the ST segment in the absence of myocardial ischemia. METHODS: The exercise test in 20 patients was seemed false positive because of normal coronary angiogram. Twenty-six patients with at least one coronary stenosis > or =50% served as a true positive group. The P waves, PR segments and ST segment were studied in leads II, III, aVF and V4 to V6 in those 46 patients whose exercise ECG suggested ischemia. RESULTS: The finding of steeply downsloping PR segment, particularly in the inferior ECG leads, in patients with longer exercise time and higher exercise heart rate might predict a false positive exercise test in those with a normal rest ECG and no apparent reason for a false positive test. The combination of downsloping PR segments in two of three inferior leads plus either exercise duration > or =5 min or peak heart rate > or =130 bests/min idenified false positive tests with a sesitivity of 75% and a specificity of 81% to 89%. CONCLUSIONS: Atrial repolarization waves might play a role in exercise induced ST segment depression.
Coronary Stenosis ; Depression ; Electrocardiography ; Exercise Test ; Heart Rate ; Humans ; Ischemia ; Myocardial Ischemia ; Sensitivity and Specificity

No abstract available.
Pulmonary Artery ; Sarcoma ; Thromboembolism

To identify the central innervating the mammary nerve, viral retrograde transneuronal labelling methods were employed. Pseudorabies virus 6 microliter was injected into the mammary nerve of adult female Sprague-Dawley rats. After 4 days of survival, the animals were perfused with 4% paraformaldehyde-lysine periodate and their brains were processed for immunohistochemistry and double immunofluorescent staining of Pseudorabies virus or oxytocin using polyclonal antibodies. Several nuclei in brain were retrogradely labelled with Pesudorabies virus.Only a few magnocellular neurons of the paraventricular nucleus throughout whole brain showed double immunoreactivity to Pseudorabies virus and oxytocin. Approximately 11 percent of the oxytocinergic cells of the paraventricular nucleus,especially in three subnuclei[dorsomedial cap, lateral magnocelluar part and ventral part] showed double positive reaction to both Pseudorabies virus and oxytocin. These data demonstrate that some CNS cells projecting to the mammary nerve contained oxytocin and it may acts as a neurotransmitter in this pathway and a hormone targeting milk production and secretion.
Adult ; Animals ; Antibodies ; Brain ; Female ; Herpesvirus 1, Suid ; Humans ; Immunohistochemistry ; Milk ; Neurons ; Neurotransmitter Agents ; Oxytocin ; Paraventricular Hypothalamic Nucleus ; Pseudorabies ; Rats* ; Rats, Sprague-Dawley

PURPOSE: To assess the characteristic features of MR findings which would be useful for the differentiation of various spinal diseases involving paraspinal soft tissue mass. MATERIALS AND METHODS: We retrospectively reviewed MR findings in 31 cases(M:F=20:11) of spinal disease in which paraspinal mass was involved. The breakdown of cases was as follows : spinal tuberculosis, 12; spinal metastasis, 13; multiple myeloma, 3; pyogenic spondylitis, 2; spinal aspergillosis; 1. RESULTS: The pattern of bone marrow invasion in spinal metastasis, multiple myeloma, spinal tuberculosis and aspergillosis was mixed ; focal, homogeneously diffuse and inhomogeneously patterns were seen. Pyogenic spondylitis showed inhomogeneously diffuse invasion; an intravertebral abscess was seen in the only five cases of spinal tuberculosis. Vertebral posterior compartment invasion was observed in seven cases of spinal tuberculosis, two of multiple myeloma, the one case of spinal aspergillosis and in all 13 cases of spinal metastasis. This and multiple myeloma showed no disc space invasion, in any case, but all cases of infectious spondylitis showed such invasion. Peripheral rim-enhancement in the paravertebral mass was seen in 11 cases of spinal tuberculosis, one case of pyogenic spondylitis and the case of aspergillosis. Bilobate anterior epidural mass was noted in 60% of spinal tuberculosis cases, 36% of spinal metastasis and one case of pyogenic spondylitis. CONCLUSION: MR findings of spinal disease involving a paraspinal soft tissue mass were useful for differentiation.
Abscess ; Aspergillosis ; Bone Marrow ; Diagnosis, Differential* ; Magnetic Resonance Imaging* ; Multiple Myeloma ; Neoplasm Metastasis ; Retrospective Studies ; Spinal Diseases ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal

Brain metastasis occurs in 3.9-24% of patients with renal cell carcinoma (RCC), with an average interval from nephrectomy to brain metastasis of 1 to 3 years. A few cases have been reported where brain metastasis occurred after a delay of more than 10 years from the initial onset of renal cell carcinoma. This long interval for central nervous system metastasis from the primary cancer has been recognized as an indicator of better prognosis. Histopathological confirmation and aggressive treatment must be considered in these delayed brain metastases cases, since the patients usually show long survival and good prognosis. We present a case of a 76-year-old woman who developed extremely late multiple brain metastases 18 years after a nephrectomy for RCC.
Aged ; Brain* ; Carcinoma, Renal Cell* ; Central Nervous System ; Female ; Humans ; Neoplasm Metastasis* ; Nephrectomy ; Prognosis ; Recurrence

Azithromycin* ; Doxycycline* ; Scrub Typhus*

BACKGROUND: Cardiac atrium is an endocrine gland secreting a family of natriuretic peptides. The secretion of atrial natriuretic peptide(ANP) had been shown to be controlled by variable factors. The change in atrial dynamics have been considered as one of the most prominent stimuli for the stimulation of ANP secretion. Hypoxic stress has been shown to increase cardiac ANP secretion. However, the mechanism by which hypoxia increases ANP secretion cardiac ANP secretions. However, the mechanism by which hypoxia increases ANP secretion has not to be defined. Therefore, the purpose of the present study was tow-fold: to develop a protocol to defined the effect of hypoxia on ANP secretion in perfused beating rabbit atria and to clarify the mechanism responsible for the accentuation by hypoxia of ANP secretion. MATERIAL AND METHOD: Experiments have been done in perfused beating rabbit atria. ANP was measured by radioimmunoassay. RESULT: Hypoxic stimulus with nitrogen decreased atrial stroke volume. The decrease in atrial stroke volume recovered basal level during the period of recovery with oxygen. ANP secretion and the concentration of perfusate ANP in terms of extracellular fluid(ECF) translocation which reflects the rate of myocytic release of ANP were increased by hypoxia and returned to basal levels during the recovery. Changes in ECF translocation paralleled by hypoxia and returned to basal levels during the recovery. Changes in ECF translocation paralleled to that of atrial stroke volume. At the start of recovery in atrial storke volume, ECF tranalocation incrased for several minutes. The above responses were stable and reproducible. Glibenclamide treatment prevented the recovery in atrial stroke volume. Increments by hypoxia of ANP secretion and ANP concentration were suppressed by glibenclamide. CONCLUSIONS: These results indicate that hypoxia incrased atrial myocytic ANP release and that the mechanism responsible for the accentuation is partially related to the change in K+ATP channel activity.
Anoxia ; Atrial Natriuretic Factor* ; Endocrine Glands ; Glyburide ; Heart Atria ; Humans ; Natriuretic Peptides ; Nitrogen ; Oxygen ; Radioimmunoassay ; Stroke Volume