Pulmonic autograft replacement of the aortic valve (Ross procedure) has been to have potential for growth in children, no complication of antiocagulation, and enhanced durability. Therefore, Ross operation is indicated in the young, in patients with an active life style, and when anticoagulation is contraindicated. However, late autograft valve has occurrd more frequently in patients with significant size discrepancy between the pulmonay valve annulus and the aortic valve annulus. In order to resolve this problem, we performed aortic annuloplasty with Duran ring for more accurate and strong reinforcement. We report a case using the Duran ring as a method of aortic annuloplasty during Ross procedure.
Aortic Valve ; Autografts ; Child ; Humans ; Life Style

No abstract available.
Animals ; Flowmeters* ; Magnets* ; Male ; Models, Animal* ; Penile Erection* ; Rats*

No abstract available.
Animals ; Clomipramine* ; Preoptic Area* ; Rats* ; Serotonin Uptake Inhibitors* ; Serotonin*

No abstract available.
Acute Kidney Injury* ; Fever* ; Nephritis, Interstitial*

Osteoporosis represents reduced amount of bone mass per unit volume as compared with controls of the same age and sex. The purpose of this study was to show how bone mineral densities of spine and intertrochanteric area decrease with aging, to investigate the relationship between the bone mineral densities (BMD) of the two areas, and to obtain fracture threshold values. We measured BMD of lumbar vertebrae and intertrochanteric areas by Dual Energy X-ray Absorptiometry (DEXA) from 241 postmenopausal women. 190 normal postmenopausal women comprised non-fracture group and there were 50 fresh thoracolumbar fracture patient and 31 intertrochanteric fracture patients in whom the fractures were not caused by high energy trauma. The mean bone mineral density values of non-fracture group were significantly higher than those of fracture groups and significant correlation held between bone density of spine and that of intertrochanteric area in non-fracture group and fracture groups. The fracture threshold was 0.837 g/cm3 in spine fracture group and 0.792 g/cm3 in the intertrochanteric fracture group.
Absorptiometry, Photon* ; Aging ; Bone Density* ; Female ; Humans ; Lumbar Vertebrae ; Osteoporosis ; Spine

Seborrheic dermatitis is a chronic recurrent inflammatory disorder presumed to be caused by increased sebaceous gland secretion, metabolic changes in the cutaneous microflora, and changes in the host immune function. Stellate ganglion block (SGB) is known to increase the blood flow rate without altering the blood pressure, heart rate, or cardiac output, to stabilize hypertonic conditions of the sympathetic nerves, and to affect the endocrine and immune systems. It is used in the differential diagnosis and treatment of autonomic nervous system disorders of the head, neck, and upper limbs. The authors report the first case of successful treatment of a patient with seborrheic dermatitis through repeated SGB trials.
Autonomic Nervous System Diseases ; Blood Pressure ; Cardiac Output ; Dermatitis, Seborrheic* ; Diagnosis, Differential ; Head ; Heart Rate ; Humans ; Immune System ; Neck ; Nerve Block ; Sebaceous Glands ; Stellate Ganglion* ; Upper Extremity

PURPOSE: The development of a new series drugs for treating erectile dysfunction presents the a need for an easy and inexpensive animal experimental models for evaluating the drug effects on penile erectile function. The intracavernous pressure (ICP) is a suitable index for evaluating a penile erection. However, the continuous monitoring of the changes in the penile blood flow volume with an electromagnetic blood flowmeter may provide a new model for measuring the peak penile blood flow volume velocity (PBFVV) as a new index for a penile erection in a rat. MATERIALS AND METHODS: To establish a new suitable index for evaluating a penile erection in rats, measuring both the PBFVV with an electromagnetic blood flowmeter and the ICP with a polygraph were performed and compared. Fifty male adult Sprague-Dawley rats (250 gm) were divided into ICP and PBFVV measurement groups. The rats were anesthetized with 50mg/kg of pentobarbital sodium by an intraperitoneal injection. The left carotid artery was cannulated to measure the systemic blood pressure. Saline or papaverine were injected intracavernously. The ICP was measured with a pressure transducer and a polygraph. The PBFVV was measured after the penile shaft was placed in the ring of a electromagnetic blood flowmeter probe. RESULTS: Both the ICP and peak PBFVV following the intracavernous injection of papaverine were higher compared to both the ICP and peak PBFVV following the saline injection. Both the ICP and PBFVV after an intracavernous papaverine injection increased up to a peak value and then decreased. There was no significant concomitant changes in the systemic blood pressure. CONCLUSIONS: The PBFVV in rats were higher and reflected the veno-occlusive response following the intracavernous papaverine injection as well as the ICP. It is suggested that the peak PBFVV with the electromagnetic blood flowmeter as well as the ICP represents a suitable index for evaluating a penile erection in a rats.
Adult ; Animal Experimentation ; Animals ; Blood Flow Velocity ; Blood Pressure ; Carotid Arteries ; Erectile Dysfunction ; Flowmeters* ; Humans ; Injections, Intraperitoneal ; Magnets* ; Male ; Papaverine ; Penile Erection* ; Pentobarbital ; Rats* ; Rats, Sprague-Dawley ; Transducers, Pressure

Giant cell myocarditis(GCM) is a rare inflammatory heart disease which is characterized by multinucleated giant cells and a granulomatous reaction. It usually progresses rapidly and results in a fatal course. We report a patient with giant cell myocarditis who was treated by cardiac transplantation. A 35-year-old male was admitted with dyspnea which had developed 4 months before. On echocardiography, the right and left ventricles were markedly dilated and severe global hypokinesia was noted. He was diagosed with dilated cardiomyopathy with secondary severe mitral regurgitation. His cardiac function deteriorated progressively. He underwent orthotopic heart transplantation. Grossly the heart was enlarged, weighing 420gm and round with a blunt apex. Both right and left ventricles were markedly dilated. There were numerous white patches, measuring up to 4cm, throughout the epi- and myocardium. Microscopically, extensive fibrosis and multiple exuberant granulomas with numerous scattered multinucleated giant cells were seen. Lymphocytes and eosinophils were also frequent. Coronary arteries were unremarkable. Neither microorganisms nor foreign materials were found. By serial endomyocardial biopsies of the transplanted heart, only mild perivascular lymphocytic infiltration was occasionally observed without any evidence of rejection or recurrence of giant cell myocarditis. The patient's postoperative course has been uneventful so far(postoperative 21 months). The etiology of GCM remains to be clarified, although various factors are suspected. No matter what the cause, our experience suggests that this grave disease might be treated well by heart transplantation.
Male ; Humans ; Biopsy

BACKGROUND: An aggressive skin cancer on the nose, tends to have poorly defined clinical margins, and has a higher recurrence rate. A small tumor on the nose is usually easily treated by any of the standard methods. However, removal and reconstruction with preserved cosmesis is more laborous in a basal cell carcinoma larger than 10 mm in diameter. This is because the nose has complex contoures, unique skin color and texture, and the limited availability of mobile adjacent skin. When available Mohs micrographic surgery is the preferred treatment for these large tumors. OBJECTIVE: Our purpose was to investigate the preferred reconstruction method(especially, local flap reconstruction) by the cosmetic unit of the nose after Mohs micrographic surgery. METHODS: From March 1991 to February 1997, twenty-one patients were diagnosed with basal cell carcinoma on the nose at our department. All the tumors were removed with Mohs micrographic surgery, and then the defects were reconstructed with a primary closure, skin graft, and local flap.
Carcinoma, Basal Cell* ; Humans ; Mohs Surgery* ; Nose* ; Recurrence ; Skin ; Skin Neoplasms ; Transplants

Recurrent peritonitis is the major complication of continuous ambulatory peritoneal dialysis (CAPD) and a common reason for discontinuation of this form of therapy. Polymicrobial peritonitis by gram- negative organisms suggests intraabdominal pathology not directly associated with CAPD, necessitating early removal of catheter and/or abdominal exploration. The source of infection may still be gastrointestinal, especially in light of the polymicrobial gram-negative peritonitis and rarely be gastrointestinal malignancy. We recently experienced a case of 64-year-old woman with recurrent CAPD peritonitis by polymicrobial gram-negative organisms, originated from colon cancer. Colon cancer was confirmed by barium enema, abdominal CT and colonoscopic biopsy. She underwent right hemicolectomy and removal of catheter simultaneously. The biopsy revealed a moderately to poorly differentiated adenocarcinoma with abundant mucin production.
Adenocarcinoma ; Barium ; Biopsy ; Catheters ; Colon* ; Colonic Neoplasms* ; Enema ; Female ; Humans ; Middle Aged ; Mucins ; Pathology ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tomography, X-Ray Computed