No abstract available.

Background: Cardiac tamponade results in a hemodynamic disorder associated with decreased cardiac output and blood pressure. To improve cardiac output in a subject with cardiac tamponade, cardiotonic drugs and vasodilators with blood volume expander can be used. The purpose of this study was to observe the hemodynamic effects of cardiotonic drugs and vasodilators following administration of plasma expander in the dogs with cardiac tamponade. Method: Three groups of dogs were studied during the induced cardiac tamponade. Following infusion of pentastarch, group I received dobutamine by dripping of 10 microg/kg/min, followed by injection of 20 microg/kg/min, group II received hydralazine (20 mg, 40 mg) and group III received sodium nitroprusside (5 microg/kg/min, 10 microg/kg/min). The heart rate, blood pressure, cardiac output and pulmonary arterial occluded pressure were measured. The atrial transmural pressure was calculated by subtracting intrapericardial pressure from mean atrial pressure. Results: Cardiac output was increased in the groups I and II, but mean arterial pressure was increased in only the group I. Atrial transmural pressure was not changed in all three groups. Conclusion: The most pronounced hemodynamic improvements during the cardiac tamponade is observed in group I with pentastarch-dobutamine combination.
Animals ; Arterial Pressure ; Atrial Pressure ; Blood Pressure ; Blood Volume ; Cardiac Output ; Cardiac Tamponade* ; Cardiotonic Agents ; Dobutamine* ; Dogs* ; Heart Rate ; Hemodynamics* ; Hydralazine* ; Hydroxyethyl Starch Derivatives* ; Nitroprusside* ; Plasma ; Vasodilator Agents

A 62-year-old male was admitted for evaluation of a mass shadow on chest film. Chest PA showed 7×5cm lobulated homogenous mass in right upper medial area of lung. On chest computed tomography, there was a Barge irregularly lobulated mass with central necrotic low density area in apical segment of right upper lobe. Right upper lobectomy of the lung was performed. Partial adhesion to parietal pleura of posterior mediastinum and severe adhesion to right upper apicoposterior segment was found during the operation Microscopic and ultrastructural studies(including immunocytochemical stains) of the mass revealed malignant fibrous histiocytoma.
Coal* ; Histiocytoma, Malignant Fibrous* ; Humans ; Lung* ; Male ; Mediastinum ; Middle Aged ; Pleura ; Thorax

No abstract available.
Angina Pectoris* ; Electrocardiography* ; Pheochromocytoma*

No abstract available.
Animals ; Rats* ; Reperfusion*

Eight patients in the state of ASA classification l, ll were investigate. Blood samples were collected before, just after, 30 minutes after and 60 minutes after induction of anesthesia. Glucose and electrolyte changes in relation to maintenance fluids in balanced and halothane anesthesia were as follows. 1) In both anesthetic techniques blood sugar level showed increasing tendency according to duration of anesthesia. 2) There were no specific changes in serum electrolytes related to type of anesthesia. 3) The administration of D/S and H/D showed a little increase in Na+ and Cl- level compared to the administration of just DsW. 4) The administration of H/d showed less increase in K+ level than the administration of DsW or D/S. 5) Just after induction of anesthesia the K+ level increased a little and decreased gradually thereafter.
Anesthesia ; Anesthesia, General* ; Blood Glucose* ; Classification ; Electrolytes* ; Glucose ; Halothane ; Humans

PURPOSE: We performed this study to compare T1-201 and Tc-99m MIBI scans for the differentiation of malignant from benign breast mass. MATERIALS AND METHODS: Thirty-eight female patients underwent T1-201 breast scan and thirty-two of them also underwent Tc-99m MIBI scan of the breast. After intravenous injection of 74-111 MBq of T1-201, early (10 minutes) and delayed (3 hours) images were obtained. Then, 555-740 MBq of Tc-99m MIBI was injected and images after 30 minutes were obtained. We compared T1-201 and Tc-99m MIBI scans with pathologic RESULTS. RESULTS: Twenty-three patients were confirmed to have infiltrating duct carcinoma and fifteen patients to have benign breast mass by excisonal biopsy. The sensitivity of early and delayed T1-201 scan and Tc-99m MIBI scan in the detection of malignant breast lesion were 100% (23/23), 82% (18/22), and 90% (18/20), respectively. The specificity of early T1-201 scan was significantly higher than that of delayed T1-201 scan (p<0.05). The specificity of early and delayed T1-201 scan and Tc-99m MIBI scan were 73% (11/15), 73% (11/15) and 83% (10/12), respectively (p:not significant). Three patients out of nine with fibroadenoma and one patient with atypical duct hyperplasia were false positive in both early and delayed T1-201 scans. The size of fibroadenoma with false positvie in early and delayed T1-201 scan (4 cases) was larger than that of 11 fibradenoma with true negative scan (p<0.01). Metastatic axillary lymph node involvement was present in fifteen patients. The sensitive to detect metastatic nodes was 38% (5/13) for early T1-201 images, 15% (2/13) for delayed T1-201 images, 58% (7/12) for Tc-99m MIBI planar images and 67% (4/6) for Tc-99m MIBI SPECT. The sensitive of Tc-99m MIBI planar or SPECT was significantly higher than that of delayed T1-201 images (p<0.05). CONCLUSION: Early T1-201 and Tc-99m MIBI scan are useful noninvasive methods to differentiate malignant form benign mass of breast. Tc-99m MIBI scan was sensitive in detecting axillary lymph node metastasis in patients with brease cancer.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis, Differential* ; Female ; Fibroadenoma ; Humans ; Hyperplasia ; Injections, Intravenous ; Lymph Nodes ; Neoplasm Metastasis ; Radionuclide Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: Acutely induced hypoxia causes an increase in the mean arterial pressure, cardiac output and oxygen consumption. However, comparisons of hemodynamic changes and oxygen consumption between subjects with and without anesthesia are rare. The purpose of this study was to examine and compare the hemodynamic changes and oxygen availability after acute apnea between the dogs with and without anesthesia. METHODS: Apnea was induced to 19 healthy mongrel dogs. Group 1 (N=10) constituted dogs with anesthesia and group 2 (N=9) constituted dogs without anesthesia. Hemodynamic data and oxygen levels were rapidly measured with 1 minute intervals. RESULTS: The survival time of group 1 was longer than that of group 2. The mean arterial pressure increased in group 1. Although the cardiac outputs in both groups increased at the same time course in early phase of apnea, the preload values increased more rapidly in group 1. Systemic vascular resistance decreased at 2 and 3 minutes of apnea in group 1 but not in group 2. The oxygen extraction ratio increased significantly at 4 and 5 minutes of apnea in group 2. CONCLUSION: In this study the dogs with anesthesia had a prolonged survival time compared to the dogs without anesthesia. Most hemodynamic values did not differ significantly between the two groups, except for an increased mean arterial pressure and decreased systemic vascular resistance in the dogs with anesthesia. It was suggested that the cause of early death in the dogs without anesthesia was decreased oxygen delivery.
Anesthesia* ; Animals ; Anoxia ; Apnea* ; Arterial Pressure ; Cardiac Output ; Dogs ; Hemodynamics* ; Oxygen Consumption ; Oxygen* ; Vascular Resistance

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.
Anaphylaxis ; Autopsy ; Forensic Medicine ; Korea ; Mast Cells ; Tryptases

BACKGROUND: Tuffier's line, which connect the two iliac crests, is the often used landmark in determining the level for the needle insertion into lumbar intervertebral space for the spinal and/or epidural blocks. However, the level of Tuffier's line varies depending on the observer. METHODS: Two methods were used to measure the level of Tuffier's line was measured on a simple abdominal X-ray taken in the supine position (study 1). Second, the level of Tuffier's line was also measured on fluroscopy of students in the sitting position (study 2). RESULTS: Overall, the level of Tuffier's line was most frequently observed along the L4-5 intervertebral space and second most frequently observed along the lower one-third of L4. In study 1 using abdominal X-ray, the level of Tuffiers line was most frequently observed along the L4-5 intervertebral space, however, the second most frequently observed level varied depending on the ages of the volunteers. In study 2 using fluoroscopy, the level of Tuffier's line was most frequently observed along the L4-5 intervertebral space and second most frequently observed along the upper one-third of L5. CONCLUSIONS: The level of Tuffier's line was most frequently observed along the L4-5 intervertebral space both in the supine and sitting positions. Further, the level of Tuffier's line went higher with age for women but stayed constant independent of age for men in the supine position.
Adult* ; Female ; Fluoroscopy ; Humans ; Male ; Needles ; Supine Position ; Volunteers