Dynamic cardiomyoplasty is a recently introduced surgical method to improve myocardial performance. It consists of a placement of a skeletal muscle flap around the heart and stimulation of the flap in synchrony with ventricular contraction. We experienced a case of cardiomyoplasty in a 25 year old male patient with congestive heart failure. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. The operation was performed for 8hrs without cardiopulmonary bypass and the patient was transferred to the intensive care unit. He was mechanically ventilated electively overnight and extubation was done 18hrs postoperatively. The patient was discharged home on the 40days after operation and improved in exercise tolerance. We report the anesthetic management and hemodynamic changes in a patient who underwent dynamic cardiomyoplasty.
Adult ; Anesthesia ; Cardiomyoplasty* ; Cardiopulmonary Bypass ; Exercise Tolerance ; Fentanyl ; Heart ; Heart Failure ; Hemodynamics ; Humans ; Intensive Care Units ; Isoflurane ; Male ; Midazolam ; Muscle, Skeletal

Intestinal capillariasis is caused by a small trichurid nematode, Capillaria philippinensis, which infects freshwater fish as intermediate hosts and subsequently fish eating birds as definitive hosts. It has occurred in areas such as the Philippines and Thailand where people eat raw fish. We report an imported case of intestinal capillariasis in a 31-year-old Korean man who lived in Saipan for ten years. He suffered from diarrhea with weight loss, abdominal distension, and pitting edema in the lower extremities for two years. He ate raw freshwater fish in the Saipan 2 years ago. The diagnosis was confirmed by jejunal biopsy. Flat mucosal surface without villi contained sections of numerous round worms with stichosome, larvae, and eggs which were identified as Capillaria philippinensis. The patient was successfully treated with albendazole.
Adult ; Albendazole ; Biopsy ; Birds ; Capillaria ; Diagnosis ; Diarrhea ; Eating ; Edema ; Eggs ; Fresh Water ; Humans ; Larva ; Lower Extremity ; Ovum ; Philippines ; Protein-Losing Enteropathies* ; Thailand ; Weight Loss

No abstract available.
Blood Donors* ; Communicable Diseases* ; Humans

In accordance with the development of EEG and polysomnography in the field of sleep research, the sleep onset period (SOP) between wakefulness and sleep has been considered an important part for understanding the physiology of sleep. SOP in the transition from wakefulness to sleep is a gradual process integrating various viewpoints such as behavior, EEG, physiology and subjective report. Particularly, based on understanding of EEG changes during sleep, SOP has been regarded as a pattern of topographical change in specific frequency and specific state in EEG. Studies on quantitative EEG (qEEG) and event-related potential (ERP) have suggested that SOP shows the changes of functional coordination at the specific cortical areas in qEEG and the changes of regular patterns in response to environmental stimulation in ERP. The development of sleep EEG and topographic mapping of EEG is expected to integrate various viewpoints of SOP and clarify the neurophysiologic mechanism of SOP further.
Electroencephalography ; Evoked Potentials ; Polysomnography ; Wakefulness

No abstract available.
Congenital Abnormalities*

Utrasonic evaluation has been suggested as a screening method for early ovarian cancer. This study was designed to evaluate the aceuracy of pelvic ultraesound to measure the ovarian volume as the preliminary study. The ovarian volume me ured. by ultrasound was compared with findings at. surgery. Subjects far this investigation were 25 menstruating patients and 12 climacteric patients who were scheduled for gynecologic surgery chiefly unrelated to adnexal masses. The mean nf ovarian volume with menstruating patients was 5.7+/-5.9cm3 and that of climacteric patients was 2.5+/-l.3cm3(P<0.01). The eorrelation coefficient between the ovarian volurne measurement made by two examiners was 0.80. The correlation coeffieient between the ovarian volume measured by transvaginai ultrasonography and ovarian volume at laparotomy was 0. 37 and poor, The ll ovaries(52%) among the 24 ovaries of 12 climacteric tients were not visualized. So, this study suggested that the ovarian volume measurements af the postmenopauml by transvaginal ultrasonograpy was not simple and demanded the skill and laboraus training.
Climacteric ; Female ; Gynecologic Surgical Procedures ; Humans ; Laparotomy ; Mass Screening* ; Ovarian Neoplasms* ; Ovary ; Ultrasonography

A girl aged 18 years and 1 month, had a Angle's Class Iff malocclusion, characterized by anterior crossbite, anterior crowding, and constriction from right lower 2nd p emolar to right lower 2nd molar This ~i5 5s patient underwent scaling and 84148 extraction, and multibanded system was placed. After 14 months, anterior crossbite and crowding was corrected, andbothdental arches were improved. After 6 months from debanding, band space disappeared, and any relapse was not detected.
Constriction ; Crowding ; Female ; Humans ; Malocclusion* ; Molar ; Recurrence

Occasionally, a bony spine of variable size, the supracondylar process, projects distally from the anteromedial surface about 5cm proximal to the medial epicondyle, to which it is joined by a band of fibrous tissue. It was found in one per cent of living white subjects and less often in the colored races; only in rare instances it is associated with clinical signs, usually median nerve neuralgia. Here, we reported a case of incidental finding of supracondylar process without a definite symptom.
Continental Population Groups ; Humans ; Humerus ; Incidental Findings ; Median Neuropathy ; Spine

Of the shoulder syndromes, acute calcific tendinitis of the rotator cuff is the least difficult to differentiate, for the mechanical and inflammatory aspects combine to produce a picture of severe, and localized pain which presents in obvious distress, splinting the affected shoulder by holding the arm to his side. The radiologic picture corresponds poorly to the clinical picture, with visible calcium deposits ranging from thin crescents to large fluffy amorphous masses. Acute calcific tendinitis is a self-limited process with a natural history of 6 to 14 days. Relief is dramatic when the inflammatory and mechanical cycle is broken, but the potential remains for exacerbation as for more serious sequellae such as adhesive capsulitis. We expereinced 5 lesions of calcific tendinitis in supraspinatus tendon treated by surgical removal in 4 lesions and by conservative measure in one lesion.
Arm ; Bursitis ; Calcium ; Natural History ; Rotator Cuff ; Shoulder ; Splints ; Tendinopathy ; Tendons

Jehovah,s Witnesses who require operation represent a challenge to the physician because of the patient,s refusal to accept blood transfusion. An orthotopic heart transplantation was succesfully performed in a 40-year old Jehovah,s Witness without use of any blood product. During the operation, cell saver was used for shed blood and aprotinin was administered intravenously. The use of blood conserving methods, meticulous operative technique and brisk postoperative diuresis has added to the efficacy of heart transplantation in this patient. Total postoperative drainage was 860 ml and the lowest hemoglobin level was 11.8 g%. The patient recovered uneventfully and discharged on the 60th postoperative day.
Adult ; Anesthesia* ; Aprotinin ; Blood Transfusion ; Disulfiram ; Diuresis ; Drainage ; Heart Transplantation* ; Heart* ; Humans ; Transplantation