Actinomycosis is an indolent, suppurative infection caused by an anaerobic gram-positive organism (usually actinomyces israelii) which usually causes infection in the face, mediastitum, lung, and abdomen. Primary esophageal actinomycosis which is not related with pulmonary or mediastinal actinomycosis, is very rare, especially in immunocompetent host. A 58-year-old woman has been suffered from dysphagia, odynophagia, and chest pain after insertion of esophageal stent in esophageal acid stricture. She underwent a esophagectomy with esophagogastrostomy for above mentioned symptoms. Pathologic diagnosis was a esophageal actinomycosis.
Abdomen ; Actinomyces ; Actinomycosis* ; Chest Pain ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Esophagectomy ; Female ; Humans ; Lung ; Middle Aged ; Stents*

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

No abstract available.
Antibodies* ; Blood Donors* ; Chemistry* ; Chlamydia* ; Chlamydophila pneumoniae* ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Prevalence*

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

No abstract available.
Headache*

It is constant controversy that exercise influence muscle regeneration in peripheral neuropathy. The aim of this experiment is to show that treadmill running exercise under well-controlled conditions is to improve of regeneration in rat gastrocnemius muscles after sciatic nerve crushing injury. Male Sprague-Dawley rats (1 month old, weight 150~180 g) were submitted to bouts of exercise on a treadmill up a 10 degrees decline and speed is 20 m/min for 60 min per day and gastrocnemius muscles were analysed at different exercise periods (5, 10, 15, 20 and 40 days) by immunohistochemistry in comparison with injured non-exercised muscles. Rats were sacrificed at 12th (5 days exercise), 19th (10 days exercise), 26th (15 days exercise), 33rd day (20 days exercise), 61st day (40 days exercise) after sciatic nerve crushing injury. It showed that type II myofibers (target fibers) on center area had reinnervation at sciatic nerve crush injury at 26th day in exercise rats, as at 33rd day appeared giant type II myofibers, myofibers grouping observed in regenerative muscle character, component ratio of closed normal muscle showed at 61st day. Giant type II myofibers showed at 33rd day in non-exercise rats, however did not nearly normal muscle at 61st day. Therefore we concluded that treadmill running exercise is able to improve regeneration processes in gastrocnemius muscles after sciatic nerve crushing injury of rats.
Animals ; Benzeneacetamides ; Humans ; Immunohistochemistry ; Male ; Muscles ; Myosins ; Peripheral Nervous System Diseases ; Piperidones ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Running ; Sciatic Nerve

The congenital long-QT syndrome (LQTS) is characterized by recurrent syncope, prolonged QT intervals, QT interval lability, polymorphic ventricular tachycardia, and sudden death. We report a case of congenital long QT syndrome in a 28-day-old male infant who presented with syncope, bradycardia with 2: 1 pseudo-atrioventricular block and a markedly prolonged QT inteval. One episode occured after crying and degenerated into ventricular fibrillation and terminated after cardioversion. A VVI type cardiac pacemaker was implanted. Subsequently, the infant's heart rate was over 110/min and 2: 1 AV block and any other arrhythmia were absent. The infant recovered from the accompanied pneumonia and sepsis and was discharged 47 days after adrnission. However, 13 days after discharge, the infant returned to our hospital ER with syncope. Ventricular fibrillation ceased after cardioversion. Despite medication with propranolol, ventricular tachycardia persisted. The infant expired the day after he was discharged against medical advice.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Bradycardia ; Crying ; Death, Sudden ; Electric Countershock ; Heart Rate ; Hospitals ; Humans ; Infant ; Long QT Syndrome ; Male ; Pneumonia ; Propranolol ; Sepsis ; Syncope ; Tachycardia, Ventricular ; Ventricular Fibrillation

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

BACKGROUND: We evaluated the performance of Modular Analytics (Roche Diagnostics, Basel, Switzerland) which is combined with automated chemiluminescent immunoassay analyzer and automated chemical analyzer

in order to assess its utility for the improvement of efficiency of routine immuno-chemistry workstation. METHODS: Within- and between-day precision, linearity, and recovery rates were evaluated for 21 items (T3, T4, TSH, E2, LH, Testosterone, FSH, prolactin, AFP, CEA, CA125, CA19-9, total PSA, CRP, ASO, RF, Ig G, Ig M, Ig A, C3C, and C4). Commercialized controls(Roche Diagnostics, Basel, Switzerland) and patient sera for test specimens were used. Centaur(Bayer Diagnostic Division, New York, USA) and LX 2200(Eiken Chemical Co., Tokyo, Japan) were used as the control analyzers to evaluate the correlation. RESULTS: Within-day Coefficients of variation(CVs) was below 5% for all the analytes and between-day CVs was below 5.0% except ASO(8.01%). The linearity was excellent(r2>0.999; slope, 0.98-1.02; p<0.001). Recovery rates for all analytes were in the range of 95% to 103%. The correlation coefficients between modular and Centaur was exceeded 0.971, and between modular

and LX2200 exceeded 0.910, except RF(r=0.834). (P<0.05) CONCLUSION: The recently developed Modular Analytics proved to be highly precise and linear for quantitative analysis of hormones, tumor markers, and serum proteins in routine immuno-chemistry workstation. Correlations with Centaur and LX 2200 were thought to be good.
Blood Proteins ; Humans ; Immunoassay ; Prolactin ; Testosterone ; Biomarkers, Tumor

No abstract available.
C-Peptide* ; Child* ; Diabetes Mellitus* ; Histocompatibility Testing* ; Humans ; Insulin* ; Islets of Langerhans*