The effect of amiodarone on reperfusion arrhthmias after release of left anterior descending coronary artery(LAD) occlusion was studied in 22 anesthetized cats. All cats underwent 20 minutes LAD occlusion followed by reperfusion and amiodarone(20mg/Kg) or normal saline was given on cats which had reperfusion arrhythmias through the left ventricular catheter to observe the antiarrhythmic effect of amiodarone. And also the incidence and type of arrhymias during occlusion and reperfusion were analyzed. During the 20 minute LAD occlusion, 10 of 22 cats(45%) had no arrhythmias, and 12 cats(55%) had nonsustatined ventricular tachycardia. After release of occlusion, 5 of 22 cats(23%) had no arrthmias, and 17 cats(77%) developed sustained ventricular arrhythmias(ventricular tachycardia (n=5), ventricular fibrillation(n=12)). The 17 cats which had reperfusion arrhythmias were randomly divided and given normal saline(control(n=8)) or amiodarone(amiodarone group(n=9)). There was no difference on 2 groups. The reperfusion arrhythmias disappeared in 6 out of 9 cats(66.7%) vs none of 8 controls(P<0.01). We conclude that amiodarone seems to be the effective antiarrhythmic drug on reperfusion arrhythmias after release of LAD occlusion in anesthetized cats, and might be useful for the treatment of reperfusion arrhythmias in human.
Amiodarone* ; Animals ; Arrhythmias, Cardiac* ; Catheters ; Cats ; Humans ; Incidence ; Reperfusion* ; Tachycardia ; Tachycardia, Ventricular

No abstract available.
Gelatin* ; Hemorrhagic Fever with Renal Syndrome*

Many reports have been published on the tissue damage of a shock wave with respect to histopatological changes in light microscopy and various imaging modalities. However, the studies on the electron microscopic findings and cause of renal functional change such as parenchymal obstructive pattern following extracorporeal shock wave lithotripsy (ESWL) have not been elucidated. In order to evaluate the microstructural changes after shock wave exposure, gross, light microscopic and trasmission electron microscopic findings were analyzed with rabbit kidneys. Preliminary study (n=2) was performed to determine the dosage intensity of shock waves to inflict damage, using a EDAP LT 01 piezoelectric extracorporeal shock wave lithotriptor. A shoke wave of various intensities were given to the left kidneys of 3 different groups of rabbits. Storage value of 100, 50, 25 at rate of 20/sec under 87% power were given to group I (n=4), group II (n=4), and group III(n=3) respectively. The right kidneys were preserved as the control group. The rabbits were killed 6-12 hours later. In gross, there were a few subcapsular hemorrhagic foci and mild congestion of corticomedullary junction without a large hematoma formation. No significant differences were noted between each group. Light microscopic findings were mainly hydropic changes in the proximal convoluted tubules and congestion without significant necrotic changes. The observed pathologic changes in the transmission electron microscopy were vacuolization of cytoplasm with swelling of epithelial cells especially porximal convoluted tubules. There were also tubular obstruction due to swelling and desquamation of epithelial cells into tubular lumen. The structural changes of intracellular organelles were not found at storage values of 25 and 50. But dilatation and structural alterations of endoplasmic reticulums were noted of 100 with cell membrane rupture. The findings of this study suggest that tubular obstructions with or without structural change of intracellular organelles is one cause of renal functional change such as parenchymal obstructive pattern after ESWL.
Cell Membrane ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum ; Epithelial Cells ; Estrogens, Conjugated (USP) ; Hematoma ; Kidney* ; Lithotripsy ; Microscopy ; Microscopy, Electron, Transmission ; Organelles ; Rabbits ; Rupture ; Shock*

PURPOSE: In order to evaluate microstructural changes after shock wave exposure, gross, light microscopic and transmission electron microscopic findings were analyzed with rabbit gallgladders. MATERIALS AND METHODS: A preliminary study(2 rabbits) was performed to determine the dosage intensity of shock waves needed to inflict damage, using a EDAP LT 01 piezoelectric extracorporeal shock wave Iothotriptor. The gallbladders of three different groups of rabbits were given shock waves of various intensity. A storage value of 100, 50, 25 at rate of 20/sec under 80% power were given to group I (4 rabbits), group II( 4 rabbits), and group III(3 tabits), respectively. The rabbits were sacrified 6--12 hours later. RESULTS: The observed pathologic changes in the transmission electron microscopy were vaculization of cytoplasm and swelling of epithelial cells with dilatation and structural alteration of intracellular organelles, especially endoplasmic reticulum. Cell membrane rupture and necrosis were observed at the markedly affected area. The structural changes of intracellular organelles were minimally found at a storage value of 25. However, above pathologeic changes with dilatation and structural alterations of endoplasmic reticulums were more profund at value of 100. CONCLUSION: Early histologic changes induced by shock waves are dose dependent and the findings of cellular damage caused by ESWL might be explained as above.
Cell Membrane ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum ; Epithelial Cells ; Gallbladder* ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rabbits ; Rupture ; Shock*

5 cases of lead poisoning were investigated clinically. Of the 5 patients, 4 were male and 1 was female. The causes of lead poisoning in 3 cases were ingestion of herb drug pills and in 2 cases were occupational poisoning. Chief complain at admission in 4 cases were ill defined colicky abdominal pain and constipation. Only 1 case complained of dizziness and palpitation without gastrointestinal symptom. On peripheral blood, normocytic normochromic anemia (mean Hgb 9.2 gm/dl), reticulocytosis (mean 4.7%) and basophilic stippling were found in 100% of patients. Bone marrow aspiration was done in 4 cases. Erythroid hyperplasia and basophilic stippling were found in all 4 cases. Mean M:E ratio was 0.7:1. The lead concentration in serum was increased in 4 cases (80%) of patients. Lead concentration, delta aminolevulinic acid concentration in 24 hours collected urine were increased in 5 patients (100%).
Abdominal Pain ; Aminolevulinic Acid ; Anemia ; Basophils ; Bone Marrow ; Constipation ; Dizziness ; Eating ; Female ; Humans ; Hyperplasia ; Lead Poisoning* ; Male ; Poisoning ; Reticulocytosis

No abstract available.
Cerebral Palsy* ; Equinus Deformity* ; Heel* ; Muscle Spasticity*

PURPOSE: Unicoronal synostosis is the craniofacial anomaly caused by premature fusion of unilateral coronal suture. Ipsilateral flattening of the frontal and parietal bones, temporal retrusion with elevation and recession of the supraorbital rim are main clinical features. Compensatory contralateral frontal bossing and deviation of the nasal root and/or chin can also occur. There is a controversy about techniques for surgical correction, however, bilateral approach technique is more effective for correction of deformity. METHODS: A 4-year-old patient with unicoronal synostosis had undergone unilateral suturectomy at 28-month-old but fronto-facial deformity had remained and aggravated as she grew older. She had both fronto-facial and endocranial asymmetry. We performed coronal cranial approach and fully exposed affected cranium including supraorbital rim. Anterior 2/3 calvarial reconstruction with bilateral frontal bone osteotomy and fronto-orbital bandeau advancement was performed. RESULTS: Fronto-facial symmetry including fronto-orbital contour, nasal devation was improved. Endocranial twisting was also improved from 158degrees to 162degrees in CSO(crista galli- sella turcica-opisthion) degree. There was no postoperative complications and no need for revision, and facial asymmetry improved at the period of 2 years of follow-up. CONCLUSION: Bilateral approach with fronto-orbital bandeau remodeling in surgery of unicoronal synostosis looked superior to unilateral approach in achieving better symmetry and preventing recurrence of asymmetry. Remodeling surgery should be tried in patients even at an older age to correct fronto-facial asymmetry.
Chin ; Congenital Abnormalities ; Facial Asymmetry ; Frontal Bone ; Humans ; Osteotomy ; Parietal Bone ; Plagiocephaly ; Postoperative Complications ; Preschool Child ; Recurrence ; Skull ; Sutures ; Synostosis

Endoscopic variceal ligation(EVL) was developed to provide a safer alternative than injection sclerotherapy for treatment of bleeding esophageal varices. EVL adds a new indication that will significantly increase the use of overtubes. overtube itself may have a role in predisposing to esophageal perforation but only one report has been published regarding an esophageal perforation related to the placement of an overtube. Recently, we experienced a case of esophageal perforation caused by overtube placement during endoscopic variceal ligation. So we report this case with review of relevant literatures.
Esophageal and Gastric Varices ; Esophageal Perforation* ; Hemorrhage ; Ligation* ; Sclerotherapy

BACKGROUND/AIMS: Colonoscopic polypectomy is highly efficient in preventing colorectal cancer, but polyps may not always be completely removed. Improved knowledge of the risk factors for incomplete polyp resection after polypectomy may decrease the cancer risk and additional costs. The aim of this study was to investigate the conditions that can cause incomplete polyp resection (IPR) after colonoscopic polypectomy. METHODS: A total of 12,970 polyps that were removed by colonoscopic polypectomy were investigated. Among them, we identified 228 cases with a positive resection margin and 228 controls with a clear resection margin that were matched for age, gender, and polyp size. We investigated the location, morphology, and histological type of the polyps and evaluated the skills of the endoscopist and assisting nurse. RESULTS: Multivariate analysis revealed that the polyps, which were located in the proximal part of the colon and rectum, were at significant risk of IPR. Histologically, an advanced polyp and an inexperienced assistant were also independent risk factors for IPR. CONCLUSIONS: Polypectomy should be performed more carefully for polyps suspected to be cancerous and polyps located in the proximal part of the colon or rectum. A systematic training program for inexperienced assistants may be needed to decrease the risk of IPR.
Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Clinical Competence ; Colon/pathology/surgery ; Colonic Polyps/pathology/*surgery ; *Colonoscopy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Treatment Failure

PURPOSE: To compare the techniques and complications of intra-arterial port implantation for intra-arterialchemotherapy between PIPS and the port system. MATERIALS AND METHODS: For intra-arterial port implantation, 27cases in 27 patients were retrospectively evalu-ated using PIPS(PIPS-200, William Cook Europe, Denmark) while for21 cases in 19 patients a pediatric ve-nous port system(Port-A-Cath, 5.8F, SIMS Deltec, U.S.A.) was used. Allintra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinomawas diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric,ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPSand the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean,150) days in the port system. RESULTS: In all cases, intra-arterial port implantations were technicallysuccessful. Port catheter tips were locat-ed in the common hepatic artery(n=8), proper hepatic artery(n=7), righthepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1),inferior mesenteric artery(n=1), lum-bar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepaticartery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferiormesenteric artery(n=1), and in-ternal iliac artery(n=1) in the port system. Port chambers were buried ininfrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four(57.1%) were catheter or cham-ber related. In the port system, catheter or chamber related complications developedin four cases(19.0%). CONCLUSION: Because PIPS and the port system have relative merits and demetrits, successfulintra-arterial port implantation is possible if equipment is properly selected.
Catheters ; Cholangiocarcinoma ; Colon ; Drug Therapy* ; Europe ; Follow-Up Studies ; Hepatic Artery ; Humans ; Neoplasm Metastasis ; Retrospective Studies ; Subcutaneous Tissue ; Vascular Access Devices