Aortic dissection is clinically suspected from the typical symptoms and signs and may be confirmed by computed tomography or aortography. But atypical presentations can be seen in a minority of cases, such as SVC syndrome, right pulmonary artery stenosis etc. We present a case which was initially suspected to be a right atrial tumor because of a large filling defect in the right atrium on radionuclide angiocardiography but finally confirmed to be dissection of ascending aorta by computed tomography.
Angiocardiography ; Aorta ; Aortography ; Constriction, Pathologic ; Heart Atria ; Pulmonary Artery

There are many hemodynamic and physiologic changes during liver transplantation much more than other surgical interventions. The oxygen delivery and oxygen consumption are af- fected by depressed hemodynamic and metabolic status during the operation. At the lower levels of oxygen present in venous blood, a linear relationship exists between saturation and tension. The use of fiberoptic oximetry system in conventional pulmonary artery flotation catheters has made the bedside application of this relationship of practical value in the continuous assessment of mixed venous oxygen saturation. This study was performed to determine changes in SvO2 and other variables of oxygen kinetics during canine OLT and study the correlation between SvO2 and cardiac output, SvO2 and oxygen consumption and oxygen utilization ratio. The continuous rnixed venous oxygen saturation and cardiac output by SO2/CO computer were monitored and the oxygen delivery, oxygen consumption and oxygen utilization ratio were calculated by arterial and venous blood gas analysis and modified Fick's equation during orthotopic liver transplantation in 20 dogs. The results were as follow as ; 1. There was no significant difference in tissue oxygen extraction between preoperative control and anhepatic phase, while cardiac output were decreased during anhepatic phase. 2. By utilizing centrifugal pump(venovenous bypass) oxygen delivery and oxygen utilization ratio were well maintained even though suppressed the change of oxygen delivery and oxygen consumption during anhepatic phase. 3. There was a significant decrease in SvO2 immediately after declamping the suprahepatic vena cava, whereas the oxygen utilization rate and oxygen consumption following reperfusion were significantly increased than just prior to reperfusion of transplanted liver. 4. A Statistically significant correlation was found between SvO2 and cardiac output, oxygen consumption in all surgical stages except reperfusion(CO;r=0.478, p<0.001, VO2,r=-0. 272, p=0.004), but their correlations were relatively poor. However, there was highly significant correlation among SvO2 and oxygen utilization ratio in all surgical stages(O2UR; r=- 0.834, P<0.001). In conclusion, continuous monitoring mixed venous oxygen via a fiberoptic pulmonary catheter could be used as the index for evaluation of hemodynamics and oxygen kinetics during canine OLT, but further research should be performed to determine whether these measurements indicate viability of the grafted liver.
Animals ; Blood Gas Analysis ; Cardiac Output ; Catheters ; Dogs ; Hemodynamics ; Kinetics ; Liver Transplantation* ; Liver* ; Oximetry ; Oxygen Consumption ; Oxygen* ; Pulmonary Artery ; Reperfusion ; Transplants

This study was performed to evaluate the method of quantification of exercise thallium-201(201Tl) myocardial perfusion imaginges(M.P.I.) for the detection of coronary artery disease. Exercise 201 Tl MPI were interpreted objectively, reproducibly, quantitatively and easily by a computer assisted technique-Circumferential profile method. Exercise 201Tl MPI and redistribution images were taken in 32 patients(9 cases of post infarction angina, 13 cases of angina pectoris, 8 cases of atypical chest pain, 1 case of arrhythmial and 1 case of caridac neurosis). The results obtained were as follows: 1) Exercise 201Tl MPI of 3 cases of angina pectoris demonstrated transient perfusion defect in 5 cases, persistent perfusion defect in 2 cases, transient and persistent perfusion defect in 1 cases and no perfusion defect in 5 cases. Exercise 201Tl MPI of 9 case of post-infarction angina revealed persistent perfusion defect in 7 cases and transient and persistent perfusion defect in 2 cases. 201Tl MPI of 8 cases of atypical chest pain showed transient perfusion defect in 1 case and no perfusion defect in 7 cases. There was no perfusion defect in 1 case of arrhythmia and another case of cardiac neurosis. 2) The location of persistent perfusion defects in several views of 201Tl MPI in 9 case of postinfarction angina were consistent with those of infarction area in the electrocardiogram. 3) While visual analysis interpreted three cases to have no perfusion defect and one case to have transient perfusion defect respectively, objective analysis revealed that one of them had transient perfusion defect, another of them had persistent perfusion defect and the other had transient and persistent perfusion defect. 201Tl MPI of three cases could be done easily by circumferential profile method, which were difficult to interprete by subjective visual analysis. The results indicate that Exercise 201Tl MPI interpreted by circumferential profile analysis would be an objective, quantitative and noninvasive method for the detection of ischemic change and location in coronary artery disease.
Angina Pectoris ; Arrhythmias, Cardiac ; Chest Pain ; Coronary Artery Disease ; Electrocardiography ; Infarction ; Myocardial Ischemia* ; Neurocirculatory Asthenia ; Perfusion

Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Background: Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty. Methods: This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion. Results: The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP. Conclusions Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.

Vitamin C, one of essential micronutrients, has been reported to modulate the humoral immune responses in some mammals. We investigated whether vitamin C might modulate this response in mice by directly affecting B cells. Splenic B cells were isolated and activated by CD40- and B cell receptor-ligation in vitro. The cells were cultured with a pretreatment of vitamin C from 0 to 1 mM of concentrations. Vitamin C slightly increased apoptosis of B cells dose-dependently and behaved as an antioxidant. We found that in vivo administration of vitamin C by intraperitoneal injection affected isotype switching as previously reported: the titer of antigen-specific IgG1 antibody was decreased, while that of IgG2a was unaffected. Somewhat different from those observed in vivo, in vitro exposure to vitamin C slightly decreased isotype switching to IgG1 and increased isotype switching to IgG2a. Pretreatment with vitamin C in the safe range did not affect either proliferation of cultured B cells or the expression of CD80 and CD86 in those cells. Taken together, in vivo results suggest that vitamin C acts to modulate isotype switching in the mouse. However, because of our in vitro results, we suggest that the modulation exerted by vitamin C in vivo is by indirectly affecting B cells, perhaps by directly influencing other immune cells such as dendritic cells.
Animals ; Apoptosis ; Ascorbic Acid ; B-Lymphocytes ; Dendritic Cells ; Immunity, Humoral ; Immunoglobulin Class Switching ; Immunoglobulin G ; Injections, Intraperitoneal ; Mammals ; Mice ; Micronutrients ; Reactive Oxygen Species ; Vitamins

Vitamin C is an essential water-soluble nutrient which primarily exerts its effect on host defense mechanisms and immune homeostasis, but the mechanism related to immune-potentiation is poorly understood. Since dendritic cells (DCs) are known as a potent antigen presenting cell (APC) that could enhance the antigen specific immune responses, we investigate the effects of vitamin C on activation of DCs and its related mechanism by using dendritic cell lines, DC-1. First, we found that there was no damage on DC-1 by 2.5 mM of vitamin C. In the presence of vitamin C, the expression of CD80, CD86, and MHC molecules was increased, but it was decreased by the pre-treatment of SB203580, p38 MAPK-specific inhibitor. We confirmed the phosphorylation of p38 MAPK was increased by the treatment of vitamin C. Taken together, these results suggest that vitamin C could enhance the activity of dendritic cells via the up-regulation of the expression of CD80, CD86, and MHC molecules and the activation of p38 MAPK is related to this process.
Ascorbic Acid ; Defense Mechanisms ; Dendritic Cells ; Homeostasis ; Imidazoles ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; Pyridines ; Up-Regulation ; Vitamins

Vocal cord paralysis is a comlex disorder which may result from numerous causes. It is often associated with trauma, disease in adjacent tissue, or a generalized neuroligical disorder. Laryngeal EMG is a useful technique for vocal cord paralysis. However it has not been used due to the uncertainties of normal human vocal cord physiology and the technical difficulties in performing these studies. We investigated the pathophysiology of vocal cord paralysis with laryngeal electromyography(LEMG). We studied 20 patients with idiopathic vocal cord paralysis. 6 patients were denervated in the cricothyroid(CT) and 6 patients in the thyroarytenoid(TA), and 3 patients in both CT and TA muscles. These indicated superior laryngeal neuropathy, recurrent laryngeal neuropathy, and proximal laryngeal or vagus neuropathy, respectively. LEMG proved to be a safe and effective procedure in the diagnosis of laryngeal neuropathy, and make it possible to use electromyography as a routine procedure in diagnosis laryngeal paralysis.
Diagnosis ; Electromyography* ; Humans ; Muscles ; Physiology ; Vagus Nerve Diseases ; Vocal Cord Paralysis* ; Vocal Cords*

Gestational trophoblastic disease (GTD) is a condition of uncertain etiology, choriocarcioma, or placental-site hydatidiform moles, invasive moles, choriocarcinoma, and placental-site trophoblastic tumors. It arises from the abnormal proliferation of trophoblastic tissue and spreads beyond the uterus hematogenously. The early diagnosis of GTD is important to ensure timely and successful management and the preservation of fertility. We report the unusual case of a metastatic choriocarcinoma that formed bullae on the lung surface and presented as recurrent pneumothorax in a 38-year-old woman with elevated beta-human chorionic gonadotropin (hCG) levels. She underwent thoracoscopic wedge resection of the involved lung and four subsequent cycles of consolidation chemotherapy. No other evidence of metastatic disease or recurrent pneumothorax was noted during 22 months of follow-up. GTD should be considered in the differential diagnosis of spontaneous pneumothorax in reproductive-age women with an antecedent pregnancy and abnormal beta-hCG levels.
Adult ; Choriocarcinoma* ; Chorionic Gonadotropin ; Consolidation Chemotherapy ; Diagnosis, Differential ; Drug Therapy ; Early Diagnosis ; Female ; Fertility ; Follow-Up Studies ; Gestational Trophoblastic Disease ; Humans ; Hydatidiform Mole, Invasive ; Lung ; Neoplasm Metastasis* ; Pneumothorax* ; Pregnancy ; Trophoblastic Tumor, Placental Site ; Trophoblasts ; Uterus