No abstract available.
Erectile Dysfunction* ; Male

No abstract available.
Sleep Initiation and Maintenance Disorders*

No abstract available.
Pain Clinics* ; Pain Management*

No abstract available.
Breast Neoplasms* ; Breast* ; Diagnosis*

In order to investigate a hemodynamic complication associated with the resection of a large arteriovenous malformation, we planed the following experiment. We divided the left common caroted artery and the internal jugular vein for microsurgical anastomsis between the rostral carotid and caudal jugular vessel ends : the 2 remaining wessel stumps were ligated. This created an arteriovenous shunt with afferent flow from the contralateral caroted and the basilar artery and retrograde down to the carotid-jugular anastomosis. And then, we occluded the shunt vessels at the each stage of the first and fourth week after anteriovenous shunt. Forty adult cats weighing from 2.2 to 2.4kg were used in this study The animals were devided into 4 groups : group 1(acute occlusion-1 week after shunt, n=10), group 2(staged occlusion-1 week after shunt, n=10), group 3(acute occlusion-4 week after shunt, n=10), group 4(staged occlusion-4 week after shunt, n=10) respectively. The regional cerebral blood flow(rCBF), cardiopulmonary function were measured in each animal group and also observed the response of the cerebral blood flow on induced changes of the blood pressure and the arterial bicarbonate. The arteriovenous shunt patency was evaluated by serial angiography. The results were as follows ; 1) Considerable increases in the mean arterial blood pressure(mABP) as well as bradycardia were observed in acute occlusion groups(group 1, 3). After induced hyercarbia, the increments of mABP in acute occlusion groups were less than staged occlusion groups, considerbly. 2) Significant decreases in the mean pulse rate were observed in acute occlusion groups. the mean pulse rate were the highest decrease in group 3. 3) The values of rCBF of left frontal cortex in acute occlusion groups were more greater increase than those of staged occlusion groups considerably. 4) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and increases of the rCBF were lowest in group 3 compared with the other groups. After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and reductions of the rCBF were lowest in group 3 compared with the other groups. 5) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups. The rCBFs were the highest increase in group3 and lowest increase in group 2 compared with the other groups. After induced hypotension, considerable reductions of the rCBF were demonstrated in all groups. The rCBFs were the highest reduction in group 3 and lowest reduction in group 2 compared with the other groups. It might be infered from these results that patients with large arteriovenous malformations, particulary those with cerebral steal symptoms, are at risk to develp neurologic defictis related to perfusion breakthrough if their malformed vessels are abruptly removed, and staged or gradual occlusion of feeding arteries may prevent this potentially devastating complication.
Adult ; Angiography ; Animals ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Blood Pressure ; Bradycardia ; Cats ; Heart Rate ; Hemodynamics ; Homeostasis* ; Humans ; Hypotension ; Jugular Veins ; Perfusion

BACKGROUND: Medical emergency teams (METs) have shown their merit in preventing unexpected cardiac arrest. However, it might be impractical for small- or medium-sized hospitals to operate an MET due to limited manpower and resources. In this study, we sought to evaluate the feasibility of a medical alert system (MAS) that alerts all doctors involved in patient care of patient deterioration via text message using smart-phones. METHODS: The MAS was test-operated from July 2015 to September 2015, in five general wards with a high incidence of cardiac arrest. The number of cardiac arrests was compared to that of 2014. The indication for activation of MAS was decided by the intensive care unit committee of the institution, which examined previous reports on MET. RESULTS: During the three-month study period, 2,322 patients were admitted to the participating wards. In all, MAS activation occurred in 9 patients (0.39%). After activation, 7 patients were admitted to the intensive care unit. Two patients (0.09%) experienced cardiac arrest. Of 13,129 patients admitted to the ward in 2014, there were 50 cases (0.38%) of cardiac arrest (p = 0.009). CONCLUSIONS: It is feasible to use MAS to prevent unexpected cardiac arrest in a general ward.
Emergencies ; Heart Arrest ; Hospital Rapid Response Team ; Humans ; Incidence ; Intensive Care Units ; Mortality ; Patient Care ; Patients' Rooms ; Pilot Projects* ; Text Messaging

PURPOSE: This study tried to evaluate the effectiveness of combined treatment using radiation therapy and concurrent cisplatin as a radiosensitizer in the management of locally advanced head and neck cancer. MATERIALS AND METHODS: From January 1995 to August 1998, 29 evaluable patients with locally advanced head & neck cancers (AJCC stage II-IV) were received curative radiation therapy (total 70-75.6 Gy/35 -42 fractions , 1.8-2 Gy/fraction) and concurrent cisplatin chemotherapy (100 mg/m2, D1, D22, D43). The neck dissections were performed for residual lymphadenopathy. Follow- up ranged from 5 to 55 months (median 24 months). RESULTS: Twenty- one (72.4%) patients achieved clinical complete responses. The partial response and minimal response rates were 17.2% and 10.4%, respectively. Locoregional failure rate was 27.6%, and included 6 patients with local failures , 4 patients with regional failures, and 2 patients with combined local and regional failures. Four of 29 patients (13.8%) developed distant metastasis. The disease free survival rate at 3 years was 60%. Nasopharyngeal primary tumors or complete responders showed significantly higher disease free survival rate. The grade 3 mucositis and nausea/vomiting was noted in 34.5%, respectively. Major prolongation of radiation therapy duration was inevitable in three patients. Twenty- one patients (72.4%) completed 3 courses of cisplatin and 5 patients received 2 courses of cisplatin. Three patients received only one course of cisplatin due to nephrotoxicity and neurotoxicity, and then changed to 5- FU regimen. CONCLUSIONS: Concurrent cisplatin- radiation therapy in locally advanced head and neck cancer showed high response rate, reasonable locoregional control, and survival rate. As expected, acute toxicities were increased, but compliance to treatment was acceptable. Assess ment of the effect of the combination in this setting requires further accrual and follow- up.
Cisplatin* ; Compliance ; Disease-Free Survival ; Drug Therapy ; Head and Neck Neoplasms ; Head* ; Humans ; Lymphatic Diseases ; Mucositis ; Neck Dissection ; Neck* ; Neoplasm Metastasis ; Survival Rate

No abstract available.

Although alpha2-adrenoceptor agonists are widely used as postoperative sedatives in adults, the postoperative effects in pediatric patients with secondary pulmonary arterial hypertension (PAH) due to congenital heart disease are not well known. We experienced a case of successful ventilator weaning with continuous intravenous administration of dexmedetomidine (DEX) after surgical correction in a 46-month-old child with congenital ventricular septal defect (VSD) with severe PAH. She underwent VSD closure on cardiopulmonary bypass (CPB). After successful weaning from the CPB, hemodynamics and oxygenation were stabilized on DEX and nitroglycerin in the intensive care unit. The patient was successfully weaned from the ventilator 46 hours after surgery. The transthoracic echocardiogram two weeks after surgery showed a closed VSD with no residual shunt and trivial tricuspid regurgitation (Vmax = 2.5 m/sec) without PAH.
Administration, Intravenous ; Adult ; Cardiopulmonary Bypass ; Child* ; Child, Preschool ; Dexmedetomidine* ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Hemodynamics ; Humans ; Hypertension* ; Hypnotics and Sedatives ; Intensive Care Units ; Nitroglycerin ; Oxygen ; Tricuspid Valve Insufficiency ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning

No abstract available.
Endocrine Disruptors* ; Humans*