BACKGROUND: Left ventricular (LV) remodeling manifests as an increase in LV end-diastolic and end-systolic volumes, an increase in myocardial mass, and a change in chamber geometry to a more spherical shape, and has been considered to be a consequence of heart failure, myocardial infarction or mitral regurgitation. However, less is known about change of LV geometry, especially LV sphericity, in asymptomatic population according to aging. METHODS:We investigated 261 asymptomatic subjects who volunteered for health screening and underwent transthoracic echocardiography. Those with poor echo image, significant coronary artery disease, LV dysfunction, hypertension, and diabetes mellitus were excluded. LV sphericity index is defined as the ratio of the long-axis length divided by LV short-axis length, both during systole and diastole. LV mass was calculated from septal and posterior wall thickness and LV internal dimension at end-diastole and then divided by body surface area to calculate LV mass index RESULTS: The mean age of subjects was 49.6+/-6.7 years and the percentage of male was 81%. LV sphericity index at diastole showed significant correlation with age (r=-0.17, p value<0.01), but LV sphericity index at systole did not. Both indices did not showed significant association with aerobic fitness, blood pressure, glucose, insulin resistance and LV function. LV mass index showed significant correlation with age (r=0.14, p value<0.05). CONCLUSION: Among the parameters of LV geometry, sphericity index showed decrease with aging in healthy population, meaning LV becoming more spherical with aging. Longitudinal follow-up study is needed to determine its usefulness as a predictor of future LV dysfunction in asymptomatic population.
Aging ; Blood Pressure ; Body Surface Area ; Coronary Artery Disease ; Diabetes Mellitus ; Diastole ; Echocardiography ; Glucose ; Heart Failure ; Humans ; Hypertension ; Insulin Resistance ; Male ; Mass Screening ; Mitral Valve Insufficiency ; Myocardial Infarction ; Systole

A number of noninvasive technics have been advocated as reflecting left ventricular performance. These methods include systolic time intervals, echocardiography and imaging of the left ventricular chamber with radionuclides during systole and diastole. Radionuclide evaluation of left ventricular function by means of the gamma camera and gating currently appears to be the most reliable noninvasive method for approximating angiographic evaluation of left ventricular performance. Utilizing the radionuclide angiography, we measured the left ventricular function in 19 normal healthy control, 60 patients with coronary artery diseases 7 patients with dilated cardiomyopathy, 5 patients with hypertension. 1) Left ventricular ejection fraction decreased in 12 patients with anterior myocardial infarction (39.9+/-11.6%), 17 patients with inferior myocardial infarction (49.9+/-8.4%) and 7 patients with dilated cardiomyopathy (19.0+/-5.8%), and there was a statistically significant difference compared with 19 normal control group (63.5+/-8.2%)(p<0.005). However there were no statistically significant difference between normal control group, patients with hypertension (58.8+/-7.6%) and patients with angina pectoris (60.1+/-6.5%). 2) Left ventricular ejection fraction decreased in both anterior and inferior myocardial infarction, and there was a statisically significant difference between both groups (p<0.01). All 13 patients with acute myocardial infarction had abnormal LVEF (40.5+/-9.1%) whcih was significantly lower than that of 16 patients with old myolardial infarction (50.1+/-10.5%)(p<0.01).
Angina Pectoris ; Cardiomyopathy, Dilated ; Coronary Artery Disease* ; Coronary Vessels* ; Diastole ; Echocardiography ; Gamma Cameras ; Humans ; Hypertension ; Infarction ; Inferior Wall Myocardial Infarction ; Myocardial Infarction ; Radioisotopes ; Radionuclide Angiography* ; Stroke Volume ; Systole ; Ventricular Function, Left*

In order to extract useful tumor cell-specific information. DNA contents and other morphological parameters were measured by image analysis. Single cell preparation was made from archived paraffin blocks of 14 cases of bronchogenic squamous cell carcinoma, poorly differentiated, by protease treatment. The cells were Feulgen stained, and DNA content, area, perimeter, and major axis of the tumor cell nuclei were measured. Inflammatory lymphocytes concurrent with the tumor cells were used as an internal standard. DNA ploidies of the lymphocytes and 2C tumor cells showed simple peaks with Gaussian distribution and mean coefficients of variation of 10% and 14% respectively. By the location and proportion of the tumor cells other than 2C cells, DNA ploidies could be classified into diploidy(1 case), polyploidy(2 cases), and aneuploidy(11 cases). The mean proportion of DNA aneuploidal tumor cells relative to the total tumor cells was 82.8%. In 8 cases, nuclear areas showed more or less overlapped distribution, whereas DNA contents showed discrete peaks. THes results suggest that many bronchogenic squamous cell carcinomas, poorly differentiated, have DNA aneuploidy and high proportion of aneuploidal cells, and that nuclear size and DNA content are more or less independent parameters.

Age Distribution ; Airway Management ; Body Weight ; Classification ; Fluid Therapy ; Humans ; Klebsiella pneumoniae ; Mortality ; Prognosis ; Retrospective Studies ; Serum Albumin ; Streptococcus ; Tooth ; Tracheostomy ; Wounds and Injuries

No abstract available.
Catheterization* ; Catheters* ; Fallopian Tube Diseases* ; Fallopian Tubes* ; Female

Sudden sensorineural hearing loss due to the initial manifestation of hematologic disease is very rare. Chronic myelogenous leukemia has been implicated as a causative factor of sudden sensorineural hearing loss. Leukemic infiltration, hemorrhage, infection, and hyperviscosity have been suggested as possible mechanisms in patients with chronic myelogenous leukemia. A 49-year-old male presented unilateral sudden sensorineural hearing loss. The patient was found to have chronic myelogenous leukemia during the work-up for the hearing loss. The WBC count upon admission was 485,100/mm(3). Hemoglobin, hematocrit, and platelet count were within the normal limits. The patient underwent three cycles of leukapheresis and chemotherapy with interferon alpha and hydroxyurea for the treatment of leukemia. The hearing threshold level was 75 dB on admission. It improved to 35 dB when the WBC count fell to 294,000/mm(3), and finally settled at 32 dB two weeks after the termination of chemotherapy when the WBC count was 125,900/mm(3). We present a case of a chronic myelogenous leukemia patient who initially presented with sudden sensorineural hearing loss. We presume that cochlear vessel occlusion as a result of elevated blood viscosity was responsible for this patient's hearing loss. Early onset of sudden deafness in a chronic myelogenous leukemia patient may be due to the hyperviscosity syndrome and be possible to reverse hearing loss through early leukapheresis.
Blood Viscosity ; Drug Therapy ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Hematocrit ; Hematologic Diseases ; Hemorrhage ; Humans ; Hydroxyurea ; Interferon-alpha ; Leukapheresis ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukemic Infiltration ; Male ; Middle Aged ; Platelet Count

BACKGROUND: Although considerable efforts have been made to improve the graft patency in coronary artery bypass surgery, the role of biomechanical factors remains underrecognized. The aim of this study is to investigate the influences of geometric configurations of the bypass graft on hemodynamic characteristics in relation to anastomosis. MATERIALS AND METHODS: The Numerical analysis focuses on understanding the flow patterns for different values of inlet and distal diameters and graft angles. The Blood flow field is treated as a two-dimensional incompressible laminar flow. A finite volume method is adopted for discretization of the governing equations. The Carreau model is employed as a constitutive equation for blood. In an attempt to obtain the optimal aorto-coronary bypass conditions, the blood flow characteristics are analyzed using in vitro models of the end-to-side anastomotic angles of 45degrees, 60degrees and 90degrees. To find the optimal graft configurations, the mass flow rates at the outlets of the four models are compared quantitatively. RESULTS: This study finds that Model 3, whose bypass diameter is the same as the inlet diameter of the stenosed coronary artery, delivers the largest amount of blood and the least pressure drop along the arteries. CONCLUSION: Biomechanical factors are speculated to contribute to the graft patency in coronary artery bypass grafting.
Bays ; Computer Simulation ; Coronary Artery Bypass ; Coronary Vessels ; Hemodynamics ; Transplants

PURPOSE: Monoclonal antibodies (mAb) specific for CD45RB as a potent tolerogenic target can prolong allograft survival in several animal models. The mechanisms of CD45RB mAb-mediated tolerance are largely unknown. Therefore, the present studies were performed to determine the immunomodulatory effects of CD45RB mAb on T cells in early or late time after allogenic skin transplantation. METHODS: Skin grafts and bone marrows from BALB/c donor mice were transplanted on C57BL/6 recipient mice and Busulfan was administerd. Group 1 was composed of anti-CD154 mAb administerd mice, group 2 was composed of anti-CD154 and anti-CD45RBB mAb administerd mice, and group 3 consisted of anti-CD154 mAb and CTLA4-Ig administerd mice. The proportion of splenic CD4+ and CD8+ T cell and range of CD45RB was observed by flow cytometry. Cytokines secreted by CD4+ T cell were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: CD45RB mAb in combination with CD154 mAb enhanced graft survival in allogenic skin transplantation model where CD45RB mAb specific for CD45RB, which was proven mainly expressed by CD8+ T cells, had inhibitory effects on the proportion of splenocyte-derived CD8+ and CD4+CD45RB(high) T cells in early or late time posttransplant. CONCLUSION: The combined therapy showed decreases in the proliferation of CD8+ T cells in vivo and allospecific responses of IFN-gamma-producing cells. Such immunomodulatory effects may be associated with the tolerogenic ability of CD45RB mAb in allogenic skin transplantation.
Abatacept ; Allografts ; Animals ; Antibodies, Monoclonal ; Bone Marrow ; Busulfan ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Graft Survival ; Humans ; Immune Tolerance* ; Lymphocytes* ; Mice* ; Models, Animal ; Skin ; Skin Transplantation ; T-Lymphocytes ; Tissue Donors ; Transplants

Schwannoma of the stomach is a rare controversial neoplasm which requires extensive studies to clarify its nature as a stromal tumor or leiomyoma. We describe the pathologic, immunohistochemical, and ultrastructural characteristics of schwannoma of the stomach in a 33-year-old woman. The tumor was a well-circumscribed submucosal mass located in the posterior wall of the midbody of the stomach. Microscopically, the cells were made up of fasciculating bundles of spindle cells featured with peripheral lymphoid cell cuffing. The tumor cells revealed a diffuse, strong immunoreactivity to S-100 protein and vimentin, but were negative to desmin and smooth muscle actin. They also had a focal positive reaction to glial fibrillary acidic protein. Ultrastructurally, many tumor cells showed a number of thin, elongated and interdigitating dendritic-cell-like processes, distinctly uniformed basal laminae, frequent cellular attachments, and microfilaments. These findings support the schwannian nature of the tumor.
Actin Cytoskeleton ; Actins ; Adult ; Basement Membrane ; Desmin ; Female ; Glial Fibrillary Acidic Protein ; Humans ; Leiomyoma ; Lymphocytes ; Muscle, Smooth ; Neurilemmoma* ; S100 Proteins ; Stomach ; Vimentin

OBJECTIVE: The purpose of this study is to review the surgical results of 19 patients with idiopathic trigeminal neuralgia treated by percutaneous ballooning compression(PBC) of trigeminal gasserian ganglion under brief general anesthesia. METHODS: The mean patient age was 63.5 years(range, 27-78). The mean follow-up period was 24 months(range, 1-46). Three patients had already undergone radiofreqnency trigeminal rhizotomy and two patients had previously microvascular decompression. The balloon was inflated by injecting radio-contrast media 0.7-1cc in amount. The mean inflating time is 81 seconds(range, 60-90). RESULTS: During the procedure, brief intraoperative bradycardia and hypotension were noted in seven cases(36.7%). All patients had immediate relief of pain except 1 case. 18 cases(94.5%) of patients were satisfied or very satisfied with their pain relief. There were immediate, mild to moderate sensory complication of hypesthesia, dysesthesia or paraesthesia in all cases and the immediate motor complication-difficulty of mastication in 3 cases, transient 6th nerve palsy in 2 cases. The immediate motor and sensory complications disappeared or much improved after 3-4 months. CONCLUSION: It is the simple technique that can be performed effectively in a brief period of general anesthesia. This procedure might be one of attractive methods in the treatment of idiopathic trigeminal neuralgia.
Abducens Nerve Diseases ; Anesthesia, General ; Bradycardia ; Follow-Up Studies ; Humans ; Hypesthesia ; Hypotension ; Mastication ; Microvascular Decompression Surgery ; Paresthesia ; Rhizotomy ; Trigeminal Ganglion* ; Trigeminal Neuralgia*