No abstract available.
Heart Septal Defects, Ventricular* ; Pulmonary Valve Stenosis*

No abstract available.
Hypertension, Renovascular*

No abstract available.
Neurilemmoma*

No abstract available.
Anemia, Aplastic*

Malignant hyperthermia is a well-recognized syndrome of uncertain etiology. The confusing facts are: the variety and different nature of the triggering agents, the variation in time of onset of rigidity and fever coupled with a variation in response to succinylcholine, the lack of family history in some patients, and its occurence in some who have had previously normal general anesthetics. A case is a 23 year old relatively healthy male patient in whom subtotal gastrectomy was performed under N2O-O2-ether and gallamine anesthesia with induction after pentothal sodium and succinylcholine. This was complicated by an abrupt, high rise in body temperature, muscle rigidity, flushing with peripheral cyanosis, disseminated intravascular coagulation and hyperpnea 40 minutes after induction. He died 3 hours after cessation of anesthesia without effective response to any active antipyretic therapy. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
Anesthesia* ; Anesthetics, General ; Body Temperature ; Cyanosis ; Disseminated Intravascular Coagulation ; Fever ; Flushing ; Gallamine Triethiodide ; Gastrectomy ; Humans ; Incidence ; Male ; Malignant Hyperthermia* ; Muscle Rigidity ; Prognosis ; Sodium ; Succinylcholine ; Thiopental

Endodermal sinus tumor of the mediastinum is a very rare malignant tumor, usually affecting young adolescents, and its histologic findings are characteristic as that of gonadal germ cell origin. We describe the cytologic finding of fine needle aspiration of mediastinal endodermal sinus tumor in a 19-year-old male patient, comparing with tissue section. The tumor cells in smears were usually in tight clusters with large overlapping cells, which were arranged in a papillary or microacinar pattern, suggesting carcinoma. The tumor cells were large, round or oval with a small amount of cytoplasm which was occasionally vacuolated and had indistinct border. The nuclei were large, pleomorphic, and vesicular with large promi- nent nucleoli. The tissue sections showed typical findings of endodermal sinus tumor. Careful correlation of cytological findings and the serum alpha-fetoprotein level would be helpful to confirm the diagnosis.
Adolescent ; alpha-Fetoproteins ; Biopsy, Fine-Needle ; Biopsy, Needle ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Child* ; Clonorchiasis ; Cytoplasm ; Diagnosis ; Dietary Proteins* ; Endodermal Sinus Tumor ; Female ; Germ Cells ; Giant Cells ; Gonads ; Humans ; Kidney Failure, Chronic* ; Male ; Mediastinum ; Middle Aged ; Thyroid Gland ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux* ; Young Adult

Systemic lupus erythematosus, an autoimmune disease with multisystem involvement, has been reported to be associated with a number of gastrointestinal complications and symptoms such as nausea, vomiting, and abdominal pain. However, acute pancreatitis only rarely has been reported as a complication of SLE. We report a case of SLE presenting drug unrelated acute pancreatitis as a initial manifestation.
Abdominal Pain ; Autoimmune Diseases ; Lupus Erythematosus, Systemic* ; Nausea ; Pancreatitis* ; Vomiting

Endogenous nitric oxide (NO) has been known to regulate the salivary secretion and glandular blood flow. However, the distribution of nitric oxide synthase (NOS) responsible for NO synthesis has not been well studied in salivary glands. The present study was aimed to investigate the distribution of nitric oxide synthase isoforms (endothelial, neuronal, and inducible NOS). Immunohistochemistry, using monoclonal mouse anti-endothelial NOS, anti-neuronal NOS, and anti-inducible NOS, was performed in 3 major salivary glands (parotid, submandibular and sublingual gland) of the rat. Endothelial NOS (eNOS)-positive immunoreactivity was observed in arterial endothelium, striated duct, granular convoluted duct of the submandibular gland, intercalated duct, and mucous acinar cells of the sublingual gland. The eNOS-positive immunoreactivity was most prominent in the arterial endothelial layer and that of the striated and granular convoluted duct was well concentrated in columnar epithelial layer. In the intercalated duct and mucous acinus, eNOS-positive immunoreactivity was weakly detected. Neural NOS (nNOS)-positive immunoreactivity was observed in submandibular ganglion, autonomic postganglionic fiber, striated duct, granular convoluted duct, and intercalated duct. nNOS-positive immunoreactivity of the submandibular ganglion and autonomic postganglionic fiber was most prominent and that of the ductal system was well concentrated in the epithelial layer. eNOS-positive immunoreactivity was not detected either in excretory ducts or in serous acinar cells. Inducible NOS-positive immunoreactivity was not detected. There results reveal the presence of eNOS and nNOS in the salivary gland, which may be related with regulation of the glandular secretion and blood flow through synthesis and secretion of NO.
Acinar Cells ; Animals ; Endothelium ; Ganglia, Autonomic ; Ganglion Cysts ; Immunohistochemistry ; Mice ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Protein Isoforms ; Rats ; Salivary Glands* ; Sublingual Gland ; Submandibular Gland

PURPOSE: Three-dimensional(3D) magnetic resonance(MR) projection imaging was evaluated as a noninvasive alternative to direct cholangiography for the assessment of its reliability in patients with obsructive jaundice. METHODS AND MATERIALS: A heavily T2-weighted gradient-echo sequence(PSIF) was used for 3D MR projecion imaging of the biliary system in five healthy volunteers and 25 patients with obstructive jaundice. The 3D images of the bile ducts were formed by stacking consecutive coronal MR images obtained with a fast imaging method to a maximum-intensity projection algorithm. RESULTS: In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. The extrahepatic and intraheparic bile ducts were well visualized in 23 patients with obstructive jaundice. The leve of obstruction and the grade of dilatation were dipicted with MR cholangiography in all cases. And the cause of obstruction could be determined with MR cholangiography in 18 cases, MR cholangiography was successful in two patients in whom ERCP failed. The gallbladder or dilated pancreatic duct not demonstrated by means of direct cholangiography was demonstrated with MR cholangiography in six cases.
Bile Ducts ; Biliary Tract ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Dilatation ; Gallbladder ; Healthy Volunteers ; Humans ; Jaundice ; Jaundice, Obstructive* ; Pancreatic Ducts ; Volunteers

A case of invasive cribriform carcinoma of the breast is presented with fine need- le aspiration cytologic features. The aspiration was performed from a papable 2.0cm mass in the upper outer quadrant of the right breast in a 53 year-old woman. The aspirate showed cellular smear composed of larger three dimensional tight clusters, smaller monolayered loose clusters, and many individual cells on the clean background. In the clusters, the tumor cells were bordering central lumina, quite similar to the cribriform in histology. The tumor cells in the clusters and individual tumor cells had uniform, small and round nuclei. The chromatin was finely granular, and nuclear membrane was smooth. No discernible nucleoli were present (nuclear grade 1-2). Unless the abundance of individual cells and the cribriform growth pattern are recognized in the smear, the cytologic diagnosis of invasive cribriform carcinoma is difficult.
Female ; Humans ; Biopsy