BACKGROUND: We evaluated 1) the sequential changes of angiotensin-converting enzyme (ACE) mRNA expression in lung (main site for circulating ACE synthesis) and left ventricle, and 2) whether such expression is modified by ACE inhibitor or angiotensin II receptor blocker treatment after acute myocardial infarction (MI) in rats. METHODS: Placebo, captopril (2 g/liter drinking water) or TCV-116 (10 mg/kg/day gavage) was administered 3 days before left coronary occlusion and continued for 6 weeks. At 1, 3 and 6 weeks after operation, hemodynamic measurement was performed and pulmonary and myocardial ACE mRNA expression was analyzed by quantitative RT-PCR using rcRNA as an internal standard. RESULTS: Mean BP and LVEDP increased in untreated rats compared with captopril- and TCV-116-treated rats (post-MI 6week, p<0.05). Pulmonary ACE mRNA increased in acute phase (post-MI 1 week, max. 1.4 fold, p<0.05 vs. pre-MI) and returned to pre-MI value thereafter. In contrast, cardiac ACE mRNA expression showed slightly decreasing tendency in acute phase, and was increased up to 1.6 fold in chronic phase after MI (post-MI 3 and 6weeks, p<0.05 vs. pre-MI). No changes in pulmonary ACE gene expression were found with RAS blockade. However, in acute phase after MI, cardiac ACE mRNA increased with both captopril and TCV-116 treatment (post-MI 24hour and 1week, max. 2 fold, p<0.05 vs. untreated group). CONCLUSION: 1) In contrast to the pulmonary ACE mRNA that is activated in acute phase, the cardiac ACE mRNA is activated in chronic phase after MI. 2) RAS blockade does not affect the change of pulmonary ACE expression, but modulate the change of cardiac ACE expression after MI.
Animals ; Captopril ; Coronary Occlusion ; Drinking ; Gene Expression* ; Heart Ventricles ; Hemodynamics ; Lung* ; Myocardial Infarction* ; Myocardium* ; Peptidyl-Dipeptidase A ; Rats ; Receptors, Angiotensin ; RNA, Messenger

Laparoscopy is a frequently used technique in surgery and gaining wide popularity replacing laparotomy. The advantages of laparoscopy are shorter hospital stay, faster recovery, more decreased postoperative pain and smaller scar than laparotomy. But inducing artificial pneumoperitoneum with gas causes various complications. Among them, gas embolism is a rare but fatal complication and may occur more frequently when laparoscopy is performed simultaneously with hysteroscopy. We experienced one case of gas embolism during diagnostic laparoscopy for secondary infertility and hysteroscopic resection of uterine myoma under general anesthesia. Early diagnosis and prompt treatment seem to be the keys to prevent catastrophic outcome and the anesthesiologist should know about it's patho- physiology, preventive methods, diagnosis and treatment.
Anesthesia, General ; Cicatrix ; Diagnosis ; Early Diagnosis ; Embolism, Air* ; Hysteroscopy ; Infertility ; Laparoscopy* ; Laparotomy ; Leiomyoma ; Length of Stay ; Pain, Postoperative ; Physiology ; Pneumoperitoneum, Artificial

Desmoplastic trichiepithelioma is a solitary tumor of the hair follicle with female preponderance, most commonly located on the face. Clinically the lesions appear annular and firm with a raised border and a depressed nonulcerated center, but the appearance is not so distinctive to hair follicle tumors that definite dignosis is established by the histopathologic findings. We report herein a case a case of desmoplastic trichoepithelioma in a 21-yeaar-old woman who had an asymptomatic hard, annular lesion, 0.4cm sized in diameter with a raised border and a depressed center on the right cheek. Histopathologic findings showed narrow strands of basaloid cells, horny cysts and desmoplastic stnoma, the features corresponding to the desmoplastic trichoepithelioma.
Cheek ; Female ; Hair Follicle ; Humans

While there is little controversy about the surgical resection for the torn discoid lateral meniscus, there are some contradictory reports for the treatment of discoid lateral meniscus without tear. Some authors argue that initial treatment should be observation after diagnostic arthroscopy in the cases without tear. Others reported that excellent results were obtained after partial resection of the discoid lateral meniscus without tear or with slight degeneration. We reviewed our series of symptomatic discoid lateral menisci without tear, confirmed by arthroscopic examination. We retrospectively reviewed 8 knees in 8 patients who had had partia! Meniscectomy for discoid latera1 meniscus without tear, confirmed by arthroscopic examination. They were 5 males and 3 females. The average age was 22.8 years (range, 7 to 57 years). The average duration of follow-up was 2 years and three months. The patients had continuing pain and locking or snapping preoperatively. Preoperative MRI had grade Il intrameniscal signal in all the cases. The patients were evaluated hy Lysholm pain score and total Lysholm score. There were 7 complete types and one incomplete type. The average Lysholm pain score and the total Lysholm score improved from 13.1, 67.8 preoperatively to 28.8. 97.9, at the last follow-up, respectively. Mechanical symptoms including click and 1ocking were disappeared in all, and no complication was obser ved. We suggest that symptomatic discoid lateral meniscus should he resected e.ven though there is no tear visible on arthroscopy, especially when the MRl shows grade lI intrameniscal signal.
Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial* ; Retrospective Studies

No abstract available.
Adult* ; Humans ; Mass Screening*

It has been known that the vestibular system is concerned with feelings of dizziness or vertigo. The vestibulo-thalamic pathway has also been described previously. However, there has been no confirmative report so far regarding the pathway through the internal capsule to the cortex. We have experienced 13 patients with symptoms of dizziness and/or vertigo whose lesions are located only around the internal capsule, mainly at the posterior limb and/or the genu. It is suggestive that fibers with dizziness may pass through a part of the internal capsule, probably through some part of the posterior limb and/or the genu.
Adult ; Aged ; Basal Ganglia/*physiopathology ; Dizziness/*physiopathology ; Female ; Humans ; Male ; Middle Aged ; Neural Pathways/physiopathology

BACKGROUND: Significant analgesic synergy is obtained when opioids are combined with dilute local anesthetics, but serious side effects of intraspinal opioid can develope. The purpose of this study was to see how much does additional fentanyl make change of hemodynamics and analgesic dermatome according to variation of local anesthetic concentration. METHODS: Thirty patients were divided into three groups who were receiving epidurally 0.33% bupivacaine 15 ml(group 1), 0.33% bupivacaine 15 ml including fentanyl 100 g(group 2), 0.25% bupivacaine 15 ml including fentanyl 100 g(group 3) at the C7-T1 interspace. We observed mean arterial blood pressure, pulse rate and arterial blood gas analysis to be changed. Evaluation of the onset and duration of analgesic action by pin prick test were taken. Also side effects and complications were checked. RESULTS: Decreases of mean arterial blood pressure was statistically significant between 10 and 120 minutes in group 1, between 10 and 50 minutes in group 2, between 10 and 40 minutes in group 3 after drug administration. Decreases of pH and increases of PaCO2 were statistically significant between 30 and 60 minutes in group 1, between 30 and 120 minutes in group 2, 3 after drug administration. In three groups, number of analgesic dermatome was maximal at 40 minutes after drug administraion. The duration of analgesia in C8 dermatome was 153 29 minutes in group 1, 168 21 minutes in group 2, 131 31 minutes in group 3. Inadvertant dural puncture was developed in one patient. Transient pruritus, nausea/vomiting and solmnolence were developed in group 2, 3. CONCLUSIONS: Three groups provided sufficient analgesia for operation. fentanyl affects on hemodynamics, ventilation but not on number of maximal analgesic dermatome. Also it produces side effects such as, mild pruritus, somnolence, nausea/vomiting.
Analgesia ; Analgesics, Opioid ; Anesthesia, Epidural* ; Anesthetics ; Anesthetics, Local ; Arterial Pressure ; Blood Gas Analysis ; Bupivacaine* ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Pruritus ; Punctures ; Ventilation

PURPOSE: The objectives of this study are to compare the hospital employees' and patients' recognition and attitudes toward the opening of the medical services market, to analyze the differences between hospital employees and patients on the factors in selecting a foreign hospital. MATERIALS AND METHODS: This study collected and analyzed data using systematic questionnaires that were self-administered by employees and outpatients to compare their recognition of the opening of the medical services market and the factors involved in selecting a foreign hospital. RESUTLS: Employees exhibited a higher level of recognition than the patients. Reasons for agreement were to ensure the right of selection for both the employees and patients. Reasons for disagreement, however, were split between the two groups: degraded public characteristics of medical services, for employees; and expensive medical fees, for patients. The most urgent task to prepare for the opening of the medical services market is the improvement of the diagnosis and treatment technologies for employees, and improvement of the services provided by hospital staff for patients. CONCLUSION: Korean hospitals shall need to improve their diagnosis and treatment technologies and provide medical services of high quality in order to compete with foreign hospitals.

No abstract available.
Fertilization in Vitro* ; Humans* ; Micromanipulation* ; Pregnancy Rate* ; Pregnancy*

No abstract available.
Asthma*