No abstract available.
Aged* ; Humans

The purpose of this study was to investigate the inhibitory role of vitamin A with respect to activation of Ito cells in fibrosis of the rat liver induced by common bile duct ligation(CBDL). The liver was examined by immunohistochemical staining for a-smooth muscle actin,the known marker of activated Ito cells, and light and electron microscopy after CBDL andCBDL with intraperitoneal injection of retinoic acid (Sigma, USA) 1 mg/Kg in 3 times per week. The results were sumrrlerized as follows: After CBDL, the bile ductules were markedly proliferated in the periportal areas extending toterminal hepatic veins. Interstitial fibrosis and inflammatory cell infiltration appeared, however,cholestasis was minimal. Retinoic acid treatment with CBDL decreased bile ductular proliferationand interstitial fibrosis compared to CBDL only. After CBDL, proliferated and activated Ito ceIs showing positive reaction in smooth muscle actin were present in the periductular andperisinusoidal areas, and areas of increased interstitial fibrosis. Activated ito cells weredecreased in number after CBDL with vitamin A treatment. Electron microscopically,intracytoplasmic fat droplets and the cytoplasmic processes of Ito cells were decreased afterCBDL. Myofibroblasts were frequently appeared in the interstitial fibrosis after CBDL. But,intracytoplasmic fat droplets of Ito cells were well preserved, and myofibroblasts were found lessfrequently after CBDL with vitamin A treatment. The results suggest that vitamin A plays an inbitory role in the activation and fibrogenesis ofIto cells after CBDL.
Rats ; Animals

No abstract available.
Bipolar Disorder*

Pulmonary artery sling is an uncommon and potentially lethal vascular anomaly that can produce airway obstruction. Despite the availibility of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of the tracheobronchial tree. We experienced a 70-day-old male infant who was admitted to our unit because of sudden dyspnea, cyanosis, coarse expiratory wheezing and inspiratory stridor. At first, he was treated with bronchodilator and steroid under the impression of infantile asthma, but the symptoms went on without interval change. We performed magnetic resonance imaging study followed esophagography and two dimensional echocardiography. Finally he was diagnosed as a vascular sling. We report this with a brief review and related literatures.
Airway Obstruction ; Asthma ; Cyanosis ; Dyspnea ; Echocardiography ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Mortality ; Pulmonary Artery ; Respiratory Sounds

Lipomas of the heart are benign neoplasms and have rarely been described. Due to the fact that they normally cause no symptoms, diagnosis is often purely accidental. Because of the rarity of these tumors, it seems worthwhile to present an example studied at autopsy. It was associated with the sudden death of a 15-year-old boy. The tumor arose from the wall of the left ventricle and occupied the pericardial cavity, measuring 13x7x6 cm in size. The tumor was whitish-yellow, translucent, and soft. Microscopically, the tumor was composed of mature adipose tissue which extended between muscle fibers. This current case, the giant cardiac lipoma is believed to produce disturbances of the conduction system and distrubances of cardiac filling.

Hemangioblastomas are histologically benign tumors, which generally occur at the posteriro fossa and rarely in supratentorial region. The authors analyzed 18 cases of posterior fossa hemangioblastoma which have been operated at the Department of Neurosurgery, Seoul National University Hospital from 1982 to 1989. The clinico-pathological and radiological features were as follows : 1) Among 18 cases, 13 cases were cystic type with or without mural nodule and 5 cases were solid type. 2) 2 cases were compatible with Von Hippel Lidau's complex, one of which was associated with retinal angiomatosis and the other with mulitple cysts in the pancreas and kidney. In 3 cases, hemoglobin level was above 18g/dl, implying polycythemia, but returned to normal level postoperatively. 3) Mural nodules were not visible in the enhanced CT scan in the 2 cases, in one of which mural nodule was visible in the angiography and so, angiography was more helpful than the CT scan in the detection and the localization of the mural nodule. 4) Among 18 cases, 2 cases(11%) recurred at 34 months and 48 months postperatively.
Angiography ; Angiomatosis ; Hemangioblastoma* ; Kidney ; Neurosurgery ; Pancreas ; Polycythemia ; Retinaldehyde ; Seoul ; Tomography, X-Ray Computed

No abstract available.
Muscle, Smooth* ; Smooth Muscle Tumor*

The surgical correct1on of blepharoptosis is accomplished by utilizing certain materials, the levator, the frontalis or the superior rectus muscle. The perfect postoperative results are complete cover of the eye on lid closure, adequate mobility when blinking, normal lid fold and no diplopia. The authors obtained good results in two children of congenital ptosis by attaching medial one third of superior rectus muscle to lid margin which was reported by Motais in 1897. The operation which use the superior rectus muscle is not favored recently because of complicationals such as partial corneal exposure, vertical diplopia, difficulty in blinking, and partial obliteration of the upper conjunctival fornix. But, the results of these simple physiologic proceures for binocular paralytic ptosis were remarkable without any complications as the aboves for 3 months of follow up check.
Blepharoptosis ; Blinking ; Child ; Diplopia ; Follow-Up Studies ; Humans ; Telescopes

Clonidine, an a2-adrenergic agonist, has sedative and analgesic properties and reduces the inhalation anesthetic requirement and modifies the hemodynamic responses to surgery. But occasionally, severe bradycardia and hypotensian during inhalation anesthesia develops following oral clonidine premedication. To predict intraoperative hemodynamic changes during enflurane anesthesia, author evaluated noninvasive autonomic tests consisted of respiratory sinus arrhythmia (RSA), Valsalva's maneuver (VSV), R-R interval difference in head up tilt (HTR) and diastolic blood pressure difference in head up tilt (HTP) in fifty-one patients (ASA physical status I~II ) scheduled for elective surgery. Patients were received 5 ug/kg of oral clonidine at 90 min before operation. Anesthesia was maintained with enflurane, oxygen (2 liter/min) and nitrous oxide (2 liter /min). The enflurane concentration was controlled to maintain blood pressure within +/-20% of preinduction value. After anesthesia, patients were allocated to two groups according to above and below 0.5 MAC (0.84 vo1%) enflurane concentration. Each preoperative autonomic test results revealed significant correlation with heart rate (HR), mean arterial pressure (MAP), and enflurane concentration (EC), respectively (p<0.05). Values of RSA, HTR, HTP, MAP and HH wm 81+/-14.4 ms, 76+/-43.5 ms, -6+/-5.2 mmHg, 76+6.4 mmHg and 63+/-5.5 beats/min, respectively in below 0.5 MAC enflurane concentration group and were significantly different from values of RSA; 16933.7 ms, HTR; 175+/-41.7 ms, HTP; 6+/-3.1 mmHg, MAP; 90+/-11.0 mmHg and HR; 76+/-7.6 beats/min in above 0.5 MAC enflurane concen- tration group (p<0.05). In conclusion, the simple noninvasive autonomic tests are recommended in prediction of intra-operative hemodynamic changes during enflurane anesthesia when oral clonidine premedication is indicated.
Anesthesia* ; Anesthesia, Inhalation ; Arrhythmia, Sinus ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Clonidine* ; Enflurane* ; Head ; Heart Rate ; Hemodynamics* ; Humans ; Inhalation ; Nitrous Oxide ; Oxygen ; Premedication ; Valsalva Maneuver

Clonidine, an a2-adrenergic agonist, has sedative and analgesic properties and reduces the inhalation anesthetic requirement and modifies the hemodynamic responses to surgery. But occasionally, severe bradycardia and hypotensian during inhalation anesthesia develops following oral clonidine premedication. To predict intraoperative hemodynamic changes during enflurane anesthesia, author evaluated noninvasive autonomic tests consisted of respiratory sinus arrhythmia (RSA), Valsalva's maneuver (VSV), R-R interval difference in head up tilt (HTR) and diastolic blood pressure difference in head up tilt (HTP) in fifty-one patients (ASA physical status I~II ) scheduled for elective surgery. Patients were received 5 ug/kg of oral clonidine at 90 min before operation. Anesthesia was maintained with enflurane, oxygen (2 liter/min) and nitrous oxide (2 liter /min). The enflurane concentration was controlled to maintain blood pressure within +/-20% of preinduction value. After anesthesia, patients were allocated to two groups according to above and below 0.5 MAC (0.84 vo1%) enflurane concentration. Each preoperative autonomic test results revealed significant correlation with heart rate (HR), mean arterial pressure (MAP), and enflurane concentration (EC), respectively (p<0.05). Values of RSA, HTR, HTP, MAP and HH wm 81+/-14.4 ms, 76+/-43.5 ms, -6+/-5.2 mmHg, 76+6.4 mmHg and 63+/-5.5 beats/min, respectively in below 0.5 MAC enflurane concentration group and were significantly different from values of RSA; 16933.7 ms, HTR; 175+/-41.7 ms, HTP; 6+/-3.1 mmHg, MAP; 90+/-11.0 mmHg and HR; 76+/-7.6 beats/min in above 0.5 MAC enflurane concen- tration group (p<0.05). In conclusion, the simple noninvasive autonomic tests are recommended in prediction of intra-operative hemodynamic changes during enflurane anesthesia when oral clonidine premedication is indicated.
Anesthesia* ; Anesthesia, Inhalation ; Arrhythmia, Sinus ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Clonidine* ; Enflurane* ; Head ; Heart Rate ; Hemodynamics* ; Humans ; Inhalation ; Nitrous Oxide ; Oxygen ; Premedication ; Valsalva Maneuver