No abstract available.
Anti-Bacterial Agents* ; Ascorbic Acid* ; beta Carotene* ; Tretinoin*

Heart transplantation is an accepted procedure for treatment of end-staged cardiac failure. A return to near-normal quality on life can be expected in many patients with a nonrejecting cardiac allograft, and many of these patients will return to the operating room for noncardiac surgical procedures. Anesthesiologists should be alert to recognizing problems caused by the presence of infection in immunosuppressed patients, modes of presentation of rejection phenomena and how transplanted organs, notably significantly denervated ones, may behave and respond under the pathophysiologic circumstance that arise during surgery, resuscitation and intensive care. The use of regional techniques require adequate preloading to avoid exaggerated hypotension and aseptic technique to avoid infection. Hypobaric spinal anesthesia has some benefit. It does not depress cardiovascular and respiratory system and keep adequate venous return by trendelenberg position. We report herein a case of successfully undergone total hip replacement in a patient who had previously undergone orthotopic heart transplantation under hypobaric spinal anesthesia.
Allografts ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Heart Failure ; Heart Transplantation ; Heart* ; Humans ; Hypotension ; Critical Care ; Operating Rooms ; Respiratory System ; Resuscitation

Infection with V. vulnificus resulting in septicemia accompanied with skin gangrene and high mortality of 50% or more freqently occurs in people with liver disenses. And it has also been demonstrated that serum iron, essential to the growth of microorganisms, has been elevated in liver damaged animals. In spite of many efforts to reveal the pathogenesis of this fatal disease, there is no clear conclusion so far. Significant increase or decrease in LD of V. vulnificus (CDC C7184) was observed when mice were treated with ferric arnmonium citrate (FAC) and a specific iron chelator, desferal(Df), originated from Streptomyces pilosus and a broad spectrurn cation chelator, calciurn disodium ethylenediaminetetraacetate (CaEDTA) widly used in heavy metal poisoning treated alone or in combination. The results were obtained as follows. FAC and Df lowered LD to approximately 1.96x 10(3) colony forming unit (CFU) and 9.77x10(2) CFU respectively from 4.46 x 10(5) CFU, LDso of the control group. However, CaEDTA elevated the I D to 4.97 X 10(7) CFU. The LD of the group administered FAC and Df simultaneously was about 9.28x10(1) CFU. Whereas, the LD of the group administered FAC and CaEDTA simultaneously was approximately 7.88 x 10(5), similar to that of the control group. This study demonstrates that there is a close association of the iron with V. vulnificus septicemia and Df lowers LD of the rnice. CaED7A, however, elevated the LD. The author hereby proposes carefully iron chelators such as CaEDTA as an agent for a new adjuvant therapy of the V. vulnificus septicernia.
Animals ; Chelating Agents* ; Citric Acid ; Gangrene ; Iron* ; Liver ; Mice* ; Mortality ; Poisoning ; Sepsis* ; Skin ; Stem Cells ; Streptomyces ; Vibrio vulnificus* ; Vibrio*

The authors present a case of intracranial chordoma in a 53-year-old woman who presented with gradual onset of dizziness, gait disturbance. Clinical features and various diagnostic findings are described.
Chordoma* ; Dizziness ; Female ; Gait ; Humans ; Middle Aged

Purpose: We sought to provide a new classification system for Duane retraction syndrome (DRS) according to type and angle of strabismus during primary gaze and to analyze the clinical features of each DRS type. Methods: The medical records of 65 DRS patients who visited the department of pediatric ophthalmology at Seoul National University Children's Hospital between 2010 and 2017 were retrospectively analyzed. Patients whose angle of exotropia at primary gaze exceeded 3 prism diopters (PDs) were classified as “Exo-Duane,” those whose angle of strabismus at primary gaze did not exceed 3 PDs were classified as “Ortho-Duane,” and those whose angle of esotropia at primary gaze exceeded 3 PDs were classified as “Eso-Duane.” Results: Among 65 DRS patients, Ortho-Duane was the most common (53.8%) type, followed by Eso-Duane (33.8%) and Exo-Duane (12.3%). The mean age at diagnosis was significantly higher in the Exo-Duane group than the Ortho-Duane or Eso-Duane group (p = 0.003 and p < 0.001, respectively). A predominance of left eye involvement was observed in the Ortho-Duane (62.9%) and Eso-Duane (90.9%) groups. The frequencies of upshoot, downshoot, fissure narrowing, and globe retraction were not significantly different among the subgroups. Head-turn was more frequent in Eso-Duane patients than in Exo-Duane or Ortho-Duane patients (p = 0.001 and p < 0.001, respectively). Myopia accounted for the most common refractive error among Exo-Duane patients (71.4%), while hyperopia was found more often in both Ortho-Duane (64.7%) and Eso-Duane (85.0%) patients. The majority of patients showed gross stereoacuity (93.1%), and a large proportion had good stereoacuity (Exo-Duane 60.0%, Ortho-Duane 81.3%, Eso-Duane 87.5%). Conclusions Our newly proposed classification of DRS according to type and angle of strabismus at primary gaze was practically useful and showed potential for use as an objective guideline in the clinical setting.

No abstract available.
Chelating Agents* ; Lead Poisoning*

No abstract available.
Calcitriol* ; Dehydroepiandrosterone* ; Gene Expression* ; Tumor Necrosis Factor-alpha*

No abstract available.
Calcitriol* ; Dehydroepiandrosterone* ; Gene Expression* ; Tumor Necrosis Factor-alpha*

No abstract available.
Animals ; Listeria* ; Listeriosis* ; Mice*

BACKGROUND: Nonimmune hydrops fetalis has become an important perinatal problem since it was first described in 1943. Although recent advances in antenatal ultrasound have made it possible to detect and manage nonimmune hydrops fetalis in early pregnancy, the perinatal mortality is still high. OBJECTIVE: To obtain clinically useful data regarding antenatal diagnosis, management, and perinatal outcomes of nonimmune hydrops fetalis, and to assist clinicians offer proper antepartum counseling and obstetric management which may be able to improve prognosis. Study design: We retrospectively reviewed 33 cases of nonimmune hydrops fetalis delivered in our hospital over a 4-year period. RESULTS: The antenatal diagnosis was possible by ultrasonography in all cases. Accumulation of fluid in fetal serous cavity and generalized skin edema were observed in all cases. A probable etiology was found in 23 (69.7%) cases through ultrasonography, various laboratory studies including fetal karyotyping, and autopsies. These were cardiovascular (4), respiratory (6), chromosomal (4), skeletal (1), and others (8). Despite extensive diagnostic studies, no definite etiology was found in 10 (30.3%) cases. Excluding the ten fetuses delivered after induced abortion, eight infants were born alive and six died in the neonatal period. The mortality rate was 91.3% (21/23). CONCLUSION: Nonimmune hydrops fetalis represents a very poor perinatal outcome. It is suggested that to improve the prognosis, various antenatal and postnatal approaches to find associated etiologic factors should be performed, and intensive perinatal cares are needed.
Abortion, Induced ; Autopsy ; Counseling ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Infant ; Karyotyping ; Mortality ; Perinatal Mortality ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Retrospective Studies ; Skin ; Ultrasonography