No abstract available.
Kidney Transplantation* ; Urinary Diversion*

Essential thrombocythemia is a kind of myeloproliferative disorder characterized by primary elevation in the number of platelet and by multiple episodes of bleeding or thrombotic complications. Rarely, thrombocythemia itself causes coronary arterial occlusion and leads to ischemic heart disease. Fewer than twenty cases of coronary artery occlusive disease in thrombocythemia have been reported since Cheitlin et al had included thrombocythemia in their review of rare causes of myocardial infarction. We experienced a case of coronary artery disease in a 53-year-old woman with thrombocythemia, who had not coronary artery disese risk factors at all. Presence of multiple thrombus in the coronary artery was suggested in coronary angiography.
Angina, Unstable* ; Blood Platelets ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Female ; Hemorrhage ; Humans ; Middle Aged ; Myeloproliferative Disorders ; Myocardial Infarction* ; Myocardial Ischemia ; Risk Factors ; Thrombocythemia, Essential ; Thrombocytosis* ; Thrombosis

No abstract available.
Pulmonary Artery*

Between 1986 and 1990, four children with recurrent CNS leukemia who had previous CNS prophylaxis therapy were treated with intermittent central nervous system irradiation and intrathecal chemotherapy (IIIC). There was no isolated CNS recurrence. One patient died form bone marrow relapse. Three patients are alive without evidence of disease for 3E3/12 year to 3E6/12 year after the diagnosis of recurrence of CNS leukemia. This experience suggests that IIIC may be an effective treatment for preventing the recurrence of CNS leukemia without any serious side effects.
Bone Marrow ; Central Nervous System* ; Child* ; Diagnosis ; Drug Therapy* ; Humans ; Leukemia* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence

Mitomycin C (MMC) trabeculectomy combined with extracapsular cataract extraction and posteor chamber intraocular lens implantation (glaucoma triple procedure, 30 eyes) was clinically compared with MMC trabeculectomy alone (30 eyes). The age, type of glaucoma, and preoperative number of medications were matched with the previous group (P>0.05). The mean preoperative intraocular pressures (IOPs) were 30.2+/-8.3mmHg (range, 22~56mmHg) in the glaucoma triple procedure group and 31.6+/-8.9mmHg (range, 22~57mmHg) in the trabeculectomy alone group (p=0.55). The mean postoperative IOPs were significantly higher in the glaucoma triple procedure group compared with the trabeculectomy alone group at all postoperative vistis (one month to nine months) (p<0.05). However, there were no statistically significant differences in the mean number of postoperative rise exceeding 30 mmHg within the postoperative one month tended to occur more frequently in the glaucoma triple procedure group (7 eyes (23%)) than the trabeculectomy alone group (2 eyes(7%)) (p=0.13). Conjunctival filtering blebs were significantly frequently observed in the trabeculectomy alone group than the glaucoma triple procedure group (28 eyes (93%), 20 eyes (67%), respectively, P=0.02) at 6 months postoperatively. The common postoperative complications were hyphema (4 eyes) and posterior capsular opacification (4 eyes) in the glaucoma triple procedure group and shallow anterior chamber(4 statistical difference was noted between these two groups (p>0.05). Although hypotensive effect of MMC on the glaucoma triple procedure was less than on the trabeculectomy alone, glaucoma triple procedure using MMC could be recommended to be safe and effective on controlling the high IOP for treating glaucoma patients with coexisting cataract.
Blister ; Cataract ; Cataract Extraction ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Mitomycin* ; Postoperative Complications ; Trabeculectomy*

To build a clinical data base for the patient is one of the important works in the department of anesthesiology. Many of the works can be accomplished by presonal computer, of which include registration of patient data, searching for articles, and analysis of clinical data etc. We would like to introduce a computer programs for the management of various data of anesthesia department and patients. We expect that more advanced and beneficial programs appear to the management of data for anesthesia department and patients.
Anesthesia Department, Hospital* ; Anesthesia* ; Anesthesiology ; Humans ; Microcomputers*

Coronary neovascularity may be formed in patients with the left atrial thrombus, and coronary artery disease may be associated with valvular heart disease. From August 1989 through September 1990, 109 patients over 40 years old with valvular heart disease were performed coronary arteriogram to evaluate the incidence of the associated coronary artery disease. And 9 patients with left atrial thrombi detected noninvasively were also performed coronary arteriogram to evaluate the significance of the neovascularity to predict the left atrial thrombus. The results were as follows : 1) Significant coronary arterial lesion(greater than 50% narrowing of the luminal diameter) was noted in three of 109 patients over 40 years old(2.8%), but there was no typical chest pain in all of the three patients. 2) The coronary neovascularity was found in 19 of 118 patients -18 with mitral valvular disease and one with combined valvular disease. All of the patients with the coronary neovascularity had established atrial fibrillataion and the neovasculaity was originated from the left circumflex artery in all of them. 3) Prosthetic valve replacement was performed in 42 of 118 patients during the study period and left atrial thrombus was found in ten patients with mitral valve disease. Neovascularity on coronary arteriogram was detected in six patients(sensitivity 60%) of the above 10 patiets, and 28 patients without neovascularity had no left atrial thrombus (28/32, specificity 87.5%). Our observation revealed that neovascularity might represent the left atrial thrombus in valvular heart disease, and the incidence of the associated coronary artery disease in valvular heart disease was very low(2.8%) in Korea. Coronary arteriography as a routine preoperative evaluation might be unnecessary in valvular heart disease in Korea.
Adult ; Angiography ; Arteries ; Chest Pain ; Coronary Artery Disease ; Heart Valve Diseases* ; Humans ; Incidence ; Korea ; Mitral Valve ; Phenobarbital ; Sensitivity and Specificity ; Thrombosis

Nowadays in the field of plastic surgery, operations with no general anesthesia have been much increased, using daily surgery center. We used "Propofol TCI system" to control exact target concentration of conscious sedation and to reduce any systemic complication of the other local anesthetics. Twenty of ASA Class I or II patients were scheduled for elective surgery using Diprifusor(R) TCI system at 0.8-1.9 ug/ml target concentration. We estimated the proper target concentration, time of awakening, postoperative patient satisfaction and presence of postoperative amnesia. All the patients was satisfied except one patients who underwent nasal tip plasty. The target concentration of the conscious sedation varies with age and the type of operation but average concentration was 1.4-1.6 ug/ml. The average time of awakening, which we estimated by the time of eye opening was 2.6 minutes. Postoperative systemic complication and unusual vital sign were not present. We present here our satisfactory results using propofol infused by TCI(Target controlled infusion) system. This system is called 'Diprifusor(R)' and has a benefit of excellent sedative effect, low complication rate, safety, and rapid awakening time which enables the patient to return to his normal life cycle.
Amnesia ; Anesthesia, General ; Anesthesia, Intravenous* ; Anesthesia, Local* ; Anesthetics, Local ; Conscious Sedation ; Humans ; Hypnotics and Sedatives ; Life Cycle Stages ; Patient Satisfaction ; Propofol* ; Surgery, Plastic* ; Vital Signs

BACKGROUND/AIMS: To evaluate the therapeutic outcomes of the endoscopic submucosal dissection (ESD) technique for the treatment of gastric subepithelial tumors (SETs). METHODS: A systematic literature review was conducted using the core databases. Data on the complete resection rates and the procedure-related perforation rates were extracted and analyzed. A random effects model was then applied for this meta-analysis. RESULTS: In all, 288 patients with 290 SETs were enrolled from nine studies (44 SETs originated from the submucosal layer; 246 SETs originated from the muscularis propria layer). The mean diameter of the lesions ranged from 17.99 to 38 mm. Overall, the pooled complete resection rate was estimated to be 86.2% (95% confidence interval [CI], 78.9 to 91.3). If the analysis was limited to the lesions that originated from the submucosal layer, the pooled complete resection rate was 91.4% (95% CI, 77.9 to 97). If the analysis was limited to the lesions that originated from the muscularis propria, the pooled complete resection rate was 84.4% (95% CI, 78.7 to 88.8). The pooled procedure-related gastric perforation rate was 13% (95% CI, 9.4 to 17.6). Sensitivity analyses showed consistent results. Finally, publication bias was not detected. CONCLUSIONS: ESD, including endoscopic muscularis dissection, is a technically feasible procedure for the treatment of SETs. However, selection bias is suspected from the enrolled studies. For the development of a proper indication of ESD for SETs, further studies are needed.
Gastrointestinal Stromal Tumors ; Humans ; Publication Bias ; Selection Bias

OBJECTIVE: To determine the effect of functional electrical stimulation (FES) in the paralyzed muscles of rabbits with spinal cord injury (SCI). METHOD: Fifteen male New Zealand white rabbits were injured by spinal cord transection at the T6 level. We classified animals into a normal control group (n=3), and SCI without FES (n=3), SCI with 10 Hz FES (n=6) and SCI with 40 Hz FES (n=6) groups. FES was applied on both tibialis anterior (TA) muscles at two frequencies (10 Hz, 40 Hz) for 1 hour daily for 2 weeks. After treatment TA muscles were separated and apoptotic features were measured by in situ DNA nick-end labeling (TUNEL), DNA fragmentation assays and western blotting for Bcl-2and Bax protein. RESULTS: In TUNEL and DNA fragmentation assay results, the FES groups showed more fragmented myonuclei and DNA, and western blotting showed more Bax protein expression in FES groups than no FES group and control (higher in 40Hz group), whereas Bcl-2 protein expressions were similar in all groups. CONCLUSION: Apoptosis of paralyzed muscle was increased in FES group with higher Bax/Bcl-2 in 40 Hz than in 10 Hz. To evaluate the clinical significance of muscle apoptosis with FES in SCI, further study would be needed.
Animals ; Apoptosis* ; bcl-2-Associated X Protein ; Blotting, Western ; DNA ; DNA Fragmentation ; Electric Stimulation* ; Humans ; In Situ Nick-End Labeling ; Male ; Muscles ; Rabbits ; Spinal Cord Injuries* ; Spinal Cord*