No abstract available.

Giant cell myocarditis(GCM) is a rare inflammatory heart disease which is characterized by multinucleated giant cells and a granulomatous reaction. It usually progresses rapidly and results in a fatal course. We report a patient with giant cell myocarditis who was treated by cardiac transplantation. A 35-year-old male was admitted with dyspnea which had developed 4 months before. On echocardiography, the right and left ventricles were markedly dilated and severe global hypokinesia was noted. He was diagosed with dilated cardiomyopathy with secondary severe mitral regurgitation. His cardiac function deteriorated progressively. He underwent orthotopic heart transplantation. Grossly the heart was enlarged, weighing 420gm and round with a blunt apex. Both right and left ventricles were markedly dilated. There were numerous white patches, measuring up to 4cm, throughout the epi- and myocardium. Microscopically, extensive fibrosis and multiple exuberant granulomas with numerous scattered multinucleated giant cells were seen. Lymphocytes and eosinophils were also frequent. Coronary arteries were unremarkable. Neither microorganisms nor foreign materials were found. By serial endomyocardial biopsies of the transplanted heart, only mild perivascular lymphocytic infiltration was occasionally observed without any evidence of rejection or recurrence of giant cell myocarditis. The patient's postoperative course has been uneventful so far(postoperative 21 months). The etiology of GCM remains to be clarified, although various factors are suspected. No matter what the cause, our experience suggests that this grave disease might be treated well by heart transplantation.
Male ; Humans ; Biopsy

No abstract available.
Gardner Syndrome* ; Rectal Neoplasms*

BACKGROUND: The purpose of this study was to investigate the mechanism of endothelium-dependent and independent responses to endothelins (ETs) in porcine coronary artery. METHODS: The vascular rings of left anterior descending artery or left circumflex artery from 7 pigs were suspended in conventional organ chambers for the measurement of isometric force. To evaluate relaxation responses, vascular rings with endothelium were exposed to ET-1 and ET-3. To evaluate contraction responses, vascular rings with and without endothelium were exposed to ET-1 and ET-3 in the presence or absence of BQ 123 (ET(A) receptor antagonist) or TAK-044 (ET(A) and ET(B) receptor antagonist). RESULTS: Transient relaxation responses of vascular rings occurred after exposure of ET-1 and ET-3. These transient responses disappeared after preincubation with N-nitro-L arginine. There was an increased contractions of vascular rings according to increasing concentration of ET-1 and ET-3. The initial responses were enhanced in vascular rings without endothelium in ET-1 and ET-3. In vascular rings with endothelium, the contraction responses were more reduced in vascular rings with preincubation of BQ 123 than in vascular rings without BQ 123 in ET-1. In vascular rings without endothelium, the contraction responses were more reduced in vascular rings with preincubation of TAK-044 than in vascular rings without TAK-044 in ET-1. CONCLUSION: ET(B) receptor on the endothelium might mediate the transient vasodilator responses to ET-1 and ET-3 through release of nitric oxide in porcine coronary artery. ET(A) and ET(B) receptor on vascular smooth muscle cells might mediate vasoconstrictor responses to ETs.
Arginine ; Arteries ; Coronary Vessels* ; Endothelins* ; Endothelium ; Muscle, Smooth, Vascular ; Nitric Oxide ; Receptors, Endothelin ; Relaxation ; Swine

No abstract available.
Embryo Transfer* ; Embryonic Structures* ; Estradiol* ; Fertilization in Vitro*

Interest in the prevalence of patent foramen ovale(PFO) and its relation to embolic stroke has increased with the sophistication of methods for noninvasive cardiac assessment. The effect of foramen ovale closure on the risk for subsequent strokes is promised. A 22-year old woman was presented with sudden onset of cerebral infarct. She had a patent formen ovale, and right to left shunt during the Valsalva maneuver, which was diagnosed by transesophageal contrast echocardiography. Transcatheter closure of PFO was performed with Rashkind PDA umbrella under the guidance of transesophageal echocardiography. Transcatheter closure of PFO can be accomplised with little morbidity and may reduce the risk of embolic episode.
Echocardiography ; Echocardiography, Transesophageal* ; Female ; Foramen Ovale ; Foramen Ovale, Patent* ; Humans ; Prevalence ; Stroke* ; Valsalva Maneuver ; Young Adult

No abstract available.
Paraganglioma*

No abstract available.
Hernia*

No abstract available.

BACKGROUND: Analyzing the attitudes toward organ donation and the factors that influence such attitudes is fundamental to improving the quality of management for the process of brain dead organ donation. METHODS: We interviewed 23 primary carers of donors after a minimum period of one year post organ donation from a single hospital, from 2008 to 2011. This telephone survey analyzed factors including relationship with the donor and the impact of such factors on making the decision for donation and attitude towards organ donation. RESULTS: With respect to the carers' relationship with the donor, seven carers who participated in the interview were spouses (30.4%), six were parents (26.0%), three were offspring (13.0%), and seven were siblings (30.4%). Ten of the decision makers (43.4%) were not legal priority holders. Twenty-two interviewees (95.6%) experienced no regret for their decision to go through with the donation. Fifteen participants (65.1%) were willing to donate their own organs in case of brain death, and the favorability towards organ donation was significantly related to the satisfaction with their experience of medical services during the process of organ donation. CONCLUSIONS: Organ donation after brain death is still viewed favorably by carers even after the bereavement period. Positive attitude and favorability toward organ donation were significantly related to the satisfaction with the medical service. We suggest interventions to improve the quality of medical services in order to promote organ donation.
Bereavement ; Brain Death* ; Caregivers ; Humans ; Parents ; Siblings ; Spouses ; Telephone ; Tissue and Organ Procurement* ; Tissue Donors*