No abstract available.
Infection Control*

The protein C system is a natural anticoagulant and profibrinolytic system consisting of protein C and protein S and thrombomodulin. Because the increased fibrinolysis and the decreased activities of coagulation factor V and VIII are observed in patients undergoing cardiopulmonary bypass, which are known main effects of achivated protein C, we studied the protein C system in the plasma of patients undergoing operation with extracorporeal circulation(ECC group, 31 patients) and without ECC(control group, 10 patients). The nature of the enhanced blood fibrinolytic activity that evolved during extraacorporeal circulation was charaacterized by significantincrease or fibrin degradation product(FDP) in ECC group(P<0.01) but not in control group. The changes of protein C system also showed only in ECC group. The changes of protein C system were most pronounced in the early phase of cardiopulmonary bypass. The changes of FDP ane protein C system were observed in both bubble and membrane oxygenator-used group, but the pattern and degree of change were quite different (P<0.01), i,e., more severe in membrane oxygenator-used group. These results confirm the disturbance of protein C system by extracorporeal circulation, which is possibly activated by the contact activation between blood and synthetic surface. So measurement of changes of protein C system could be used as a good method in the development of new materials for extracorporeal circulation.
Cardiopulmonary Bypass ; Extracorporeal Circulation ; Factor V ; Fibrin ; Fibrinolysis ; Heart* ; Humans ; Membranes* ; Oxygen* ; Oxygenators* ; Plasma ; Protein C* ; Protein S ; Thoracic Surgery* ; Thrombomodulin

From July 1988, open heart surgery was performed on fifty adults utilizing the pulmonary artery vent instead of conventional venting methods. The open heart procedures included were twenty coronary artery bypass grafitings(CABG), ten mitral valve replacements(MVR), ten aortic aneurysms(DA), and three ventricular septal defects(VSD). To determine the effectiveness of the pulmonary artery venting, non-cardiotomy procedures(CABGs') were classified into satisfactory, ordinary and poor group in terms of the degree of chamber dilatation throughtout the entire period of the operation. Again, cardiotomy procedures were categorized as degree 0, I, II, III and IV according to the clearness of the operative fields. Out of the twenty non-cardiotomy procedures, 17 cases(85%) were fallen into the satisfactory group, while the remained three cases into ordinary group. The degree of satisfaction, in cardiotomy procedures, was III or IV in patients having mitral valve replacement, aortic valve replacement, double valve replacement or dissecting aneurysm repair, and it was I or II in patients having ventricular septal defect repair, on the other hand. There was neither bleeding complication nor stenosis on the vent site. There was only one suspicious perfusion defect on routine postoperative perfusion lung scan. The study demonstrated that venting the pulmonary artery was very helpful in most of the procedures, because it was easy to reach, removal of the vent cannula was safe and simple and complications were trivial.
Adult ; Aneurysm, Dissecting ; Aortic Valve ; Catheters ; Constriction, Pathologic ; Coronary Artery Bypass ; Dilatation ; Hand ; Heart ; Heart Septal Defects, Ventricular ; Hemorrhage ; Humans ; Lung ; Mitral Valve ; Perfusion ; Pulmonary Artery* ; Thoracic Surgery

Bronchial artery embolization is well-accepted and widely used for management of massive and recurrent hemoptysis. This may either provide a definite therapeutic measure or a stabilizing effect on the patents in preparation for surgery. Retrospectively we reviewed 129 cases(106 patients) of bronchial artery embolization with Gelfoam pudding & Ivalon for control of hemoptysis from July 1985 to january 1991. The causes of hemoptysis were pulmonary tuberculosis(80.2%). Bronchiectasis(11.3%), asperigilloma(2.8%), and others(5.7%). The cases of pulmonary tuberculosis included tuberculous bronchiectasis (40.0%), active(34.1%), undetermined(14.1%) and inactive(11.8%). @ES The results were as follows: @EN Immediate control of hemoptysis was achieved in 104 of 122 cases(85.2%). Immediate control of massive hemoptysis was achieved in 94 of 107 cases(87.6%) and of chronic intermittent hemoptysis in 10 of 15 cases(76.0%). Hemoptysis recurred in 39 of 90 follow up cases(43.3%) on follow-up studies performed ranging in period from 2 to 49 month after the initial studies. Thirty three of 81 cases of massive hemoptysis recurred(40.7%) and six of 9 cases of chronic intermittent hemoptysis recurred(67.0%). One years rebleeding rate of massive hemoptysis was 34.6%. The rebleeding cases of massive hemoptysis were controlled by conservative treatment in 25 of 33 cases(75.8%). In conclusion. Bronchial artery embolization for hemoptysis control is effective in massive hemoptysis, but nearly ineffective in chronic intermittent hemoptysis, The goal of bronchial artery embolization is lifesaving procedure without permanent effect. Especially hemoptysis related to pulmonary tuberculosis.
Bronchial Arteries* ; Bronchiectasis ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Hemoptysis ; Retrospective Studies ; Tuberculosis, Pulmonary

Six patients with twenty histologically proven neurilemmomas of the extremities were studied using magnetic resonance(MR) imaging. The size, number, signal intensity on spin-echo T1WI(TR 500-650ms/TE 14-25ms)and gradient -echo (TR 200-600ms/TE 14-20ms; flip angle 25-30)image, enhancement pattern, detectability of nerve of origin, nerve-lesion relationship, and presence of a capsule were analyzed. The masses ranged from 1 to 12cm in longitudinal diameter and originated from the median nerve, ulnar nerve, sciatic nerve, radial nerve, and tibial nerve. All the nerve tracts except for those of 5 lesions, which could not be detected due to their small diameter, were visualized as low intensity tubular structures. All visible nerve tracts were situated along the periphery of the lesion and this finding was considered to be specific for neurilemmona. All neurilemmomas were isointense with the surrounding muscle on spin-echo T1WI and hyperintense on gradient-echo image. After a GD-DTPA injection, all masses showed moderate or marked enhancement and more prominent inhomogeneity than that on nonenhanced scan. In 19 out of 20 lesions(95%), a low signal intensity capsule surrounding the masses could be seen. Four of the six patients showed multiple masses, which was unusual as neurilemmoma usually arises as a solitary mass. In conclusion, the MR findings, especially the eccentric location of the mass lesion from the nerve of origin and the presence of a capsule, were useful in making a diagnosis of neurilemmoma of the extremity and that multiple neurilemmomas were not uncommon.
Diagnosis ; Extremities* ; Gadolinium DTPA ; Humans ; Median Nerve ; Neurilemmoma* ; Radial Nerve ; Sciatic Nerve ; Tibial Nerve ; Ulnar Nerve

The aim of this study was to characterize the morphology of a polycystic kidney which was found in 100% of the transgenic mice homozygous for inv mutation and to gain insight into the pathogenesis of inherited polycystic kidney disease during the pre- and postnatal periods. The fetal and postnatal kidneys from the homozygous and heterozygous transgenic mice were examined by the light, transmission and scanning electron microscopes, image analyzer, and an immunohistochemistry utilizing the antibodies specific for each segment of the renal tubules (Tetragonolobus purpureas, Arachis hypogaea, Tamm-Horsfall protein, AE1/AE3, EMA, vimentin, Phaseolus vulgaris) was performed to determine the site of origin of renal cysts. Two developmental phases of a cystic disease were identified. The first phase, seen in fetal kidneys, was characterized by dilatation mainly of the proximal tubules and a few distal tubules. The later phase, in postnatal period, was characterized by progressive enlargement of the kidneys due to mainly cystic change of the collecting ducts, which distorted the normal architecture of both cortex and medulla and almost completely replaced the renal parenchyma. The cystic dilatation involved all segments of the nephron and the collecting duct as well as the Bowman's spaces of glomeruli. The epithelial cell hyperplasia was found as a micropolyp formation within the renal cysts and an increase in PCNA positive cells. These findings suggest that a cyst is not simply a ballooning of a renal tubule and the stretching of cells, formerly thought to be due to an altered compliance of an abnormal basement membrane, but indeed the result of increased numbers of tubular epithelial cells.
Animals ; Antibodies ; Arachis ; Basement Membrane ; Compliance ; Dilatation ; Epithelial Cells ; Hyperplasia ; Immunohistochemistry ; Kidney ; Mice ; Mice, Transgenic* ; Microscopy, Electron ; Nephrons ; Phaseolus ; Polycystic Kidney Diseases* ; Proliferating Cell Nuclear Antigen ; Uromodulin ; Vimentin

No abstract available.
Humans ; Infant, Newborn* ; Tetralogy of Fallot*

No abstract available.
Liver*

BACKGROUND: Reactive oxygen free radicals have been implicated as an important factor in the development of ischemia-reperfusion injury of heart. Captopril, a SH-containing angiotensin converting enzyme(ACE) inhibitor has been reported to provide the protective effect in different models of myocardial ischemia and reperfusion injury of animal hearts. It is postulated that the myocardial protective effect may be related to a potential anti-free radical effect independent of ACE inhibition. The present study was designed to elucidate the myocardial protective mechanism of Captopril by investigating the drug effect on the experimentally induced oxygen free radical-mediated myocardial injury in isolated hearts of rats. METHODS: The heart isolated from rat was perfused retrogradly by Langendorff method. Myocardial dysfuntion was induced by oxygen free radicals generated by electrolysis of the perfusing solution(Kreb-Henseleit) with 2mA direct current for 45 sec. The cardiac functions(left ventricular pressure, dP/dt, heart rate, coronary flow) and the ventricular content of a lipid peroxidation product, malondialdehyde(MDA) were measured under presence of absence of Captopril and the compairing drugs(enalaprilat, cysteine and dithiothreitol). RESULTS: Electrolysis of oxygen-saturated Krebs-Henseleit perfusing solution led to the production of superoxide anion increasingly with intensity and duration of the applied electric current. The hearts perfused with the electroyzed solution demonstrated significant decrease in left ventricular pressure, dp/dt, heart rate, coronary folw and increase in myocardial MDA content. The depression of myocardial function as well as the increase of MDA content and oxygen radical production were reversed by Captopril(0.75~2mM) dose-dependently. Enalaprilat, a non-SH containing ACE inhibitor, however, showed no protective effect at all. Cysteine and dithiothreitol, the SH-containing agents without ACE inhibitory action showed also protective effects on the myocardial depression induced by electrolysis. CONCLUSION: It is suggested that Captopril may exert protective effect on oxygen radical-mediaed myocardial injury probably by its antioxidative and anti-free radical mechanism related to SH-group.
Angiotensins ; Animals ; Captopril* ; Cysteine ; Depression ; Dithiothreitol ; Electrolysis ; Enalaprilat ; Free Radicals ; Heart ; Heart Rate ; Lipid Peroxidation ; Myocardial Ischemia ; Oxygen ; Rats ; Reperfusion Injury ; Superoxides ; Ventricular Pressure

A case of acquired lymphangioma was reported and the literature was reviewed. The patient was 28 yeara old pregnant woman at 7 months gestation who develo- ped multiple white-gray tense vesicles measuring 2-4mm in diameter on bilateral major labia following lymphedema of the lower extremities due to tubercuIous inguinal lymphadenitis.
Female ; Humans ; Lower Extremity ; Lymphadenitis ; Lymphangioma* ; Lymphedema ; Pregnancy ; Pregnant Women ; Transcutaneous Electric Nerve Stimulation