BACKGROUND AND OBJECTIVES: Perfluorocarbon exposed sonicated dextrose albumin (PESDA) microbubbles has been suggested to facilitate thrombus disruption under the transcutaneous ultrasound (US). Thus, we investigated whether such a noninvasive approach could augment thrombolytic effect of fibrinolytic agent in an experimental thrombotic model. MATERIALS AND METHODS: Thrombus formation was induced with electrical injury in the rabbit iliofemoral arteries (n=20): Thrombus occlusion was documented by angiography in all arteries. In the control group, only tissue plasminogen activator (t-PA, 3 mg/kg) was administered intrav-enously in five rabbits. In the Group 1 (n=9), injured arteries were exposed to transcutaneous US (20 kHz, 30 W/cm2, continuous mode) with t-PA (3 mg/kg). In the Group 2 (n=6), the same treatment was given while administering PESDA continuously (10 ml/min, intravenous). Angiographic results were evaluated at 10 minute interval for 1 hour respectively. RESULTS: In the control group, two of five iliofemoral arteries (40.0%) were recanalized and one of nine iliofemoral arteries (11.1%) was recanalized in Group 1. In contrast, four of six iliofemoral arteries (66.7%) were recanalized angiographically in Group 2 (p=0.392 vs. control group: p=0.047 vs. Group 1). However, late reocclusion occurred in all iliofemoral arteries of Group 2. CONCLUSION: Although PESDA with transcutaneous US significantly enhanced initial angiographic patency rate of t-PA, it was associated with high rate of reocclusion. Further studies will be necessary for clinical application of this noninvasive method in acute arterial occlusion.
Angiography ; Arteries ; Glucose* ; Microbubbles ; Rabbits ; Thrombolytic Therapy* ; Thrombosis ; Tissue Plasminogen Activator ; Ultrasonography*

Mucoceles usually occur as solitary, asymptomatic, translucent, and dome-shaped cysts containing clear viscous fluid on lower lip or oral mucosa. The authors reviewed the clinical and histopathological findings in 33 patients with mucocele and attempted to clarify the difference between the histopathologic types (retention and extravasation). The results were summarized as follows. 1. Age distribution was from 2 to 53 years and mean age was 21.4 years. Male to female ratio was 1.2:1(18 males.15 females). 2. Histopathologic type was classified. 4 cases(12.1%, mean age.17.3 years) were retention type, 19 cases(57.6%, mean age.'21.5 years) mixed type, and 10 cases(30.3 %, mean age.20.9 years) extravasation type. Among 19 mixed types, 13 cases were retention dominant and 6 cases extravasation dominant. 3. Durations from the onset to the diagnosis could be clarified in 16 cases. Those were below 1 year in 14 cases(87.5% ) and below 3 years in 16 cases all. Mean duration was 9.4 months. 4. The sites of involvement were lower lip(72.7%), tongue(24.3%), and oral mucosa(3.0%), in decreasing order of frequency. 5. The visited departments were otolaryngology(72.7%), dentistry(12.1%), plastic surgery(9,1%) and dermatology(6.1%), in decreasing order of frequency. 6. In the histopathologic observation, surface epithelium was observed in 25 cases (75.8%), cyst in 23 cases(69.7%), granlation tissue in 29 cases(87.9%), mucin in 28 cases(84.8%), surrounding salivary glands in 20 cases(60.6%) and foamy macrophages in 32 cases(97.0% ), 7. Special stains(PAS, D-PAS, and alcian blue at pH2.5 and 0.4) for the mucin were performed in 10 cases. The results were compatible with sialomucin.
Age Distribution ; Alcian Blue ; Diagnosis ; Epithelium ; Female ; Humans ; Lip ; Macrophages ; Male ; Mouth Mucosa ; Mucins ; Mucocele* ; Salivary Glands ; Sialomucins

No abstract available.
Hypopigmentation*

No abstract available.
Calcium Gluconate* ; Calcium*

No abstract available.
Endometriosis* ; Female ; Humans ; Hyperplasia* ; Leiomyoma*

BACKGROUND: Spontaneous echo contrast (SEC) of the left atrium (LA) is associated with increased risk of thromboembolism in patients with mitral stenosis(MS). The determination of the presence and severity of LA spontaneous echo contrast(SEC) is of prognostic importance in these patients. Harmonic imaging(HI), a novel echocardiographic technique that differs from conventional fundamental imaging(FI) by transmitting ultrasound at one frequency and receiving at twice the transmitted frequency, produces better endocardial border definition and myocardial opacification. However, there are no data about its value on the detection of LA SEC. The purpose of this study was to investigate the utility of transthoracic noncontrast HI in the detection of LA SEC in patients with. METHODS: Seventy-four consecutive patients with MS (49 female, mean age 51) underwent standard transthoracic echocardiograms (TTE) in both HI and FI and transesophageal echocardiography (TEE) to determine the presence and severity of LA SEC. LA SEC was graded by TEE; mild if only seen at high gain, severe if visible in the entire LA at normal gain control of the equipment. Control subjects comprised of 30 patients randomly selected from patients who did not have LA SEC at TEE examination. RESULTS: Atrial fibrillation was found in 46 patients (62.2%). The mean mitral valve area and mean mitral gradient were 1.0+/-0.3cm2 and 8.2+/-4.1mmHg, respectively. Nine patients (12.2%) had episodes of systemic embolism; stroke in 8 and peripheral embolism in 1. LA thrombus was found in 11 patients (14.9%) by TEE. LA SEC was present in all but one patient by TEE (mild in 35, severe in 38 patients). FI of TTE, however, revealed LA SEC in only 5 (6.8%) of the 73 patients. In contrast, in HI, LA SEC could be detected in 63 (86.3%) of the 73 patients. In the detection of severe LA SEC, the sensitivity of FI and HI were 13.2% (5/38) and 100% (38/38), respectively. LA SEC was not observed in control subjects either by FI or HI. CONCLUSION: Transthoracic HI significantly enhances the detection of LA SEC in patients with MS.
Atrial Fibrillation ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Female ; Heart Atria ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Stroke ; Thromboembolism ; Thrombosis ; Ultrasonography

BACKGROUND: The estimation of coronary flow velocity(CFV) is essential for assessing the impaired coronary flow reserve in patients whith angina pectoris and normal coronary arteries. But, intracoronary blood flow velocity measurement remains invasive,requiring cardiac catheterization and can not be repeated without risk during serial follow-up study. Transesophageal Doppler echocardiography(TEE) is a new noninvasive method of assessing CFV in the proximal portion of left anterior descending coronary artery. This study was performed to clarify the value of TEE in evaluating CFV, to compare the coronary flow patterns among various cardiac diseases, to estimate the coronary flow dynamics according to change of blood pressure, and to evaluate the parameters influencing CFV. METHODS: We studied 95 subjects, 51 men and 44 women, mean age 46. Normotensive subjects were 29, hypertensive patients 41, aortic stenosis 5, aortic regurgitation 4, mitral stenosis 8, and others 8. After transthoracic echocardiography(H-P Sonos 1000,2.5 MHz), transesophageal echocardiography was performed using a 5-Hz(omniplane)transesophageal probe connected to a H-P Sonos 1000 to assess CFV in the proximal portion of left anterior descending coronary artery. Doppler evaluation of left anterior descending coronary blood flow velocity was obtained in restiong conditions and after sublingual administraion of nitroglycerim(0.6mg), Blook pressure and heart rate were monitored thoughout the entire procedure. RESULTS: 1) The detection rate of CFV by TEE was 89.5%. 2) The morphology of CFV in proximal left anterior descending coronary artery was biphasic(greater diastolic and smaller systolic). 3) The baseline CFV in hypertensive patients was greater than in normotensive subjects(p<0.05) but there was no difference between two groups in diastolic/systolic CFV ratio. 4) The diastolic CFV and diastolic/systolic CFV ratio in patients with aortic stenosis were greater than in normotensive subjects(p<0.05). 5) The CFV was significantly decreased after administration of nitroglycerin(p<0.05) and the decrement of CFV correlated closely with the decrement of systolic(r=0.65, p<0.05) and diastolic blood pressure(r=0.57, p<0.05). 6) Major parameters influencing CFV were systolic blood pressure and heart rate. CONCLUSION: The CFV is influenced by various parameters and the TEE may be a useful, noninvasive tool to investigate the coronary flow dynamics.
Angina Pectoris ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Blood Flow Velocity ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Echocardiography, Doppler* ; Echocardiography, Transesophageal ; Female ; Follow-Up Studies ; Heart Diseases ; Heart Rate ; Humans ; Male ; Mitral Valve Stenosis

Wegener`s granulomatosis (WG) is a multisystem disorder of unknown origin characterized by necrotizing granulomatous vasculitis. WG usually affects the upper respiratory tract, lungs, and kidneys with focal glomerulonephritis, but almost any organ can be affected. The ureter is primarily an unusual location for lesions of WG. A 30-year-old woman presented with intermittent right flank pain and hematuria. A renal ultrasound demonstrated unilateral hydronephrosis and a retrograde pyelography revealed a filling defect at right mid ureter and a computed tomography displayed marked concentric thickening of the right ureteral wall which was mimicking ureteral tumor. At nephroureterectomy, the right ureter was found to be obstructed by dense, intramural fibroinflammatory reaction. There was a necrotizing granulomatous vasculitis in the muscle layer of the ureter. Our case represents the rare occurrence of WG presenting ureteral bstruction.
Adult ; Female ; Flank Pain ; Glomerulonephritis ; Hematuria ; Humans ; Hydronephrosis ; Kidney ; Lung ; Respiratory System ; Ultrasonography ; Ureter* ; Urography ; Vasculitis

No abstract available.
Bronchoscopes*

No abstract available.
Eosinophilic Granuloma* ; Eosinophils* ; Lymph Nodes*