Intravenous administration of high dose of fentanyl is gaining wide popularity as the sole anesthetic agent for patients undergoing cardiac surgery because of its favorable characteristics such as, simplicity, stable hemodynamics and supression or modification of stress response to surgery. But some investigators reported the necessity of supplementary anesthetic agent in addition to fentanyl to maintain hemodynamic stability during the surgical procedure. Therefore, we measured the heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure(MAP), and rate pressure product(RPP) at induction, tracheal intubation, skin incision, and sternotomy time to evaluate the cardiovascular responses to surgical procedure under fentanyl-O2 anesthesia on 12 patients with acquired valvular heart disease. The patients were anesthetized with a loading dose (30ug/kg fentanyl for induction and 1.5ug/ kg/min until sternotomy) followed by continuous infusion of fentanyl (0.3pg/kg/min until the end of cardiopulmonary bypass.) The patients required total doses of 108+/-4.6ug/kg fentanyl for the entire operation. These measurements were compared with control data (before induction). The results were as followings: 1) During induction (infusion of fentanyl 30ug/kg), HR, SBF, DBP, MAP, and RPP revealed no significant change compared with control data. 2) During intubation and skin incision, HR, SBP, DBP, MAP, and RPP slightly increased but were not statistically significant (p>0.05) 3) During sternotomy, SBP increased from 119.8+/-16.36 torr to 136.5+/-15.22 torr, DBP increased from 79.1+/-12.76 torr to 95.4+/-10.87 torr, MAP increased from 99.4+/-13.96 torr to 115.5+/-12.70 torr, and RPP increased from 10929+/-2206 torr.beats/min to 13889+/-2865 torr. beats/min (p<0.05). HR increased from 90.7+/-8.71 beats/min to 100.2+/-13.79 beats/min, but was not statistically significant(p> 0.05). 4) One of the patients had recall of the sternotomy and spreading of the chest with the sternal retractor. These data demonstrate that anesthetic doses of fentanyl and O produce minimal change in cardiovascular dynamics during the surgical procedures except sternotomy time. Our findings suggest that fentanyl-O2 anesthesia may be an attractive anesthetic technique in patients with valvular heart disease undergoing valve replacement operations but, will be needed considerations about infusion method, dosage of fentanyl and use of supplementary anesthetic agent according to patients conditions.
Administration, Intravenous ; Anesthesia* ; Anesthetics ; Fentanyl* ; Heart ; Heart Valve Diseases ; Hemodynamics ; Humans ; Intubation ; Methods ; Research Personnel ; Skin ; Sternotomy ; Thoracic Surgery ; Thorax

The development of antibody titers and cross reation between Sarcocystis and Toxoplasma were investigated by means of IFA test and ELISA in pigs experimentally infected with 1.5 x 10(6) S. suicanis sporocysts and 10,000 T. gondii oocysts, respectively. The intact and soluble Sarcocystis antigens were prepared from the bradyzoites harvested by peptic digestion of infected pork. The intact and soluble Toxoplasma, antigens were prepared from the tachyzoites in mouse peritoneal cavity. IgG antibodies in pigs infeded with Sarcocystis and Toxoplasma, respectively were detected first at 2 weeks post infection on both IFA test and ELISA. The antibody titer to Toxoplasma reached its maximum at 6 weeks post infection and decreased thereafter. The antibody titer to Sarcocystis reached its maximum terminally. The cross-reaction titer in pigs infected with Toxoplasma against Sarcocystis antigen was up to 1:16 in IFA test and up to 1:32 in ELISA. The titer in control group was below 1:4 in both reactions.
parasitology-protozoa ; Toxoplasma gondii ; Sarcocystis suicanis ; immunology ; diagnosis ; immunofluorescence ; enzyme-linked immunosorbent assay

Thromboembolism is the most common serious complication following total hip arthroplasty and most common cause of death after total hip arthroplasty. A prospective randomized study in 170 cases of elective cementless total hip arthroplasty was carried out to examine the incidence of deep vein thrombosis and pulmonary embolism after cementless total hip arthroplasty from Aug. 1993 to May 1995. Laboratory study, clinical symptoms and signs, chest roentgenograph and precipitating factors were analysed. Venography and lung perfusion scan using radionuclide scan were used for this study. The weight, height, sex, habitus of alcohol and smoking, hypertension, diabetes mellitus, previous operation history of ipsilateral lower extremity, etiology of hip joint disease, and transfusion of blood were not precipitating factors, but the age over 40 and previous history of pulmonary embolism had a significant effect on the incidence of deep vein thrombosis. There was no significant relationship between the incidence of deep vein thrombosis and the laboratory assay, clinical symptoms and signs. Deep vein thrombosis was detected in 29 cases(17.0%), pulmonary embolism in 22 cases(12.9%), and fatal pulmonary embolism in 1 case(0.6%). The most common location of deep vein thrombosis was the popliteal area.
Arthroplasty, Replacement, Hip* ; Cause of Death ; Diabetes Mellitus ; Hip Joint ; Hypertension ; Incidence ; Lower Extremity ; Lung ; Perfusion ; Phlebography ; Precipitating Factors ; Prospective Studies ; Pulmonary Embolism* ; Smoke ; Smoking ; Thorax ; Thromboembolism ; Venous Thrombosis*

No abstract available.
Leiomyosarcoma* ; Rectum*

The internal morphology of the right and left atria of rabbit, cat, pig, and human, particularly on the luminal structures of the auricle, were observed by stereomicroscope improving corrosion casting method using latex. Structures of the right auricular casts markedly differ from those of the left side, consisting of defined surface sturctures with distinct folds and branching patterns. The main atrial region consists of smooth surfaced single mass of the latex, and the auricular region is characterized by well developed branching patte and delicate small folds. The results of this study indicate that auricula have well organized duct-like luminal structures and many small pouches (out-pocketings) expanding the internal wall of the duct-like structures and small pouches. The endocardial nuclear imprints on the surface of the folds in the auricular region appeared larger and deeper than those on the atrium proper region of the atrial cast. These morphological observation will be aid in understanding structures of auricular lumen, regional differences of the endocardium and their function to the secretory process of atrial natriuretic peptide (ANP) release.
Animals* ; Cats ; Corrosion Casting* ; Corrosion* ; Endocardium ; Humans ; Latex ; Methods* ; Phenobarbital* ; Secretory Pathway

Pregnancy-induced osteoporosis is a rare disorder characterized by fragility fracture and low bone mineral density (BMD) during or shortly after pregnancy, and its etiology is still unclear. We experienced a case of a 39-year-old woman who suffered from lumbago 3 months after delivery. Biochemical evidence of increased bone resorption is observed without secondary causes of osteoporosis. Radiologic examination showed multiple compression fractures on her lumbar vertebrae. We report a case of patient with pregnancy-induced osteoporosis improved her clinical symptom, BMD and bone turnover marker after teriparatide therapy.
Adult ; Bone Density ; Bone Resorption ; Female ; Fractures, Compression ; Humans ; Low Back Pain ; Lumbar Vertebrae ; Osteoporosis* ; Pregnancy ; Teriparatide*

Focal nodular hyperplasia (FNH) is a benign hepatic tumor that likely represents a local hyperplastic response of hepatocytes to a congenital vascular anomaly. The histological feature of focal nodular hyperplasia is dominated by a progressive fibrotic process. Focal lesions of the liver represent a significant diagnostic problem for various imaging modalities. Because of that, in some cases, the distinction between focal nodular hyperplasia and other primary hepatic neoplasms is not possible. In the present report, we describe focal nodular hyperplasia observed in three patients with and without chronic liver disease. These patients were disclosed by various imaging procedures. Under the clinical impression of a hepatocellular carcinoma, operations were performed. The results were consistent with the typical observation in focal nodular hyperplasia. We report three cases of focal nodular hyperplasia of the liver mimicking hepatocellular carcinomas in patients with and without chronic liver disease.
Carcinoma, Hepatocellular ; Focal Nodular Hyperplasia* ; Hepatocytes ; Humans ; Liver Diseases ; Liver Neoplasms ; Liver*

No abstract available.
Humans ; Insulin Resistance* ; Insulin*

Renal angiomyolipoma is a relatively uncommon benign tumor and may be associated with tuberous sclerosis, which is characterized by adenoma sebaceum, epilepsy and mental retardation. When a renalangiomyolipoma occurs with tuberous sclerosis, it can be easily diagnosed and the incidence of multiple and bilateral angiomyolipoma is high in patients with multiple sclerosis. Recently we experienced a case of unilateral renal angiomyolipoma associated with tuberous sclerosis which occurred in a 38 year-old housewife, who had right flank mass, adenoma sebaceum on the face, shagreen patches of the back and sublingual fibromas. So we report a case of unilateral renal angiomyolipoma associated with tuberous sclerosis with review of literatures.
Adult ; Angiomyolipoma* ; Epilepsy ; Fibroma ; Humans ; Incidence ; Intellectual Disability ; Multiple Sclerosis ; Tuberous Sclerosis*

BACKGROUND: Ventrlcular tachyarrhythmias are major cause of sudden cardiac death in patients after myocardial infarction and their accurate detection seems to be important in prevention of sudden cardiac death. Clinical findings, treasmill test, holter monitoring and coronary angiography have been used to search for high risk group in sudden cardiac death. Recently electrographysiologic stimulation has been to this, but it is not practical, because of high cost and invasiveness. Signal averaged electrocardiogram(SAECG) may be helpful in prediction of high risk group in sudden cardiac death. So we try to know the values of SAECG in Korean patients without heart disease. RESULTS: 1) The mean value and standard deviation of Time domain analysis is as follows ; fQRS : 106.8+/-12.3ms, RMS : 36.2+/-21.5(micro)V, LAS : 27.2+/-8.1ms. 2) The mean value and standard deviation of Spectral turbulence analysis is a follows ; LSCR : 58.6+/-3.9, ISCM : 95.2+/-0.8, ISCSD : 71.8+/-15.7, SE : 6.9+/-1.8. CONCLUSION: There was no significant difference between male and female. Time domain analysis shows significant differences among each hour but spectral turbulence analysis did not. Spectral turbulence analysis shows high specificity.
Coronary Angiography ; Death, Sudden, Cardiac ; Electrocardiography* ; Electrocardiography, Ambulatory ; Female ; Heart Diseases* ; Heart* ; Humans ; Male ; Myocardial Infarction ; Sensitivity and Specificity ; Tachycardia