No abstract available.
Bile* ; Biliary Tract Diseases* ; Biliary Tract*

No abstract available.
Myxoma*

No abstract available.
Colorectal Neoplasms* ; Electrophoresis* ; Genes, ras* ; Humans* ; Point Mutation* ; Polymerase Chain Reaction*

We encountered a case of neonatal altoimmune thrombocytopenia(NAIT) due to anti-HLA-B7+B60+B61. Bilateral cephal hematoma and umbilical hematoma were noted at the time of birth. Purpura developed at the third day. Platelet count was 110,000 at birth and decreased to 66,000/micro liter at the day 4. Prothrombin time and partial prothrombin time were within normal limit. The mother's platelet count was 220,000/micro liter and she had no history of abnormal bleeding. Platelet antibody tests empolying mixed passive hemagglutination and immunofluorescence revealed that the mother's serum was reactive against the platelets from the father and the neonate, but was not reactive with her own platelets. Platelets from eight volunteer group 0 donors were tested with the mother's serum; seven were reactive and one was negative. The positive reactions were lost after chloroquine treatment of platelets. Antigen capture ELISA(ACE) and modified antigen capture ELISA employing monoclonal antibodies against platelet glycoproteins In, IIa, IIb, and IIIa were negative. Mother's serum was tested for lymphocytotoxicity against 49 donor ]ymphocytes and the specificity was found to be anti-HLA-B7+B60+B61. At the 9th day, one unit of platelet concentrate from the mother was transfused and the platelet count of the neonate rose up to 340,000/micro liter. The neonate was discharged at the day of sixteenth and the platelet count remained high thereafter.
Antibodies, Monoclonal ; Blood Platelets ; Chloroquine ; Enzyme-Linked Immunosorbent Assay ; Fathers ; Fluorescent Antibody Technique ; Hemagglutination ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Membrane Glycoproteins ; Prothrombin Time ; Purpura ; Sensitivity and Specificity ; Thrombocytopenia* ; Tissue Donors ; Volunteers

BACKGROUND: Recently, measurement of heart rate variability and the nonlinear complexity of heart rate dynamics have been used as indicators of cardiovascular health. Hypertensive patients showed alternation of cardiovascular homeostasis. We designed this study to evaluate the effect of anesthesia in hypertensive patients with approximate entropy (ApEn), representing the nonlinear complexity. METHODS: With informed consent, none premedicated normotensive (n=18) and hypertensive patients (n=18) were included in this study. ECG data were collected from 10 minutes before induction to 15 minutes after induction. Collected ECG data were stored into computer binary files. We calculated ApEn from the collected ECG data. RESULTS: Before induction, ApEn of hypertensive patients was significantly lower than that of normotensive patients (p<0.05). During induction and maintenance of anesthesia, there was no difference of ApEn between the two groups. ApEn of normotensive patients during induction and maintenance of anesthesia was significantly lower than that of pre-induction (p<0.05). ApEn during maintenance of anesthesia was lower than that of induction of anesthesia (p<0.05). ApEn of hypertensive group during maintenace of anesthesia was significantly lower than that of pre-induction of anesthesia (p<0.05). CONCLUSIONS: As the ApEn of hypertensive patients is lower than that of normotensive patients during pre-inducton period, the heart rate dynamics of hypertensive patients is more regular normotensive patients. The anesthesia is deepened, the heart rate dynamics of the both group is more regular. During the maintenance of anesthesia, the regularity of the heart rate dynamics that not different in both group from the results.
Anesthesia* ; Electrocardiography ; Entropy* ; Heart Rate ; Homeostasis ; Humans ; Hypertension* ; Informed Consent

BACKGROUND: Vasoconstricting drugs such as dopamine, phenylephrine (PE) and epinephrine constrict normoxic lung vessels preferentially, thereby disproportionately increasing normoxic lung pulmonary vascular resistance (PVR) and inhibit hypoxic pulmonary vasoconstriction (HPV). In this study, we evaluated the effect of PE on HPV and arterial oxygenation. METHODS: This study was performed on 21 patients undergoing thoracotomy. After induction of anesthesia, Swan-Ganz catheter was inserted. After one lung ventilation was started, systolic blood pressure (SBP) of the patient was reduced to 100 mmHg using inhalation anesthetic agent and then the blood pressure was raised up to 140 mmHg by PE infusion. Hemodynamic variables were measured and arterial blood gas was analyzed at the start of one lung ventilation (control), SBP of 100 mmHg and SBP of 140 mmHg. RESULTS: The mean dose of PE infused was 5.9 +/- 3.8 microgram/kg. Infusion of PE did not increase pulmonary vascular resistant index (PVRI) significantly and did not reduce arterial PO2. There was no statistically significant difference in intrapulmonary shunt fraction (Qs/Qt) between the time of low and high blood pressures. CONCLUSION: Pulmonary vasomotor changes induced by PE are minimal and so should not affect the distribution of blood flow during one lung ventilation. On the basis of this result, PE appears to a reasonable vasoconstrictor to be used in patients undergoing thoracotomy.
Anesthesia ; Blood Pressure ; Catheters ; Dopamine ; Epinephrine ; Hemodynamics ; Humans ; Hypertension ; Inhalation ; Lung ; One-Lung Ventilation* ; Oxygen* ; Phenylephrine* ; Thoracotomy ; Vascular Resistance ; Vasoconstriction*

BACKGROUND: The early stage of Alzheimer disease might show early memory impairment with normal general cognitive function. Our study aimed to investigate elderly with normal Korean version of mini-mental state examination (K-MMSE) score and recall score of 0 for 1 year. We predicted that the patients would show different characteristics and would progress more rapidly compared with normal controls. METHODS: This study was based on the data from complete enumeration survey of Mapo-gu Regional Center for Dementia in 2009. We divided all subjects into three groups: subjects with normal K-MMSE scores and recall score of 0 were group 1-1 (n=152), subjects with abnormal K-MMSE scores were group 1-2 (n=64) and subjects with normal K-MMSE scores and recall score of 1 to 3 were group 1-3 (n=941). We compared basic demographics and social characteristics among the three groups. After 1 year (2010), the subjects in group 1-1 (90 out of 152) underwent follow-up examinations for dementia diagnosis. They were also divided into three groups (2-1, 2-2, 2-3) according to K-MMSE and recall scores. RESULTS: Group 1-1 showed different baseline characteristics compared with normal controls. After 1 year, 25.5% (23 out of 90) of the group 2-1 were diagnosed as mild cognitive impairment (n=16) or dementia (n=7). CONCLUSION: Our study suggested that subjects with normal K-MMSE scores but recall score of 0 are not entirely "normal". Further detailed evaluation might be needed if memory impairment is suspicious although the K-MMSE scores are within normal range.
Aged* ; Alzheimer Disease ; Dementia* ; Demography ; Diagnosis* ; Follow-Up Studies* ; Humans ; Memory ; Mild Cognitive Impairment ; Pilot Projects* ; Reference Values ; Sociology

BACKGROUND: In the acute phase of myocardial infarction, the hemostatic mechanism is known to be activated. However, it remains unclear whether increased activity of the hemostatic mechanism is only a marker of the acute thrombotic episode or precedes its appearance. It is also inapparent whether a hypercoagulable state persist for a prolonged period after the apparent resolution of these disorders. METHODS: In a group of 23 patients with acute myocardial infarction who received fibrinolytic therapy with urokinase(group A) or tPA(group B), the plasma level of fibrinogen, antithrombin compared to those of the 10 normal controls. RESULTS: The plasme level of fibrinogen was significantly decreased in both group A and B before and 4 to 24 hours after thrombolytic therapy compared to that of normal controls. But it was increased 7 to 14 days after thrombolytic therapy. In a few of the patients, the plasma level of FDP and D-dimer were positive before thrombolytic therapy and in the most patients they were positive 4 hours after thrombolytic therapy. The plasma level of AT-III was significantly increased in both group A and B before thrombolytic therapy compared with that of normal controls, but, after thrombolytic therapy, there was no significant change in its level. CONCLUSIONS: In the patients with acute myocardial infarction, the thrombolysis occurred before thrombolytic therapy and it lasted for 24 hours after thrombolytic therapy.
Antithrombin III* ; Fibrinogen ; Humans ; Myocardial Infarction* ; Plasma ; Thrombolytic Therapy*

BACKGROUND/AIMS: Hypoxemia is often associated with liver cirrhosis without cardiopulmonary diseases. Pulmonary vascular impairments including intrapulmonary shunt have been considered as a major mechanism of hypoxemia. The aim of this study was to determine the incidence and pathophysiologic basis of hypoxemia in cirrhotic patients without respiratory symptoms. METHODS: In fourty three cirrhotic patients without heart and lung diseases, we performed the arterial blood gas analysis and calculated alveolar arterial oxygen gradient (A-aO2). According to the A-aO2, the patients were divided into hypoxemic and normoxemic groups. In each group, a Tc-99m-macroaggregated albumin (Tc-99m-MAA) scan, a contrast-enhanced echocardiography and a pulmonary function test were performed. RESULTS: Twenty-eight of 43 patients (65%) showed hypoxemia. Hypoxemic patients showed significantly more increased shunt fraction of 3.1 1.4% than normoxemic one of 2.1 1.1% in the Tc-99m-MAA scan (p<0.05). However, only two of hypoxemic patients had shunt fraction above physiologic shunt range. By contrast-enhanced echocardiography, an intrapulmonary shunt was confirmed in one patient. There was no significant correlation between the shunt fraction and the hepatic reserve based on the Child-Pugh classification in hypoxemic patients. In the results of pulmonary function test, only DLco decreased more significantly in hypoxemic group than in normoxemic group (58.4 14.2 % vs 75.3 16.5% of predicted, p<0.05). CONCLUSIONS: Hypoxemia is not infrequently observed in cirrhosis, but incidence of significant intrapulmonary shunt is low. Therefore, other mechanism such as diffusion defect may be suggested to play a role in the development of hypoxemia in cirrhotic patients without respiratory symptoms.
Anoxia ; Blood Gas Analysis ; Classification ; Diffusion ; Echocardiography ; Fibrosis ; Heart ; Humans ; Incidence ; Liver Cirrhosis* ; Liver* ; Lung Diseases ; Oxygen ; Respiratory Function Tests ; Technetium Tc 99m Aggregated Albumin

PURPOSE: We assessed the correlation between ocular abnormalities and the degree of intraocular pressure (IOP) in the DBA/2J (D2) transgenic mice which were proven to have pigmentary dispersion syndrome and developing glaucoma. METHODS: Nine-months-old D2 mice were examined with biomicroscopy under anesthesia and measured for IOP by Tono-Pen, Hematoxylin and eosin staining was performed on the eye sections of the mice to analyze differences between the low-grade IOP group and the high-grade IOP group. RESULTS: Ocular abnormalities including iris pigment loss, iris transillumination, iris stromal atrophy, anterior synechia, thinning of the retina, and ganglion cell loss were found; all of which appeared to be pressure- dependent. CONCLUSIONS: These results corroborate that both IOP and age might be considered for studies using D2 mice, and suggest that D2 mice are a useful glaucoma model to study the mechanisms of retinal ganglion cell death and to evaluate strategies for neuroprotection.
Anesthesia ; Animals ; Atrophy ; Eosine Yellowish-(YS) ; Ganglion Cysts ; Glaucoma ; Hematoxylin ; Intraocular Pressure* ; Iris ; Mice* ; Mice, Transgenic ; Retina ; Retinal Ganglion Cells ; Transillumination