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

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

No abstract available.
Myxoma*

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

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: 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*

BACKGREOUND: The pneumonectomy may depress the right ventricular (RV) function transiently. The thermodilution ejection/volumetric catheter is known to be most useful method assessing the changes in RV performance during pulmonary resection. The purpose of this study was to examine the RV function during and immediately after pneumonectomy using thermodilution methods. METHODS: 16 patients undergoing pneumonectomy were studied. After induction of anesthesia, a multilumen thermodilution catheter mounted with a rapid response thermister was inserted. Using computer system, RV ejection fraction (RVEF), cardiac output, and RV end-diastolic volume (RVEDV) were measured when the patient was in lateral position (control), after one lung ventilation (OLV) and the main pulmonary artery ligated, and at the completion of resection. Arterial blood gases were analyzed and pulmonary vascular resistance (PVR) was calculated. RESULTS: Systolic pulmonary blood pressure (SPAP)(28.3 +/- 6.2 mmHg) increased compared to the control (24.6 +/- 5.9) without a significant change of PVR. No statistically significant difference was found in either RVEF or RVEDV at each times. CONCLUSIONS: Our study demonstrate the pneumonectomy do not depress the RV function immediately and RVEF do not show any correlation with PVR or RVEDV.
Anesthesia ; Blood Pressure ; Cardiac Output ; Catheters ; Computer Systems ; Gases ; Humans ; One-Lung Ventilation ; Pneumonectomy* ; Pulmonary Artery ; Thermodilution ; Vascular Resistance ; Ventricular Function, Right*

A 46-year-old woman was admitted with an ulcerative lesion on the posterior neck. Four months before admission, the patient took part in a faith healing ritual, which the pastor performed with his fingernails causing wounds. This abnormal method of healing caused repeated injury to the patient in the posterior neck area. Treatment with cefazolin was begun, but the lesion did not improve. Biopsy of the skin lesion and cervical lymph nodes was performed. Microscopical examination revealed findings highly suggestive of syphilis. Serological tests for syphilis were positive and a computed tomographic (CT) scan of the neck showed enlargement of regional lymph nodes and tonsils. A single dose of penicillin G 2.4 million units was given intramuscularly. Two weeks later, the wound had healed. Eight weeks after treatment, the Venereal Disease Research Laboratory titer had decreased and a CT scan of the neck showed a decrease in the size of the lymph nodes. We reasoned that syphilis was non-sexually transmitted, and that the healing ritual was the cause. Our case suggests that skin trauma by scratching with the fingernails may cause an accidental direct inoculation of Treponema pallidum, resulting in extragenital primary syphilis.
Biopsy ; Cefazolin ; Faith Healing ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Nails* ; Neck ; Palatine Tonsil ; Penicillin G ; Serologic Tests ; Sexually Transmitted Diseases ; Skin ; Syphilis* ; Tomography, X-Ray Computed ; Treponema pallidum ; Ulcer ; Wounds and Injuries