No abstract available.
Bile Ducts* ; Bile* ; Choledochal Cyst*

No abstract available.
Recurrence* ; Seizures, Febrile*

A case of anesthesia for a patient of "pulaeless disease" (Takayasu's disease) was reported. During her general anesthesia, blood pressure was measured at the femoral artery by auscultatory method. There are numerous problems to evaluate the result of indrect measurements of arterial blood pressure obtained by auscultatory method. For accurate measurements of blood pressure, the relationship between the circumference of the arm and the blood pressure should be considered, which was emphasized by Ragan and Bordley. The auscultatory method of blood pressure measurement was reviewed.
Anesthesia* ; Anesthesia, General ; Arm ; Arterial Pressure ; Blood Pressure ; Femoral Artery ; Humans ; Takayasu Arteritis*

PURPOSE: Atrial ectopic tachycardia (AET) in older children and adult is characterized by being chronic, incessant and intractable. However, the nature of infantile AET is not defined yet. The purpose of this study was to evaluate our experience of infantile AET. METHODS: We retrospectively reviewed the medical records of 13 infants (mean onset age, 2.8 +/- 2.3 months) diagnosed at Seoul National University Children's Hospital from June, 1988 to June, 1996. Multifocal atrial tachycardia (AT) and postoperative AT were excluded. RESULTS: AET was presented with congestive heart failure in 8, fast heart rate in 4 and associated cardiac defect in 1. During tachycardia, atrial rates ranged 150-300 beats/min (mean +/- SD, 214 +/- 45 beats/min). Four had associated cardiac anomalies: atrial septal defects in 3, multiple cardiac tumor associated with tuberous sclerosis in 1. All infants with AET were received medical therapy: digoxin (D) only (4), D+beta-blocker (1), D+amiodarone (4), D+flecainide (3), D+amiodarone+flecainide+beta-blocker (1). Conventional drug with digoxin was partially effective. In intractable 7 cases, combination of D, amiodarone and/or class Ic drug (flecainide) was necessary to control AET. This medical regimen suppressed AET in all. During follow up (mean +/- SD, 37.1 +/- 15.8 months), all except 1 recovered from AET. In 1 with large atrial septal defect, AET could be controlled only after operation. A case died of sepsis. CONCLUSION: In this study, infantile AET showed good prognosis and resolved during follow up. Medical management was possible in all cases. However, proper selection and combination of complex antiarrhythmic drug, including amiodarone and class Ic drugs were necessary to control AET in almost all the cases.
Adult ; Age of Onset ; Amiodarone ; beta-Aminoethyl Isothiourea ; Child ; Digoxin ; Follow-Up Studies ; Heart Failure ; Heart Neoplasms ; Heart Rate ; Heart Septal Defects, Atrial ; Humans ; Infant* ; Medical Records ; Prognosis ; Retrospective Studies ; Seoul ; Sepsis ; Tachycardia ; Tachycardia, Ectopic Atrial* ; Tuberous Sclerosis

No abstract available.
Tuberculosis, Pulmonary*

No abstract available.
Cerebrospinal Fluid* ; Immunoglobulin G* ; Meningitis, Aseptic*

BACKGROUND: Phantom limb sensation is an unusual position sense of the extremity during nerve block that the position of extremity is misinterpreted as being flexed, or elevated, when actually they are in neutral position. Whether it is from the fixation of proprioceptive input at the time of motor blockade or from unmasking of the pattern which has been already present in the CNS is still controversial. We perfomed this study under the assumption that phantom limb sensation can still be reproduced without the influence of position at the time of nerve blockade. METHODS: Thirty-six patients scheduled for elective orthopedic surgery were randomly assigned. For 26 patients, spinal anesthesia was performed with hyperbaric 0.5% tetracaine or bupivacaine at lateral decubitus position and the position was changed to supine immediately. Existence of phantom limb sensation and the level of anesthesia was recorded at 10 and 20 minutes after injection of local anesthetics. For 10 patients, same local anesthetics were injected after patient's legs were straightened in lateral decubitus position. RESULTS: Forteen out of 26 patients whose position were changed to supine immediately after the injection of local anesthetics experienced phantom limb sensations. Five out of 10 patients whose legs were kept straight before the injection of local anesthetics experienced phantom limb sensations. Previous history of trauma was positively related to the expression of phantom limb sensation. CONCLUSION: Our data showed that the expression of phantom limb sensation is reproducible. And this was not related to the position at the time of spinal anesthesia. Trauma seems to be an important factor related to the expression of phantom limb sensation.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine ; Extremities ; Humans ; Leg ; Nerve Block ; Orthopedics ; Phantom Limb* ; Proprioception ; Sensation* ; Tetracaine

BACKGROUND: Germline mutations in the breast cancer-associated genes BRCA1 and BRCA2 confer susceptibility and a lifetime risk of breast. Several morphological and clinical features have been attributed to hereditary tumors. However, in sporadic breast cancer, the interrelationship between the loss of heterozygosity (LOH) of these loci and clinical features remains to be fully elucidated. METHODS: Microdissected paraffin-embedded tissue blocks of 48 cases of surgically resected breast carcinoma were investigated to identify the LOH of BRCA1 and BRCA2 using microsatellite markers. RESULTS: Of 48 cases, 22 (45.9%) exhibited LOH at BRCA1 locus while in 29 out of 48 (60.4%) cases LOH was observed for the BRCA2 region. There was no significant correlation between LOH at BRCA1/2 and the patient's age, tumor size, histologic grade or lymph node metastasis. When comparing the frequency of LOH with the expression of several prognostic factors, such as p53, c-erb B2 protein, estrogen and progesterone receptor using immunohistochemical stain, there was only correlation with LOH at BRCA2 and the progesterone receptor. CONCLUSIONS: Our results suggest that allelic deletion play a role to the development of sporadic breast cancers.
Breast Neoplasms* ; Breast* ; Estrogens ; Germ-Line Mutation ; Loss of Heterozygosity* ; Lymph Nodes ; Microsatellite Repeats ; Neoplasm Metastasis ; Paraffin* ; Receptors, Progesterone

The study of microsatellite instability (MSI) has provided the evidence to support asequential, progressive pathway for the development of cancer. In this study, we analyzed the role of MSI at chromosome 11p15.5 using microdissection of paraffin-embedded tissue from 68 matched normal and breast tumor samples. Components of intraductal, invasive and metastatic foci in lymph node were assessed for MSI using the polymorphic markers D11S922, tyrosine hydroxylase (TH) and D11S988. We found that MSI at D11S922 was relatively high incidence than other two markers and increased during breast cancer progression. The overall frequency of MSI at D11S922 was 26.7% in pure intraductal carcinoma, 36.4% in invasive carcinoma, and 40.0% in invasive carcinoma with metastases. We observed no significant correlation between MSI at chromosome 11p15.5 and the patient's age, tumor size, histological grade, or lymph node metastasis. We compared the MSI incidence with the expression of prognostic markers, such as p53, c-erb B2, estrogen receptor, and progesterone receptor, and found no significant correlation. We suggest that the MSI of chromosome 11p15.5 is increased during breast cancer progression, but long-term follow-up study would establish whether MSI at chromosome 11p15.5 could be useful as a potential prognostic marker for breast cancer.
Breast Neoplasms/*genetics/metabolism/pathology ; Carcinoma, Ductal, Breast/*genetics/metabolism/pathology ; Carcinoma, Intraductal, Noninfiltrating/*genetics/metabolism/pathology ; *Chromosomes, Human, Pair 11 ; Female ; Humans ; Immunohistochemistry ; Microsatellite Repeats ; Prognosis ; Protein p53/metabolism ; Receptor, erbB-2/metabolism ; Receptors, Estrogen/metabolism ; Receptors, Progesterone/metabolism

PURPOSE: The aim of this study was to introduce a method of obtaining the oscillation graphs of the dental x-ray tube heads relative to time using an accelerometer. MATERIALS AND METHODS: An Accelerometer, Piezotron type 8704B25 (Kistler Instrument Co., Amherst, NY, USA) was utilized to measure the horizontal oscillation of the x-ray tube head immediately after positioning the tube head for an intraoral radiograph. The signal from the sensor was transferred to a dynamic signal analyzer, which displayed the magnitude of the acceleration on the Y-axis and time lapse on the X-axis. The horizontal oscillation of the tube head was measured relative to time, and the settling time was also determined on the basis of the acceleration graphs for 6 wall type, 5 floor-fixed type, and 4 mobile type dental x-ray machines. RESULTS: The oscillation graphs showed that tube head movement decreased rapidly over time. The settling time varied with x-ray machine types. Wall-type x-ray machines had a settling time of up to 6 seconds, 5 seconds for fixed floor-types, and 11 seconds for the mobile-types. CONCLUSION: Using an accelerometer, we obtained the oscillation graphs of the dental x-ray tube head relative to time. The oscillation graph with time can guide the operator to decide upon the optimum exposure moment after xray tube head positioning for better radiographic resolution.
Acceleration ; Head Movements ; Head* ; Radiography