Isolated right ventricular hypoplasia, unassociated with severe pulmonary or tricuspid valvar malformations, is a rare primary congenital cardiac anomaly in which of the trabecular portion of right ventricle fails to develop. An atrial septal defect or a patent foramen ovale serves as an escape valve. We observed a 2-day-old neonate with this disorder who suffered from cyanosis. The diagnosis was made by Doppler-echocardiography which revealed marked reduction in right ventricular size and right-to-left shunt through the atrial septal defect. There was no other cardiac malformation such as pulmonary atresia or tricuspid atresia.
Cyanosis ; Diagnosis ; Foramen Ovale, Patent ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Ventricles ; Humans ; Infant, Newborn ; Pulmonary Atresia* ; Tricuspid Atresia* ; United Nations

BACKGROUND: Recent studies have conflicting results concerning the role of p53 protein related to the discovery that a wild-type of p53 is a nuclear protein that plays a role both as a tumor suppressor and may play roles in the control of transcription and as a negative regulator of cell growth, whereas mutant p53 supports tumor formation in experimental oncogenic settings and is overexpressed in some human tumors. The mutant p53 is abnormally stable, leading to increased expression. p53 has been most widely studied by the immunohistochemical method. p53 overexpression often found in some studies, but not always in other studies, have been shown to be an independent predictor of poor prognosis. METHODS: To evaluate a possible prognostic factor, we studied the expression of the p53 protein by an immunohistochemical method and compared these results with the established prognostic factors for breast carcinomas. RESULTS: 78 patients aged 28-69 were included in this study. The mean age was 46.3, and 53 patients out of 78 were less than 50 years old. There were 28 cases with tumor diameters of less than 2 cm, and 50 with tumor diameters of more than 2 cm. The most common pathologic type was an infiltrating duct carcinoma, 71 out of 78 cases (91.0%), and proportions of histologic grade I, II, and III tumors was 23 (29.5%), 41 (52.6%), 14 (17.9%), respectively. Cases with lymph node metastasis numbered 52 of 78 (66.7%). We observed a remarkable increase in the nuclear staining intensity at the invasive margins of some tumors, which may be linked to a higher incidence of proliferating cells. CONCLUSIONS: p53 overexpression was associated with tumor size (p<0.05), but was not associated with lymph node status, age, histologic grade, or estrogen receptor status.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Incidence ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Nuclear Proteins ; Prognosis

PURPOSE: The identification of factors present at the time of initial evaluation may be important to predict the prognosis in patients with superficial bladder carcinoma. Attempts were made to identify predictive factors of recurrence and progression. MATERIALS AND METHODS: This study included twenty seven patients with superficial bladder tumor(pTa-pTl) who had no recurrence within 5 years. A comparative non-randomized study was performed of a control group of twenty six patients with same superficial bladder tumor who had recurrence within 1 year after transurethral resection of bladder tumor(TURBT) was done. Between the former and the latter patients cumulative and multivariate analyses were performed to estabilish predictive factors of pathological recurrence and progression. The resected tumors were immunohistochemically stained with anti-lamin rabbit serum to evaluate the presence or absence of basement membrane breakage, the vascular and/or lymphatic invasion, and to count number of neovascularizasion. RESULTS: In superficial bladder carcinoma, invasion of basement membrane, grade, invasion of lymphatics and vessels, and neoangiogenesis were significant factors affecting recurrence and progression, and these factors acted independently. CONCLUSIONS: These factors used to predict recurrence and progression of superficial bladder tumor were thought to be the important risk factors. These results suggested that close follow-up and aggressive treatment such as BCG instillation should be considered for the treatment of superficial bladder cancer with unfavourable prognostic factors.
Basement Membrane ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Mycobacterium bovis ; Prognosis ; Recurrence* ; Risk Factors ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: We aimed to investigate the clinical and phylogenetic characteristics of Escherichia coli Urinary Tract Infections (E. coli UTI). METHODS: We enrolled patients with culture-proven E. coli UTI, who were admitted at the study hospital from September 2008 to August 2009. We investigated clinical data of patients with E. coli UTI and characteristics of isolated E. coli strains. The phylogenetic groups were classified using triplex polymerase chain reaction (PCR), and the distribution of nine virulent genes was determined by multiplex PCR. RESULTS: A total of 47 patients have participated in this study. Thirty (63.8%) were under 6 months; eight (17.0%) were between 6-12 months; and nine (19.1%) were over 12 months. We compared two age groups between under 6-month and over 6-month. In the age group under 6-month, higher proportion of male (P=0.002) and group B2 strains (P=0.020) were observed. In contrast, higher proportion of female and group non-B2 strains were observed in age group over 6-month. Frequencies of papC, papGII, papGIII, sfa/foc, hlyC, cnf1, fyuA, iroN and iucC were estimated as 68.1%, 57.4%, 42.6%, 46.8%, 46.8%, 31.9%, 87.2%, 48.9% and 63.8%, respectively. In the comparison of phylogenetic groups, group B2 showed higher distribution of virulent genes, while group D included more strains resistant to trimethoprim/sulfamethoxazole (TMP/SMZ) than other groups. CONCLUSION: We showed the age group-specific difference in the distribution of sex ratios and phylogenetic groups; more male and group B2 strains in age group under 6-month, while more female and group non-B2 in age group over 6-month. However, further evaluation including larger number of patients will be necessary to confirm above thesis in future molecular epidemiological studies.
Epidemiologic Studies ; Escherichia ; Escherichia coli ; Female ; Humans ; Infant ; Iron ; Male ; Multiplex Polymerase Chain Reaction ; Sex Ratio ; Urinary Tract ; Urinary Tract Infections

PURPOSE: To analyze the optical coherence tomography (OCT) result at the area of hyperfluorescence by scanning laser ophthalmoscopy (SLO) in central serous chorioretinopathy. METHODS: We investigated sensory detachment, pigment epithelial detachment (PED), choroidal neovascularization (CNV), and retinal pigment epithelial atrophy using OCT in the area of hyperfluorescein by scanning laser ophthalmoscopy (SLO) in 29 eyes of 29 patients with CSC. RESULTS: Of 29 eyes, no specific finding was noted in 19 eyes. Small PED corresponding to the leaking point was noted in 3 eyes, large serous PED with leaking point in 2 eyes, hemorrhagic PED in 1 eye, subretinal precipitate and PED in 1 eye, and retinal pigment epithelial atrophy in 2 eyes. CONCLUSIONS: OCT provided intuitive and objective information on the pathophysiologic state of the retinal pigment epithelial layer at the area of hyperfluorescence by SLO in CSC.
Atrophy ; Central Serous Chorioretinopathy* ; Choroidal Neovascularization ; Humans ; Ophthalmoscopes* ; Ophthalmoscopy ; Retinaldehyde ; Tomography, Optical Coherence*

PURPOSE: Microperimetry with the scanning laser ophthalmoscope (SLO) allows precise point-to-point correlation between visual functions and retinal pathology. The aim of this study was to evaluate the retinal sensitivity in patients with diabetic retinopathy. METHODS: We divided 15 eyes into 3 study based on the severity of the diabetic retinopathy and 5 healthy eyes as a control. Twenty eyes of 20 patients were prospectively examined with static manual microperimetry using the SLO (Scanning laser microscope 101, Rodenstock, Munich, Germany) to compare the retinal sensitivity according to the severity of retinal pathology. RESULTS: We observed a generalized decrease in retinal sensitivity in diabetic retinopathy patients. There was a significant decrease in retinal sensitivity over 5degrees in non-proliferative diabetic retinopathy and proliferative diabetic retinopathy (p<0.05). CONCLUSIONS: Results indicate that the higher the degree of diabetic retinopathy, retinal sensitivity decreased. A decreased in retinal sensitivity was also observed with retinal hemorrhage, exudate and neovascularization. It may help in making management decisions in diabetic patients by offering sensitive parameters in addition to the visual acuity.
Diabetic Retinopathy ; Exudates and Transudates ; Humans ; Ophthalmoscopes ; Pathology ; Prospective Studies ; Retinal Hemorrhage ; Retinaldehyde* ; Visual Acuity

BACKGROUND AND OBJECTIVES: Mechanisms of restenosis following successful coronary angioplasty (PTCA) are knownasvascularsmoothmuscle cells(VSMCs)proliferationandmigration, elastic recoil or vascular wall remodeling. Paclitaxel whose effect on the stabilization of microtubles leads to cell death is highly lipophilic, permitting easy pass through cell membrane, and has a long-term antiproliferative effect. This study was performed to evaluate effect of paclitaxel on VSMCs proliferation and whether locally delivered paclitaxel can prevent stenosis and neointimal formation in rat carotid artery injury model. MATERIALS AND METHODS: Cultured VSMCs were exposed to sequential concentrations of paclitaxel in vitro, and proliferation inhibition was analyzed with 3H-thymidine incorporation. Paclitaxel of a suitable concentration was applied to the endothelium-denuded carotid artery of Fisher 344 inbred rats for 20 minutes. Angiogram and morphometric analysis of carotid artery was performed after 2 weeks. RESULTS: 3H-thymidine incorporation in cultured VSMCs was decreased dose-dependently from the concentration of 0.1 micromol/L (2,454+/-149cpm/ microgram protein) to 100 micromol/L (1,323+/-69cpm/ microgram protein) of paclitaxel by single and 20-minute exposure in the presence of platelet-derived growth factor (p<0.005). In the absence of platelet-derived growth factor, the decrement of 3H-thymidine incorporation was evident above the concentration of 5 micromol/L of paclitaxel. To evaluate in vivo effect, paclitaxel (0.1 or 1 micromol/L) was administered into the endothelium-denuded carotid artery by balloon injury and incubated for 20 minutes. Percent stenoses (32.2+/-9.8%) of paclitaxel-treated group was less than those (46.3+/-7.5%) of control group on histologic analysis (p<0.01). Paclitaxel-treated group also had wider lumen on carotid angiogram and less neointimal thickening than control on histologic examination (p<0.005). CONCLUSION: Proliferation of VSMCs was effectively inhibited and neointimal formation and luminal stenosis was prevented in rat carotid artery injury model by single, brief and local delivery of low-dose paclitaxel. This strategy could be applied to clinical settings for the prevention of restenosis after PTCA.
Angioplasty ; Animals ; Carotid Arteries* ; Carotid Artery Injuries ; Cell Death ; Cell Membrane ; Constriction, Pathologic ; Neointima ; Paclitaxel* ; Phenobarbital ; Platelet-Derived Growth Factor ; Rats*

BACKGROUND: Near-infrared spectroscopy (NIRS) continuously measures regional cerebral oxygen saturation (rSO2) noninvasively and has been shown to detect even small changes in cerebral oxygen supply-demand balance. Although widely used, only the effect of midazolam on cerebral blood flow has been studied in humans and evidence is lacking about its effect on cerebral metabolic rate. We therefore evaluated the effect of midazolam on cerebral oxygen supply-demand balance with NIRS. METHODS: Sixty patients undergoing elective coronary artery bypass graft surgery were randomly allocated into either midazolam (n = 30) or propofol (n = 30) group. rSO2 was recorded before induction while patients were breathing room air as baseline, after pre-oxygenation with 100% oxygen, after administration of either midazolam or propofol, after completion of administration of sufentanil and after tracheal intubation. Hemodynamic variables including cardiac index and mixed venous oxygen saturation were recorded at the same time points. RESULTS: rSO2 and hemodynamic variables were similar between the groups throughout the study period. After pre-oxygenation, rSO2 significantly increased compared to baseline in each group, and did not show any additional increase after administration of either midazolam or propofol and sufentanil in both groups. CONCLUSIONS: Midazolam preserves cerebral blood flow-metabolism coupling to a similar degree to propofol as assessed by near infrared spectroscopy.
Anesthesia ; Coronary Artery Bypass ; Coronary Vessels ; Hemodynamics ; Humans ; Intubation ; Midazolam ; Oxygen ; Propofol ; Respiration ; Spectroscopy, Near-Infrared ; Spectrum Analysis ; Sufentanil ; Transplants

BACKGROUND: Cisatracurium is a nondepolarizing muscle relaxant. It less likely release histamine and has better cardiovascular stability. It presumably undergoes pH and temperature- dependent, nonenzymatic chemical process, Hofmann reaction. In vitro studies, Hofmann reaction was enhanced with increasing pH, but, in vivo the influence of acid-base imbalance is not well defined. METHODS: To evaluate the effects of acid-base imbalance on the neuromuscular blockade of cisatracurium in the cat, we induced acid-base imbalance and performed cumulative dose-response studies. RESULTS: ED50 of the cisatracurium was significantly reduced in all groups. Dose-response curves from all acid-base imbalance groups did not have significant differences in slopes. But, all showed shift-to-left when compared with control curve, showing decreased ED50. Duration of action was not affected. Recovery index was significantly changed in respiratory and metabolic alkalosis. CONCLUSIONS: It may be concluded that acid-base imbalance significantly augmented the potency of cisatracurium, but, changes of recovery index in this study may be resulted from systemic instability such as unstable hemodynamic state by the prolonged experiment.
Acid-Base Imbalance* ; Alkalosis ; Animals ; Cats* ; Chemical Processes ; Hemodynamics ; Histamine ; Hydrogen-Ion Concentration ; Neuromuscular Blockade*

No abstract available.
Blood Flow Velocity*