Diaphragmatic eventration and spontaneous rupture of the diaphragm are not common. Authors experienced a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome, visited emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic cavity. She underwent exploratory laparotomy. Reduction of the herniated abdominal viscera, trimming of the ruptured diaphragm and plication of the diaphragm were done. Postoperative course was uneventful. In the English literature there is only one reported case of spontaneous rupture of eventrated diaphragmatic.
Abdominal Pain ; Child* ; Diaphragm* ; Diaphragmatic Eventration ; Emergency Service, Hospital ; Female* ; Humans ; Laparotomy ; Nephrotic Syndrome* ; Rupture, Spontaneous* ; Thoracic Cavity ; Thorax ; Ultrasonography ; Viscera ; Vomiting

BACKGROUND: The purpose of this study was to investigate the mechanism of endothelium-dependent and independent responses to endothelins (ETs) in porcine coronary artery. METHODS: The vascular rings of left anterior descending artery or left circumflex artery from 7 pigs were suspended in conventional organ chambers for the measurement of isometric force. To evaluate relaxation responses, vascular rings with endothelium were exposed to ET-1 and ET-3. To evaluate contraction responses, vascular rings with and without endothelium were exposed to ET-1 and ET-3 in the presence or absence of BQ 123 (ET(A) receptor antagonist) or TAK-044 (ET(A) and ET(B) receptor antagonist). RESULTS: Transient relaxation responses of vascular rings occurred after exposure of ET-1 and ET-3. These transient responses disappeared after preincubation with N-nitro-L arginine. There was an increased contractions of vascular rings according to increasing concentration of ET-1 and ET-3. The initial responses were enhanced in vascular rings without endothelium in ET-1 and ET-3. In vascular rings with endothelium, the contraction responses were more reduced in vascular rings with preincubation of BQ 123 than in vascular rings without BQ 123 in ET-1. In vascular rings without endothelium, the contraction responses were more reduced in vascular rings with preincubation of TAK-044 than in vascular rings without TAK-044 in ET-1. CONCLUSION: ET(B) receptor on the endothelium might mediate the transient vasodilator responses to ET-1 and ET-3 through release of nitric oxide in porcine coronary artery. ET(A) and ET(B) receptor on vascular smooth muscle cells might mediate vasoconstrictor responses to ETs.
Arginine ; Arteries ; Coronary Vessels* ; Endothelins* ; Endothelium ; Muscle, Smooth, Vascular ; Nitric Oxide ; Receptors, Endothelin ; Relaxation ; Swine

No abstract available.
Emergencies* ; Emergency Medical Services*

No abstract available.
Adult* ; Fistula* ; Humans

Discoid meniscus is a congenital morphological variable anomaly of meniscus which is often asymptomatic. Arthroscopic surgeries on 91 symptomatic lateral discoid menisci of 84 patients were performed at the Department of Orthopedic Surgery, Seoul National University Hospital during the period of Jan. 1987 to Jan. 1994, which equals 19.2% of arthroscopic meniscectomies performed. Follow up was done from minimum of 1 year to maximum of 8 years, with an average period of 3 years and 10 months. Retrospective study was done with the review of clinical records, roentgenograms, MRI, and arthroscopic findings on recorded videotapes to evaluate the clinical and radiological features, results of arthroscopic treatment and possible prognostic factors. The followings are the results: 1. The lateral discoid meniscus encompassed 19.2% of arthroscopic meniscectomies performed at the same period, which was relatively high incidence. Arthroscopic partial and subtotal menis- cectomy resulted in satisfactory results. 2. Since 8 (11%) knees were not diagnosed preoperatively as discoid meniscus due to type being incomplete or torn meniscus displacement, these points should be considered with clinical findings at diagnosis of discoid meniscus. 3. 34.9% of 83 menisci with tear had previous trauma history which showed high vulnerability to tear. Discoid menisci without tears but with grade II intrasubstance increased signal and symptoms were treated with arthroscopic meniscectomy and showed good results. Therefore discoid menisci without tears should be considered of arthroscopic meniscectomy in the presence of clinical symptoms and MRI findings. 4. Lysholm total and pain scores were significantly improved at postop. 1 year and at the final follow up with p<0.05. Factors such as degenerative changes, sex, age, duration of preoperative symptoms, presence of tears and types of meniscectomy gave no significant influence on the results and the prognosis.
Arthroscopy ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Knee* ; Magnetic Resonance Imaging ; Orthopedics ; Prognosis ; Retrospective Studies ; Seoul ; Videotape Recording

Hemorrhagic cystitis is potentially life-threatening sequellae of chemotherapy using oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide). Mesna contains a sulfhydryl group that is believed to bind acrolein within the urinary collecting system and reduce the hemorrhagic cystitis without affecting the chemotherapeutic potential. To date, about thirty cases of hypersensitivity or allergic reactions of the delayed and urticarial type associated with mesna have been reported. We reported two patients with systemic lupus erythematosus who developed facial rash and flushing associated with mesna which imitate malar rash.
Acrolein ; Alkylating Agents ; Cyclophosphamide ; Cystitis ; Drug Therapy ; Exanthema* ; Flushing ; Humans ; Hypersensitivity* ; Lupus Erythematosus, Systemic ; Mesna*

No abstract available.
Child* ; Glomerulonephritis, IGA ; Hematuria* ; Humans ; Nephritis* ; Purpura, Schoenlein-Henoch*

No abstract available.
Antibodies* ; Rheumatic Diseases*

BACKGROUND: The bispectral index (BIS), a parameter derived from the electro-encephalography (EEG), has been shown to correlate with the sedative state of anesthetic agents. This study was designed to evaluate the effect of BIS monitoring on anesthetic use and recovery characteristics in long duration sevoflurane anesthesia. METHODS: Forty adult patients who were scheduled for prolonged anesthesia (above 150 minutes) were randomly assigned to the control group (n = 20) or the BIS group (n = 20). In the control group, the anesthesiologists were blinded to the BIS values, and sevoflurane was administered according to standard clinical practice. In the BIS group, sevoflurane was titrated to maintain the BIS value between 45 60. Mean arterial pressure (MAP), heart rate (HR), end-tidal sevoflurane, BIS was monitored at intervals of 15 minutes. Time to response (TR), time to extubation (TE), time to reach 10 points of PAR score (TPAR10) and time to the discharge from postanesthetic care unit (TDis) were recorded from withdrawal of sevoflurane for recovery time. RESULTS: ET-Sevoflurane was significantly lower in the BIS group than the control group. BIS and 95% SEF values were higher in the BIS group compared with the control group. All values of recovery time (TR, TE, TPAR10, TDis) were significantly shorter in the BIS group than control group. In MAP and HR, there was no significant difference between the groups. CONCLUSIONS: BIS is considered a good index of proper use of sevoflurane. Decrease of total amount of sevoflurane, early emergence and early discharge from PACU are expected, so more safe and economic anesthesia may be possible in clinics.
Adult ; Anesthesia* ; Anesthetics ; Arterial Pressure ; Consciousness Monitors* ; Heart Rate ; Humans

No abstract available.
Carcinoma, Non-Small-Cell Lung* ; Drug Therapy, Combination*