No abstract available.
Child* ; Humans ; Peak Expiratory Flow Rate*

This study was aimed to elucidate the effect of intracerebroventricular losartan administration on arterial pressure regulation during hemorrhage in rats by power spectral analysis of blood pressure and heart rate variability. Nineteen male Sprague-Dawley rats weighing 240-300g were divided into losartan-administered(n=10) and control(n=9) groups. Hemorrhage was induced with a withdrawal pump from the femoral artery at 3ml/kg/min for 5min. Arterial presure was measured with a pressure transducer connected to the contralateral femoral artery for 5min before, during and after hemorrhage. The blood pressure signal digitized at 500 Hz through a data acquisition system was analyzed with fast Fourier transform algorithm to yield power spectra of systolic(SP) and diastolic(DP) blood pressure and instantaneous heart rate(HR). Powers of very low frequency (VLF, 0.02-0.26 Hz), low frequency(LF, 0.26-0.75 Hz) and high frequency(HF, 0.75-5.00 Hz) band were obtained. Basal systolic and diastolic blood pressure was 149+/-9 and 99+/-2mmHg, respectively, and was not changed by hemorrhage in control rats. Basal blood pressure in losartan group was 143+/-9 and 97+/-6mmHg and was significantly lowered to 116+/-13 and 77+/-9mmHg, respectively. HR was significantly increased during and after hemorrhage in both groups. Total power of SP variability in losartan group was 13.9+/-3.2mmHg2 before hemorrhage and was significantly increased to 66.6+/-25.3mmHg2 during hemorrhage. VLF, LF and HF powers of SP variability were 7.3+/-2.0, 3.8+/-1.1 and 2.8+/-0.7mmHg2, respectively, in losartan group and 5.5+/-1.4, 3.7+/-1.5 and 2.8+/-0.8mmHg2 in control rats. VLF and HF powers of SP were increased to 33.0+/-15.2 and 20.3+/-6.4mmHg2 in losartan group, and VLF power was increased to 7.9+/-1.5mmHg2 in control group. VLF power of DP variability increased from 3.3+/-0.9 before hemorrhage to 5.9+/-1.0mmHg2 during hemorrhage in control group. Powers of DP variability in losartan group and those of HR variability in both groups were not changed by hemorrhage. The above results suggested that losartan aggravated the arterial pressure fall during hemorrhage by impairing the sympathetic nerve activation by central angiotensin II.
Angiotensin II ; Animals ; Arterial Pressure ; Blood Pressure* ; Femoral Artery ; Fourier Analysis ; Heart Rate* ; Heart* ; Hemorrhage* ; Humans ; Lateral Ventricles* ; Losartan* ; Male ; Rats ; Rats, Sprague-Dawley ; Transducers, Pressure

No abstract available.

A electrical safety in the operating room is one of important responsibility for the anesthesiologists and surgeons. When the patient is included in an electric circuit with poor ground during operation under the general anesthesia electrical accident might be occurred, such as sustained muscular contration with asphixia, impairment of CNS function, ventricular fibrillation, and more commonly, burn and other physiological injuries. Authors report an electrical burn on the right calf area (3X5 cm) and both heels by ground plate of electrosurgical unit which is probably poor contacts with the patient and review about its prevention and safety of electric practice.
Anesthesia, General ; Burns* ; Heel ; Humans ; Operating Rooms ; Ventricular Function

No Abstract Available.
Tinea Capitis* ; Trichophyton*

STUDY DESIGN: A retrospective analysis of the patients who had cauda equina syndrome caused by a herniated lumbar disc. OBJECTIVES: To assess the clinical debates concerning the diagnosis, treatment, and results of treatment. SUMMARY OF LITERATURE REVIEW: This syndrome has been considered as an absolute indication of surgical treatment in the herniated lumbar disc and poor prognosis after surgery were reported. Although there are debates on the timing of surgery, early recognition early surgical treatment are recommended for a better results of treatment. MATERIALS AND METHODS: 23 consecutive patients having a cauda equina syndrome caused by herniated lumbar disc were reviewed retrospectively. They were 14 males and 9 females having ages of 41.6 in average. The incidence of this syndrome was 3.8% of the patients who had surgical treatment of herniated lumbar disc. RESULTS: All patients had bladder dysfunction in addition to the low back pain and radicular pain in the leg, but five patient did not recognize their urinary retention which were shaded by severe leg pain. A surgical treatment were performed for all patients at 6.8 days in average after onset of the bladder dysfunction. At follow-up of 3 years and 3 months in average after surgery, 20 patients(86.9%) had satisfactory resolution of the low back pain and leg pain, and all patients had complete recovery of motor weakness except one patients who had residual foot drop. Bladder function recovered satisfactorily in 18 patients (78.3%), but 4 patients had some difficulty of urination and one patient needed a sphinterotomy for urination. CONCLUSIONS: The cauda equine syndrome in herniated lumbar disc was often not recognized early and a poor result of treatment was not rare, particularly in the patients who had acute onset and severe bladder dysfunction. So, early diagnosis and active surgical treatment are recommended for a better results of treatment.
Cauda Equina* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Foot ; Humans ; Incidence ; Leg ; Low Back Pain ; Male ; Polyradiculopathy* ; Prognosis ; Retrospective Studies ; Urinary Bladder ; Urinary Retention ; Urination

Congenital lipoid adrenal hyperplasia, the most severe form of congenital adrenal hyperplasia, is caused by mutations in the steroidogenic acute regulatory protien (StAR). It is characterized by failure of synthesis of all three classes of adrenal steroids and massive accumulation of lipids and cholesterol in the adrenal cortex. The computed tomography (CT) unequivocally delineated massively enlarged adrenal glands of fat-tissue attenuation, enabling early diagnosis and replacement therapy. We report a case of congenital lipoid adrenal hyperplasia, in which CT established that lipoid deposition at the adrenal cortex disappeared after the adrenal hormone replacement therapy.
Adrenal Cortex ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Cholesterol ; Early Diagnosis* ; Hormone Replacement Therapy ; Hyperplasia* ; Steroids

Radiofrequency catheter ablation (RFCA) has been established as an effective and safe treatment modality for atrioventricular nodal reentrant tachycardia and WPW syndrome. Surgical ablation or direct current catheter ablation had been performed to cure focal atrial tachycardia (AT), however, these treatments had limitations such as the need of open thoracotomy or the risk of barotrauma. RFCA could be an effective treatment modality for cure of AT. We performed RFCA for AT in 22 patients (male 13, mean age 38.1+/-15.4 years) among 831 patients who underwent electrophysiologic study between Jul. 1996 and May. 1999. Clinical pattern of tachycardia was paroxysmal (17 patients) or incessant (mean duration of symptoms, 41.1+/-42.3 months). Associated cardiac diseases were tachycardia-mediated cardiomyopathy (3 patients), aortic stenosis (1 patient) and ventricular septal defect with pulmonic stenosis (1 patient). AT was induced by programmed electrical stimulation in 17 patients: AT in the other 5 patients was incessant. The RFCA was successful in 17 patients (77.3%). The mean interval between atrial electrogram of mapping catheter and P wave of surface ECG was -53.5+/-24.9msec in 17 successful sites. Fractionated atrial activities were invariably found in the successful sites. Successful sites of RFCA for right AT were around coronary sinus ostium (5), crista terminalis (4), lower portion of sinus node (1), inferior portion of tricuspid annulus (1), and His area (1), respectively. In left AT, lateral portion near atrioventricular groove (2), inferoposterior portion (2) and near left atrial appendage (1) were successful site. During follow-up (mean 23 months), one patient had recurrence (recurrence rate 5.9%). RFCA for AT is an effective and curative treatment in selected cases.
Aortic Valve Stenosis ; Atrial Appendage ; Barotrauma ; Cardiomyopathies ; Catheter Ablation* ; Catheters ; Coronary Sinus ; Electric Stimulation ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Follow-Up Studies ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Pulmonary Valve Stenosis ; Recurrence ; Sinoatrial Node ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Thoracotomy ; Wolff-Parkinson-White Syndrome

No abstract available.
Anemia, Hypoplastic, Congenital*

STUDY DESIGN: A retrospective review of the patients who have a fixation failure of instrumentalion for the spinal fusion in lumbar region. OBJECTIVES: To assess the incidence and different types of the mechanical failure of fixation and to evaluate their managements and their influences on the progression of a spinal fusion and to the clinical outcomes. SUMMARY OF LITERATURE REVIEW: Most of the spine surgeons have been experiencing the mechanical failures after instrumentations for a spinal fusion, eden though the incidence is decreasing with a modification of the implants. Reports on this problem are sporadic in conjunction with the other topics, rarely focusing on their management and their influences on the final outcomes. MATERIALS AND METHODS: 338 consecutive patients who had a lateral fusion in the lumbar region with an instrumentation of pedicle screws and rods, mostly with decompression, were reviewed to analyse the fixation failures of instrumentation after surgery. RESULTS: There were 26 patients (7.7%) who had the fixation failures of instrumentation, in terms of loosening around the pedicle screws in 18 patients (5.3%), the breakage of the pedicle screws in fide patients (1.5%), and the migration of a rod in three patients (0.9%). They were managed by prolonged use of brace and ergonomic back cares. Even with the fixation failures, 19 patients (73.1%) disclosed solid union uneventfully, but one patient had re-operation to obtain solid fusion. The final outcomes were satisfactory in 22 patients (84.6%), including four of six patients who had pseudoarthrosis. CONCLUSIONS: The fixation failure of instrumentation after a spinal fusion in lumbar region was not rare, but the progression of a spinal fusion usually quite well achieved and the final outcomes were not so bad, even with the implant failures and pseudoarthrosi s. Except for the persistently symptomatic pseudoarthrosis, only a prolonged use of brace and the ergonomic back cares are recommended for symptomatic patients.
Braces ; Decompression ; Humans ; Incidence ; Lumbosacral Region* ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion* ; Spine