Tri- and tetra-cyclic antidepressants are known to cause dry mouth among other several major complications. The present study was designed to compare the degree of reduced salivation due to antidepressants and to explore whether intracellular calcium-increasing agents ameliorate the salivation. Effects of antidepressants and agents increasing intracellular calcium on the cholinergic submandibular secretion and blood flow induced by the chorda stimulation or intra-arterial acetylcholine were observed in anesthetized cats. Effects of antidepressants and calcium-mobilizing agents on K+ efflux were also observed in excised gland slices. The results obtained were as follows: 1. Salivary secretion in response to the chorda stimulation (3 V, 20 Hz, 1 msec) was significantly attenuated by antidepressants in a dose-dependent manner, whereas the blood flow was not affected. 2. Salivary secretion and increased blood flow evoked by intra-arterial acetylcholine (20 microgram/kg) were markedly diminished by antidepressants, the magnitude of which was amitryptyline>imipramine >mianserin in order. 3. Cholinergic salivation was significantly decrease by cyclopiazonic acid, a calcium pump inhibitor of the endoplasmic reticulum, or by BAPTA/AM, a specific intracellular calcium chelator. 4. Caffeine and ryanodine potentiated the cholinergic salivation and ameliorated the depressed salivary secreation due to antidepressants. 5. Calcium ionophore A 23187 ameliorated the depressed salivation due to antidepressants. 6. Antidepressants inhibited the K+ efflux, which were restored by caffeine or A 23187. These results suggest that the depressed salivary secreation due to antidepressants is ameliorated by increasing intracellular calcium levels.
Acetylcholine ; Animals ; Antidepressive Agents ; Caffeine ; Calcimycin ; Calcium* ; Cats ; Endoplasmic Reticulum ; Mouth ; Ryanodine ; Salivation*

All-ceramic restorations have become an attractive alternative to porcelain-fused-to-metal crowns. In-Ceram, and more recently IPS Empress 2 were introduced as a new all-ceramic system for single crowns and 3-unit fixed partial dentures. But their strength and marginal fit are still an important issue. This study evaluated the fracture resistance and marginal fit of three systems of 3 unit all-ceramic bridge fabricated on prepared maxillary anterior resin teeth in vitro. The 3 all-ceramic bridge systems were: (1) a glass-infiltrated, sintered alumina system (In-Ceram) fabricated conventionally, (2) the same system with copy-milled alumina cores (copy-milled In-Ceram), (3) a heat pressed, lithium disilicate reinforced glass-ceramic system (IPS Empress 2). Ten bridges of each system with standardized design of framework were fabricated. All specimens of each system were compressed at 55degree at the palatal surface of pontic until catastrophic fracture occurred. Another seven bridges of each system were fabricated with standard method. All of the bridge-die complexes were embedded in epoxy resin and sectioned buccolingually and mesiodistally. The absolute marginal discrepancy was measured with stereomicroscope at x50 power. The following results were obtained: 1. There was no significant difference in the fracture strength among the 3 systems studied. 2. The Weibull modulus of copy-milled In-Ceram was higher than that of In-Ceram and IPS Empress 2 bridges. 3. Copy-milled In-Ceram (112micrometer) exhibited significantly greater marginal discrepancy than In-Ceram (97micrometer), and IPS Empress 2 (94micrometer at P=0.05. 4. The lingual surfaces of the ceramic crowns showed smaller marginal discrepancies than mesial and distal points. There was no significant difference between teeth (incisor, canine) at P=0.05. 5. All-ceramic bridges of three systems appeared to exhibit sufficient initial strength and acceptable marginal fit values to allow clinical application.
Aluminum Oxide ; Ceramics ; Crowns ; Denture, Partial, Fixed ; Hot Temperature ; Lithium ; Tooth

BACKGROUND: Intra-aortic balloon pump (IABP)is well known for its hemodynamic benefit but still has its own complications.Proper use of IABP is the best way t o obt ai n maximum benefit with low complication rate. MATERIALS AND METHOD: Twenty one(men 10,female 11) patients were included in this study among the 100 consecutive adult cardiac surgery patients in our hospital.Eighteen(85.7%)were ischemic heart disease patients.They all received IABP therapy due to postcardiotomy cardiogenic shock according to the well-known indications.Their preoperative conditions,intraoperative factors including hemodynamics, postoperative conditions and IABP-related complications were analyzed. RESULT: Nineteen patients(90.5%)were successfully weaned from IABP.There were 2 patients of operative death and the mortality rate was 9.5%.Duration of IABP use was 40.7+/-24.3 hours.There were 2 cases(9.5%)of IABP-related vascular complications that required surgical intervention. CONCLUSION: We concluded that IABP could be used effectively and safely for postcardiotomy cardiogenic shock patients with low complication rate.
Adult ; Hemodynamics ; Humans ; Mortality ; Myocardial Ischemia ; Shock, Cardiogenic* ; Thoracic Surgery

Chronic iron overload is associated with life-threatening complications, such as cardiomyopathy, liver cirrhosis, diabetes, hypothyroidism, hypoparathyroidism and hypogonadism. We experienced a case of secondary hemosiderosis with hepatic fibrosis in a 8-year-old boy who had been transfused 56 pints of packed red blood cells for a supportive therapy of acute myelogenous leukemia for a 27-month period. Intramuscular injection of Desferroxamine (40mg/kg/ day) was done for 9 months, however, there was no sign of improvement in hepatic size, consistency, and in liver biopsy findings. Except for mild thrmobocytopenia which seems to be the result of hypersplenism, the boy remained in remission for 3 2/3 years. We think, the prompt use of Desferroxamine therapy may be needed to avoid iron overload, if patients recieved multiple transfusions and high serum ferritin level.
Biopsy ; Blood Transfusion ; Cardiomyopathies ; Child ; Deferoxamine ; Erythrocytes ; Ferritins ; Fibrosis* ; Hemosiderosis* ; Humans ; Hypersplenism ; Hypogonadism ; Hypoparathyroidism ; Hypothyroidism ; Injections, Intramuscular ; Iron Overload ; Leukemia, Myeloid, Acute* ; Liver ; Liver Cirrhosis ; Male

BACKGROUND: Disordered lactate metabolism which is due to tissue hypoxia and hypoperfusion is frequently encountered in critically ill patients. These patients suffer from a high hospital mortality rate and are at great risk of developing multiple organ failure. The present study was designed to evaluate the prognostic value of blood lactate as a determinant of mortality in comparison with the APACHE II score. METHODS: 29 adult ICU patients participated in this study. Blood lactate concentrations, arterial blood gas analysis, hemodynamic data and APACHE II scores were collected on the first and last days of ICU stay. These data were compared between survivor and non-survivor groups. RESULTS: On the day of admission, blood lactate concentrations and APACHE II scores of non-survivors were 48.5 +/- 27.0 mg/dl and 18.5 +/- 5.9, while those of survivors were 23.7 +/- 12.9 mg/dl and 6.7 3.1. On the day of discharge, arterial blood lactate concentrations and APACHE II scores of non-survivors were 143.2 +/- 54.0 mg/dl and 28.2 +/- 6.0, while those of survivors were 14.9 +/- 7.1 mg/dl and 4.7 +/- 2.2. There was a significant positive correlation between high arterial blood lactate concentration and fatal outcome in critically-ill patients. There was also a significant positive correlation between arterial blood lactate concentration and APACHE II score. Furthermore, decreases in arterial blood lactate levels during the course of ICU stay may indicate a favorable outcome. The mortality increased abruptly in critically-ill patients with an initial arterial blood lactate concentration higher than 40 mg/dl. CONCLUSIONS: The result shows that arterial blood lactate concentration can serve as a reliable prognostic predictor and clinical guide to therapy in critically ill patients.
Adult ; Anoxia ; APACHE* ; Blood Gas Analysis ; Critical Illness* ; Fatal Outcome ; Hemodynamics ; Hospital Mortality ; Humans ; Lactic Acid* ; Metabolism ; Mortality ; Multiple Organ Failure ; Survivors

No abstract available.
Nitric Oxide Synthase* ; Nitric Oxide*

Neonatal lupus erythematous is a rare syndrome, which is characterized by a transient lupus dermatitis, hematologic abnormalities and isolated congenital heart block. We detected the atrioventricular dissociation, bradycardia and pericardial effusion by fetal echocardiography in a female fetus at 25th weeks of gestational age. The baby was born in the 38th week of pregnancy by Cesarean section with 1790 gram of body weight. In spite of atrioventricular dissociation with bradycardia and pericardial effusion, cardiac pacemaker was not needed during neonatal period because she was doing well, no evidence of congestive heart failure and around 80 beat per minute of heart rate. The serologic markers for diagnosis of neonatal lupus are the autoantibodies specific to SS-A/Ro and/or SS-B/La. These antibodies are produced by the mother and passed to the fetus through the placenta. Autoantibodies of cytoplasmic SS-A antigens or SS-B antigen were found in the blood of this patient and her mother. We report a case of neonatal lupus syndrome with congenital atrioventricular dissociation with Rt. Bundle branch block and hematologic abnormality.
Antibodies ; Autoantibodies ; Body Weight ; Bradycardia ; Bundle-Branch Block ; Cesarean Section ; Cytoplasm ; Dermatitis ; Diagnosis ; Echocardiography ; Female ; Fetus ; Gestational Age ; Heart Block* ; Heart Failure ; Heart Rate ; Heart* ; Humans ; Mothers ; Pericardial Effusion ; Placenta ; Pregnancy

A case of invasive cribriform carcinoma of the breast is presented with fine need- le aspiration cytologic features. The aspiration was performed from a papable 2.0cm mass in the upper outer quadrant of the right breast in a 53 year-old woman. The aspirate showed cellular smear composed of larger three dimensional tight clusters, smaller monolayered loose clusters, and many individual cells on the clean background. In the clusters, the tumor cells were bordering central lumina, quite similar to the cribriform in histology. The tumor cells in the clusters and individual tumor cells had uniform, small and round nuclei. The chromatin was finely granular, and nuclear membrane was smooth. No discernible nucleoli were present (nuclear grade 1-2). Unless the abundance of individual cells and the cribriform growth pattern are recognized in the smear, the cytologic diagnosis of invasive cribriform carcinoma is difficult.
Female ; Humans ; Biopsy

A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*