No abstract available.
Central Venous Catheters* ; Prospective Studies* ; Thrombophlebitis*

A 52-year-old women, suffering from generalized pruritus due to intrahepatic and common hepatic duct stones, was treated with astemizole, 30mg daily. Sixty one days later, convulsions and syncope developed suddenly during hospitalization. She had no history of arrhythmia, heart disease, electrolytes imbalance, or CNS disorders. As another case, a 44-year-old man suffering from pruritus due to liver cirrhosis, was treated with astemizole, 30mg daily. Thirty two days later, palpitations and syncope also developed suddenly during hospitalization. He was diagnosed liver cirrhosis, 3 years ago and there was no history of arrhythmia, heart disease, electrolytes imbalance, or CNS disorders. Administration of astemizole was stopped immediately. The laboratory investigations revealed the normal range of serum potassium, calcium and magnesium in both cases. The ECG finding showed the prolongation of QTc interval, frequent VPCs and intermittent polymorphic drugs. On 1st and 3rd day, after discontinue of astemisole, the ECG abnormalities disappeard. It is suggested that astemizole overdose can induce prolongation of QTc interval and torsade de pointes, especially in the patient with liver disease.
Adult ; Arrhythmias, Cardiac ; Astemizole* ; Calcium ; Electrocardiography ; Electrolytes ; Female ; Heart Diseases ; Hepatic Duct, Common ; Hospitalization ; Humans ; Liver Cirrhosis ; Liver Diseases ; Magnesium ; Middle Aged ; Potassium ; Pruritus ; Reference Values ; Seizures ; Syncope ; Torsades de Pointes*

PURPOSE: The current organ shortage in renal transplantation underscores the importance of optimizing long- term graft survival. Despite the significant improvement in the results of renal transplantation since the introduction of cyclosporine, graft loss after fist year of transplantation remains a significant and unresolved problem. This study showed renal function at 1 month after transplantation as a prognostic factor influencing long-term renal graft survival. METHODS: The results of 683 cases of renal transplantations performed from 1978 to 2001 in our center were analysed. We divided into 3 groups according to the serum creatinine level (group 1: <1.5, group 2: 1.5~2.0, group 3: 2.0<) at first month of transplantation. And risk factors such as donor age (<60 or >60), donor sex, donor type (related, unrelated, cadevaric), recipient age (<60, or >60), recipient sex, HLA matching, acute rejection, delayed graft function were also analysed. RESULTS: The acute rejection rates in each group were 17.1%, 40.6%, 71.7% retrospectively (P=0.000). The frequencies of delayed graft function were 3.9%, 9.0%, 36.2% retrospectively (P=0.000). There was significant difference of graft survival between each group (P=0.000). In addition, graft survival in group with acute rejection showed significant difference according to creatinine level at 1 month. CONCLUSION: We can predict long-term graft survival and early renal function through serum creatinine levels after transplantation. Therefore, serum creatinine level at first month of transplantation was prognostic factor in predicting long-term graft survival.
Creatinine* ; Cyclosporine ; Delayed Graft Function ; Graft Survival ; Humans ; Kidney Transplantation ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplants*

Basal cell adenocarcinoma is an epithelial neoplasm which is cytologically and histomorphologically similar to basal cell adenoma but is different because of the infilitrative growth. This tumor, a rare salivary gland tumor newly classified as basal cell adenocarcinoma by the WHO in 1991, is infiltrative, locally destructive and tends to recur but metastasis is less common. The differential diagnosis includes basal cell adenoma, adenoid cystic carcinoma, and basaloid squamous carcinoma. Nearly 90 percent of these tumors occurr in the parotid gland and can be classified into low grade carcinomas with a relative good prognosis. Basal cell adenocarcinoma of minor salivary gland is very rare and has a less favorable clinical course compared with that of the major salivary glands. This is a case of basal cell adenocarcinoma occurring at the minor salivary gland of the soft palate. We treated this patient with block excision and adjunctive radiation therapy.
Adenocarcinoma* ; Adenoma ; Carcinoma, Adenoid Cystic ; Carcinoma, Squamous Cell ; Diagnosis, Differential ; Humans ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial ; Palate, Soft ; Parotid Gland ; Prognosis ; Salivary Glands ; Salivary Glands, Minor*

Tracheotomy and end-to-end anastomosis is a relatively rare operation, but it is one of the most challenging for anesthesiologists. During surgery, the principal anesthetic consideration is to maintain the ventilation and oxygenation throughout the procedure. We experienced anesthetic management of a 49-year-old man with upper tracheal stenosis after long-term intubation and ventilation care. The stenotic lesion was located at 2 cm below the vocal cords, and the length of the stenotic segment was about 2 cm. The anesthesia was induced and maintained with intravenous propofol and alfentanil. The airway was managed with LMA and distal tracheal intubation on the surgical field and we were able to maintain adequate ventilation and oxygenation throughout the operational period.
Alfentanil ; Anesthesia ; Humans ; Intubation ; Laryngeal Masks* ; Middle Aged ; Oxygen ; Propofol ; Tracheal Stenosis* ; Tracheotomy* ; Ventilation ; Vocal Cords

Blunt trauma to the chest may result in various cardiac injuries. But traumatic myocardial infarction with coronary artery fistula as a complication of chest trauma has been reported in very few cases. The etiology of myocardial infarction is not entirely clear. A 40 years old male was admitted after a traffic accident. He complained of acute retrosternal pain of about one hours duration. There was an area of contusion over the right sternal border. The ECQ showed deep Q wave and elevated ST segments in leads 2, 3 and aVF. There was a considerable increase in creatine kinase(CK) peak level and a CK-MB fraction. Coronary angiography revealed a total proximal occlusion of the right coronary that communicated directly with the right atrium. The left ventridulogram showed hypokinesia of the inferior wall. He was managed with conservative treatments and has remained well sebsequently. We reported a middle aged man who developed an acute transmural inferior wall myocardial infarction associated with coronary artery fistula secondary to blunt cheat trauma in an automobile accident.
Accidents, Traffic ; Adult ; Automobiles ; Contusions ; Coronary Angiography ; Coronary Vessels* ; Creatine ; Fistula* ; Heart Atria ; Humans ; Hypokinesia ; Inferior Wall Myocardial Infarction* ; Male ; Middle Aged ; Myocardial Infarction ; Thorax*

BACKGROUND: In the acute phase of myocardial infarction, the hemostatic mechanism is known to be activated. However, it remains unclear whether increased activity of the hemostatic mechanism is only a marker of the acute thrombotic episode or precedes its appearance. It is also inapparent whether a hypercoagulable state persist for a prolonged period after the apparent resolution of these disorders. METHODS: In a group of 23 patients with acute myocardial infarction who received fibrinolytic therapy with urokinase(group A) or tPA(group B), the plasma level of fibrinogen, antithrombin compared to those of the 10 normal controls. RESULTS: The plasme level of fibrinogen was significantly decreased in both group A and B before and 4 to 24 hours after thrombolytic therapy compared to that of normal controls. But it was increased 7 to 14 days after thrombolytic therapy. In a few of the patients, the plasma level of FDP and D-dimer were positive before thrombolytic therapy and in the most patients they were positive 4 hours after thrombolytic therapy. The plasma level of AT-III was significantly increased in both group A and B before thrombolytic therapy compared with that of normal controls, but, after thrombolytic therapy, there was no significant change in its level. CONCLUSIONS: In the patients with acute myocardial infarction, the thrombolysis occurred before thrombolytic therapy and it lasted for 24 hours after thrombolytic therapy.
Antithrombin III* ; Fibrinogen ; Humans ; Myocardial Infarction* ; Plasma ; Thrombolytic Therapy*

The purpose of this study was to evaluate the effect of thickness, filling methods and curing methods on the polymerization of dual cured core materials by means of microhardness test. Two dual cured core materials, MultiCore Flow (Ivoclar Vivadent AG, Schaan, Liechtenstein) and Bis-Core (Bisco Inc., Schaumburg, IL, USA) were used in this study. 2 mm (bulky filled), 4 mm (bulky filled), 6 mm (bulky and incrementally filled) and 8 mm (bulky and incrementally filled)-thickness specimens were prepared with light cure or self cure mode. After storage at 37degrees C for 24 hours, the Knoop hardness values (KHN) of top and bottom surfaces were measured and the microhardness ratio of top and bottom surfaces was calculated. The data were analyzed using one-way ANOVA and Scheffe multiple comparison test, with alpha = 0.05. The effect of thickness on the polymerization of dual cured composites showed material specific results. In 2, 4 and 6 mm groups, the KHN of two materials were not affected by thickness. However, in 8 mm group of MultiCore Flow, the KHN of the bottom surface was lower than those of other groups (p < 0.05). The effect of filling methods on the polymerization of dual cured composites was different by their thickness or materials. In 6 mm thickness, there was no significant difference between bulk and incremental filling groups. In 8 mm thickness, Bis-Core showed no significant difference between groups. However, in MultiCore Flow, the microhardness ratio of bulk filling group was lower than that of incremental filling group (p < 0.05). The effect of curing methods on the polymerization of dual cured composites showed material specific results. In Bis-Core, the KHN of dual cured group were higher than those of self cured group at both surfaces (p < 0.05). However, in MultiCore Flow, the results were not similar at both surfaces. At the top surface, dual cured group showed higher KHN than that of self cured group (p < 0.05). However, in the bottom surface, dual cured group showed lower value than that of self cured group (p < 0.05).
Acrylic Resins ; Composite Resins ; Hardness ; Light ; Methacrylates ; Polymerization ; Polymers ; Polyurethanes

No abstract available.
Nevus

No abstract available.
Edema* ; Humans ; Hydrops Fetalis* ; Infant, Newborn*