No abstract available.
Epidermal Growth Factor* ; Gonadotropin-Releasing Hormone* ; Myoma* ; Receptor, Epidermal Growth Factor*

BACKGROUND: Despite improvement of mortality in acute myocardial infarcrtion, high mortality rate associated with cardiogenic shock remains essentially unchanged. We have reviewed our result of coronary intervention in 15 patients and found relative survival advantage. METHODS: Between Sep. 1992 and Aug. 1995, 15 consecutive patients(M. 10, F. 5) with cardiogenic shock in acute myocardial infarction were treated with coronary intervention using ballon PTCA. IABP was inserted in all patients prior to PTCA. RESULTS: 1) Most commonly found infarct related artery was left anterior descending artery(11) followed by right coronary artery(3) and left main coronary artery(1). 2) Successful reperfusion rate was 86.7%(13/15), and in-hospital mortality rate was 26.7%(4/15). 3) In-hospital mortality was higher in elderly patients compared with less than 70yaer old patients(0%(0/11)vs. 75.0%(3/4)(P < 0.05). 4) Mortality rate was lower in single vessel disease than multivessel disease(11.1%(1/9) vs. 50%(3/6) p<0.05). CONCLUSION: Although this study is uncontrolled, the date suggest that urgent coronary intervention for improving coronary perfusion may reduce mortality of acute myocardial infarction complicated by cardiogenic shock, particularly with single vessel disease and young age group.
Aged ; Arteries ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Shock, Cardiogenic*

Obstructive sleep apnea (OSA), a common comorbidity in patients with stroke, has shown increasing prevalence over the past few decades. OSA is an important risk factor for stroke in addition to other well-known contributors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. Moreover, OSA is an independent predictor of neurological outcomes and mortality. The pathological mechanisms underlying the association between OSA and stroke include autonomic dysfunction, hypertension, cardiac arrhythmia, dyslipidemia, impaired glucose tolerance, hypoxia, and inflammation. Continuous positive airway pressure (CPAP) therapy has proven clinical utility in improvement of neurological symptoms in patients with stroke. Findings from a CPAP withdrawal model have shown increased sympathetic activity in OSA with a consequent significant elevation in blood pressure, relevant cerebral hypoxia, and disturbed cardiac repolarization. In this review, we present an overview of the literature that describes an association between OSA and stroke in addition to the vascular risk factors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. This study highlights the importance of early and accurate diagnosis and management of OSA for stroke prevention and care and will benefit physicians in clinical practice.

Purpose: The aim of this study was to assess the incidence and causes of percutaneous radiofrequency ablation (RFA) infeasibility in cases of metastatic colorectal cancer and to evaluate factors affecting the invisibility of the tumor on planning ultrasonography (US). Methods: This study screened 386 patients who underwent planning US using fusion imaging and/or contrast-enhanced US for percutaneous RFA for suspected metastatic colorectal cancer between January 2013 and December 2020, from whom 136 patients with a single hepatic metastasis from colorectal cancer measuring <3 cm were included. The factors related to the infeasibility of percutaneous RFA were investigated. Univariate and multivariate analyses were performed to assess the factors associated with tumor invisibility on planning US. Results: Among the 136 patients, percutaneous RFA was considered infeasible in 24.3% (33/136) due to a high risk of the heat-sink effect caused by the abutment of a large vessel (n=12), an inconspicuous tumor on planning US (n=11), a high risk of collateral thermal damage to an adjacent organ (n=8), and the absence of a safe electrode path (n=2). In univariate and multivariate analyses, tumor size was a statistically significant factor affecting invisibility on planning US (P=0.003 and P=0.018, respectively). Conclusion Percutaneous RFA was infeasible in approximately one-fourth of patients with metastatic colorectal cancer. The reason for the infeasibility was mainly an unfavorable tumor location and invisibility on planning US. Small tumor size was the sole significant factor affecting the invisibility of hepatic metastases on planning US.

PURPOSE: We performed a prospective study to determine whether unenhanced helical computed tomography(UHCT) findings predict the spontaneous passage of ureteral calculi. MATERIALS AND METHODS: Between April 2006 and June 2007, 175 patients with a single ureteral calculus <1cm in diameter were enrolled in this study, and a UHCT was performed. All of the patients were managed conservatively for 2 weeks. Patients without spontaneous passage of ureteral calculi within 2 weeks were treated by ureteroscopy or extracorporeal shock wave lithotripsy(ESWL). The secondary signs (hydronephrosis, perinephric edema, and the tissue rim sign) were graded on a scale of 0-3. We evaluated whether spontaneous passage of ureteral calculi was associated with stone diameter, location, Hounsfield units(HU), and the degree of secondary signs. RESULTS: Ninety-two patients(52.6%) had spontaneous passage of ureteral calculi. The mean stone diameter was significantly smaller in the passage group than the non-passage group(4.28mm vs. 6.73mm, p=0.002). The rate of spontaneous passage was significantly higher involving distal ureteral calculi(66.1%) than proximal ureteral calculi(30.3%, p<0.001). The incidences of hydronephrosis and perinephric edema were significantly lower in the spontaneous passage group than the non-passage group(8.7% vs. 73.5% and 5.4% vs. 69.9%, respectively). The grades of hydronephrosis and perinephric edema were significantly lower in the spontaneous passage group than the non-passage group(p=0.001). Although there was a tendency toward increasing grades of hydronephrosis and perinephric edema with increasing stone size, the grades were more frequent and severe in the non-passage group in patients with similarly sized stones. CONCLUSIONS: The degree of hydronephrosis and perinephric edema are useful ancillary signs in predicting the likelihood of spontaneous passage of ureteral calculi.
Edema ; Humans ; Hydronephrosis ; Incidence ; Prospective Studies ; Shock ; Tomography, Spiral Computed ; Ureter ; Ureteral Calculi ; Ureteroscopy

BACKGROUND: The transplantation of adrenal medullary tissue into the CNS of the rat can reduce pain. This results from the release of opioid peptides and catecholamines from the transplanted chromaffin cells. However, whether the adrenal gland transplanted in peripheral tissue can also reduce the pain is not well documented. The purpose of this study was to assess the potential for theadrenal gland implanted into the peripheral tissue of the rat to reduce mechanical hyperalgesia induced by inflammation. METHODS: Fifteen male Wistar rats were divided into three groups; one for implantation of the adrenal gland (AG), another for the kidney (Kd), and the other for a Sham operation (S). Tissues for transplantation were harvested from Sprague-Dawley rats. Two weeks after surgery, inflammation was induced by injecting 0.05 ml of Freund's Complete Adjuvant (FCA) into the dorsum of the rat's hind paw. Mechanical hyperalgesia was assessed using automated Randall-Sellito algesiometer at 6 hr, 1, 2, 3, 7 and 14 days after injecting FCA. RESULTS: Paw withdrawal thresholds against mechanical stimuli were 84.8 6.9%, 112.1 4.6%, 86.3 8.5%, 93.6 7.4%, 90.5 3.8%, 96.9 3.8%, respectively, in the AG group, and 71.3 10.8%, 93.3 11.3%, 79.1 10.3%, 73.7 8.1%, 62.6 6.4%, 77.7 6.2%, respectively, in Kd group, and 67.2 8.3%, 88.1 11.7%, 67.7 8.1%, 69.6 8.2%, 74.5 8.5%, 81.2 6.6%, respectively, in the S group. The AG group showed less pain sensitivity compared with that of the Kd and S groups especially 7 and 14 days after injecting the drug. CONCLUSIONS: This study indicates that the transplanted adrenal gland into the peripheral tissue may provide analgesic effect for a long time after it is transplanted in the rat.
Adrenal Glands* ; Animals ; Catecholamines ; Chromaffin Cells ; Humans ; Hyperalgesia* ; Inflammation ; Kidney ; Male ; Opioid Peptides ; Rats* ; Rats, Sprague-Dawley ; Rats, Wistar

BACKGROUND: The transplantation of adrenal medullary tissue into the CNS of the rat can reduce pain. This results from the release of opioid peptides and catecholamines from the transplanted chromaffin cells. However, whether the adrenal gland transplanted in peripheral tissue can also reduce the pain is not well documented. The purpose of this study was to assess the potential for theadrenal gland implanted into the peripheral tissue of the rat to reduce mechanical hyperalgesia induced by inflammation. METHODS: Fifteen male Wistar rats were divided into three groups; one for implantation of the adrenal gland (AG), another for the kidney (Kd), and the other for a Sham operation (S). Tissues for transplantation were harvested from Sprague-Dawley rats. Two weeks after surgery, inflammation was induced by injecting 0.05 ml of Freund's Complete Adjuvant (FCA) into the dorsum of the rat's hind paw. Mechanical hyperalgesia was assessed using automated Randall-Sellito algesiometer at 6 hr, 1, 2, 3, 7 and 14 days after injecting FCA. RESULTS: Paw withdrawal thresholds against mechanical stimuli were 84.8 6.9%, 112.1 4.6%, 86.3 8.5%, 93.6 7.4%, 90.5 3.8%, 96.9 3.8%, respectively, in the AG group, and 71.3 10.8%, 93.3 11.3%, 79.1 10.3%, 73.7 8.1%, 62.6 6.4%, 77.7 6.2%, respectively, in Kd group, and 67.2 8.3%, 88.1 11.7%, 67.7 8.1%, 69.6 8.2%, 74.5 8.5%, 81.2 6.6%, respectively, in the S group. The AG group showed less pain sensitivity compared with that of the Kd and S groups especially 7 and 14 days after injecting the drug. CONCLUSIONS: This study indicates that the transplanted adrenal gland into the peripheral tissue may provide analgesic effect for a long time after it is transplanted in the rat.
Adrenal Glands* ; Animals ; Catecholamines ; Chromaffin Cells ; Humans ; Hyperalgesia* ; Inflammation ; Kidney ; Male ; Opioid Peptides ; Rats* ; Rats, Sprague-Dawley ; Rats, Wistar

'Duplication of the middle cerebral artery' is a rere vascular anomaly of the brain. The authors experienced a case of duplication of the middle cerebral artery in a patient with a posterior communicating artery aneurysm. It was demonstrated by angiography and confirmed at surgery. The neck of aneurysm was successfully clipped. Postoperative course was uneventful.
Aneurysm ; Angiography ; Brain ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery* ; Neck

No abstract available.
Brain* ; Choriocarcinoma* ; Female ; Neoplasm Metastasis* ; Pregnancy

No abstract available.