No abstract available.
Aged, 80 and over* ; Humans

Mitral regurgitation (MR) was analyzed by Doppler echocardiography, preoperatively and postoperatively, in 59 patients with patent ductus arteriosus (PDA). The ratio of left atrial dimension and aortic root dimension (LAD/AOD) and the maximal velocity of the mitral valve (MVmax) were compared in pre, postop group. The degree of the regurgitation was given to the MR group. In preop MR group (13 of 59,22%), we compared the LAD/AOD by echo and the Qp/Qs by catheterization with non-MR group. The following results were obtained: 1) In preop MR group, about half of them had a grade 1 regurgitation, where as one fourth showed grade 2, remaining one fourth showed grade 3. The later were all changed to grade 2, postoperatively. The whiffle or mild MR (grade 1 or 2) shown preoperatively were slightly reduced in their degrees of regurgitation, but most were not disappeared and persisted to 7th postop day. 2) LAD/AOD and MVmax were significantly reduced at postop state of PDA. 3) In preop MR group (n=13), LAD/AOD was significantly increased. Qp/Qs was higher in MR grade 2 group (n=6). In conclusion, left atrial dilatation could be a factor causing mitral regurgitation in the PDA. The amount of the pulmonary blood flow also related to that. The size of the PDA itself, Rp/Rs and associated cardiac lesions were not related to the regurgitation.
Catheterization ; Catheters ; Dilatation ; Ductus Arteriosus, Patent ; Echocardiography, Doppler ; Humans ; Mitral Valve ; Mitral Valve Insufficiency*

PURPOSE: Delirium in the elderly is common in the postoperative period but there are only few reports on detailed studies of this condition. Number of urologic patients with postoperative delirium was increas ed in our hospital for recent 24 months. The clinical characteristics of patients with postoperative delirium was analyzed retrospectively. MATERIALS AND METHODS: We selected the patients with postoperative delirium from 1010 patients who had undergone urological surgery under general or spinal anesthesia in the period from Jan. 1997 to Dec. 1999. Diagnosis of postoperative delirium was established with Diagnostic and Statistical Manual of Mental Disorders(DAM-III-R) by psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric disorder, relationship with anesthesia, drugs, and surgical procedures, concomittant medical conditions, and complications were retrospectively reviewed. RESULTS: Postoperative delirium was observed in 13 patients (1.3%). All patients were male and mean age was 70.4 years (46-86 years). Surgical procedures included TURP(8 patients), cystectomy (3 patients), nephroureterectomy (1 patient), and bladder rupture repair (1 patient). Delirium became apparent between one day and two days after the operation (mean 32.2 hours) and lasted for up to 7 days (mean 53 hours). Several factors such as older age (>65 years), male patient, longterm medication, past history of CVA, memory impairment, hearing difficulty, traumatic brain contusion, and obsessive personality were thought to be risk factors of postoperative delirium. Treatment with Haloperidol(R) intramuscular injection (2.5-5mg, every 30 minutes, 2-4 times until symptom resolution was achieved) with or without Ativan(R) intravenous injection (2mg) were effective. Complete symptom recovery was seen in 92.3% (12/13) of patients. One patient (7.7%) with previous history of dementia had persistent memory disturbance and disorientation during follow-up periods. CONCLUSIONS: Generally, postoperative delirium is an acute transient confusional state without considerable sequeles. Treatment is sedation and prevention of inadvertent accident associated with confusional state. Urologic surgeon must be attentive to the development of this illness especially when high risk factors were present.
Aged ; Anesthesia ; Anesthesia, Spinal ; Brain Injuries ; Cystectomy ; Delirium* ; Dementia ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Male ; Memory ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Rupture ; Urinary Bladder

No abstract available.
Heart Failure* ; Heart* ; Hypertension, Pulmonary* ; Nifedipine*

Human lymphoblastoid B-cell lines immortalized by Epstein-Barr virus (EBV) were established from peripheral blood of patients with acute myeloblastic and chronic lymphocytic leukemia and chronic fatigue syndrome. The sera of patients with acute myeloblastic and chronic lymphocytic leukemia did not show antibodies to Epstein-Barr viral capsid antigen (VCA), but serum of a patient with chronic fatigue syndrome disclosed antibodies to VCA (IgG, IgM), and EBNA was demonstrated in peripheral blood mononuclear cells by polymerase chain reaction. The established cell lines were mature B-cell phenotypes with polyclonal proliferation in early passage and no evidence for commitment to other lineages. The immortalized cells by EBV were designated as CSUP-1 and CSUP-2 (from acute myeloblastic leukemia, FAB classification M2 and M1), CSUP-3 (from chronic lymphocytic leukemia) and CSUP-4 (from a patient with chronic fatigue syndrome). The CSUP-1, 2, 3, and 4 grew in suspension forming clumps with a doubling time of 38 to 49 hours. Colony formation was not recognized in plate. By light and electron microscopic examination, the immortalized cells showed features of lymphoblastoid to plasmacytoid lymphocytes, and multinucleated giant cells. The lymphoblastoid cells showed scanty cytoplasm with poorly developed organelles. Immunophenotypic analyses of CUSP-1, 2, 3, and 4 with monoclonal antibodies by flow cytometry showed B-cell phenotype with polyclonal proliferation in early passage. Epstein-Barr virus nuclear antigen was confirmed in the extracted DNAs from immortalized cells by polymerase chain reaction. DNA analysis showed a normodiploid stemline with a DNA index of 1.12. The established cells were strongly reactive for CD10, CD30 (Ki-1) in early passage, and bcl-2 and c-myc onco-protein in early and late passage. Karyotypic analysis of CSUP-1, 2, 3 and 4 showed 46, XY or 46, XX. No tumorigenesis in heterotransplanted SCID mouse was recognized. This immortalized cells by EBV should be a valuable cell lines to study the pathogenesis of EBV-related malignant lymphoma.
Animals ; Antibodies ; Antibodies, Monoclonal ; B-Lymphocytes* ; Capsid ; Carcinogenesis ; Cell Line ; Classification ; Cytoplasm ; DNA ; Fatigue ; Fatigue Syndrome, Chronic ; Flow Cytometry ; Giant Cells ; Granulocyte Precursor Cells ; Herpesvirus 4, Human* ; Humans* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Leukemia, Myeloid, Acute ; Lymphocytes ; Lymphoma ; Mice ; Mice, SCID ; Organelles ; Phenotype ; Polymerase Chain Reaction

The author observed one case of typical Linear bassal cell nevus who was 3 year old girl. Since birth, skin lesions reveal a linear band like nodules along the left lateral margin of nose, which are consists of pinhead sized, normal skin colored, pearly and translucent papules. Histopathologically, the preparations showed muItifocal irregular masses of basal type epithelial cells in continuity at pilosebaceous follicles and the cells were oval or spindle shaped and a peripheral palisade arrangement. But comedones and nevus cells were not identified. Diagnosis confirmed by clinical appearance, histopathologically and other clinical study. There were marked improvement by the locaI application of 2% 5-Fluorouracil solution.
Child, Preschool ; Diagnosis ; Epithelial Cells ; Female ; Fluorouracil ; Humans ; Nevus* ; Nose ; Parturition ; Skin

No abstract available.
Ethmoid Sinus*

Botulium toxin A has been used therapeutically in humans for over 20 years for a variety of medical indications. Some wrinkle and unsightly facial expressions are due to hyperkinetic muscle. For the past year, the author has injected it for variant purpose, so we describe the our experience with the variant extended use of the toxin including correction for just dynamic wrinkle, used with subperiosteal face lifting or peeling, post-traumatic twitching, and facial paralysis and relevant anatomy are discussed. Also we have another concept about muscle anatomy which have superficial and deep portion. The superficial portion is for harmonious action with SMAS during facial expression, which is also related to fine wrinkle, and the deep portion play role gross movement. Botulium toxin is safe and effective in varient field without complication. Its use is associated with a high degree of patient and physician satisfaction.
Exotoxins* ; Facial Expression ; Facial Paralysis ; Humans ; Rhytidoplasty

No abstract available.
Animals ; Cardioplegic Solutions* ; Oxygen* ; Rats*

PURPOSE: We reviewed 5 years worth of experience with peritoneal drainage and dialysis in infants who underwent open heart surgery. The aim of this study was to investigate the effect of peritoneal drainage and peritoneal dialysis on fluid balance and several parameters of intensive care. METHODS: Six(10%) of 60 consecutive infants who underwent open heart surgery required peritoneal dialysis during peritoneal drainage. Simple peritoneal drainage was performed in the remaining 54 infants. The silicone rubber peritoneal dialysis catheter was inserted into the center of abdominal cavity just after operation, and subsequent peritoneal drainage was maintained during intensive care. RESULTS: Mean age of the study group was 0.48+/-0.21 years(M: F=32: 28). Early postoperative mortality amang the infants with congenital heart disease was 1.6%. Total amount of output was 7.0+/-2.28mL/kg/hr, urine output 5.14+/-2.9lmL/kg/hr, pleural fluid 0.80+/-0.5lmL/kg/hr, and peritoneal fluid 1.20+/-0.90mL/kg/hr. The ratio of output to intake(O/I) was 1.06. None of the complications required early termination of peritoneal drainage or peritoneal dialysis. Hemodynamics and pulmonary function were maintained steadily during postoperative intensive care. CONCLUSION: The early institution of peritoneal drainage and peritoneal dialysis in infants with congenital heart disease after cardiac operations not only removes fluid, thus easing fluid restriction, but may also improve cardiopulmonary function.
Abdominal Cavity ; Ascitic Fluid ; Catheters ; Dialysis ; Drainage* ; Heart Defects, Congenital* ; Heart* ; Hemodynamics ; Humans ; Infant* ; Critical Care ; Mortality ; Peritoneal Dialysis ; Silicone Elastomers ; Thoracic Surgery ; Water-Electrolyte Balance