Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

Two hundreds fifty seven cases of normal mammogram were analysis for classification of types of breasts.Ranging from 20 to 79 years of age, mean age was 45 years. Two projections, craniocaudal & mediolateral, were used. Age, nutrient condition, familial tendency and hormonal factors influence to breats hisologically. Normalbreats were classified into the standard (9.75%), ductal (71.7%), glandular (6.2%) and atrophic (12.4%) types.Ductal type was further subclassified into intraductal, periductal and mixed types. Atrophic type was susbdividedinto fibrous and fatty, Standard type was observed in younger women, instead of atrophic type was seen in olderage group, especially after menopause. Periductal type was most common (65.4%), Glandular type was mostly intwenty to thirty year group. According to increase of age, gladular or ductal type transformed into atrophic type.
Classification ; Female ; Humans ; Menopause

OBJECTIVES: Considering large diversity of clinical presentation of schizophrenia, it is important to identify valid clinical subtypes or dimensions that might have homogeneous biological underpinning. The current study aimed to explore lifetime symptom-based dimensional phenotypes in patients with chronic schizophrenia, and to investigate their correlation with cognitive functions and other clinical characteristics. METHODS: Lifetime-based symptoms and additional clinical variables were measured using the Diagnostic Interview for Genetic Studies and the Schedule for the Deficit Syndrome in 315 clinically stable patients with chronic schizophrenia. Through principal components factor analysis, eight dimensional phenotypes were obtained. Comprehensive neuropsychological tests were administered for 103 out of 315 patients, and domain scores were calculated for cognitive domains defined in the MATRICS consensus battery. RESULTS: 'Non-paranoid delusion factor' including delusions of grandiose or religious nature, showed significant negative correlation with processing speed, working memory, attention/vigilance, and general cognitive ability, and positive correlation with intra-individual variability. 'Negative symptom factor' showed significant negative correlation only with general cognitive ability. Those two factors were also negatively correlated with function levels measured by Global Assessment Scale (GAS), and associated with poor treatment responses. CONCLUSION: Symptom-based dimensional phenotypes of schizophrenia measured on a lifetime basis showed discriminative correlation with cognitive function domains, global functioning level, and overall treatment responses, indicating their possibility as valid phenotype axes of schizophrenia having homogeneous biologic basis.
Appointments and Schedules ; Cognition ; Consensus ; Delusions ; Humans ; Memory, Short-Term ; Neuropsychological Tests ; Phenotype ; Schizophrenia*

A lateral chest radiograph is frequently useful and sometimes decisive in detecting chest pathology. Certainparts, such as the posterior wall of the bronchus intermedius (PWBI) and subcarinal regions, can be evaluated onlyon lateral chest radiograph. The authors present and emphasize the findings of PWBI and subcarinal abnormalities. Abnormal PWBI, more than 3 mm thick, is seen in cases of minor degree of oblique position, pulmonary edema, inflammation, neoplasm and enlarged lymph nodes. It can also be seen in patients with subcarinal mass. The findings of subcarinal mass on lateral view are ill-defined increased opacity, fullness of the inferior hilarregion, doughnut sign, extra-density and thickening of the PWBI. Detection of changes in the PWBI and subcarinalregion may be the only diagnostic evidence of hilar and subcarinal disease and helps in its early detection priorto computed tomography.
Bronchi* ; Humans ; Lymph Nodes ; Pathology ; Radiography, Thoracic* ; Thorax*

Bony defect is one of the most common problems in craniomaxillofacial surgery. Although aurogenous bone graft is the best choice for the treatment of bone defect, it provides many problems such as donor site morbidity, irregular absorption, and limited amount of harvest. To overcome the shortcomings of autogenous bone graft many bone substitutes have been introduced. The ideal bone substitution is to have characteristics such as cheap, easy to obtain, rapid fusion to recipient bone, hard structure, long maintenance of shape and volume, low infection rate, and low exposure rate. Among those bone substitutes which have been widely used we chose lyophilized cartilage allograft because of low antigenecity, low resorption rate, easiness of carving and ling term preservation. From August 1993 to August 1997, 66 patients had been performed craniomaxillofacial reconstruction with lyophilized cartilage allograft. Orbital wall reconstruction and correction of enophthalmos were 24, correction of cleft lip and nose deformity were 19, temporal augmentations were 7, and others 16. Complications such as infection, exposure were not common. And partially removed cartilage was proved some calcification. Radiologic follow-up presented well positioned lyophilized cartilage allograft. Two radiologic works revealed haziness of bone density at the site of cartilage allograft. This suggests the ossification of lyophilized cartilage allograft. Together with liw infection rate, low exposure rate, and good framework for osteoconduction, lyophilized cartilage allograft are regarded as one of the good bone substitutes.
Absorption ; Allografts* ; Bone Density ; Bone Regeneration ; Bone Substitutes ; Cartilage* ; Cleft Lip ; Congenital Abnormalities ; Enophthalmos ; Follow-Up Studies ; Humans ; Nose ; Orbit ; Tissue Donors ; Transplants

PURPOSE: A common finding of carotid artery on magnetic resonance angiograms(MRAs) is a signal dropout along the posterior wall of carotid bulb due to reverse flow. The purpose of this study is to evaluate variable flow patterns on bifurcated carotid arterial phantoms using steady-state flow. MATERIALS AND METHODS: We designed phantoms of a bifurcated carotid artery with acrylic materials. Flow patterns were evaluated with axial and coronal imaging of MRA(2D-TOF, 3D-TOF), color Doppler imaging, and computational fluid dynamics (CFD) within the phantoms constructed of an automated closed-type circulatory system filled with 4% sugar solution. These findings were compared with findings obtained from normal volunteers. RESULTS: Axial 3D-TOF MRA images exhibited closer resemblance to the contour of the inner wall of phantoms when compared to coronal 2D-TOF MRA imaging. However, 2D-TOF MRA showed good contrast difference of signal intensities between forward flow area and reverse flow area. Dark zones with reduced signal intensities due to reversed flow were separated from the outer wall of the internal and external carotid arteries by a thin layer of forward flow along the wall on the source slice image of MRA. The general hemodynamics of the phantoms on MRA were identical to hemodynamics on color Doppler imaging and CFD. The results obtained with the phantoms matched the findings on normal volunteers. CONCLUSION: Although representations of bifurcated carotid arterial phantoms on axial 3D-TOF MRA were excellent if ideally desinged, the zone of reversed flow could be a significant factor in creating distorted image when the zone of reversed flow contacted directly with curved or deformed arterial wall.
Carotid Arteries ; Carotid Artery, External ; Healthy Volunteers ; Hemodynamics ; Humans ; Hydrodynamics ; Magnetic Resonance Angiography* ; Patient Dropouts

Percutaneous balloon mitral valvuloplasty(PMV) was comparable to surgical commissurotomy in initial and long term follow-up results in selected patients with symptomatic severe mitral stenosis. Transseptal puncture was necessary for antegrade introduction of balloon. In patient with kyphoscoliosis, PMV was relatively contraindicatied due to difficulty and risk of septal puncture. We performed the PMV in a patient with kyphoscoliosis and severe mitral stenosis. The patient was presented with NYHA class III. Echocardiographic evaluation revealed mitral valve area of 0.8cm2 and mean diastolic pressure gradient of 12mmHg. X-ray film of T-L spine showed severe kyphoscoliosis. Transseptal puncture was possible with modification of angle of Brockenbrough needle at the site of 15cm from the needle tip. After transseptal puncture, Inoue balloon was introduced into the LV and gradual ballooning was performed with optimal results. Hemodynamic variable were improved immediately after intervention and mitral valve area was increased from 0.7cm2 to 1.8cm2. Patient was discharged with NYHA class I.
Blood Pressure ; Echocardiography ; Follow-Up Studies ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Needles ; Punctures ; Spine ; X-Ray Film

No abstract available.
Gallstones* ; Lithotripsy* ; Ultrasonography*

PURPOSE: The study was done to investigate the effect of ethanol inhalation on postoperative nausea in patients using Patient Controlled Analgesia (PCA). METHODS: The data were collected from June 1st 2006 to September 30th, 2007. The subjects were 70 patients who had had orthopedic surgery under general anesthesia. The levels of the Visual Analogue Scale (VAS) was used to measure postoperative nausea. The experimental group was given ethanol inhalation using ethanol pads and the control group received normal saline pads. All participants were instructed to take two deep sniffs with the pad one inch from the nose. This was repeated every five minutes for three doses. The collected data were analyzed using SPSS/WIN 12.0 program. RESULTS: The study supported all hypotheses. "The experimental group given first dose of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -5.900, p = .000). "The experimental group given second doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -7.507, p = .000). "The experimental group given third doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -6.685, p = .000). CONCLUSION: According to these results, the ethanol inhalation can be considered an effective nursing intervention for relieving the postoperative nausea in patients using PCA.
Analgesia, Patient-Controlled ; Anesthesia, General ; Ethanol ; Humans ; Inhalation ; Nose ; Orthopedics ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Salivary Glands*