To darify the cardiotoxic mechanism, the effect of bupivacaine on the cardiac function, especially in coronary flow rate was inveetigated in the isolated working rat heart. When administered into left atrium of the heart, lidocaine(10(-6)-10(-4) M) decreased heart rate in a dose-related fashion, whereae rate of coronary flow and mean coronary resistance tend to decrease and increase transiently, respectively. On the other hand, bupivacaine decreased the coronary flow rate and increased the mean coronary resistanee in a dose(10(-6)-10(-4) M) dependent manner. However, the decrement of heart rate by bupivacaine was not clear, but larger dose(10(-4) M) produced marked bradycardic effect. Bupivaeaine decreased the coronary flow and increased the mean coronary resistance in the isolated working heart, in which the heart rate and aortic pressure were kept constantly by electrical stimulation(3-6 pps, 0.5 mS, 20 V). These effects of bupivacaine were not influenced by 1 uM prazosin and 2 uM atropine pretreatment. But the bupivacaine effeets were completely abolished by 100 mM KC1 pretreatment and were inhibited markedly by 10(-7) M diltiazem, a Ca2+ -antagonist, pretreatment. From these results, it is suggested that the bupivacaine-induced coronary flow decrease is elicited via direct coronary vasoconstriction. And this vasoconstriction is due to the increments of intracellular Ca2+ concentration.
Animals ; Arterial Pressure ; Atropine ; Bupivacaine* ; Diltiazem ; Hand ; Heart Atria ; Heart Rate ; Heart* ; Prazosin ; Rats* ; Vasoconstriction

A papillary adeno-carcinoma of the renal pelvis is very rare tumor and mostly diagnosed by histopathologic findings. A 10-years-old female was admitted to Fatima Hospital with Rt. flank pain and intermittent gross hematuria.Herein, we report a case of papillary adeno-carcinoma of the renal pelvis.
Adenocarcinoma ; Female ; Flank Pain ; Humans ; Kidney Pelvis*

A clinical observation was made on the 7 cases of ureteropyeloplasty secondary to ureteropelvic junction obstruction during the period from July, 1980 to January, 1982 and brief review of literature was made. 1. Hydronephrosis secondary to obstruction at the ureteropelvic junction was caused by congenital ureteropelvic junction stricture in 4 cases, aberrant vessels in 1 Case and combined cases in 2 cases. 2. The youngest age was 15 year old and the oldest 53 year old. The ratio of male to female and left to right were 3:4 and 2:1. 3. The types of ureteropyeloplasty were Anderson-Hynes pyeloplasty in 5 cases, Sand Cormoily tube-flap pyeloplasty in 1 case and nondismembered pyeloplasty with elimination of aberrant vessels in 1 case. 4. Multiple holed stent was used in all cases. 5. Postoperative complications were developed in2 cases, which were intractable urinary leakage and restricture and were treated by nephrostomy and nephrectomy respectively. 6. Follow up study was performed in 6 cases. Among 7 cases of ureteropyeloplasty, good results included in 4 cases, fair in 1 case and poor in 2 cases.
Adolescent ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis ; Male ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Silicon Dioxide ; Stents

No abstract available.
Acute Kidney Injury* ; Nifedipine* ; Plasma* ; Renin*

The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.
Blast Crisis* ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Fever ; Follow-Up Studies ; Hemorrhage ; HLA-DR Antigens ; Humans ; Hydroxyurea ; Karyotype ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Male ; Middle Aged ; Pancytopenia ; Peroxidase ; Sepsis ; Splenomegaly

A clinical observation was made on 70 nephrectomized patients during the period from Jan, 1978 to June, 1981. The results were as follows. 1. The total number of inpatients during the period was 1,122 and nephrectomies were performed in 70 of the 744 total urologic operations (9.4%). 2. The age distribution showed the highest in 5th decade with 25.7% and the youngest case was observed at the age of 3, the oldest at 68 and 43 males and 27 females with male to female ratio 1.6:1. 3. The causative diseases of nephrectomy were tuberculosis (25.7%), renal stone (24.3%), renal injury (14.3%), renal tumor (10.0%) and hydronephrosis (8.0%) etc. 4. Percentage of nephrectomy in each disease were 39.1% in tuberculosis, 22.7% in renal stone, 31.3% in renal injury, 77.9 % in renal tumor and 50.0 % in hydronephrosis. 5. Surgical approaches consisted of frank subcostal approach in 38.6%, anterior abdominal extraperitoneal approach in 35.7 % and abdominal transperitoneal approach in 25.7 %. 6. Among the transfused patients who nephrectomized, the average amount of transfused whole bleed were 1757 ml on renal tumor, 1320 ml in renal injury, 700 ml in renal stone and 533 ml in renal tuberculosis. 7. Postoperative complications were postoperative bleeding in 3 cases, wound infection in 2 cases, paralytic ileus in 2 cases, wound disruption in 1 case, uremia in 1 case and upper G-I bleeding in 1 case.
Age Distribution ; Female ; Hemorrhage ; Humans ; Hydronephrosis ; Inpatients ; Intestinal Pseudo-Obstruction ; Male ; Nephrectomy ; Postoperative Complications ; Tuberculosis ; Tuberculosis, Renal ; Uremia ; Wound Infection ; Wounds and Injuries

The advantage of the radiofrequency lesion method are presented, with excellent control of the lesion volume, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The presence of afferent fibers in the ventral root which are spared by dorsal rhizotomy suggested an explanation for the failure of this procedure. Nerve fibers with their cells in the ganglion from ventral root will be destructed with streotactic radiofrequency ganglionotomy. Since the dorsal root ganglion cells are more sensitive to than are other structures within the bundle, one is using a differential heat lesion to specifically affect pain pathways while leaving motor pathways. proprioception, and afferent input relatively intact. In the higher thoracic regions, the pleura can be injured when using an traditional approach. Hence in the upper thoracic region(T2-T9), this type of approach requires that a small burr-hole be made at the superior aspect of the corresponding thoracic zygapophyseal joint. Stereotactic thoracic dorsal root ganglionotomy have carried out under local anesthesia on an inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have treated with stereotactic radiofrequency lesioning of the thoracic dorsal root ganglion. Four out of these 6 patients have been relieved of pain without serious complications. I think this should be a good armamentarium to the pain therapists in the management of intractable pain. (Korean J Anesthesiol 1997; 32: 857~862)
Anesthesia, Local ; Efferent Pathways ; Electrodes ; Fractures, Compression ; Ganglia, Spinal ; Ganglion Cysts ; Hot Temperature ; Humans ; Inpatients ; Nerve Fibers ; Pain, Intractable ; Pleura ; Proprioception ; Rhizotomy ; Spinal Nerve Roots ; Zygapophyseal Joint

Augmentation of the body contour by localized injection of hard and soft paraffin rose to a zenith of popularity in the early 1900s, whereafter the severe destructive consequences of such injections became widely recognized. However in Korea, these injections are still performed much by nonmedical person. Paraffin or other mineral oil injection into body is no more a useful method to change body contour. We reviewed 26 cases of sclerosing lipogranuloma of penis with complications in recent 13 years after mean 18.5 months from previous injection of paraffin or vaseline. We conclude that the public should be informed of detrimental effects of paraffin injections and that the best treatment of penile paraffinoma is complete excision and appropriate penoplasty.
Adult ; Aged ; Granuloma, Foreign-Body/*pathology/surgery ; Human ; Male ; Middle Age ; Paraffin/*adverse effects ; Penile Diseases/*pathology/surgery ; Sclerosis

PURPOSE: To evaluate the accuracy of intraocular lens (IOL) power calculations according to the chosen formulas and anterior chamber depths in eyes with short axial lengths. METHODS: A retrospective analysis was performed on 57 eyes of 50 patients (axial length < 22.0 mm) and 42 eyes of 36 patients (22.0 mm < or = axial length < 25.0 mm) who underwent cataract surgery. IOL power was calculated with the SRK II, SRK/T, Binkhorst, Holladay I, and Hoffer Q formulas. The differences between the predicted refraction and the actual refraction were compared and analyzed. The errors according to the anterior chamber depth were also evaluated. RESULTS: The SRK II formula showed a lower predictive accuracy, and the other formulas showed similar accuracies in eyes with short axial lengths. The Holladay 1 and Hoffer Q formulas showed good predictive accuracies in eyes with short axial lengths. Hyperopic shift tended to occur with all formulas in eyes with short axial lengths. When using SRK II and SRK/T formulas, a correlation between axial length and hyperopic shift was observed, with shorter axial length patients shifting to more hyperopic conditions. In eyes with short axial lengths, larger hyperopic shifts tended to occur in eyes with relatively deeper anterior chambers. CONCLUSIONS: In eyes with short axial lengths, preoperative predicted IOL power showed good accuracies with Holladay 1 and Hoffer Q formulas. Preoperative anterior chamber depth and axial length had a strong influence on the accuracies of predicted IOL power.
Anterior Chamber ; Cataract ; Eye ; Humans ; Lenses, Intraocular ; Retrospective Studies

No abstract available.
Hemangioma* ; Liver*