No abstract available.
Electrodes* ; H-Reflex* ; Muscles*

BACKGROUND: Recently involvenment of apoptosis, or programmed cell death, has been suggested in myocardial reperfusion injury. Free radicals are one of the inducers of apoptosis, and superoxide dismutase(SOD), a oxygen free radical scavenger, inhibits apoptotic cell death of neurons. Reperfusion of ischemic myocardium results in a burst of oxygen free radical production, however, it has not been defined that oxygen free radicals mediate apoptosis in myocardial reperfusion injury. This study was undertaken to investigate the role of oxygen free radicals by examining the inhibition of apoptosis by SOD. METHOD: New Zealand white rabbits (n=16) weighing 1.8-20kg underwent 30 minutes of left anterior descending coronary artery occlusion followed by reperfusion for 1 or 4 hours. In control group, bovine serum albumin(5mg/kg) was administered continuously via the left atrial appendage starting 10 minutes before reperfusion and ending simultaneously with reperfusion for 1 hour(n=4) or 4 hours(n=4). In SOD group, bovine erythrocyte SOD(15,000u/kg) was administered starting 10 minutes before reprefusion and ending simultaneously with reperfusion for 1 hour(n=5) or 4 hours(n=3). Ventricles were excised immediately after intervention. Tissues were fixed in 10% buffered formalin and 2.5% glutaraldehyde. Apoptosis was examined by hematoxylin and eosin(H&E) staining, in situ nick end labeling, and transmission electron microscopy. Number of apoptotic cells was evaluated semi-quantitatively on H&E stained section. RESULTS: Evidence of apoptosis was detected in every ischmia-reperfused myocardium, and apoptotic cells were found in the non-necrotic myocardium near areas of contraction band necrosis. In control group, the average number of apoptotic cells was 1.7(range 1.5-2.0)for 1 hour reperfused myocardium and 1.4(range 0.3-2.5) for 4 hours reperfused myocardium per high power field(x400). In SOD group, the average number of apoptotic cells was 0.2(range 0.2 -0.3) for 1 hour reperfused myocardium and 0.3(range 0.2-0.4) for 4 hours reperfused myocardium. There was a significant difference in the number of apoptotic cells between conrol and SOD groups (as a whole group 1.5 +/- 0.2 vs 0.3 +/- 0.1,p<0.01). CONCLUSION: SOD partially, however, singificantly inhibits apoptosis, which suggests that oxygen free radicals may induce apoptosis in ischemia-reperfused myocardium of rabbit.
Apoptosis* ; Atrial Appendage ; Cell Death ; Coronary Vessels ; Erythrocytes ; Formaldehyde ; Free Radicals ; Glutaral ; Hematoxylin ; In Situ Nick-End Labeling ; Microscopy, Electron, Transmission ; Myocardial Reperfusion Injury ; Myocardium* ; Necrosis ; Neurons ; Oxygen ; Rabbits ; Reperfusion ; Superoxide Dismutase* ; Superoxides*

No abstract available.
Heart Diseases* ; Heart* ; Humans ; Infant*

No abstract available.
Anemia* ; Humans ; Spinal Cord*

No abstract available.

Nurses working with families who has a hospitalized child are aware of the complexity of the tasks and stresses they deal with new setting of environment. The challenge is to assess the family coping activity that require the most immediate intervention for the effective nursing care for child and family. This study describe the family coping inventory for the clinical guidance to identify a family coping with stressors. The purpose of this study was to look at the factors related to the family's coping activity when the child was hospitalized. The data were collected with a questionnaire between July and August, 1999, in a sample of 106 families who have hospitalized child. Family coping was assessed using Family Crisis Oriented Personal Evaluation Scale(F-COPES). Data was analyzed using correlation coefficent and analysis of variance. Positive correlation was found between social support, reframe with mobilizing the family to acquire and accept help in sub-domain of family coping. Strongest correlation existed between the family's spiritual support and total family coping. The type of diagnosis, the level of family income, religion, and child's age were significantly different in family coping. The result show that the family coping is affected by the characteristics of child and family, as well as the factors of coping activity. Therefore, early assessment of family coping skill and activity is important to the prevention of problem with function toward wholeness as a unit and child's well being. It can be used with a broad range of child's hospitalization process. It also serve as a nursing record and planning tool for documenting issues that may become priorities for future interventions.
Adaptation, Psychological ; Child ; Child, Hospitalized* ; Diagnosis ; Hospitalization ; Humans ; Nursing Care ; Nursing Records ; Child Health ; Surveys and Questionnaires

The number of Kupffer cells was evaluated in hepatocellular carcinomas, including 18 primary lesions, 3 tumor emboli within the portal vein radicles and 4 metastatic lesions and in non-neoplastic liver adjacent to the primary lesions, to persue the origin of Kupffer cells dwelling in hepatocellular carcinoma. Hepatocellular carcinomas of the sinusoidal(trabecular) type were carefully selected, and excluded were those carcinomas which showed inflammation or other changes evoking inflammation. The immunohistochemical stains for CD 68 and lysozyme were done to identify Kupffer cells and to draw the mean Kupffer cell number per high power microscopic field of each lesion. Kupffer cell was most numerous in primary lesions followed by tumor emboli and still fewer in metastatic lesions. The Kupffer cell number in the primary lesions of hepatocellular carcinoma was in turn smaller than that of the adjacent non-neoplastic liver. The results suggest that, during the early neoplastic transformation, sinusoids of the non-neoplastic liver could creep into the carcinomatous tissue accompanying Kupffer cells.
Carcinoma, Hepatocellular ; Neoplasm Metastasis

Patients with atypical or incomplete Kawasaki disease are at same risk for development of coronary artery complications as typical Kawasaki disease. In this communication we report six patients with unusual presentation of Kawasaki disease complicated by coronary artery aneurysms, in whom correct diagnosis were not made in time for proper treatment. One of these patients died from massive myocardial ischemia due to giant aneurysms along the entire coronary artery system. These patients had either less than enough number of diagnostic criteria at initial presentation or diagnostic signs which occurred over an extended period of time, resulting in difficulty in diagnosis during the acute phase. As a result, none of these patients received intravenous gamma globulin treatment. Thus strict adherence to currently accepted criteria for diagnosis of Kawasaki disease may lead to failure to recognize atypical form of this illness with potential sequelae of myocardial ischemia or sudden death. We would like to emphasize from this experience that clinicians must be aware of the wide variations in clinical presentation of Kawasaki disease and take an aggressive approach in making correct diagnosis by obtaining early cardiac evaluation in order to initiate prompt treatment with intravenous gamma globulin.
Aneurysm ; Coronary Aneurysm* ; Coronary Vessels ; Death, Sudden ; Diagnosis ; gamma-Globulins ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia

To examine the usefulness of cardiac MRI in assessing patients (pt) with congenital heart diseases(CHD), informations obtained from MRI and echocardiogrphy (echo) were compared in 91 consecutive pt with CHD and was correlated with findigs at cardiac catheterization (53pt) and at surgery (71pt). Pt were studied with 1.5 Tesla MRI unit and multiplanar images of the heart and great vessels were obtained using ECG-gated multislice spin-echo technique. Age ranged from newborn to 22 years. We obtained the following results. MRI was vary useful in providing important diagnostic informations in 19pt, provided informations which was not crucial to the clinical decision in 28pt, and did not provide additional informations in 44pt. MRI was very useful in assessing complex lesions, particularly in identifying atrial situs, rudimentary ventricular chamber, criss-cross atrioventricular connection, total anomalous pulmonary venous connection, anatomy of ventricular septal defect in double outlet right ventricle, anomalous ventricular muscles, aortopulmonary collateral artery and distal pulmonary artery anatomy. En face view of the ventricular septum was very useful in clearly outlining the ventricular septal defect. MRI gave false information in 17pt. Diagnostic accuracy of MRI was poor for coarctation of the aorta in neonates and small infants, patent ductus arteriosus and pulmonary stenosis. Cardiac MRI is recommended for preoperative planning in selected pt with CHD, particularly with complex lesions.
Aortic Coarctation ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Double Outlet Right Ventricle ; Ductus Arteriosus, Patent ; Echocardiography* ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging* ; Muscles ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Ventricular Septum

BACKGROUND: Diagnosis of aortic arch obstruction can be made with two-dimensional and Doppler echocardiography in most cases.However,not infrequently,clear imaging of the aortic arch can not be obtained,particularly in sick neonates and young infants from a number of reasons and heart catheterization and angiography carries significant risk in sick babies.Therefore it is the purpose of this study to assess the feasibility and safety of counter-current aortography through a peripheral artery in young infants and neotates with suspected aortic arch obstruction. METHOD: We studied 56 patients with suspected aortic arch anomaly at Asian Medical Center from Feburary 1990 to April 1997.First choice for the peripheral artery was radial artery on the same side as the aortic arch,followed by brachial artery and axillary artery.Small 24 gauge plastic cannula was inserted and special attention was given to ensure that the peripheral artery,plastic cannula,and a syringe containing contrast material are all in the same plane.1ml/kg of contrast material was injected by rapid hand injection and biplane cineangiograms were taken at 60 frame/second. RESULTS: Fifty six patients underwent 58 angiograms.Age ranged from 5-255 days(median 30 days) and body weight nanged from 2.1-5.4kg(mean3.4kg).There were 27 males and 29 females.Arteries used were:Radial artery in 37,brachal artery in 19,and axillary artery in 2 cases.Peripheral arteries were ipsilateral side as the aortic arch in 54,contralateral side in 2 and bilateral in 2 cases.In 8 patients heart catheterization was done because of inadequate visualization of aortic arch anatomy and/or need for evaluating other defects.In 48 patients who had periperal angiography only,fluoroscopic time ranged from 0.6 to 3.5 minutes and total procedure time ranged from 10 to 15 minutes.Among these 48 patients,only 11 patients(23%) were given intraveous sedation and 37 patients(77%) did not recieve any sedation.Diagnosis of aortic arch anomaly was aortic coarctation in 38,aortic interruption in 10 and nomal aortic arch in 8 patients.Aortic arch anatomy was well demonstrated in all cases where injected artery was on the same side as the aortic arch.In patients who had angiograms through peripheral arteries contralateral to the side of the aortic arch did not haveadequate visualization of the arch.Compression of the carotid artery did not enhance the imaging of the arch.Simultanous bilateral angiography did not improve the imaging quality as compared to ipsilateral artery angiography.Transient complication,related to cannulation,e.g.,prolonged bleeding was seen in only one patient with aortic interruption.Circulation on the upper extremities was normal after angiography in all patients. CONCLUSION: Counter-current aortography using 24 gauge plastic cannular through peripheral artery is feasible,rapid,safe,economic and relatevely non-invasive procedure and provides adquate imaging of aortic arch obstruction in infants and neonates without risk of heart catheterization and angiography.We,therefore,recommend this procedure in selected patients in whom echocardiographic imaging alone is not conclusive for planning corrective sursery.
Angiography ; Aorta, Thoracic* ; Aortic Coarctation ; Aortography* ; Arteries* ; Asian Continental Ancestry Group ; Axillary Artery ; Body Weight ; Brachial Artery ; Cardiac Catheterization ; Cardiac Catheters ; Carotid Arteries ; Catheters ; Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Hand ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Infant* ; Infant, Newborn* ; Male ; Plastics ; Radial Artery ; Syringes ; Upper Extremity