No abstract available.
Leiomyoma*

Although tubuloglomerular feedback (TGF) is involved in ureteral obstruction-induced increase in renal blood flow (RBF), its contribution to RBF is not well established due to the concommitant increases in prostaglandin (PG) and renal interstitial fluid pressure (Pisf), both of which affect RBF one way or the other. Since Pisf and TGF are closely affected by renal hemodynamics, RBF will respond differently to increases in ureteral pressure depending on renal hemodynamic conditions. Therefore, the purpose of the present study was to investigate how the changes in renal hemodynamics affect the response of RBF to increases in ureteral pressure. The effect of PG on RBF was assessed by comparing the effects obtained before and after indomethacin, a cyclooxygenase inhibitor. Six anesthetized dogs were prepared with flow probes and inflatable silastic occluder around the renal artery, the ureteral catheter with its free end attached to a water reservoir, and the arterial and venous catheters. RBFs were obtained at ureteral pressures of 0, 15, and 40cmH2O during the maintenance of the renal artery pressure (RAP) at the level of systemic arterial pressure, 10mmHg above and below the lower autoregulatory limit of RBF (65+/-4 mmHg) both before and after indomethacin administration (10mg/kg). In response to the ureteral pressure of 40cmH2O, RBF increased from 172+/-6 to 185+/-10ml/min when RAP's were equal to systemic arterial pressure and decreased from 162+/-10 to 120+/-9 ml/min when RAP's were 55+/-4mmHg. Indomethacin pretreatment, depending on the level of RAP either prevented an increase or augmented a decrease in RBF in response to ureteral pressure elevation. This suggests that RAP-dependent changes in susceptibility of the renal venous system to compression by increased Pisf is the main mechanism by which the changes in renal perfusion pressure modulate the response of RBF to ureteral pressure elevation.
Animals ; Arterial Pressure ; Catheters ; Dogs* ; Extracellular Fluid ; Hemodynamics ; Indomethacin ; Perfusion ; Prostaglandin-Endoperoxide Synthases ; Renal Artery ; Renal Circulation* ; Ureter* ; Ureteral Obstruction* ; Urinary Catheters ; Water

No abstract available.
Female ; Pregnancy ; Pregnancy, Multiple*

The radiologic and clinical findings of foreign bodies in the chest of children are well recognized. Foreign bodies in adults are infrequent, however, and the radiologic findings of these unusual circumstances have rarely been described. We classified various thoracic foreign bodies into three types according to their cause: Type I, Aspiration, Type II, Trauma or Accident; Type III, Iatrogenic. This pictorial essay will illustrate the radiologic findings and consequences of thoracic foreign bodies in adults, which have rarely been described in the radiologic literature. The clinical significance of thoracic foreign bodies will be also be discussed.
Accidents ; Adolescent ; Adult ; Aged ; Aspiration ; Esophagus/radiography ; Female ; Foreign Bodies/*etiology/*radiography ; Heart/radiography ; Human ; Iatrogenic Disease ; Male ; Middle Age ; Radiography, Thoracic ; Support, Non-U.S. Gov't ; *Thorax ; Wounds and Injuries/complications ; Wounds, Gunshot/complications

No abstract available.
Dermatitis, Seborrheic* ; Humans

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

BACKGROUNDs: A retrospective study was performed to define objective radiologic parameters in diagnosing epiglottitis on soft-tissue lateral neck radiographic study. METHODS: Parameters of soft-tissue structures(epiglottis width, third vertebral body width, ratio of epiglottic width to third vertebral body width) in 30 adult patients compared with those of age and sex-matched controls with foreign body in throat whose radiographic reading was normal. RESULTS: Epiglottis width of more than 11mm, ratio of epiglottis width(EW) to the third vertebral body width(C3W) of more than 0.5 were, respectively, found to be 100% sensitive and specific in differentiating between patients with and without epiglottitis. CONCLUSION: These preliminary results suggest that EW/C3W ratio of more than 0.5, EW of more than 11mm, respectively, may be useful in the diagnosis of epiglottitis in adult patients.
Adult* ; Diagnosis* ; Epiglottis ; Epiglottitis* ; Foreign Bodies ; Humans ; Neck ; Pharynx ; Retrospective Studies

PURPOSE: The diagnosis of Budd-Chiari syndrome on CT is difficult if CT do not demonstrate obstruction of the IVC or hepatic vein and other parameter is needed for the correct diagnosis. The purpose of our study was to determine the usefulness of measuring the diameter of azygos-hemiazygos vein on CT to differentiate Budd-Chiari syndrome from advanced liver cirrhosis. MATERIALS AND METHODS: Fourteen patients who were proven as Budd-Chiari syndrome on vena cavography were studied for analysis. All patients showed evidence of liver cirrhosis on CT. As a control group fifteen cases of advanced liver cirrhosis who underwent endoscopic sclerotheraphy due to esophageal variceal bleeding were also included for comparison. The largest short axis diameter of azygos-hemiazygos vein was measured in all patients at the level of diaphragm on axial CT and the results were compared in both groups. RESULTS: In patients with Budd-Chiari syndrome the largest short axial diameter of azygos-hemiazygos vein ranged from 0.5cm to 2.5cm(mean ;1.5cm). Only one patient who showed hepatic venous obstruction demonstrated a diameter of less than 1 cm(0. Scm). In contrast, the diameter in patients with advanced liver cirrhosis without obstruction of IVC or hepatic vein was less than 1 cm with a range from 0.2cm to 1 cm(mean ;0.6cm). CONCLUSION: The short axis diameter of azygos-hemiazygos vein was an indicator of IVC obstruction (Budd-Chiari syndrome).
Axis, Cervical Vertebra ; Budd-Chiari Syndrome* ; Diagnosis* ; Diaphragm ; Esophageal and Gastric Varices ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Veins*

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

Although the pterional approach is the standard surgical procedure for cerebral aneurysms, an eyebrow approach has been recently explored as minimal microneurosurgery with a small cranial opening along the eyebrow. To evaluate the efficacy and limitation of the eyebrow approach, the authors randomly selected patients to undergo surgery via pterional approach (n=32) and via eyebrow approach (n=38) within a period of 12 months. There was no significant difference in age distribution between patients with eyebrow approach and those with pterional approach (p<0.01). Also preoperative clinical Hunt & Hess grades and CT Fisher grades were not significantly different in both groups (p<0.01). On average, it took 70 minutes less to open and close the bone flap using the eyebrow approach than with the pterional approach. The success of the procedure was graded as good, fair, poor, or death. Favorable outcome rate consisting of good and fair was 90% for eyebrow approach and 82% for pterional approach. Mortality rate was 2.6% for eyebrow approach and 3.1% for pterional approach. The clinical evaluation showed no significant differences between the groups (p<0.01). The eyebrow approach for cerebral aneurysm is a simple and timesaving procedure with good cosmetic results. Also it gives good sucess rate with minimal brain retraction. Therefore, this approach can be alternative procedure for cerebral aneurysms. It may also be more useful for patients with poor general condition and old age.
Age Distribution ; Brain ; Eyebrows* ; Humans ; Intracranial Aneurysm* ; Mortality