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*

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

Primary role of ultrasound in patients with thyroid nodule is to determine the multiplicity and detect occult carcinoma. We analyzed US findings of 53 thyroid carcinomas with multiple nodular lesions from january 1988 to december 1991. The results were as follows: 1. 109 malignant nodules in 53 cases and 24 benign in 23 were comfirmed. 2. The nature of the masses were solid in 72 malignant nodules (74.2%), and complex in 25 (25.8%) of which 19 were predominantly solid. 3. The echo pattern of the solid and solid predominant masses were hypoechoic in 78 malignant nodules (80.4%), hyperechoic in 10 (10.3%), and isoechoic in 3 (9.3%) 4. Internal punctate calcifications within the masses were observed in 31 malignant nodules (31.9%). 5. Halo sign was present in 16 malignant nodules(16.5%). 6. The preoperative sonographic diagnosis of thyroid carcinoma was made in 39.4% of 53 cases with multiple nodules on US. In conclusion, the number, and halo formation of nodules were insignificant to differentiate the benign nodule from the malignant. The heterogeneous hypoechoic nodules with size greater than 4cm, multiple stippled calcifications, displacement of the trachea or other surrounding structures of combined lymph node enlargements seem to indicate the possibility of malignancy.
Diagnosis ; Goiter* ; Humans ; Lymph Nodes ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Trachea ; Ultrasonography

The use of osseointegrated implants is an accepted procedure for the treatment of Total, or partial edentulism and offers good predictability of long-term success. Osseointegration implies a firm and direct interlocking between vital bone and screw-shaped titanium implants. There should be not to interposed tissue between fixture and bone. This study was undertaken to assess the clinical condition, complication, and prosthodontic aftercare of different implant systems. One hundred fifty-nine patients treated with a total of 503 endosseous implants (364 Steri-oss threaded type, 69 Integral cylinder with HA coated type, 35 Steri-oss threaded with HA coated type, 21 Steri-oss cylinder with HA coated type and 14 3i implant type), Most of the implant were placed in type B and C bone quantity and type 2 and 3 bone quality according to Lekhorm and Zarb. The success rate of Steri-oss threaded type during healing and function was 92%, Steri-oss threaded type with hydroxyapatite coated was 91%, Steri-oss cylinder type with hydroxyapatite coated was 90%, Integral cylinder type with hydroxyapatite coated was 90% and 3i implant type was 93%. One hundred twenty-nine patients had been treated with implant prosthesis. 79 of these patients had received a fixed type prosthesis and 50 patients had received a removable type prosthesis. There were no differences between the implant systems with regard to age, gender. Failures were associated with poor bone quality, smaller implant sizes, a surgical installation technique and stress distribution when in function. Visual analgoue scales recorded as satisfied results functionally and esthetically, but 15% dissatified with chewing ability.
Aftercare ; Dental Implants* ; Durapatite ; Humans ; Mastication ; Mouth Rehabilitation* ; Mouth* ; Osseointegration ; Prostheses and Implants ; Prosthodontics ; Titanium ; Weights and Measures

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