ABSTRACT
The cause of a congenital diaphragmatic hernia is unknown. However, it is believed to result from a failure of pleuroperitoneal canal closure in a developing embryo. Congenital herniation of the anteromedial, retrosternal diaphragm is known as Morgagni hernia. We experienced a case of Morgagni hernia in an eighty three-year-old female who was admitted complaining of right upper abdominal pain. The Morgagni hernia was found incidentally by abdominal CT, Chest PA and right lateral view during the work up. A reduction of the transverse colon and greater omentum, and a cholecystectomy were performed. The size of the opening was 5x6 cm. The patient was discharged without complications.
Subject(s)
Female , Humans , Abdominal Pain , Cholecystectomy , Colon, Transverse , Diaphragm , Embryonic Structures , Hernia , Hernia, Diaphragmatic , Omentum , Thorax , Tomography, X-Ray ComputedABSTRACT
Perfluorocarbon liquids (PFCLs) are useful tools during vitreous surgery for complicated retinal detachments. Generally, these liquids are used as short-term vitreous replacement without retinal toxicities. But long-term tolerance of intraocular fluorochemicals is not established. We evaluated long-term tolerances to intraocular perfluorophenanthrene(Vitreon) or perfluorodecalin(DK-line) in the rabbit retina for a period of up to 3 months. Three days after C3F8 gas-compression of the vitreous, 1.2ml of highly purified PFCLs were injected into 26 rabbit eyes. Control eyes received same volumes of balanced salt solution. Eyes were examined by indirect ophthalmoscopy and light and electron microscopy. Clinically PFCLs were emulsified and dispersed into small bubbles after 2-3 weeks. Mild posterior subcapsular cataracts and vitreous opacities were observed after long-term retention of PFCLs. Histopathologically, at 1 week after surgery, several epiretinal macrophages were present in both groups. Focal disarrangements of photoreceptors were observed in perfluorodecalintreated group. At I month after surgery, protrusion of Muller cell, dropdown of photoreceptor nuclei, loss of photoreceptors, outer and inner segments and retinal pigment epithelial hypertrophy were observed. In perfluorodecalin-treated group, atrophy in outer nuclear layer and thinning of all the retinal layers occurred. At 3 months after surgery, small oil-like droplets were scattered throughout the retinal layers and retinal pigment epithelium in perfluorodecalin-treated group. These findings were almost totally confined to the lower part of retina that has been long-term contact with the liquids. Our findings suggest that perfluorodecalin is more toxic to the retina than perfluorophenanthrene. Both liquids are not adequate for long-term vitreous replacement, but may be useful for short-term intraoperative use.
Subject(s)
Atrophy , Cataract , Hypertrophy , Macrophages , Microscopy, Electron , Ophthalmoscopy , Retina , Retinal Detachment , Retinal Pigment Epithelium , RetinaldehydeABSTRACT
BACKGROUND: The relation between treadmill exercise testing and ambulatory ST segment monitoring in detection of ischemia in patients with coronary artery disease has not been well established, with pathophysiologic mechanisms underlying the development of ischemia in the ambulatory setting not being well elucidated. This study was performed to determine the relation between myocardial ischemic indexes on exercise testing and on Holter monitoring. METHODS: We analized 25 patients with stable angina and angiographically documented coronary artery disease, who exhibited ischemia both on a Bruce protocol exercise test and on 24-hr Holter monitoring while receiving routine antianginal medications. RESULTS: Mean heart rate at the onset of 1mm ST segment depression during exercise testing(74.4 VS 114.1 beats/min, p<0.01). Overall the correlations between ischemic indexes on both test were weak. But heart rate at the onset of ischemic episodes during Holter monitoring had a good correlation with heart rate at 1mm ST depression during exercise test. And the number of ischemic episodes on Holter monitoring revealed a weak negative correlation with duration of exercise during treadmill test. CONCLUSION: Ischemic indexes on exercise testing cannot accurately predict ischemic indexes on Holter monitoring in patients with coronary artery disease. In that regard, Holter monitoring may provide other clinical information in addition to that obtained by exercise testing in selected patients.
Subject(s)
Humans , Angina, Stable , Coronary Artery Disease , Depression , Electrocardiography, Ambulatory , Exercise Test , Heart Rate , Ischemia , Myocardial IschemiaABSTRACT
Cardiovascular changes has been reported eating and digestion. Experimental studies showed an early rise in cardiac output during eating which was attributable to an increased heart rate. This changes reverted to baseline valuse at the end of eating. To investigate postprandial cardiac functional change, we studied 20 healthy young men(average age 27 years) nonivasively with BP measurement, electrocardiography and M-mode echocardiohrapy before, 30 minutes and 3 hours after a lunch(600 Kcal). There was no significant changes in mean blood pressure after eating. On echocardiography, diastolic and systolic left ventricular internal dimensions were 4.9+/-0.4 and 3.1+/-0.4cm before meal and 4.9+/-0.4 and 2.9+/-0.3cm 30 minutes after eating. There was an average increase of 9% in cardiac output 30 minutes after meal. Fractional shortening was 36.4+/-6.4% before meal and 40.4+/-6.1(p<0.05) 30 minutes after eating. Ejection fraction changed from 73.5+/-7.9% to 78.2+/-6.3%(p<0.05) at postprandial 30 minutes. Myocardial contractility index assessed by the ratio of systolic BP to end-systolic volume was 4.3+/-1.6mgHg/ml before and 5.3+/-2.2mmHg/ml 30 minutes after eating. Peripheral resistance index as the ratio of mean blood pressure divided by cardiac index changed from 2,536+/-1,120dynesdSdcm-5/m2 to 2,048+/-472dynesdSdcm-5/m2 at postprandial 30 minutes. Electorcardiographic study revealed no changes in ST SE segment, T wave and heart rate after a meal. In conclusion, the increase of cardiac output after a moderate meal in healthy young men was associated with an increase in myocardial contractility and a decrease in peripheral vascular resistance.
Subject(s)
Humans , Male , Blood Pressure , Cardiac Output , Digestion , Eating , Echocardiography , Electrocardiography , Heart Rate , Meals , Vascular ResistanceABSTRACT
Authors evaluated the retinal toxic reation of intravitreal injection with a regimens of 10 microgram of amphotericin B on both phakic and aphakic eyes of rabbits. In addition to the eye receiving single injection, the effects of repeating the same dose second and third time at interval of 1 week were examined by light microscopy after last injection. The results were as follows: 1. Even a single intravitreal injection with regimens of 10 microgram amphotericin B, vitreous opacities and posterior subcapsular lens opacities were observed ophthalmoscopically. 2. A single and repeated intravitreal injections with regimens of 10 microgram amphotericin B showed focal areas of retinal toxic reation. 3. Lens extraction did not modify the retinotoxic reation of intravitreally administrated amphotericin B. 4. Repetitive intravitreal injection of amphotericin B did not show increasing retinal toxic reation.
Subject(s)
Rabbits , Amphotericin B , Cataract , Intravitreal Injections , Microscopy , RetinaldehydeABSTRACT
Ocular ischemic syndrome, characterized by rubeosis iridis, anterior uveitis, retinal arterial narrowing, retinal hemorrhage, cherry red spot, and neovascularization of the disc and/ or retina, is due to anterior and posterior segment ischemia caused by carotid artery obstruction. A 67-year-old man presented a typical ocular ishemic syndrome. The patient complained marked visual disturbance of the both eyes and headache for 15 days. On slit-lamp examination, there were no abnormal findings of the cornea, iris, and lens. Funduscopic finding revealed bilateral edema of the optic disc, marked attenuation of the arteriole with focal constriction, and dilatation of the veins. Fluorescein angiography showed prolonged arm-to-retinal circulation and retinal arteriovenous transit time, multiple microaneurysms, and staining retinal vessels of the both eyes. About 1+1/2 months later, iritis, rubeosis iridis, and cataract of both eyes were noticed. In carotid angiogram the left internal carotid artery was completely occluded, and the right internal carotid artery was incompletely occluded. About 7 months later, he died of CVA.