BACKGROUND: The proper management of the patients with hypotention remains a difficult clinical problem. This study was designed to evaluate the efficacy and safety of gepefrin in the treament of symptomatic hypotensive patients in outpatient clinic of university hospital. METHODS: Thirty milligrams of Gepefrin was given twice daily for 4 weeks in 30 patients with hypotension(6 males, 24 females ; 23-60 years of age). Blood pressure, heart rate, subjective symptoms and side effects were checked before medication and at the end of 1st, 2nd, 3rd, 4th week of medication. RESULTS: 1) Grpefrin increased sitting systolic blood pressure significantly(p<0.05) by the end of 1st week and thereafter. 2) Hypotensive symptoms were improved in 76% of hypotensive patients and overall rate of usefulness was 70%. 3) Heart rate did not change significantly. 4) One patient complained of loose bowel movement and another one, of anorexia among 30 study patients and all laboratory parameters were within normal limits before and after drug treatment, thus the rate of safety was 93%. CONCLUSION: Results from this study suggests that gepefrin 60mg daily increases the blood pressure mildly and improves the symptoms moderately in symptomatic hypotensive patients.
Ambulatory Care Facilities ; Anorexia ; Blood Pressure ; Female ; Heart Rate ; Humans ; Hypotension* ; Male ; Quality of Life

This study was conducted to determine the effect of oxantel/pyrantel tablets, oxantel suspension, pyrantel dry syrup and pyrantel tablets against T. trichiurus and A. lumbricoides infections. Twenty-four cases of mixed infections of T. trichiurus and A. lumbricoides were treated with oxantel/pyrantel tablets at a single dose of 20 mg/kg of body weight, and 49 cases of single infection of T. trichiurus were administered oxantel suspension at a single dose of 15 mg/kg of body weight. On the other hand, single infection of A. lumbricoides in 18 cases was administered pyrantel dry syrup at a single dose of 5 mg/kg of body weight. In the above 91 cases, the negative conversion rate and the egg reduction rate of egg out-put before and after the drug administration were examined by the cellophane thick smear method and Stoll's egg counting technique. A follow-up examination was carried out 3-4 weeks after the drug administration. Other 59 cases of single and mixed infection of T. trichiurus and A. lumbricoides were examined by the cellophane thick smear method only and administered pyrantel tablets at a single dose of 2.5 mg/kg of body weight. The results were summarized as follows: The prevalence rates of T. trichiurus and A. lumbricoides infection in this study were 42.8% and 27.2% respectively by the cellophane thick smear method among 1,066 stool specimens. The egg negative conversion rate and the egg reduction rate in the administration of oxantel/pyrantel tablets at a single dose of 20 mg/kg body weight were 75.0% and 97.8% respectively in T. trichiurus infection and 100% each in A. lumbricoides. The egg negative conversion rate and the egg reduction rate in the administration of oxantel suspension at a single dose of 15 mg/kg body weight were 85.7% and 93.0% respectively in sinlge infection of T. trichiurus. The egg negative conversion rate and the egg reduction rate in the administration of pyrantel dry syrup at a single dose of 5 mg/kg body weight were 100% each in single infection of A. lumbricoides. The qualitative evaluation in cases of single and mixed infection of T. trichiurus and A. lumbricoides were by means of pyrantel tablets at a single dose of 2.5 mg/kg body weight, the cure being 100% against A. lumbricoides but 17.0% against T. trichiurus. There were no undesirable side effects in this study and oxantel suspension and pyrantel dry syrup were well accepted and tolerated.
parasitology-helminth-nematoda ; Trichuris trichiurus ; Ascaris lumbricoides ; chemotherapy ; oxantel ; pyrantel

PURPOSE: The 8 pancreatic cancer cell lines (BxPC-3, Capan-2, CFPAC-1, HPAC, Capan-1, AsPC-1, MIA PaCa-2, and PANC-1) were investigated to identify the factors which would increase CA19-9 related to the Lewis antigen. CA19-9 in serum is a well-known tumor marker, and is frequently used for the clinical diagnosis of pancreatic cancer. The oligosaccharide on the CA19-9 epitope is a sialylated Lewis A blood group antigen. METHODS: beta3Gal-T was detected by reverse transcriptase polymerase chain reaction (RT-PCR). The phenotypes and genotypes of Lewis antigen were determined by flow cytometry analysis and restriction fragment length polymorphism (RFLP), respectively. The phenotypes of sLe(a) were assessed by flow cytometry analysis and the sLe(a) on supernatants was detected by sodium dodecyl sulfate - polyacrylamide gel electrophoresis (SDS-PAGE). CA19-9 and DUPAN-2 on supernatants were measured by enzyme immunoassay. RESULTS: CA19-9 productions were possible from all cell lines since they all had beta3Gal-T and there were no genotypical Lewis negative (le/le). The elevation of CA19-9 was noted on Capan-2 and CFPAC-1, which were phenotypically Lewis positive (Le(a+b+)), as expected. Interestingly, it was also elevated in BxPC-3 even though the line was known to be phenotypically Lewis negative (Le(a-b-)). Sialyl Le(a) appeared to play an important role in this phenomenon. Although CA 19-9 was not detected in the phenotypically Lewis negative pancreatic cell line without sialyl Le(a), the levels of DUPAN-2 were variable. CONCLUSION: It was revealed that an elevated CA19-9 was related with increased expression of Lewis gene, not merely the existence of the gene. Further investigations on the role of ST3Gal are warranted to explain the mechanisms of the variable levels of DUPAN-2 in Le(a-b-) cell lines.
Cell Line* ; Diagnosis ; Electrophoresis, Polyacrylamide Gel ; Flow Cytometry ; Genotype ; Immunoenzyme Techniques ; Pancreatic Neoplasms* ; Phenotype ; Polymorphism, Restriction Fragment Length ; Reverse Transcriptase Polymerase Chain Reaction ; Sodium Dodecyl Sulfate

BACKGROUND: Negative U wave is frequent maker of systemic hypertension, aortic or mitral regurgitation and myocardial ischemia. This study was undertaken to determine the diagnostic significance of exercise-induced negative U wave in coronary artery stenosis. METHOD: 72 patients(46 men and 26 women ; 24~66 years of age) with chest pain were analysed with exercised-induced negative U wave and coronary angiographic finding. RESULT: Exercise-induced negative U wave was seen in 14 patients(19%). Among 14 patients with exercise-induced negative U wave, the predictive value of significant coronary artery stenosis(> or =75% stenosis of major coronary artery) was 71%, Exercise-induced negative U wave is more prevalent in patients with significant coronary artery stenosis(p<0.05). CONCLUSION: Exercise-induced negative U wave is a good marker of significant coronary artery stenosis.
Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Humans ; Hypertension ; Male ; Mitral Valve Insufficiency ; Myocardial Ischemia

1,25-Dihydroxyvitamin D3(1,25(OH)2D3) and interferon-gamma(IFN-gamma) are capable of regulating cells in immune system and are representative differentiation inducer/activator of monocyte/macrophage lineage cells. They may affect the proinflammatory and immune effector functions of monocyte/macrophage activated with immunostimulants such as bacterial endotoxin. The expression of HLA-D, costimulatory adhesion molecules such as ICAM-1(CD54) and Mac-1(CD11b), and secretion of IL-1betawere used to evaluate the influence of 1,25(OH)2D3 and IFN-gammaon human promyelocytic cell line THP-1 cells. IFN-gammamarkedly induces the expression of ICAM-1 and HLA-D, and 1,25(OH)2D3 induces the expression of Mac-1 to a lesser extent. LPS alone markedly induces the expression of ICAM-1 molecule without any increase of HLA-D expression. LPS-induced ICAM-1 expression is synergistically increased by IFN-gammapriming, but fail to increase Mac-1 and HLA-D expression. IFN-gamma, 1,25(OH)2D3, and LPS separately do not induce the secretion of IL-1betaby THP-1, however, IL-1betasecretion is synergistically increased when THP-1 is exposed to the combination of IFN-gammaand LPS. LPS-induced IL-1betaproduction by IFN-gamma-primed cell is much higher when THP-1 have been previously exposed to 1,25(OH)2D3. In conclusion, these results show that expression of MHC class II and costimulatory adhesion molecules, and production of IL-1betaby cells of monocyte/macrophage lineage is highly regulated and monocyte /macrophage differentiation is required for optimal proinflammatory and immune reaction in response to exposure of bacterial endotoxin.
Humans

Guillain-Barre syndrome (GBS) is clinically characterized by acute, progressive, symmetrical weakness and areflexia. However there have been several reports of patients with the acute motor axonal neuropathy type of GBS showing hyperreflexia. We experienced a patient with acutely developed ascending progressive weakness of low extremities up to face following enteritis and concomitantly developed hyperreflexia following initial treatment with IVIG. The spinal MRI scan revealed radiological features of acute diffuse myelitis. The treatment with steroid resulted in fairly good clinical and electrophysiological outcome.
Axons ; Enteritis ; Extremities ; Guillain-Barre Syndrome* ; Humans ; Immunoglobulins, Intravenous ; Magnetic Resonance Imaging ; Myelitis* ; Reflex, Abnormal

Multicentric reticulohistiocytosis(MR) is a rare systemic disease of unknown etiology, characterized by destructive polyarthritis and mucocutaneous eruptions in various locations. In most cases rapidly progressive destructive polyarthritis is the presenting symptom, followed by typical skin eruptions. Skin lesions are characterized clinically by erythematous to brownish nodular lesions on the face, periungual areas and the trunk. The biopsy demonstrating the characteristic granulomatous infiltration of multinucleated giant cells and histiocytes with a ground-glass appearance is diagnostic. We report a case of multicentric reticulohistiocytosis in a 57-year-old female patient, who had skin lesions with polyarthritis and cardiac problem. To our knowledge, this is the first case report in Korea.
Arthritis ; Biopsy ; Female ; Giant Cells ; Histiocytes ; Humans ; Korea ; Middle Aged ; Skin

Video capsule endoscopy (VCE) is an ingestible video camera that transmits high-quality images of the small intestinal mucosa. This makes the small intestine more readily accessible to physicians investigating the presence of small bowel disorders, such as Crohn's disease (CD). Although VCE is frequently performed in Korea, there are no evidence-based guidelines on the appropriate use of VCE in the diagnosis of CD. To provide accurate information and suggest correct testing approaches for small bowel diseases, the Korean Gut Image Study Group, part of the Korean Society of Gastrointestinal Endoscopy, developed guidelines on VCE. Teams were set up to develop guidelines on VCE. Four areas were selected: diagnosis of obscure gastrointestinal bleeding, small bowel preparation for VCE, diagnosis of CD, and diagnosis of small bowel tumors. Three key questions were selected regarding the role of VCE in CD. In preparing these guidelines, a systematic literature search, evaluation, selection, and meta-analysis were performed. After writing a draft of the guidelines, the opinions of various experts were solicited before producing the final document. These guidelines are expected to play a role in the diagnosis of CD. They will need to be updated as new data and evidence become available.
Capsule Endoscopy* ; Crohn Disease* ; Diagnosis ; Endoscopy, Gastrointestinal ; Hemorrhage ; Intestinal Mucosa ; Intestine, Small ; Korea ; Writing

Although a metastasis to the gastrointestinal tract (GI) is rare in patients with hepatocellular carcinoma (HCC), it can occur by hematogenous or lymphatic spread, or by direct invasion of a tumor. A 61-year old woman who had a progressing large primary liver cancer presented with upper gastrointestinal (UGI) bleeding. UGI endoscopy showed a large duodenal submucosal tumor-like mass with a central ulcer and adherent blood clots. Endoscopic biopsy and coagulation using argon plasma probe were performed. The microscopic examination revealed a HCC. We report this unusual case of HCC with direct invasion of the duodenum.
Argon ; Biopsy ; Carcinoma, Hepatocellular* ; Duodenum* ; Endoscopy ; Female ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Liver Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Plasma ; Ulcer

Crohn’s disease (CD) is a relapsing and progressive condition characterized by diarrhea, abdominal pain, weight loss, and hematochezia that results in serious complications such as perforations, fistulas, and abscesses. Various medications, interventions, and surgical treatments have been used to treat CD. The Korean guidelines for CD management were distributed in 2012 and revised in 2017 by the Inflammatory Bowel Disease (IBD) Research Group of the Korean Association for the Study of Intestinal Diseases. Substantial progress in mucosal immunologic research has elucidated the pathophysiology of IBD, leading to development of biological agents for treatment of CD. The first developed biologic agent, tumor necrosis factor-α agents, were shown to be efficacious in CD, heralding a new era in management of CD. Subsequently, vedolizumab, a monoclonal antibody against integrin α4β7, and ustekinumab, a human monoclonal antibody that inhibits the common p40 subunit of interleukin-12 and interleukin-23, were both approved for clinical use and are efficacious and safe for both induction and maintenance of remission in moderate-to-severe CD patients. Moreover, a recent study showed the non-inferiority of CT-P13, an infliximab biosimilar, compared with infliximab in CD patients. The third Korean guidelines for CD management provide updated information regarding treatment of moderate-to-severe CD patients with biologic agents.