Anterograde and retrograde conduction properties of dual AV nodal pathways were analyzed in 15 patients having no accessory pathway and showing dual AV nodal pathways during extrastimulation. Four patients in whom the supraventricular tachycardia of common type (common type SVT) was induced during electrophysiological study were classified into group A. The remained 11 patients in whom the common type SVT was not induced were classified into group B. There was a history of paroxysmal supraventricular tachycardia(PSVT) in all of group A but none of group B. Among the properties of dual AV nodal pathways, effective refractory period (ERP) of anterograde fast pathway (FP) and retrograde FP were not different in both group. Maximal AH interval of anterograde slow pathway (SP) was significantly shorter in group A than in group B (P<0.01). In group A, all patients had intact ventriculoatrial (VA) conduction, but in group B, 5 patients had no VA conduction. The paced atrial cycle length producing Wenckebach block (WBCL) and the paced ventricular cycle length producing retrograde VA block (VABCL) were significantly shorter in group A the in group B (p<0.05). There were two patients showing retrograde dual AV nodal pathways. The common type SVT was not induced in both of them probably due to long ERP of retrograde FP. In conclusion, in patients with anterograde dual AV nodal pathways, the occurrence of common type SVT is highly related to anterograde slow pathway refractoriness (WBCL) and retrograde fast patway refactoriness (VABCL).
Humans ; Tachycardia, Atrioventricular Nodal Reentry* ; Tachycardia, Supraventricular

BACKGROUND: An increase in oxidative stress has been suggested to play major roles in the complications of diabetes. The bulk of the experimental data favors enhanced free radicals in diabetes and antioxidant defense mechanisms may be reduced in diabetes. Melatonin, the major secretory product of the pineal gland has been shown to be a potent and specific hydroxyl radical scavenger. The purpose of our study was to determine the antioxidative effeet of melatonin in streptozotocin-induced diabetic rats. METHODS: Sprague-Dawley rats weighing 200-240 g were divided into 3 groups: normal controls(n-7), diabetic contmls(n-9), melatonin-treated diabetic animals(n-9). Diabetes was induced by intraperitoneal injection of streptozotoein(55 mg/kg body weight) and melatonin(6 mg/kg body weight) was orally administered for 20 days. At day 20 after streptozotocin administration, blood was collected for the assay of glucose, albumin and cholesterol. Erythrocyte membrane lipid peroxidation was determined by malonyldialdehyde(MDA) reactivity. RESULTS: 1) The MDA resctivity of erytbrocyte membrane in melatonin-treated diabetic animals (meanstandard deviation: 5.52+-1.52nmol/ml packed cells) were lower(p<0.05) than that in diabetic controls(7.68+-1.16nmol/mL packed cells). But, there was no significant difference between melatonin-treated diabetic animals and normal contls(4.93+-1.19 nmol/mL packed cells). 2) There were no significant differences of blood glucose and body weight between diabetic controls and melatonin-treated diabetic animals. CONCLUSION: These results show the antioxidative effect of melatonin in streptozotocin-induced diabetic rats. Further clinical and long-term experimental studies are needed to assess the effect of melatonin on development and progression of diabetic complications.
Animals ; Blood Glucose ; Body Weight ; Cholesterol ; Defense Mechanisms ; Diabetes Complications ; Erythrocyte Membrane ; Free Radicals ; Glucose ; Hydroxyl Radical ; Injections, Intraperitoneal ; Lipid Peroxidation ; Melatonin* ; Membranes ; Oxidative Stress ; Pineal Gland ; Rats* ; Rats, Sprague-Dawley ; Streptozocin

Two cases of familial asymmetric septal hypertrophy diagnosed by myocardial biopsy and clinical studies are reported with literature reviewed. Myocardial biopsy was done at right ventricular septal wall, and pedigree of family members was observed clinically and examined by noninvasive methods including chest X-ray and echocardiography.
Biopsy ; Cardiomyopathy, Hypertrophic* ; Echocardiography ; Humans ; Pedigree ; Thorax

It is known that radiation can induce various kind of mutations, cancers and congenital malformations. Day 9 rats embryos were cultured by whole embryo culture method and irradiated 0.1, 0.5, 2 and 5 Gy at day 10 to study the effect of radiation on the development of rat embryos. Haversting after 48 hours culture, the morphological changes and apoptosis were investigated. In addition, we assessed the expression patterns of p53, WAF1, Bcl -2, Bcl -x and Bax. Compared to the control group, no remarkable morphological changes were observed in the low dosage group (0.1 and 0.5 Gy). But at high dosage group (2 and 5 Gy), growth was retarded and the heart beats were weak. The crown rump length, the number of somites, and branchial arch were decreased and the rotation of embryo and development of otic pit and lens pit, and upper limb bud was delayed significantly. Especially in the 5 Gy group the most of external morphology were difficult to discriminate. In histological observations, high dosage group showed marked increase in the number of apoptotic bodies in the optic cup, trigeminal ganglion, pharyngeal arches, heart and small intestine. In western blot analysis, Bcl -x and Bax were not expressed in all groups. Expression level of Bcl -2 was constant regardless of the amount of radiation. Expression level of p53 and WAF1 increased significantly in accordance with the increasing amount of radiation. Especially, WAF1 was expressed 7.2, 6.3, 9.9 and 11.3 folds more than the control groups when embryos were exposed to 0.1, 0.5, 2 and 5 Gy, respectively. Considering WAF1 arrests cell cycle, we concluded that cell cycle was affected most sensitively to radiation injury. From these results, radiation showed growth retardation, decrease in protein synthesis, increase in apoptosis and expression of related genetic materials. These results may be used as a standard to test the effect of drugs for reducing and protecting agents against deterious effect of radiation in developing embryo and fetus.
Animals ; Apoptosis ; Blotting, Western ; Branchial Region ; Cell Cycle ; Crown-Rump Length ; Embryonic Structures* ; Fetus ; Heart ; Intestine, Small ; Radiation Injuries ; Rats ; Somites ; Trigeminal Ganglion ; Upper Extremity

A 30-year-old primigravida with gestational age of 25 weeks and 4 days was admitted for emergency cesarean section. She was diagnosed as pre-eclampsia with fetal distress. We anesthetized the patient through the combined spinal-epidural anesthetic technique, and there was no specific event throughout the surgical procedures and in post anesthetic care unit. Subsequently, she complained of unilateral hearing difficulty in the ward and an otolaryngology consultation was obtained. She was diagnosed with left sudden sensorineural hearing loss in full frequency range after an acoustic examination. She received intravenous and local steroid treatments for 4 weeks. She showed 32 dB on pure tone audiometry after 5 months. However, we could not continue follow-up testing on the patient because she stopped visiting the hospital since the last examination. We reported a case of uncommon unilateral sudden sensorineural hearing loss after a combined spinal-epidural anesthesia for emergency cesarean section.
Acoustics ; Adult ; Anesthesia* ; Audiometry ; Cesarean Section* ; Emergencies* ; Female ; Fetal Distress ; Follow-Up Studies ; Gestational Age ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural* ; Humans ; Otolaryngology ; Pre-Eclampsia ; Pregnancy

In order to understand the effect of retinoic acid (RA) on the craniofacial pattern formation during embryogenesis, we injected RA intraperitoneally into the pregnant female rat on day 11 post coitum (p.c.) and then embryos of day 13 to day 17 p.c. were isolated consequently. The overall morphology and the differential gene expression patterns were analyzed by the microscopic and (DD) RT-PCR methods, respectively. For the morphological study, the retardation of craniofacial region, the shortage of crown rump length and limbs were analyzed in the RA-treated embryos. In the RA-treated embryos of day 17, it was observed that the palatogenesis was completely finished just like in the normal embryos. However, the cleft plate was observed in 36 out of 52 total samples with the distance of cleft palate being 0.80+/-0.36 mm in average. The temporal expression pattern of Hox genes through RT-PCR revealed that the expression of Hoxa7 reached its peak on day 13 then slowly declined in the normal embryos. Whereas in the RA-treated embryos, the expression peak was observed on day 15, then declined subsequently. With the Hoxc8 gene, its expression was low in all stages until the day 16 of normal embryogenesis. On the other hand, Hoxc8 gene expression was detected slightly early on day 15 in the RA-treated embryos. In the study of Bcl-2 family genes, uniformly strong expression of anti-apoptotic and pro-apoptotic genes was observed from day 13 to day 17 of normal embryos, whereas anti-apoptotic gene expressions were decreased after day 16 in the RAtreated embryos. Additionally, a dramatic decline of pro-apoptotic gene expression was observed from day 13 to day 15 of the RA-treated embryos. Therefore, we believe that RA is a potential factor that is actively involved in the cleft palate formation. Moreover, it is profoundly linked with the regulation of Hox and Bcl-2 family gene expression pattern that leads to the embryonic malformation.
Animals ; Cleft Palate ; Crown-Rump Length ; Embryonic Development* ; Embryonic Structures ; Extremities ; Female ; Gene Expression ; Genes, Homeobox ; Hand ; Humans ; Palate* ; Pregnancy ; Rats* ; Tretinoin*

PURPOSE: To report the short-term effects of intravitreal bevacizumab alone, low-dose bevacizumab combined with low-dose triamcinolone injection, and intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) injection in patients with macular edema following central retinal vein occlusion (CRVO). METHODS: The medical records of 70 patients (70 eyes) with macular edema secondary to CRVO were reviewed retrospectively. Of these, 25 eyes (IVB group) were injected with intravitreal bevacizumab, 23 eyes (intravitreal low-dose bevacizumab and triamcinolone injection [IVB+IVTA] group) were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL), and 20 eyes (intravitreal dexamethasone implant [IVD] group) were injected with an intravitreal dexamethasone implant. The best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) of treated eyes were measured before injection and at 1 month and 3 months after injection. RESULTS: Groups were similar in age and gender distribution. At 1 month, the CMT of all groups was significantly lower, and the BCVA of all groups had increased significantly in patients with CRVO; there were no significant differences among the three groups (p = 0.246, p = 0.974). At 3 months, the CMT and BCVA had improved significantly only in the IVD and IVB+IVTA groups; the short-term effect was comparable to the IVD group. IOP showed no significant change at 3 months after injection for all groups. CONCLUSIONS: Considering various clinical variables in the treatment of macular edema associated with CRVO, intravitreal injection of bevacizumab, low-dose bevacizumab combined with triamcinolone, and dexamethasone implants may be used selectively.
Bevacizumab ; Dexamethasone ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema ; Medical Records ; Retinal Vein Occlusion ; Retinal Vein ; Retrospective Studies ; Triamcinolone ; Visual Acuity

PURPOSE: An optimal timing for diagnosis and management of papillary thyroid microcarcinoma (PTMC) has become the subject for much controversy. The aim of the present study is to analyze people's preference in Korea for timing of diagnosis and management of PTMC using an online questionnaire. METHODS: The questionnaire consists of 3 questions about preference for the diagnosis and management of PTMC and 3 additional questions about respondents' personal information. An online survey was conducted from March 3 to June 3 in 2015 using Google Survey (http://goo.gl/forms/b81yEjqNUA). RESULTS: A total 2,308 persons (1,246 males, 1,053 females) answered the questionnaire. Respondents' ages varied widely from teenagers to 70-year-olds. If there was a suspicious thyroid nodule from PTMC measuring less than 1 cm in diameter, 95.7% of respondents want to know a cytological diagnosis for it. If a thyroid nodule turned out to be a PTMC, 59.5% of respondents wanted it removed immediately. For surgical management of PTMC, 53.0% of respondents were worried more about recurrences than complications. In subgroup analyses, respondents younger than 40 years old more often want immediate surgery than others: 66.7% vs. 32.7% (P < 0.05). Respondents who underwent thyroid cancer surgery (n = 91) were worried more about recurrences than others: 69.2% vs. 52.4% (P < 0.05). CONCLUSION: Almost all respondents in the present study wanted diagnosis of suspicious thyroid nodules immediately. However, there were opposing opinions about the preferred timing for surgical treatment and surgical extents. A patient's right to know their disease status and decision on treatments should be emphasized all the more.
Adolescent ; Aged ; Diagnosis* ; Humans ; Korea* ; Male ; Patient Rights ; Recurrence ; Surveys and Questionnaires ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule

PURPOSE: To evaluate the sensitivity and specificity of the DNA chip method in diagnosing patients with granular corneal dystrophy type II (GCD II) induced by mutation of the betaigh3 gene. METHODS: Two hundred twenty-seven patients who visited Severance Eye hospital, corneal dystrophy clinic, from 1 July 2006 to 30 September 2007 were included in this study after history taking and review of their medical records. All subjects were examined by slit lamp microscopy, and blood sampling was done. The sampled blood was used in DNA sequencing and the DNA chip method. RESULTS: Among 227 subjects, 125 (54.6%) patients had GCD II and 103 (45.4%) patients showed normal results according to the DNA sequencing method. The sensitivity and specificity of the DNA chip method were both 100%, while the sensitivity of the slit lamp method was 99.19% and the specificity was 100%. CONCLUSIONS: The DNA chip method for diagnosing GCD II is a more simple, time-saving, and accurate method than DNA sequencing method, and the sensitivity and specificity were both 100%.
DNA ; Eye ; Humans ; Medical Records ; Microscopy ; Oligonucleotide Array Sequence Analysis ; Sensitivity and Specificity ; Sequence Analysis, DNA

BACKGROUND: Bacterial and Helicobacter gene were commonly detected in diseased human bile, although the meaning of the presence of Helicobacter in biliary tract is still unclear. The aim of this study was to evaluate the changes of bile acid composition in bacterial and Helicobacter infected bile, and to determine whether Helicobacter pylori might grow in human bile or not. METHODS: Thirty bile samples were obtained by percutaneous transhepatic biliary drainage or gallbladder puncture during cholecystectomy. According to the polymerase chain reaction analysis using bacterial 16S rRNA and Helicobacter genus specific 16S rRNA primers, 3 groups were divided; Group I; no presence of any bacterial DNA, Group II; positive bacterial DNA only, Group III; positive bacterial and Helicobacter DNA. Bile acid analysis for deoxycholic acid (DCA), chenodeoxycholic acid (CDCA), lithocholic acid (LCA), and ursodeoxycholic acid (UDCA) was performed by high performance liquid chromatography. And then Helicobacter pylori was tried to culture in broth mixed with human bile at a final bile concentration of 50%. RESULTS: The concentrations of DCA in group II and III were very low and significantly reduced compared to group I (p<0.01, respectively). The concentrations of LCA or UDCA were not shown any relationships between groups. Helicobacter pylori has grown actively in the broth mixed with human bile containing both of less than 0.1 gm/L of DCA and CDCA, compared to no growth in media mixed with human bile containing more than 3.0 gm/L of DCA and/or CDCA. CONCLUSION: DCA seems to have the strongest antibacterial effect. Helicobacter pylori is likely to grow in human bile containg very low concentrations of CDCA and DCA.
Bile* ; Biliary Tract Diseases* ; Biliary Tract* ; Chenodeoxycholic Acid ; Cholecystectomy ; Chromatography, Liquid ; Deoxycholic Acid ; DNA ; DNA, Bacterial ; Drainage ; Gallbladder ; Helicobacter Infections* ; Helicobacter pylori ; Helicobacter* ; Humans ; Lithocholic Acid ; Polymerase Chain Reaction ; Punctures ; Ursodeoxycholic Acid