BACKGROUND: Ischemic preconditioning(IP) is known to be effective in the protection of myocardial necrosis, arrhythmia, and the restoration of the myocardial function in the ischemia-reperfusion state of the heart. However the exact mechanism is not clearly understood. The purpose of this study was to elucidate the trigger mechanism of IP on the restoration of the myocardial function after ischemia-reperfusion. MATERIAL AND METHOD: By connecting a Langendorff perfusion apparatus with an isolated heart of a rat, the normal temperature of the heart was maintained. The experiment was conducted in seven groups, which were divided according to the preconditioning stimuli and blockage methods: Group I(n=10) was a group without IP, Group II(n=10) a group of three-minute IP, Group III(n=10) a group of PEIP, Group IV(n=10) a group of clonidine IP, Group V(n=10) a group of IP after reserpine, Group VI(n=10) a group of PE & prazosin IP, and Group VII(n=10) a group of clonidine & yohimbine IP. Hemodynamic parameters of DP, LVEDP, +/-dP/dT and the changes of perfusion in the coronary artery were evaluated. RESULT: Developed pressure and +dP/dT changed per unit time. After 20 minutes of reperfusion, those of Group II and III were 63.1+/-3.7%, 64.8+/-4.6% and 64.5+/-4.6%, 63.8+/-4.4%, which improved more significantly than those of Group I(P<0.05). However, there were no significant differences between the Groups V and VI, and Group I. CONCLUSION: The Brief ischemic preconditioning and pharmacological preconditioning using alpha-receptor sympathomimetics have protecting effects on the restoration of myocardial function after reperfusion. And the protecting effect of preconditioning seems to be related to sympathetic neurotransmitters and to the selective action of the alpha1-adrenergic receptor.
Animals ; Arrhythmias, Cardiac ; Clonidine ; Coronary Vessels ; Heart ; Hemodynamics ; Ischemic Preconditioning ; Ischemic Preconditioning, Myocardial* ; Necrosis ; Neurotransmitter Agents ; Perfusion ; Prazosin ; Rats* ; Reperfusion ; Reserpine ; Sympathomimetics ; Yohimbine

OBJECTIVE: To evaluate for the clinical analysis on abruptio placenta, we examined its incidence, diagnostic methods, symptom and sign, perinatal mortality, and recurrence rate. METHODS: We reviewed the medical records of the 396 cases of abruptio placenta among 72.580 deliveries, from Jan. 1, 1990 to Dec. 31, 1997, at St. Mary, Kang Nam St. Mary, and Holy Family Hospital of Catholic University. RESULTS: The total incidence of abruptio placenta was 0.51%, the incidence plotted by age from 1993 to 1997 has shown that the age incidence was higher in 20-24years old(0.7%), and over 35years old (0.8%). 42.5% of the case occurred between 32 to 37weeks of gestational age, 39.6% was over 37weeks. 38% of the patient was diagnosed before delivery with ultrasonography and the most common complaint was vaginal bleeding. The complication of abruptio placenta is as follows, Couvelaire uterus occurred in 26cases(7.0 %), DIC in 10cases(2.7 %), ARF in 4cases (1.1 %), and uterine rupture in 1case(0.3 %). Perinatal mortality including 41cases of stillbirth was 19.9 %(73cases) but no maternal death was noted. A history of abruptio placenta increased risk of a similar incident in a subsequent pregnancy by 19 cases(4.6 %: 9.0 fold)complicated with 13 cases of pregnancy induced hypertension(76.5 %). CONCLUSION: The incidence of abruptio placenta plotted by age have shown higher in 20-25years old and over 35 years old, hypertensive women experienced abruptio placenta are more likely to have higher graded recurrent rate in subsequent pregnancy, and abruptio placenta is major obstetric bleeding disease causing serious maternal and fetal complication.
Adult ; Dacarbazine ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Maternal Death ; Medical Records ; Perinatal Mortality ; Placenta* ; Pregnancy ; Recurrence ; Stillbirth ; Ultrasonography ; Uterine Hemorrhage ; Uterine Rupture ; Uterus

PURPOSE: we often find variable degrees of FDG uptake and patterns in stomach, which can make difficult to distinguish physiologic uptake from pathologic uptake on FDG PET. The purpose of this study was to find out the significant findings of stomach on FDG PET. MATERIALS AND METHODS: Thirty-eight patients who underwent both FDG PET and endoscopy within one week from Jun. 2003, to Aug. 2004 were included in this study. We reviewed 38 patients (18 for medical check up, 15 for work up of other malignancies, and 5 for the evaluation of stomach lesion). Their mean age was 56 years old (range: 32~79), men and women were 28 and 10, respectively. Two nuclear physicians evaluated five parameters on FDG PET findings of stomach with a consensus: 1) visual grades 2) maximum SUV (max.SUV) 3) focal 4) diffuse and 5) asymmetric patterns. We correlated the lesions of FDG PET findings of stomach with those of endoscopy. We considered more than equivocal findings on FDG PET as positive. RESULTS: The six of 38 patients were proven as malignant lesions by endoscopic biopsy and others were inflammatory lesions (ulcer in 3, chronic atrophic gastritis in 12, uncommon forms of gastritis in 5), non-inflammatory lesions (n=3), and normal stomach (n=9). By the visual analysis, malignant lesions had higher FDG uptake than the others. The max.SUV of malignant lesions was 7.95 4.83 which was significantly higher than the other benign lesions (2.9 0.69 in ulcer, 3.08 1.2 in chronic atrophic gastritis, 3.2 1.49 in uncommon forms of gastritis (p=0.044) ). In the appearance of stomach on FDG PET, malignant lesions were shown focal (5 of 6) and benign inflammatory lesions were shown diffuse (9 of 20) and asymmetric (14 of 20). Benign lesions and normal stomach were shown variable degrees of uptake and patterns. Some cases of benign inflammatory lesions such as ulcer and gastritis were shown focal and mimicked cancerous lesion (4 of 15). CONCLUSION: Gastric malignant lesions had higher FDG uptake and focal pattern. However, benign inflammatory lesions had moderate degrees of uptake and diffuse and asymmetric patterns rather than focal. It is difficult to differentiate between benign lesions including normal.
Biopsy ; Consensus ; Electrons* ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography* ; Stomach* ; Ulcer

Alexander disease is a rare degenerative leukodystrophy caused by dominant mutations in glial fibrillary acidic protein (GFAP). The neonatal form of Alexander disease may manifest as frequent and intractable seizures or obstructive hydrocephalus, with rapid progression leading to severe disability or death within two years. We report a case of a 50-day-old male who presented with intractable seizures and obstructive hydrocephalus. His initial magnetic resonance imaging (MRI) suggested a tumor-like lesion in the tectal area causing obstructive hydrocephalus. Despite endoscopic third ventriculostomy and multiple administrations of antiepileptic drugs, the patient experienced intractable seizures with rapid deterioration of his clinical status. After reviewing serial brain MRI scans, Alexander disease was suspected. Subsequently, we confirmed the de novo missense mutation in GFAP (c.1096T>C, Y366H). Although the onset was slightly delayed from the neonatal period (50 days old), we concluded that the overall clinical features were consistent with the neonatal form of Alexander disease. Furthermore, we also suspected that a Y366 residue might be closely linked to the neonatal form of Alexander disease based on a literature review.
Alexander Disease* ; Anticonvulsants ; Brain ; Glial Fibrillary Acidic Protein ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging ; Male ; Mutation, Missense ; Seizures* ; Ventriculostomy

We report an unusual case of venous thrombosis complicated by pyogenic psoas muscle abscess in a patient with chronic biliary tract disease. A 64-year-old woman presented with high fever and progressive back and left flank pain. She had been admitted because of recurrent cholangitis and liver abscess 7 months ago. Both abscess and blood cultures had revealed Klebsiella pneumoniae and she had improved with treatment of antibiotics and percutaneous drainage of abscess. Computed tomography demonstrated psoas abscess and thrombosis of inferior vena cava and left iliac vein adjacent to abscess. Several days later, abscess culture showed Klebsiella pneumoniae. Because there was no evidence of deep vein thrombosis and the thrombosis was confined only to the vein adjacent to the abscess, we considered that the thrombosis would be associated with the abscess. She was immediately treated with percutaneous drainage of abscess and antibiotics. Follow-up computed tomography demonstrated complete disappearance of both psoas abscess and venous thrombosis.
Abscess* ; Anti-Bacterial Agents* ; Biliary Tract Diseases ; Cholangitis ; Drainage* ; Female ; Fever ; Flank Pain ; Follow-Up Studies ; Humans ; Iliac Vein ; Klebsiella pneumoniae ; Liver Abscess ; Middle Aged ; Psoas Abscess* ; Psoas Muscles ; Thrombosis ; Veins ; Vena Cava, Inferior ; Venous Thrombosis*

The cDNA nucleotide sequence of genome segment B encoding the VP1 protein was determined for the aquatic birnavirus GC1 isolated from the rockfish Sebastes schlegeli in Korea. The VP1 protein of GC1 contains a 2,538 bp open reading frame, which encodes a protein comprising 846 amino acid residues that has a predicted MW of 94 kDa. The sequence contains 6 potential Asn-X-Ser/Thr motifs. Eight potential Ser phosphorylation sites and 1 potential Tyr phophorylation site were also identified. GC1 contains the Leu-Lys-Asn (LKN) motif instead of the typical Gly-Asp- Asp (GDD) motif found in other aquatic birnaviruses. We also identified the GLPYIGKT motif, the putative GTPbinding site at amino acid position 248. In total, the VP1 regions of 22 birnavirus strains were compared for analyzing the genetic relationship among the family Birnaviridae. Based on the deduced amino acid sequences, GC1 was observed to be more closely related to the infectious pancreatic necrosis virus (IPNV) from the USA, Japan, and Korea than the IPNV from Europe. Further, aquatic birnaviruses containing GC1 and IPNV have genogroups that are distinct from those in the genus Avibirnaviruses and Entomo-birnaviruses. The birnavirusstrains were clustered into 5 genogroups based on their amino acid sequences. The marine aquatic birnaviruses (MABVs) containing GC1 were included in the MABV genogroup; the IPNV strains isolated from Korea, Japan, and the USA were included in genogroup 1 and the IPNV strains isolated primarily from Europe were included in genogroup 2. Avibirnaviruses and entomobirnaviruses were included in genogroup 3 and 4, respectively.
Amino Acid Sequence ; Animals ; Base Sequence ; Birnaviridae/classification/*genetics ; Capsid Proteins/chemistry/*genetics ; Cell Line ; Fishes/*virology ; Korea ; Molecular Sequence Data ; Phylogeny

Granular cell tumor (GCT) is an uncommon, usually benign neoplasm; however, a malignant potential has been described. Malignant GCT is an extremely rare neoplasm showing rapid growth and invasion into adjacent muscles, lymph nodes, or vessels, or even distant metastasis. We recently experienced a case of a histologically benign or atypical but clinically malignant GCT, with invasion of the lymph nodes and vessels in the sigmoid colon, diagnosed by segmental colon resection with lymph node dissection. We also performed a review of relevant medical literature.
Colon ; Colon, Sigmoid* ; Granular Cell Tumor* ; Lymph Node Excision ; Lymph Nodes ; Muscles ; Neoplasm Metastasis

BACKGROUND AND OBJECTIVES: This study aims to evaluate the usefulness of customized vestibular exercise through literature review. MATERIALS AND METHOD: We searched several literature database such as Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library etc., with the following inclusion criteria: 1) studies of patients with dizziness and balance disorders, 2) studies in which a customized vestibular exercise was performed, and 3) studies in which one or more of the appropriate medical outcomes have been reported. At the same time, we excluded the following: 1) non-human studies and pre-clinical studies, 2) non-original articles, for example, non-systematic reviews, editorial, letter and opinion pieces, 3) research not published in Korean and English, 4) grey literature (thesis, congress or conference materials, abstract etc.), and 5) case studies. Finally, 10 studies were selected and analyzed. RESULTS: The safety of customized vestibular exercise was reported in three documents which reported no side effects related to the procedure. The effectiveness of customized vestibular exercise was proven by the assessment of symptom change, functional change, and other physiological measures based on a total of 10 randomized clinical trial studies. CONCLUSION: For patients with vestibular dysfunction, a customized vestibular exercise can be a safe and effective technique for improving dizziness and balance function.
Dizziness ; Humans ; Methods

BACKGROUND AND OBJECTIVES: Endoscopic technique in intranasal repair of cerebrospinal fluid (CSF) leakage has many advantages over external approaches. This study aimed to review the clinical manifestations of CSF leakage and to investigate the efficacy of the endoscope in the diagnosis and the management of CSF leakage. SUBJECTS AND METHOD: Twenty-four cases of CSF rhinorrhea were reviewed retrospectively. RESULTS: Seven out of 22 patients had only rhinorrhea and 14 cases had meningitis. Four cases were successfully managed with conservative management including bed rest and lumbar drains. Intranasal repairs with endoscopes have been applied to 17 cases out of 20 operated cases including 1 case in which both endoscopic repair and craniotomy was used. Endoscopic repairs were not useful in 3 cases in which the operative exposures were insufficient and the leakage sites could not be accessible with endoscope. One case was treated with a craniotomy approach, and in-dwelling shunt operations were required in 2 cases. Leak sites were repaired with free grafts using buccal fat, nasal mucosa, or temporalis muscle and fascia. In some cases, especially when the defect was large, we incorporated bone or cartilage into the grafts. There was no recurrence after the endoscopic closure. CONCLUSION: Endoscopic approach is safe and effective in managing the CSF rhinorrhea except in cases in which the operative exposure with endoscope is insufficient.
Bed Rest ; Cartilage ; Cerebrospinal Fluid Rhinorrhea ; Cerebrospinal Fluid* ; Craniotomy ; Diagnosis ; Endoscopes ; Fascia ; Humans ; Meningitis ; Nasal Mucosa ; Recurrence ; Retrospective Studies ; Transplants

The Shprintzen–Goldberg syndrome (SGS) is an extremely rare genetic disorder caused by heterozygous variant in SKI . SGS is characterized by neurodevelopmental impairment with skeletal anomaly. Recognition of SGS is sometimes quite challenging in practice because it has diverse clinical features involving skeletal, neurological, and cardiovascular system. Here we report a case of a 6-month-old boy who initially presented with developmental delay and marfanoid facial features including prominent forehead, hypertelorism, high arched palate and retrognathia. He showed motor developmental delay since birth and could not control his head at the time of first evaluation. His height was above 2 standard deviation score. Arachnodactyly, hypermobility of joints, skin laxity, and pectus excavatum were also noted. Sequencing for FBN1 was negative, however, a novel missense variant, c.350G>A in SKI was identified by sequential whole exome sequencing. To our knowledge, this is the first case with SGS with phenotypic features of SGS overlapping with those of the Marfan syndrome, diagnosed by next generation sequencing in Korea.