In case of cardiopulmonary bypass, organ transplantation and massive transfusion, the electrolyte(Na+, K+, Ca++) and pH are very changeable, and it is very important to correct the pH and electrolyte immediately. We studied the bedside electrolyte monitoring with VIA(Vascular Intermittent Access) 1-01 and its accuracy validation. We selected 13 patients who went an open heart surgery in the Seoul National University HospitaL The patient was catheterized with 16 G triple lumen catheter into the SVC-right atrium junction via right internal jugular vein. Then we connected VIA 1-01 to one lumen. The electrolyte samplings were done during perianesthetic period. The electrolyte values(Na+, K+, ionized Ca++) of each sample was measured by laboratory, NOVA of PAR(postanesthetic recovery room) and VIA 1-01. We compared the values with correlation. The Pearson product-moment coefficient(r) of laboratory vs VIA 1-01 are 0.9073(Na+), 0.9471(K+) 0.6485(Ca++). The r of NOVA vs VIA 1-01 are 0.6348(Na+), 0.9330 (K+), 0.5206(Ca++ ). The r of laboratory vs NOVA are 0.6719(Na+), 0.9532(K+ ), 0.8221(Ca+). All pvalues of r were lower than 0.01. We conclude that bedside electrolyte monitoring with VIA l- 01 is very useful to critically ill-patient and major operations during anesthesia and it improves the prognosis of such patients.
Anesthesia ; Cardiopulmonary Bypass ; Catheters ; Humans ; Hydrogen-Ion Concentration ; Jugular Veins ; Organ Transplantation ; Prognosis ; Seoul ; Thoracic Surgery ; Transplants

We evaluated the feasibility of the transradial coronary intervention (TRCI) in 85 consecutive patients with chronic total occlusion (CTO). Clinical, angiographic and procedural factors were compared between the success and failure groups. An overall success rate of 65.5% (57 of 87 lesions) was achieved with TRCI, and the most common cause of failure was an inability to pass the lesion with a guidewire. A multivariate analysis demonstrated that the most significant predictor of failure was the duration of occlusion (OR 1.064 per month, 95% CI 1.005 to 1.126, p = 0.03). The procedural success rate improved with use of new-generation hydrophilic guidewires. The 6 Fr guiding catheters were used in the majority of the 70 cases (81%). Five cases were crossed over to a femoral artery approach due to engagement failure of the guiding catheter into the coronary ostium because of severe subclavian tortuosity and stenosis in two cases, radial artery looping in one case, and poor guiding support in two cases. There were no major entry site complications. In conclusion, the radial artery might be a feasible vascular route in coronary interventions for CTO, with comparable procedural success and no access site complications.
Treatment Outcome ; Radial Artery/surgery ; Intraoperative Complications ; Humans ; Feasibility Studies ; Coronary Disease/diagnosis/*therapy ; Angioplasty, Transluminal, Percutaneous Coronary/adverse effects/*methods

BACKGROUND: The association of androgenetic alopecia and coronary artery disease has not been well documented although many studies have tried to reveal this association. This relationship is still a controversial issue. OBJECTIVES: The aim of this study is to investigate the association between the androgenetic alopecia and lipid parameters for risk factors of coronary artery disease. METHODS: The subjects of this study were 102 patients with androgenetic alopecia who had visited the Department of Dermatology, Pil-dong Hospital, College of medicine, Chung-Ang University during 2 years (from January 2000 to December 2001). The subjects of control group were 40 male individuals who had no androgenetic alopecia, no risk factor of coronary artery disease and no coronary artery disease. RESULTS: 1. There were significant differences in the serum total lipid, phospholipid, triglyceride between the patients and the control group. But there were no significant differences in serum LDL-cholesterol, HDL-cholesterol, and total cholesterol between the two groups. 2. There were significant differences in the serum total lipid, phospholipid, triglyceride between frontal baldness patients and the control group (p<0.05). But there were no significant differences in the serum LDL-cholesterol, HDL-cholesterol, and total cholesterol between the two groups. 3. There were significant differences in the serum total lipid, phospholipid, triglyceride, LDL-cholesterol, and total cholesterol between vertex baldness patients and the control group (p<0.05). But there were no significant differences in serum HDL-cholesterol between two groups. 4. There were no significant differences in the serum total lipid, phospholipid, triglyceride, LDL-cholesterol, HDL-cholesterol and total cholesterol between androgenetic alopecia patients who were increased serum testosterone and the control group. CONCLUSION: These data suggest that androgenetic alopecia involving the vertex scalp is associated with significantly increased total cholesterol and LDL-cholesterol for risk factors of coronary artery disease. We recommend that dermatologists should investigate the lipid parameters, especially total cholesterol and LDL-cholesterol in vertex baldness patients.
Alopecia* ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; Dermatology ; Humans ; Male ; Risk Factors* ; Scalp ; Testosterone ; Triglycerides

Gastrointestinal hemorrhage in neonates is commonly associated with necrotizing enterocolitis, cow's milk protein allergy, and gastrointestinal malformation. Gastrointestinal bleeding on the first day of life, presenting as the first manifestation of a disorder, has rarely been reported associations with gastric ulceration, Salmonella infection, and allergic colitis. Hemophilia B is also a rare cause of gastrointestinal bleeding during the neonatal period. In the present case, a male infant developed repetitive hematemesis on the first day of life. His initial level of coagulation factor IX was 1.9%, and he was diagnosed with moderate hemophilia B. No further hematemesis or melena was observed during recombinant factor IX therapy. The infant did not have a family history of hemophilia. In conclusion, although gastrointestinal hemorrhage on the first day of life as the first manifestation of a disease is rare, infants who present with spontaneous gastrointestinal hemorrhage after birth and with unexplained prolonged activated partial thromboplastin time should be evaluated for coagulation factor deficiency regardless of whether they have any family history of hemophilia.
Blood Coagulation Factors ; Colitis ; Enterocolitis, Necrotizing ; Factor IX ; Gastrointestinal Hemorrhage* ; Hematemesis ; Hemophilia A* ; Hemophilia B* ; Hemorrhage ; Humans ; Hypersensitivity ; Infant ; Infant, Newborn ; Male ; Melena ; Milk Proteins ; Partial Thromboplastin Time ; Parturition ; Salmonella Infections ; Stomach Ulcer

PURPOSE: To evaluate the long-term therapeutic efficacy and durability of lamivudine in Korean children with chronic hepatitis B. METHODS: A total of 48 children (31 male and 17 female; age, 1~18 years, mean, 8 years) with chronic hepatitis B who received lamivudine for at least six months from March 1999 to September 2004 were followed for a mean period of 29 months (8~66 months) at Department of Pediatrics, Kyungpook National University Hospital in Korea. Response to treatment was defined as the normalization of ALT and HBV DNA levels, and HBeAg seroconversion after the initiation of treatment. RESULTS: Twenty nine (60%) among the 48 children treated with lamivudine responded and nine (19%) children lost HBsAg during therapy. ALT and HBV DNA level had normalized in 94% one year after the initiation of treatment. Kaplan-Meier estimates of cumulative HBeAg seroconversion rates over the years were 13% (0.5 year), 34% (1 year), 50% (1.5 years), 68% (2 years), 79% (2.5 years) and 90% at 3 years respectively. Above all, among the 22 children treated before the age of seven, loss of HBsAg occurred in eight (36%), which showed superior rate of HBsAg loss (p=0.002 vs age >7). CONCLUSION: Long-term treatment of lamivudine improved the rate of HBeAg seroconversion in Korean children with chronic hepatitis B. After three years' observation, most of treated children have sustained HBeAg clearance. We believe that lamivudine should be tried as the first therapeutic option for children with chronic hepatitis B in immune clearance phase.
Child* ; DNA ; Female ; Gyeongsangbuk-do ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Korea ; Lamivudine* ; Male ; Pediatrics

No Abstract Available.

D variant of encephalomyocarditis (EMC-D) virus causes diabetes in susceptible mice by direct infection and cytolysis of pancreatic beta cells. cDNA covering the major outer capsid protein (VP1) of EMC-D virus was cloned into Mycobacterium bovis bacillus Calmette-Guerin (BCG). None of the SJL/J male mice, immunized with live recombinant BCG-VP1, became diabetic when challenged with highly diabetogenic EMC-D virus. But the control mice inoculated with normal BCG or rBCG transformed with vector alone developed diabetes in the same challenge. VP1-specific antibodies including neutralizing antibodies were markedly increased as time went on and reached to the maximum titer at week 10 after a single immunization. The plateau of the titer lasted longer than following 4 weeks. Guinea pigs immunized with the live rBCG-VP1 showed strong delayed type hypersensitivity (DTH) to the VP1of EMC-D virus. It means that the live rBCG-VP1 elicit efficient humoral and cell-mediated imrnune responses against EMC-D virus, resulting in prevention of virus-induced diabetes in susceptible mice.
Animals ; Antibodies ; Antibodies, Neutralizing ; Bacillus ; Capsid Proteins ; Clone Cells ; DNA, Complementary ; Guinea Pigs ; Humans ; Hypersensitivity ; Immunization* ; Insulin-Secreting Cells ; Male* ; Mice* ; Mycobacterium bovis*

BACKGROUND AND OBJECTIVES: Despite the proven benefit of cholesterol- lowering therapy in patients with CAD, there is no consensual opinion on guideline of cholesterol-lowering therapy in patients with CAD in Korea. The aim of this study is to evaluate the risk of CAD according to the cholesterol level and to consider current guideline of cholesterol-lowering therapy for the secondary prevention in patients with CAD. MATERIALS AND METHODS: Consecutive 600 patients were assigned into two groups - coronary artery disease group (364 patients) and normal coronary artery group (236 patients) - depending on the coronary angiographic findings. Lipid profiles (total cholesterol, Triglyceride, HDL-cholesterol, LDL-cholesterol) were obtained and the odd ratio of CAD was evaluated according to the national cholesterol education program treatment guideline (NCEP: LDL cholesterol > or = 130 mg/dl) and the national heath insurance treatment guideline (NHI: total cholesterol > or = 220 mg/dl) by multi-variate logistic regression analysis. RESULTS: According to the NHI and NCEP guideline, the proportion of patients with CAD indicated on cholesterol-lowering therapy were 25%, 36.5% respectively and the odd ratio of CAD was 1.00 (95% CI 0.52 - 1.89, p=0.99), 4.89 (95% CI 2.78 - 8.60, p< 0.01) respectively . CONCLUSIONS: Our data showed that LDL-cholesterol > or = 130 mg/dl only reflected the risk of CAD in both guidelines and more proportion of the patients were indicated on cholesterol-lowering therapy in NCEP guideline than in NHI guideline.
Cholesterol ; Cholesterol, LDL ; Coronary Artery Disease* ; Coronary Vessels* ; Education ; Humans ; Insurance ; Korea ; Logistic Models ; Secondary Prevention ; Triglycerides

Wegener's granulomatosis (WG) is a systemic necrotizing vasculitis belonging to the small- to medium-sized vessel. A 46-year-old male presented with erythematous hard plaque on chest, calf and multiple subcutaneous nodules on buttock, upper arm. Incisional biopsy was done and the histopathologic finding revealed the features of necrotizing vasculitis with focal granulomatous inflammation in subcutaneous tissue. PNS MRI showed abnormal meningeal enhancement and lung HRCT imaging showed mild infiltration. Inspite of severe systemic involvement, serum tests about ANCA showed negative result. He was treated with systemic corticosteroid and cyclophosphamide pulse therapy. Initially his condition showed improvement but later the disease worsened.
Antibodies, Antineutrophil Cytoplasmic ; Arm ; Biopsy ; Buttocks ; Cyclophosphamide ; Glycosaminoglycans ; Humans ; Inflammation ; Lung ; Male ; Middle Aged ; Subcutaneous Tissue ; Thorax ; Vasculitis ; Wegener Granulomatosis

Dermatophytes usually do not invade beyond the epidermis. However mechanical breakage of the skin resulting from scratching or trauma and immunocompromised state may allow penetration of the fungi into reticular dermis. We report a patient with an unusual manifestation of Trichophyton rubrum infection. A 39-year-old male presented with 3.5x5 cm sized, erythematous, ulcerated lesion on the left heel for about 1 month. Histologic findings of the skin lesion showed granulomatous change and numerous hyphae in the dermis. Trichophyton rubrum was isolated on the fungus culture. The patient was treated with terbinafine (250 mg/day) for 10 weeks, resulting in the clearing of the skin lesion.
Adult ; Arthrodermataceae ; Dermis ; Epidermis ; Fungi ; Granuloma* ; Heel ; Humans ; Hyphae ; Male ; Skin ; Trichophyton* ; Ulcer