BACKGROUND: Naringin, one of the flavonoids in citrus fruit peels, is known to have antioxidant and hepatotonic effects in animal studies. We evaluated the effect of naringin on 1) blood lipid profiles, 2) regression of fatty streak of aorta, and 3) liver toxicity in diet-induced hypercholesterolemic rabbits. METHODS: New Zealand White Rabbits (2.0 - 2.5 Kg) were divided to three groups; group without treatment, group treated with 100 mg/kg/d or 500 mg/kg/d naringin, and group treated with 1 mg/kg/d or 20 mg/kg/d lovastatin. They were fed on 0.25% or 1.0% cholesterol-containing diet for 8 weeks and then sacrificed. Blood samples were collected for measurement of total cholesterol, HDL-cholesterol, triglyceride, serum GOT and GPT. Aortas and livers were harvested for evaluation of fatty streak and pathologic examination. RESULTS: 1)Feeding of 1% cholesterol diet for eight weeks significantly increased the cholesterol level upto 20 folds. Neither lovastatin nor naringin did lower these marked hypercholesterolemia. But both naringin (500 mg/kg/d) and lovastatin (1 mg/kg/d) significantly reduced the area of fatty streak by 75% and 58%, respectively. Naringin was more effective in inhibition of fat infiltration into liver than lovastatin which showed hepatotoxicity as increase of serum GPT level (p=0.01). 2)Feeding of 0.25% cholesterol diet for eight weeks significantly increased the cholesterol level upto 17 folds. Total cholesterol and triglyceride levels tended to decrease by treatment with naringin (500 mg/kg/d) and lovastatin (20 mg/kg/d), but this decreases were not statistically significant. However, areas of fatty streak significantly decreased by treatment with naringin and lovastatin by 64 and 82%, respectively (p<0.05). Microscopic analysis revealed that foam cell infiltration into intima was significantly reduced by naringin and lovastatin. In contrast to lovastatin, naringin significantly reduced the level of serum GPT (p<0.05). CONCLUSION: Like lovastatin, naringin has strong antiatherogenic action which may not be associated with its very mild lipid lowering action. In contrast to lovastatin, naringin does have hepatoprotective effect.
Animals ; Aorta ; Cholesterol ; Citrus ; Diet ; Flavonoids ; Foam Cells ; Hypercholesterolemia ; Liver ; Lovastatin ; Rabbits* ; Triglycerides

Early detection of neoplastic disese and metastatic spred is very important. Carcinoma of the breast is knownto readily metastasize to the bone. The use of Tc-99m-phophate as bone imaging agent has been shown to demonstrate early evidence of bone metastasis well before radiographic evidence is visualized and as thus become a very usefultechnique for establishing and monitoring the bony metastatic element of breast cancer. In this study, serial boneimaging studies were performed to monitor the management of 84 breast cancer patients before and after mastectomyand biopsy. We attempted to analyse bone scans of breast cancer and to correlated the scan findings with theclinical stage, status of lymphnodes, distanat metastasis, bone pain, and laboratory datas. The following useful patterns were emerged: 1. Postive bone scan rate was definitely higher in clinical stage III and IV (42, 57%) thatin stage I and II(4, 18%) in initital studies. However, no correlation between positive bone scan rate andclinical stage was found in follow up studies. 2. Positive bone scan rate was high in both groups with locallyadvanced tumor(T3 & T4) and distant metastasis. 3. No correlation between postive bone scan and status oflymphnode involvement was noted. 4. Positive bone scan rate was also very high in patients with bone pain andabnomral laboratory data.
Biopsy ; Breast Neoplasms ; Breast ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radionuclide Imaging

The occurrence of the colonic obstruction secondary to colorectal carcinoma (CRC) has been reported in 7~30% of the CRC patients. It is generally believed that obstructive CRC is associated with a poor prognosis with respect to operative mortality and five-year survival. A series of 1064 cases of the CRC treated surgically at Asan Medical Center from June 1989 to December 1996 has been analyzed to compare clinicopathological findings between obstructive and non-obstructive CRC and to evaluate surgical treatment options in obstructive CRC. Complete obstruction was present in 49 cases (4.6%). There were no differences between obstructive and non-obstructive CRC in tumor location, size, Dukes' stage, and differentiation. In forty-nine obstructive CRC cases, primary resections were performed in 29 cases after peri-operative bowel decompression. In this group, right colon cancer was more prevalent than staged operation group (45% vs. 5%, P<0.05) and hospital stay was significantly short (16 days vs. 38 days, P<0.05). Postoperative complication rate was higher in staged operation group (65% vs. 28%, P=0.01). It may be due to stoma related wound complication. In obstructive left colon cancer, there was a significant difference in complication rate between primary resection and staged operation (P<0.05). Overall 5-year survival rate were 66% and 53% in non-obstructive and obstructive group, respectively. Survival rate according to the Dukes' B and C stages did not show statistical differences, either. Conclusively, primary resection is preferred to the obstructive CRC when supportive care, preoperative bowel decompression, and intraoperative colonic irrigation were performed adequately.
Chungcheongnam-do ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Decompression ; Humans ; Length of Stay ; Mortality ; Postoperative Complications ; Preoperative Care ; Prognosis ; Survival Rate ; Wounds and Injuries

Congenital absence of the gallbladder is a rare anomaly and an interesting subject. The overall incidence of gallbladder agenesis is said to approximately 0.035% to 0.065%. It is extremely difficult to make the correct diagnosis of gallbladder agenesis preoperatively in symptomatic patients because its clinical and radiological features are like those of cholecystitis, cholelithiasis, or choledocholithiasis in patients with anatomically normal biliary tracts. Gallbladder agenesis is suspected when the surgeon or the pathologist has failed to identify the gallbladder in its usual position but ectopic location or necrosis of the gallbladder from any causes should be ruled out. Recently, two cases of gallbladder agenesis were encountered in adult patients. We summarize our experience and give a brief review of the literature.
Adult ; Biliary Tract ; Cholecystitis ; Choledocholithiasis ; Cholelithiasis ; Diagnosis ; Gallbladder* ; Humans ; Incidence ; Necrosis

Backgroud: In one-lung ventilation using the left-sided double-lumen tube (LDLT), it is important to place the LDLT in correct position to maintain adequate ventilation. We investigated the frequency of and the factors affecting the LDLT malposition in endotracheal intubation. Methods: Ninety one (55 male and 36 female) patients were observed. After endotracheal intubation, using 35 and 37 Fr. sized Robertshaw type LDLT, auscultation and fiberoptic bronchoscope were performed to make sure the correct position of LDLT. The heights, weights, age, and sex were noted. The lengths and diameters of trachea, and the angles and diameters of both bronchi on chest x-ray were measured for comparison. Results: Normal in auscultation and gross malposition were 87.9% and 12.1%. Among those normal in auscultation, normal in bronchoscope, advancing and removing fine malposition were 66.2%, 18.8% and 15.0%, respectively. The angle of left bronchus is 37.71+/-4.60degrees in normal in ausculation and 37.71+/-4.60degrees in gross malposition. The length of trachea is 13.41+/-0.90 cm in normal in bronchoscope, 14.49+/-0.78 cm in advancing fine malposition and 11.86+/-0.35 cm in removing fine malposition. The patient's height is 167.27+/-7.12 cm in normal in brochoscope, 172.45+/-6.67 cm in advancing fine malposition and 163.12+/-6.54 cm in removing fine malposition. Conclusions: The angle of left bronchus is a factor affecting gross malposition. And the length of trachea and the patient's height are factors affecting fine malposition. Thus it is necessary to obtain in advance information on patient's height, length of trachea and angle of left bronchus on chest x-ray, to reduce the occurrence of the LDLT malposition.
Auscultation ; Bronchi ; Bronchoscopes ; Humans ; Incidence* ; Intubation, Intratracheal ; Male ; One-Lung Ventilation ; Thorax ; Trachea ; Ventilation ; Weights and Measures

This study was performed to evaluate the effects of acute withdrawal of antiepileptic drugs in epileptic patients during continuous BEG monitoring. One hundred sixty-five withdrawals in 134 patients who were candidates for epileptic surgery were included for this study. Clinical features and frequency of seizure were observed after drug withdrawal with daily monitoring of serum drug level. The phases after withdrawal of antiepileptics were divided into phase of therapeutic drug level, phase of falling drug level, and phase of subtherapeutic or undetectable(zero) drug level. There were significant increase in frequency of seizure and seizure of secondary generalization after acute withdrawal of antiepileptic drugs. Number of seizure during the period of drugs withdrawals was not correlated with onset age of epilepsy, duration of epilepsy, duration of medication, and number of administrated antiepiteptic drugs. The number of frequency of seizure before drug withdrawal was correlated with the number of frequency of withdrawal seizure. The number of seizure frequency after carbamazepine withdrawal was significantly higher during the phase of subtherapeutic or zero drug level, and not during phase of rapid falling antiepileptic drug level.
Age of Onset ; Anticonvulsants* ; Carbamazepine ; Epilepsy ; Generalization (Psychology) ; Humans ; Seizures*

This study was retrospectively undertaken to evaluate clinical manifestations, electroencephalographic findings, response to antiepileptic drugs and prognosis of 80 benign childhood epilepsy with centrotemporal spikes (BCECT) patients seen between 1967 and 1993 and followed up for more than 2 years. The age of onset ranges from 3 to 15 years. In 93 percent of patients, seizures appeared between 4 to 12 year-old, with peak of 5 year-old. The main manifestations of partial seizure were hemifacial spasm (53%) and oropharygeal signs (52%) with hypersalivation, abnormal sensation of mouth, gutteral sounds, swallowing difficulty and feeling of suffocation. The types of seizure consist of partial seizure(66%) and partial seizure with secondary generalization (34%). Distributions of seizure attack were nocturnal sleep (83%), diurnal sleep state(4%) and waking state (13%). The typical EEG findings were slow diaphasic high voltage centrotemporal spikes with unilateral (94%) and bilateral foci(6%) with normal background. In addition to typical EEG findings, there were associated with multifocal independent sharp-waves (8.9%) and generalized sharp-wave discharges (7.8%). BCECT patients were well controlled by antiepileptic drugs and had good prognosis. During the follow-up period (2-17years), we observed that all patient were well adapted to school and society. Seizures did not occur after adolescent period.
Adolescent ; Age of Onset ; Anticonvulsants ; Asphyxia ; Child ; Child, Preschool ; Deglutition ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Follow-Up Studies ; Generalization (Psychology) ; Hemifacial Spasm ; Humans ; Mouth ; Prognosis ; Retrospective Studies ; Seizures ; Sensation ; Sialorrhea

The authors have experienced 9 cases of postgastrectomy efferent loop obstruction during the past 16 months' period and analyzed the clinical features, radiological findings, causes, and types of obstruction. The incidence of efferent loop obstruction was 1.3%(9/673). Among the 9 cases, eight patients were male and one patient was female. Median age was 60 years and more than half(5 out of 9 cases) of the patients were obese(defined by more than 110% of ideal body weight). None of the cases showed signs of strangulation, including persistent pain, fever, focal abdominal tenderness, and/or leukocytosis. Gastrointestinal anastomoses were done using a GIA stapler in 6 cases, and manually in 3 cases. The diagnoses were made on the basis of clinical symptoms and signs, further supported by radiologic contrast studies. All the patients were initially treated with conservative measures, including nasogastric drainage and fluid therapy for about 2 weeks in average. 7 cases underwent re-laparotomy using separate left subcostal incisions as conservative management had failed. Among the relaparotomy cases, adhesiolysis and side to side jejunojejunostomy were performed in 5 patients, Roux-en-Y gastrojejunostomy in 1 patient, and gastrojejunostomy revision in 1 patient. Causes of the obstruction in the seven re-opened cases were confirmed as postoperative adhesion. The authors have analyzed the pattern of obstruction and classified the patterns into 4 types. One of the remaining two patients underwent balloon dilatation successfully and the other was managed with prolonged nasogastric decompression. The average hospital stay was 32 days. Adequate omentectomy, gentle tissue handling during dissection, avoidance of ischemia along the suture line of anastomosis, and the use of biologically inert suture material would prevent this kind of postoperative adhesive obstruction.
Adhesives ; Decompression ; Diagnosis ; Dilatation ; Drainage ; Female ; Fever ; Fluid Therapy ; Gastric Bypass ; Humans ; Incidence ; Ischemia ; Length of Stay ; Leukocytosis ; Male ; Stomach Neoplasms ; Sutures

We performed laparoscopic pelvic lymphadenectomy in 7 patients with squamous cell carcinoma in the uterine cervix. Among them, 5 cases were subsently laparotomy with radical hysterectomy. The others, one case was performed Laparoscpic pelvic lymphadenectomy as Staging Procedure and the other was laparoscopically assisted radical vaginal hysterectomy with pelvic lymphadenectomy without complication. The following results were obtained 1. Total number of pelvic nodes obtained at laparoscopy in 7 cases were 104 2. Averege number of pelvic nodes obtained at laparoscopy were 14.2+/-6.38(7-23) 3. Average number of additional pelvic nodes obtained at laparotomy were 10.4+/-279(7-13) 4. % yield by laparoscopy/laparoscopy+laparotomy was 71/123(58%) 5. No positive metastatic lymph nodes were missed by laparartomy 6. Average time, blood loss at laparoscopic lymphadenectomy was 172.1min and 304.3ml, seperately 7. surgical staging procedure was performed at Case 3 8. Laparoscopic Pelvic lym phadenectomy with radieal vaginal hysterectomy (type II radical) was done in Case 5. without Laparotomy or complication.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Laparoscopy ; Laparotomy ; Lymph Node Excision* ; Lymph Nodes ; Uterine Cervical Neoplasms*

PURPOSE: 99mTc-HMPAO is a radiopharmaceutical for imaging cerebral blood flow. HMPAO (RR, SS)-4,8- diaza-3,6,6,9-tetramethylundecan-2,10- dione bisoxime) has three stereoismers such as, meso-, d-, and l-HMPAO. Techentium complexes of meso-HMPAO and d,l-HMPAO are known to have different in vivo brain uptakes. In this study, enantiomers of HMPAO (d-HMPAO and l-HMPAO) were separated from d,l-HMPAO. These enantiomers were labeled with 99mTc and the biodistribution studies were performed in mice. MATERIALS AND METHODS: An intermediate imine product was produced from 2,3-butanedione monooxime and 2,2-dimethyl- 1,3-propanediamine (54% yield) and was reduced into a mixture of three isomers (35% yield). The meso-isomer was separated from d,l-mixture by repeated fractional crystallization (11% yield). The d- and l-enantiomers were subsequently separated by co-crystallization with optical isomers of tartaric acid (25% and 5% yield, respectively). Each enantiomeric HMPAO was labeled with 99mTc by reacting with SnCl2 2H2O and 99mTc-pertechnetate. Biodistribution study was performed 1 hr after tail vein injection to ICR mice. RESULTS: Radiochemical purities of each compound were over 80%. In biodistribution study, the brain uptakes of d,l- d- and l-form were 1.34, 1.12 and 1.67% ID/g, respectively. In case of l-Isomer the brain uptake was higher (1.5 fold) than d-isomer. CONCLUSION: We successfully purified each enantiomeric HMPAO. In biodistribution study of stereoismers of 99mTc-HMPAO in mice, l-HMPAO may show better brain image than d,l-HMPAO which was supplied in a commercial kit.
Animals ; Brain* ; Crystallization ; Dental Calculus ; Diacetyl ; Mice ; Mice, Inbred ICR ; Stereoisomerism ; Technetium Tc 99m Exametazime* ; Veins