BACKGROUND: Coronary blood flow shows phasic and diastolic dominant flow pattern in normal coronary artery, which can be changed in coronary artery stenosis. We measured and analysed coronary blood flow velocity by Doppler-tipped guidewire to clarify the change of flow pattern in the proximal and distal segments of coronary narrowings. METHODS: Coronary flow velocity were measured by 0.018 or 0.014 inch Doppler-tipped guidewire in 14 paients, 17 sites(LCS 11, RCA 6) in the proximal and distal segment of coronary narrowings, during coronary angiography or coronary angioplasty after bolus intracoronary infusion of 20microg nitroglycerine. Coronary flow reserve also measured after adenosine intracoronary infusion(LCA 12gmicrog, RCA 6microg). Perent stenosis of coronary artery was measured by digital cailper in 2 different projections and averaged. RESULTS: 1) The was no significant correlation between percent stenosis and proximal distal velocity ratio(P/D) ration(r=0.56. P>0.05). 2) Average peak velocity(APV, cm/sec) and diastolic artery, respectively(p<0.01) Distal APV was significantly lower than proximal APV(p<0.01) but DSVR showed no significant difference(P>0.01). 3) Coronary flow reserve(CFR) was significantly lower in significant coronary stenotic patients compared to insignificant stenotic patients(1.8 vs 3.6, P<0.01). CONCLUSION: Coronary flow velocity measurement by Doppler dipped guidewire gave us physiologic information. We think it could be used as an important tool to assess the significance of the intermediate coronary narrowings and the effect of conorary angioplasty.
Adenosine ; Angioplasty ; Arteries ; Blood Flow Velocity ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels* ; Humans ; Nitroglycerin

We retrospectively reviewed magnetic resonance image findings of primary CNS lymphomas in six patients. All patients showed parenchymal masses (n=8), a solitary mass in 4 and multiple in the other two. One patients showed leptomeningeal lesion. Parenchymal masses were located in forntal lobe (n=4), cerebellum (n=2), basal ganglia (n=1), and parietal lobe (n=1), These masses showed hypointensity on T1-weighted images (WI). On T2 WI, the signal intensity of mass was isointense to the brain parenchyma in 5 and hyperintese in 3. After Gadlinium-DTPA injection, seven lesions were enhanced homogeneously, and the margin of the mass was smooth in 5 and irregular in 3. Peritumoral edema was moderate in 4, absent in 3, and severi in 1. These characteristics may be useful in the diagnosis of primary CNS lymphoma.
Basal Ganglia ; Brain ; Cerebellum ; Diagnosis ; Edema ; Humans ; Lymphoma* ; Magnetic Resonance Imaging* ; Parietal Lobe ; Retrospective Studies

Acute coronary closure occurs 2-10% during the procedure of PTCA, 50-80% of those events are in the catheterization room. The causes of acute coronary closure are mainly due to dissection, thrombosis or spasm. We recently experienced a case of acute left main coronary artery closure due to guiding catheter induced embolization in the 56 year-old female, unstable angina patient complicated by diabetes mellitus and chronic renal failure. The patient received cardiopulmonary resuscitation shortly after acute closure because of cardiac arrest. During the resuscitation, we performed PTCA at the site of acute closure. The blood pressure maintained normaly after successful recanalization. And then we inserted IABP(intraaortic balloon pump) balloon and did PTCA of original stenosis sites. The patient removed IABP 24 hours later and discharged a month later without complication.
Angina, Unstable ; Blood Pressure ; Cardiopulmonary Resuscitation* ; Catheterization ; Catheters* ; Constriction, Pathologic ; Coronary Vessels ; Diabetes Mellitus ; Female ; Heart Arrest ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Resuscitation ; Spasm ; Thrombosis

A 49-year-old man with liver cirrhosis and hypertension was found to have hyperkalemia out of a degree of renal insufficiency and metabolic acidosis with low to normal anion gap, aggravated by volume contraction with diarrhea and medications (captopril, spironolactone and atenolol) interfering with potassium homeostasis. Plasma renin activity and serum aldosterone levels of this patient on a regular diet after discontinuation of medications were very low compared to those of five other cirrhotic patients with normokalemia as controls. Also, the renin-aldosterone stimulation testing on this patient performed by sodium restricted diet and furosemide, upright position and by angiotensin converting enzyme inhibition (captopril, 50 mg) showed the blunted renin and aldosterone responses to each of these stimuli, almost no changes from baseline renin and aldosterone levels, it was concluded that the underlying defect responsible for hyperkalemia in this case was hyporeninemic hypoaldosteronism and this was aggravated by other factors or drugs affecting potassium homeostasis.
Aldosterone/blood ; Captopril/pharmacology ; Furosemide/pharmacology ; Humans ; Hyperkalemia/*etiology ; Hypertension/*complications ; Hypoaldosteronism/*complications ; Liver Cirrhosis/*complications ; Male ; Middle Aged ; Renin/blood

No abstract available.
Humans ; Sarcoma, Kaposi*

PURPOSE: To evaluate the plain radiographic and CT findings of the necrotizing fasciitis. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of 4 cases with necrotizing fasciitis. Three cases were proven pathologically. We evaluated pattern and extent of the gas shadows in plain films. CT findings were analysed, with emphasis on : (a) gas pattern, (b) extent, (c) location and involved site, (d) associated focal abscess, and (e) swelling of the adjacent muscles. RESULTS: On plain radiographs, four cases showed streaky or mottled gas densities in the pelvis, three cases in the perineum, one case in the abdomen, and two cases in the thigh. On CT images, gas pattern was mottled and streaky appearance with swelling of the adjacent muscles. Gasshadows located in the extraperitoneal space in four cases, fascial layer in four cases, and subcutaneous layer infour cases. There were gas shadows in pelvic wall, perineum, abdominal wall, buttock, thigh, and scrotum. Focallow density lesion suggestive of focal abscess was not visualized. CONCLUSION: Plain radiography is useful forearly diagnosis of the necrotizing fasciitis and CT is very useful for detection of precise location and extent of the disease. CT is also useful for differentiation of necrotizing fasciitis from focal abscess and cellulitis.
Abdomen ; Abdominal Wall ; Abscess ; Buttocks ; Cellulitis ; Diagnosis ; Fasciitis, Necrotizing* ; Muscles ; Pelvis ; Perineum ; Radiography ; Retrospective Studies ; Scrotum ; Thigh

BACKGROUND AND OBJECTIVES: The mucosal epithelium of middle ear and eustachian tube needs hydration to maintain proper amount of moisture. Recent discoveries of various types of water channel proteins (aquaporins ; AQPs) in mucous epithelium suggest that they play critical roles in the regional regulation of water balance. The purpose of this study is to assess the distribution and expression of different subtypes of AQPs in the rat eustachian tube. SUBJECTS AND METHOD: We analyzed the distribution and expression of AQP1, 2, 4, 5, and 7 using RT-PCR, Western blot, and immunohistochemistry study in the rat middle ear and eustachian tube samples. RESULTS: The expression of the mRNA of AQP1, 4, and 5 were observed in the rat eustachian tube and middle ear. The bands of AQP1, 4, and 5 were detected at 28 kDa, 31 kDa, and 26 kDa proteins in the Western blot analysis, respectively. The immunohistochemical analysis demonstrated that AQP1 was expressed in fibroblasts at subepithelial portions of the rat eustachian tube and that AQP4 was observed at the basolateral membrane of the ciliated epithelial cells. The distribution of AQP5 in rat eustachian tube was limited to the apical surface of serous gland cells, but all of the epithelial goblet cells were labeled negative. CONCLUSION: We demonstrated that there are various subtypes of AQP in rat eustachian tube and that they existed at specific cells and sites. This study may be a preliminary study to determine the possibility of relationship between AQP expression and AQP-related disease in the middle ear and eustachian tube.
Animals ; Aquaporins ; Blotting, Western ; Ear, Middle ; Epithelial Cells ; Epithelium ; Eustachian Tube* ; Fibroblasts ; Goblet Cells ; Immunohistochemistry ; Membranes ; Rats* ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger

BACKGROUND: Celiprolol is a beta-adrenergic blocker characterized by selective blokade of beta1 receptors and partial agonist activity at beta2 receptors. This study was designed to evaluate the antihypertensive efficacy, metabolic effects and safety of celiprolol in patients with essential hypertension. METHODS: Celiprolol 200mg was administered once daily in 20 hypertensive Korean adults(9 males and 11 females) for ten weeks with dose titration every 2 weeks. RESULTS: The supine blood pressure was decreased from 168.8+/-20.6/106.5/12.0mmHg(mean/S.D) to 131.2+/-12.8/88.2+/-7.9mmHg at the end treatment(P<0.05). Heart rate was not changed significantly throughout the period. Total cholesterol(TC) was decreased from 211.3+/-12.6mg/dl to 186.7+/-10.4mg/dl(P<0.05) and triglyceride(TG) from 223.7+/-24.5mg/dl to 198.4+/-12.9mg/dl after 10 weeks treatment(P<0.05). LDL(low-density lipoprotein)-cholesterol was decreased from 126.4+/-13.4mg/dl to 118.5+/-12.3mg/dl after 10 weeks treatment(P<0.05). During the period of the study, headache and fatigue developed in a few patient but were not troublesome enough to stop medication. CONCLUSIONS: Celiprolol 200mg once daily regimen was well tolerated and effective in the treatment of essential hypertensiove patients with favorable effects on blood lipids.
Blood Pressure ; Celiprolol* ; Fatigue ; Headache ; Heart Rate ; Humans ; Hypertension ; Male

Coronary artery spasm plays an important role for evoking myocardial ischemia and infarction as well as sudden cardiac death in patients with variant angina. The coronary anatomy in patients with variant angina has been defined both at autopsy and during coronary arteriography. Severe porximal coronary atherosclerosis of at least one major vessel occurs in 3/4 of patients and the remainder have normal coronary arteries. Coronary angiography is a relatively insensitive diagnostic tool especially in the early stages of coronary artery disease. Due to arterial remodelling, angiographic luminogram may show little or no narrowing even though a large part of the total vessel area is occupied by plaque. Intravascular ultrasonography(IVUS) enables accurate determination of vessel dimensions and wall characteristics and is more sensitive in delineating early intimal changes than angiography. We experienced 2 cases that IVUS showed focal or diffuse atherosclerosis in spastic segments of the coronary arteries, even though they appeared angiographically normal.
Angiography ; Atherosclerosis ; Autopsy ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Death, Sudden, Cardiac ; Humans ; Infarction ; Muscle Spasticity* ; Myocardial Ischemia ; Spasm

PURPOSE: The MIB1 labeling index is new method utilizing a monoclonal antibody against Ki-67 antigen and useful for evaluating the proliferation rate in breast cancer due to its ease of use and reliability. We compared the MIB1 labeling index to other, well established prognostic factors and assessed the prognostic value of MIB1 in 564 breast cancers. METHODS: The MIB1 (Ki-67 equivalent monoclonal antibody) proliferation rate, MIB1 labeling index, was determined in formalin-fixed, paraffin-embedded tissue specimens of 564 primary breast cancer patients who underwent surgery between March 1998 and February 2000 at Seoul National University Hospital. The clinicopathologic characteristics of the primary tumor such as age, tumor size, histologic type, nuclear grade, histologic grade, hormone receptor status and various tumor markers (p53, c-erbB-2, bcl-2) were compared with the value of the MIB1 labeling Index. RESULTS: The mean value of MIB1 labeling index was 6.9. MIB1 labeling index was correlated to younger age (p= 0.011), histologic types, low nuclear grade (p=0.0001), high histologic grade (p=0.0001), p53 positive (IDC) (p=0.0001), c-erbB-2 positive (DCIS) (p=0.01), comedo type (DCIS) (p= 0.001) and inversely correlated to hormone receptor positivity (p=0.0001), bcl-2 positive (IDC) (p=0.001). No correlation was found in tumor size, lymph node status and c-erbB-2 positive (IDC). CONCLUSION: The MIB1 labeling index correlated well with well-established poor prognostic factors. The MIB1 labeling index may be an important prognostic determinant in breast cancer.
Biomarkers, Tumor ; Breast Neoplasms* ; Breast* ; Humans ; Ki-67 Antigen ; Lymph Nodes ; Seoul