No abstract available.
Animals ; Carbohydrate Metabolism* ; Hindlimb Suspension* ; Hindlimb* ; Insulin* ; Muscle, Skeletal* ; Rats* ; Receptor, Insulin*

This study examined the roles of the initial level of muscle glycogen content and available substrate on glycogen repletion in muscle. The rats were randomly assigned to normal, starvation and exercise groups. The glycogen content of muscle was lowered by starvation and exercise for the purpose of this experiment. The normal rats remained sedentary in their cage without any restriction of food and water. The exercise and starvation groups were divided each group into two subgroups depending on the degree of stress, i.e. 16 and 64 hours starvation, and 30 minutes and 2 hours exercise loading. All experimental aninals sacrificed 9~10 O'clock in the morning. The glycogen content of gastrocnemius and liver were 0.416+0.0433 and 1.70+0.410gm/100gm wet tissue in normal rats, respectively. The glycogen content of gastrocnemius in stravaton groups was reduced to 83.5 and 75.5% of the values of normal groups by starvation for 16 and 64 hours, respectively. In exercise group, the content of glycogen was reduced to 63.7 and 49.8% of the normal group by 30 minutes and 2 hours exercise loading, respectively, After above exercise loading and forced starvation, glucose, 2.0gm/100gm body weight was ingested, and 2 hours later the glycogen content was determined to evaluate the role of initial level of muscle glycogen content on the repletion in gastrocnemius, and the different amount of glucose, 1.0, 1.5 and 2.0mg/100gm body weight, was given orally, and 2 hours later the glycogen content of gastrocnemius was determined to evaluate the role of available substrate on the glycogen repleted in muscle of the lowest initial glycogen content, and the larger the amount of glucose ingestion, the larger amount of glycogen repletion in muscle. The experiment demonstrates that the reducing level of muscle glycogen and increased amount of available substrate are the important factors for the acceleration of muscle glycogen repletion, and in the aspect of repletion of glycogen, the repletion rate of liver glycogen is 2~5 times faster than that of muscle, whereas there is no difference of repletion rate of liver glycogen between starvation and exercise groups.
Acceleration ; Animals ; Body Weight ; Eating ; Glucose ; Glycogen ; Liver ; Liver Glycogen ; Muscle, Skeletal ; Rats ; Starvation ; Water

BACKGROUND: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in paients who developed acute respiratory failure after extubation. METHOD: We retrospectively analyzed thirty one patients (eighteen males and thirteen females, mean ages 63+/-13.2 years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 cmH2O of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. RESULTS: 1) NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. 2) There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and PaO2/FiO2 between the success and the failure group. 3) Heart rate and respiration rate were significantly decreased with increase SaO2 after thirty minutes of NIPPV in both groups (p<0.05). Ho wever, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in SaO2 leading to endotracheal reintubation. 4) The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases (62% vs 39%) (p=0.007). 6) The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease (n=9), aggravation of undelying disease (n=5), mask intolerance (n=2), and retained airway secretion (n=1). CONCLUSION: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.
APACHE ; Blood Gas Analysis ; Chungcheongnam-do ; Female ; Heart Rate ; Humans ; Critical Care ; Intubation ; Intubation, Intratracheal ; Male ; Masks ; Oxygen ; Positive-Pressure Respiration* ; Pulmonary Disease, Chronic Obstructive ; Respiration ; Respiration, Artificial ; Respiratory Insufficiency* ; Respiratory Rate ; Retrospective Studies ; Weaning

No abstract available.
Leiomyoma*

Primary nodal marginal zone B-cell lymphoma (MZBCL) is recognized as a rare and distinct entity. The rate of histologic transformation into diffuse large B-cell lymphoma (DLBCL) seems lower than the rate of transformation in follicular lymphoma. We herein report a rare case ofnodal MZBCL showing transformation into DLBCL. The patient was a 73-year-old female withcervical lymphadenopathy. On the initial biopsy, the lymph node architecture was diffuselyeffaced with an extensive interfollicular and parafollicular infiltrate of monocytoid B-cells. Therewere scattered large blastic B-cells without formations of compact sheets. The diagnosis ofnodal MZBCL was made. The patient did not receive chemotherapy and was treated with aconservatively supportive regimen. Forty two months later, the patient developed a new cervicallymphadenopathy and a biopsy was performed. Histologically, the lymph node revealeddiffuse sheets of transformed large B-cells showing prominent nucleoli. The diagnosis ofDLBCL transformed from nodal MZBCL was made. The patient was treated with 3 cycles ofcombined CHOP chemotherapy and she showed clinical improvement. These observationssuggest that an untreated primary nodal MZBCL may undergo high-grade transformation.
Aged ; B-Lymphocytes ; Biopsy ; Diagnosis ; Drug Therapy ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Follicular

BACKGROUND AND OBJECTIVES: Radiofrequency (RF) catheter ablation of the pulmonary vein (PV) can treat drug refractory focal atrial fibrillation (AF). However, high RF energy (RFE) can cause severe PV damage, and the lower limits of effective RFE in PV have not yet been elucidated. This study attempts to evaluate the changes of PV structure after various modes of RFE delivery. MATERIALS AND METHODS: Right heart and transseptal catheterization were performed in 5 anesthetized mongrel dogs. RFE was delivered at the right superior pulmonary vein (RSPV) with 50 watts and 70degreesC and at the left superior pulmonary vein (LSPV) with 20 watts and 50degreesC. After the procedures, the endocardiums of the left atrium and both superior PVs were examined. RESULTS: Total applied RFE in both PVs was 14.2+/-.2 vs. 13.5+/-.6 watts, 46.6+/-.1 vs. 64.5+/-.2degreesC (p<0.05), in LSPV vs. RSPV, respectively. Follow up pulmonary venograms showed that total occlusions of PV branches and severe stenosis of proximal PV (>70% luminal narrowing) developed in 4 dogs with high RFE. Mild stenosis (<50% luminal narrowing) of PV developed in 1 dog with low RFE. Histological examination of the 5 dogs revealed coagulation necrosis over the whole PV layer, including the adventitia and some portion of the myocardial sleeve, and severe hemorrhage and destruction of PVs from high energy treatment, in contrast to intimal damage and swelling of subintimal PV layers in low energy treatment. CONCLUSION: High RF current may result in severe damage of pulmonary veins and sub-structures whereas low RF current may cause suboptimal pulmonary vein damage such as intimal only damage.
Adventitia ; Animals ; Atrial Fibrillation ; Catheter Ablation ; Catheterization ; Catheters ; Constriction, Pathologic ; Dogs ; Endocardium ; Follow-Up Studies ; Heart ; Heart Atria ; Hemorrhage ; Necrosis ; Phenobarbital ; Pulmonary Veins*

BACKGROUND: beta-thalassemia is primarily found in individuals of Mediterranean and Southeast Asian ancestry. With rapid growth in the Southeast Asian segments of the Korean population, the geographic distribution of hemoglobinopathies is expected to become significantly different from what it is today. In this study, Hb fractions were measured in patients with hypochromic microcytosis to detect thalassemia and Hb variants. To evaluate the feasibility of replacing cellulose acetate electrophoresis (CA) with capillary electrophoresis (CE) in a clinical laboratory, both techniques were performed and the outcomes were compared. METHODS: To evaluate hemoglobinopathies, complete blood cell counts (CBC), CA, and CE were carried out on samples from healthy and microcytic hypochromic groups. The microcytic hypochromic group consisted of 103 patients whose mean corpuscular volume (MCV) was less than 75 fL and mean corpuscular hemoglobin (MCH) was less than 24 pg. Quantitative analysis of Hb fractions was performed on 143 whole blood samples. RESULTS: There was a good correlation for measurements of HbA (r=0.9370, P<0.0001), HbA2 (r=0.8973 P<0.0001), and HbF (r= 0.8010, P=0.0304) between the two methods. In the microcytic hypochromic group, there were 29 cases (28.2%) with decreased HbA2, 2 cases (1.9%) with increased HbA2, 3 cases (2.9%) with increased HbF, and 2 cases (1.9%) with increased HbA2 and HbF. CONCLUSIONS: CE is comparable to CA for reliable measurement of Hb fractions. It is suitable for screening of hemoglobinopathies in many clinical laboratories.
Adult ; Aged ; Aged, 80 and over ; Blood Cell Count ; *Electrophoresis, Capillary ; *Electrophoresis, Cellulose Acetate ; Erythrocyte Indices ; Female ; Fetal Hemoglobin/analysis ; Hemoglobin A/analysis ; Hemoglobin A2/analysis ; Hemoglobinopathies/*diagnosis ; Humans ; Male ; Middle Aged

Color Doppler echocardiographic examination was performed to detect and evaluate semiquantitatively the severity of mitral regurgitation in 38 patients who underwent left ventriculography. The sensitivity and specificity of the technique in the detection of mitral regurgitation was 84% and 100% as compared with left ventriculography.Mitral regurgitation in the false negative cases was mostly mild. On the bases of the farthest distance reached by the regurgitation flow signal from the mitral value orifice, the severity of regurgitation was graded on a four point scale and these results were compared with those of angiography. A significant correlation(r=0.87) was found between Doppler imaging and angiography in the evaluation of the severity of mitral regurgitation.Also results was obtained for the evaluation based on the area covered by the regurgitant signals in the left atrial cavity & the regurgitant jet area(RJA) experssed as a percentage of the left atrial are(LLA) obtained in the same plane(RJA/LLA%). In conclusion, Color Doppler echocardiography is a useful noninvasvive thechique that is not only sensitive and specific in the identification of mitral regurgitation but also provides accurate estimation og its severity.
Angiography ; Echocardiography ; Echocardiography, Doppler, Color ; Humans ; Mitral Valve Insufficiency* ; Sensitivity and Specificity

Long QT syndrome is a cardiac disorder of repolarization which is characterized by elctrocardiographic abnormalities including prolonged QT interval, T-wave abnormalities and polymorphic ventricular tachycardia known as Torsades de Pointes. Its clinical manifestation are recurrent syncope, seizure, and sudden death. Recently,we experienced Torsades de Pointes(TdP) by head-up tilt test in 24 year-old female patient presenting recurrent syncope and long QT interval. Beta-blocker and left cervicothoracic sympathetic ganglionectomy were not effictive, then we tried mexiletine. After mexiletine medication, the QT interval was significantly shortened and there was no more syncope.
Death, Sudden ; Female ; Ganglionectomy ; Humans ; Long QT Syndrome* ; Mexiletine ; Seizures ; Syncope ; Tachycardia, Ventricular ; Torsades de Pointes* ; Young Adult

PURPOSE: To evaluate the changes of differential counts and lymphocyte subsets in cancer patients' leukocyte before and after radiotherapy. METHODS AND MATERIALS: From Dec. 1994 to May 1995, the changes of leukocyte and its subsets in 16 patients who received radiotherapy in the Dept. of Radiation Oncology of Dong-A University Hospiatal were investigated. Radiation was delivered from 2700 cGy to 6660 cGy with median dose of 5400 cGy. The results of pre- and post-radiotherapy were analyzed by paired T-test. The results of patients who received < 50 Gy and > or = 50 Gy were analyzed by wilcoxon test. RESULTS: Before and after radiotherapy, there was not any significant differences in the counts of leukocyte, granulocyte and monocyte. A remarkable decrease was noted in lymphocyte counts after radiotherapy(p=0.015). T cells, B cells and natural killer cells were also decreased in number after radiotherapy but it was not significant statistically. T helper cells and T suppressor cells were also decreased in number(p>0.05). The ratio of T helper/suppressor cell was decreased from 1.52 to 1.11 and it was significant statistically(p=0.016). The portion of T suppressor cell among all T cells was increased after radiotherapy (p=0.0195). No significant difference was observed in the analysis of leukocyte and its subsets between patients who reveived < 50 Gy and > or = 50 Gy. CONCLUSION: Radiotherapy caused remarkable decrease in lymphocyte count and its subsets. Among all lymphocyte subsets, T helper cell might be the most vulnerable to radiation, considering decreased ratio of T helper/surppressor cell count after radiotherapy.
B-Lymphocytes ; Cell Count ; Granulocytes ; Humans ; Killer Cells, Natural ; Leukocytes ; Lymphocyte Count ; Lymphocyte Subsets* ; Lymphocytes* ; Monocytes ; Radiation Oncology ; Radiotherapy* ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer