BACKGROUND: The pattern of left ventricular filling as depicted by Doppler echocardiographic transmitrial flow velocities has been used to left ventricular diastolic properties. Especially, altered transmitral flow by abnormal myocardial wall motion and left ventricular function in ischemic heart disease, was predicted during exercise test. METHODS: To determine the effects of exercise on Doppler echocardiographic measures of left ventricular diastolic filling, we studied 15 angina pectoris patients and 20 normal control subjects. Transmitral flow measurements comprised peak and integrated early passive(E) and late atrial(A) filling velocities and diastolic filling period. RESULTS: Heart rate in negative exercise treadmill test group was 70/min at rest, 111/min just after exercise, and 86/min at 5 minutes after exercise. Positive exercise treadmill test group was 69/min, 109/min and 82/min, respectively. DFP and E duration were also significantly decreased after exercise in group with negative treadmill exercise test. In positive treadmill exercise group, peak A was significantly increased from 0.57+/-0.15m/sec to 0.75+/-0.20m/sec at just after exercise(p<0.01), 0.67+/-0.12m/sec at 5 minuties after exercise. DFP and E duration were also significantly decreased after exercise. CONCLUSION: Doppler echocardiographic transmitral flow was altered by abnormal regional wall motion and left ventricular dysfunction in ischemic heart disease during exercise test. The use of Doppler echocardiography for this purpose is limited, however, because a number of variables may influence transmitral flow patterns, including age, preload, afterload and systolic function.
Angina Pectoris ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Echocardiography ; Echocardiography, Doppler* ; Exercise Test ; Heart Rate ; Humans ; Isoflurophate ; Myocardial Ischemia ; Ventricular Dysfunction, Left ; Ventricular Function, Left

No abstract available.
Endosonography* ; Insulinoma*

OBJECTIVE: This study is aimed whether bcl-xl could protect C4 cells from the cell death induced by serum deprivation. METHODS: The transient transfection of the bcl-xl gene was made with a LipofectAMINE reagent. An immunohistocytochemical assay and Western-blotting were performed to examine the bcl-xl transfection into the C4 cells. In order to analyze the effect of the bcl-xl transfection, the number of cells on the well plate were serially counted each day, for 5 days, from the 2nd to the 6th day after transfection. The number of GFP-positive cells in the defined fields, following serum deprivation, was counted using fluorescence microscopy, and the total number of viable cells, including transfected cells, were also assessed. RESULTS: Immunocytochemical staining showed positive cells in 52% of nestin staining, 60% of GFAP and 20% of MAP-2. The number of cells decreased after transfection using the LipofectAMINE in the serum free medium (p<0.001). Western blotting using an anti-human bcl-xl antibodies showed that bcl-xl was expressed in both the non-transfected and bcl-xl transfected C4 cells. Cell death in the C4 cells, and the number of cells, were serially monitored each day for 5 days. In the bcl-xl transfected cells, the cell death induced by serum deprivation was significantly inhibited and delayed compared to that in the control cells (p<0.001). CONCLUSION: It is suggested that the bcl-xl transfected human neural progenitor cells might improve the survival of the grafted cells, and may be an alternative source of cells for neural transplantation in degenerative diseases.
Antibodies ; Blotting, Western ; Cell Death ; Humans* ; Microscopy, Fluorescence ; Nestin ; Stem Cells* ; Transfection ; Transplants

Hemorrhage into a pancreatic pseudocyst is a rare, but increasingly recognized as a cause of massive gastrointestial bleeding. Bleeding pseudocysts may rupture into the stomach, duodenum, common bile duct, and splenic vein, or can be decompressed via the duct of Wirsung. Also it will result in upper gastrointestinal bleeding. This represents a life-threatening and frequently unrecognized complication of pancreatic disease. Proper diagnostic workup and prompt surgical management afford the patient the best chance for survival. We report a patient with pseudocyst bleeding into the gastrointestinal tract via the duct of Wirsung and discuss the current diagnostic and therapeutic approach.
Common Bile Duct ; Duodenum ; Gastrointestinal Hemorrhage* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Rupture ; Splenic Vein ; Stomach

No abstract available.
Adenoma, Liver Cell/*diagnosis/diagnostic imaging/pathology ; Aged ; Antigens, CD34/metabolism ; Bile Ducts, Intrahepatic/pathology ; C-Reactive Protein/metabolism ; Female ; Humans ; Liver Neoplasms/*diagnosis/diagnostic imaging/pathology ; Magnetic Resonance Imaging ; Serum Amyloid A Protein/metabolism ; Tomography, X-Ray Computed

Objective: Diffuse interstitial lung disease (DILD) is a group of diverse diseases that share common clinical, radiologic, and pulomonary function features. Open lung biopsy (OLB) has been regarded as gold standard in differential diagnosis of DILD. However open lung biopsy is a invasive diagnostic tool not free of its own risk or complications. These days, high-resolution computed tomography (HRCT) has become an important diagnostic tool in DILD through its precise image analysis. In many instances, HRCT could provide specific diagnosis or, at least, provide information on the disease activity of DILD. The authors re-evaluate the role of open lung biopsy in this "HRCT era" by investigating the additional diagnostic gain and impacts on the treatment plan in patients who have undergone high-resoluticm CT. Method: Diagnoses obtained by high-resolution CT and open lung biopsy were compared and changes of treatment plans were evaluated retrospectively in 30 patients who had undergone open lung biopsy for the purpose of diagnosis of diffuse interstitial lung disease from March 1988 to June 1994. Results: High-resolution CT suggeted specific diagnoses in 22 out of 28 patients (78.6%) and the diagnoses were confirmed to be correct by open lung biopy in 20 of those 22 cases (91%). Open lung biopsy could not give specific diagnosis in 5 out of 30 cases (16.7%). In 5 out of 6 cases (83.3%) in whom high reolution CT was not able to suggest specific diagnosis, open lung biopsy gave specific diagnoses. Treatment plan was altered by the result of open lung biopsy in only 2 cases. Conclusion: The above findings suggest that in "HRCT era", when HRCT could suggest specific diagnosis, the need for open lung biopsy should be re-evaluated.
Biopsy* ; Diagnosis* ; Diagnosis, Differential ; Humans ; Lung Diseases, Interstitial* ; Lung* ; Retrospective Studies

Objective: Diffuse interstitial lung disease (DILD) is a group of diverse diseases that share common clinical, radiologic, and pulomonary function features. Open lung biopsy (OLB) has been regarded as gold standard in differential diagnosis of DILD. However open lung biopsy is a invasive diagnostic tool not free of its own risk or complications. These days, high-resolution computed tomography (HRCT) has become an important diagnostic tool in DILD through its precise image analysis. In many instances, HRCT could provide specific diagnosis or, at least, provide information on the disease activity of DILD. The authors re-evaluate the role of open lung biopsy in this "HRCT era" by investigating the additional diagnostic gain and impacts on the treatment plan in patients who have undergone high-resoluticm CT. Method: Diagnoses obtained by high-resolution CT and open lung biopsy were compared and changes of treatment plans were evaluated retrospectively in 30 patients who had undergone open lung biopsy for the purpose of diagnosis of diffuse interstitial lung disease from March 1988 to June 1994. Results: High-resolution CT suggeted specific diagnoses in 22 out of 28 patients (78.6%) and the diagnoses were confirmed to be correct by open lung biopy in 20 of those 22 cases (91%). Open lung biopsy could not give specific diagnosis in 5 out of 30 cases (16.7%). In 5 out of 6 cases (83.3%) in whom high reolution CT was not able to suggest specific diagnosis, open lung biopsy gave specific diagnoses. Treatment plan was altered by the result of open lung biopsy in only 2 cases. Conclusion: The above findings suggest that in "HRCT era", when HRCT could suggest specific diagnosis, the need for open lung biopsy should be re-evaluated.
Biopsy* ; Diagnosis* ; Diagnosis, Differential ; Humans ; Lung Diseases, Interstitial* ; Lung* ; Retrospective Studies

Background/Aims: To investigate whether serum Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA+-M2BP) can predict the recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection. Methods: Patients with chronic hepatitis B (CHB) who underwent curative resection for HCC between 2004 and 2015 were eligible for the study. Recurrence was sub-classified as early (<2 years) or late (≥2 years). Results: A total of 170 patients with CHB were selected. During the follow-up period (median, 22.6 months), 64 (37.6%) patients developed recurrence. In multivariate analyses, WFA+-M2BP level was an independent predictor of overall (hazard ratio [HR]=1.490), early (HR=1.667), and late recurrence (HR=1.416), together with male sex, des-gamma carboxyprothrombin level, maximal tumor size, portal vein invasion, and satellite nodules (all P<0.05). However, WFA+- M2BP level was not predictive of grade B-C posthepatectomy liver failure. The cutoff value that maximized the sum of sensitivity (30.2%) and specificity (90.6%) was 2.14 (area under receiver operating characteristic curve=0.632, P=0.010). Patients with a WFA+-M2BP level >2.14 experienced recurrence more frequently than those with a WFA+-M2BP level ≤2.14 (P=0.011 by log-rank test), and had poorer postoperative outcomes than those with a WFA+-M2BP level ≤2.14 in terms of overall recurrence (56.0 vs. 34.5%, P=0.047) and early recurrence (52.0 vs. 20.7%, P=0.001). Conclusions WFA+-M2BP level is an independent predictive factor of HBV-related HCC recurrence after curative resection. Further studies should investigate incorporation of WFA+-M2BP level into tailored postoperative surveillance strategies for patients with CHB.

PURPOSE: The aim of this study was to identify the prognostic factors and compare the long-term outcomes of staged hepatectomy and transarterial chemoembolization (TACE) for patients with spontaneous rupture of hepatocellular carcinoma (HCC). METHODS: This study is a multicenter, retrospective analysis of patients with newly diagnosed ruptured HCC. To compare overall survival between staged hepatectomy group and TACE alone group, we performed propensity score-matching to adjust for significant differences in patient characteristics. To identify prognostic factors, the clinical characteristics at the time of diagnosis of tumor rupture were investigated using Cox-regression analysis. RESULTS: From 2000 to 2014, 172 consecutive patients with newly diagnosed ruptured HCC were treated in 6 Korean centers. One hundred seventeen patients with Child-Pugh class A disease were identified; of which 112 were initially treated with transcatheter arterial embolization (TAE) for hemostasis and five underwent emergency surgery for bleeder ligation. Of the 112 patients treated with TAE, 44 underwent staged hepatectomy, 61 received TACE alone, and 7 received conservative treatment after TAE. Those that underwent staged hepatectomy had significantly higher overall survival than those that underwent TACE alone before matching (P < 0.001) and after propensity score-matching (P = 0.006). Multivariate analysis showed that type of treatment, presence of portal vein thrombosis, pretreatment transfusion >1,200 mL, and tumor size >5 cm were associated with poor overall survival. CONCLUSION: Staged hepatectomy may offer better long-term survival than TACE alone for spontaneous rupture of HCC. Staged hepatectomy should be considered in spontaneous rupture of HCC with resectable tumor and preserved liver function.
Carcinoma, Hepatocellular ; Chemoembolization, Therapeutic ; Diagnosis ; Emergencies ; Hemostasis ; Hepatectomy ; Humans ; Korea ; Ligation ; Liver ; Multivariate Analysis ; Retrospective Studies ; Rupture ; Rupture, Spontaneous ; Venous Thrombosis

PURPOSE: The endoscopic surgery has been widely used and developed in operations of the thyroid and parathyroid gland because of the cosmetic advantage and the development of laparoscopic instrument. Since the first endoscopic thyroid surgery in late 1990's, many endoscopic operations for thyroid tumors have been performed in Korea. The authors analyzed the current status of endoscopic thyroid surgery performed in Korea. METHODS: We have collected and analyzed the data of endoscopic thyroid operations using survey. RESULTS: The surgeons working in 16 hospitals answered the questions in survey. The total endoscopic thyroid operations were performed over 1,200 cases until the end of 2004. In the pathologic diagnosis, nodular hyperplasia was most frequent in 64.5%. The axillary approach was most frequently applied in 9 hospitals (56.2%). Most of endoscopic thyroid operations were performed in 2~3 hours. The operation time was decreased according to the experience. The endoscopic surgery for malignant tumors were also performed in 11 hospitals, The hospital stay was usually 3~4 days. The most common complications in endoscopic thyroid surgery were temporary recurrent laryngeal nerve paralysis and anteior chest wall discomfort or paresthesia. The most common reason for conversion to conventional surgery was the intraoperative diagnosis as for a malignancy. CONCLUSION: Endoscopic thyroid surgery has been perfomed in many hospitals not only special thyroid clinic in Korea. The operation cases are increasing rapidly in these days. According to the development of technique and instrument, the endoscopic surgery are applied to various neck disease involving malignancy. The safety and efficacy of endoscopic surgery for malignancy should be further evaluated with accumulation of experience of endoscopic operation and long term follow-up of thyroid cancer patients.
Diagnosis ; Follow-Up Studies ; Humans ; Hyperplasia ; Korea* ; Length of Stay ; Neck ; Paralysis ; Parathyroid Glands ; Paresthesia ; Recurrent Laryngeal Nerve ; Surgeons ; Thoracic Wall ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy*