INTRODUCTION: It is now generally accepted that free radicals play an important role in the development of various forms of tissue damage and pathological events, such as heart disease, cancer, and aging. On the other hand, it is difficult to demonstrate the injurious actions of free radicals in vivo, and it has not been clearly proven experimentally whether the damage is really caused by free radicals, nor how the free radicals damage biological molecules, primarily because of the difficulty in generating free radicals in biological systems under controlled conditions. PURPOSES OF STUDY: In this study, we investigated whether the histologically different part of lesion is created in liver injuries by free radicals formed from each mechanism. we investigated the usefulness of the ICG excretion test as an early indicator of liver injury, and the significance of an increase of urinary biopterin in free radical injury. MATERIALS & METHODS: In this study, the acute hepatic injuries were induced in the Sprague-Dawley rat by intraperitoneal injection with CCl4(0.125 ml/100 gm body wt.) and AAPH(1 mg/100 gm body wt.). Control rats were treated with 0.5 ml of corn oil per 100 gm via intraperitoneal route. And then, liver function tests(ALT, AST, ALP, gamma-GTP, serum bilirubin and ICG excretion test), alpha-fetoprotein, urinary biopterin and histologic changes were serially examined. Total 130 rats were prepared, and each group of 5 rats of them were sampled at intervals of 2, 4, 8, 12, 24, 48 hours following administration of CCl4, AAPH solution. All values were expressed as mean +/- standard error. The results of all treatment groups and control group were analyzed by ANOVA with Duncan's multiple range test for variable. And then, the correlations between the increasing rates of urinary biopterins, ICG T1/2 and those of classic liver enzyme activities, serum bilirubin levels were analyzed for statistical significance by Pearson correlation analysis. In this analysis, a p-value below 0.05 was considered to be statistically significant. RESULTS: 1. Activities of liver enzymes(serum AST, ALT, ALP and gamma-GTP) and levels of serum bilirubin significantly increased in all the treatment groups compared to control. As time passed, these levels continued to increase(p<0.05). 2. In comparison with AAPH treatment group, serum AST and ALT of CCl4 treatment group increased more significantly(p<0.05). 3. In ICG excretion test, ICG T1/2 of all the treatment groups were greatly prolonged from about 4 - 12 hours. Compared to AAPH treatment group, ICG T1/2 of CCl4 treatment group was more significantly prolonged(p<0.05). 4. As time passed, urinary biopterin levels of all the treatment groups increased from about 24 hours. Urinary biopterin levels of AAPH treatment group increased more significantly than in CCl4 treatment group from about 48 hours(p<0.05). 5. In histopathologic view, CCl4 treated hepatic acini showed that hepatocytes in centrilobular zone were degenerated. But, AAPH treated livers showed that all hepatocytes were degenerated. 6. Passive hemagglutination tests of alpha-fetoprotein showed negative reaction in all the treatment groups and control group. 7. Correlations were statistically significant(p<0.05) between the increasing rates of urinary biopterin levels and those of classic liver enzyme activities(except, serum AST), and serum bilirubin levels in CCl4 induced hepatotoxicity. 8. In AAPH induced hepatotoxicity, the increasing rates of urinary biopterin levels correlated with those of classic liver enzyme activities(serum ALT, AST, ALP, -GTP) and serum bilirubin levels(p < 0.05). 9. The increasing rates of ICG T1/2 correlated significantly with those of liver enzyme activities and serum bilirubin in CCl4 and AAPH induced hepatotoxicity(p<0.05), but there were no statistically significant correlations between the increasing rates of ICG T1/2 and those of serum ALT in CCl4 induced hepatotoxicity. 10. And also, the increasing rates of ICG T1/2 correlated significantly with those of urinary biopterin in CCl4 and AAPH induced hepatotoxicity(p<0.05). CONCLUSION: We observed in this study that the difference in hepatic lesions induced by free radicals might be closely related to the site where free radicals had been generated. We indirectly found that the tissue damage is caused by free radicals. There were excellent correlations between urinary biopterin levels, ICG excretion test and classic liver enzyme activities, and serum bilirubin levels in acute hepatic injuries induced by free radicals from CCl4 and AAPH. Also, we determined that ICG excretion test is a saturable process for evaluation of acute hepatic injury. The urinary biopterin levels in CCl4 treated groups were significantly different from those of AAPH treated groups suggesting that an unknown mechanism is concerned with free radical induced biopterin elevation. However, the level of urinary biopterin in free radical injury may be a useful complementary index.
Aging ; alpha-Fetoproteins ; Animals ; Bilirubin ; Biopterin ; Corn Oil ; Free Radicals ; Hand ; Heart Diseases ; Hemagglutination Tests ; Hepatocytes ; Injections, Intraperitoneal ; Liver ; Rats ; Rats, Sprague-Dawley*

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the residual diameter stenosis after PTCA with fractional flow reserve (FFR) and coronary flow reserve (CFR), and investigate the correlation between FFR and CFR in patients with acute myocardial infarction (AMI). MATERIALS AND METHOD: The study population consisted of twenty seven patients with myocardial infarction. Baseline and hyperemic average peak velocity (APV) were measured using Doppler wire 15 minutes after restoration of infarct-related artery (IRA). CFR was obtained by the ratio of distal hyperemic APV to baseline APV. Distal coronary arterial pressure (Pd) was measured with advancing the wire distal to the lesion of IRA. Simultaneous proximal aortic pressure (Pa) was measured using guiding catheter. Myocardial FFR was obtained by the ratio of hyperemic Pd to hyperemic Pa. RESULTS: Post-interventional CFR and FFR were 0.85+/-0.44, 0.91+/-0.09. CFR did not show significant correlation with luminal diameter stenosis (%ST). There was no significant correlation between FFR and CFR with a correlation coefficient of 0.29 (p=.25). But, significant correlation was found between %ST and FFR, %ST and hyperemic PG (hPG) with correlation coefficient of -0.70 (p=.0012) and 0.68 (p=.0018). CONCLUSION: In AMI patients, %ST has a significant correlation with FFR and hPG after PTCA. But, there was no significant correlation between FFR and CFR.
Arterial Pressure ; Arteries ; Catheters ; Constriction, Pathologic ; Humans ; Myocardial Infarction* ; Phenobarbital

Primary hyperparathyroicism is a state of hypersecretion of PTH by the parathyroid. The etiology has not been established. The three possible etiologies of piimary hyperparathyroidism and incidences are adencena(83%), hyperplasia(15%), and carcinoma(1~2%). Parathyroid carcinoma usually presents in the fourth decades. The hallmark preoperative signs are hypercalcemia(serum calcium 15mg/dl). Palpable neck mass and bane and renal disease. Patients may present with multiple signs and syrnptoms, including recurrent nephrolithiasis, peptic ulcers, mental change, less frequently, extensive bone resorption. However, with greater awareness of the disease and wider use of screening tests, including blood calcium determinations, the diagnosis is frequently made in patients who have no symptoms and minimal, if any, signs of the disease ather than hypercalcemia and elevated levels of parathyroid Hormone. An 38-years-old woman was admitted to the hospital due to pain on the left knee joint. We experienced full-brown symptom pertaining to hyperpara- thyroidism. Thus we report a case herein and also discuss clinical anifestation, histologic features and treatment.
Bone Resorption ; Calcium ; Diagnosis ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Incidence ; Knee Joint ; Mass Screening ; Neck ; Nephrolithiasis ; Parathyroid Hormone ; Parathyroid Neoplasms ; Peptic Ulcer ; Thyroid Gland

No abstract available.
Acupuncture ; Sarcoidosis

Studies describing the effects on blood pressure control by hemodialysis(HD) or continuous amulatory peritoneal dialysis(CAPD) have yielded conflicting results with respect to 24 hour blood pressure control, diurnal variation and blood pressure loads. The aim of the study was to investigate the effect of beginning with HD or CAPD on blood pressure control, diurnal variation and blood pressure loads using ambulatory blood pressure monitoring(ABPM). Twen-ty-seven end-stage renal disease(ESRD) patients(12 on HD and 15 on CAPD) were enrolled into the study. Patients with cardiovascular diseases, erythro-poietin therapy, or severe edema were excluded. ABPM were performed two times before and after the initiation of dialysis. Mean duration of interval between pre- and post-dialysis ABPM were 17+/-4 days on HD and 13+/-3 days on CAPD. Daytime and nighttime were defined as the time from 6:00 AM to 10:00 PM and from 10:00 PM to 6:00 AM of the next day. Systolic and diastolic loads were defined as the percentage of the incidence of systolic and diastolic blood pressure over l% and 90mmHg. Dipper meaning the presence of normal diurnal difference were defined as the differences of daytime- nighttime mean arterial pressure more than 5mmHg. In HD patients, mean systolic and diastolic blood pressure and mean arterial pressure were significantly decreased after dialysis during 24 hour, day- time and nighttime. In CAPD patients, those were also significantly decreased after dialysis during 24 hour, daytime and nighttime(p<0.05). Diurnal differences were increased after CAPD(3.3+/-9.4 vs 5.4+/-6.8mmHg) but decreased after HD(4.3+/-6.2 vs 2.4+/-10.8mmHg) and the differences of diurnal difference between two groups were significantly different(+2.1+/-9.0 vs 1.9+/-8.4mmHg, p<0.05). Proportions of dipper among patients were increased from 16.7 to 66.7% in HD and from 33.3% to 60% in CAPD without statistical significance between two groups. Systolic and diastolic loads were significantly decreased after HD(from 75.0+/-38.0 to 37.5+/-43.8%, from 45.2+/-29.7 to 12.5+/-12.8%, respectively, p<0.05) and after CAPD(from 63.1+/-30,1 to 32.3+/-27.1%, from 43.4+/-36.2% to 12.2+/-16.9%, respectively, p<0.05). Systolic and diastolic loads of daytime and nighttime were significantly decreased after each dialysis modality except nighttime diastolic pressure load in HD. In conclusions, both HD and CAPD improve BP control in ESRD patients. CAPD has more benefit to control of diurnal variations in ESRD patients.
Arterial Pressure ; Blood Pressure* ; Cardiovascular Diseases ; Dialysis ; Edema ; Humans ; Incidence ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis*

Leptin, which is a plasma protein produced by the obese gene, is expressed and secreted by adipocytes. The clearance of lepdn from the circulation is unknown. But, markedly elevated serum leptin concentrations have recently been reported in patients with chronic renal failure. The purpose of the present study was to investigate plasma leptin concentration of patients with chronic renal failure and evaluate the factors affecting plasma leptin levels. Plasma leptin, insulin, and body mass index were determined in 34 patients with chronic renal failure and 55 control subjects. The plasrna leptin concentrations were not significantly different between patients with chronic renal failure and control subjects (9.4+/-11.8 vs 4.9+/-4.2ng/ml, P>0.05). The serum leptin concentrations were not significantly higher in both male and female CRF patients compared with control subjects (3.96+/-5.72 vs 2.48+/-1.65, P=0.1947, 17.07+/-14.02 vs 7.49+/-4.63ng/ml, P=0.07, respectively). And, there was no significant correlation between serum creatinine and plasma leptin. However, there was significant correlation between plasma leptin concentration and insulin level (P<0.05). We fit a multiple linear regre- ssion analysis with plasma leptin level as the dependent variable in CRF. Sex (male vs female) (P< 0.001) and insulin (P=0.004) were independently associated with plasma leptin level in CRF. These results suggested that plasma leptin level was regulated or affected by multiple factors inclu- ding sex and insulin resistance. Additional study is required to evaluate relationship between plasma leptin and insulin resistance in chronic renal failure.
Adipocytes ; Body Mass Index ; Creatinine ; Female ; Humans ; Insulin ; Insulin Resistance ; Kidney Failure, Chronic* ; Leptin* ; Male ; Plasma*

OBJECTIVE: Spontaneous intracerebral hemorrhage (ICH) in young adults is rare. The purpose of this study was to investigate causes, sites and other factors affecting the prognosis of ICH in young adults aged < or = 40 years. METHODS: We reviewed 39 consecutive patients diagnosed with spontaneous ICH between January 2001 and June 2012. Patients with primary subarachnoid hemorrhage, previously diagnosed brain tumor bleeding, or vascular malformation were excluded. We analyzed the differences in prognostic factors such as hemorrhage location and vascular structural etiology. The outcome was measured using the Glasgow outcome scale (GOS), and a good outcome was defined as a score of 4 or more. RESULTS: We retrospectively evaluated 39 patients (mean age, 33 years; SD = 6.4, range 17 to 40 years). The most common structural etiology was arteriovenous malformation. A statistically significantly higher proportion of patients with good outcomes had a lower initial systolic blood pressure (SBP < or = 160 mmHg, p = 0.036), a higher initial Glasgow coma scale (GCS) (9 or more, p = 0.034), lower cholesterol levels (< 200 mg/dl, p = 0.036), and smoking history (at discharge, p = 0.008; 6 months after discharge, p = 0.019). CONCLUSION: In this study, cryptogenic ICH was the leading cause of spontaneous ICH. A GCS score of 9 or more on admission, a lower serum cholesterol level (< 200 mg/dl), and a lower SBP (< 160 mmHg) predicted a good outcome.
Aged ; Arteriovenous Malformations ; Blood Pressure ; Brain Neoplasms ; Cerebral Hemorrhage ; Cholesterol ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage ; Humans ; Prognosis ; Retrospective Studies ; Smoke ; Smoking ; Subarachnoid Hemorrhage ; Vascular Malformations ; Young Adult

OBJECTIVE: Spontaneous intracerebral hemorrhage (ICH) in young adults is rare. The purpose of this study was to investigate causes, sites and other factors affecting the prognosis of ICH in young adults aged < or = 40 years. METHODS: We reviewed 39 consecutive patients diagnosed with spontaneous ICH between January 2001 and June 2012. Patients with primary subarachnoid hemorrhage, previously diagnosed brain tumor bleeding, or vascular malformation were excluded. We analyzed the differences in prognostic factors such as hemorrhage location and vascular structural etiology. The outcome was measured using the Glasgow outcome scale (GOS), and a good outcome was defined as a score of 4 or more. RESULTS: We retrospectively evaluated 39 patients (mean age, 33 years; SD = 6.4, range 17 to 40 years). The most common structural etiology was arteriovenous malformation. A statistically significantly higher proportion of patients with good outcomes had a lower initial systolic blood pressure (SBP < or = 160 mmHg, p = 0.036), a higher initial Glasgow coma scale (GCS) (9 or more, p = 0.034), lower cholesterol levels (< 200 mg/dl, p = 0.036), and smoking history (at discharge, p = 0.008; 6 months after discharge, p = 0.019). CONCLUSION: In this study, cryptogenic ICH was the leading cause of spontaneous ICH. A GCS score of 9 or more on admission, a lower serum cholesterol level (< 200 mg/dl), and a lower SBP (< 160 mmHg) predicted a good outcome.
Aged ; Arteriovenous Malformations ; Blood Pressure ; Brain Neoplasms ; Cerebral Hemorrhage ; Cholesterol ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage ; Humans ; Prognosis ; Retrospective Studies ; Smoke ; Smoking ; Subarachnoid Hemorrhage ; Vascular Malformations ; Young Adult

PURPOSE: We report a case of orbital B-cell lymphoblastic lymphoma in a 7-year-old boy. METHODS: A 7-year-old boy presented with proptosis and periorbital swelling of his left eye following a periorbital blunt trauma 1-month prior. During the course of routine ophthalmologic and radiologic examinatinos, the swelling spontaneously subsided without specific treatment. An outpatient follow-up was planned, but the swelling recurred 6 months later. An orbital CT and MRI showed an irregular mass with an indistinct margin in the left orbit, for which an incisional biopsy was performed. RESULTS: The orbital mass consisited of monotonous small to medium sized lymphoid cells with evenly dispersed open chromatin, thin nuclear membrane and inconspicuous nucleoli. Immunohistochemistry revealed that the cells were positive for CD79a and TdT, but negative for CD3 and CD5. These findings were compatible with a diagnosis of B cell lymphoblastic lymphoma. CONCLUSIONS: Lymphoblastic lymphoma of the orbit should be suspected and considered in the differential diagnosis for children with acutely progressing orbital mass.
B-Lymphocytes* ; Biopsy ; Child ; Chromatin ; Diagnosis ; Diagnosis, Differential ; Exophthalmos ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymphocytes ; Magnetic Resonance Imaging ; Male ; Nuclear Envelope ; Orbit* ; Outpatients ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

No abstract available.
Ultrasonography, Prenatal*