Halothane, in common use today, sensitizes the myocardium to endogenous and exogenous sympathomimetic amines arid induces cardiac arrhythmia, sometimes life threatening. Sympatbomimetic amines, however, are frequently injected subcutaneously for hemostasis or intravenously far cardiovascular stability. Therefore, this study was performed to investigate the effect of lidocaine 1 mg/kg, pro-pranolol 0.02 mg/kg, and droperidol 0.1 mg/kg pretreatment on arrhythmias(A.R.) and changes in heart ramie(H.R.), systolic bood pressure(T.B.P ) and diastolic blood pressure (D.B.P.) Induced by lV administered ephedrine 0.2 mg/kg. Patients were divided into 5 groups: 20 cases without pretreatment(Group l ), 10 cases with lidocaine prtreatment(Group ll), 10 cases with propranolol pretreatment(Group lll), 20 eases with lidocaine-propranolol pretreatment(Group lV) and 20 cases with droperidol pretreatment(Group V ). The results were as follows: 1) In Group l, ephedrine produced A.R. in 16 cases(80%) and significant increase in H.R.(d~11 bpm, p<0.001) and S.B.P. (8~22 torr, p<0.001), but D.B.P. increased insignif-icantly(2~10 torr, NS). 2) In Group ll, ephedrine produced A.R. in 5 cases(57%) and 5.B.p.(10~17 terr, p<0, 01) increased significantly, but H.R. remained unaltered. 3) In Group lll, ephedrine produced A.R. in 3 cases(30%) and H.R. (6~8 bpm, p<0.05) decreased, but S.B.P.(12~21 torr, p<0.01) and D.B.P (8~16 torr, p<0.01) increased signi-ficantle. 4) In Group lV, ephedrine produced A.R. in 2 cases(10.%) and H.R.(3~6 bpm, p<0.05) decreased, but S.B.P (4~11 torr, p<0.05) and D.B.P.(3~9 torr, p<0.01) increased signific-antly. 5) In Group V. ephedrine produced A.R. in 2 cases(10%) and H.R.(9~13 bum, p<0.001) increased siginificantly, but S.B.P. and D.B.P. remained unaltered. From the above results, it is concluded that lidocaine and propranolol mixture or droperidol protects most effectively against ventricular arrhythmias induced by ephedrine during halothane-N2O anesthesia in human volunteers.
Amines ; Anesthesia* ; Arrhythmias, Cardiac* ; Blood Pressure ; Droperidol* ; Ephedrine* ; Halothane ; Healthy Volunteers ; Heart ; Hemostasis ; Humans ; Lidocaine* ; Myocardium ; Propranolol* ; Sympathomimetics

Iodinated contrast-induced acute renal failure is estimated to occur in 0.15 to 2% of all patients undergoing contrast imaging studies. Incidence is higher in patients with renal insufficiency, diabetes mellitus, dehydration, multiple myeloma, congestive heart failure, advanced age. We here report successful vascular interventional procedure by using gadopentetate dimeglumine(Gd-DTPA) as a contrast agent in a patient with chronic renal insufficiency and right superficial femoral artery stenosis. The patient had a history of iodinated contrast-induced acute renal failure. Gd-DTPA(0.17mmoVkg) diluted 1: 1 with 0.9% norrnal saline was used as contrast agent for the interventional procedure. Percutaneous transluminal angioplasty was successfully performed and there was no evidence of contrast material- induced acute renal failure after the procedure. Gd- DTPA is an alternative contrast agent for patients with chronic renal insufficiency.
Acute Kidney Injury ; Angioplasty* ; Constriction, Pathologic ; Dehydration ; Diabetes Mellitus ; Femoral Artery ; Gadolinium DTPA* ; Heart Failure ; Humans ; Incidence ; Multiple Myeloma ; Pentetic Acid ; Renal Insufficiency ; Renal Insufficiency, Chronic*

BACKGROUND: As indicators of obesity, waist circumference (WC), body mass index (BMI), and adiponectin are well known risk factor for diabetes mellitus. The objectives of this study were to measure the independent association between these obesity indicators and diabetes and to examine the combined effect of these indicators on diabetes in a Korean population. METHODS: The WC, BMI, and serum adiponectin were measured in 6,505 healthy Koreans and were classified into tertile groups for men and women. The independent and combined associations of the obesity indicators with diabetes were measured using logistic regression analyses. Diabetes was defined as fasting serum glucose greater than 126 mg/dL or taking medication. RESULTS: Levels of adiponectin were inversely associated with BMI and WC and directly associated with age and high density lipoprotein cholesterol (HDL) cholesterol (P <0.001). After adjusting for age, WC, and other lifestyle factors, low levels of adiponectin were associated with an increased prevalence of diabetes. Further adjustment for HDL cholesterol and triglyceride attenuated this association in both men and women. The best cut-off value of adiponectin in terms of identifying the presence of diabetes was 5.5 /ml with a sensitivity and specificity of 46.7% and 63.9% for men and 9.5 /ml with a sensitivity and specificity of 68.2% and 55.2 for women. CONCLUSIONS: These results suggest that adiponectin was associated with diabetes. The association was independent of WC and was partly modified by HDL and triglyceride. There were no effect modifications of adiponectin with WC on diabetes.
Adiponectin* ; Blood Glucose ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Diabetes Mellitus ; Fasting ; Female ; Humans ; Life Style ; Logistic Models ; Male ; Obesity ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Triglycerides ; Waist Circumference

OBJECTIVE: We examined the difference between IQ(Intelligence Quotient) estimated from computerized Standard Progressive Matrices(SPM) score(SPM IQ) and Korean-Wechsler Adult Intelligence Scale(KWAIS) IQ(KWAIS IQ) in Korean patients with mental disorders in order to test the validity of SPM as a brief nonverbal intelligence test, and to find the groups that need standardization. And, we studied the method to predict KWAIS IQ more precisely from SPM test. METHODS: SPM test in Vienna test system was administered to 166 Korean patients with mental disorders. The degree of consistency and Pearson's correlation coefficient between SPM IQ and KWAIS IQ in total subjects and groups by sex, age, education, and clinical diagnosis were investigated. And, we obtained a regression equation to predict KWAIS IQ from SPM score. RESULTS: In total subjects, Pearson's correlation coefficient between SPM IQ and KWAIS IQ was as high as 0.704, and the percent of patients whose absolute value of difference between SPM IQ and KWAIS IQ is equal to or less than 10 was 54.8%. The degree of consistency between SPM IQ and KWAIS IQ was influenced by age and educational level. SPM IQ were higher than KWAIS IQ in younger age and lower education group. SPM IQ were lower than KWAIS IQ in older age and higher education group. The regression equation from SPM score, age, and education years predicted KWAIS IQ more correctly. CONCLUSION: The Computerized Standard Progressive Matrices test is validated and can be used usefully as a brief nonverbal intelligence test in patients with mental disorders. In order to provide more precise evaluation, standardized data should be prepared for age group 16 to 25 and age group 26 to 35 with lower educational level.
Adult ; Diagnosis ; Education ; Humans ; Intelligence ; Intelligence Tests ; Mental Disorders*

Pseudoachalasia secondary to primary squamous cell carcinoma (SCC) of the liver is extremely rare and has not been reported until now. Here, we report a unique case of primary SCC of the liver initially presenting with progressive dysphagia along with short periods of significant weight loss. A 58-year-old man initially presented with progressive dysphagia along with significant weight loss over brief periods of time. The radiographic and manometric findings were consistent with achalasia. Subsequent esophagogastroduodenoscopy revealed a moderately dilated esophagus without evidence of neoplasm or organic obstruction. However, firm resistance was encountered while traversing the esophagogastric junction (EGJ), although no mucosal lesion was identified. Due to the clinical suspicion of the presence of a malignant tumor, endoscopic ultrasonography (EUS) and computed tomography scans of the chest and abdomen were obtained. A huge hepatic mass with irregular margins extending to the EGJ was found. EUS-guided fine-needle aspiration was performed, and the mass was diagnosed as a primary SCC of the liver by immunohistochemical staining.
Abdomen ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Endoscopy, Digestive System ; Endosonography ; Esophageal Achalasia ; Esophagogastric Junction ; Esophagus ; Humans ; Liver ; Middle Aged ; Thorax ; Weight Loss

BACKGROUND: To detect active tuberculosis, clinicians usually rely on several methods those are so limited. As the prevalence rate of tuberculosis is high in Korea, culture is not so very effective in clinical use. The polymerase chain reaction (PCR) featuring rapidness and high sensitivity offers low specificity and it requires high test cost, complicated skills, expensive equipment. This study attempted to determine if the immunochromatographic assay, intended to measure antibodies using 38 kDa antigens, is valuable as a new method to diagnose active tuberculosis, by comparing it with existing acid-fast stain (AFB stain) and PCR. METHODS: The sera were collected from 31 BCG-vaccinated healthy persons and 55 patients subjected to AFB stain and PCR who visited Pohang Hospital of Dongguk University or Kyungpook National University Hospital, and then kept at -20degrees C until experiment. Fifty-five patients subjected to AFB stain and PCR were composed of 24 active tuberculosis patients and 31 non-TB patients. The evaluation of active tuberculosis was based on clinical criteria. RESULTS: The detection rate of antibody by the immunochromatographic method accounted for 83% in the active TB group, and each 6% in both the non-TB group and the healthy control group. The sensitivities of AFB stain, PCR and immunochromatographic method accounted for 67%, 88% and 83%, respectively, the specificities for 94%, 86% and 94%, respectively, the positive predictive values for 89%, 84% and 91%, respectively, and the negative predictive values for 78%, 89% and 88%, respectively. CONCLUSIONS: This suggests that the immunochromatographic method can be used for the rapid diagnostic method of active tuberculosis in an area with high prevalence value of tuberculosis like Korea. In addition, the immunochromatographic method showed the sensitivity approximate to that of PCR, the same specificity as AFB stain, and a high positive and negative predictive values. So it was expected not only to be greatly helpful for the diagnosis of active tuberculosis but also to be more useful in clinical practices because of short examination time, no special equipment and skills required, and inexpensive examination.
Antibodies ; Diagnosis* ; Gyeongsangbuk-do ; Humans ; Immunochromatography* ; Korea ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity ; Tuberculosis*

Hepatic eosinophilic abscess is a very rare disease which has been reported in fascioliasis, and some gastrointestinal malignancy. We experienced 5 cases with hepatic eosinophilic abscesses which were caused by unknown etiology, confirmed by liver biopsy, from 1990 to 1994. The chracteristics of the cases including clinical menifestations, serologic findings, ultrasonography and abdominal computerizes tomogram(CT) were summerized. They had no characteristic findings except eosinophilia in clinical menifestations and they showed various ultrasonographic and CT findings which are different from the radiologic findings of liver abscesses by bacterial or amebic infection. We think that hepatic eosinophilic abscess must be included in differential diagnosis of all hepatic tumors.
Abscess* ; Biopsy ; Diagnosis, Differential ; Eosinophilia ; Eosinophils* ; Fascioliasis ; Liver ; Liver Abscess ; Rare Diseases ; Ultrasonography

Gastric cancer is not only one of the most common cancers in the world but also one of the most important malignant tumors in terms of incidence in Korea. In spite of it's clinical significance, the mechanism of malignant transformation in the stomach has not yet been well characterized. Recent studies disclosed enormous data suggesting that the p53 protein and the c-erbB-2 proto-oncogene have a critical role in the tumorogenesis of gastric cancer. More recently, the expression of the p53 protein has been associated with increased proliferative activity, but serves as a poor prognostic indicator in the case of patients for whom aggressive adjuvant therapy is required. Amplification of the c-erbB-2 oncogene has also been reported in gastric cancer. In the case of breast cancer, it has been demonstrated that no close correlation exists between the c-erbB-2 expression and the prognosis. However, no reports describe the relation between c-erbB-2 expression, p53 expression, PCNA expression and the prognosis for patients with gastric cancer. So this study was done to evaluate the expression of the p53 and c-erbB-2 and to assess the prognostic value in patients eith gastric cancer. The results are as follows: 1) The overall expression rates for p53 and c-erbB-2 were 38% and 20%, respectively. 2) There was no close relation between the expression rate of p53 and the tumor size, the Borrmann type, the nodal involvement, distant metastasis, Ming's classification, or Lauren's classification. The expression rate of p53 was closely related the tumor stage. 3) The expression rate of p53 in tumors which expressed PCNA was higher than that in tumors which did not express PCNA (p<0.05). 4) The expression rate of c-erbB-2 in large tumors(>5 cm) was higher than that in small tumors(<5 cm)(p<0.05). 5) The overall cumulative 5-year survival rate in the positive expression group for p53 was lower than that in the negative group, but the difference was not statistically significant(p>0.05). 6) The overall cumulative 5-year survival rate in the positive expression group for c-erbB-2 was lower than that in the negative group and the difference was statistically significant(p<0.05). In conclusion, it is suggested that p53 expression can not used as a prognostic factor for gastric cancer, but c-erbB-2 may be such a prognostic factor.
Breast Neoplasms ; Classification ; Genes, erbB-2 ; Humans ; Incidence ; Korea ; Neoplasm Metastasis ; Oncogenes ; Prognosis ; Proliferating Cell Nuclear Antigen ; Receptor, erbB-2* ; Stomach ; Stomach Neoplasms ; Survival Rate

Infection of cattle with bovine leukemia virus (BLV) has been observed and reported worldwide, including in Korea. The onsite identification of infected cattle would help decreasing and eradicating BLV infections on farms. Here, we present a new immunochromatographic assay that employs monoclonal antibodies (MAbs) for the detection of antibodies against BLV in the field. BLV envelope glycoprotein (gp)51 was expressed in E. coli, and MAbs against recombinant BLV gp51 were generated for the development of an immunochromatographic assay to detect BLV antibodies in cattle. The sensitivity and specificity of the assay were determined by comparing these results with those obtained from a standard enzyme linked immunosorbent assay (ELISA). A total of 160 bovine sera were used to evaluate the new immunochromatographic assay. Using ELISA as a reference standard, the relative specificity and sensitivity of this assay were determined to be 94.7% and 98%, respectively. Because of its high sensitivity and specificity, this BLV antibody detection assay would be suitable for the onsite identification of BLV infection in the field.
Agriculture ; Animals ; Antibodies* ; Antibodies, Monoclonal ; Cattle ; Deltaretrovirus Antibodies ; Deltaretrovirus Infections ; Enzootic Bovine Leukosis* ; Enzyme-Linked Immunosorbent Assay ; Glycoproteins ; Immunochromatography* ; Korea ; Leukemia Virus, Bovine* ; Sensitivity and Specificity

PURPOSES: To develop a rapid, sensitive, qualitative ELISA-kit for serum adiponectin and examine correlation with adiponectin and cardiovascular risk factors. METHODS: On the base of monoclonal antibodies against adiponectin, apply indirect ELISA to study the performance parameter of the kit. The correlation was examined between adiponectin and cardiovascular risk factors including waist circumference, body mass index, triglyceride, and HDL cholesterol. RESULTS: The limited concentration of detection of the ELISA-kit was 1ug/ml. Linearity with R&D system and AdipoGen with this ELISA-kit was acceptable: the linear equation with R&D system was y=1.0116x + 0.4629 (R2=0.97) and linear equation with AdipoGen was y=0.9562x + 1.1961 (R2=0.93), respectively. The average recovery rate of the ELISA-kit ranged 92 to 104%. The correlation coefficient of waist circumference with adiponectin was -0.2276 (p<0.0001) among men and -0.2328 (p<0.0001) among women. CONCLUSION: This ELISA-kit was quick, sensitive, and stable and can be used to determine adiponectin in serum.
Adiponectin* ; Antibodies, Monoclonal ; Body Mass Index ; Cholesterol, HDL ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Risk Factors* ; Triglycerides ; Waist Circumference