Congenital adrenal hyperplasia is inherited disorder of adrenal steroidogenesis. 21-hydroxylase deficiency is the most commone enzymatic defect and is divided into classic and late-onset or nonclassic forms. Both classic non-classic 21-hydrozylase deficiencies are inherited in a recessive manner as allelic variants. But it is rare that happened in twin infants. Chief complaints of affected twins in our case were ambiguous genitalia, hyperpigmentation and dehydrations. They were revealed into hyponatremia, hyperkalemia and increased amount of serum progesterone, 17-hydroxyprogesterone and urinary 17-ketosteroid excretion and were administered with DOCA, 9alpha-fluorohydrocortisone, hydrocortisone to control the electrolyte imbalance. And now, both of them are going to normal ratio of weight gain and body growth.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Desoxycorticosterone Acetate ; Disorders of Sex Development ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyperpigmentation ; Hyponatremia ; Infant ; Progesterone ; Steroid 21-Hydroxylase* ; Twins* ; Weight Gain

The antihypertensive effect of Indapamide(Fludex(R)) was studied in 31 patients of essential hypertension and following results were obtained. 1) Daily dosage was 1mg b.i.d. and total duration of medication was weeks. 2) Mean systolic and diastolic blood pressure declined by 23mmHg(14%) and 18mmHg(17%) respectively. 3) Good or fair controls were achieved in 78% of patients. 4) There was no significant change in heart rate during and after treatment. 5) There were no significant changes in fasting blood sugar, serum creatinine, K+, uric acid, ca++, transaminase and cholesterol levels before and after treatment. 6) In 5 patients transient side effects were observed which resolved spontaneously. In view of these results Indapamide appears to be effective agent for the treatment of mild to moderate hypertension and dose not cause significant change in blood chemistry.
Blood Glucose ; Blood Pressure ; Chemistry ; Cholesterol ; Creatinine ; Fasting ; Heart Rate ; Humans ; Hypertension ; Indapamide ; Uric Acid

The force-interval relationship of cardiac muscle has been known as not only a fundamental manifestation of beat-to-beat kinetics of intracellular activator calcium which control contractile response but also a potential clinical tool for evaluating cardiac contracile function. In this study were evaluated the force-interval relationship of intact canine left ventricle through mechanical restitution curves by plotting contrctile responses to varying steady state, extrasystolic and postextrasystolic intervals, and compared the force-interval relationships of intact canine left and right ventricles quantitatively. Effects of localized myocardial ischemia on the left ventricular force-interval relationship and relaxtion function were also evaluated 30 minutes after ligating proximal left anterior descending coronary artery through observing contractile and relaxtion responses to various intervals. 1) Mechanical restitution curve of left ventricle showed that left ventricular dp/dt max responses rose stiffly until plateau level with increasing postextrasystolic intervals, then declined with further increment of postextrasystolic intervals. 2) Mechanical restitution curve of left ventricle shifted leftward and upward with shortening of steady state and extrasystolic intervals, which suggest intracellular calcium kinetics during electrical diastole may operate as a mechanism of the force-interval relationship. 3) Steady state contractile responses remained unchanged but maximal contractile responses increased significantly or contractile reserve in intact left ventricle. 4) Normalized force-interval relationships of left and right ventricle were similar quantitatively, which suggest the force-interval relationship is independent of structural factors in intact canine heart. 5) Occlusion of coronary artery lowered absolute values of left ventricular dp/dt max responses to varying postextrasystolic intervals, but didn't show significant changes of normalized dp/dt max responses, which suggest force-interval relationship be also present in spite of localized myocardial ischemia. 6) Responses of normalized left ventricular dp/dt min to varying postextrasystolic intervals were similar to those of normalized dp/dt max but reduced after coronary artery occlusion in the range above 100% dp/dt max response, which may be used for the detection and evaluation of deranged myocardial relaxation in the left ventricle with localized myocardial ischemia.
Calcium ; Coronary Vessels ; Diastole ; Heart ; Heart Ventricles ; Kinetics ; Myocardial Ischemia ; Myocardium ; Relaxation ; Ventricular Function, Left*

In an attempt to define quantitatively the relation between left atrial size and atrial fibrillation, echocardiography was used to study 58 patients with mitral stenosis and sinus rhythm, 22 patients with mitral stenosis and newly appeared atrial fibrillation, 62 patients with mitral stenosis and atrial fibrillation, 14 patients with sinus rhythm who undergone mitral valve replacement, 18 patients with atrial fibrillation who undergone mitral valve replacement,17 patients with idiopathic atrial fibrillation and 22 control persons. In all groups of mitral stenosis, atrial fibrillation was rare when left atrial dimension was below 40mm but common when this dimension exceeded 40 mm. When left atrial dimension exceeded 50 mm, sinus rhythm was rare even in patients who undergone mitral replacement operation. These data suggest that left atrial size is an important factor in the development of atrial fibrillation. To reduce the risk of systemic embolism complicating atrial fibrillation and to reduce the need of long term anticoagulant therapy postoperatively, the left atrial dimension should be followed closely for the patients with mitral stenosis.
Atrial Fibrillation* ; Echocardiography* ; Embolism ; Heart Atria* ; Humans ; Mitral Valve ; Mitral Valve Stenosis

BACKGROUND: A number of theories have been proposed to explain the nature of aging process. Unfortunately, there is so far no theory that can completely explain all aging processes. In the present study, to investigate roles of inducibility of defense mechanisms by oxidative stress, cellular mRNA level of superoxide dismutases (SODs) and metallothionein (MT) as well as their inducibility by paraquat, an intracellular superoxide generator, was examined in the liver and kidney of the mice of aging process. METHODS: The steady-state levels of SODs and MT mRNA and their induction by paraquat were determined by the RT-PCR assay in male mice of 4 ages, 1, 4, 8, and 12 months. RESULTS: In the liver, the steady-state levels of Mn-SOD, Cu/Zn-SOD and MT mRNA increased until 8 months with age and decreased significantly at 12 months. Cu/Zn-SOD and MT mRNA were induced well by paraquat at all ages but Mn-SOD mRNA not at 12 months. In the kidney, their mRNA levels of Mn-SOD, Cu/Zn-SOD and MT increased with age. Mn-SOD mRNA was induced by paraquat only at 1 month but Cu/Zn-SOD mRNA not at all ages. On the other hand, MT mRNA was significantly induced by paraquat at all ages. CONCLUSION: These results suggest that SODs and MT are differentially expressed and induced according to the age and organs. In addition, it is thought that the lack of induction of Mn-SOD by oxidative stress in both the liver and kidney may be one of causative factors in the aging process while Cu/Zn-SOD and MT in the liver and MT in the kidney may play protective roles in the aging process. It is therefore implicated that the tissue antioxidant/prooxidant balance could be one of determinants of mean life span.
Aging ; Animals ; Defense Mechanisms ; Hand ; Humans ; Kidney* ; Liver* ; Male ; Metallothionein* ; Mice* ; Oxidative Stress ; Paraquat* ; RNA, Messenger ; Superoxide Dismutase ; Superoxides*

BACKGROUND: The relationship between the NO and its vasodilatory effect of propofol has been a somewhat controversial matter. And, the effects of propofol has not been evaluated in septic condition whether it is solely due to its increased iNOS activity. METHODS: First experiment is to study that the vasodilatory effect of propofol could be caused by NO. Isolated aortic rings with or without endothelium were contracted phenylephrine (10(-9)-10(-5)M) cumulatevely after porpofol (10(-5)M) administration. The effects of L-NAME (3 x 10(-4)M) and methylene blue (10(-5)M) on contractile responses for phenylephrine were evaluated. Second experiment is to study the effect of propofol on septic vesseles. the no LPS (lypopolysaccaride) and LPS treated rings with or without endothelium were contracted phenylephrine (10(-9)-10(-5)M) cumulatevely after porpofol (10(-5)M) administration. The development of sepsis was confirmed by iNOS expression using RT-PCR. RESULTS: All the aortic rings showed decreased response on phenylephrine contractile response with propofol administration. These responses were significantly less in denuded ones than in ones with intact endothelium. The endothelium dependent relaxation of propofol was inhibited by pretreatment with L-NAME and methylene blue in rat aortic rings having intact endothelium. All the aortic rings incubated with LPS showed decreased phenylephrine contractile response. The addition of propofol produced significantly more decrease in contractile response in LPS incubated rings in a greater than additive effect. The LPS induced hyporesponsiveness to phenylephrine was reversed by addition of cycloheximide. However, with the addition of propofol to LPS treated rings, complete reversal of this hyporesponsiveness to phenylephrine, failed to occur by addition of cycloheximide. CONCLUSIONS: 1) The vasodilatory effect of propofol seems to be mediatede by EDRF/NO, 2) The vasodilatory effect of propofol is increased in septic vesseles. Moreover, the inability of nitric oxide synthase inhibitior to reverse this response completely suggest that increased induction of iNOS may not be a sole responsible factor for this finding.
Animals ; Arteries* ; Cycloheximide ; Endothelium ; Methylene Blue ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Phenylephrine ; Propofol* ; Rats* ; Relaxation ; Sepsis

Chronic mitral regurgitation may be well tolerated for decades because of favorable conditions like increased preload and decreased afterload. However, in some patients with underlying overt myocardial dysfunction, opertive correction of mitral regurgitation may result in persistent left ventricular dysfunction. Myocardial dysfunction in mitral regurgitation initially occurs subclinically and may becoma irreversible before symptoms of congestive heart failure develop. In order to identify latent myocardial dysfunction, we evaluated prognostic values of several indices from patient's characteristics, echocardiogram, cardiac catheterization data and contrast left ventriculogram in 49 patients with chronic mitral regurgitation who received mitral valve replacement. The patients were defined as Groups I who had improved symptoms with decreased left ventricular end-diastolic dimension after operation and Group II who had persistent symptoms and progressed left ventricular end-diastolic dimension, or not decreased until left ventricular end-diastolic dimension 60mm after operation. The results were as follows: 1) There was no significant difference in age, sex, duration of symptoms, preoperative NYHA functional status, and aortic cross clamping time during operation between Group I and Group II. 2) There was no significant difference in echocardiographic left ventricular end-diastolic dimension between group I and group II. There were significantly more dilated left ventricular end-diastolic dimension of Group II than that of Group I and significantly more depressed fractional shortening of Group II than that of Group I. There was significantly more increased end-diastolic wall stress of Group II than of Group I. 3) There was no significant difference in cardiac index, mean pulmonary artery pressure, mean pulmonary capillary wedge pressure and left ventricular end-diastoic pressure between Group I and Group II. 4) There were significantly more increased end-diastolic volume index and end-diastolic volum index of Group II than those of Group I, but no significant difference in ejection fraction between Group I and Group II. There was significantly more decreased ratio of end-diastolic circumferential midwall stress to end-diastolic volume index of Group II than that of Group I. 5) In Group I, end-systolic dimension, end-systolic dimension and end-systolic wall stress were decreased significantly after operation. In Group II, end-systolic dimension was decreased significantly after operation. 6) Values for combination of end-systolic left ventricular dimension greater than 28mm/m2 and end-systolic wall stress greater than 190mmHg predicted a Group II outcome with a sensitivity of 88.2%, a specificity of 93.8%, positive predictive value of 88.2% and negative predictive value of 93.8%. Values of combination of end-systolic left ventricular dimension greater than 28mm/m2 and fractional shortening less than 32% predicted a Group II outcome with a sensitivity of 88.2% a specificity of 90.6%, positive predictive value of 83.3% and negative predictive value of 93.5%, a specificity of 90.6%, positive predictive valve of 83.3% and negative predictive value of 93.5%. According to the above results, noninvasive hemodynamic variables such as end-systolic left ventricular dimension, fractional shortening and end-systolic wall stress would be useful guideline for follow-up and determining the optimal time for surgical intervention in patients with chronic mitral regurgitation.
Cardiac Catheterization ; Cardiac Catheters ; Constriction ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Hemodynamics ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Sensitivity and Specificity ; Ventricular Dysfunction, Left

No abstract available.
Ectopia Cordis* ; Hernia, Umbilical*

BACKGROUND: There has been a growing realization that a variety of anticancer drugs can induce apoptotic cell death. In the present study, an attempt was made to investigate the responsiveness of gastric cancer cells to various anticancer drugs and to identify which apoptosis-related proteins could be correlated to chemosensitivity. METHODS: Nine human Korean gastric cancer cell lines (SNU-1, -5, -16, -484, -601, -620, -638, -668, and -719) were analyzed. The cytotoxicity of each cell line to camptothecin, cisplatin, mitomycin C, vincristine, 5-FU, epirubicin, and doxorubicin was determined by using a MTT (dimethylthiazole- diphenyltetrazolium-bromide) assay. Apoptosis-related proteins (p53, p21, Bcl-2, Bcl-x, and Bax) were detected using a Western blot assay. RESULTS: Of the nine gastric cancer cell lines, SNU-1 was resistant while SNU-5 was sensitive to anticancer drugs. Mutated p53 was detected in all the cell lines. The highest expression of Bcl-2 was observed in SNU-1 while less or no expression of Bcl-2 was observed in SNU-5, -484, and -601. Bcl-xL was less expressed in SNU-5 than in the other cell lines. CONCLUSIONS: Chemosensitivity in gastric cancer cell lines was correlated mainly with the level of Bcl-2 and partly with that of Bcl-xL. There was no correlation between the chemosensitivity and other apoptosis-related proteins, such as p21, p53, Bax, and Bcl-xS in the studied gastric cancer cell lines.
Blotting, Western ; Camptothecin ; Cell Death ; Cell Line* ; Cisplatin ; Doxorubicin ; Epirubicin ; Fluorouracil ; Humans ; Mitomycin ; Stomach Neoplasms* ; Vincristine

Plasmodium vivax malaria re-emerged in South Korea in 1993, and epidemics continue since then. We examined genetic variation in the region encompassing the apical membrane antigen-1 (PvAMA-1) of the parasites by DNA sequencing of the 22 re-emerging P. vivax isolates. The genotype of the PvAMA-1, which was based on sequence data previously reported for the polymorphic regions, showed that two haplotypes were present at one polymorphic site. Compared with reported data, the two types, SKOR type I and type II, were similar to Chinese CH-10A and CH-05A isolates, respectively. Thus, the present study showed that two genotypes of AMA-1 genes coexist in the re-emerging Korean P. vivax.
Adult ; Aged ; Amino Acid Sequence ; Animals ; *Antigens, Protozoan ; Base Sequence ; Child ; Female ; Genotype ; Human ; Korea ; Malaria, Vivax/*genetics ; Male ; Membrane Proteins/chemistry/*genetics ; Middle Aged ; Molecular Sequence Data ; Polymorphism (Genetics) ; Protozoan Proteins/chemistry/*genetics ; Support, Non-U.S. Gov't