BACKGROUND: Many studies reported that endothelium-dependent vasodilator response is impaired in patients with congestive heart failure. But the opposite results also were reported. The aim of this study was to determine the presence of endothelial dysfunction and its characteristics. METHODS AND MATERIALS: Forearm blood flow was measured in 12 patients with congestvie heart failure (7 males and 5 females, mean age 53+/-11 years old) and 10 normal control subjects (5 males and 5 females, mean age 41+/-10 years old) using strain-gauge plethysmography. The endothelium-dependent vasodilators were acetylcholine (7.5, 15, and 30 microgram/min), which uses a pertussis toxin-sensitive signal transduction pathway, and bradykinin (100, 200, and 400 ng/min), which uses a pertussis toxin-insensitive signal transduction pathway to activate nitric oxide production. Sodium nitroprusside (0.8, 1.6, and 3.2 microgram/min) was used as an endothelium-independent vasodilator. All drugs were infused into the brachial artery with random order. RESULTS: The basal forearm blood flow was similar between both groups. The maximum flow in response to acetylcholine, bradykinin, and sodium nitroprusside was also similar in two groups. CONCLUSIONS: Patients with congestive heart failure showed normal endothelium-dependent vasodilator responses to both acetylcholine and to bradykinin. This finding indicates that the endothelial vasodilator function is normal in the patients with heart failure.
Acetylcholine ; Brachial Artery ; Bradykinin ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Estrogens, Conjugated (USP)* ; Female ; Forearm ; Heart Failure* ; Humans ; Male ; Nitric Oxide ; Nitroprusside ; Plethysmography ; Signal Transduction ; Vasodilation* ; Whooping Cough

No abstract available.
Intussusception*

No abstract available.
Cholecystectomy, Laparoscopic* ; Korea*

Microsurgical reconstruction is necessary for children to correct severe trauma and congenital or acuqired deformity. The aim of this study was to evaluate whether or not microsurgical reconstruction is a safe and reliable operation in children and to analyze the differences of microsurgical reconstruction in children compared to adults. The study included 12 children who underwent 13 microsurgical reconstructions among a total of 251 cases of microsurgical reconstruction from May, 1986 to August, 1998. Their ages ranged from 24 months to 14 years and 8 months. There were 7 males and 6 females. The involved sites were 9 legs, 3 hands and 1 face. The causes of microsurgical reconstruction were 9 traumas, 2 congenital anomalies, 1 acquired deformity and 1 cancer. The applied flaps were 4 scapular flaps, 2 rectus abdominis muscle flaps, 1 de-epithelized groin flap, 1 lateral arm flap, 1 forearm tendocutaneous flap, 1 forearm tendocutaneous flap, 1 latissimus dorsi muscle flap, 1 fibula flap, 1 second toe transfer, and 1 wrap-around flap. All patients have had normal growth of the donor and recipient sites without specific complications during an average 2 years follow-up. We concluded that microvascular reconstruction is a very useful and reliable procedure in children if it is performed in consideration of each child's specific characteristics and conditions.
Adult ; Arm ; Child ; Congenital Abnormalities ; Female ; Fibula ; Follow-Up Studies ; Forearm ; Groin ; Hand ; Humans ; Leg ; Male ; Rectus Abdominis ; Superficial Back Muscles ; Tissue Donors ; Toes

PURPOSE: It is well known that linear growth in diabetic children is closely related to metabolic control and age of onset. Some studies showed growth retardation in diabetic children regardless of the degree of metabolic control, whereas others reported no growth impairment. Until now, no study has been done comparing linear growth between type 1 and type 2 diabetic children. Therefore, we compared the growth and weight status between type 1 and type 2 diabetic children. METHODS: 145 children with type 1 DM and 27 patients with type 2 DM were studied. Their growth status in height standard deviation score(HTSDS), obesity according to standard weight for height and body mass index(BMI), and HbA1c level at onset, 6 months, 1 year, 3 years and 5 years after treatment were compared. RESULTS: There was no distinct correlation in HTSDS in type 1 and type 2 DM, but in type 2 DM obesity according to standard weight for height and BMI was higher than in type 1 DM. deltaHTSDS 5 years after treatment of diabetic children with poor glycemic control were significantly decreased(P<0.05), but there was no significant correlation between HbA1c and obesity according to standard weight for height and BMI. CONCLUSION: There is no significant correlation between the type of diabetes and growth status, but the poor glycemic controled group showed a significant decrease in deltaHTSDS. These data suggest that the growth of diabetic children could be impaired in the case of poor glycemic control and long duration of diabetes.
Age of Onset ; Child* ; Diabetes Mellitus* ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Humans ; Obesity

We present a case of eccrine spiradenoma occurring on the trunk in a 33 year old woman. She developed a pea sized, pinkish tender nodule on the anterior chest 8 years ago. On histologic examination, there were several lobules surrounded by thin connective tissue septa in dermis. The lobules themselves consisted of small dark staining cells and large pale-staining cells, forming solid cords or ducts.
Adult ; Connective Tissue ; Dermis ; Female ; Humans ; Peas ; Thorax

No abstract available.

No abstract available.
Subclavian Artery* ; Thoracic Outlet Syndrome* ; Thromboembolism*

No abstract available.
Delusions* ; Hallucinations* ; Humans

Breast cancer is the second leading cause of cancer death in women. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. The purpose of the study is to analyze the results of breast reconstruction using free transverse rectus abdominis myocutaneous(TRAM) flap and to suggest the operative technique for more satisfactory results. 19 patients underwent immediate breast reconstruction from 1990 to 1998, and we experienced 2 cases of bilateral immediate reconstruction of breasts following mastectomy. We have performed the free TRAM flaps based on the deep inferior epigastric vessels using microvascular technique. TRAM flap included very small portion of rectus sheath and muscle-so called muscle sparing technique. So it reduced markedly donor site morbidity. The postoperative course of these cases was uneventful with minor complication. The free TRAM flap was an excellent method of immediate breast reconstruction using autogenous tissue and provided satisfactory outcome. The goals of the immediate breast reconstruction after mastectomy are to restore body image, to achieve near normal shape of breast, and to reduce the complications. This paper represents our experience of immediate breast reconstruction using free TRAM flap, and technical options to get more satisfactory result and reduce the complications. We think this method could be regarded as the first choice for immediate breast reconstruction.
Body Image ; Breast Neoplasms ; Breast* ; Female ; Humans ; Korea ; Mammaplasty* ; Mastectomy ; Rectus Abdominis* ; Tissue Donors