Our aim was to identify histologic changes in cervical carcinoma tumor cells due to chemotherapy,by electron microscopic examination. Cisplatin and 5-fluorouracil were used between March 1, 1994 and February 28, 1995 on a total of 16 patients. The treatment schedule consisted of 75 mg/m2 cisplatin via iv with hyperhydration on Day 1, in combination with 1000 mg/m2 5-fluorouracil via continuous iv on Day 1 to 5. The treatment was repeated every 4 weeks with a maxinum of 3 courses. Ultrastructurally, chemotherapy induced apoptosis,indicated by condensation of nucleus and cytoplasm,fragmentation of nuclei, and apoptotic bodies. Due to repeat chemotherapy, increased levels of desmosomes were noted and parts of tumor nests were replaced by mature squamous cells. Tumor nests were reduced in size, mitochondria exhibited swelling, the endoplasmic reticulum was dilated, and infiltration of inflammatory cells increased after chemotherapy. These results suggest that chemotherapy induces apoptosis and injury to the cytoplasm and nuclei of tumor cells. However, the exact selection mechanism of the biochemical pathway of cell death is not fuUy understood. Further study of the molecular biologic actions of cell death after chemotherapy is warranted.
Apoptosis ; Appointments and Schedules ; Cell Death ; Cisplatin ; Cytoplasm ; Desmosomes ; Drug Therapy* ; Endoplasmic Reticulum ; Fluorouracil ; Humans ; Mitochondrial Size

To evaluate the effect of Perindopril in patients with essential hypertension, we administered Perindopril 4 to 8mg/day once daily to 30 patients(18 males, 12 females) for 12 weeks. Baseline blood pressure after 4 weeks with placebo was 150.4+/-7.5/102.0+/-4.3mmHg. The blood pressures of the patients were declined significantly at 4th(140.6+/-14.9/95.4+/-6.5), 8th(136.7+/-11.4/91.7+/-7.6), and 12th(132.3+/-11.1/87.5+/-6.9) week(p<0.01) without change of heart rate. The blood pressure of the patients was normalized below 140/30mmHg in 24 patients(80%) and declined diastolic blood pressure more than 10mmHg in one patients. Therefore the response rate of perindopril was 83.3%. There were reported 3 patients who revealed mild adverse reactions as follows; cough, indigestion, dizziness in one each. In conclusion, these results indicate that antihypertensive therapy with perindopril single daily dose was effective in patients with mild to moderate essential hypertension and well tolerated.
Blood Pressure ; Cough ; Dizziness ; Dyspepsia ; Heart Rate ; Humans ; Hypertension* ; Male ; Perindopril*

No abstract available.

No abstract available.
Cardiomyopathy, Hypertrophic*

BACKGROUND: Hyperlipidemia is the one of the major risk factors causing the atherosclerosis of coronary arteries. Treatment of hyperlipidemia with drugs has been confirmed the effects of therapy showing a decreased incidence of coronary artery disease. Pravastatin is one of the new HMG-CoA reductase inhibitors and we studied the short-term hypolipidemic effects and safety of pravastatin in patients with hyperlipidemia. METHODS: We studied 31 patients(7 males and 24 females ; range of age, 36-67 years) for 12 weeks whose plasma levels of total cholesterol were higher than 250mg% after one month period of diet therapy. Pravastatin was administered 10mg/day and measured lipid profiles at 4 week interval. RESULTS: Pravastatin reduced the plasma total cholesterol from 286.2mg% to 212.3mg% (25.9%), the LDL-cholesterol from 204.2mg% to 143.6mg% (29.7%), the triglyceride from 226.0mg% to 161.4mg% (28.6%) after 12 weeks treatment. The HDL-cholesterol increased from 25.8mg% to 46.4mg% (20.5%) after pravastatin therapy. These changes were disclosed all statistically significant compared to baseline levels(p<0.01). The clinical and laboratory examinations before and after pravastatin treatment showed no particular abnormal findings. CONCLUSIONS: These results suggested that short-term pravastatin therapy in patients with hyperlipidemia seems to be very effective and safe.
Atherosclerosis ; Cholesterol ; Coronary Artery Disease ; Coronary Vessels ; Diet Therapy ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias* ; Incidence ; Male ; Plasma ; Pravastatin* ; Risk Factors ; Triglycerides

BACKGROUND: Single pass lead VDD pacing preserves atrioventricular synchrony with a single lead system which incorporates floating atrial electrodes. The objectives of this study were to measure whether different body postures and physical activities cause significant changes of the atrial electrogram amplitudes and to evaluate the effectiveness of its atrial sensing, ventricular sensing and pacing. METHOD: Prospective study was done in 7 patients with high degree AV block and normal sinus node function in whom a single lead VDD pacing system was implanted. The P wave amplitude was been measured in different condition during follow-up period. RESULTS: 1) During follow-up period, the P wave amplitude showed variation with changes in posture and respiration, but there was no consistent increase or decrease in amplitude. The lowest P wave amplitude was above the minimal atrial sensing value of 0.2 mV. 2) The percentage of atrial synchronous ventricular pacing recorded in Holter ECG and during Treadmill exercise test was more than 99%. 3) Atrial oversensing or VA cross sensing were not observed in any of the patients. CONCLUSIONS: Despite floating atrial electrode, the single pass lead VDD pacing maintains reliable atrial sensing and ventricular pacing in different body position and physical activity, so it may offer an excellent alternative in patients with high grade AV block and intact sinus node function.
Atrioventricular Block ; Electrocardiography ; Electrodes ; Electrophysiologic Techniques, Cardiac ; Exercise Test ; Follow-Up Studies ; Humans ; Motor Activity* ; Posture ; Prospective Studies ; Respiration ; Sinoatrial Node

BACKGROUND: Single pass lead VDD pacing preserves atrioventricular synchrony with a single lead system which incorporates floating atrial electrodes. The objectives of this study were to measure whether different body postures and physical activities cause significant changes of the atrial electrogram amplitudes and to evaluate the effectiveness of its atrial sensing, ventricular sensing and pacing. METHOD: Prospective study was done in 7 patients with high degree AV block and normal sinus node function in whom a single lead VDD pacing system was implanted. The P wave amplitude was been measured in different condition during follow-up period. RESULTS: 1) During follow-up period, the P wave amplitude showed variation with changes in posture and respiration, but there was no consistent increase or decrease in amplitude. The lowest P wave amplitude was above the minimal atrial sensing value of 0.2 mV. 2) The percentage of atrial synchronous ventricular pacing recorded in Holter ECG and during Treadmill exercise test was more than 99%. 3) Atrial oversensing or VA cross sensing were not observed in any of the patients. CONCLUSIONS: Despite floating atrial electrode, the single pass lead VDD pacing maintains reliable atrial sensing and ventricular pacing in different body position and physical activity, so it may offer an excellent alternative in patients with high grade AV block and intact sinus node function.
Atrioventricular Block ; Electrocardiography ; Electrodes ; Electrophysiologic Techniques, Cardiac ; Exercise Test ; Follow-Up Studies ; Humans ; Motor Activity* ; Posture ; Prospective Studies ; Respiration ; Sinoatrial Node

BACKGROUND: The cardiac troponin I (cTnI), one of the subunits of the troponin regulatory complex, binds to actin and inhibits interactions between actin and myosin. cTnI is highly sensitive and specific marker for myocardial injury and is useful in diagnosis and detection of reperfusion in acute myocardial infarction (AMI). In this study, we measured the serum concentration of cTnI according to serial time after chest pain in patients with AMI and compared serum concentration of cTnI with CK-MB and echocardiographic data to evaluate the significance of measuring serum concentration of cTnI in AMI. SUBJECTS AND METHODS: The study was carried out on 16 patients with first attack of AMI within 6 hours of chest pain. All patients were performed thrombolytic therapy and reperfusion was confirmed by coronary angiography. Blood samples for measuring of CK-MB and cTnI were collected at 4-h intervals during the first 24 h, 12-h intervals until 48 h, and 24-h intervals until fourth days after hospitalization. Echocardiography were performed before thrombolytic therapy in all patients. RESULTS: 1) The mean age of subjects was 63.6+/-11.5 years (range:44 - 84 years) and 11 patients were men and 5 patients were women. The site of infarction was anterior in 11 patients and inferior in 5 patients. 2) The peak concentrations of CK-MB and cTnI were reached from 4-h to 12-h after admission in all patients (7.3+/-2.6-h, and 9.0+/-3.1-h, respectively), but there was no significant difference in peak time. 3) Serum concentration of CK-MB was normalized at 72-h after admission, but cTnI was remained in increased state until 96-h after admission. The numbers of the patients with above cutoff value of CK-MB and cTnI at different time after admission were significantly different after 72-h (p<0.05). 4) The peak cTnI and sigma cTnI level were significantly correlated with peak CK-MB and sigma CK-MB level, respectively (r 2 =0.7955, p<0.0001 and r 2 =0.6378, p=0.0002, respectively). 5) The ejection fraction was not correlated with peak cTnI concentration (r 2 =0.0948, p=0.2461) and sigma cTnI (r 2 =0.1867, p=0.0946). 6) The wall motion score index was not correlated with peak cTnI concentration (r 2 =0.2135, p=0.0716), but significantly correlated with sigma cTnI (r 2 =0.2540, p=0.0465). CONCLUSION: The serum concentration of cTnI was useful in late diagnosis of AMI and cTnI release in patients with AMI was correlated with myocardial infarct size.
Actins ; Chest Pain ; Coronary Angiography ; Delayed Diagnosis ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Infarction ; Male ; Myocardial Infarction* ; Myosins ; Reperfusion ; Thrombolytic Therapy ; Troponin I* ; Troponin*

The purpose of this study is to present the results of the clerkship evaluation by the students using questionnaire, to discuss the problems revealed in performing the evaluation, and to find out the ways to improve the evaluation. In 2000, the evaluation has been conducted by the Department of Radiology, Seoul National University College of Medicine. The questionnaires filled-up by 97 junior students who completed the clerkship schedule of 2 weeks were analyzed in this study. The questionnaire consisted of 28 structured items with 5-grade scale each, the contents of which included the amount and level of the overall clerkship course and those of 5 subtypes of the clerkship(self-learning, student conference, student seminar, on-site clerkship, and small group discussion with faculty). In small group discussion, enthusiasm of each faculty, delivery effect, and difficulty of the contents were also evaluated. As a result, the most items were assessed to be slightly better than average(3 or 4 point of 5 scale). It was found that the small group discussion was most favored, whereas the student seminar was least favored. Faculty activity was also scored to be better than average. There were no significant differences among all faculty activity. The limitation of this study is failure of assessing the validity and reliability of the student response. In order to improve the evaluation, we should consider following four subjects: First, all the items are carefully developed to enhance the validity and reliability of the evaluation. Second, students should be fully informed of the objects of the evaluation before it is carried out. Third, teaching support facilities for the faculty are needed. Finally, an organization which takes complete charge of the instruction evaluation must be established.
Appointments and Schedules ; Humans ; Reproducibility of Results ; Seoul ; Surveys and Questionnaires

An unusual case of embryonal rhabdomyosarcoma of the bladder in a 77 year old man, who presented with difficult urination, gross hematuria and vague lower abdominal pain. Herein, we report a case of rhabdomyosarcoma. which revealed early recurrence and rapid growing up after partial cystectomy.
Abdominal Pain ; Adult* ; Aged ; Cystectomy ; Hematuria ; Humans ; Recurrence ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Embryonal ; Urinary Bladder* ; Urination