BACKGROUND: Diabetic patients develop hypoaldosteronism which frequently caused hyperkalemia and metabolic acidosis and diabetic hypoaldosteronism is associated with selective unresponsiveness of aldosterone to angiotensin A-II, but mechanism of defect in A-II stimulated aldosterone response still remain unclear. METHODS: To elucidate the mechanism of defect in A-II stimulated aldosterone response, author evaluated the responses of aldosterone production to A-II, K+, and ACTH in adrenal glomerulosa cells prepared from streptozotocin induced diabetic rats, Inositol triphosphate (IP3) generated by activation of phospholipase C (PLC) and arachidonic acid and lysophospholipids generated by activation of phospholipase A2 (PLA2) were measured in A-II stimulated glomerulosa cells. Radiocalcium efflux and aldosterone response to second messenger of A-II such as PLC, IP3, PLA, AA and protein kinase C activator, 12-o-tetradecanoylphorbol 13 acetate (TPA). RESULTS: 1. Plasma renin activity and aldosterone levels were not different among control rats, untreated and insulin treated diabetic rats. 2. Basal, ACTH and K+ -stimulated aldosterone production were similar in cells from the three groups (p<0.05), but A-II stimulated aldosterone production was significantly decreased in cells from untreated diabetic rats compared with control and insulin treated diabetic rats (p0.05). 4. Aldosterone responses to PLC, IP3, AA and TPA were significantly decreased in glomerulosa cells from diabetic rats compared with control and insulin treated diabetic rats (p<0.05), but aldosterone response to PLA2 was similar among the three groups (p>0.05). 45Ca efflux to PLC, IP3 PLA2 and AA were similar among the three groups (p>0.05). CONCLUSION: These results suggested that decreased A-II-stimulated aldosterone response was present in glomerulosa cells from streptozotocin induced diabetic rats and reversed by insulin treatments. The main defect of altered A-II response of zona glomerulosa might be located in the step after activation of phospholipase and increase of intracellular calcium, and activation of PKC, or distal to that could be one of the causative mechanism.
Acidosis ; Adrenocorticotropic Hormone ; Aldosterone* ; Angiotensin II ; Angiotensins* ; Animals ; Arachidonic Acid ; Calcium* ; Diabetes Mellitus ; Humans ; Hyperkalemia ; Hypoaldosteronism ; Inositol ; Insulin ; Lysophospholipids ; Phospholipases A2 ; Phospholipases* ; Plasma ; Protein Kinase C ; Rats* ; Renin ; Second Messenger Systems ; Streptozocin ; Type C Phospholipases ; Zona Glomerulosa*

Reconstruction of partial ear defect to approximate the opposite normal ear is actually very difficult. Because the patterns of partial ear defect (site, shape and size of defect) are extremely variable, the operative method on each case should be changed. In an effort to overcome these problems, many reconstructive methods have been reported so far. We experienced 11 cases of partial ear defect from September, 1995 to August, 1996 and different reconstructive methods were applied In this study, the most common cause of partial ear defect was trauma (9 cases) and the most common site was middle part of ear helix. The defects were varying from 1x2 cm to 1.5x5 cm in size. The methods that has been used for reconstruction of ear defect include direct closure, helical chondrocutaneous advancement flap, Dieffenbach's method, retroauricular flap, tubed bipedicled flap and so on. We could get to know the merits and demerits of each method through this follow up study. So authors obtained the several basic conclusions about the merits and demerits of each method and standard of method selection in various patterns of ear defects. From analysis of the cases with review of literature, the our conclusions are as follows. 1. If the size of de(tract is small and the patient does not want to have two times of operation, direct closure can be done with good results. 2. If the defect exists on ear auricle confuted to helix and if there are no or small amount of associated cartilage defect, tubued bipedicled flap seems to be proper. 3. With the ear auricle defect confined to helix, especially helix of upper ear auricle, helical chondrocutaneous advancement flap can brought tile best result, though it has disadvantage of being decreased in its size 4. If there are extensive defect on ear auricle extending over scapha and antihelix, retroauricular flap can be done with good results. 5. In the ear auricle defect acompanying considerably large cartilage loss, Dieffenbach's method is thought to be proper.
Cartilage ; Ear Auricle ; Ear* ; Follow-Up Studies ; Humans

No abstract available.
Nasal Bone*

No abstract available.
Fasting* ; Female ; Humans

OBJECTIVES: Subacute thyroiditis is a nonsuppurative inflammation of thyroid gland and is probably caused by a cytopathic virus. Typical clinical symptoms and features of subacute thyroiditis vary widely during the course of illness. It has a clinical course, evolving from hyperthyroidism through a temporary hypothyroidism to recovery. However, the final outcome of this disease remains unpredictive in some patients. Permanet hypothyroidism occurs infrequently. METHODS: Thirty-three patients proven to have subacute thyroiditis at the Ewha Womans University Hospital from September 1993 to November 1995 were studied. We analyzed their clinical features, laboratory findings, and duration of recovery to cha- racterize the course of the disease. RESULTS: 1) Total 33 patients were studied: 31 patients were female and 2 patients were male. Their mean age was 42.6+/-8.3 years old. The peak months were August through October in this study. 2) Initial mean ESR was 73.0+/-35.2mm/hr, mean T3 was 217.3+/-73.9ng/dl, mean T4 was 15.2+/-8.5microgram/ dl, and TSH was 0.06+/-0.09microIU/ml. The positive rates of antithyroglobulin and anitmicrosomal antibodies were 31% and 6% respectively, and TSH receptor antibody was elevated in one patient. 3) In the thyroid scan, 91% showed both lobes nonvisualisation, and 9% showed one lobe nonvisualization. Radioactive iodine uptake(RAIU) at 24 hour was 2.4+/-3.3%. 4) With the predisolone therapy, 90% of patients completely recovered, 57% of these patients had no hypothyroid phase and remaining 33% of them had hypothyroid phase during course of the disease. Three of the patients had permanent hypothyroidim. 5) The average duration of recovery was 3.2+/-1.4 months and it has no correlation with initial thyroid hormone levels, antithyroid antibodies and duration of steroid administration. CONCLUSION: There was no historical, physical, laboratory findings that help us predict those patients likely to have an exacerbation of the disease.
Antibodies ; Female ; Humans ; Hyperthyroidism ; Hypothyroidism ; Inflammation ; Iodine ; Male ; Prednisolone ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Subacute

Dermal wound healing is a complex process that involved inflammation leading to re-epithelialization, granulation tissue, and tissue remodeling. Previous studies from our laboratory have shown that polysaccharides isolated from fungus, Phellinus gilvus (PG) have various anti-inflammatory activities. In present study, we have assessed the effect of polysaccharides from PG on the dermal wound healing of polysaccharides from PG in streptozotocin-induced diabetic rat model. Six of 6-mm circular wounds were created with biopsy punch on the 4th day after induction of diabetes. After 24 hours, each test substance was applied to the wound twice a day for next 5 days. Circular wounds treated with PG showed significantly reduced wound contraction and complete reepithelialization, as compared to wounds of non-treated (p < 0.05). These results show that polysaccharides isolated from PG enhanced wound repair in diabetic impaired healing, and could be developed as a wound healing agent in such clinical settings.
Administration, Cutaneous ; Animals ; Anti-Inflammatory Agents/pharmacology ; Basidiomycota/*metabolism ; Diabetes Mellitus, Experimental/*pathology ; Histocytochemistry ; Male ; Polysaccharides/isolation&purification/*pharmacology ; Rats ; Rats, Sprague-Dawley ; Skin/*injuries ; Streptozocin ; Wound Healing/*drug effects ; Wounds, Penetrating/*drug therapy

A case of Maffucci's syndrome is reported in a 6-year-old girl. She had multiple enchondromas of the long bones and the phalangeal bones with hemangiomatous skin lesions. The hemangiomas were the capillary type and were not anatomically related to the bone lesions.
Capillaries ; Child ; Chondroma ; Enchondromatosis ; Female ; Hemangioma ; Hemangioma, Capillary ; Humans ; Skin

No abstract available.
Orchiectomy* ; Testis*

From July 1988, open heart surgery was performed on fifty adults utilizing the pulmonary artery vent instead of conventional venting methods. The open heart procedures included were twenty coronary artery bypass grafitings(CABG), ten mitral valve replacements(MVR), ten aortic aneurysms(DA), and three ventricular septal defects(VSD). To determine the effectiveness of the pulmonary artery venting, non-cardiotomy procedures(CABGs') were classified into satisfactory, ordinary and poor group in terms of the degree of chamber dilatation throughtout the entire period of the operation. Again, cardiotomy procedures were categorized as degree 0, I, II, III and IV according to the clearness of the operative fields. Out of the twenty non-cardiotomy procedures, 17 cases(85%) were fallen into the satisfactory group, while the remained three cases into ordinary group. The degree of satisfaction, in cardiotomy procedures, was III or IV in patients having mitral valve replacement, aortic valve replacement, double valve replacement or dissecting aneurysm repair, and it was I or II in patients having ventricular septal defect repair, on the other hand. There was neither bleeding complication nor stenosis on the vent site. There was only one suspicious perfusion defect on routine postoperative perfusion lung scan. The study demonstrated that venting the pulmonary artery was very helpful in most of the procedures, because it was easy to reach, removal of the vent cannula was safe and simple and complications were trivial.
Adult ; Aneurysm, Dissecting ; Aortic Valve ; Catheters ; Constriction, Pathologic ; Coronary Artery Bypass ; Dilatation ; Hand ; Heart ; Heart Septal Defects, Ventricular ; Hemorrhage ; Humans ; Lung ; Mitral Valve ; Perfusion ; Pulmonary Artery* ; Thoracic Surgery

Background: Postpartum thyroiditis is a painless, destructive lymphocytic inflammation of the thyroid gland that occurs during the postpartum period and is associated with a high prevalence of serum thyroid autoantibodies. Clinical symptoms and laboratory fi#ndings of postpartum thyroiditis vary widely during the course of illness and the final outcome of this disease remains unpredictive in some patients. The purpose of this study is to investigate the clinical course and the predictors of the outcome of the disease. Methods: Thirty-eight patients proven to have postpartum thyroiditis at the Ewha Womans University Hospital were studied. We analyzed their clinical features, laboratory findings and duration of recovery to characterize the course of the disease. Results: Their mean age was 29.0±3.3 years and the time of diagnosis was 4.9±1.9 months after delivery. The prevailed months of delivery were November through January in this study. Twenty six patients were hypothyroid and 12 were thyrotoxic at initial thyroid function. The positive rates of antithyroglobulin and anitmicrosomal antibodies were 92%, 67% in the hypothyroid group and 75%, 67% in th thyrotoxic group respectively. TSH receptor antibodies were negative in all patients. In the hypothyroid group the titers of antimicrosomal antibodies were significantly higer than the thyrotoxic group. The titers of antimicrosomal antibodies were positively correlated with serum TSH and negatively correlated with serum T4. In all patients, the titers in thyroid function tests returned to the normal range without long-term hypothyroidism. Conclusion: The titers of antimicrosomal antibodies were significantly higher in the hypothyroid group than the thyrotoxic group. Thus the titers of antimicrosomal antibodies can help guide the physician in the care of patients with postpartum thyroiditis who will probably be hypothyroid. In this study, we were surprised that all patients became euthyroid without permanent hypothyroidism.
Antibodies ; Autoantibodies ; Clinical Study ; Diagnosis ; Female ; Humans ; Hypothyroidism ; Inflammation ; Postpartum Period ; Postpartum Thyroiditis ; Prevalence ; Receptors, Thyrotropin ; Reference Values ; Thyroid Function Tests ; Thyroid Gland ; Thyroiditis