No abstract available.
Lung Neoplasms* ; Lung*

OBJECTIVE AND METHODS: To determine correlations among ambulatory renin activity, ambulatory blood pressure and microalbumin excretion rate, 66 Korean essential hypertensives were studied after 4 week wash-out period. The ambulatory blood pressure was monitored every 30 minutes and mean BP were calculated automatically. Urinary microalbumin excretion rate(UAER) and ambulatory plasma renin activity(aPRA) collected at mid-day were measured by radioimmunoassays. Subjectives were divided into 2 groups by aPRA value(2ng/ml/hr). RESULT: 14 cases were high renin group and 52 cases low renin group. The mean BP were 148.83/94.69mmHg in low renin group, and 146.57/98.07mmHg in high-renin group without difference. UAER were not different also between both groups. 23.07%(4/14) of non-dippers were included in high renin group and 25.58%(12/52) in low renin group without statistical difference. The aPRA was significantly related to UAER and systolic and diastolic mean blood pressure. Also UAER was related significantly to day mean blood pressures. CONCLUSION: Thus aPRA is thought to be a meaningful indicator to predict hypertensive renal target organ damage as well as blood pressure measured with 24-hr ABPM.
Blood Pressure* ; Hypertension* ; Plasma* ; Radioimmunoassay ; Renin*

PURPOSE: The aim of this study was to review the outcome of local control after the local excision for T1/T2 rectal cancers and, thus, to assess its effectiveness as an alternative to a more radical resection. METHODS: This retrospective study analyzed 23 patients with T1/T2 rectal cancer treated by local excision (LE), and their results were compared with the results for 22 patients with rectal cancer of the same stage treated by a radical resection (RR). All patients with pT2 lesions in the LE group received postoperative adjuvant chemoradiation. The outcomes were defined as 5-year local-recurrence-free survival (LRFS). The median follow-up was 72 (range, 40~92) months. RESULTS: Recurrence occurred in 4 patients (pT1, 1; pT2, 3) in the LE group and in 3 patients (all pT2) in the the RR group. One patient with vascular invasion (T2N1M0) in the RR group showed multiple liver metastases at 23 months postoperatively. The difference in 5-year LRFS was not statistically significant between the two groups. In the LE group, the 5-year LRFS for pT2 lesions was significantly less favorable than that for pT1 lesions (40% vs. 94%; P= 0.005). The 5-year LRFS for pT2 in the RR group was more favorable than that in the LE group, although the difference was not statistically significant (76.9% vs. 40%, P=0.138). CONSLUSIONS: Local excision provides a favorable local control for pT1 rectal cancers. A more radical resection, however, remains an effective surgical option for pT2 lesions because local excision, even combined with adjuvant chemoradiation, showed substantial local recurrences.
Follow-Up Studies ; Humans ; Liver ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies

No abstract available.
Sympathectomy

High-resolution (HR) ultrasound, which has been progressing continuously in technology, has improved in aspect of spatial and contrast resolution. The HR ultrasonography is a noninvasive, readily applicable imaging technique, which could get static and dynamic image in real-time for various neuromuscular disorders, especially in entrapment neuropathy. It is also a reliable tool to detect dynamic muscle movements such as fasciculation as well as muscle atrophy in chronic myopathies or neuropathies. Although reliability of the HR ultrasonography has not been investigated in large series of patients, different neuromuscular disorders tend to show specific changes on the ultrasound, which can be helpful in differential diagnosis. The HR ultrasonography is an ideal tool for the clinical and research investigation of neuromuscular system complementary to electrodiagnostic studies. This review briefly describes applicability for various neuromuscular disorders with previous study results and the technical aspects of ultrasound and its physical principles.
Diagnosis, Differential ; Fasciculation ; Humans ; Muscles ; Muscular Atrophy ; Muscular Diseases ; Nerve Compression Syndromes

Primary intracranial choriocarcinoma is a extremely rare neoplasm since the case was reported by Askanasy, in 1906, there have been 35 reported, even if germinal neoplasms containing chorocarcinoma-like tissue are added. But pure choriocarcinoma was rarely reported. The purpose of this paper is to report a case of 18-year-old boy with tumor in subependymal region around left frontal horn, which was present with high level of serum beta chain of chorionic gonadotropin(B-HCG) and was verified as germine choriocarcinoma by biopay.
Adolescent ; Animals ; Choriocarcinoma* ; Chorion ; Female ; Horns ; Humans ; Male ; Pregnancy

PURPOSE: Necrotizing enterocolitis (NEC) is one of the most common surgical emergencies during the neonatal period. The aim of this study was to identify and assess the factors affecting the postoperative mortality in infants with NEC that require surgical treatment. METHODS: The authors retrospectively reviewed 37 infants surgically treated, at the Department of Surgery, Pusan National University Hospital, between Jan. 2000 and Dec. 2004. The patients were divided two groups according to the clinical outcomes; the survival and non-survival groups. Eight variables, i.e., sex, gestational age, weight at birth and at the time of the first operation, weight change between birth and the time of the first operation, degree of clinical manifestations (as a modified Bell's stage), interval between the onset of symptoms and the time of the first operation, the extent of necrotic intestine and associated anomalies, were analyzed. RESULTS: Among 37 infants, 6 expired (a mortality rate of 16.2%). The postoperative mortality was not affected by sex, gestational age, and the weight at birth and at the time of the first operation, weight change between birth and at the time of the first operation, degree of clinical manifestations and the interval between the onset of symptoms and the time of the first operation. However, the extent of necrotic intestine was associated with a significantly increased mortality (P=0.046). CONCLUSION: These data suggest that the extent of necrotic intestine is the only statistically significant factor affecting the postoperative mortality in infants with NEC that require surgical treatment.
Busan ; Emergencies ; Enterocolitis, Necrotizing* ; Gestational Age ; Humans ; Infant ; Intestines ; Mortality* ; Parturition ; Retrospective Studies

BACKGROUND: The inhibitory effects of nitric oxide(NO) on platelet adhesion and vascular smooth muscle cell(VSMC) proliferation may have a possible role inhibiting development of neointima following balloon catheter induced injury. We tested the hypothesis that L-arginine, the precursor of NO, would attenuate neointima formation following balloon catheter induced injury via regulation of antagonistic balance between proliferation and apoptosis of VSMC. METHODS: Adult, male Sprague-Dawley rats(300 to 400g) were anesthetized with ketamine (100mg/kg intraperitoneally). The left common and external carotid artery were exposed. For endothelial denudation, 2mm angioplasty catheter was introduced through the left external carotid artery into the left common carotid artery. The catheter was inflated at I atm. and withdrawn three times. Animals were randomized to receive 2.25% L-arginine in their drinking water(n=14) or placebo(n=16) from 2 days prior to and 9 days following denudation. VSMC proliferation was quantified by immunohistochemical staining with an antibody to the proliferating cell nuclear antigen(PCNA). The cells undergoing apoptosis were identified by terminal nucleotidyl transferase-mediated nick end labeling(TUNEL) method and morphologic changes by computerized planimetry and transmission electron microscopy. RESULTS: 1) The neointimal area in injured arteries were significantly reduced in L-arginine supplemented animals compared with placebo group(p<0.05). 2) L-arginine administration significantly reduced the number of PCNA positive cells in neointima when compared with placebo at 9 days(p<0.05). 3) Positive TUNEL cells were not influenced by L-arginine supplementation. 4) On transmission electron microscopy, there were no cells showing characteristics of apoptosis in neointima. CONCLUSION: These results suggested that the inhibitory effect of L-arginine on neointima formation is due to reduced VSMC proliferation, but is not due to increased VSMC apoptosis at the early time period after initmal injur .
Adult ; Angioplasty ; Animals ; Apoptosis ; Arginine* ; Arteries ; Blood Platelets ; Carotid Artery, Common ; Carotid Artery, External ; Catheters ; Drinking ; Humans ; In Situ Nick-End Labeling ; Ketamine ; Male ; Microscopy, Electron, Transmission ; Muscle, Smooth, Vascular ; Neointima* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Vascular System Injuries*

PURPOSE: This study was performed to determine the usefulness of blood culture in the management of febrile immunocompetent patients presenting emergency department. METHODS: We prospectively analysed the medical characteristic and the result of blood culture of febrile immunocompetent patients who presented to Chonnam National University Hospital emergency center form April 2005 to October 2005. RESULTS: The study included 182 patients. The characteristic associated with the positive result of blood culture on multivariate analysis was the low initial level of albumin. Of the 182 culture, only 26 were true positive(14.3%). Of them, the result of blood culture influenced management in five patients (2.7%). CONCLUSION: The blood cultures has usually been ordered in febrile immunocompetent patients at emergency department has the limited usefulness. The emergency physician who initially treats them has to consider this limitation of it.
Emergencies* ; Emergency Service, Hospital* ; Fever ; Humans ; Jeollanam-do ; Multivariate Analysis ; Prospective Studies

BACKGROUND AND OBJECTIVES: Diabetes is associated with a unique form of cardiomyopathy in the absence of atherosclerosis. The mechanisms of diabetic cardiomyopathy have not been defined, but is associated with early left ventricular (LV) diastolic dysfunction following an altered LV contractile performance. However, less attention has been paid to the right ventricular (RV) diastolic function in diabetes. Therefore, the changes in the RV ans LV filling dynamics, in patients with early type 2 diabetes, were investigated. SUBJECTS AND METHODS: The transtricuspid and trans-mitral flows were assessed by transthoracic Doppler echocardiography, at maximal inspiration and expiration, in 48 subjects (mean age: 62+/-9 years, M:F=16:32) with type 2 diabetes (Type 2 DM group) and 34 normal subjects (control group ; mean age:59+/-9 years, M:F=15:19, ranging from 45-75 years of age) with normal LV systolic function and ECG at rest. Subjects with diabetic complication, nephropathy (Cr >1.5 mg/dL), LVH and COPD were excluded. RESULTS: The mitral E/A ratio and DT (deceleration time) showed no significant difference between the type 2 DM and control groups. The LV and RV systolic functions also showed no significant difference between the two groups. However, the type 2 DM group had a lower tricuspid E/A ratio (0.98+/-0.25 vs. 1.17+/-0.21, p<0.001) and a longer tricuspid DT (241+/-65 msec vs. 208+/-51 msec, p=0.016) than the control group. CONCLUSION: The right ventricular diastolic function is frequently abnormal in early type 2 diabetes. This suggests that right ventricular diastolic dysfunction may be an important predictor for the early detection of diabetic cardiomyopathy.
Atherosclerosis ; Cardiomyopathies ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Cardiomyopathies ; Diastole ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Heart Ventricles ; Humans ; Pulmonary Disease, Chronic Obstructive