1.Two-Dimensional Echocardiographic Predictors of Ventricular Enlargement after Acute Myocardial Infarction.
Chul Min KIM ; Sung Rae KIM ; Ho Jung YOUN ; Man Young LEE ; Kyu Bo CHOI ; Soon Jo HONG
Korean Circulation Journal 1996;26(2):455-464
BACKGROUND: Ventricular remodeling after myocardial infarction increase mortality and morbidity. Two-dimensional echocardiography in acute myocardial infarction provides a useful diagnostic tool for evaluation of ventricular remodeling. The aims of this study were to verify whether follow-up two-dimensional echocardiography could detect ventricular enlargement after acute myocardial infarction and to find early echocardiographic predictors and clinical charateristics of ventricular enlargement. METHODS: Two-dimensional echocardiography was done prospectively at 2 week, 3 month, and 6 month after the first Q-wave acute myocardial infarction in 18 patients. The control group was 11 patients of a normal chest roentgenogram and echocardiogram who were studied for chest pain or arrhythmia. The patients were divided by the mean value of the control group left ventricular end-diastolic volume index(LVEDVI) 56.8ml/m2. The group A was more than 60ml/m2(the control group LVEDVI 56.8ml/m2) and the group B was less than 60ml/m2 of LVEDVI at 2 week post myocardial infarction. The left vantricular volume was measured by the modified disk method at the apical four chamber view. The wall motion abnormality of left ventricle was examined by the recommendation of the American Society of Echcardiography. RESULTS: The left vntricular end-diastolic volume and the left ventricular end-systolic volume were enlarged after 3 month of acute myocardial infarction in the group A compare with those of the control group. There was no ventricular enlargement during 6 month after myocardial infarction in the group B. The frequency of ventricular enlargement was increased in anterior myocardial infarction. There was no difference in left ventricular ejection fraction at 2 week post myocardial infarction between the group A(51.4+/-15.7%) and the group B(50.8+/-10.3%). The wall motion score index more than 1.5 at 2 week post myocardial infarction means the enlarged LVEDVI more than 60ml/m2 and the group of ventricular enlargement. CONCLUSION: The left ventricular enlargement could be diagnosed by the follow-up two-dimensional echocardiography in acute myocardial infarction. The echocardiographic early predictors of ventricular enlagement were the left ventricular end-diastolic volume greater than 60ml/m2 and increased wall motion score index more than 1.5 at 2 week post myocardial infarstion. The anterior myocardial infarction was the electrocardiographic predictor of ventricular dilatation. Therefore these early predictors could identify the patients of ventricular enlargement and these patients could be a candidate of follow-up echocardiography and of a specific treatment for limiting ventricular remodeling.
Arrhythmias, Cardiac
;
Chest Pain
;
Dilatation
;
Echocardiography*
;
Electrocardiography
;
Follow-Up Studies
;
Heart Ventricles
;
Humans
;
Mortality
;
Myocardial Infarction*
;
Prospective Studies
;
Stroke Volume
;
Thorax
;
Ventricular Remodeling
2.Psychiatric Evallution of Alopecia Ateata.
Youn Rae PARK ; Dong Un KIM ; Cheol Heon LEE ; Hong Jig KIM ; Chang Jo KOH ; Baik Kii CHO
Korean Journal of Dermatology 1981;19(2):161-165
One hundred and seven patients with alopecia areata were studied in regard to the character of personality, emotional stress during their military life, socioeconomic status and their possible role in the pathogenesis of alopecia areata by ready-made chart and Minnesota Multiphasic Personality Inventory (M.M.P.I,) While only 55. 4% of out patients were enlisted men, 73. 0% of alopecia areata patients were soldiers suggesting that soldiers are more prone to develop alopecia areata. This trend was more apparent among soldiers who were less than 6 months in the service. In clinical scale, abnormal MMPI profiles were noted in 65 patients (60. 7%). Among abnormal MMPI profiles, hysteria scale is most common (23. 1%) and followed by hypochondriasis scale 18. 5%, psychiasthenia scale 16. 9%, and paranoia scale 12. 3%. The alopecia areata group showed significant difference in psychopathic deviate, schizophrenia, and paranoia which is high in person having psychotic symptoms and psychopathic personality. The neurotic triad or anxiety index is not significantly elevated.
Alopecia Areata
;
Alopecia*
;
Antisocial Personality Disorder
;
Anxiety
;
Humans
;
Hypochondriasis
;
Hysteria
;
Male
;
Military Personnel
;
MMPI
;
Outpatients
;
Paranoid Disorders
;
Schizophrenia
;
Social Class
;
Stress, Psychological
3.Thymic Carcinoid Tumor: 1 Case report.
Jae Young LEE ; Myung Chun KIM ; Seh Young YOU ; Hwang Rae JO ; Hong Mo KANG ; Moon Ho YANG
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(3):319-323
Thymic carcinoid tumor is a rare mediastinal tumor, which was firstly described by Rosai and Higa in 1972. A carcinoid tumor of the thymus has recently been regarded as a distinct tumor from thymoma, and is probably Kultschizky cell origin. The pathologic diagnosis of thymic carcinoid is made from findings from light microscopy, immunohistochemical studies and electron microscopy. About 50% of thymic carcinoids were seen with endocrinopathies. Recurrences and extrathoracic metastasis are characteristics of thymic carcinoids. Surgical removal of the intial and tumor recurred are considered to be the most effective treatment today. However, the role of the adjuvant radiotherapy and the chemotherapy is still uncertain. Herein we report a case of thymic carcinoid tumor, which was confirmed by operation and pathologic study.
Carcinoid Tumor*
;
Diagnosis
;
Drug Therapy
;
Mediastinal Neoplasms
;
Microscopy
;
Microscopy, Electron
;
Neoplasm Metastasis
;
Radiotherapy, Adjuvant
;
Recurrence
;
Thymoma
;
Thymus Gland
;
Thymus Neoplasms
4.The Comparision of Nicardipine and Sodium Nitroprusside on Postoperative Hypertension after Coronary Artery Bypass Graft Surgery.
Young Jun OH ; Young Lan KWAK ; Sou Ouk BANG ; Jong Hwa LEE ; Hyuk Rae JO ; Yong Woo HONG
Korean Journal of Anesthesiology 2002;42(4):500-507
BACKGROUND: Hypertension following coronary artery bypass graft surgery (CABG) occurs frequently. Pharmacologic therapy of postoperative hypertension has often been treated with sodium nitroprusside (SNP). Nicardipine which is a dihydropyridine calcium-channel blocker, has little or no direct negative effects on cardiac contractility. Thus, we have compared the effects on hemodynamics between nicardipine and SNP after a CABG. METHODS: After a CABG, when systolic blood pressure (SBP) was elevated above 140 mmHg, patients were randomized to receive either nicardipine (N-group, n = 26) or SNP (S-group, n = 21) at an initial rate of 2ng/kg/min until the SBP was lowered to 120 130 mmHg (target blood pressure, TBP) for 10 minutes. If the TBP was not achieved, the infusion rates of both drugs were increased by 1ng/kg/min every 10 minutes. If SBP was lowered below 100 mmHg, phenylephrine was infused. Hemodynamic measurements were obtained just before (T1) and at 10 min (T2), 60 min (T3) and 24 h (T4) after the infusin of nicardipine or SNP. Infusion time, total doses, creatine phosphokinase (CK)-MB, plasma catecholamine and the use of phenylephrine were compared between groups. RESULTS: The SBP and systemic vascular resistance were significantly decreased in both groups. The cardiac index and stroke volume index were significantly increased at T3 in both groups but they were significantly increased only in the N-group at T2. The infusion time and the total doses of both drugs were significantly less in the N-group than the S-group. There were no significant differences in CK-MB, plasma catecholamine and the use of phenylephrine between groups. CONCLUSIONS: It has been suggested that the infusion of nicardipine is as effective as the infusion of SNP for the control of postoperative hypertension and the increase of cardiac output after a CABG. However, immediately after the drug infusion, nicardipine was superior to SNP in maintaining left ventricular performance.
Blood Pressure
;
Cardiac Output
;
Coronary Artery Bypass*
;
Coronary Vessels*
;
Creatine Kinase
;
Hemodynamics
;
Humans
;
Hypertension*
;
Nicardipine*
;
Nitroprusside*
;
Phenylephrine
;
Plasma
;
Sodium*
;
Stroke Volume
;
Transplants
;
Vascular Resistance
5.A Case of Tuberculous Lymphadenitis Causing Obstructive Jaundice.
Chang Hong LEE ; Jae Seon KIM ; Goo LEE ; Young Tae BAK ; Jin Ho KIM ; Jong Guk KIM ; Nam Hee WON ; Eun Rae JO ; Sung Joon LEE ; Hong Young MOON
Korean Journal of Gastrointestinal Endoscopy 1994;14(1):115-120
Obstructive disorders of the biliary trees include occlusions of the bile duct lumen by stones, intrinsic disorders of the bile ducts, and extrinsic compressions. The most common biliary cause of obstructive jaundice is the presence of stones. Intrinsic disorders of the bile ducts may be inflammatory, infectious, or neoplastic. And significant enlargement of adjacent lymph nodes due to metastatic tumors or lymphoma can occasionally obstruct the extrahepatic bile ducts. But obstructive jaundice produced by periportal tuberculous lymphadenitis with no evidence of pulmonary tuberculosis is very rare. We report a case of tuberculous lymphadenitis causing obstructive jaundice with a mass around mid common bile duct on abdominal sonogram, CT scan and ERCP, and it was confirmed by an exploratory laparotomy.
Bile Ducts
;
Bile Ducts, Extrahepatic
;
Cholangiopancreatography, Endoscopic Retrograde
;
Common Bile Duct
;
Jaundice, Obstructive*
;
Laparotomy
;
Lymph Nodes
;
Lymphoma
;
Tomography, X-Ray Computed
;
Tuberculosis, Lymph Node*
;
Tuberculosis, Pulmonary
6.Relation between Serum Carboxy-Terminal Propeptide of Type 1 Procollagen(PIP), a Marker of Myocardial Fibrosis, and Left Ventricular Diastolic Function in Patients with Early Type 2 Diabetes Mellitus.
Sang Hyun IHM ; Ho Joong YOUN ; Sung Rae KIM ; Chul Soo PARK ; Ki Yuk CHANG ; Ki Bae SEUNG ; Jae Hyung KIM ; Soon Jo HONG ; Kyu Bo CHOI
Korean Circulation Journal 2005;35(7):500-506
BACKGROUND AND OBJECTIVES: This study was designed to investigate whether the serum concentration of the carboxy-terminal propeptide of procollagen type I PIP, a marker of myocardial fibrosis, was related to the change of the ventricular filling dynamics in patients with early type 2 diabetes mellitus (DM). SUBJECTS AND METHODS: Echocardiography was performed in 28 patients with type 2 DM and 32 age-matched healthy controls, ranging from 31-69 years of age, with normal left ventricular (LV) systolic function and ECG at rest. Subjects with diabetic complications, including microalbuminuria, nephropathy (Cr>1.3 mg/dL), severe obesity (BMI> or =30 kg/m2), LV hypertrophy (LV septal thickness and/or posterior wall thickness 12 mm on M-mode) and hypertension, were excluded. The serum concentrations of PIP and Transforming growth factor TGF-beta1 were measured by enzyme immunoassay methods. RESULTS: The type 2 DM group had lower mitral (Type 2 DM vs. Control: 0.88+/-0.28 vs. 1.17+/-0.34, p<0.01) and tricuspid E/A ratios (1.15+/-0.25 vs. 1.30+/-0.25, p=0.01) than the control group. The level of serum PIP was higher (p<0.05) in patients with type 2 DM than in the control group (131.1+/-45.6 vs. 109.3+/-32.5). The difference in the duration between transmitral forward (A) and pulmonary venous retrograde (Ar) waves (A-Ar) was considered an estimate of a passive diastolic function. A-Ar was inversely related with the serum PIP level in type 2 diabetes (r=-0.43, p=0.03). CONCLUSION: These results show a relationship between the LV diastolic function and the serum concentration of PIP in early type 2 DM. These findings suggest that the determination of the serum level of PIP is a useful method for the screening and early diagnosis of myocardial fibrosis associated with DM.
Collagen Type I
;
Diabetes Complications
;
Diabetes Mellitus
;
Diabetes Mellitus, Type 2*
;
Diastole
;
Early Diagnosis
;
Echocardiography
;
Electrocardiography
;
Fibrosis*
;
Humans
;
Hypertension
;
Hypertrophy
;
Immunoenzyme Techniques
;
Mass Screening
;
Obesity, Morbid
;
Procollagen
;
Transforming Growth Factor beta1
;
Transforming Growth Factors
7.Remifentanil-induced pronociceptive effect and its prevention with pregabalin.
Hyong Rae JO ; Young Keun CHAE ; Yong Ho KIM ; Hong Seok CHAI ; Woo Kyung LEE ; Sun Soon CHOI ; Jin Hye MIN ; In Gyu CHOI ; Young Soon CHOI
Korean Journal of Anesthesiology 2011;60(3):198-204
BACKGROUND: Experimental and clinical studies have suggested that remifentanil probably causes acute tolerance or postinfusion hyperalgesia. This study was designed to confirm whether remifentanil given during propofol anesthesia induced postoperative pain sensitization, and we wanted to investigate whether pregabalin could prevent this pronociceptive effect. METHODS: Sixty patients who were scheduled for total abdominal hysterectomy were randomly allocated to receive (1) a placebo as premedication and an intraoperative saline infusion (control group), (2) a placebo as premedication and an intraoperative infusion of remifentanil at a rate of 3-4 ng/ml (remifentanil group), or (3) pregabalin 150 mg as premedication and an intraoperative infusion of remifentanil at a rate of 3-4 ng/ml (pregabalin-remifentanil group). Postoperative pain was controlled by titration of fentanyl in the postanesthetic care unit (PACU), followed by patient-controlled analgesia (PCA) with fentanyl. The patients were evaluated using the visual analogue scale (VAS) for pain scores at rest and after cough, consumption of fentanyl, sedation score and any side effects that were noted over the 48 h postoperative period. RESULTS: The fentanyl titration dose given in the PACU was significantly larger in the remifentanil group as compared with those of the other two groups. At rest, the VAS pain score in the remifentanil group at 2 h after arrival in the PACU was significantly higher than those in the other two groups. CONCLUSIONS: The results of this study show that remifentanil added to propofol anesthesia causes pain sensitization in the immediate postoperative period. Pretreatment with pregabalin prevents this pronociceptive effect and so this may be useful for the management of acute postoperative pain when remifentanil and propofol are used as anesthetics.
Analgesia, Patient-Controlled
;
Anesthesia
;
Anesthetics
;
Cough
;
Fentanyl
;
gamma-Aminobutyric Acid
;
Humans
;
Hyperalgesia
;
Hysterectomy
;
Pain, Postoperative
;
Piperidines
;
Postoperative Period
;
Premedication
;
Propofol
;
Pregabalin
8.Combination Chemotherapy with 5-Fluorouracil and Heptaplatin as First-line Treatment in Patients with Advanced Gastric Cancer.
Young Joo MIN ; Sung Jo BANG ; Jung Woo SHIN ; Do Ha KIM ; Jae Hoo PARK ; Gyu Yeol KIM ; Byung Kyun KO ; Dae Hwa CHOI ; Hong Rae CHO
Journal of Korean Medical Science 2004;19(3):369-373
Heptaplatin is a recently developed platinum derivative. This agent has been reported to have a response rate of 17% as a single agent, and tolerable toxicity in the treatment of advanced gastric cancer. The aim of this study was to evaluate the efficacy and toxicity of a combination of 5-fluorouracil (5-FU) and heptaplatin in patients with advanced gastric cancer. Forty-seven chemotherapy-naive patients with advanced or recurred gastric cancer were recruited. 5-FU was administered over 120 hr by continuous intravenous infusion from day 1 to 5, at a daily dose of 1,000 mg/m2 and heptaplatin was administered over 1 hr by intravenous infusion on day 1 at 400 mg/m2, and this cycle was repeated every 4 weeks. The response rate was 21%, median progression-free survival was 1.9 months (95% CI, 1.6 to 2.2 months). Median overall survival was 6.2 months (95% CI, 4 to 8.4 months) and the 1-yr survival rate was 29% for all patients. The most frequent toxicity was proteinuria. Toxicities were generally mild and reversible. This study demonstrates that the combination of 5-FU/heptaplatin combination is less active but tolerated in patients with advance gastric cancer.
Adult
;
Aged
;
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
;
Disease-Free Survival
;
Female
;
Fluorouracil/*administration & dosage
;
Follow-Up Studies
;
Human
;
Male
;
Malonates/*administration & dosage
;
Middle Aged
;
Organoplatinum Compounds/*administration & dosage
;
Stomach Neoplasms/*drug therapy
;
Time Factors
;
Treatment Outcome
9.A case of Thrombotic thrombocytopenic purpura - hemolytic uremic syndrome presenting with cortical blindness confirmed by MRI.
Gueon Jo LIM ; Yong Eun KIM ; Kyong Duk SUH ; Yu Seong JEONG ; Jin Do KIM ; Ju Hong LEE ; Dae Young KOO ; Tae Yoon LEE ; Yong Hun SIN ; Yong Ki PARK
Korean Journal of Medicine 1999;56(1):119-123
Thrombotic thrombocytopenic purpura (TTP) and the related hemolytic uremic syndrome (HUS) are disorders characterized by thrombocytopenia, microangiopathic hemolytic anemia, a variable degree of impairment of renal function and fluctuating neurological symptoms, which are thought to be due to platelet activation and subsequent formation of thrombi in the microcirculation. The fact that there was no clear-cut clinical and laboratory features that differentiate HUS from TTP has lead to view these two syndromes as a clinical continuum. Microvascular thrombosis is the typical lesion and closely related with endothelial injury and platelet activation. Pathologic alterations of the brain parenchyma are mainly manifested by small multiple infarcts. Numerous cases of CNS complications of these syndromes have been evaluated by using CT, but few reports have mentioned the MR findings. We experienced a case of TTP-HUS that had clinical features of cortical blindness and the brain lesion was confirmed by MRI showing cerebral infarct at the occipital area but it was reversible course. So we report this case with a brief review of literature.
Anemia, Hemolytic
;
Blindness, Cortical*
;
Brain
;
Hemolytic-Uremic Syndrome*
;
Magnetic Resonance Imaging*
;
Microcirculation
;
Platelet Activation
;
Purpura, Thrombotic Thrombocytopenic*
;
Thrombocytopenia
;
Thrombosis
10.The Significance of Mucosal Biopsy in Normal Colonoscopy.
Jae Seon KIM ; Eun Rae JO ; So Young KWON ; Kwan Soo BYUN ; Young Tae BAK ; Jin Ho KIM ; Jong Guk KIM ; Chang Hong LEE ; Chul Hwan KIM ; Nam Hee WON
Korean Journal of Gastrointestinal Endoscopy 1993;13(4):713-718
Many patients of gastroenterology clinics complain symptoms requiring colonic investigations. Radiological examinations may fail to detect early inflammatory bowel diseases and small neoplasms or polyps. And therefore colonoscopies are performed in preference to barium enema. Recently several reports raised a question regarding whether biopsy is necessary in a macroscopically normal colon. To determine what proportion of apparently normal colons is histologically abnormal, to measure the thickness of subepithelial basement membrane(SEBM) in normal colons, and to see whether the thiekness varies according to the different areas of the large bowel we prospectively analyzed 100 consecutive subjects with normal laboratory findings and normal mucosa on colonoscopy. Significant histologic abnormalities were not detected in all 100 cases. Thickness of SEBM (mean+SD) was 1.6+0.4 um at hepatic flexure, 1.6+0.4um at splenic flexure and 1.7+0.4 pm at sigmoid colon. The SEBM was significantly thicker at the sigmoid colon than at the hepatic flexure. Range of thickness of normal SEBM was 0.8 to 2.5 pm(mean+2SD). Maximum thickness of SEBM was 3 pm. The result of this study suggests that doing colonoscopic biopsies in all normal colons do not seem to be essential in Koreans yet.
Barium
;
Biopsy*
;
Colon
;
Colon, Sigmoid
;
Colon, Transverse
;
Colonoscopy*
;
Enema
;
Gastroenterology
;
Humans
;
Inflammatory Bowel Diseases
;
Mucous Membrane
;
Polyps
;
Prospective Studies