No abstract available.
Immunohistochemistry* ; Sciuridae*

BACKGROUND: Perfusion scintigraphy with dipyridamole have been reported to be useful for diagnosis of coronary artery disease and the assessment of the presence and extent of myocardium at ischemic risk, especially in patients who can not undergo dynamic exercise testing. Dipyridamole, pharmacologic coronary vasodilator, also induces fall in blood pressure and rise in heart rate. The purpose of this study was to answer the question if dipyridamole induced peripheral hemodynamic responses were related to chest pain, ST changes on EKG, scintigraphic defect or extent of coronary stenosis. METHODS: Dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 43 subjects who were suspected to have coronary artery disease. The peripheral hemodynamic response was graded as absent(group 0) if there was a < or =10mm fall in systolic blood pressure (SBP) and/or < or =10 beats/min rise in geart rate(HR) ; moderate(group 1) if there was >10 but < or =20mm fall in SBP and/or >10 but < or =20 beats/min rise in HR ; and marked (group 2) if there was >20mm fall in SBP and/or >20 beats/min rise in HR. RESULTS: The overall diagnostic sensitivity and specificity for coronary artery disease of dipyridamole perfusion scintigraphy were 68%, 83% while per vessel sensitivity and specificity for coronary artery disease were 66%, 97%. The numbers of induced chest pain and ischemic ST changes among hemodynamic subgroups, were 40%, 40% in group 0, 33%, 27% in group 1 and 50%, 40% in group 2 without significant difference in each hemodynamic subgroups. Either the numbers of diseased coronary arteries or the numbers of patients demonstrationg reversible scintigraphic defects were not statically different among each subgroups. CONCLUSION: Although the peripheral hemodynamic response dose not always correlate with its central coronary effect but dipyridamlole 99mTc-MIBI myocardial perfusion scintigraphy is an useful test for diagnosis of coronary artery disease.
Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis ; Dipyridamole* ; Electrocardiography ; Exercise Test ; Heart Rate ; Hemodynamics* ; Humans ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion Imaging ; Sensitivity and Specificity

High glucose activates protein kinase C, induces reactive oxygen species generation, and upregulates expression of transforming growth factor-beta1(TGF-beta1) and fibronectin by human peritoneal mesothelial cells(HPMC). High glucose also induces premature senescence in mesothelial cells. Mesothelial cells shrink after exposure to hypertonic medium and intracellular uptake of amino acids increase to ensure subsequent volume increase. Based on these observations, new and more biocompatible peritoneal dialysis solutions that are glucose free and/or iso-osmolar have been developed. We investigated the effects of different osmolality and different osmotic agents including glucose, mannitol, and icodextrin on viability and proliferation of HPMC. HPMC were obtained from the omental tissues of consenting patients undergoing Cesarean section or elective abdominal surgery. All experiments were performed using cells in the 2nd or 3rd passage. Near-confluent HPMC grown in culture dishes were incubated with serum-free medium for 48 hours to arrest and synchronize cell growth. Lactate dehydrogenase(LDH) release was measured for cell viability and [3H]-thymidine incorporation for proliferation of cultured HPMC, after exposing HPMC to different concentrations of glucose, mannitol, and icodextrin for up to 96 hours. High glucose and mannitol at concentrations up to 100 mM(375 mOsm) did not increase LDH release up to 96 hours compared to control M199. When HPMC were exposed to 2, 4, 7.5, and 9% of icodextrin for 24-96 hours, LDH release did not increase. Glucose at 30, 50, and 100 mM significantly inhibited [3H]-thymidine incorporation by HPMC at 24 and 48 hours. Mannitol at 30, 50, and 100 mM for 24 hours and at only 100 mM for 48 hours also significantly inhibited cell proliferation. Icodextrin 9% (305 mOsm) inhibited cell proliferation compared with control M-199 at 24 hours. In conclusion, high osmolality per se dose not appear to increase HPMC death. However, high osmolality appears to inhibit HPMC proliferation at early stage. In addition, high glucose appears to inhibit HPMC proliferation independent of osmolality since high glucose continues to inhibit cell proliferation at 48 and 72 hours when mannitol at the same concentration did not. Icodextrin 9% of which osmolality is 305 mOsm inhibits HPMC proliferation at early stage but does not appear to increase HPMC death.
Humans

Purpose: To confirm that the phaco chop method using an illuminated chopper (iChopper; Oculight, Seongnam, Korea) can reduce cataract surgery complications, and that even beginners can safely and effectively perform phaco chop. Methods: We retrospectively analyzed the medical records of the first 30 phaco chop cases using illuminated chopper of four cataract surgeons. Four ophthalmologists had a variety of empirical backgrounds, from those who have experienced more than 10,000 cataract surgery, to beginners who have experienced 20 cataract surgery. Results: Of the total 120 eyes, two eyes (1.67%) had posterior capsule rupture. The chopping method was changed from phaco chop to stop and chop in three eyes (2.5%) including one eye with brown cataract with pseudoexofoliation syndrome and two eyes with nuclear opacity grade ≥5. Conclusions The rates of posterior capsule rupture of phaco chop using an illuminated chopper were very low in four surgeons with various experiences and who became proficient shortly in phaco chop.

PURPOSE: This study was conducted in order to determine the most cost-effective strategy, in terms of interval and age range, for liver cancer screening in the high-risk population of Korea. MATERIALS AND METHODS: A stochastic model was used to simulate the cost-effectiveness of liver cancer screening by combined ultrasonography and alpha-fetoprotein testing when varying both screening intervals and age ranges. The effectiveness of these screening strategies in the high-risk population was defined as the probability of detecting preclinical liver cancer, and cost was based on the direct cost of the screening and confirmative tests. Optimal cost-effectiveness was determined using the incremental cost-effectiveness ratio. RESULTS: Among the 36 alternative strategies, one-year or two-year interval screening for men aged between 50 and 80 years, six-month or one-year interval screening for men aged between 40 and 80 years, and six-month interval screening for men aged between 30 and 80 years were identified as non-dominated strategies. For women, identified non-dominated strategies were: one-year interval screening between age 50 and 65 years, one-year or six-month interval screening between age 50 and 80 years, six-month interval screening between age 40 and 80 years, and six-month interval screening between age 30 and 80 years. CONCLUSION: In Korea, a one-year screening interval for men aged 50 to 80 years would be marginally cost-effective. Further studies should be conducted in order to evaluate effectiveness of liver cancer screening, and compare the cost effectiveness of different liver cancer screening programs with a final outcome indicator such as quality-adjusted life-years or disability-adjusted life-years.
Adult* ; alpha-Fetoproteins ; Cost-Benefit Analysis ; Female ; Humans ; Korea ; Liver Neoplasms* ; Male ; Mass Screening* ; Republic of Korea* ; Ultrasonography

A bleeding peptic ulcer is the most common cause of upper gastrointestinal bleeding as well as for hospitalization and death. Many endoscopic methods of treating bleeding peptic ulcers are currently being studied and developed. Among them, the endoscopic pure ethanol injection therapy is favored because of its high efficacy, low cost, and rapid administration. Pure ethanol is an excellent agent to stop bleeding and manifests itslef by inducing tissue dehydration, fixation and vessel compression, which in turn causes arterial coagulation and tissue necrosis. However, an excessive injection volume may bring about extensive mucosal necrosis; hence, caution should be taken when deciding upon the injection volume and depth. We report a case of extensive necrosis of the gastric mucosa following endoscopic ethanol injection therapy of a bleeding peptic ulcer along with a review of the relevant literature.
Dehydration ; Ethanol ; Gastric Mucosa ; Glycosaminoglycans ; Hemorrhage ; Hospitalization ; Necrosis ; Peptic Ulcer

PURPOSE: Rotavirus is an enteric pathogen that affects millions of children globally each year. But no specific therapy is available for the management of rotavirus diarrhea. Due to the clear need to define improved modality for treatment of rotavirus diarrhea, we evaluated the efficacy of anti- rotavirus IgY in the treatment of infants and children with gastroenteritis. METHODS: First, the amount of viral particle in the stools of thirteen patients (seven were given IgY, 6 placebo) infected by rotavirus were evaluated for 3 days with the quantitative RT-PCR method. Second, 36 children with known rotavirus infection identified by ELISA or semi-quantitative RT- PCR were evaluated. We gave 5 g anti-rotavirus egg yolk daily in two equally divided doses for 3 days to two groups (an 18 IgY group and an 18 placebo group), respectively after parenteral consent. Daily vomiting frequency, stool frequency, oral intake and urine output were monitored for 3 days, and electrolyte and blood chemistry were checked at the first and third days. RESULTS: First, in the placebo group, the amount of virus particles increased daily, but in the IgY group it decreased daily. Second, when IgY and placebos were given to children infected with rotavirus, diarrhea on the third day decreased significantly in the IgY group, compared with the placebo group. CONCLUSION: Treatment with antirotavirus immunoglobulin from immunized chicken's egg resulted in a decrease in the amount of viral particles in stools and diarrhea frequency in children. These results suggest that anti-rotavirus IgY is effective in the treatment of rotavirus gastroenteritis.
Infant ; Child ; Male ; Female ; Humans

Hamartomatous polyps in the stomach have been described as gastric lesions of familial polyposis coli or not associated with polyposis coli. However, submucosal tumor-like lesion of the gastric hamartoma is very rare. We have experienced an unusual hamartoma in the stomach in a 69-year-old man. He was hospitalized with epigastric discomfort. Endoscopy revealed a submucosal mass at the greater curvature of the high body of the stomach. The resected mass measured 3 X 2 X 1.5 cm and was characterized by cystic dilation of glandular structures. The glandular structures consisted of various types of lining cells, including surface foveolar cell types, pyloric cell types and parietal-like cells, and irregularly arranged smooth muscle bundles and collagen fibers were noted. We report this unusual gastric hamartoma presenting as a submucosal tumor with a review of literatures.
Adenomatous Polyposis Coli ; Aged ; Collagen ; Endoscopy ; Hamartoma* ; Humans ; Muscle, Smooth ; Polyps ; Stomach

The occurrence of papillary restenosis following endoscopic sphincterotomy is uncommon and usually reported as a late complication. Its frequency varies from 0.8% to 3% and at present, only a few reports describe the late complication rate for a mean follow-up exceeding 10 years. The diameter of the sphincterotomy opening diminishes by about 30% in the first year without further narrowing, suggesting that restenosis occurs mainly during the first post-sphincterotomy year. Papillary restenosis may be promoted by insufficient cutting and may depend on the indication for EST such as common bile duct stones, papillary stenosis, duodenal diverticular, sphincter of Oddi dysfunction. A bleeding sphincterotomy requiring a sclerosing injection is considered a potential risk factor for papillary stenosis. However, stenosis may develop in the absence of specific predisposing factors. A case of papillary restenosis following endoscopic sphincterotomy for gollstone pancreatitis in a 33-year-old female patient is herein reported.
Adult ; Causality ; Common Bile Duct ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Pancreatitis ; Risk Factors ; Sphincter of Oddi Dysfunction ; Sphincterotomy, Endoscopic

Although various endoscopic treatments, such as laser photocoagulation, electrocoagulation, heater probe, injection have been used for treatment of arteriovenous malformation (AVM), associated complications also have been reported. In order to avoid the complications, elastic band ligation has recently been used as an alternative method for endoscopic treatment of gastric AVM. A 58-year-old man was admitted due to hematemesis and melena. A gastroscopy revealed AVM with vessel exposure and active bleeding at the greater curvature of fundus, and we performed arteriography for emergency embolization, but, we do not find the bleeding vessel. Endoscopic band ligation therapy was performed as an alternative method for control of bleeding. 2 months later, follow-up endoscopy showed disappearance of AVM and no evidence of hemorrhage.
Angiography ; Arteriovenous Malformations* ; Electrocoagulation ; Emergencies ; Endoscopy ; Follow-Up Studies ; Gastroscopy ; Hematemesis ; Hemorrhage ; Humans ; Ligation* ; Light Coagulation ; Melena ; Middle Aged