PURPOSE: We conducted a study to determine which factors may be useful as predictive markers in identifying Kawasaki disease (KD) patients with a high risk of resistance to intravenous immunoglobulin (IVIG) and developing coronary artery lesions (CAL). METHODS: We enrolled 287 patients in acute phase of KD at a single center. The demographic, clinical and laboratory data were collected retrospectively. RESULTS: There were 34 patients in the IVIG resistant group. The IVIG resistant group had significantly higher serum N-terminal-pro-brain natriuretic protein (NT-proBNP) levels (P<0.01) and polymorphonuclear neutrophil (PMN) percentage (P<0.01) in comparison to the IVIG responders. The results yielded sensitivity (78.8%, 60.6%), specificity (58.2%, 90%) and cutoff value (628.6 pg/mL, 80.3%) of NT-proBNP and PMN respectively, in predicting IVIG resistance. Despite IVIG administration, 13 of the 287 patients developed CAL. The patients in the CAL group had higher NT-proBNP levels (P<0.01) and higher PMN percentage (P<0.01). In these patients, the results yielded sensitivity (73.3%, 56.7%), specificity (67.9%, 88.9%) and cutoff value (853.4 pg/mL, 80.3%) of NT-proBNP and PMN respectively, for predicting CAL. The area under the curve (AUC) for predicting resistance to IVIG was NT-proBNP 0.712, PMN 0.802. The AUC for predicting CAL was NT-proBNP 0.739, and PMN 0.773. CONCLUSION: Serum NT-proBNP levels and PMN percentage were significantly elevated in patients with KD with IVIG resistance and CAL. Thus, they may be useful predicting markers for IVIG resistance and development of CAL in KD patients.
Area Under Curve ; Coronary Vessels* ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils ; Retrospective Studies ; Sensitivity and Specificity

The propose of this study was to evaluate the difference of cellular activity dependent on intermittent compressive force by determining the alkaline phosphatase activity. Alkaline phosphatase activity was measured on control and experimental groups every 24, 48, 72hours. Experimental groups consisted of continous and intermittent compressive group which were compressed by 300g/cm2 of diaphram pump. The intermittent compressive group was connected by timer which was worked on 10 minutes an off 10 minutes. The results were as follows; 1. The alkaline phosphatase activity between control and experimental groups showed not significant difference at compressed 24 hours. 2. The alkaline phosphatase activity of experimental groups were more increased than control group at compressed 48 hours. 3. The alkaline phosphatase activity of intermittent compressive group showed significant increased to control group. Whereby continuous compressive group showed not significant difference to control at 72 hours. 4. The alkaline phosphatase activity of intermittent compressive group were stringly increased than continuous compressive groups. 5. Between experimental groups and control group no other morphologic changes were detected by microscopic findings.
Alkaline Phosphatase*

OBJECTIVE: This study was designed to investigate the efficacy in the combination of haloperidol and clonidine with chronic schizophrenia. Moreover, we evaluated the effects of clonidine to the plasma haolperidol and reduced haloperidol concentration 36 patiens were entered on 4 weeks by the double blind trial. METHOD: The patients (male=11, female=25) were randomly divided into two groups of eighteen patients each. Their antipsychotic medication was fixed for 2 weeks before double blind trial with haloperidol and clonidine or placebo. Clonidine was started at 0.15 mg/day and then raised 0.6mg/day during 4 days, and the placebo was applied by same method as clonidine. The clinical assessment of the patients was assessed with BPRS and NOSIE. The plasma concentrations of haloperidol and reduced haloperidol were measured by HPLC (UV detector). RESULTS: 1) There were no statistical differences in sex distribution, age, duration of illness, dosages of haloperidol, plasma concentration of haloperidol and reduced haloperidol of each groups before clonidine or placebo trial. 2) On total and subcluster scores of BPRS and total score of NOSIE, there were decreased tendencies over the time, but there was no statistical significance in both groups. 3) Plasma concentrations of haloperidol and reduced haloperidol after 4 weeks of clonidine trial were revealed statistically significant increasement as compared to baseline. CONCLUSION: The combination of haloperidol and clonidine for 4 weeks did not reveal the improvement. In our opinions the reasons of those results were that our samples were not made of paranoid type of schizophrenia, the duration of clonidine trial was not good enough. So we should suggest that more specifying design will be needed.
Chromatography, High Pressure Liquid ; Clonidine* ; Haloperidol* ; Humans ; Norepinephrine ; Plasma ; Schizophrenia* ; Sex Distribution

PURPOSE: Although subintimal angioplasty (SIA) has been advocated to treat chronic lower extremity arterial occlusions, numerous reports have described differences in its results. We evaluated the effect of SIA in a group of patients with severe lower extremity arterial occlusive disease. METHOD: During a 5-month period, 6 limbs in 4 patients with arterial occlusions (mean length, 17.7 cm; range, 9 to 27 cm) were treated with SIA. Three limbs had gangrene, and all patients had resting pain. There were two external iliac-superficial femoral, two superficial femoral-popliteal and two femoral-popliteal-tibial artery lesions. With fluoroscopic guidance, via an antegrade common femoral artery puncture, a subintimal dissection plane was created across the occlusion with standard hydrophilic guidewire and catheter. The arterial lumen was reentered distal to the occlusion, and the recanalized segment was balloon (3 to 6 mm) dilated. RESULT: SIA was technically successful in all 6 limbs (100%). Pain was completely resolved and all areas of gangrene were healed. The mean increase in ankle-brachial index after SIA was 0.51 (range, 0.25 to 0.71). There was no significant complication related with SIA and all arteries were patent during 3.6-months mean follow-up period. CONCLUSION: SIA for long occlusions of the crural arteries is safe and effective and can be an excellent alternative to reconstructive surgery in elderly and frail patients.
Aged ; Angioplasty* ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Catheters ; Extremities ; Femoral Artery ; Follow-Up Studies ; Gangrene ; Humans ; Lower Extremity* ; Punctures

Spontaneous intracerebral hemorrhage(ICH) is one of the most common neurosurgical disorders associated with high morbidity and mortality. However, the treatment of the disease remains controversial. While aggressive removal of the blood clot is advocated by some, supportive care without clot removal is recommended by others. This dichotomy in therapeutic approaches undoubtedly derives from a poor understanding of the pathophysiological mechanisms that result in brain injury following intracerebral hematoma. Thus, effective animal model of intracerebral hematoma is necessary so that the injury mechanisms can be identified and the specific therapy developed. In an attempt to establish the highly reliable and reproducible experimental model of intracerebral hematoma, various amount(sham. 25microliter, 50microliter and 100microliter) of autologous blood was injected stereotactically into the left basal ganglia of the anesthetized rats. 16 Sprague-Dawley rats were divided into 4 groups. The sham operation and injections of 25microliter, 50microliter and 100microliter of autologous arterial blood were performed on each group. The animals were assessed for the size and pattern of the hematoma and the neurological outcome at 24 hours after the formation of intracerebral hematomas. The 25microliter-injection group showed the more reproducible size and shape of the hematoma confined to the basal ganglia with better neurological outcome, Additionally, the perihematomal ischemic zone was observed after intracardiac perfusion with 2% 2,3,5-triphenyltetrazolium chloride(TTC). Another 18 rats were assessed for the histopathological changes during the hyperacute stage of the intracerebral hematoma with Hematoxylin-Eosin staining. Finally another 24 rats were divided into 6 groups and injected with 25microliter of blood. They underwent intravenous infusion of Evans blue and were sacrificed at 1, 3, 6, 12, 24 and 72 hours after the formation intracerebral hematomas. The Evans blue extra asation was noted around the needle tract and hematoma that meant disruption of the blood-brain barrier. Significant increment of the water content with resultant brain edema was noted on the ipsilateral brain 6-12 hours after the formation of the intracerebral hematoma.
Animals ; Basal Ganglia ; Blood-Brain Barrier ; Brain ; Brain Edema ; Brain Injuries ; Evans Blue ; Hematoma* ; Infusions, Intravenous ; Models, Animal ; Models, Theoretical* ; Mortality ; Needles ; Perfusion ; Rats* ; Rats, Sprague-Dawley

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax

PURPOSE: To investigate whether the result of RigiScan after intracorporeal injection could predict the result of duplex ultrasonography, and determine the necessity of duplex ultrasonography. MATERIALS AND METHODS: We performed both RigiScan and duplex ultrasonography after intracorporeal injection in 18 men with erectile dysfunction. All of the patients were evaluated by history taking, physical examination, laboratory test, hormonal tests, and neurologic examination before RigiScan and duplex ultrasonography. We measured maximal arterial diameter, peak systolic velocity, end-diastolic velocity using a 7 MHz. color Doppler unit and these results of duplex ultrasonography were compared with penile rigidity and tumescence measured by RigiScan. RESULTS: The positive and negative predictive value of RigiScan were 81.8% and 85.7%, respectively. The result of RigiScan was comparable with that of duplex ultrasonography and the accuracy of RigiScan was resonable. CONCLUSIONS: According to this results, duplex ultrasonography was needed if the response of RigiScan is abnormal after intracorporeal injection. However, duplex ultrasonography can be ommitted if the response of RigiScan is normal after intracorporeal injection.
Erectile Dysfunction ; Humans ; Male ; Mass Screening* ; Neurologic Examination ; Physical Examination ; Ultrasonography*

OBJECTIVE: To determine the relationships among the grade of cervical pathology, HPV infection status, p16 expression, and p53 expression in cervical neoplasia. METHODS: From July of 2002 to June of 2003, authors did HPV typing with HPV Oligonucleotide Microarray DNA Chip (Biomed, Seoul, Korea), p16 and p53 immunochemical staining in cervical tissues obtained from conization or hysterectomy RESULTS: 41 patients were enrolled in this study. There were 16 normal (WNL) patients, 9 CIN patients, 8 microinvasive cancer (MIC) patients, and 8 invasive cervical cancer (ICC) patients. The HPV infection rate in WNL, CIN, MIC and ICC were 0%, 100%, 50% and 50% retrospectively. The expression rate of p16 was 13% in WNL, 67% in CIN, 50% in MIC and 100% in ICC. That of p53 was 0% in WNL, 67% in CIN, 75% in MIC and 100% in ICC. With regard to p16 staining in HPV negative cases, negative staining was 67%, weakly positive was 13% and strongly positive was 21%. But in HPV-infected cases, negative staining of p16 was 29%, weakly positive was 53% and strongly positive was 18%. With regard to p53 staining in HPV negative cases, without HPV infection, negative staining was 62%, weakly positive was 33% and strongly positive was 4%. But in HPV infected cased, negative staining of p53 was 18%, weakly positive was 53% and strongly positive was 29%. Finally, in p16 negative cases, negative staining of p53 was 62%, weakly positive was 38% and strongly positive was 0%. But in p16 weakly positive cases, with weakly positive p16, negative staining of p53 was 33%, weakly positive was 42%, and strongly positive was 25%. In p16 strongly positive cases, negative staining of p53 was 13%, weakly positive was 50% and strongly positive was 38%. CONCLUSION: There were significant associations among grades of cervical pathology, HPV infection, p16 and p53 expression. Thus there might be some possibilities that expression of p16 and p53 induced by E7 and E6 proteins of HPV can impact on the tumorigenesis.
Carcinogenesis ; Conization ; Humans ; Hysterectomy ; Negative Staining ; Oligonucleotide Array Sequence Analysis ; Pathology ; Retrospective Studies ; Seoul ; Uterine Cervical Neoplasms

Gastrointestinal complications of diabetes mellitus include diarrhea, constipation, small bowel bacterial overgrowth, and gastropathy. Diabetic gastropathy is well-described motility disorder probably caused by an automatic neuropathy of the upper gastrointestinal tract. Diabetic gastropathy is rarely discrbed in pregnant women. We have experienced two cases of diabetic gastropathy in pregnant diabetic women. We report these cases with a review of literatures.
Constipation ; Diabetes Complications ; Diabetes Mellitus ; Diarrhea ; Female ; Humans ; Pregnant Women ; Upper Gastrointestinal Tract

The inhibitory effects of Asparagus cochinchinensis against inflammatory response induced by lipopolysaccharide (LPS), substance P and phthalic anhydride (PA) treatment were recently reported for some cell lines and animal models. To evaluate the hepatotoxicity and nephrotoxicity of A. cochinchinensis toward the livers and kidneys of ICR mice, alterations in related markers including body weight, organ weight, urine composition, liver pathology and kidney pathology were analyzed in male and female ICR mice after oral administration of 150, 300 and 600 mg/kg body weight/day saponin-enriched extract of A. cochinchinensis (SEAC) for 14 days. The saponin, total flavonoid and total phenol levels were found to be 57.2, 88.5 and 102.1 mg/g in SEAC, respectively, and the scavenging activity of SEAC gradually increased in a dose-dependent manner. Moreover, body and organ weight, clinical phenotypes, urine parameters and mice mortality did not differ between the vehicle and SEAC treated group. Furthermore, no significant alterations were measured in alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), blood urea nitrogen (BUN) and the serum creatinine (Cr) in the SEAC treated group relative to the vehicle treated group. Moreover, the specific pathological features induced by most toxic compounds were not observed upon liver and kidney histological analysis. Overall, the results of the present study suggest that SEAC does not induce any specific toxicity in the livers and kidneys of male and female ICR mice at doses of 600 mg/kg body weight/day.
Administration, Oral ; Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartate Aminotransferases ; Blood Urea Nitrogen ; Body Weight ; Cell Line ; Creatinine ; Female ; Humans ; Kidney ; L-Lactate Dehydrogenase ; Liver ; Male ; Mice ; Mice, Inbred ICR* ; Models, Animal ; Mortality ; Organ Size ; Pathology ; Phenol ; Phenotype ; Saponins ; Substance P