No abstract available.
Congenital Hypothyroidism*

No abstract available.
Adenocarcinoma* ; Female* ; Humans ; Urethra*

BACKGROUND: There are many factors such as diffusion abnormality, V/Q mismatch, intrapulmonary shunt, alveolar hypoventilation and FIO2 in reducing arterial hypoxemia. Intrapulmonary shunting can be due to blood going from the right to the left side of the heart without respiring with alveolar gas(true shunt mechanism) or blood that respires but achieves a PaO2 less than the ideal (shunt effect mechanism). Understanding the portion of true shunt in patients with hypoxemia is very important indicator to analyze the effects of oxygen therapy. Several equations are used for calculation of physiologic shunt. The aim of this study was to calculate and compare shunts derived from four shunt equations; classic physiologic, estimated, modified clinical and simple equations. METHOD: After cardiovascular stability following open heart surgery, 40 patients were mechanically ventilated with an FIO2=1.0. Arterial and mixed blood gases were measured. We calculated and compared shunts by classic physiologic [S/T=(CcO2 CaO2)/(CcO2 CO2)], estimated [S/T=(CcO2 CaO2)/ (3.5 CcO2 CO2)], modified clinical [S/T= AaDO2 0.0031/(AaDO2 0.0031 CcO2 CaO2)], and simple equations [S/T=AaDO2/20]/ RESULTS: Shunts by classic physiologic, estimated, and modified clinical shunt equation were 26.9 8.5%, 25.1 7.1%, and 26.3 8.2%, respectively and did not differ one another significantly. Shunts by simple shunt equations was 18.8 6.2% and significantly lower than those by other 3 equations(P<0.05). CONCLUSIONS: It is reasonable to conclude that in post-open heart patients with stable cardiovascular function and mechanically ventilated with an FIO2=1.0, classic physiologic, estimated, and modified clinical shunt equations show a reliable reflection of the physiologic shunt. But simple equation (AaDO2/20) might be used as a simple estimate.
Anoxia ; Diffusion ; Gases ; Heart ; Humans ; Hypoventilation ; Oxygen ; Thoracic Surgery

ST-elevation myocardial infarction (STEMI) caused by an acute aortic dissection is relatively rare. A diagnosis of dissection can be missed and the situation can become complicated. We report a patient who presented with acute aortic dissection responsible for STEMI related to a dissecting flap into the right coronary artery. This case emphasizes the need for careful assessment of the aorta in cases of atypical coronary occlusion in patients with STEMI without evidence of atherosclerosis in non-culprit coronary segments. The patient was discharged 7 days after primary percutaneous intervention for STEMI. However, she revisited the emergency department for recurrent chest pain and aortic dissection and was diagnosed and managed successfully with surgery.
Aorta ; Atherosclerosis ; Chest Pain ; Coronary Occlusion* ; Coronary Vessels ; Diagnosis ; Emergencies ; General Surgery ; Humans ; Masks* ; Myocardial Infarction* ; Myocardial Revascularization

ST-elevation myocardial infarction (STEMI) caused by an acute aortic dissection is relatively rare. A diagnosis of dissection can be missed and the situation can become complicated. We report a patient who presented with acute aortic dissection responsible for STEMI related to a dissecting flap into the right coronary artery. This case emphasizes the need for careful assessment of the aorta in cases of atypical coronary occlusion in patients with STEMI without evidence of atherosclerosis in non-culprit coronary segments. The patient was discharged 7 days after primary percutaneous intervention for STEMI. However, she revisited the emergency department for recurrent chest pain and aortic dissection and was diagnosed and managed successfully with surgery.
Aorta ; Atherosclerosis ; Chest Pain ; Coronary Occlusion* ; Coronary Vessels ; Diagnosis ; Emergencies ; General Surgery ; Humans ; Masks* ; Myocardial Infarction* ; Myocardial Revascularization

BACKGROUND: Prader-Willi syndrome (PWS) is a congenital disorder, which is clinically characterized by a short stature, muscular hypotonia, hypogonadism, mental retardation and hyperphagia, leading to early childhood obesity. Impaired growth hormone (GH) secretion, hypogonadism, and obesity are common in patients with PWS. The purpose of this study was to find the effects of growth hormone treatment in patients with PWS. METHODS: Six patients with PWS confirmed by a genetic study were recruited, and treated with growth hormone(Eutropin(R))(0.8-1 IU/kg/week) divided into five or seven day doses per week for six months. The heights and weights of the subjects were evaluated. GH status were evaluated using the serum insulin-like growth factor (IGF)-I level, the L-dopa test, and insulin-induced hypoglycemia tess. Glucose metabolism was evaluated using the random serum glucose and HbA1c levels. RESULTS: GH was found to be deficient in 2 out of 6 subjects by the insulin test, in 3 out of 6 by the IGF-I level, and in 5 out of in 5 by the L-dopa test. After six months of GH treatment, the height percentile was increased and weight percentile decreased. The serum glucose and HbA1c levels remained unchanged. CONCLUSION: Six months of GH treatment in patients with PWS improved the height and degree of obesity. This study has shown the beneficial effects of GH treatment for patients with PWS, and without significant side effects.
Blood Glucose ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Glucose ; Growth Hormone* ; Humans ; Hyperphagia ; Hypoglycemia ; Hypogonadism ; Insulin ; Insulin-Like Growth Factor I ; Intellectual Disability ; Levodopa ; Metabolism ; Muscle Hypotonia ; Obesity ; Pediatric Obesity ; Prader-Willi Syndrome* ; Weights and Measures

ST-elevation myocardial infarction (STEMI) involving multivessel coronary arteries is extremely rare. Consecutive STEMI in a nonculprit vessel during primary percutaneous coronary intervention (PCI) of the culprit vessel has not been reported. A 53-year-old male presented to the emergency department with anterior wall STEMI. Just after successful primary PCI of the left anterior descending artery, inferior wall STEMI developed. PCI of the right coronary arteries was performed successfully. Five days later, the patient was discharged without symptoms of heart failure. This case underlines the high thrombogenicity along the coronary arteries in patients with STEMI.
Arteries ; Coronary Vessels ; Emergency Service, Hospital ; Heart Failure ; Humans ; Male ; Middle Aged ; Myocardial Infarction* ; Percutaneous Coronary Intervention*

Although previous studies revealed the association of physical activity with mortality rate, it is unclear whether there is a linear trend between physical activity and mortality rate. In this study, the association of physical activity with the risk of all-cause mortality was analysed using Cox's proportional hazard model for a cohort of 14,204 healthy Korean men aged 40-59 years followed up for 4 years(Jan. 1993 - Dec. 1996). Physical activity and other life style were surveyed by a postal questionnaire in December 1992. Total of 14,204 subjects were grouped into quartiles by physical activity. Using death certificate data, 123 deaths were identified. The second most active quartile had a lowest mortality rate with relative risk of 0.44(95% C.I.: 0.23-0.84) compared with most sedentary quartile, showing a J-shape pattern of physical activity-mortality curve. By examining the difference in proportion of cause of the death between most active quartile and the other quartiles, there was no significant difference of proportional mortality from cardiovascular deaths, cerebrovascular deaths or deaths from trauma. The covariates were stratified into two group between which the trend of RR was compared to test the effect modification. There was no remarkable effect modification by alcohol intake, smoking, body mass index, calorie consumption, percent fat consumption. In conclusion, moderate activity was found to have more protective effect on all-cause mortality than vigorous activity and that the J-shape pattern of physical activity-mortality curve was not due to the difference of mortality pattern or effect modification by alcohol intake, smoking, body mass index, calorie consumption and percent fat consumption.
Body Mass Index ; Cohort Studies* ; Death Certificates ; Humans ; Life Style ; Male ; Mortality* ; Motor Activity* ; Proportional Hazards Models ; Surveys and Questionnaires ; Seoul* ; Smoke ; Smoking

The involvement of NF-kappaB binding activity is known to be important in the mechanism of acute liver injury and in the induction of cyclooxygenase (COX-2). This study was performed to evaluate NF-kappaB binding activity and the expression of COX-2 in chronic liver injury induced by carbon tetrachloride (betaCCI(4)). Liver tissues from Sprague - Dawley rats were collected at 1, 3, 5, and 7th week after intraperitoneal injection of 0.1 mL of betaCCI(4)/100 g body weight twice a week. Reactive oxy-gen species (ROS) were measured in the postmitochondrial fraction by dichlorofluorescein formation with a fluorescent probe. An electrophoretic mobility shift assay was performed for NF-kappaB binding activity. Western blot was performed to measure the level of COX-1, COX-2, p65, p50, and I B proteins. ROS and NF-kappaB activity increased during the CCl4-induced chronic liver injury. The expression of nuclear p65 protein and p50 protein increased compared with that of the control, while the cytoplasmic I B protein decreased as the inflammation persisted. The expression of COX-2 in betaCCI(4)-treated rat liver increased compared with that of the control. It could be suggested that ROS produced by betaCCI(4) treatment increased NF-kappaB binding activity and thereby COX-2 expression, and these might be implicated in the progress of chronic liver damage.
Animals ; Biological Transport ; Carbon Tetrachloride/administration & dosage/*adverse effects ; Carbon Tetrachloride Poisoning/*metabolism/pathology ; Cell Nucleus/metabolism ; Cyclooxygenase 1 ; Cyclooxygenase 2 ; Cytoplasm/metabolism ; I-kappa B Proteins/biosynthesis ; Isoenzymes/*biosynthesis ; Liver/drug effects/*injuries/pathology ; Membrane Proteins ; NF-kappa B/antagonists & inhibitors/*metabolism ; NF-kappa B p50 Subunit ; Prostaglandin-Endoperoxide Synthases/*biosynthesis ; Protein Binding ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Transcription Factor RelA

BACKGROUND: Osteogenesis imperfecta (OI) is a congenital disorder of type I collagen, with variable phenotypes, due to increased bone fragility and low bone mass. Previous pharmacological treatments for OI have been attempted with calcitonin and growth hormone but with little beneficial effects. Recently, Glorieux reported the beneficial effects of bisphosphonates in OI. METHODS: In this study, the effects of pamidronate treatment were evaluated in 9 patients with OI. All patients received intravenous pamidronate infusions, which was dose adjusted according to the patients' age. The outcome measures included the biochemical bone markers; serum alkaline phosphatase, urine deoxy-pyridinoline, urine Ca/Cr ratio, and bone mineral density (BMD). RESULTS: Serum alkaline phosphatase, urine deoxypyridinoline, and urine Ca/Cr ratio were slightly decreased after 1 year of therapy, although these changes were not statistically significant. The BMDs of the lumbar spine and proximal femur were significantly increased after 1-year of pamidronate treatment. No fractures were reported during the 1 year treatment periods. CONCLUSION: Pamidronate treatment had an effect on the BMD in osteogenesis imperfecta, probably due to decreasing bone resorption
Alkaline Phosphatase ; Bone Density ; Bone Resorption ; Calcitonin ; Collagen Type I ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Diphosphonates ; Femur ; Growth Hormone ; Humans ; Osteogenesis Imperfecta* ; Osteogenesis* ; Outcome Assessment (Health Care) ; Phenotype ; Spine