The antiarrhythmic effect of oral Mexiletine was evaluated by Holter monitoring on 10 subjects with chronic high-frequency ventricular premature complexes and ventricular tachycardia referred to our cardiology clinic of Severance Hospital from June, 1982 through September, 1983. The frequency of the ventricular premature complexes and the ventricular tachycardia was measured by 24-hour ambulatory electrocardiography on each patient before and during the administration of Mexiletine(450-600 mg/day). The results were as follows : 1) In 10 patients with ventricular tachycardia total suppression of ventricular tachycardial was demonstrated in 8 patients during the administration of oral Mexilletine. 2) The number of the ventricular premature complexes was reduced markedly in 6 out of the 10 patients. 3) Side effects occurred in 5 out of 10 patients. These include tremor, weakness, dry mouth, indigestion, anorexia, chest discomfort, and dizziness but were tolerated except in one.
Anorexia ; Arrhythmias, Cardiac* ; Cardiology ; Dizziness ; Dyspepsia ; Electrocardiography, Ambulatory* ; Humans ; Mexiletine* ; Mouth ; Tachycardia, Ventricular ; Thorax ; Tremor ; Ventricular Premature Complexes

The Dichloromethane(methylene chloride) is a highly volatile liquid used as a solvent, extraction medium, and paint remover. The most significant route of intoxication to dichloromethane is generally inhalation at work site or home, but ingestion is rare. The main toxicological harvard insults from in vivo conversion of dichloromethane to carbon monoxide. We present a case of dichloromethane intoxication following ingestion. A 71 years old male patient ingested 60-70cc of dichloromethane was brought to emergency department after stomach washout via nasogastric tube at other hospital. On arrival at emergency department(approximately 19 hours after ingestion), he was stuporous with a blood pressure 140/90mmHg, heart rate of 92 beats/min, dyspneic, respiratory rate of 24/min and body temperature 36.8 degrees C. His Pupils were isocoric, miotic, and sluggishly reactive. There were mucosal bums and significant secretion in oral cavity. On auscultation, breathing sound was coarse without role on both lung field. The COHb levels were 6.3%at 32 hours after ingestion and normalized to 0.6%at 44 hours after ingestion. Patient was transfered to intensive care unit and supportive care was started with 100% oxygen. On ingestion 4th day, chest X-ray showed pulmonary edema and acute respiratory distress syndrome developed. Patient regained the consciousness on the 11th day. On the 30th day, respiratory function improved and the ventilator was removed. Alveolitis and mild pulmonary fibrosis developed and mild dyspnea was continued. On the 36th day, gastroscopic examinations showed ulceration of esophagus and stomach. On the 76th day, patient was discharged after pulmonary rehabilitation.
Aged ; Auscultation ; Blood Pressure ; Body Temperature ; Carbon Monoxide ; Consciousness ; Dyspnea ; Eating* ; Emergencies ; Emergency Service, Hospital ; Esophagus ; Heart Rate ; Humans ; Inhalation ; Intensive Care Units ; Lung ; Male ; Methylene Chloride* ; Mouth ; Oxygen ; Paint ; Pulmonary Edema ; Pulmonary Fibrosis ; Pupil ; Rehabilitation ; Respiratory Distress Syndrome, Adult ; Respiratory Rate ; Respiratory Sounds ; Stomach ; Stupor ; Thorax ; Ulcer ; Ventilators, Mechanical ; Workplace

No abstract available.

No abstract available.
Apoptosis* ; Prostate* ; Prostatic Hyperplasia* ; Prostatic Neoplasms* ; Proto-Oncogene Proteins c-myc*

No abstract available.

Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) are weakly expressed in normal glomerular cells and vascular endothelial cells, but not in tubules. Granzyme B is a cytotoxic granule present in activated cytotoxic T cells and natural killer cells. To determine the effect of ICAM-1 and VCAM-1 expression and granzyme B-positive cells on histologic grade of rejection, we performed the immunohistochemical study on 19 renal biopsy specimens and one nephrectomy specimen from 14 patients with acute renal allograft rejection using monoclonal antibodies against theses proteins. According to severity of rejection based on Banff classification, three biopsies were classified as borderline, 4 grade I, 12 grade II, and 1 grade III. In all the cases with acute rejection, ICAM-1 and VCAM-1 were expressed in the tubular epithelial cells. The numerical score of ICAM-1 in the tubular epithelial cells was 1.0 in borderline cases, 1.3 0.4 in grade I cases, 2.2 0.8 in grade II cases, and 3.0 in grade III case. The staining intensity of ICAM-1 in the tubular epithelial cells was increased in accordance with histologic rejection grade (P<0.05). The staining intensity of ICAM-1 and VCAM-1 in the renal tubular epithelial cells was increased in accordance with the number of T lymphocytes in the renal parenchyme (r=0.46; P<0.05, r=0.61; P<0.01). The number of granzyme B-positive cells was 6.4 1.6/HPF in borderline cases, 8.1 2.5 in grade I cases, 19.6 11.7 in grade II cases, and 53 in grade III case. The number of T lymphocytes and granzyme B-positive cells was also increased in accordance with histologic rejection grade (P<0.05). These results suggest that ICAM-1 and granzyme B-positive cells may play an important role in the induction of renal allograft rejection and that the grading of severity of these parameters may be useful to predict the prognosis of renal allograft.
Allografts* ; Antibodies, Monoclonal ; Biopsy ; Classification ; Endothelial Cells ; Epithelial Cells ; Granzymes* ; Humans ; Intercellular Adhesion Molecule-1 ; Killer Cells, Natural ; Nephrectomy ; Prognosis ; T-Lymphocytes ; Vascular Cell Adhesion Molecule-1

Pachydermoperiostosis (idiopathic hypertrophic osteoarthropathy) ia an unusual syndrome of familial nature and characterized by clubbing of the digits, periosteal new bone formation especially over the distal ends of the long bones, and coarsening of the facial features with thickening and furrowing of the skin of the face and forehead. The case of a 46 year old male exhibiting the above characteristics is reported, The same tendencies were exhibited by his father before him. A review of literature is included.
Fathers ; Forehead ; Humans ; Male ; Osteoarthropathy, Primary Hypertrophic ; Osteogenesis ; Skin

No abstract available.
Borrelia burgdorferi* ; Borrelia* ; Ixodes* ; Korea* ; Lyme Disease* ; Ticks*

Purpose: Paclitaxel, on systemic administration, is widely known to be effective in the treatment of bladder cancer. However, the intravesical use of paclitaxel has not been attempted because of its liposolubility and direct toxicity to the bladder mucosa. The purpose of this study was to evaluate the efficacy and toxicity of paclitaxel-loaded glyceryl monooleate (GMO) in the intravesical treatment of superficial bladder cancer, by enhancing its bioadhesiveness and bioavailability. Materials and Methods: 12 mice were divided into two groups, and bladder carcinomas induced by the addition of 0.05% BBN to their drinking water for 12 weeks. Group 1 received an intravesical instillation of 0.1ml GMO-paclitaxel-free buffer and Group 2 an intravesical instillation of 0.1ml GMO-paclitaxel. On day 21, the tumor incidence, bladder weight and toxicity were evaluated. Results: The incidence of cancer in groups 1 and 2 were 83 and 17%, respectively. The incidence of cancer was significantly reduced in group 2 compared to group 1 (p<0.05). There was a tendency for the average bladder weight in group 1 to be heavier than that in group 2, but there was no significant difference (p=0.375). There were no liver, kidney or bone marrow toxicities in either group. Conclusions: Intravesical GMO-paclitaxel therapy may have an inhibitory effect on the growth of superficial bladder cancer in a BBN-induced bladder cancer model; therefore, it could potentially be used in those patients showing little to no response to intravesical Bacillus Calmette- Guerin (BCG) or other anticancer drug therapies.
Administration, Intravesical ; Animals ; Bacillus ; Biological Availability ; Bone Marrow ; Carcinoma, Transitional Cell* ; Drinking Water ; Drug Therapy ; Humans ; Incidence ; Kidney ; Liver ; Mice ; Mucous Membrane ; Paclitaxel ; Urinary Bladder ; Urinary Bladder Neoplasms

BACKGROUND: Aprotinin, which is a nonspecific serine protease inhibitor, has an antiinflammatory and thrombogenic effect. However, it has an antithrombogenic effect during the cardiopulmonary bypass. This study was performed to evaluated the effects of aprotinin on the activated clotting time(ACT) and the total amount of the heparin used during the cardiopulmonary bypass. MATERIAL AND METHOD: From December 1998 to November 1999, 82 consecutive patients electively underwent open heart surgery at Gachon medical school. The patients were older than 18 years. Eighty two patients were classified into a control group(group C, n=36) and a aprotinin-treated group(group A, n=46). Body weight, height, body surface area(BSA), pump time(PT), aortic cross clamping time(ACCT), and body temperature(BT) were determined. Total amount of heparin and protamine during the CPB were also measured. ACT was determined before heparin administration, at 20, 40 and 60 minutes after heparin administration, and after protamine administration. RESULT: No significant differences were noted in either group in body weight, height, BSA, BT, and the total amoun of heparin and protamine. Group A demonstrated a significant(p<0.05) increase in age, PT, ACCT, and ACT at 20, 40, and 60 minutes after heparin administration. CONCLUSION: In summary, the use of aprotinin prime resulted in an increase in ACT. The total amount of heparin in aproinin-treated patient was similar to that of the control group in spite of having the prolonged pump time. Therefore aprotinin may reduce the requirement of heparin.
Aprotinin* ; Body Height ; Body Weight ; Cardiopulmonary Bypass ; Constriction ; Heart* ; Heparin* ; Humans ; Schools, Medical ; Serine Proteases ; Thoracic Surgery*