No abstract available.
Lung*

Femorofemoral bypass was chosen as a primary(n=71) and redo (n=7) procedures for 78 patients with unilateral iliac artery occlusive disease during the period of 4 and a half years at the Department of Surgery, Kyungpook National University Hospital. The patients were categorized into 3 groups according to the patency of the superficial femoral artery on the recipient-side leg and the performance of concomitant leg arterial bypass: Group I (n=34), patent superficial femoral artery (SFA); Group II (n=19), occluded SFA left untreated; Group III (n=25), occluded SFA treated with leg arterial bypass. Adjuvant procedures during the femorofemoral bypasses included 16 femoral endarterectomies, 5 donor-side iliofemoral interposition grafts, and 4 donor-side iliac balloon angioplasties. The primary cumulative patency rates for all femorofemoral bypasses at 1, 2, 3, and 4 years were 96.3%, 84.7%, 84.7%, and 74.2%, respectively calculated by the life table method. The primary patency rates were 90.0%, 62.9%, 62.9%, 62.9% in Group II and 95.7%, 89.5%, 89.5%, 89.5% in Group III at 1, 2, 3, and 4 years after bypass grafting. The statistical analysis with log rank test to compare the patency rates between Group II and III revealed no significant (p=0.2425) differences. In summary, femorofemoral bypass was a durable bypass procedure for the patients with unilateral iliac artery occlusion. Further follow-up is required to confirm the effects of concomitant leg arterial bypass to the patency of femorofemoral bypass.
Angioplasty ; Endarterectomy ; Femoral Artery ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Iliac Artery ; Leg ; Life Tables ; Transplants

No abstract available.
Animals ; Glycogen Synthase ; Glycogen ; Insulin ; Rats

No abstract available.
Physiology* ; Prognosis* ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Insufficiency*

Peptic ulcer (PU) bleeding is the main cause of non-variceal gastrointestinal bleeding. Negative outcomes include re-bleeding and death, and many of the deaths are associated with decompensation of coexisting medical conditions precipitated by acute bleeding event. Accurate analysis of risk for clinical features can help physician to decide treatment modality. Endoscopy can detect bleeding stigmata and perform therapeutic hemostasis. Proton pump inhibitor (PPI) compared with placebo or H2RA reduces mortality following PU bleeding among patients with high-risk endoscopic findings, and reduces re-bleeding rates and surgical intervention. PPI treatment initiated prior to endoscopy in upper gastrointestinal (UGI) bleeding significantly reduces the proportion of patients with stigmata of recent hemorrhage (SRH) at index endoscopy but does not reduce mortality, re-bleeding or the need for surgery. The strategy of giving oral PPI before and after endoscopy, with endoscopic hemostasis for those with major SRH, is likely to be the most cost-effective. The treatment of H. pyori infection was found to be more effective than anti-secretory therapy in preventing recurrent bleeding from PU. H. pyori eradication alone and eradication followed by misoprostol (with switch to PPI, if misoprostol is not tolerated) are the two most cost-effective strategies to prevent ulcer bleeding among H. pyori-infected NSAID users, although the data cannot exclude PPIs also being cost-effective treatment. This review focuses specifically on the current treatment of patients with acute bleeding from a peptic ulcer.
Anti-Ulcer Agents/therapeutic use ; Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/diagnosis ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Hemostasis, Endoscopic ; Humans ; Misoprostol/therapeutic use ; Peptic Ulcer/surgery/*therapy ; Peptic Ulcer Hemorrhage/surgery/*therapy ; Proton Pump Inhibitors/therapeutic use

BACKGROUND: Rapid adrenocorticotropin (ACTH) stimulation test using 250ug of ACTH (1-24) has been used as a standard test in the initial assessment of adrenal function. However, it has recently been suggested that a rnaximal cortisol response can be achieved with a much lower ACTH dose, and reducing the dose might further enhance the sensitivity of the test in the detection of mild adrenal insufficiency. This study was performed to evaluate the role of low-dose (lug) ACTH stimulation test in the assessment of adrenal function and the diagnosis of subtle adrenal insufficiency. METHODS: Twenty-two subjects with suspected adrenal insufficiency due to long-term corticosteroid use were included in this study. The correlations between clinical features and the serum cortisol responses to low dose (lug) and high dose (250 ug) ACTH stimulation were evaluated. RESULTS: In high dose test, 10 (67%) out of 15 subjects with clinical features of adrenal insufficiency showed decreased serum cortisol response (peak cortisol level <18 ug/dL), but 5 (33%) subjects showed normal response (peak cortisol level > 18ug/dL). On the other hand, 14 (93%) subjects with clinical features of adrenal insufficiency showed decreased serum cortisol response in low dose test, while only one showed normal response. In 7 subjects without clinical features of adrenal insufficiency, 5 subject (71%) showed normal response, and 2 subjects (29%) showed decreased response in both low and high dose tests. CONCLUSION: These results suggest that the 1-ug low dose ACTH stimulation test might be more sensitive than conventional 250-ug test in the detection of mild adrenal insufficiency. Further studies are needed to determine the optimal dose of ACTH and the criteria for normal response to ACTH stimulation.
Adrenal Insufficiency* ; Adrenocorticotropic Hormone* ; Cosyntropin ; Diagnosis* ; Hand ; Hydrocortisone

BACKGROUND: Atopic diseases have been increasing according to changes in life style and indoor environments. Atopic rhinitis is a prevalent atopic disease in children, but the prevalence has been reported differently according to geographic areas. OBJECTIVE: This study was conducted to elucidate the prevalence of childhood atopic rhinitis and to identify the distribution of causative allergens in total children living in rural areas of Cheju island. METHOD: A total of 7,145 subjects aged 7-15 years in South Cheju County was recruited in this study. They responded to an ISAAC questionnaire and underwent allergy skin prick test with common aeroallergens. Chronic rhinitis was positive in this respect if subjects experienced two or more rhinitis symptoms such as sneezing, runny nose, itchy nose and nasal blockage, which were not related to the common cold. Atopy was regarded as positive when the wheal caused by one or more of the common allergens was the same or larger than that caused by histamine. RESULTS: The prevalence of chronic rhinitis was 10.5%. The prevalence of chronic rhinitis was the same between girls and boys, but higher as the ages of the subjects were older (7-9 years: 7.7%; 10-12: 10.6%; 13-15: 12.3%, p< 0.001). The atopy rate was 59.7%, meaning that the prevalence of atopic rhinitis was 6.2% and non-atopic rhinitis 4.2%. The common sensitizing allergens in decreasing order were Dermatophagoides pteronyssinus (40.4%), D. farinae (36.3%), citrus red mite (16.4%), cockroach (14.4%), outdoor Fungi (9.8%), Hop Japanese (5.6%) and Japanese cedar (4.5%) pollens. CONCLUSION: The prevalence of atopic rhinitis was 6.2% and the causative allergens such as citrus red mite and Japanese cedar pollen were different from the Korean mainland area.
Allergens* ; Asian Continental Ancestry Group ; Child* ; Citrus ; Cockroaches ; Common Cold ; Cryptomeria ; Dermatophagoides pteronyssinus ; Female ; Fungi ; Histamine ; Humans ; Humulus ; Hypersensitivity ; Jeju-do* ; Life Style ; Mites ; Nasal Obstruction ; Nose ; Pollen ; Prevalence* ; Rhinitis* ; Skin ; Sneezing ; Surveys and Questionnaires

BACKGROUND: The pattern of left ventricular filling as depicted by Doppler echocardiographic transmitrial flow velocities has been used to left ventricular diastolic properties. Especially, altered transmitral flow by abnormal myocardial wall motion and left ventricular function in ischemic heart disease, was predicted during exercise test. METHODS: To determine the effects of exercise on Doppler echocardiographic measures of left ventricular diastolic filling, we studied 15 angina pectoris patients and 20 normal control subjects. Transmitral flow measurements comprised peak and integrated early passive(E) and late atrial(A) filling velocities and diastolic filling period. RESULTS: Heart rate in negative exercise treadmill test group was 70/min at rest, 111/min just after exercise, and 86/min at 5 minutes after exercise. Positive exercise treadmill test group was 69/min, 109/min and 82/min, respectively. DFP and E duration were also significantly decreased after exercise in group with negative treadmill exercise test. In positive treadmill exercise group, peak A was significantly increased from 0.57+/-0.15m/sec to 0.75+/-0.20m/sec at just after exercise(p<0.01), 0.67+/-0.12m/sec at 5 minuties after exercise. DFP and E duration were also significantly decreased after exercise. CONCLUSION: Doppler echocardiographic transmitral flow was altered by abnormal regional wall motion and left ventricular dysfunction in ischemic heart disease during exercise test. The use of Doppler echocardiography for this purpose is limited, however, because a number of variables may influence transmitral flow patterns, including age, preload, afterload and systolic function.
Angina Pectoris ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Echocardiography ; Echocardiography, Doppler* ; Exercise Test ; Heart Rate ; Humans ; Isoflurophate ; Myocardial Ischemia ; Ventricular Dysfunction, Left ; Ventricular Function, Left

Congenital pseudarthrosis of the clavicle is a rare condition, which rarely produces functional disabilities except for cosmetic problems. Surgical treatment involves autogenous iliac bone grafts and internal fixation. Few studies have reported long-term results of surgical treatment or morphological changes of the clavicle. We report a patient with a congenital pseudarthrosis of the clavicle, who demonstrated a near normal radiographic appearance of the clavicle and an excellent result 22 years after the operation performed at 4 years of age.
Clavicle ; Cosmetics ; Follow-Up Studies ; Humans ; Pseudarthrosis ; Transplants

In order to examine the usefulness of the sympathetic skin response(SSR) as an indicator of autonomic dysfunction, we measured the amplitudes and latencies of the SSR in 64 consecutive non-insulin dependent diabetic patients, which were compared with those of 54 normal controls. The SSR on stimulation of median and posterior tibial nerves with EMG electrographer were correlated with nerve conductoin velocity(NCV) findings of median, posterior tibial and sural nerves and with beat-to-beat variation, measured as difference beeen maximum and minimum heart rate during deep breathing. Diabetic patients were also divided into 5 subgroups according to the symptoms of peripheral neuropathy, autonomic neuropathy and NCV findings for further comparisons. The results were as follows: 1. The shapes of the SSR were similar in the hand and the foot, but the amplitude was consistently greater in the hand than in the foot(p<0.001). The latency was shorter in the hand than in the foot(P<0.001). 2. The latencies of the foot and hand SSR in the diabetic patients were not significantly different from the normal controls. On the other hands, the amnplitude of the hand and foot SSR was significantly reduced compared to the control(p<0.001). 3. Of the patients with absent foot SSR, 20(59%) had two or more symptoms of autonomic involvement, whereas 14(14%) had no autonomic symptoms. These difference were significant(p Diabetes Mellitus ; Diabetic Neuropathies ; Extremities ; Foot ; Hand ; Heart Rate ; Humans ; Peripheral Nervous System Diseases ; Respiration ; Skin* ; Sural Nerve ; Tibial Nerve