No abstract available.
Prostatic Hyperplasia* ; Transurethral Resection of Prostate* ; Ultrasonography*

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

No abstract available.
Leiomyosarcoma*

BACKGROUND AND OBJECTIVES: Diabetes is associated with a unique form of cardiomyopathy in the absence of atherosclerosis. The mechanisms of diabetic cardiomyopathy have not been defined, but is associated with early left ventricular (LV) diastolic dysfunction following an altered LV contractile performance. However, less attention has been paid to the right ventricular (RV) diastolic function in diabetes. Therefore, the changes in the RV ans LV filling dynamics, in patients with early type 2 diabetes, were investigated. SUBJECTS AND METHODS: The transtricuspid and trans-mitral flows were assessed by transthoracic Doppler echocardiography, at maximal inspiration and expiration, in 48 subjects (mean age: 62+/-9 years, M:F=16:32) with type 2 diabetes (Type 2 DM group) and 34 normal subjects (control group ; mean age:59+/-9 years, M:F=15:19, ranging from 45-75 years of age) with normal LV systolic function and ECG at rest. Subjects with diabetic complication, nephropathy (Cr >1.5 mg/dL), LVH and COPD were excluded. RESULTS: The mitral E/A ratio and DT (deceleration time) showed no significant difference between the type 2 DM and control groups. The LV and RV systolic functions also showed no significant difference between the two groups. However, the type 2 DM group had a lower tricuspid E/A ratio (0.98+/-0.25 vs. 1.17+/-0.21, p<0.001) and a longer tricuspid DT (241+/-65 msec vs. 208+/-51 msec, p=0.016) than the control group. CONCLUSION: The right ventricular diastolic function is frequently abnormal in early type 2 diabetes. This suggests that right ventricular diastolic dysfunction may be an important predictor for the early detection of diabetic cardiomyopathy.
Atherosclerosis ; Cardiomyopathies ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Cardiomyopathies ; Diastole ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Heart Ventricles ; Humans ; Pulmonary Disease, Chronic Obstructive

BACKGROUND: Pharmacological ACTH test provide information only about the ability of the adrenal gland to respond to unusual stimuli and may not reflect the daily cortisol secretion. There were some controversies in the diagnosis of mild adrenal insufficiency by using a pharmacological dose of ACTH. The purpose of the present study was to assess and compare the effect of low dose 1 pg ACTH and high dose 249 pg ACTH in the evaluation of adrenal function. The intravenous injection of a pharmacological dose(250 pg) of ACTH has been used as a standard test in the initial assessment of adrenal function. So we low dose ACTH to evaluate the adrenal function and compare the result of high dose ACTH. METHOD: Basal serum cortisol sampling was done at 2:00 p.m.. And after 1 pg ACTH iv bolus injection, cortisol sampling was done at 20, 30, 45 and 60 min respectively. On the next day same procedure was repeated at same time, but 249 mg ACTH was given instead of the low dose. Normal adrenal function was diagnosed with the criteria of stimulated serum cortisol concentration over 20 mg/dL. Total 65 patients took part in this study. Three hypopituitarism patients and one Addisons disease were included. Sixty-one patients had the history of glucocorticoid ingestion or had physical findings of cushingoid features with symptoms suggest the adrenal insufficiency. RESULTS: Sixteen patients showed normal response to both low dose and high dose ACTH. Thirty-six patients were not stimulated to both low dose and high dose ACTH. The remaining thirteen patients revealed normal response to high dose ACTH, but not to low dose ACTH. CONCLUSION: It appears that low dose ACTH stimulation test is more sensitive and specific than high dose ACTH and is capable of revealing mild adrenal insufficiency.
Addison Disease ; Adrenal Glands ; Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Diagnosis ; Eating ; Humans ; Hydrocortisone ; Hypopituitarism ; Injections, Intravenous

The authors analysed retrospectively, 69 cases of chronic subdural hematoma admitted to the Department of Neurological Surgery, from January 1992 to February 1995. All hematomas were operated on by one burr hole trephination and continuous closed-system cather drainage system. The results were as follows: 1) Male was more frequently involved than female with ratio of 5.3:1 and the incidence was prredominent in the patients whose ages were over 50. 2) History of head trauma was found in 52 cases(75.4%), among which habitual alcoholism was found in 6 cases(8.7%). 3) The major symptoms and signs at admission were headache(55.1%), hemiparesis(44.9%), and mental changes(30.4%). 4) On the brain CT scan, hematoma showed low, iso, mixed, and high in density, and the shapes of hematoma were crescenteric, biconvex, planoconvex, and concave in order of frequency. 5) We have found a significant relationship between the neurological grade at admission and the prognosis, and noted full recovery in 45 cases(65.2%) and no d eath as a result of 1-burr hole trephination.
Alcoholism ; Brain ; Craniocerebral Trauma ; Drainage ; Female ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Male ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Trephining

BACKGROUND : There are various factors affecting the nutritional status of the elderly. Depression has been known as an important factor of malnutrition in them. We had already reported the poor nutritional status of elderly diabetics [J Kor Diabetes Association 22(1):71, 1998]. We investigated to document the prevalence of malnutrition and its relationship to depression in elderly diabetic patients. METHODS : We studied 52 patients aged 65 and over (65-00 y, mean 76.7 y; 22 men, 30 women) with diabetes mellitus admitted during from 1996 through 1997. Malnutrition was diagnosed on presence of 1 or more criteria; 10% weight loss in last 3 months, serum albumin <3.3 g/dL, serum transferrin <200 mg/dL, and blood total lymphocyte<1,800/mm3. There was no significant differences between depressed Group and non-depressed Group in duration of diabetes, body mass index, fasting plasma glucose, HbA1c, and number of complication including hypoglycemic episodes. Depression was assessed on Hamilton Depression Scale score of 16 or more. Data were analyzed by Chi square test. RESULTS : 28/52 (53.9%) were malnourished, 12/52 (23.1%) having depression. Of the 12 patients with depression, only 5 had malnutrition. No significant relation between depression and malnutrition was found (Chi squre=2.689, p=0.992). CONCLUSION : Depression might have no significant relationship to malnutrition in the elderly diabetic in-patients.
Aged* ; Blood Glucose ; Body Mass Index ; Depression* ; Diabetes Mellitus ; Fasting ; Humans ; Male ; Malnutrition* ; Nutritional Status ; Prevalence ; Serum Albumin ; Transferrin ; Weight Loss

Intradural spinal lipomas are rare, primary genign tumor of the spinal canal. A case of intradural spinal lipoma with intramedullary extension is presented. Clinical feature was slowly progressing paraparesis. A subtotal excision was performed, and pathological studies confirmed the diagnosis.
Diagnosis ; Lipoma* ; Paraparesis ; Spinal Canal ; Spinal Cord Compression ; Spinal Cord Neoplasms

OBJECTIVE: Diabetic nephropathy is an important cause of end stage renal disease in Korea and associated with major morbidity and mortality. The precise pathogenic mechanism of this disease is still controversial, but it has been considered that multiple factors are contribute to the development and progression of diabetic nephropathy. One of these factors, renin-angiotensin system has been proven to be a major mediator of this disease via activation of angiotensin II, which has multiple functions such as induction of production of extracellular matrix protein and various intraglomerular cells, tubulointerstital component and increment of intraglomerular pressure. Transforming growth factor(TGFbeta) is a multifunctional cytokine with major profibrotic character, which stimulates the production of extracellular matrx(ECM) protein, inhibit the degradation of ECM and induce the interaction of mesangial cells with ECM via integrin receptors. This study was done to evaluate the role of angiotensin II and angiotensin converting enzyme inhibitor in expression of TGFbeta mRNA which is a main mediator in the pathogenesis of diabetic nephropathy. METHODS: Human mesangial cells(MCs) were cultured by standard culture techniqne. For this study, cells in the 5th to 7th passage were used. To make a different glucose concentration in culture medium, normal(100mg/dl) or high glucose(450mg/dl) concentrations of D-glucose were added, and cultured in 17% heat inactivated fetal bovine serum. Angiotensin II and ACE inhibitor(captopril) were administered to the culture medium at final concentration of 10-6M. After 72 hours, MCs were harvested to measure the expression of TGFbeta mRNA. To measure the mRNA expression of TGFbeta in each condition, semi quantitative PCR was done and all results were corrected by beta-actin gene. RESULTS: mRNA expression of TGFbeta was significantly increased in the high glucose medium(30 mM) compared to normal glucose medium(5.5mM) (3.82+/-0.465 vs 2.27+/-0.13, p<0.05). Administration of angiotensinII(10-6M) in high glucose medium induced a further increase in the TGFbeta expression to 4.29+/-0.476(p<0.05). AngiotensinII(10-6M) in normal glucose medium also showed a significant increase in TGFbeta expression as 3.40+/-1.88(p<0.05). Administration of ACE inhibitor(Captopril, 10-6M) in high glucose medium prevented the increse of TGFbeta expression(1.20+/-0.18 vs 3.82+/-0.465, p<0.05). CONCLUSION: From these findings, it suggest that angiotensinII is an important mediator in the pathogenesis of diabetic nephropathy. ACE inhibitor may have a role in the progress of this disease via direct suppression of TGFbeta system as well as beneficial intraglomerular hemodynamic effect.
Actins ; Angiotensin II* ; Angiotensins* ; Diabetic Nephropathies ; Extracellular Matrix ; Glucose* ; Hemodynamics ; Hot Temperature ; Humans* ; Kidney Failure, Chronic ; Korea ; Mesangial Cells* ; Mortality ; Peptidyl-Dipeptidase A ; Polymerase Chain Reaction ; Renin-Angiotensin System ; RNA, Messenger* ; Transforming Growth Factor beta*

BACKGROUND: Diabetic ketoacidosis (DKA) is usually thought of as a condition of young, insulin-requiring diabetic patients. The clinical characteristics of older adults with DKA have not been well characterized. To characterize the elderly patients with DKA, we described how DKA in the elderly differs from that in the young adults. METHODS: We analyzed the clinical data of 112 patients who were diagnosed DKA for the first time from July, 1987 to June, 1997 at Hallym Univ. Sacred Heart Hospitals. We divided our patients into 3 groups according to the age at the first DKA and compared the clinical characteristics of DKA patients aged 65 or over with those of under 30 of age. RESULTS: Forty-four patients were under 30 of age and 8 patients were 65 or over of age. The duration of DM prior to DKA was 11.9+/-3.0 years in the elderly gouty and 1.6+/-0.4 years in the young group, and the debut DKA's were 12.5% and 47.7%, respectively. The elderly patients were less likely to have been using insulin before DKA (12.5% vs. 74%). The most frequent precipitating factor of DKA was 'infection' in the elderly group (50%) and 'unidentifiable' in the young group (46%). The elderly group showed the higher arterial pH (7.22+/-0.03 vs. 7.09+/-0.02), bicarbonate (10.9+/-1.5 vs. 5.1+/-0.7 mEq/L), and serum fasting C-peptide (0.37+/-0.08 vs. 0.19+/-0.04 nmol/L) levels, and the higher mortality rate (25% vs. 2.3%) compared with the young group. CONCLUSION: The elderly patients with DKA showed the longer duration of DM and less debut DKA's, the less previous history of insulin-treatment, the higher proportion of infection as precipitating (actors, the higher arterial pH, bicarbonate, and serum fasting C-peptide levels, and the higher mortality rate compared with the young patients with DKA.
Adult ; Aged* ; C-Peptide ; Diabetes Mellitus ; Diabetic Ketoacidosis* ; Fasting ; Heart ; Humans ; Hydrogen-Ion Concentration ; Insulin ; Mortality ; Precipitating Factors ; Young Adult