Coronary spasm may be induced by a variety of physiologic and pharmacologic stimuli but specific receptor blockade has not been consistently shown to prevent the attacks. Most patients with variant angina respond well to treatment with calcium antagonists and nitrates. A small proportion of patients are refractory to this therapy. We report a case of the patient with a 9-year-history of variant angina who has been refractory to high doses of calcium antagonists and nitrates. The repeated addition of clonidine was consistently effective in abolishing both symptoms and objective evidence of myocardial ischemia in this particular patient.
Calcium ; Clonidine* ; Humans ; Myocardial Ischemia ; Nitrates ; Spasm

No abstract available.
Echocardiography, Doppler, Color* ; Mitral Valve Insufficiency*

Pheochromocytomas can arise wherever chromaffin cells are found, and most of them(90%) are in one or both adrenal glands. But they may be located anywhere along the sympathetic chain and rarely in aberrant sites. One of the common extra-adrenal sites from which these tumors can arise is a collection of para-aortic and para-ganglion cells around the origin of the inferior mesenteric artery. We experienced a case of extra-adrenal pheochromocytoma located at the organ of Zukerkandl in a 21-year-old female patient with abdominal colic and paroxysmal hypertension, whose symptoms and blood pressure returned to normal after successful surgical excision of the tumor.
Adrenal Glands ; Blood Pressure ; Chromaffin Cells ; Colic* ; Female ; Humans ; Hypertension* ; Mesenteric Artery, Inferior ; Pheochromocytoma* ; Young Adult

A 29-year-old woman presented with secondary amenorrhea, primary infertility, and virilization, which had developed over the past 2 years was suspected to have a virilizing tumor at her left ovary. Her serum testosterone level was markedly elevated (380 ng/dL). Left salpingooophorectomy was performed, and histopathological examination revealed a thecoma of the left ovary. The postoperative serum testosterone level returned to 65 ng/dL. The patient did not have regression of virilism soon. However, the patient had a normal menstruation 29 days after surgery and gave birth to a baby 13 months after surgery.
Adult ; Female ; Humans ; Menstruation ; Ovarian Neoplasms/blood/*complications/*surgery ; Ovariectomy ; Pregnancy ; Pregnancy Outcome ; Testosterone/blood ; Thecoma/blood/*complications/*surgery ; Virilism/blood/*etiology/surgery

BACKGROUND: The knowledge about the nucleotides sequence of 9th chromosome that regulates the phenotype of ABO blood group has made the ABO genotyping possible. Since the genotyping can be done with only a small amount of DNA sample, it was primarily applied to the field of forensic medicine. When applied to the blood bank, it is useful in the resolution for ABO discrepancies between the cell and serum typing and determination of A and B subgroups. Rapid ABO genotyping using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and its value in determination of ABO subgroups is presented. METHODS: ABO genotyping was performed in seven patients and three families, seven were the cases of ABO discrepancies in routine ABO grouping and three families were for the confirmation of the ABO group. To identify the 261th nucleotide, a 252 bp PCR amplifed fragment was amplified by PCR and digested with Kpn I. For 703th nucleotide, a 128 bp PCR amplified fragment was designed and digested with Alu I. To determine the ABO genotype, the patterns of digestion in DNA fragment were examined. RESULTS: Among the seven cases of ABO discrepancies, B3 and Ael were two cases each. Weakened B due to leukemia was the one, and the other two cases were cis-AB and Am. The three families for confirmation of the ABO group were acquired B due to infection one family, cis-AB two families. CONCLUSIONS: ABO genotyping is a rapid and reliable method that can be used in the case of ABO discrepancies and determination of ABO subgroups.
Blood Banks ; Digestion ; DNA ; Forensic Medicine ; Genotype ; Humans ; Leukemia ; Nucleotides ; Phenotype ; Polymerase Chain Reaction

We reported on a 60-year-old man presenting lymphedema of both lower extremities and scrotum for 3 years with unknown cause. We took a computed tomography scan of the lower extremities as a follow-up. There were diffuse subcutaneous edema in both lower extremities and multiple enlarged lymph nodes along the para-aortic and bilateral inguinal areas. For further evaluation, biopsy of an enlarged inguinal lymph node was taken, yielding a diagnosis of primary amyloidosis. A treatment of chemotherapy for amyloidosis was recommended for him. To our knowledge, this is the first report of lymphedema presenting with primary amyloidosis in Asia. This case suggests that primary amyloidosis could be one of the differential diagnoses in patients with lymphedema in the lower extremities.
Amyloidosis* ; Asia ; Biopsy ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Edema ; Follow-Up Studies ; Humans ; Lower Extremity ; Lymph Nodes ; Lymphedema* ; Middle Aged ; Scrotum

BACKGROUND: Three cell separators are being used and they collect platelets with different centrifuge speed and duration. Because centrifugation may cause platelet activation, the differences of centrifuge speed and duration are important in controlling the quality of apheresis platelet products. We compared many parameters of activation of platelets collected by Spectra (Cobe BCT, Lakewood, CO, USA), CS3000plus (Baxter Healthcare, Fenwal Division, Round Lake, IL, USA) and Mobile Collection SystemTM (MCS, Haemonetics co., Braintree, MA, USA). METHODS: Platelets were collected from ninety-five normal donors with Spectra (n=39), CS3000plus (n=19) and MCS (n=37). We underwent the procedure according to the automatic program set. We measured platelet yield and assayed pH, hypotonic shock respose (HSR), CD62 (p-selectin, GMP140) expression and beta-thromboglobulin in each stored unit on day 0 and day 3 for evaluation of the storage lesions. RESULTS: Platelet yield per product was 3.7 +/- 1.2 x 1011, mean final product volume was 316 +/- 69 mL and mean procession time was 100 +/- 19 minutes. Mean collection efficiency was 42.5 +/- 8.3%. The cell separator volume of product collected by CS3000plus was the smallest while platelet concentration and total yield were the highest in the product collected by Spectra. The pH of the products were 7.1 +/- 0.1 on day 0 and 6.7 +/- 0.4 on day 3. Hypotonic shock response was 69 +/- 13 % on day 0 and 28 +/- 17 % on day 3. P-selectin expression was 19 +/- 9 % (4.2 +/- 1.9 relative fluorescence intensity, RFI) on day 0 and 60 +/- 22 % (17.9 +/- 14.2) on day 3. beta-thromboglobulin was 28.5 +/- 7.0 IU/107 platelets on day 0 and 31.3 +/- 7.2 IU/107 platelts on day 3. The comparison of the three cell separators showed that on day 0 platelet product of MCS has lower pH and higher beta-thromboglobulin release than others (p<0.05). And on day 3 platelet product of MDS has better hypotonic shock response than others (p<0.05). Other parameters revealed no differences among three cell separators. The expression of p-selectin was shown to correlate highly with pH reduction (r=0.72), but not with the release of beta-TG (r=0.24). CONCLUSIONS: Most parameters showed no differences among three cell separators, but apheresis platelet concentrates processed by MCS showed lower pH on day 0 and higher beta-thromboglobulin concentration on day 0 and day 3 than apheresis platelet concentrates processed by Spectra or CS3000plus and hypotonic shock response on day 3 was the lowest in CS3000plus. So platelet activation produced during apheresis processing was lowest in apheresis platelet concentrates with Spectra.
beta-Thromboglobulin ; Blood Component Removal* ; Blood Platelets* ; Centrifugation ; Delivery of Health Care ; Fluorescence ; Humans ; Hydrogen-Ion Concentration ; Lakes ; Osmotic Pressure ; P-Selectin ; Platelet Activation* ; Tissue Donors

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Echocardiography*

PURPOSE: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. MATERIALS AND METHODS: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. RESULTS: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. CONCLUSION: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.
Aged ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Disease-Free Survival ; Esophagitis ; Humans ; Lymph Nodes ; Pneumonia ; Retrospective Studies ; Survival Rate

PURPOSE: The prognosis of stage III non-small cell lung cancer (NSCLC) treated with radiotherapy alone has been disappointing. Combined therapy including chemotherapy and radiotherapy has potential of improving both local and distant metastatic control. Paclitaxel and cisplatin have demonstrated activity as radiation sensitizers. The aim of this study was to evaluate the efficacy of paclitaxel and cisplatin with concurrent radiotherapy for stage III NSCLC. MATERIALS AND METHODS: Between April 2000 and July 2002, twenty-four previously untreated patients with unresectable stage III NSCLC received paclitaxel (60 mg/m2) and cisplatin (20 mg/m2) with concurrent radiotherapy. Chemotherapy was given on the first day of each week during radiotherapy. Concurrent radiotherapy was performed in 1.8 Gy daily fractions to a total dose of 54~59.4 Gy in 6~7 weeks (median: 59.4 Gy). RESULTS: Among 24 evaluable patients, the overall response was 83.3%, with four complete responses and 16 partial responses. Median survival was 16 months, with survival rates of 62.5% at 1 year and 28.7% at 2 years. Serious side effect was generally limited to grade 3 pulmonary toxicity in 37.5% of patients. CONCLUSION: Paclitaxel and cisplatin with concurrent radiotherapy has acceptable response with manageable toxicity in patients with stage III NSCLC. More randomized studies with a larger group of patients are required to improve the true efficacy
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy ; Humans ; Paclitaxel* ; Prognosis ; Radiation-Sensitizing Agents ; Radiotherapy* ; Survival Rate