BACKGROUND AND OBJECTIVES: Percutaneous transluminal septal myocardial ablation (PTSMA) and surgical septal myotomy-myectomy are two treatment options for patients with drug-resistant hypertrophic cardiomyopathy & a left ventricular outflow tract (LVOT) obstruction. The clinical courses, after nonsurgical and surgical septal myotomy-myectomy, are described in 3 patients with hypertrophic cardiomyopathy that continued to be symptomatic following medical management. SUBJECTS AND MEHTODS: 3 patients (2 women, 1 man), with symptomatic drug-refractory obstructive hypertrophic cardiomyopathy, were the subjects of this study. One patient underwent a PTSMA by injection of ethanol into the septal perforator branches of the left anterior descending coronary artery, and 2 a surgical myotomy-myectomy. Examinations of the early and late follow-up echocardiographic results were performed. RESULTS: Both treatment modalities significantly reduced the peak gradient across the LVOT (ablation : 85 to 7.7 mmHg, myectomy : 104 to 10 mmHg), and led to similar improvements in the New York Heart Association class (ablation : NYHA IV to II, myectomy : NYHA III or IV to NYHA I or II). One patient, who underwent a successful PTSMA, showed a temporary right bundle branch block on the ECG for several days following the PTSMA. At the 1-year follow-up, 2 patients were observed to have persistent symptomatic improvements, with no cardiac complications. CONCLUSION: Both a percutaneous septal myocardial ablation and a surgical myotomy-myectomy resulted in similar degrees of significant improvements of the left ventricular outflow tract obstructions, with improvements of the symptoms. Prospective studies are necessary to compare the long-term efficacy of these two treatment modalities.
Bundle-Branch Block ; Cardiac Surgical Procedures ; Cardiomyopathy, Hypertrophic* ; Catheter Ablation ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Ethanol ; Female ; Follow-Up Studies ; Heart ; Humans ; Ventricular Outflow Obstruction*

Carbamylated hemoglobin (CarHb) is formed by the reaction of hemoglobin with cyanate derived from the spontaneous dissociation of in vivo urea. Previous studies have shown that formation of CarHb depends upon both the severity and the duration of renal failure. To study the clinical significances of CarHb in Korean patients with chronic renal failure, we measured CarHb levels by high-performance liquid chromatography in 159 CRF patients and 46 normal controls. Patients with CRF had a higher CarHb concentration than normal controls (107.9+/-58.8 vs 35.1+/-14.2 microgramVH/gHb; P<0.001). In patients with CRF, nondialysis group had a higher value than dialysis group (129.8+/-77.9 vs 98.7+/-46.1 microgramVH/gHb; P<0.05). There were no siginificant difference in CarHb levels between hemodialysis (92.0+/-35.8microgramVH/gHb) and peritoneal dialysis (106.7+/-55.3microgramVH/gHb) groups. CarHb levels were not different between diabetic and nondiabetic patients in predialysis and hemodialysis groups. Although there was a significant difference in peritoneal dialysis group, the BUN levels were also lower in diabetic patients than nondiabetic patients. There were no correlation between CarHb and HbA1c percentage in patients with diabetes. CarHb levels were positively correlated with BUN (r=0.489; P<0.001) and creatinine (r=0.458; P<0.01) concentrations. There were negative correlations between CarHb and both Kt/V (r=-0.358; P<0.05) and URR (r=-0.415; P<0.05) in hemodialysis patients. In conclusion, CarHb may be a useful index of uremic control in patients with chronic renal failure, and are independent of the mode of dialysis and the presence of diabetes.
Chromatography, Liquid ; Creatinine ; Dialysis ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Renal Dialysis ; Renal Insufficiency ; Urea

BACKGROUND: Monocytes and T helper cells play major roles in the immunologic dysfunction of atopic dermatitis (AD). Many studies have been done on the cytokine pattern to evaluate abnormalities or differences of immune cells in AD, but the results were conflicting among studies and most of these previous reports were performed with various kinds of mitogen-stimulation. OBJECTIVE: The purpose of this study was to investigate spontaneous cytokine pattern in peripheral blood mononuclear cells (PBMC) from patients with AD. We focused on the expression of monokines that had effects on monocytes and T cells. METHODS: We measured mRNA expression of IL-10, GM-CSF and TNF-alpha in freshly isolated PBMC with semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). The intensity of cytokine cDNA was normalized to that of beta-actin product as a standard marker. RESULTS: IL-10 mRNA expression was significantly enhanced in AD compared:with control subjects (p<0.05). Spontaneous mRNA expression of TNF-alpha was significantly lower in AD patients (p <0.01). The level of GM-CSF mRNA expression was heterogeneous and spontaneous mRNA expression was slightly increased in AD although the difference did not reach the level of statistical significance. CONCLUSION: Our data was able to represent in vivo cytokine expression state of PBMC in atopic dermatitis. Increased expression of IL-10 and GM-CSF may have been associated with monocyte dysfunction in AD although increase in the expression of GM-CSF mRNA was not statistically significant. TNF-alpha mRNA expression was decreased in AD and increased IL-10 was suggested to exert an inhibitory effect on the expression of TNF-alpha mRNA.
Actins ; Dermatitis, Atopic* ; DNA, Complementary ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Interleukin-10 ; Monocytes ; Monokines ; RNA, Messenger* ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; Tumor Necrosis Factor-alpha

In order to evaluate the confounding factors of neurobehavioral tests and the neurobehavioral effects in the workers exposed to organic solvents, NCTB was carried out on 100 workers. 46 workers had never been exposed to neurotoxic substances, and the others were being exposed to the solvents, mainly toluene. Simple reaction time, digit symbol, Santa Ana dexterity test and persuit aiming were different with age in non exposure group. Simple reaction time was carried out well in males, and digit symbol and persuit aiming were in females. There was no difference at educational level when the subject was educated over 12 years. Santa Ana dexterity and Benton visual test differed according to exposure level to toluene, however simple reaction time didn't. The acute neurotoxic effect was not excluded in this study. But, NCTB could be used to evaluate and prevent neurobehavioral changes in workers exposed to neurotoxic solvents in Korea.
Female ; Humans ; Korea ; Male ; Reaction Time ; Solvents* ; Toluene

BACKGROUND: Glutaraldehyde is used most commonly as a high-level disinfectant for semicritical patient-care equipments. However, its potential toxicity to healthcare workers and a long exposure time needed to kill mycobacteria can be problematic. Recently, Perasafe(R) (Antec International, UK) has been introduced in the market as a safe and very effective disinfectant. This study was to evaluate the efficacy of Perasafe(R) against not only bacteria and yeast but also mycobacteria and bacterial spores and compare it with glutaraldehyde. MATERIAL AND METHOD: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Mycobacterium tuberculosis, and Bacillus subtilis were used for the test. Perasafe(R) and Cidex(R) were used at the final concentration of 1.62% and 2.25%, respectively; the disinfectants were neutralized by Tween 80 (0.5%) in the mycobacterial test and by lecithin (0.75%) in all other tests. Bacterial suspensions were made in phosphate buffer with or without fetal bovine serum (1%) to simulate dirty or clean conditions, respectively. The disinfectants were tested at 0, 24 and 48 hr of preparation to check stability. An effective disinfectant activity was defined as a 5 log10 reduction in viable counts. RESULTS: E. coli, S. aureus, P. aeruginosa and C albicans were effectively disinfected in less than 5 min by both Perasafe(R) and Cidex(R) and the both disinfectants remained equally effective under the dirty conditions or at 48 hr of preparation. Perasafe(R) was effective in 1 min against B. subtilis spores compared to Cidex(R) which took 30 min for the same activity. M. tuberculosis was effectively disinfected in 10 min by Perasafe(R) and 20 min by Cidex(R). CONCLUSIONS: Perasafe(R) showed greater tuberculocidal and sporicidal activities than Cidex(R), although both disinfectants were equally effective against common bacterial and yeast pathogens. Perasafe(R) may be an outstanding high-level disinfectant for endoscopes and other semicritical medical equipment.
Bacillus subtilis ; Bacteria* ; Candida albicans ; Delivery of Health Care ; Disinfectants ; Endoscopes ; Escherichia coli ; Glutaral ; Lecithins ; Mycobacterium tuberculosis ; Polysorbates ; Pseudomonas aeruginosa ; Spores ; Spores, Bacterial* ; Staphylococcus aureus ; Suspensions ; Tuberculosis ; Yeasts*

No abstract available.

No abstract available.
Carotid Artery, Common* ; Rupture*

No abstract available.
Glomerular Basement Membrane*

No abstract available.
Humans

No abstract available.
Carcinoma, Non-Small-Cell Lung* ; Drug Therapy, Combination*