It has been well known that variable complications oecur in multiple organs in chronic renal failure patients. Of them gastrointestinal complications are also variable including nausea, vomiting, gastritis, peptic ulcer, gastrointestinal bleeding, hepatitis, pancreatitis, telangiectasia, angiody- splasia etc. Of such complications the incidence of peptic ulcer had been known to be high, but after endoscopic study, the incidence of nonulcer mueosal lesion has been more common. So we evaluated tbe upper gastrointestinal mucosal lesion in chronic renal failure patients by endoscopic examination. 129 subjects(mean age, 42 years, creatinine clearance ratio<10 ml/min) participated in this study. After overnight fasting the subjects were premedicated with simethicon and benoxinate. The mucosal lesion was diagnosed by two endoscopists with observing the TV monitor of electronic endoscope Fujinon EVG-FP. Of the 129 patients, 78 patients(76%) were revealed to abnormal endoscopic finding. Of the abnormal findings, the incidence of gastritis was most common in 34.9%, and then gastic erosion, duodenal erosion, gastric petechiae, gastric telangiectasia, duodenitis, gastric ulcer, gastric xanthoma, esophageal erosion, duodenal ulcer, esophageal uicer in orders. There was no difference in abnormal finding according to therapeutic type. From our study, we conclude that the incidence of nonulcer mucosal lesion is higher than ulcer disease in chronic renal failure patient, moreover those lesion can be diagnosed only by endoseopy. So we think that upper gastrointestinal endoscopy is necessory for evaluation of upper gastrointestinal tract in chronic renal failure patient.
Creatinine ; Duodenal Ulcer ; Duodenitis ; Endoscopes ; Endoscopy, Gastrointestinal ; Fasting ; Gastritis ; Hemorrhage ; Hepatitis ; Humans ; Incidence ; Kidney Failure, Chronic* ; Nausea ; Pancreatitis ; Peptic Ulcer ; Purpura ; Stomach Ulcer ; Telangiectasis ; Ulcer ; Upper Gastrointestinal Tract ; Vomiting ; Xanthomatosis

The esophageal lymphoma is a very rare feature among gastrointestinal lymphoma, and there was no surgical report in Korea. A 62-year-old male patient with submucosal tumor detected on routine esophagoscopy had resection of tumor including the esophageal mucosa, which was confirmed as esophageal lymphoma. As the severe leakage was detected on esophagogram on post-op 7th day, esophagectomy and esophagogastrostomy was followed. Though adjuvant chemotherapy was not performed, there were no evidence of recurrence for 1 year follow up. We experienced a patient with esophageal lymphoma and reported with brief review of literature.
Chemotherapy, Adjuvant ; Esophagectomy ; Esophagoscopy ; Follow-Up Studies ; Humans ; Korea ; Lymphoma* ; Male ; Middle Aged ; Mucous Membrane ; Recurrence

PURPOSE: To identify the normal range of factors which can be measured with Ocular Response Analyzer (ORA, Reichert Inc., Depew, NY, USA) in normal Korean, and to analyze factors affecting ORA by measuring intraocular pressure (IOP) of noncontact tonometer (NCT) and central corneal thickness (CCT). METHODS: Three hundred and one normal Korean subjects who did not have specific ophthalmological diseases and surgeries in the past were recruited for this study. Corneal hysteresis (CH), corneal response factor (CRF), corneal-compensated IOP (IOPcc), and Goldmann correlated IOP (IOPg) were measured using ORA. In addition, IOP of NCT and CCT were measured and the results and factors analyzed. RESULTS: The mean CH measured among normal Korean subjects in this study was 10.70 mmHg. The mean CRF was 10.40 mmHg. CH and CRF were significantly higher in the juvenile group. IOPcc and IOPg as measures of IOP using the ORA had significant correlation with IOP of NCT. In particular, IOPcc appeared to be independent of CCT. CONCLUSIONS: CH and CRF were different according to age, indicating a difference in biomechanical properties of the cornea. In particular, IOPcc is more important as it is independent of corneal thickness and should be compensated in general measurements of IOP reflecting biomechanical properties.
Cornea ; Intraocular Pressure ; Reference Values

BACKGROUND: Adiponectin is a fat-based protein that alters the insulin sensitivity, has anti-inflammatory properties, and reduces the incidence of cardiovascular disease (CVD). However, this connection is unclear in patients with chronic wasting disease, such as heart failure or end-stage renal disease (ESRD). Therefore, this study examined the relationship between adiponectin and the cardiovascular risk/predictive factors in ESRD patients. METHODS: The serum concentrations of adiponectin and leptin were measured in 48 adult patients on maintenance hemodialysis. In addition, the blood levels of B-type natriuretic peptide (BNP) and cardiac troponin T (cTnT) as cardiovascular biomarkers were measured, and the CVD history was reviewed in order to determine if there was any correlation with adiponectin. RESULTS: There was a significant correlation between the adiponectin levels and the serum concentrations of HDL-cholesterol (r=0.456, p=0.001), triglyceride (r=-0.528, p<0.001), and leptin (r=-0.427, p=0.002) and an inverse correlation with the body mass index (BMI) (r=-0.326, p=0.024). The BNP levels were positively correlated with the adiponectin concentrations (r=0.372, p=0.009) and negatively correlated with the BMI (r=-0.310, p=0.032), and there was a slight positive correlation between cTnT and adiponectin (r=0.276, p=0.058). Patients with a history of CVD had higher levels of cTnT (p=0.012) and BNP (p=0.017), and a lower BMI (p=0.026) than patients without such a history. There was no significant difference in the adiponectin levels between the two patient groups. CONCLUSIONS: A higher adiponectin level is related to a favorable lipid profile. However, adiponectin is not directly associated with a history of CVD, and there was a correlation between a higher adiponectin level and a higher BNP and lower BMI, which are cardiovascular predictive factors, in ESRD patients. However, further research with more patients will be needed to properly determine the complicated relationship between adiponectin and the development of CVD.
Adiponectin* ; Adult ; Biomarkers ; Body Mass Index ; Cardiovascular Diseases* ; Heart Failure ; Humans ; Incidence ; Insulin Resistance ; Kidney Failure, Chronic* ; Leptin ; Natriuretic Peptide, Brain ; Renal Dialysis ; Triglycerides ; Troponin T ; Wasting Disease, Chronic

BACKGROUND: Liver cirrhosis is characterized by fibrous scarring and hepatocellular regeneration. Matrix metalloproteinases (MMPs) comprise a family of zinc-dependent enzymes that degrade the extracellular matrix (ECM) components. This study examined whether or not gene delivery of human MMP-3 can attenuate established liver cirrhosis in a rat. METHODS: Rat liver cirrhosis was induced by an intraperitoneal injection of dimethylnitrosamine (DMN) three times a week for 8 weeks. The rats were infected once with either a recombinant adenovirus, AdMMP3.GFP, or a control adenovirus, Ad.GFP, into a portal vein and followed up for 3 weeks. In the rat liver tissues, the collagen content, histopathology and immunohistochemical staining were measured. RESULTS: Liver fibrosis in the DMN induced cirrhotic rat was attenuated along with a diminished hydroxyproline content and increased dried liver weight after the gene delivery of AdMMP3.GFP. In addition, the number of activated hepatic stellate cells was lower whereas the proliferation of hepatocytes, which was confirmed by immunohistochemical staining using anti-proliferating cell nuclear antigen (PCNA) antibody, was observed in the AdMMP3.GFP infected rats, suggesting that human MMP-3 stimulated hepatocyte proliferation. CONCLUSIONS: These results suggest that the gene transfer of human MMP-3 in the liver attenuates established fibrosis and induces hepatocyte proliferation. Therefore, gene therapy using MMP-3 in liver cirrhosis might be a promising therapeutic option in the future.
Adenoviridae* ; Animals ; Cicatrix ; Collagen ; Dimethylnitrosamine ; Extracellular Matrix ; Fibrosis ; Genetic Therapy* ; Hepatic Stellate Cells ; Hepatocytes ; Humans ; Hydroxyproline ; Injections, Intraperitoneal ; Liver Cirrhosis* ; Liver* ; Matrix Metalloproteinases ; Models, Animal* ; Portal Vein ; Rats* ; Regeneration

BACKGROUND: Acute Complications of Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum Recently, Remodelling Plasty of Costochondral Rib Cage has been introduced as an minimally invasive procedure and expanded its application for pectus excavatum. Outcomes and acute complications were reviewed MATERIAL AND METHOD: A retrospective survey of 55 patients who underwent Remodelling Plasty of Costochondral Rib Cage from September, 1999 to February, 2002 was conducted to review complications, postoperative treatments, and outcomes. RESULT: Age ranged from 1 to 27 years(mean 11.4+/-7.1). 35(64%) were less than 15-year old and 20(36%) were more than 15-year old. There were 44(80%) Male patients and 11(20%) female patients. Length of hospital stay was 7.8+/-2.1 days for less than 15-Y-old group, 10.6+/-6.2 days for more than 15-Y-old group(p = 0.042) One substernal bar was inserted in 52 patients and two substernal bars were inserted in 3 patients. As for stabilizer, one lateral side was fastened in 15 patients and both lateral sides were fastened in 6 patients. In the less than 15-Y-old group, 4 patients needed stabilizer, whereas in the more than 15-Y-old group, 18 patients needed stebilizer(s)(p = 0.000).Including all kinds of complications, 28(51%)patients had postoperative complications. Of them, only 7 patients were treated for complications(C-tube insertion was done in 7 patients and reoperation for bar refixation or removal was done in 3 patients of them). CONCLUSION: Most complications after Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum were trivial without treatment although C-tube drainage was needed in some patients. However bar displacement such as rotation and lateral sliding should be corrected as soon as detected in order not to remove the bar(the worst situation).
Adolescent ; Drainage ; Female ; Funnel Chest* ; Humans ; Length of Stay ; Male ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Ribs*

BACKGROUND AND OBJECTIVES: Although increasing evidence has indicated that radial access is a beneficial technique, few studies have focused on Korean subjects. The aim of this study was to evaluate current practice of coronary angiography (CAG) and percutaneous coronary intervention (PCI) using radial access in South Korea. SUBJECTS AND METHODS: A total of 6338 subjects were analyzed from Korean Transradial Intervention prospective registry that was conducted at 20 centers in Korea. After evaluating the initial access, subjects intended for radial access were assessed for their baseline, procedure-related, and complication data. Subjects were categorized into three groups: group of overall subjects (n=5554); group of subjects who underwent PCI (n=1780); and group of subjects who underwent primary percutaneous coronary intervention (PPCI) (n=167). RESULTS: The rate of radial artery as an initial access and the rate of access site crossover was 87.6% and 4.4%, respectively, in overall subjects. Those rates were 82.4% and 8.1%, respectively, in subjects who underwent PCI, and 60.1% and 4.8%, respectively, in subjects who underwent PPCI. For subjects who underwent CAG, a 6-F introducer sheath and a 5-F angiographic catheter was the most commonly used. During PCI, a 6-F introducer sheath (90.6%) and a 6-F guiding catheter were standardly used. CONCLUSION: The large prospective registry allowed us to present the current practice of CAG and PCI using radial access. These data provides evidence to achieve consensus on radial access in CAG and PCI in the Korean population.
Catheters ; Consensus ; Coronary Angiography* ; Korea ; Percutaneous Coronary Intervention ; Prospective Studies* ; Radial Artery ; Registries

The efficacy of low molecular weight heparin (LMWH) with low dose unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) with or without glycoprotein (Gp) IIb/IIIa inhibitor compared to UFH with or without Gp IIb/IIIa inhibitor has not been elucidated. Between October 2005 and July 2007, 2,535 patients with ST elevation acute myocardial infarction (STEMI) undergoing PCI in the Korean Acute Myocardial Infarction Registry (KAMIR) were assigned to either of two groups: a group with Gp IIb/IIIa inhibitor (n=476) or a group without Gp IIb/IIIa inhibitor (n=2,059). These groups were further subdivided according to the use of LMWH with low dose UFH (n=219) or UFH alone (n=257). The primary end points were cardiac death or myocardial infarction during the 30 days after the registration. The primary end point occurred in 4.1% (9/219) of patients managed with LMWH during PCI and Gp IIb/IIIa inhibitor and 10.8% (28/257) of patients managed with UFH and Gp IIb/IIIa inhibitor (odds ratio [OR], 0.290; 95% confidence interval [CI], 0.132-0.634; P=0.006). Thrombolysis In Myocardial Infarction (TIMI) with major bleeding was observed in LMHW and UFH with Gp IIb/IIIa inhibitor (1/219 [0.5%] vs 1/257 [0.4%], P=1.00). For patients with STEMI managed with a primary PCI and Gp IIb/IIIa inhibitor, LMWH is more beneficial than UFH.
Acute Disease ; Aged ; Drug Therapy, Combination ; Female ; Hemorrhage ; Heparin/*therapeutic use ; Heparin, Low-Molecular-Weight/*therapeutic use ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/epidemiology/mortality/*therapy ; Myocardial Revascularization ; Odds Ratio ; Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors/metabolism ; Prognosis ; Registries