Radioimmunoassay for the measurenment of plasma renin activity (PRA) was performed in 43 normal Koreans and 67 patients with essential hypertension. Urinary sodium excretion rates were measured in the concurrently collected 24 hour urine samples as an index of their sodium balance. The results were as follows: 1. There was an inverse correlation between 24 hour sodium excretion and PRA. The normal values of PRA in supine position ranged from 1.0 to 7.0 ng/ml/hr. When 24 hour sodium excretion were between 50 to 150 mEq. PRA in elderly persons tended to be low. 2. Of the 67 patients with essential hypertension, PRA was low in 20 cases (29.9%), normal in 36 (53.7%), and high in 11 cases (16.4%). 3. In the normal and high renin groups, who tended to be younger in ages, blood urea nitrogen was slightly higher than in low renin group, and hypertensive retinopathy was more prevalent in normal and high renin groups. 4. There were 17 cases with cardiovascular complications(12 with cerebrovascular accidents, 5 with heart failure): 6 in low renin group (30%), 9 in normal (25%) and 2 in high renin group (18.2%). There was no evidence that more frequent complications developed in higher renin groups.
Aged ; Blood Urea Nitrogen ; Heart ; Humans ; Hypertension* ; Hypertensive Retinopathy ; Plasma* ; Radioimmunoassay ; Reference Values ; Renin* ; Sodium ; Stroke ; Supine Position

This study was designed to investigate the effect of diazepam on the spontaneous contraction and oxytocin induced contraction of the isolated rat uterus. Female rat (Sprague-Dawley) pretreated with oophorectomy and 4 days administration of estrogen. Weighing about 200 g, was sacrificed by cervical dislocation, and the uteruses were isolated. A longitudinal muscle strip was placed in temperature controlled (37℃) muscle chamber containing Locke's solution and myographied isometrically. Diazepam inhibited the spontaneous contraction and oxytocin induced contraction of the isolated rat uterus in a concentration-dependent manner. GABA, muscimol, a GABA A receptor agonist, bicuculline, a competitive GABA A receptor antagonist, picrotoxin, a non competitive GABA A receptor antagonist, baclofen, a GABA B receptor agonist, and delta-aminovaleric acid, a GABA B receptor antagonist, did not affect on the spontaneous and oxytocin induced contraction of the isolated rat uterus. The inhibitory actions of diazepam on the spontaneous and oxytocin induced contraction were not affected by all the GABA receptor agonists and antagonists, but exceptionally potentiated by bicuculline. This potentiation-effect by bicuculline was not antagonized by muscumol. In normal calcium PSS, addition of calcium restored the spontaneous contraction preinhibited by diazepam and recovered the contractile of oxtrocin preinhibited by diazepam. A23187, a calcium inophore, enhanced the restoration of both the spontaneous and oxytocin induced contraction by addition of calcium. In calcium-free PSS, diazepam suppressed the restoration of spontaneous motility by addition of calcium but allowed the recovery of spontaneous motility to a considerable extent. Diazepam could not inhibit some development of contractility by oxytocin in calcium-free PSS, but inhibited the increase in contractility by subsequent addition of calcium. These results suggest that the inhibitory action of diazepam on the rat uterine motility does not depend on or related to GABA receptors and that diazepam inhibits the extracellular calcium influx to suppress the spontaneous and oxytocin induced contractilities.
Animals ; Baclofen ; Bicuculline ; Calcimycin ; Calcium ; Diazepam* ; Dislocations ; Estrogens ; Female ; GABA Agonists ; GABA-A Receptor Agonists ; GABA-A Receptor Antagonists ; GABA-B Receptor Agonists ; GABA-B Receptor Antagonists ; gamma-Aminobutyric Acid ; Humans ; Muscimol ; Ovariectomy ; Oxytocin* ; Picrotoxin ; Rats* ; Receptors, GABA ; Uterus*

PURPOSE: Right middle lobe symdrome is characterized by a spectrum of disease from recurrent atelectasis and pneunomitis to brobchiectasis of the Right middle lobe symdrom. It was first reported gy Grahm describing 12 patients with middle loge atelectasis and bronchiectasis due to enlarged lymph nodes. The incidence of Right middle lobe syndome seems tobe increasing in children, byt there have been only a few studies of right middlelobe syndrome in Korea. METHODS: Twenty-five children with RMLS who had been admitted during the last 10 years were evaluated with particular attention to clinical features, laboratory results, bronchographic findings, and treatment RESULTS: All patients were symptomatic and complained of chronic cough(25), sputum(20), fever(16), dyspnea(3), vomiting(2), and foreign body in the bronchus(2). Most of the patients had recurrent pneumonia: 6 patients had Mycoplasma pneumonia, and 6 patients had ashma and allergic disorders. Only 5 out of the 25 patients showed sufficient obstruction on bronchography and 6 patients took computed tomography scans. Chest radiography, bronchography and computed tomography scans were evaluated for review in 25 patients showing consolidation(17), patchy infiltration(14), atelectasis(12), hyperinflation(5), bronchiectasis(2), and air bronchogram(2). Most patients were improved by conservative medical management and only 2 patients had closed thoracostomy. CONCLUSION: These 25 patients who had been diagnosed as Right middle lobe syndrome were improved after 2 week treatment of antibiotics and conservative management and their prognosis were good during the follow-up period.
Anti-Bacterial Agents ; Bronchiectasis ; Bronchography ; Child ; Follow-Up Studies ; Foreign Bodies ; Humans ; Incidence ; Korea ; Lymph Nodes ; Middle Lobe Syndrome* ; Pneumonia ; Pneumonia, Mycoplasma ; Prognosis ; Pulmonary Atelectasis ; Radiography ; Thoracostomy ; Thorax

No abstract availble.
Aged ; Humans ; Liver Neoplasms/radiography/*radionuclide imaging/*secondary ; Male ; Neoplasm Recurrence, Local/*radionuclide imaging ; *Positron-Emission Tomography ; Rectal Neoplasms/pathology/*radionuclide imaging ; Sigmoidoscopes

BACKGROUND: As surgical techniques and postoperative care are improving, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other types of pulmonary resection. However, a postpneumonectomy complication is a serious life-threatening problem if it occurrs. The purpose of this study is to evaluate determinants for postoperative mortality after pneumonectomy. METHODS: Patients were divided for study as follows: the Dead group versus the Alive group. To determine whether age, operation site, operation time, intraoperative fiuid intake, urine output, blood loss, complications, preoperative and intraoperative arterial blood gas analyses, and preoperative pulmonary function tests influence the determinants for postoperative mortality after pneumonectomy, a rettospecive analysis was performed on 71 patients who had undergone pneumonectomy from 1990to 1994 in Kosin Medical COLLEGE hOSPITAL. RESULTS: Operation time and blood loss were longer and greater respectively in the Dead group. The intraoperative PaO2 was lower and incidence of complications was more frequent in the Dead group.Otherwise there were no significant differences between two groups. CONCLUSION: We concluded that operation time, blood loss, incidence of complications and intra-operative PaO2 were closely related with postoperative mortality.
Blood Gas Analysis ; Humans ; Incidence ; Mortality* ; Pneumonectomy* ; Postoperative Care ; Respiratory Function Tests

STUDY DESIGN: Retrospective radiologic assessment OBJECTIVES: To assess the clinical importance of MRI for the diagnosis of posterior spinal ligament complex injuries in thoracolumbar fractures. SUMMARY OF LITERATURE REVIEW: Evaluation of spinal instability is important in thoracolumbar fractures. When simple radiography and CT alone are performed, spinal instability may be missed, especially that involving the posterior spinal ligament complex. MATERIALS AND METHODS: Eighty-seven patients who were evaluated using simple radiography, computed tomography (CT), and magnetic resonance imaging (MRI) between March 1994 and March 2003 were included in the study. The local kyphotic angle was measured on lateral radiography, and it was then compared to the fracture pattern on MRI. Statistical analysis was performed using ANOVA. RESULTS: There was no correlation between the local kyphotic angle on radiography and fracture involvement on MRI (p=0.106). In 41 patients who were found to have involvement of the anterior column on CT, 25 had anterior column involvement, 4 had middle column involvement, and 12 had posterior column involvement on MRI. In 36 patients who were found to have involvement of the middle column on CT, 17 had involvement of the middle column and 19 had involvement of the posterior column on MRI. The fractures of the ten patients who were found to have posterior column involvement on CT were all seen on MRI. The coincidence of fracture patterns between CT and MRI, which was evaluated using Cohen's Kappa analysis, was 0.434. The sensitivity of CT compared with MRI was 0.741 in the middle column and 0.243 in the posterior column. CONCLUSIONS: Many thoracolumbar fractures are missed on both simple radiography and CT. MRI is essential for accurate diagnosis of posterior spinal ligament complex injuries, especially when there is involvement above the middle column, or when canal encroachment is seen on CT.
Humans ; Ligaments ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Fractures

Some circulating cancer cells in the blood play a central role in the metastatic process and may have a major influence on patient progress. Their numbers can be very small and techniques for their detection need to be both sensitive and specific. Polymerase chain reaction (PCR) has been successfully used to detect small numbers of tumor cells in cancer. We used a reverse transcriptase-polymerase chain reaction (RT-PCR) to detect circulating breast cancer cells in venous blood samples before operations and assessed cytokeratin-19 (CK-19) and cytokeratin-20 (CK-20) as target mRNA markers in the blood of healthy donors (n=6) and breast cancer patients (n=30) with American Joint Committee on Cancer stages 0 to IIIa. CK-19 mRNA was expressed in all blood samples of healthy donors and patients. But CK-20 was the only mRNA marker not detected in the blood from healthy donors. Seven of 30 (23%) venous blood isolates of breast cancer patients yielded a CK-20 mRNA with positive results. There was no correlating CK-20 mRNA expression with stage and axillary lymph node status. In conclusion, CK-19 showed no diagnostic value as a mRNA marker in the detection of circulating cancer cells by RT-PCR assay because this was expressed in the blood of healthy donors. CK-20 mRNA was an useful marker to detect circulating cancer cells in breast cancers.
Breast Neoplasms/pathology* ; Breast Neoplasms/genetics* ; DNA Primers ; Female ; Gene Expression Regulation, Neoplastic ; Genetic Markers ; Human ; Intermediate Filament Proteins/genetics ; Keratin/genetics ; Neoplasm Circulating Cells* ; RNA, Messenger/analysis ; RNA, Neoplasm/analysis* ; Reverse Transcriptase Polymerase Chain Reaction/methods* ; Sensitivity and Specificity ; beta 2-Microglobulin/genetics

The pyruvate dehydrogenase complex (PDC) activity is crucial to maintains blood glucose and ATP levels, which largely depends on the phosphorylation status by pyruvate dehydrogenase kinase (PDK) isoenzymes. Although it has been reported that PDC is phosphorylated and inactivated by PDK2 and PDK4 in metabolically active tissues including liver, skeletal muscle, heart, and kidney during starvation and diabetes, the precise mechanisms by which expression of PDK2 and PDK4 are transcriptionally regulated still remains unclear. Insulin represses the expression of PDK2 and PDK4 via phosphorylation of FOXO through PI3K/Akt signaling pathway. Several nuclear hormone receptors activated due to fasting or increased fat supply, including peroxisome proliferator-activated receptors, glucocorticoid receptors, estrogen-related receptors, and thyroid hormone receptors, also participate in the up-regulation of PDK2 and PDK4; however, the endogenous ligands that bind those nuclear receptors have not been identified. It has been recently suggested that growth hormone, adiponectin, epinephrine, and rosiglitazone also control the expression of PDK4 in tissue-specific manners. In this review, we discuss several factors involved in the expressional regulation of PDK2 and PDK4, and introduce current studies aimed at providing a better understanding of the molecular mechanisms that underlie the development of metabolic diseases such as diabetes.
Adenosine Triphosphate ; Adiponectin ; Blood Glucose ; Epinephrine ; Fasting ; Growth Hormone ; Heart ; Insulin ; Insulin Resistance ; Isoenzymes ; Kidney ; Ligands ; Liver ; Metabolic Diseases ; Muscle, Skeletal ; Oxidoreductases ; Peroxisome Proliferator-Activated Receptors ; Phosphorylation ; Phosphotransferases ; Protein-Serine-Threonine Kinases ; Pyruvate Dehydrogenase Complex ; Pyruvic Acid ; Receptors, Cytoplasmic and Nuclear ; Receptors, Glucocorticoid ; Receptors, Thyroid Hormone ; Starvation ; Thiazolidinediones ; Up-Regulation

This study was performed to evaluate the tensile strength of solder joint in titanium and the wettability of 14K gold solder on titanium. Two pieces of titanium rod 30 mm in length and 3mm in diameter were butt-soldered with a 14K gold solder using the electric resistance heating under flux-argon atmosphere, the infrared heating under argon atmosphere, and the infrared heating under vacuum-argon atmosphere. A tensile test was performed at a crosshead speed of 0.5mm/min, and fractere surfaces were examined by SEM. To evaluate the wettability of 14K gold solder on titanium, titanium plates of a 17x17x1mm were polished with #80-#2000 emery papers, and the spreading areas of solder 10mg were measures by heating at 840 * for 60 seconds. The solder-matrix interface regions were etched by the solution of 10% KCN-10%(NH4)2S2O8, and analyzed by EPMA. The results obtained were summarized as follows: 1. The maximun tensile strength was obtained when the titanium surface was polished with #2000 emery paper and soldered using the electric resistance heating under fluxargon atmosphere. Soldering strengths showed the significant difference between the electric resistance heating and the infrared heating(p<0.05). 2. The fracture surfaces showed the aspect of brittle fracture, and the failure developed along the interfaces of solder-matrix reaction zone. 3. The EPMA data for the solder-matrix interface region revealed that the diffusion of Au and Cu occurred to the titanium matrix, and the reaction zone showed the higher contents of Au, Cu and Ti than others.
Argon ; Atmosphere ; Diffusion ; Electric Impedance ; Heating ; Hot Temperature ; Joints* ; Tensile Strength* ; Titanium* ; Wettability

PURPOSE: To report a case of chronic central serous chorioretinopathy treated with an intravitreal injection of 2.5 mg of bevacizumab. CASE SUMMARY: A 38-year-old male complained of visual disturbance in the right eye. He had a history of central serous chorioretinopathy which improved without treatment. Since the patient did not feel any ocular discomfort, he did not visit our clinic for approximately 11 months. At the time of presentation, fundus examination revealed exudative retinal detachment involving the macular area. Additionally, fluorescein angiography revealed multiple early phase hyperfluorescent lesions. Neurosensory detachment around the macula and increased central macular thickness were also observed using optical coherence tomography. Under the diagnosis of chronic central serous chorioretinoapthy, the patient was treated with 2.5 mg of intravitreal bevacizumab. Visual acuity improved two months after treatment, with improvement in both neurosensory retinal detachment and fluorescein leakage. No changes were observed at the six-month follow-up.
Adult ; Antibodies, Monoclonal, Humanized ; Central Serous Chorioretinopathy ; Eye ; Fluorescein ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Male ; Retinal Detachment ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Bevacizumab