BACKGROUND: The acute effect, of ethanol (EOH) include lowered blood pressure through peripheral vasodilation and decreased circulating blood volume. This study was aimed at examing the effects of EOH on the hemodynamic response to up and down head tilts. METHODS: Ten 21 to 23 year old male adults served as subjects. Each subject participated in both control and EOH experiments. In the EOH experiment, 3 mls of 25% EOH per liter of total body water was administered orally, 35 min were allowed for the blood EOH level to reach maximum before the tilt protocol was initiated. The tilt protocol consisted of 5 stages, each stage was 3-min in duration : supine (0 degrees)-head down tilt (HDT, 15 degrees)-supine (0 degrees)-head up tilt (HUT, 25 degrees)-supine (0 degrees). Hemodynamic parameters were measured with an impedance cardiograph (NCCOM3-R7, BoMed) with two electrodes placed around the neck and two around the thorax. Blood pressure (BP) was measured with an automatic sphygmomanometer (DATEX). Data was collected during every second half-minute throughout the duration of the protocol. RESULTS: In the control, HDT produced an increase in the end-diastolic index (EDI), the stroke index (SI), the cardiac index (CI), and the peak flow index (PFI) ; there were no significant changes in heart rate (HR), the systemic vascular resistance index (SVRI), and BP. In contrast, HUT resulted in a decrease in EDI, SI, EF, CI, and PFI and an increase in HR, SVRI, and BP ; the latter changes sugges a sympathetic overactivation. In the EOH experiment, the basal EDI, SI, and systolic BP were lower and HR was higher than in control. HDT and HUT caused similar changes as in control experiments. CONCLUSIONS: There results indicate that EOH cause volume depletion to result in reduced central blood volume and compensatory tachycardia. These EOH-induced changes were not altered by 15 degreeshead-down and 25 degreeshead-up tilts.
Adult ; Blood Pressure ; Blood Volume ; Body Water ; Cardiography, Impedance ; Eating* ; Electric Impedance ; Electrodes ; Ethanol* ; Gravitation ; Head ; Heart Rate ; Hemodynamics* ; Humans ; Male ; Neck ; Sphygmomanometers ; Stroke ; Tachycardia ; Thorax ; Vascular Resistance ; Vasodilation ; Young Adult

No Abstract Available.
Cataract*

No abstract available.
Erythema* ; Leukemia, Myelomonocytic, Juvenile*

Low-grade endometrial stromal sarcoma (LGESS) with intravascular extension is very rare, with only 26 cases having been reported. We experienced a case of LGESS with inferior vena cava (IVC) extension. A 60-year-old female presented with left leg edema. She had a history of total hysterectomy, and was diagnosed of leiomyoma at that time. On imaging study, tumor masses were located around both common iliac veins (CIV), and within the CIV and IVC. The pelvic masses on both side and IVC mass were resected, and then the patient received adjuvant hormonal therapy and radiotherapy over the remnant pelvic masses. LGESS with IVC extension is difficult to distinguish from intravascular leiomyomatosis. LGESS is a malignant disease and commonly recurs, even in early stages. Accurate diagnosis, complete resection, proper adjuvant therapy and close follow-up are very important.
Diagnosis ; Edema ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Iliac Vein ; Korea ; Leg ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Radiotherapy ; Sarcoma, Endometrial Stromal* ; Vena Cava, Inferior*

We report a case of malignant histiocytosis which began with intermittent fever and scaly skin lesions. A 3-year-old girl presented with erythematous scaly papules on the face and the trunk, and high fever for 3 months. The cutaneous lesions consisted of widespread coin-sized erythematous scaly papules with marginal brownish pigmentation. She was anemic and thrombocytopenic and had impairment of the liver function. Histopathologic study of the skin lesions showed non-specfic findings except for hyperkeratosis. However, bone marrow examination revealed an increased number of histiocytes, mostly immature with active phagocytosis of erythroid cells, myeloid cells, and platelets. She was diagnosed as having malignant histiocytosis and treated with cyclophosphamide and vincristine. She died the next day after the treatment had begun.
Bone Marrow Examination ; Child, Preschool ; Cyclophosphamide ; Erythroid Cells ; Female ; Fever* ; Histiocytes ; Histiocytic Sarcoma* ; Humans ; Liver ; Myeloid Cells ; Phagocytosis ; Pigmentation ; Skin* ; Vincristine

An internal hernia is defined as the protrusion of an internal organ through a defect in the abdominal cavity. Broad ligament hernia (BLH) is an extremely rare type of internal hernia that is difficult to diagnose preoperatively because the symptoms are nonspecific. However, early diagnosis is crucial, and early surgery is required to reduce complications such as strangulation. Laparoscopy has the advantage of enabling simultaneous diagnosis and treatment of BLH. With the advancement of the laparoscopic techniques, several cases of laparoscopic treatment of BLH have been reported. Nevertheless, open surgery is primarily performed in patients requiring bowel resection. We present a case of laparoscopic surgery for a strangulated internal hernia through a broad ligament defect. We successfully resected the strangulated small intestine and closed the defect of the broad ligament laparoscopically with a minor incision.

Purpose: To investigate the correlation between preoperative De Ritis ratio (aspartate transaminase [AST]/alanine transaminase [ALT]) and postoperative clinical outcome in patients with upper urinary tract carcinoma (UTUC) who underwent radical nephroureterectomy (RNU) and adjuvant chemotherapy (ACH). Materials and Methods: We respectively analyzed the clinical and pathological data of 102 patients who underwent RNU and ACH for UTUC. Patients were divided into 2 groups, according to the optimal value of AST/ALT ratio. The effect of the AST/ALT ratio was analyzed by the Kaplan-Meier method and Cox regression hazard models for patients’ cancer-specific survival (CSS) and overall survival (OS). Results: Mean survival time was 50.5±41.2 months. Mean age was 61.4±9.7years. Forty-one of the patients (46.5%) were in the high AST/ALT group. According to receiver operating characteristic analysis, the optimal AST/ALT ratio was 1.2. In Kaplan-Meier analyses, the high AST/ALT group showed worse outcomes in OS (p=0.007) and CSS (p=0.011). Using Cox regression models of clinical and pathological parameters to predict OS, high AST/ALT ratio (hazard ratio [HR], 5.428; 95% confidence interval [CI]; 1.803–16.334; p=0.002), pathological T3 (pT3) or higher (HR, 1.464; 95% CI; 1.156-1.857; p=0.002), and to predict CSS, high AST/ALT ratio (HR, 4.417; 95% CI; 1.545–12.632; p=0.005), and pT3 or higher (HR, 1.475; 95% CI; 1.172–1.904; p=0.002) were determined as independent prognostic factors. Conclusions Pretreatment AST/ALT ratio is a significant independent predictor of CSS and OS in advanced UTUC patients receiving systemic ACH after RNU.

Early recognition of coalescence in pneumoconiotic lesions is important because such coalescence is associated with the respiratory symptoms and deterioration of lung function. This complicated form of pneumoconiosis also has worse prognosis than does simple pneumoconiosis. High resolution computerized tomography(HRCT) provides significant additional information on the stage of the pneumoconiosis because it easily detects coalescence of nodules and emphysema that may not be apparent on the simple radiograph. The Purpose of this study is to clarify the role of HRCT in detection of large opacity and the relationship of change between the coalescence of nodules or emphysema and lung function in dust exposed workers. 1. There was good correlation between the HRCT grade of pneumoconiosis and ILO category of profusion. 5(9.09%) in 55 study population had confluent nodule extending over two or more cuts on HRCT. HRCT could identify the pneumoconiotic nodules which was not found by simple radiography in 6 workers with category 0/0. 2. No significant difference was observed coalescence of nodules and emphysema by dust type. 3. There was no significant difference in pulmonary function according to ILO and HRCT classification. 4. HRCT could detect the significant reduction in FEV1, FEV1/FVC, PEER, FEF25, FEF50, and FEF75 and remarkable increase in RV and TLC in study persons with emphysema compared with non-emphysema group. 5. Emphysema was found more often in nodules-coalescence group than small opacity group by HRCT. We found that HRCT could easily detect areas of coalescence and complicated emphysema compared to plain chest X-ray. Also our data suggest that it is primarily the degree of emphysema rather than the degree of pneumoconiosis that determines the level of pulmonary function.
Classification ; Dust ; Emphysema ; Humans ; Lung ; Pneumoconiosis* ; Prognosis ; Radiography ; Thorax

OBJECTS: It has been reported that the incidence of tardive dyskinesia(TD), the remarkable abnormal involuntary movement, was higher in the schizophrenics with high blood sugar levels and that TD had been improved by small amount of insulin-injection for 90 days. And also it was generally known that the blood lipids were higher in the schizophrenics with tardive dyskinesia. Thus, we tried to replicate the correlations of abnormal involuntary movements with blood sugar levels and blood lipids in chronic schizophrenics treated with antipsychotics. METHODS: Thirty-eight male schizophrenic inpatients who were stable in clinical state with medications, were included. The patients who had been already diagnosed as diabetes mellitus(DM), organic brain disorder, substance-related disorder, physical illness were excluded and also we excluded female patients to remove the hormonal effect on TD. Eleven patients who ranked higher(above five) in the Abnormal Involuntary Movement Scale(AIMS) were assigned into 2 groups, a dibenese group and a placebo group. Diabinese or placebos were administrated for 3 weeks with antipsychotics and AIMS was rechecked. RESULTS: There were no correlations between the total AIMS scores and blood sugar and lipids levels in all subjects. The means of total and subscale scores(objective, face, and extremity) of AIMS did not reveal statistical significances between diabinese and placebo groups. However(total, jaw, face, upper arm, and objective feeling), were statistically higher in the diabinese group than those in the placebo group. And correlations of total cholesterol(TC) with fast blood sugar(FBS), weight with body mass index(BMI) and waist, total glycerol (TG) with BMI were statistically significant. CONCLUSION: In this study, there were statistical significances in the changes in ratings of AIMS scores between the diabinese group and the placebo group. Application of oral hypoglycemic agent might be a way of improving abnormal involuntary movements in schizophrenics with abnormal involuntary movements or TD. Althogugh it was not certain that there were correlations of abnormal involuntary movement with blood sugar and lipids, correlations of TC/TG with AIMS, of FBS with AIMS cautiously suggest that the regular check of HbA1C, waist, and weight are recommended for schizophrenics.
Antipsychotic Agents ; Arm ; Blood Glucose* ; Brain Diseases ; Chlorpropamide ; Dyskinesias* ; Female ; Glycerol ; Humans ; Hyperglycemia ; Hyperlipidemias ; Incidence ; Inpatients ; Jaw ; Male ; Movement Disorders ; Placebos ; Schizophrenia

PURPOSE: Non-blood transfusion is of increasing interest as more patients are refusing a blood transfusion because of religious belief, infection, or fear of a blood-transmitted disease such as AIDS. This study analyzed clinical findings to help the treatment and management of patients who want a non-blood transfusion. METHODS: Of the 83 patients who visited the non-blood transfusion center in Chosun University Hospital from June 2001 to December 2003, 59 patients had a sufficient clinical record, and these were reviewed retrospectively. We investigated sex, age, the reason for the visit, the reason for refusing a blood transfusion, the degree of anemia, the necessity of the blood transfusion, the histories of transfusion and attempted non-blood transfusion, and the histories of visits to emergency departments and the outcomes. RESULTS: The male-to-female ratio was 1:2.93, and the most prevalent ages of the patients were in the forties (26 patients) and thirties (10 patients). The reasons for refusing a blood transfusion were religion (48 patients, 81.4%), risk of infection (1 patients, 1.7%), and other (10 patients, 16.9%). Among the specialty departments, the proportions of patients from the departments of obstetrics and gynecology, internal medicine, general surgery and orthopedics were 40.7% (24 patients), 25.4%, 11.9%, and 6.8%, respectively. Of the patients, 28 patients (47.5%) were admitted directly to the emergency department, and 39 patients (66.1%) were operated on. A blood transfusion was considered to be necessary for 16 patients (27.1%), but only a 2 patients (3.4%) actually received a blood transfusion. Of those 14 patients, 3patients (21.4%) died. After admission, 17 patients (29.8%) received a non-blood transfusion. CONCLUSIONS: Most of the patients visited the non-blood transfusion center for religious reasons, and the majority of the patients were admitted from the Department of Obstetrics and Gynecology. Many of the patients medically should have received blood transfusion, but only a few actually did.
Anemia ; Blood Transfusion* ; Emergency Service, Hospital ; Gynecology ; Humans ; Internal Medicine ; Obstetrics ; Orthopedics ; Religion ; Retrospective Studies