The angiotensin I converting enzyme inhibitor (Captopril) has recently been studied extensively in various experimental models of radiation injury and has proven its protective effects in various organs, such as the lungs, gastrointestinal tract, and kidneys. Twenty-three Sprague-Dawley rats were divided into experimental and control group. The experimental group was divided into two large groups: the first one received a single dose of 18 Gy irradiation from an electron beam on the local field of the kidney region only, and the second group received captopril per oral continuously after the same doses of irradiation. The second experimental group was divided into four subgroups by captopril doses: 62.5 mg/l, 125 mg/l, 250 mg/l, and 500 mg/l, respectively. On light and electron microscopy, the kidneys of the irradiated rats with no captopril treatment showed diffuse glomerular contraction, congestion with occlusion and focal necrosis of the endothelial, and mesangial cells. The tubules showed ballooning degeneration, desquamation, and diffuse coagulation necrosis. Captopril treated rats, especially those given a high dose (more than 250 gm/l), revealed a marked reduction of the tubular and glomerular injuries. There was a statistically significant difference in the degree of renal injury among the experimental groups (p<0.05). The result of this study suggests that an administration of high dose captopril might prevent radiation-induced renal injury, especially in the early post-irradiation period.
Animals ; Captopril* ; Estrogens, Conjugated (USP) ; Gastrointestinal Tract ; Kidney ; Lung ; Mesangial Cells ; Microscopy, Electron ; Models, Theoretical ; Necrosis ; Peptidyl-Dipeptidase A ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley

BACKGROUND/AIMS: Thrombopoietin (TPO) is an important cytokine for megakaryocyte maturation and platelet production. Because the main site of its production is liver, the failing liver may have a role in thrombocytopenia in chronic liver disease. The aims of this study were to determine the serum TPO levels in cirrhotic patients with thrombocytopenia and clarify the relation between the serum TPO levels and liver function impairment. METHOD: Cirrhotic paitents with thrombocytopenia (LC, n=57, Child class A/B/C; 20/13/24), chronic hepatitis patients (CH, n=24), oncologic patients with thrombocytopenia induced by chemotherapy (HO, n=7), acute viral hepatitis patients (AVH, n=5) and healthy controls (HC, n=5) were enrolled. Serum TPO was measured by an ELISA method. RESULTS: Although the mean platelets counts of LC (69+/-32, x103/ul: mean+/-SD) were lower than those of HC (229+/-29, x103/ul), serum TPO levels in LC (108+/-63 pg/ml: mean+/-SD) were not significantly different from HC (122+/-24 pg/ml). In HO, serum TPO was significantly higher than LC (623+/-746 vs 108+/-63 pg/ml, p<0.05) inspite of comparable platelets counts. In LC, serum TPO level was not significantly different among Child class groups. It was not correlated with serum ALT, serum albumin levels, prothrombin time, serum bile acid, Child class, Child score and partial thromboplastin time, but weakly correlated with serum total bilirubin (p=0.038, r=0.288) and platelet counts (p=0.041, r=0.287). CONCLUSIONS: Although impaired hepatic production of TPO seems to be the main cause of low serum TPO levels in thrombocytopenic cirrhotic patients, there was no correlation between serum TPO level and the severity of liver dysfunction. The role of other factors such as megakaryocyte mass in bone marrow, portal hypertension and hypersplenism may be necessary to explain the putative mechanism between TPO and platelet numbers in liver cirrhosis with thrombocytopenia.
Bile ; Bilirubin ; Blood Platelets ; Bone Marrow ; Child ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Hepatitis ; Hepatitis, Chronic ; Humans ; Hypersplenism ; Hypertension, Portal ; Liver ; Liver Cirrhosis ; Liver Diseases ; Megakaryocytes ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Serum Albumin ; Thrombocytopenia* ; Thrombopoietin*

We describe a case of Takotsubo cardiomyopathy in an elderly woman after status epilepticus. In an emergency echocardiography, not only left ventricular apical ballooning but also right ventricular apical hypokinesia was observed. After a medical management, the patient's condition was improved and a follow-up echocardiography showed substantial recovery of left and right ventricular apical ballooning.
Aged ; Echocardiography ; Emergencies ; Epilepsy* ; Female ; Follow-Up Studies ; Humans ; Hypokinesia ; Status Epilepticus ; Takotsubo Cardiomyopathy*

No abstract available.
Chickens* ; Yolk Sac*

PURPOSE: Despite appropriate preventive measures, measles outbreaks occurred in the year of 1989-1990 and 1994 in Korea. Especially, the ratio of young infantile patients below 15 months old was high in those outbreaks, and the reason was, we thought, low serum level of measles specific IgG antibody in pregnant women and low transplacental transfer rate of measles specific IgG antibody to neonate. This study was performed to evaluate the serum level of measles specific IgG antibody in term pregnant women- neonate pairs. METHODS: During Oct. 1. 1994 to Mar. 31. 1995, we collected the 44 paired sera of term pregnant women and their neonate(umbilical cord) in Anam hospital of Korea university medical center and then we measured the measles specific IgG antibody using enzyme linked immunosorbent assay(ELISA: Sigma Diagnostics, SIATM Measles IgG Kit). RESULTS: 1) There was close relationship between maternal and neonatal umbilical cord sera in the level of measles specific IgG antibody(r=0.9288, p<0.001). 2) The mean antibody level of neonates was higher than that of mothers by 1.4 times (p<0.05). 3) The seropositivity of measles specific IgG antibody in term pregnant women was 45.5%(20/44) and that of neonatal umbilical cord was 56.8%(25/44). CONCLUSIONS: Above results demonstrates that the seropositivities and levels of measles specific IgG antibody in term pregnant women and neonates were lower than expected value and partially explain the reasons for the recent measles epidemic in Korea.
Academic Medical Centers ; Disease Outbreaks ; Female ; Humans ; Immunoglobulin G* ; Infant ; Infant, Newborn ; Korea ; Measles* ; Mothers ; Pregnant Women* ; Umbilical Cord*

No abstract available.
Sperm-Ovum Interactions* ; Spermatozoa*

BACKGROUND: Although native radiocephalic arteriovenous fistula provides the best possible vascular access for hemodialysis, available veins for this fistula are limited. Ulnobasilic arteriovenous fistula (UBF) is alternative method for native fistula of forearm. But this method is not commonly used because detection of the vein is difficult and cannulation for hemodialysis id uncomfortable. This study was performed to evaluate clinical usefulness of UBF. METHODS: From June 1999 to April 2000 and from September 2001 to February 2002, 256 arteriovenous fistulae were made in 239 patients with chronic renal failure and among them, 26 UBF were made by one surgeon. At April 2002, a total of 26 UBF were reviewed. RESULTS: The results were as follows : There were 17 men and 9 women, aged 31 to 72 years. There were 7 diabetic patients. 22 patients of them had previous history of arteriovenous fistula operation. There were six failures : one delayed occlusion; one venous hypertension due to proximal stenosis during hemodialysis; four inadequate maturation. The 20 patients showed good patency. CONCLUSION: This study shows that UBF can be useful method in patients with failed radiocephalic arteriovenous fistula or poor cephalic vein and preserve upper arm vein for future operation.
Arm ; Arteriovenous Fistula* ; Catheterization ; Constriction, Pathologic ; Female ; Fistula ; Forearm ; Humans ; Hypertension ; Kidney Failure, Chronic ; Male ; Renal Dialysis* ; Veins

BACKGROUND: There are many documents about the hemodynamic changes during sympathetic blockade produced by epidural anesthesia, but few reports have addressed the effects of epidural anesthesia on renal blood flow and function. We evaluated the effects of epidural anesthesia on renal function in patients undergoing total abdominal hysterectomy with general anesthesia. METHODS: Thirty patients were randomized to groups I (n = 15) or II (n = 15). The epidural catheter was inserted via 17 gauge Tuohy needle through the L2-L3 intervertebral space of the patients in both groups, only in group II, the patients received 15 ml of 0.125% bupivacaine. All the patients were anesthetized with enflurane, nitrous oxide and oxygen. We measured mean arterial pressure and urine output, creatinine clearence, Na clearence, fractional excretion of Na and free water clearance during operation and compared the data between the two groups. RESULTS: Mean arterial pressure was lower in group II than in group I (P < 0.05), but other data were not different significantly between the two groups. CONCLUSIONS: Renal function was maintained even though epidural anesthesia reduced mean arterial pressure.
Anesthesia, Epidural ; Anesthesia, General* ; Arterial Pressure ; Bupivacaine ; Catheters ; Creatinine ; Enflurane ; Hemodynamics ; Humans ; Hysterectomy* ; Needles ; Nitrous Oxide ; Oxygen ; Renal Circulation ; Water

Aspergillus endocarditis is an uncommon, but often fatal, disease that usually occurs in patients who have had prior cardiac surgery. Endophthalmitis is a very rare complication of infective endocarditis, especially at presentation. We report a case of Aspergillus endocarditis in a 68-year-old woman who presented with endophthalmitis.
Aged ; Aspergillus ; Endocarditis ; Endophthalmitis ; Female ; Humans ; Thoracic Surgery

BACKGROUND: There has been a study reporting those cases with elevated blood pressure (BP) above 140/90 mmHg on admission and normotension on ward showed more increase in mean arterial pressure(MAP) and pressure-pulse product than the normotensive or hypertensive patients in both situations. But the mean ages of the groups were different each other. This study was done to see if the same results would come without age differences. METHODS: One hundred and sixty-two patients between the age of 45 and 64 were divided into three groups. The patients with BP below 140/90 mmHg on admission and on ward were included in group 1(N=66) and those with BP above 140/90 mmHg on admission and below 140/90 mmHg on ward, in group 2(N=42) and those with BP above 140/90 mmHg in both situations were included in group 3(N=54). Preiinduction BP, PR, the changes of BP, PR during operation, incidence of hypertension at post-anesthesia room(PAR), and the number of cases who needed the use of inotropics or antihypertensives perioperatively were checked. RESULTS: As for the increase of BP just before induction the group 2 showed the greatest, group 1 was the next, and group 3 showed the least compared to ward value. Just after induction group 1 showed the greatest, group 2 the next, and group 3 the least amount increase. As for the increase of preinduction pressure-pulse product(PPP) group 2 showed the greatest, group 3 the next, and group 1 the least compared to ward value. Just after induction group 1 showed the greatest, group 2 the next,and group 3 the least amount increase. CONCLUSIONS: Intensive anesthetic care is needed also at periinduction period for the patients who showed hypertensive BP on admission and normotension on ward thereafter.
Antihypertensive Agents ; Blood Pressure* ; Humans ; Hypertension ; Incidence