In order to observe the changes in left ventricular function during coronary artery occlusion and reperfusion, left anterior descending (LAD) coronary arteries in the anesthetized dogs were occluded for 1 hour and then reperfused for 4 hours. Hemodynamic indexes of global systolic and diastolic function and regional wall thickness changes as a regional contractile index were measured during occlusion and reperfusion. The results were as follows; 1) Indexes of global systolic function (left ventricular peak systolic pressure, peak positive dP/dt) and global diastolic function (peak negative dP/dt, time constant, left ventricular end-diastolic pressure) showed deterioration in early occlusion period (10-30 minutes) but gradually improved even if coronary occlusion persisted. Reperfusion did not induce significant changes except that peak positive dP/dt transiently deteriorated 30 minutes after reperfusion and left ventricular end-diastolic pressure decreased 1.5-2 hours after reperfusion. 2) Indexed of regional function (i.e, end-diastolic thickness and % systolic thickening of anterior left ventricular wall) deteriorated by 10 minutes' occlusion which persisted during the entire occlusion period. Reperfusion induced no significant improvement in regional contractile function compared with occlusion 60 minutes' data, which suggested reperfusion for 4 hours after 1 hour's LAD occlusion may be insufficient for the ischemic region to recover its contractility. 3) Reperfusion arrhythmia (ventricular tachycardia) was noted in most (6/9) of the dogs, one of which deteriorated into ventricular fibrillation and the others spontaneously converted to normal sinus rhythm.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Hemodynamics ; Reperfusion* ; Ventricular Fibrillation ; Ventricular Function, Left*

BACKGROUND/AIMS: Gabexate, a protease inhibitor, has been known to prevent pancreatic damage following ERCP. We conducted a prospective and randomized study to assess the preventive effect of gabexate. Methods: Of the 96 patients enrolled, 46 were treated with gabexate and 50 with placebo. The groups were similar with regard to sex, age, body-mass index, and the final diagnosis of ERCP. RESULTS: 24 patients (25.0%) had elevated pancreatic-enzyme levels; the frequency was similar in the two groups (P=0.48). Mean serum amylase value at 4 hours after ERCP was similar in patients with elevated basal level (220.5+/-43.2 U/L) and those with normal basal level (170.4+/-31.2 U/L). After the procedures, serum amylase values were lower in the gabexate group (137.1+/-19.8 U/L) than in the placebo group (212.0+/-50.4 U/L). The differences were not significant in the mean levels of amylase between the groups for any of imaging of the pancreatic ducts (pancreatic-duct imaging, 201.5+/-49.4 U/L, bile-duct imaging, 153.7+/-30.0 U/L). But in the patients with pancreatic duct imaging, serum amylase values were significantly higher in the placebo group (295.0+/-97.6 U/L) than in the gabexate group (112.0+/-10.6 U/L)(p<0.05). CONCLUSIONS: Prophylactic treatment with gabexate does not reduce pancreatic damage related to ERCP, but only in the patients with pancreatic duct imaging there were the significant differences between in the gabexate group and in the placebo group.
Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Gabexate* ; Humans ; Pancreatic Ducts ; Pancreatitis ; Prospective Studies ; Protease Inhibitors

BACKGROUND: Clinically apparent thyroid nodule is a very common disease in adults. Patients are often treated with thyroxine in order to reduce the size of the nodule, but the efficacy of thyroxine-suppressive therapy with thyroxine remains uncertain. We investigated the efficacy of thyroxine-suppressive therapy and the hormonal characteristics during thyroxine therapy to find out whether such measurement could be used to determine the effectiveness of this therapy in patients with benign solitary thyroid nodule proved by aspiration biopsy. METHODS: In this study, 54 patients were randomly assigned to receive L-thyroxine (Group I, n=24) or placebo (GroupII, n=30) for 1 year. High resolution ultrasonography (10MHz) was used to measure the size of the nodules at six month intervals. Thyroid hormones and thyroglobulin assay and FNA (fine needle aspiration) was done at the same time. The dose of thyroxine was 200ug/day. Patients were followed at 6 month intervals. RESULTS: The results were as follows: 1) 13 (54.1%) out of 24 Group I patients after adequate TSH suppression had a statistically significant reduction of nodule size and before-to-after nodule volume ratios were significantly different between the Group I and Group II patients. 2) In the responders among Group I patients, the before-to-after therapy ratio of the nodule volume was not related to the pretreatment nodule size, thyroid hormones and thyroglobulin levels. CONCLUSION: Thus we concluded that an adequate suppressive dose of L-thyroxine significantly altered the volume of the benign solitary thyroid nodules 12 months later.
Adult ; Biopsy, Needle ; Humans ; Needles ; Thyroglobulin ; Thyroid Gland* ; Thyroid Hormones ; Thyroid Nodule* ; Thyroxine* ; Ultrasonography

Author analyzed 117 patients with traumatic lesions in posterior cranial fossa who had been treated at the Department of Neurosurgery in Jeonju Presbyterian Medical Center from January 1982 to December 1985. Results are summarized as follows: 1) The traumatic lesions in posterior cranial fossa were 4.97% of all head injuries. 2) 73 out of 117 patients were male and female were 44 cases. 75.2% of cases were found below age of 40. 3) The most common cause of injuries was traffic accident with motor vehicle(50%). 4) Occipital skull fractures were found in 69 cases(50.4%). Most of them were linear type. There were 15 epidural hematoma(12.8%), 6 cerebellar hematoma, 4 pontine hematoma, 1 subdural hematoma. 5) 67 cases of all patients were on Grady coma scale grade 1 and 2. 48 cases were on Grady coma scale grade 3 and 4. 2 cases were on Grady coma scale grade 4 and 5 on admission. 6) 13 cases with traumatic hematomas in posterior cranial fossa were treated surgically and 13 cases conservatively. 3 of them were expired. 7) There were 61 cases associated injuries(52.1%). Commonly associated injuries were the fracture of rib, clavicle and femur. 8) 50 out of 117 cases showed sequelae:Motor weakness and cranial nerve palsies were main deficits. 9) The total mortality of traumatic posterior fossa lesions was 12.8%(15 cases) and the operative mortality was 15.4%(2 cases).
Accidents, Traffic ; Clavicle ; Coma ; Cranial Fossa, Posterior* ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Female ; Femur ; Hematoma ; Hematoma, Subdural ; Humans ; Jeollabuk-do ; Male ; Mortality ; Neurosurgery ; Protestantism ; Ribs ; Skull Fractures

Author analyzed 117 patients with traumatic lesions in posterior cranial fossa who had been treated at the Department of Neurosurgery in Jeonju Presbyterian Medical Center from January 1982 to December 1985. Results are summarized as follows: 1) The traumatic lesions in posterior cranial fossa were 4.97% of all head injuries. 2) 73 out of 117 patients were male and female were 44 cases. 75.2% of cases were found below age of 40. 3) The most common cause of injuries was traffic accident with motor vehicle(50%). 4) Occipital skull fractures were found in 69 cases(50.4%). Most of them were linear type. There were 15 epidural hematoma(12.8%), 6 cerebellar hematoma, 4 pontine hematoma, 1 subdural hematoma. 5) 67 cases of all patients were on Grady coma scale grade 1 and 2. 48 cases were on Grady coma scale grade 3 and 4. 2 cases were on Grady coma scale grade 4 and 5 on admission. 6) 13 cases with traumatic hematomas in posterior cranial fossa were treated surgically and 13 cases conservatively. 3 of them were expired. 7) There were 61 cases associated injuries(52.1%). Commonly associated injuries were the fracture of rib, clavicle and femur. 8) 50 out of 117 cases showed sequelae:Motor weakness and cranial nerve palsies were main deficits. 9) The total mortality of traumatic posterior fossa lesions was 12.8%(15 cases) and the operative mortality was 15.4%(2 cases).
Accidents, Traffic ; Clavicle ; Coma ; Cranial Fossa, Posterior* ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Female ; Femur ; Hematoma ; Hematoma, Subdural ; Humans ; Jeollabuk-do ; Male ; Mortality ; Neurosurgery ; Protestantism ; Ribs ; Skull Fractures

No abstract available.
Hyperplasia* ; Melanoma*

No abstract available.
Carcinoma, Adenoid Cystic* ; Humans ; Knee* ; Male

No abstract available.
Child* ; Humans

PURPOSE: To develop a reliable prognostic model for patients with metastatic renal cell carcinoma (RCC) based on features readily available in common clinical settings. PATIENTS AND METHODS: A total of 197 patients with RCC who underwent nephrectomy and immunotherapy from 1995 to 2004 were retrospectively reviewed. Their mean age was 55.1+/-11.8 yrs (24-83yrs) and mean survival time from metastasis was 22.6+/-20.2mos (3-120mos). The impact of 24 clinicopathological features on disease specific survival was investigated. RESULTS: On univariate analysis, constitutional symptoms, sarcomatoid differentiation, tumor necrosis, multiple primary lesions, liver metastasis, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), thrombocytosis, alkaline phosphatase, hematocrit, T stage, N stage, and nuclear grade had significant influence on survival (p<0.05). Multivariate analysis revealed the following features associated with survival: sarcomatoid differentiation [hazard ratio (HR)=2.99, p<0.001], liver metastasis (HR=2.09, p=0.002), ECOG-PS (HR=1.95, p= 0.005), N stage (HR=1.94, p=0.002), and number of metastatic sites (HR=1.76, p=0.003). An individual prognostic score was defined as the sum of the weight of these features. According to prognostic scores, patients could be subdivided into 3 groups: low risk (score 0), intermediate risk (score 1 or 2), and high risk (score> or =3). CONCLUSION: A comprehensive prognostic stratification model was developed to predict survival and stratify patients for prospective clinical trials.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell/pathology/*therapy ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Humans ; Immunotherapy/methods ; Kidney Neoplasms/pathology/*therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Nephrectomy/methods ; Prognosis ; Retrospective Studies

PURPOSE: The incidence of accidentally detected small renal tumors is increasing throughout the world. In this multi-institutional study performed in Korea, histopathological characteristics of contemporarily surgically removed renal tumors were reviewed with emphasis on tumor size. MATERIALS and METHODS: Between January 1995 and May 2005, 1,702 patients with a mean age of 55 years underwent surgical treatment at 14 training hospitals in Korea for radiologically suspected malignant renal tumors. Clinicopathological factors and patient survival were analyzed. RESULTS: Of the 1,702 tumors, 91.7% were malignant and 8.3% were benign. The percentage of benign tumors was significantly greater among those < or = 4cm (13.2%) than those > 4cm (4.5%) (p < 0.001). Among renal cell carcinoma patients, the percentage of tumors classed as stage > or = T3 was significantly less among tumors < or = 4cm (5.2%) than those > 4cm (26.8%) (p < 0.001). The percentage of tumors classed as Fuhrman's nuclear grades > or = 3 was also significantly less among tumors < or = 4cm (27.3%) than tumors > 4cm (50.9%) (p < 0.001). The 5-year cancer-specific survival rate was 82.7%, and T stage (p < 0.001), N stage (p < 0.001), M stage (p = 0.025), and Fuhrman's nuclear (p < 0.001) grade were the only independent predictors of cancer-specific survival. CONCLUSION: In renal tumors, small tumor size is prognostic for favorable postsurgical histopathologies such as benign tumors, low T stages, and low Fuhrman's nuclear grades. Our observations are expected to facilitate urologists to adopt function-preserving approach in the planning of surgery for small renal tumors with favorable predicted outcomes.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney Neoplasms/classification/*pathology/*surgery ; Male ; Middle Aged ; Neoplasm Staging