BACKGROUND: The effects of intravenous thrombolytic therapy depend on maintaining the patency of infarct-related artery in acute myocardial infarction. Thirty-two patients with acute myocardial infarction and ST segment elevation were studied to determine the usefulness of early resolution of ST segment elevation as an index of recanalization after intravenous urokinase administration. METHOD: 32 patients(male 24, female 8, mean age+/-standard deviation 62+/-11 years) were given intravenous urokinase therapy for acute myocardial infarction. Patients were classified into two groups according to changes of Summation operator ST segment elevation : early resolution(group I)=resolution to <25% of peak value within 12 hours of commencing urokinase therapy : no resolution(group II)=decreased in Summation operator ST segment elevation to > or =25% of peak value. The relationship between early changes in Summation operator ST segment elevation, time to peak creatinine kinase(CK), peak CK, changes of QRS score and & stenosis of infarct-related artery were investigated in both group. RESULTS: 1) The Summation operator ST segment elevation decreased by more than 75% of initial Summation operator ST within 12 hours after urokinase administration in 13 patients(40.6%). 2) The initial Summation operator ST segment was higher in the early resolution group than in the nonresolution group(26.0+/-4.2 vs 15.2+/-1.9mm, p<0.05). 3) The initial QRS score in both groups were not different significantly(7.2+/-0.9 vs 5.4+/-0.6 p<0.05), but QRS score decreased in the early resolution group and did not change in the no resolution group(-0.69+/-0.23 vs 0.63+/-0.16, p<0.05). 4) The early resolution group showed higher peak CK level(2409.2+/-347.7 vs 1445.2+/-280.4, p<0.05) and earlier peak time(10.6+/-1.0 vs 24.2+/-4.6, p<0.05). 5) There was no total occluded artery in both group, but the early resolution group tended to less stenosis in infarct related arteries(66.7+/-80 vs 86.7+/-3.3%, p=0.13) in predischarge coronary angiography. CONCLUSIONS: Early ST resolution after intravenous urokinase administration in acute myocardial infarction is an useful clinical index of recanalization or benefit induced by thrombolytic therapy.
Arteries ; Constriction, Pathologic ; Coronary Angiography ; Creatinine ; Female ; Humans ; Myocardial Infarction* ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator*

BACKGROUND: Upper gastrointestinal symptoms is the one of the most frequent symptom in primary medicine, those manifestations are various and can not find the cause in many cases. In Korea the management patterns for upper gastrointestinal symptoms are using drug store, oriental medicine, folk methods, diet therapy in addition to medical service. We have investigated the behavioral patterns for the control of upper gastrointestinal symptoms. METHODS: The authors surveyed the patients who had visited Dong guk university Kyung ju hospital with upper gastrointestinal symptoms from April 1 to June 30 in 2000. RESULTS: 269 questionnaires were collected and among them 247 completed ones were analysed. 112 subjects were used medical service only(45.3%), 135 subjects were used alternative methods also(54.7%). Among the 135 subjects who used alternative methods, 60 visited to drug store(44.4%), 36 took oriental medicine(26.7%), 18 used folk herbal remedy(26.7%), 5 used diet therapy(3.7%), 16 used folk manual therapy(11.9%), most commonly. Women more commonly used alternative methods(P<0.01). By occupation, housewives more commonly used alternative methods and specialists less commonly used alternative methods. There were no significant difference between two groups in other general characteristics, most severe symptom, cost, satisfaction. CONCLUSION: We find the behavioral patterns for relieving upper gastrointestinal symptoms are using alternative methods(drug store, oriental medicine, folk herbal remedy, folk manual therapy, diet therapy) in addition to using medical service. Women and housewives more commonly used alternative methods, and specialist less commonly used alternative methods.
Diet ; Diet Therapy ; Female ; Humans ; Korea ; Medicine, East Asian Traditional ; Medicine, Traditional ; Musculoskeletal Manipulations ; Occupations ; Specialization ; Surveys and Questionnaires

BACKGROUND: Oncogenes and EGF-Receptor(EGFR) may be involved n different stages of the multistep carcinogenesis process. A specific pattern of karyotypic abnormalities in solid tumors can be detected by cytogenetic methods. OBJECTIVE: This study is intnded to observe the cytomolecular kiologic chracterization of c-myc, erb B and EGFR genes in squasnous cell carcinoma(SCC) of the skin and cervix. METHODS: We have eytogenet,ically examined the short-term culturs from SCC. The rearrangement, amplification or expressi.on of erb B, c-myc, and EGFR genes were studied by Southern blot, analysis of genomic DNA and by slot blot analysis of tota! RNA extracted from biopsies of normal skin and SCC tissues. EGFR expression was examined immunohistochemially using monoclonal antibodies and the localizat,ion of the c-myc oncogene mRNA by in situ hybridization. RESULTS: A remarkably structural aberration was del 6(q21-qter) counted 20 metaphases among 28 metaphases ana1yzed. In nunierical aberration, all chromosomes were lost or gained randomly. Amenploid including triploid and tetraploid were observed in 8 metaphases, 6 tumor cells contained marker chromosome. In Southern blot analysis, rearrangement and amglificaton of EGFR in primary squamous cell carcinoma of cervix uteri and skin respectively. In slot blot analysis, the levels of c-myc, erb B and EGFR mRNA increaaed respectively 3.5, 2.5 and 2.8 times in SCC when compared to normal tissues. In immunoperoxidase stain, EGFR was present, in SCC where keratinocytes with strong cyto-plasmic staining but no membr, line labelling, where as in normal skin the were primarily present in t,he membrane and cytoplasm of basal cells. In situ hybridization with c-myc cDNAs allowed detection of grains representative of biotin labelled cDNA-mRNA hybrids in the frozden section of SCC tissues. CONCLUSION: These results suggest that specific patterns of karyotypir abnormalites, rearrangement, or amplification of EGFR gene, and overexpression of oncogenes and EGFR gene may be associated with the carcinogenesis of SCC.
Antibodies, Monoclonal ; Biopsy ; Biotin ; Blotting, Southern ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Edible Grain ; Cervix Uteri ; Cytogenetics ; Cytoplasm ; DNA ; DNA, Complementary ; Epidermal Growth Factor* ; Female ; Genes, erbB-1 ; In Situ Hybridization ; Keratinocytes ; Membranes ; Metaphase ; Oncogenes ; RNA ; RNA, Messenger ; Skin ; Tetraploidy ; Triploidy

BACKGROUND AND OBJECTIVES: We investigated the seasonal variation of nonspecific hyperreactivity by performing the cold dry air (CDA) provocation test in both summer and winter in patients with rhinitis. SUBJECTS AND METHOD: We performed the CDA provocation test in 57 patients with allergic rhinitis (AR) or non-allergic rhinitis (NAR). Depending on the season and the type of rhinitis, we divided patients into four groups (Summer AR group, n=17; Winter AR group, n=15; Summer NAR group, n=18 and Winter NAR group, n=7) and compared the changes in nasal symptoms, total nasal volume (TNV), and minimal cross-sectional area (MCA) measured by acoustic rhinometry after CDA provocation in each group. RESULTS: When the CDA provocation was performed for AR patients in summer, nasal symptoms improved slightly, which was significantly different from those shown in winter (Summer AR vs. Winter AR, p=0.012). In addition, there was a significant difference in symptom change between AR and NAR patients in the summer (Summer AR vs. Summer NAR, p=0.033). There was no significant difference in TNV or MCA changes after CDA provocation depending on the type of rhinitis and season (p>0.05). CONCLUSION: When performing CDA provocation in AR patients in summer, the examiner should pay attention to the possible paradoxical response.
Humans ; Methods ; Nasal Provocation Tests ; Rhinitis ; Rhinitis, Allergic ; Rhinometry, Acoustic ; Seasons

BACKGROUND AND OBJECTIVES: We investigated the seasonal variation of nonspecific hyperreactivity by performing the cold dry air (CDA) provocation test in both summer and winter in patients with rhinitis.SUBJECTS AND METHOD: We performed the CDA provocation test in 57 patients with allergic rhinitis (AR) or non-allergic rhinitis (NAR). Depending on the season and the type of rhinitis, we divided patients into four groups (Summer AR group, n=17; Winter AR group, n=15; Summer NAR group, n=18 and Winter NAR group, n=7) and compared the changes in nasal symptoms, total nasal volume (TNV), and minimal cross-sectional area (MCA) measured by acoustic rhinometry after CDA provocation in each group. RESULTS: When the CDA provocation was performed for AR patients in summer, nasal symptoms improved slightly, which was significantly different from those shown in winter (Summer AR vs. Winter AR, p=0.012). In addition, there was a significant difference in symptom change between AR and NAR patients in the summer (Summer AR vs. Summer NAR, p=0.033). There was no significant difference in TNV or MCA changes after CDA provocation depending on the type of rhinitis and season (p>0.05). CONCLUSION When performing CDA provocation in AR patients in summer, the examiner should pay attention to the possible paradoxical response.

Incidence of testicular tumor is 1-2% in all male tumor. Various series report that 3.6-11.6% of testicular tumor arise in patient with cryptorchidism or a history of cryptorchidism. But testicular tumors developed in suprapubic ectopic testis were reported rarely. Seminoma is one of the most radiosensitive tumor. However, the survival of patients with advanced tumor is poor. Therefore adjuvant systemic chemotherapy is essential for proper treatment of these patients. Recently we experienced a case of advanced seminoma resulted from suprapubic ectopic testis and treated by orchiectomy, systemic chemotherapy and radiation with good result.
Cryptorchidism ; Drug Therapy ; Humans ; Incidence ; Male ; Orchiectomy ; Seminoma* ; Testicular Neoplasms ; Testis*

Pituitary apoplexy refers to a clinical syndrome characterized by sudden headache, visual impairmentm and ophthalmoplegia, which are caused by infarction or hemorrhage of the pituitary tumor. There is disagreement regarding the role of early surgery. All the patients may not require surgical decompression because spontaneous recovery is possible. We report 4 cases of pituitary tumor showing spontaneous resolution after pituitary apoplexy treated only by hormonalreplacement therapy.
Decompression, Surgical ; Headache ; Hemorrhage ; Humans ; Infarction ; Ophthalmoplegia ; Pituitary Apoplexy* ; Pituitary Neoplasms

Venous thrombectomy and temporary arteriovenous (AV) fistula are performed for the treatment of iliofemoral venous thrombosis. The theory behind creation of an AV fistula is to increase venous flow, thereby maintaining patency. But AV fistula might induce severe peripheral venous hypertension in the condition of proximal venous segment reocclusion. A 62-year-old woman who developed severe peripheral venous hypertension after postthrombectomy AV fistula visited our clinic. We treated this patient with simple ligation of the AV fistula.
Arteriovenous Fistula ; Female ; Fistula ; Humans ; Hypertension ; Ligation ; Middle Aged ; Thrombectomy ; Venous Thrombosis

Cornified envelope is highly insoluble structure formed beneath the plasma membrane during terminal differentiation of keratinocytes and is stabilized by cross linking of various proteins, including involucrin, loricrin, and cornifin. Psoriasis is a chronic skin disease characterizing inflammatory reaction and hyperproliferation of keratinocyte. There are some differences in involucrin immunolabelling in stratum corneum between normal and psoriasis epidermis. Labelling was convergent to cornified envelope in psoriasis skin but throughout cytoplasm in normal skin. To compare terminal differentiation patterns of normal and psoriasis keratinocytes, we reconstructed normal and psoriatic artificial skin by using primary cultured keratinocytes from normal and psoriasis skin and then performed immunogold labelling for involucrin in stratum corneum. Psoriatic artificial skin had thin and poorly organized corneal layer. Immunogold labelling for involucrin revealed same pattern of that in vivo by showing throughout cytoplasm in lower layer but convergent cornified envelope in upper layer. Compared with psoriatic artificial skin, normal artificial skin had well organized and thick stratum corneum. Involucrin labelling was throughout cytoplasm in most of corneal layer but convergent to cornified envelope in some uppermost cells. Even though some cells show convergent pattern in normal artificial skin, absolute number of this pattern was no lesser than in artificial psoriatic skin because of normal artificial skin had thick stratum corneum. This result showed there was no difference in involucrin distribution in terminal differentiation of normal and psoriasis keratinocytes in organotypic culture model. It is concluded that although well organized multiple corneal layers are formed in normal artificial skin, they can not reach to full maturation of cornified envelope, and difference of involucrin localization in cornified envelope of psoriasis epidermis is related with not peculiarities of the cells but rapid growing in vivo.
Cell Membrane ; Cytoplasm ; Epidermis ; Keratinocytes ; Psoriasis ; Skin ; Skin Diseases ; Skin, Artificial*

PURPOSE: Most patients who undergo a curative resection of a pancreatic ductal adenocarcinoma (PDAC) develop recurrence, usually at the tumor bed or in the liver, which has been associated with the poor prognosis of a PDAC. In this study, the clinical characteristics of the recurrences following curative resection of a PDAC were analyzed to discover the surgical and adjuvant treatment strategies. METHODS: Between May 1990 and December 2002, 156 patients diagnosed with a recurrence after curative resection of a PDAC were analyzed for the pattern of recurrence, time of recurrence, associations with stage and adjuvant therapy, and survival using a retrospective review of their medical records. RESULTS: Local and systemic recurrences were found in 41.0 and 25.7%, respectively. About half of the recurrences occurred within 6 months of the operation. A local recurrence was found more frequently in the body and tail than in the head, which occurred earlier than a systemic recurrence at an advanced stage. A local recurrence occurred in 40% of patients treated with surgery alone, and in 29.4% of those treated with surgery plus radiotherapy, whereas a systemic recurrence occurred in 25.5% of patients treated with surgery alone, and in 17.4% of those treated with surgery plus chemotherapy. The patients with a local recurrence had a significantly prolonged median disease free survival time (7.8 months) than those with a systemic recurrence (5.8 months). The two-year survival rate for the locally recurred patients was greater than that for those with a systemic recurrence (23.4% vs. 17.5%). CONCLUSION: Our study showed a high rate and early occurrence of local recurrence, with a poor survival rate within 1 year, even after curative resection of the PDAC. There is still a great need for advances in meticulous surgical techniques for the control of local recurrence, especially in body and tail lesion or an advanced stage, and new adjuvant therapeutic modalities following curative resection to improve the survival rate of patients with a PDAC.
Adenocarcinoma* ; Carcinoma, Pancreatic Ductal ; Disease-Free Survival ; Drug Therapy ; Head ; Humans ; Liver ; Medical Records ; Pancreas* ; Pancreatic Ducts ; Prognosis ; Radiotherapy ; Recurrence* ; Retrospective Studies ; Survival Rate