BACKGROUND: Various hemodynamic changes occur during left ventriculography, such as myocardial depression, hypotension, peripheral circulatory changes, ECG changes(such as arrhythmias and conduction abnormalities) and anaphylactic reaction etc. These effects are somewhat caused by osmolality, ionic concentration of Na+, viscosity and molecular weight of contrast dye and underlying various heart disease itself during left ventriculography. We compared the hemodynamic differences between ionic(ioxaglate) and non-ionic(iopromide) low osmolar contrast agents during routine ventriculography. METHODS: In a prospective, randomized, double blind study of 124 patients underwent left ventriculography, we examined the various hemodynamic effects of the two contrast agents on left ventricle. All subjects were divided into 2 groups : ioxaglate and iopromide groups. Also, each agent was used in randomized double blind fashion in both groups ; normal control subjects(14 in ioxaglate group : 12 in iopromide group) and subjects whose ejection fraction less than 50%(12 in ioxaglate group : 16 in iopromide group). Left ventricular systolic pressure(LVSP), left ventricular end-diastolic pressure(LVEDP), maximum dP/dt, (dP/dt)/P ratio, peak - dP/dt and Tau were obtained immediately before and left ventriculography. RESULTS: 1) In total(normal+angina+MI) subjects of both groups, LVEDP(p<0.001) and maximum dP/dt(p<0.001) were increased and T(au) was reduced significantly(p<0.05). But LVSP(p<0.001) and peak - dP/dt(p<0.005) were increased significantly only in ioxaglate group. 2)In normal(control) subjects, there were no significant differences in both groups, except LVEDP that was increased by equal magnitude(p<0.001). 3) In subjects with ejection fraction less than 50%, there were no significant hemodynamic differences in both contrast agent groups bur LVEDP increased significantly in both groups(p<0.001). CONCLUSIONS: This present study showed that both ionic(ioxaglate) and non-ionic(iopromide) low osmolar contrast agents were very safe without any significant side effects except two agents caused an increase in LVEDP and did not show major differences between ioxaglate and iopromide contrast agents from a hemodynamic point of view. Two contrast agents tend to improve contractilities and diastolic properties of left ventricle since both caused an increase in maximum dP/dt and a reduce in Tau, in total subjects. This effect may be caused by cardiac compensation, probably because of osmolality, volume loading by contrast agents and secondary activation of sympathetic system immediately after injection of contrast agents. Thus, it is concluded that two ioxaglate and iopromide contrast agents amy be used safely in left ventriculography in patients with and without left ventricular dysfunction, with paying attention to an increase in LVEDP.
Anaphylaxis ; Arrhythmias, Cardiac ; Compensation and Redress ; Contrast Media* ; Depression ; Double-Blind Method ; Electrocardiography ; Heart Diseases ; Heart Ventricles ; Hemodynamics* ; Humans ; Hypotension ; Ioxaglic Acid ; Molecular Weight ; Osmolar Concentration ; Prospective Studies ; Ventricular Dysfunction, Left ; Viscosity

We present a case of recurrent left atrial myxoma which occurred 7 years and 10 months after initial operation despite resection of originaltumor and adjacent atrial septum. This is the first case report of recurrence in Korea. Among the possible causes of recurrence, regrowth from pretumorous focus seems to be the most suggesting one in this case. Histopathologic findings of recurrent myxoma showed increased cellularity with active proliferation and nuclear hyperchromasia. These findings, together with the rapidity of regrowth, suggest that recurrent myxoma may have 'wilder' behavior. Prolonged postoperative observation is important, even if ample resection was done at the initial operation including atrial septum.
Atrial Septum ; Korea ; Myxoma* ; Recurrence*

Leber's hereditary optic neuropathy(LHON) is an optic nerve disease that causes blindness and is associated with maternally inherited mitochondrial DNA(mt DNA) mutations. The most common mitochondrial DNA mutation among LHON patients is a point mutation at the nucleotide 11778 in the subunit 4 of complex I. In one 45-year old male LHON patient with bilateral optic neuropathy, we investigated the presence of a point mutation of mitochondrial DNA and identified a single guanine to adenine transition mutation in the mitochondrial DNA at nucleotide point 11778.
Adenine ; Blindness ; DNA, Mitochondrial* ; Guanine ; Humans ; Male ; Middle Aged ; Optic Atrophy, Hereditary, Leber ; Optic Nerve Diseases ; Point Mutation*

Sweet's syndrome is an acute febrile neutrophilic dermatosis that occurs with malignant disease, mainly myeloid hemopathies, in about 20% of cases. When associated with myelodysplasia, clinical and histologic features of Sweet's syndrome can be atypical; however its significance is still debated. We encountered a case of Sweet's syndrome associated with myelodysplastic syndrome in a 63-year-old woman. The clinical presentation strongly suggested Sweet's syndrome but, histopathologic examination showed dense histiocytic infiltration with prominent upper dermal edema and little neutrophil infiltration. In the evaluation for atypical histopathology and laboratory abnormalities, she was diagnosed with myleodysplastic syndrome by peripheral blood smear and bone marrow biopsy. Histiocytoid Sweet's syndrome is a currently accepted concept and probably has a close relation with underlying myeloid hemopathies.
Biopsy ; Bone Marrow ; Edema ; Female ; Humans ; Middle Aged ; Myelodysplastic Syndromes* ; Neutrophil Infiltration ; Sweet Syndrome*

Various cutaneous cysts such as epidermal cysts, trichilemmal cysts, vellus hair cysts, steatocystoma, or pilomatricoma can arise from a different part of the pilosebaceous unit, namely the infundibulum, isthmus, sebaceous ducts, and bulbar or inferior portion. Rarely, a hybrid cyst that includes two or more components of a cystic lesion arising from the pilosebaceous unit can develop. The pathogenesis of this unusual disease is not yet known. We report a case of a follicular hybrid cyst which showed combined histologic features of both an epidermal cyst and pilomatricoma, and discuss the possible pathomechanism of the development of this hybrid cyst with a review of the literature.
Epidermal Cyst ; Hair ; Pilomatrixoma

With the increase of industrialization, leisures, sports activities and traffic, the risk of trauma has increased markedly. Midfacial bones are relatively common sites of trauma, and are difficult sites of correct reduction and reconstruction, because midface is composed of mostly thin cortical bone surrounding cavities filled with either air or fat with discrete areas of bony condensation. A clinical study on 208 patients with midfacial bone fracture who visited Sanggye Paik Hospital during 5 years(1990~1995) was done by analyzing sex, age, cause, fracture site, treatment method, complication and involvement of other body part, etc. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with ratio of 2.7 : 1 and most frequently in twenties. 2. Traffic accident was the most common cause of midface fractures. 3. Zygoma was the most frequently occurred site(50%) of midface fractures. 4. Simple fracture(75%) was more frequently occurred than compound fracture(25%). 5. As treatment method, open reduction(76.4%) was used more frequently than closed reduction(23.6%) 6. Generally, operations are done in 5 days after admission(59.1%), and intermaxillary fixation was done in 78.4% of cases. 7. Teeth and alveolar bone damages were occurred in 32.2% of cases. 8. Other injuries that were related to midface fracture occurred in 63.3% of cases. 9. Post-operative complications occurred in 9% of cases.
Accidents, Traffic ; Female ; Fractures, Bone ; Humans ; Leisure Activities ; Male ; Sports ; Tooth ; Zygoma

Neonatal lupus erytematosus is characterized by cutaneous findings showing the morphology of subacute cutaneous lupus erythematosus, congenital heart block, and anti-Ro/SSA and/or anti-La/SSB autoantibodies which result from the transplacental passage of maternal autoantibodies. We report two cases of a 25-day-old female infant and a 30-day-old male infant who presented with characteristic clinical features of cutaneous neonatal lupus erythematosus but without evidence of congenital heart block. The serological studies in both infants revealed the presence of anti-SSA/Ro antibodies and antinuclear antibodies. We diagnosed their mothers as systemic lupus erythematosus with the clinical and laboratory findings.
Antibodies ; Antibodies, Antinuclear ; Autoantibodies ; Female ; Heart Block ; Humans ; Infant ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic ; Male ; Mothers

BACKGROUND: The present work was designed to examine the altered expression of peritoneal AQP-1 and water transport of peritoneal membrane during the long-term peritoneal dialysis with hypertonic glucose solution in rats. METHODS: Eighteen Sprague-Dawley male rats were randomly divided into 2 groups: control rats (n=6) with peritoneal catheter but not dialyzed; rats with peritoneal dialysis (PD) (n=12) were dialyzed with 4.25% glucose dialysate for all exchanges. Before completion of the study, 4 animals in PD group were euthanized owing to nonfunctional catheters or peritonitis, leaving 14 animals for the analysis. Dialysis exchanges were performed 3 times a day with 25 mL/each exchange for 12 weeks. Immunoperoxidase staining was performed using monoclonal anti-AGE antibody and polyclonal anti-AQP-1 antibody. The slides were read by 5 different examiners in a blind fashion. The staining intensity was graded semiquantitively from 0 to 3. The peritoneal membrane function was assessed by performing one-hour peritoneal equilibration tests every 6 week for comparing transport characteristics. Peritoneal membrane transport rate was assessed by D/P of urea nitrogen and D/Do of glucose. Water transport of peritoneal membrane was assessed by D/P of sodium at 12 week. RESULTS: The expression of peritoneal AQP-1 was increased in rats with PD, compared to control rats. Consistent with this, D/P of sodium in rats with PD was significantly decreased compared to control rats (0.58+/-0.04 vs 0.86+/-0.07, p<0.05), indicating high peritoneal water permeability in response to long-term peritoneal dialysis. Moreover, rats with PD were associated with significantly lower D/Do of glucose and higher D/P of urea nitrogen, suggesting high peritoneal membrane transport. CONCLUSION: High expression of peritoneal AQP-1 was associated with an increased peritoneal water permeability in response to long-term peritoneal dialysis with 4.25% glucose for 12 weeks. The underlying mechanisms for the increased AQP-1 expression need to be examined whether it is due to the continuous exposure to the dialysis solution containing high glucose concentration itself or compensatory effects of slowly developed concomitant ultrafiltration failure in chronic peritoneal dialysis.
Animals ; Catheters ; Dialysis ; Glucose ; Glucose Solution, Hypertonic ; Humans ; Male ; Membranes ; Nitrogen ; Peritoneal Dialysis* ; Peritonitis ; Permeability ; Rats* ; Rats, Sprague-Dawley ; Sodium ; Ultrafiltration ; Urea ; Water*

BACKGROUND AND OBJECTIVES: Ultrasonography (USG)-guided sclerotherapy using a sclerotherapic agent such as ethanol, OK-432, recently has gained popularity as a treatment for nonfunctioning benign thyroid nodules. The study evaluates the efficacy and safety of the USG-guided sclerotherapy for that purpose. SUBJECTS AND METHOD: Included in the study were 23 patients who had complaints of applied pressure or cosmetic problems due to cystic thyroid nodules, which had been diagnosed as benign and nonfunctioning by fine-needle aspiration biopsy and thyroid function test. Sclerotherapy was performed with OK-432 or 99.9% ethanol following nearly complete evacuation of the fluid from the cystic portion of thyroid nodule. At each USG follow-up, we measured the volume of cysts, symptom scores, cosmetic scores using a visual analog scale, and related complications were examined at postoperative dates of one and six months. RESULTS: The volume of thyroid cysts were significantly reduced (p<0.01) with mean volume reduction rates of 77.3+/-21.2% at postoperative 6 months. The cosmetic score and symptom score were significantly improved following sclerotherapy (p<0.01). Major complications related to sclerotherapy, such as vocal cord paralysis, thyrotoxicosis and tissue necrosis, did not happen during the follow-up observation. CONCLUSION: USG-guided sclerotherapy could be a simple and effective treatment modality for benign cystic thyroid nodules.
Biopsy, Fine-Needle ; Chronology as Topic ; Cosmetics ; Ethanol ; Follow-Up Studies ; Humans ; Necrosis ; Picibanil ; Prospective Studies ; Sclerotherapy ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Nodule ; Thyrotoxicosis ; Vocal Cord Paralysis

STUDY DESIGN: In-vitro experiments using human mesenchymal stem cells (MSCs), intervertebral disc (IVD) cells and type 5 adenovirus/transforming growth factor-beta1 construct (Ad/TGF-beta1). OBJECTIVES: To determine the effect of MSC-based gene therapy for matrix regeneration of IVD cells. SUMMARY OF LITERATURE REVIEW: MSCs are known to be multipotent in tissue regeneration. In degeneration of IVD, cellular replacement with genetic modification other than that of IVD cells may prove an enhanced mechanism for the regeneration of MATERIALS AND METHODS: MSCs and IVD cells were cultured and an adenovirus construct containing TGF-beta1 cDNA (Ad/TGF-beta1) was also produced. In the first step, the MSCs were transduced with Ad/TGF-beta1, then mixed with IVD cells in various proportions and three dimensionally cultured. [methyl-(3)H]Thymidine and [(35)S]Sulfur incorporation for DNA and proteoglycan synthesis, respectively, were measured. RT-PCR was performed to assess the aggrecan and collagen types I and II mRNA RESULTS: Mixed cultures of MSC and IVD cells showed relatively similar amounts of newly synthesized proteoglycan compared with cultures of IVD cells only. In mixed cultures transduced with Ad/TGF-beta1, there were significant decreases in newly synthesized proteoglycan with increasing the proportions of MSCs, which was also found with the aggrecan and collagen type II mRNA expressions. However, the collagen type I mRNA expression increased with increased proportions of MSCs transduced with Ad/TGF-beta1. CONCLUSION: Cell therapy with MSCs and IVD cells provided a mechanism for cellular augmentation. However, MSC-based gene therapy coupled with IVD cells did not maintain a chondrogenic phenotype.
Adenoviridae ; Aggrecans ; Cell- and Tissue-Based Therapy ; Collagen ; Collagen Type I ; Collagen Type II ; DNA ; DNA, Complementary ; Genetic Therapy* ; Humans ; Intervertebral Disc ; Mesenchymal Stromal Cells ; Phenotype ; Proteoglycans ; Regeneration ; RNA, Messenger ; Stem Cells* ; Transforming Growth Factor beta1