Echocardiographic evaluation of left ventricular function permits the demonstration of preclinical diabetic cardiomyopathy. In order to define the relationship between diabetic retinopathy and precence of myocardial dysfunction, M-mode echocardiograms were recorded in three groups of diabetics ; group 1, no retinopathy, group 2, background retinopathy, group 3, proliferative retinopathy, and normal controls without evidence fo coronary heart disease. The resultant traces were digitized, and systolic and diastolic parameters were evaluated. None of parameters fo systolic function was modified. however peak velocity of posterior wall thinning was decreased in group 3(p<0.005), peak velocity of left ventricular demension increase was decreased in all three groups(p<0.005, P<0.001, P<0.001 respectively), duration of rapid thinning of posterior wall increased in group 2 and 3(p<0.001, p<0.001 respectively), and duration of rapid inflow of left ventricle was increased in group 3(p<0.005). These results indicate a diminution of myocardial compliance and relaxation in diabetics with retinopathy. It is concluded that abnormalities of left ventricular diastolic function is present in diabetics when left ventricular systolic function is normal and that more severe abnormalities of left ventricular diastolic function in diabetics with proliferative retinopathy reflect a subclinical diabetic cardiomyopathy due to small vessel disease.
Compliance ; Coronary Disease ; Diabetes Mellitus ; Diabetic Cardiomyopathies ; Diabetic Retinopathy ; Echocardiography* ; Heart Ventricles ; Relaxation ; Ventricular Function, Left*

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

No abstract available.
Dyspnea* ; Hypothyroidism*

Human membranous nephropathy (MN) is morphologically characterized by subepithelial immune complex deposits and progressive thickening of glomerular basement membranes (GBM). Studies have suggested that the enhanced secretion of classical and novel type IV collagen chains in MN contributes to spike formation and the novel type IV collagen chain is particularly related to thickening of GBM. It is unclear whether the increased accumulation of extracellular matrix (ECM) proteins in GBM is due to the increased mRNA expression for type IV collagen in glomerular visceral epithelial cells (GECs). To answer this question, we analyzed seven renal biopsies of patients with idiopathic MN using in situ hybridization. In MN, the number of GECs expressing mRNA for alpha1(IV) collagen was 2.82+/-1.80/glomerular cross section (gcs), and the number expressing mRNA for alpha4(IV) collagen was 8.42+/-2.85/gcs. The number of GECs expressing mRNA for alpha4(IV) collagen was significantly larger than that of alpha1(IV) collagen mRNA. The expression of mRNA for these ECM proteins in normal controls was negligible. These results suggest that subepithelial immune complexes stimulate the gene expression of alpha1(IV) collagen and alpha4(IV) collagen in glomerular GECs which, in turn, increase the secretion of ECM proteins and contribute to the thickening of GBM in MN.
Antigen-Antibody Complex ; Biopsy ; Collagen ; Collagen Type IV* ; Extracellular Matrix ; Gene Expression ; Glomerular Basement Membrane ; Glomerulonephritis, Membranous* ; Humans* ; In Situ Hybridization ; Podocytes ; RNA, Messenger*

Transcatheter hepatic arterial embolization (THAE) is one of the treatment modalities that can be applied to hepatocellular carcinomas (HCC) and metastatic tumors of the liver. Complications such as cholecystitis and gallbladder necrosis, are common with THAE, but liver and peripheral bile duct necrosis are rare, and intrahepatic stones with main bile duct necrosis have never been reported. To prevent intrahepatic spread during operative manupulation and to decrease the vascularity and size of the tumor, we performed a THAE on a huge-sized HCC five times before performing the hepatectomy. We succesfully undertook a right lobectomy after the THAE with lipiodol, gelform, and adriamycin. However, severe bile duct stricture and intrahepatic stones were confirmed during the operation.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular ; Cholecystitis ; Constriction, Pathologic* ; Doxorubicin ; Ethiodized Oil ; Gallbladder ; Hepatectomy ; Liver ; Necrosis

No abstract available.
Breast* ; Glucuronidase* ; Lipase* ; Milk, Human*

No abstract available.
Aneurysm* ; Cerebral Infarction* ; Foramen Ovale, Patent*

No abstract available.
Cor Triatriatum*

No abstract available.
Urinary Tract Infections* ; Urinary Tract*

From July 1989 to February 1993, twelve patients were analysed for infected bone loss which treated with radically debriding all infected dead bone and closed suction-irrigation system with antibiotics and internal lengthening by using the external fixator. The results are summarized as follows. 1, The average time for application of external fixation was 30.7 weeks in tibia, 27 weeks in femur and average time for bone union was 31.5 weeks in femur, 34.2 weeks in tibia. 2. Soft tissue defects were treated with split thickness skin graft in 6 cases, secondary closure in 4 cases, gastrocnemius rotational flap in 2 cases. 3. The length of bone defects after infected bone excision ranged from 2cm to 9.3cm, averaging 4.5cm. The bone defect was treated by internal lengthening after corticotomy with the Ilizarov apparatus in 4 cases, the Orthofix external fixator in 8 cases. 4. Four cases in this series were complicated; one pin tract infection, one angulation deformity, one checkrein deformity, one flexion contracture of knee joint. 5. Infection was managed with radical debriding infected dead bone and closed suction-irrigation system with antibiotics in all cases. 6. We recommend that the infected bone loss can be effectively managed with radically debriding dead bone and closed suction-irrigation system with antibiotics and lengthening with Ilizarov apparatus or Orthofix external fixator.
Anti-Bacterial Agents ; Congenital Abnormalities ; Contracture ; External Fixators ; Femur ; Humans ; Knee Joint ; Skin ; Tibia ; Transplants