No abstract available.
Adrenocortical Carcinoma* ; Cushing Syndrome ; Humans ; Infant* ; Male* ; Puberty, Precocious

Epidermal keratinocytes are important sources of a wide variety of cytokines that include the endothelin-1 (ET-1). Glucocorticoids have been shown to inhibit the production of several cytokines. However, their effect on ET-1 synthesis by keratinocytes is still unknown. It has been reported that ultraviolet B (UVB) irradiation stimulates both the synthesis and release of ET-1 and it was observed that ET-1 secretion by HaCat cells increased with increasing UVB exposure. In this study, the effects of glucocorticoid on ET-1 production were evaluated using cultured HaCat keratinocytes. The results showed that dexamethasone suppressed basal re-lease of ET-1. In addition, it strongly inhibited the UVB-mediated augmentation of ET-1 production. Furthermore, lincomycin slightly enhanced the inhibitory effect of dexamethasone on ET-1 synthesis.
Cytokines ; Dexamethasone* ; Endothelin-1 ; Glucocorticoids ; Keratinocytes* ; Lincomycin

To clarity the effect of biliary obliteration on copper metabolism of rat liver and on the hepatic morphology, 0.5% cuppuric sulfate was administered intraperitoneally for 42 days following ligation of the common bile duct (CBD) of Sprague-Dawley rats. The blood copper concentration, the hepatic copper content and the accumulation patterns of copper and copper binding protein in the liver were examined and compared with those of the simple CBD ligation group and the simple copper over loaded group. CBD ligation induced marked proliferation of bile ductular structures which, after expanding the portal tracts, invaded and divided the hepatic lobules. There was, however, no excess fibosis beyond what needed to support the new ductules. The blood copper concentration and the hepatic copper content were increased by copper overload with or without CBD ligation, particularly incases with CBD ligation. Liver cell necrosis did not occur by the overloaded copper alone in rats. The hepatic copper and copper binding protein were accumulated at periportal liver cells in the group of coppe overload after CBD ligatio, whereas they began to appear at perivenular hepatocytes in the simple copper overloaded group. In conclusion, it is suggested that CBD ligation does not induce excess fibrosis or liver cirrhosis in rat as far as during our experimental period, but affect significantly on copper metabolism by intrahepatic redistribution of the copper and the copper binding proteins.
Rats ; Animals

To evaluate the usefulness of computed tomography (CT) in radiotherapy treatment planning in malignant tumors of thoracic cage, the computer generated dose distributions were compared between plans based on conventional studies and those based on CT scan. 22 cases of thoracic malignancies, 15 lung cancers and 7 esophageal cancers, diagnosed and treated in Department of Therapeutic Radiology of Seoul National University Hospital from September, 1982 to April, 1983, were analyzed. In lung cancer, dose distribution in plans using AP, PA parallel opposing ports with posterior spinal cord block and in plans using box technique both based on conventional studies were compared with dose distribution using AP, PA and two oblique ports based on CT scan. On esophageal cancers, dose distribution in plans based on conventional studies and those based on CT scans, both using 3 port technique were compared. The results are as follows: 1. Parallel opposing field technique were inadequate in all cases of lung cancers, as portion of primary tumor in 13 of 15 cases and portion of mediastinum in all were out of high dose volume. 2. Box technique was inadequate in 5 of 15 lung cancers as portion of primary tumor was not covered and in every case the irradiated normal lung volume was quite large. 3. Plans based on CT scan were superior to those based on conventional studies as tumor was demarcated better with CT and so complete coverage of tumor and preservation of more normal lung volume could be made. 4. In 1 case of lung cancer, tumor localization was nearly impossible with conventional studies, but after CT scan tumor was more clearly defined and localized.
Esophageal Neoplasms ; Lung ; Lung Neoplasms ; Mediastinum ; Radiation Oncology ; Radiotherapy* ; Seoul ; Spinal Cord ; Tomography, X-Ray Computed

BACKGROUND: Almost all of the blood loss occurring postoperatively in total knee arthroplasty (TKA) is due to the use of an intraoperative tourniquet in all cases. So we tried having blood transfusions done, not by anesthesiologists intraoperatively but by orthopedic surgeons postoperatively. The purpose of this study is to analyze postoperative blood loss and transfusion practice in TKAs. METHODS: We analyzed retrospectively the medical records of 64 TKAs in 40 patients between March, 1997 and February, 1999. RESULTS: Six male and fifty-eight female patients were enrolled. Their mean preoperative, immediate postoperative, and post-transfusion hematocrit were 37.1+/- 3.4, 34.4+/- 3.3, and 34.4+/-3.9, respectively. The preoperative and post-transfusion hematocrit were measured in all cases, but immediate postoperative hematocrit was measured in only 21 cases, and the hematocrit of 17 among the 21 cases was over 32 percent. Drainage amount, for the 1st postoperative day were 843 328 ml, and the total drainage amount was 993+/-362 ml. The blood transfusion amount was 2.6+/-0.9 units. There were no statistically significant differences in preoperative hematocrit, immediate postoperative hematocrit, postoperative drainage amount and postoperative transfusion amount between the general and regional anesthetic group; Preoperative hematocrit did not statistically affect the postoperative transfusion amount, but the postoperative drainage amount was statistically associated with an increased postoperative transfusion amount. CONCLUSIONS: Based on these results, it was concluded that postoperative blood transfusion in TKA was to be done on the basis of clinical impressions of orthopedic surgeons in which postoperative drainage amount was the most important consideration. Therefore, postoperative transfusion should be based on appropriate transfusion guidelines and a careful clinical examination of the patient.
Arthroplasty* ; Blood Transfusion* ; Drainage ; Female ; Hematocrit ; Humans ; Knee* ; Male ; Medical Records ; Orthopedics ; Postoperative Hemorrhage ; Retrospective Studies ; Tourniquets

Objective: Mild cognitive impairment (MCI) is considered a pre-stage of dementia. This study aims to develop a cognitive intervention treatment program (CITP) as a non-pharmacological therapy, apply this program into MCI patients, and examine patients’ changes in cognitive function. Methods: Among 16 patients with MCI, 10 patients were randomly assigned to the experimental group and 6 patients were assigned into the control group. The patients assigned to the experimental group participated in the CITP once a week for a period of 15 weeks.The control group were suggested to live a normal daily life without CITP given. After 15 weeks (3 months), pre- and post-investigations, such as cognitive function test, emotional test, brain oxygen saturation test, were conducted and compared for each group. Results: The cognitive function scores and the brain oxygen saturation levels taken during the Verbal Fluency Test showed a sta-tistically significant difference between those of experimental and the control groups. To be specific, while the cognitive function score improved in the experimental group, there was a decline in the control group. There was no statistically significant difference in emo-tional changes between two groups. Looking at the changes within each group, the overall cognitive function score of the experimen-tal group was significantly increased, but no pre- and post-significantly changes were observed in brain oxygen saturation activation. On the other hand, the control group showed a statistically significant decline in the attention criteria of the cognitive functional ar-eas, and no statistically significant changed in brain activation. Conclusion The result from this study has given some promising views on maintaining and improving the deteriorating cognitive function in patients with MCI. Conducting CITP on patients is expected to strengthen the neural network. Eventually, there would be a less deterioration of cognitive function and less progression of MCI into dementia.

BACKGROUND: Though caudal block is a relative simple technique, it has not been widely used in adults because of a high failure rate. We assumed that any tests to quantify the changes of sympathetic tone in the affected areas would be excellent indicators of successful block. We tested the usefulness of two candidates (pulse oximetry plethysmographic waveform amplitude measured at 5th toe and calf minus 5th toe skin temperature gradient) as indicators of successful caudal block. METHODS: In 45 adult patients undergoing anal surgery with caudal block, these two variables were simultaneously measured at 2-min intervals for 20 min. A two-fold increase in the plethysmographic waveform amplitude from baseline and skin temperature gradient of 0oC were predefined as test criteria of successful block. RESULTS: While the sensitivity, specificity, positive predictive value, and negative predictive value of the skin temperature gradient test were 45.9%, 100%, 100%, and 9.1%, those of the plethysmographic waveform test were 86.5%, 100%, 100%, and 28.6%. The plethysmographic waveform test showed a significantly higher discriminative capacity than the skin temperature gradient test (94.9% vs. 48.7%, P < 0.05) CONCLUSIONS: Unlike the skin temperature gradient test, the plethysmographic waveform test showed a considerably high validity in detecting successful block. Considering its simple and real time monitoring potentials together with a high failure rate of caudal block in adults, we cautiously recommend it as a supplemental diagnostic tool to predict successful block, especially when verbal communication with patient is difficult.
Adult ; Humans ; Oximetry* ; Sensitivity and Specificity ; Skin Temperature* ; Skin* ; Toes

A carotidynia is a syndrome of vascular neck pain or tenderness arising from one or both carotid artery which is frequently associated with various forms of extracranial vascular headache, Carotidynia is a common but infrequently recognized syndrome. Careful history taking, physical examination and appropreate Lab(ex: CT scan of neck) may be indicated for accurate diagnosis and adequate management. We experienced a case of carotidynia which was believed to be related to a carotid arteritis evidenced by elevated ESR, abnormalities of neck CT, angiogram, and good response to steroid.
Arteritis ; Carotid Arteries ; Diagnosis ; Neck ; Neck Pain ; Physical Examination ; Tomography, X-Ray Computed ; Vascular Headaches

Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. If a patient had tachypnea, cold sweating and hypoxemia in postoperative period, PTE must be thought to be one of possible causes of tachypnea. We have experienced one case of PTE after operation. A 40 year-old woman underwent total hystrectomy and partial omentectomy due to huge, bizarre shaped and inflammatory myoma presenting as an abdominal mass with abscess pocket accompanied by severe and adhesion. At the 5 th postoperative day tachypnea and hypoxemia were developed suddenly. PTE was confirmed with lung perfusion scan and leg edema with deep vein thrombosis occurred later. Proper cardiopulmonary support and anticoagulant therapy were done and the patient was recovered and discharged in improved condition.
Abscess* ; Adult ; Anoxia ; Diagnosis ; Edema ; Female ; Humans ; Leg* ; Leiomyoma* ; Lung ; Myoma ; Perfusion ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism* ; Sweat ; Sweating ; Tachypnea ; Venous Thrombosis*

Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. If a patient had tachypnea, cold sweating and hypoxemia in postoperative period, PTE must be thought to be one of possible causes of tachypnea. We have experienced one case of PTE after operation. A 40 year-old woman underwent total hystrectomy and partial omentectomy due to huge, bizarre shaped and inflammatory myoma presenting as an abdominal mass with abscess pocket accompanied by severe and adhesion. At the 5 th postoperative day tachypnea and hypoxemia were developed suddenly. PTE was confirmed with lung perfusion scan and leg edema with deep vein thrombosis occurred later. Proper cardiopulmonary support and anticoagulant therapy were done and the patient was recovered and discharged in improved condition.
Abscess* ; Adult ; Anoxia ; Diagnosis ; Edema ; Female ; Humans ; Leg* ; Leiomyoma* ; Lung ; Myoma ; Perfusion ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism* ; Sweat ; Sweating ; Tachypnea ; Venous Thrombosis*