No abstract available.
Anxiety* ; Arachnoid*

BACKGROUND: Aside from its well known peripheral antihypertensive effects, calcium also lowers blood pressure, when administered into the cerebral ventricle. The present study was aimed to determine whether the central depressor response to calcium is mediated by a stimulation of endogenous L-arginine-nitric oxide (NO) pathway. METHODA: Mean arterial pressure (MAP) and heart rate (HR) were continuously recorded from the femoral artery in anesthetized rats. Administration of calcium was performed into the right lateral cerebral ventricle. The effects of N G-nitro-L-arginine methyl ester (L-NAME) on the cardiovascular response to calcium were examined. RESULTS: Intracerebroventricular (ICV) injection of calcium consistently produced a decrease in MAP and HR. The depressor and bradycardiac responses to calcium showed a dose-dependent fashion. Pretreatment with a calcium channel blocker, diltiazem (1 micromol, ICV), attenuated cardiovascular responses to calcium. ICV infusion (1 microl/min) of L-NAME (200 microgram/kg and 20 microgram/kg/min for 60 min) increased MAP without significant changes in HR. Chronic ingestion of L-NAME (5 mg/100 ml in drinking water, 4 weeks) also increased the systolic blood pressure as compared with control. The depressor effect of ICV calcium was significantly diminished in acute or chronic L-NAME treated rats. CONCLUSION: These findings suggest that the central depressor response to calcium, at least in part, is NO-dependent.
Animals ; Arterial Pressure ; Blood Pressure ; Calcium Channels ; Calcium* ; Cerebral Ventricles ; Diltiazem ; Drinking Water ; Eating ; Femoral Artery ; Heart Rate ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Rats

The angiotensin-converting enzyme (ACE) gene DD homozygote has been suggested to be a significant risk factor for the progression of diabetic nephropathy. We analyzed clinical parameters and ACE genotype distribution between type 2 diabetic patients at the extremes of renal risk, i.e. an end-stage renal failure (ESRF) group (n = 103, group 1) who were on dialysis therapy due to progression of diabetic nephropathy, and a no progression group (n = 88, group 2) who had maintained normal renal function and normoalbuminuria for more than 15 years. There were no significant differences in age, sex, body mass index, HbA1c level, or lipid profiles between the two groups (p > 0.05). Group 1 had a significantly higher prevalence of hypertension [group 1: 82.5% (85/103) vs. group 2: 50.0% (44/88), p < 0.05] and diabetic retinopathy [group 1: 103/103 (100%) vs. group 2: 28/88 (31.8%), p < 0.05] than group 2. Daily urinary albumin excretion was also higher in group 1 than in group 2 [group 1: 2873 +/- 2176 mg/day vs. 12 +/- 7 g/day, p < 0.05]. The frequencies of the DD, ID, and II genotypes of the ACE gene in group 1 and group 2 were 26.2%, 47.6%, and 26.2%, and 7.9%, 57.9%, and 34.2%, respectively. The ACE genotype frequencies between the two groups were significantly different according to a chi-square test with Bonferroni's correction (p = 0.004). The presence of the DD genotype increased the risk of ESRF 4.286-fold compared to the II genotype [odds ratio 4.286, 95% CI 1.60- 11.42, p = 0.005]. The frequency of the D-allele was higher in both male and female patients in group 1 compared to group 2, but reached statistical significance only in males [male, group 1: 50.8% vs. group 2: 35.0%, p = 0.018, female, group 1: 48.8% vs. group 2: 39.5%, p = 0.231]. This study, although limited by sample size, showed that type 2 diabetic ESRF patients more frequently expressed the DD genotype. These findings may substantiate the previously noted relationship between the ACE DD genotype and the progression of diabetic nephropathy in Korean type 2 diabetic patients.
Renal Dialysis ; *Polymorphism, Genetic ; Peptidyl-Dipeptidase A/*genetics/metabolism ; Middle Aged ; Male ; Kidney Failure, Chronic/diagnosis/*genetics ; Humans ; Homozygote ; Gene Frequency ; Female ; Diabetic Nephropathies/diagnosis/*genetics ; Diabetes Mellitus, Type 2/diagnosis/*genetics ; Aged

No abstract available.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Humans ; Lung*

Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-term use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4-fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd anti-tuberculosis regimens for the first time. We separated the patients by two groups.(Group I: OFX+PTA+CS+PAS + Injection, Group II: PZA+PTA+CS+PAS+Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by chi2-test and T-test. Results: 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced state was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group I and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1% in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5% in Group I and 83.3% in Group II but had no significant difference. Conclusion: In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.
Age Distribution ; Arthralgia ; Ciprofloxacin ; Cohort Studies ; Drug Resistance ; Hospitals, Chronic Disease ; Humans ; Korea ; Ofloxacin ; Pyrazinamide* ; Recurrence ; Retreatment* ; Retrospective Studies ; Sex Distribution ; Sputum ; Tuberculosis, Pulmonary*

No abstract available.
Adenosine Deaminase* ; Adenosine* ; Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Humans ; Tuberculosis, Pulmonary*

Fecal incontinence is a disabling condition with devastating psychosocial impact due to diverse etiology. This study was performed to assess various causes of fecal incontinence, clinical evaluation, and adequate surgical treatment. METHODS: Eighty patients presenting fecal incontinence during July 1989 and June 1997 were included. They were evaluated by clinical parameters and physiologic tests including the defecography, electromyography, transanal ultrasonography, and anorectal manometry. Surgery was performed in 31 patients based on those evaluation. Pre- and post-operative comparison of manometric findings, clinical assessment, incontinence score, and the outcome of surgery were assessed. Mean postoperative follow-up was 22 (2~84) months. RESULTS: Inappropriate anal surgery was the most common cause, and then injuries during delivery, trauma, rectal prolapse, and hysterectomy in descending order. Defecography was performed in 21 patients and mean values of anorectal angles were 115+/-15degrees at rest, 98+/-18degrees during squeezing, and 136+/-10degrees during push. Electromyography was performed in 8 patients showing pudendal neuropathy in 2, bilateral lumbosacral polyradiculopathy in 4, and normal finding in 2 patients, respectively. Transanal ultrasonography was performed in 33 patients and 22 among them showed finding of an injury of the anal sphincters. Surgery was performed in 31 patients due to anal sphincter damage, rectovaginal fistula, and anal stricture in descending order. Type of surgery was determined by respective cause: plication, triple repair (sphincteroplasty, anoplasty, perineorrhaphy), and posterior rectopexy in descending order. Nerve preserving graciloplasty was performed in a 12 year-old girl who had severe defect of the anal sphincters by traffic accident, showing sound recovery with a good functional outcome. Although there was no significant difference of manometric variables between pre- and post-operative periods, sphincter length, and maximum resting and squeezing pressure, revealed an increasing tendency postoperatively. According to the clinical assessment between pre- and post-operative periods, urgency to evacuate, soiling, sensation on defecation, and quality discrimination were significantly improved postoperatively (P<0.01). Incontinence score was markedly decreased from 10.6+/-6.1 during preoperative period to 2.9+/-4.7 during postoperative period (P<0.01). Eighty one percent of the patients undergone surgery experienced a significant symptomatic improvement. CONCLUSIONS: According to the analysis of the causes of fecal incontinence, inappropriate anal surgery, injuries during delivery, and trauma were main causes. Adequate application of physiologic tests, such as, defecography, electromyography, transanal ultrasonography, and anorectal manometry, were helpful in determining treatment modality and types of surgery. We got satisfactory results with adequate surgery based on the physiologic tests.
Accidents, Traffic ; Anal Canal ; Child ; Constriction, Pathologic ; Defecation ; Defecography ; Discrimination (Psychology) ; Electromyography ; Fecal Incontinence* ; Feces ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Manometry ; Polyradiculopathy ; Postoperative Period ; Preoperative Period ; Pudendal Neuralgia ; Rectal Prolapse ; Rectovaginal Fistula ; Sensation ; Soil ; Ultrasonography

Patients who have repaired cleft lip and palate generally undergo restriction of maxillary growth. Concave facial profile is often exhibited with relatively normalized mandible. Horizontal and sagittal deficiency of the maxilla could cause anterior and posterior crossbites. In growing patients, orthodontic and orthopedic treatment is acceptable with maxillary expansion and protraction. However, surgical approach has to be accompanied with orthodontic treatment in skeletally matured patients. We used SARPE and BSSRO to expand the constricted maxilla and retract the mandible in a patient who had cleft palate repaired in infancy. Through SARPE, orthodontic treatment and BSSRO, we sufficiently expanded the maxillla and improved facial profile.
Cleft Lip ; Cleft Palate ; Humans ; Malocclusion ; Mandible ; Maxilla ; Orthopedics ; Palatal Expansion Technique ; Palate

Patients who have repaired cleft lip and palate generally undergo restriction of maxillary growth. Concave facial profile is often exhibited with relatively normalized mandible. Horizontal and sagittal deficiency of the maxilla could cause anterior and posterior crossbites. In growing patients, orthodontic and orthopedic treatment is acceptable with maxillary expansion and protraction. However, surgical approach has to be accompanied with orthodontic treatment in skeletally matured patients. We used SARPE and BSSRO to expand the constricted maxilla and retract the mandible in a patient who had cleft palate repaired in infancy. Through SARPE, orthodontic treatment and BSSRO, we sufficiently expanded the maxillla and improved facial profile.
Cleft Lip ; Cleft Palate ; Humans ; Malocclusion ; Mandible ; Maxilla ; Orthopedics ; Palatal Expansion Technique ; Palate

Pulmonary pleomorphic carcinomas are rare malignant tumors that account for 0.1 to 0.4% of all lung cancers. They are notable for their aggressive clinical behavior and poor prognosis. We report here on a patient who is alive and disease-free 12 years after receiving surgical treatment for the rib recurrence of pulmonary pleomorphic carcinoma.
Humans ; Lung Neoplasms ; Prognosis ; Recurrence* ; Ribs