The author studied the effect of the recirculation on the energy metabolism in acute focal cerebral ischemia. Acute focal cerebral ischemia was produced by transorbital occlusion of the left middle cerebral artery with a Heifetz clip under the operating microscope. The animals were divided into three groups according to the duration of the ischemia. Each group was reperfused for 1, 4 and 7 hour by removing the clip from the artery. In 1-hour ischemic group ATP and GTP was reduced to 38% and IMP to 40% of the sham control. After 7-hour recirculation in this group ATP was resynthesized to 85%, GTP to 85%, and IMP to 180% of the sham control. In 3-hour ischemic group ATP was reduced to 19%, GTP to 23%, and IMP to 29% of the sham control. In this group ATP, GTP and IMP rose to 43%, 49% and 84%, respectively after 7-hour recirculation ATP, GTP and IMP were markedly reduced in 5-hour ischemic group, and despite recirculation these substances continued to decrease and none of them were detected after 7-hours of recirculation, It was suggested that the restoration of the circulation must be accomplished within 1-hour or at least within 3-hour of the ischemic insult of the cats to prevent the irreversible brain infarction.
Adenosine Triphosphate ; Animals ; Arteries ; Brain Infarction ; Brain Ischemia ; Cats ; Edema* ; Energy Metabolism* ; Guanosine Triphosphate ; Ischemia ; Middle Cerebral Artery

Two cases of spontaneous kidney rupture with literatural review was presented at first in Korea. 1) 56 years male patient and 25 years male patient admitted to our department of Urology through Emergency Room after onset of 2 and 1 day. after treatment at local clinic. 2) Chief complaints were one side flank pain which was followed by total gross hematuria. 3) Preoperative diagnoses were kidney rupture due to necrotic pelvic tumor in 56 years male and hypernephroma in 25 years male patient. 4) Operation was procedured at 8 days and 4 days after admission respectively. 5) The operative procedure were nephrectomy in both cases. 6) The pathological diagnoses were pelvis rupture due to renal stone and parenchymal rupture due to renal infarction in each case.
Carcinoma, Renal Cell ; Diagnosis ; Emergency Service, Hospital ; Flank Pain ; Hematuria ; Humans ; Infarction ; Kidney* ; Korea ; Male ; Nephrectomy ; Pelvis ; Rupture ; Rupture, Spontaneous* ; Surgical Procedures, Operative ; Urology

Hypertensive encephalopathy is an acute clinical syndrome that shows central nerve dysfunction with sudden and marked elevation in blood pressure. But its pathophysiologic mechanisms, clinical courses and prognosis are still not clear. In order to study clinical manifestations and response to treatment in patients with hypertensive encephalopathy, we reviewed 45 patients with hypertensive encephalopathy who were admitted in Dept. of Internal Medicine, National Medical Center, from January 1975 to December 1984. The following results were obtained: 1) The ratio of male to female was 1.1:1. The peak age of incidence was in the 6th and 7th decade with mean age of 57.5 years. 2) Among 45 patients, only 29 had known history of hypertension and the average duration of hypertension was 8.1+/-3.6 years. 3) The most common sympotm was severe headache (68.9%). And altered consciousness, nausea and/or vomiting, focal neurologic signs and visual disturbance were also common symptoms in decreasing order of frequency. 4) Funduscopic examination showed hypertensive retinopathy in 20 of 24 (91.7%) patients and lumbar puncture revealed increased CSF pressure in 12 of 20 (60%) patients. 5) In most patients, the mean interval to symptomatic improvement was 2.1 days after administration of anti hypertensive agents, but in 6 patients with initial mean arterial blood pressure above 170mmHg, 4 patients showed delayed response and 2 patients were expired.
Antihypertensive Agents ; Arterial Pressure ; Blood Pressure ; Consciousness ; Female ; Headache ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Hypertensive Retinopathy ; Incidence ; Internal Medicine ; Male ; Nausea ; Neurologic Manifestations ; Prognosis ; Spinal Puncture ; Vomiting

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

BACKGROUND: Skin Biopsy is a equently used diagnostic tool in dermatology and clinical impressions before biopsy may be different with pathologic diagnosis. OBJECTIVES: The purpose of this study was to investigate the concordance rate of clinical impression and pathologic diagnosis. METHODS: Clinical and Pathological studies were done on 559 biopsied skin diseases among 16, 944 out-patients in Dermatologic department of Chungnam University Hospital during the period of 1 year from March, 2002 to February, 2003. RESULTS AND CONCLUSION: The study results are summarized as follows: 1. The most frequently biopsied skin disease group was non-tumor, noninfectious disease (40.8%), followed by benign tumor (37.4%), infectious disease (11.8%), malignant tumor (10.0%). 2. The concordance rate between clinical impression and pathologic diagnosis showed 68.9% in complete agreement and 79.6% in complete and partial agreement. 3. The concordance rate of professor committed cases was 68.8% and that of residents committed cases was 69.1%. 4. The concordance rates among disease groups were highest in malignant tumor (74.6%), then benign tumor (70.8%), non-tumor infectious disease (67.4%) and non-tumor noninfectious disease (65.2%).
Biopsy* ; Chungcheongnam-do ; Communicable Diseases ; Dermatology ; Diagnosis* ; Humans ; Outpatients ; Skin Diseases ; Skin*

PURPOSE: The purpose of this study is to analyze the usefulness of breast thermography in assessing the prognosis in breast cancer and to obtain correlative evidence between thermographic prognosis and prognostic factors for breast cancer. MATERIALS AND METHODS: Thermographic examinations were performed in a room maintained at 20C. The patient was undressed to the waist, with both arms elevated for 10 minutes prior to the examination in order to cool and equilibrate the breast skin at room temperature. Digital infrared thermographic system was used (NEC, San-ei, Therm Tracer 6T67). The thermographic prognosis was classified according to Dr. Hobbins (Sl good, S2=fair and S-poor) suggested by Dr. Hobbins. The results were analyzed by Chi-Squire. One hundred three patients of breast cancer were examined by digital infrared thermographic system between Jan 1992 and December 1996. RESULTS: The mean age was 48, with a range from 20 to 85. According to the TNM classification 25 (24%) were in stage I, 47 (46%) stage II, 29 (28%) stage III, and 2 (2%) stage IV. The tumor size ranged from 0.5 to 20 cm (mean 4 cm), On histologic examination, 43 (43.%) patients had metastasis in the axillary nodes, 40 (55%) patients was estrogen-receptor positive. The nuclear grade I was 46 (35%) patients, II 24 (28%) and III 16 (19%). The classification of thermographic prognosis were Sl in 47 cases (46%), 82 in 32 (31%) and 83 in 24 (23%). The classification of the thermographic prognosis was found to be statistically correlated with tumor size (p<0.0001), axillary node status (p<0.0001) and TNM tumor stage (p<0.0001). But nuclear grade and estrogen receptor were not statistically correlated with the thermographic prognosis. The correlation between thermographic prognosis and actual survival rate was not available. CONCLUSION: These results suggest that breast thermography would be useful as a predictor in breast cancer before surgery.
Arm ; Breast Neoplasms* ; Breast* ; Classification ; Estrogens ; Humans ; Neoplasm Metastasis ; Prognosis* ; Skin ; Survival Rate ; Thermography*

BACKGROUND: Left ventricular hypertrophy is common in chronic renal failure patients and may contribute increased risk of cardiovascular morbidity and mortality. We evaluated the left ventricular morphology and function in renal transplant recipients to find the relationship between hemodynamic changes and morphologic and functional improvement after transplantation. METHODS: Serial echocardiographic evaluations were performed in 27 adults(20 men and 7 women) at the time of transplantaion and posttransplantation 1 month and 4 months. The average duration of hemodialysis was 16+/-24 months(mean+/-S.D.). RESULTS: At the time of transplantation, the hematocrit level was 21+/-6% and posttransplantation 1 month and 4 months, that was increased to 39+/-5% and 42+/-7%, respectively(p<0.001). Left ventricular mass index by echocardiography was decreased significantly from 246+/-87g/m2(pre-KT) to 169+/-38g/m2(post-KT 1 month) and 153+/-40g/m2(post-KT 4 months), respectively (p<0.001). Interventricular septal thickness and left ventricular posterior wall thickness were decreased significantly after 4 months of transplantation. Left ventricular systolic and diastolic dimensions were also decreased significantly after 1 month and 4 months of transplantation. Left ventricular volumes and cardiac output were also decreased significantly. But A/E ratio, ejection fraction and fractional shortening did not change significantly. CONCLUSION: These findings showed that pretransplant high output state was resolved radipidly(within 1 month) but the diastolic function did not improved after transplantation 1 month and 4 months.
Cardiac Output ; Echocardiography* ; Hematocrit ; Hemodynamics ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Mortality ; Renal Dialysis ; Transplantation*

PURPOSE: The results of the bronchial provocation test were different by the method of inhalation, but there was no data in children. We performed the provocation test by 2 different methods such as two-minute tidal breathing versus five vital capacity breathing and compared the datas. METHODS: Methacholine inhalation test was performed for the In 17 patients with suspected bronchial hyperresponsiveness in Pocheon university Bundang Cha hospital, under identical conditions, except for the method of inhalation. All the patients were performed two-minute tidal breathing (2 min-TB) in one test and five vital capacity breathing (5VCB) with interval 1 to 7 days. Baseline and postsaline FEV1 were also measured to compare effects by two inhalation methods. Methacholine PC20 was calculated by linear interpolation between the last two data parts on the dose-response curve, and the cut off value of bronchial asthma was 8 mg/mL. RESULTS: The rate of positive brochial provaction test in 5VCB was 88.24% which was not significantly lower than 70.59% in 2 min-TB. In 12 patients with positive bronchial provocation test in both inhalation methods, the mean PC20 in 5VCB (5VC-PC20) was 4.40 mg/mL, being significantly higher than 1.02 mg/mL in 2 min-TB (2 min-PC20) (P< 0.05). There was a significant positive correlation between 5VC-PC20 and 2 min-PC20 (R=0.76, P< 0.001). CONCLUSION: We conclude from this study that the results of bronchial provocation test in children are different according to methods of inhalation in using the same nebulizer. Therefore, when we analyze the result of bronchial provocation test, we need attention to factors which are nebulizer output and method of inhalation to influence the response to the test.
Asthma ; Bronchial Provocation Tests* ; Child* ; Humans ; Inhalation ; Methacholine Chloride ; Nebulizers and Vaporizers ; Respiration* ; Vital Capacity*

BACKGROUND: The catheter ablation usin radiofrequency(RF) energy in patients with atrioventricular nodal reentrant tachycardia(AVNRT) and atrioventricular reentrant tachycardia(AVRT) ahs been proved as a safe and effective nonpharmacologic therapeutic modality. The purpose of our study was to evaluate the success rate and complications of the initial experience and to determine the extent of myocardial damage of RF catheter ablation. METHODS: Electrophysiologic study was performed with the standard technique. Twenty five patinents(M:F=16:9, mean age:42 years old) underwent RF catheter ablation in St. May's Hospital from April to December in 1994. The RF generator in this study was RFG-3D model and catheters were 6F or 7F steerable catheters with 4mm kistal tip. In order to evaluate the extent of myocardial damage the WBC count, LDH, CK, and CK-MB fraction were checked before and after RF catheter ablation and the Tc99m myocardial scintigraphy was performed within 72 hours of the porcedure. RESULTS: Six of twenty five patients had AVNRT, in which the success rate of selective ablation of the slow pathway was 83.8%. Nineteen patients with AVRT had one accessory pathway. The ablation success rate of 14 accessory pathways in left free wall location was 85.7%, and that of 3 in left posteroseptal location was 66.6%. Two right sided accessory pathways were not ablated successfully. The level of CK-MB fraction after ablation was within normal limit. Only one case revealed grade 2 of hot spot in Tc99m myocardial scintigraphy. CONCLUSION: The RF catheter ablation in patients with AVNRT and AVRT is a safe and effective nonpharmacologic therapeutic modality. But right sided accessory pathways are more difficult to ablate than left sided accessory pathways, requiring more experiences and better technique. The extent of myocardial damage after RF catheter ablation reveals relatively minimal by cardiac enzyme study and Tc99mmyocardial scintigraphy.
Catheter Ablation* ; Catheters ; Humans ; Myocardial Perfusion Imaging ; Radionuclide Imaging ; Tachycardia, Supraventricular*

To evaluate the effectiveness and to find out which grade(clinical and computed tomography) of subarachnoid hemorrhage(SAH) patients are most effected with the medication of the calcium antagonist, we did this study. We selected 339 cases(study cases) among a total of 603 cases of SAH who were admitted to our hospital from Sept. 1982 to Aprial 1991. The criteria of study cases are patients who were admitted and who had a brain computed tomography(CT) taken within 3 days after the SAH and who had a clinical grade(Hung & Hess) on admission between I-IV. We divided study cases into 3 groups. Group I:surgery was done more than 7 days after the SAH and together with non-surgical patients, no medication was used(N=126). Group II:surgery was done more than 7 days after teh SAH and together with non-surgical patients medication of the calcium antagonist was given orally(N=120). Group III:surgery was done more than 7 days after the SAH and together with non-surgical patients, medication of nimodipine intravenously was given, and also patients, medication of nimodipine intravenously was given, and also patients who received surgery did within 3 days after the SAH were given intravenous injection and cisternal irrigation of nimodipine(N=93). We compared the overall management outcome and the incidence of delayed ischemic dificit(DID) and unfavorable outcome due to DID in each group. We also analyzed the causes of unfavorable outcome according to the clinical grade on admission and the amount of blood in the cistern seen on the brain CT in each group. The results of this study showed that overall management outcome was improved by using the calcium antagonist. The calcium antagonist reduced the incidence of DID as well as the unfavorable outcome related to DID. In clinical grade III patients on admission, the unfavorable outcome due to DID was significantly lower in group II and III than in I(group I vs. II:p<0.05, group I vs. III:P<0.01). In cases with a large amount of blood in the cistern seen on the brain CT, the unfavorable outcome was significantly lower in groups II and III than in I(group I vs. II:p<0.01, group I vs. III:p<0.05). We conclude that the overall management outcome of aneurismal SAH patients may be improved by using a calcium antagonist and the effect of the calcium antagonist is prominent in clinical grade III patients on admission and patients with a large amounts of blood in the cistern seen on the brain CT.
Aneurysm* ; Brain ; Calcium* ; Humans ; Incidence ; Injections, Intravenous ; Nimodipine ; Subarachnoid Hemorrhage*