The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

A simple, rapid and selective liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) is developed and validated for quantification of venlafaxine in human plasma with simple liquid-liquid extraction step consisted of extraction with ether and dichloromethane for 10 min and mixing with 1 M sodium acetate in human plasma using fluoxetine as an internal standard (IS). The analyte are separated using an isocratic mobile phase consisted of acetonitrile and 5 mM ammonium formate (4/3, v/v) on a isocratic YMC hydrosphere C18 (2.0x50.0 mm, 3.0 microm) column and analyzed by MS/MS in the multiple reaction monitoring (MRM) mode using the transitions of respective [M+H](+) ions, m/z 278.2-->260.3 and m/z 310.1-->148.1 for quantification of venlafaxine and IS, respectively. The standard calibration curves showed good linearity within the range of 1.0-200.0 ng/mL (r2=0.9986, 1/chi2 weighting). The lower limit of quantification (LLOQ) was 1.0 ng/mL. The retention times of venlafaxine and IS were 0.6 min and 0.7 min that means the potential for the high-throughput potential of the proposed method. In addition, no significant metabolic compounds were found to interfere with the analysis. Acceptable precision and accuracy were obtained for the concentrations over the standard curve range. The validated method was successfully applied to bioequivalence study after 75-mg of venlafaxine sustained-release (SR) capsule in 24 healthy Korean subjects.
Ammonium Compounds ; Calibration ; Chromatography, Liquid ; Ether ; Fluoxetine ; Humans ; Ions ; Liquid-Liquid Extraction ; Methylene Chloride ; Pharmacokinetics ; Plasma* ; Sodium Acetate ; Tandem Mass Spectrometry ; Therapeutic Equivalency* ; Venlafaxine Hydrochloride

A total of 212 cases of gastric carcinoma resected at Kang-Dong Sacred Heart Hospital during the period of 4 years from December 1986 to December 1990 were examined according to Borrmann, Mulligan-Rember, Ming and WHO methods based on histopathological investigations. In Mulligan-Rember (M-R) classification, intestinal cell type (IC) was frequently seen in Borrmann type I and II; pyloro-cardiac gland cell type (PC) in II and III, and mucous cell type (MC) in IV and III. Expanding growth pattern was more frequent in IC, infiltrative growth pattern in MC, and PC showed less infiltrative growth than MC. In gross type, the most expanding growth pattern was seen in Advanced gastric carcinoma type (AGC) I and the next one was in AGC II; the ratio of infiltrative versus expanding type was highest in AGC IV and next in AGC resembling early gastric carcinoma (EGC) and AGC III in order. On WHO classification except squamous type, all the papillary type showed expanding growth and infiltrative growth was frequently seen in signet-ring cell, undifferentiated, tubular and mucinous types in order. Lymphoid stroma was more frequently found in expanding type than infiltrative type. The frequency of angioinvasion of tumor cells observed was high in AGC resembling EGC, AGC II, III, IV, I and EGC in order. In WHO classification excluding squamous type, undifferentiated and signet-ring cell types occurred more frequently under the age of 60 and papillary type were more frequnetly seen over the age of 60. But tubular type had no difference between the two age groups. In Ming's classification, expanding type was more frequently seen than infiltrative type over the age of 60.

Acinetobacter species encounters frequently with clinical specimens and now accounts for a substantial proportion of endemic nosocomial infections in Korea. Recent trends indicate that the antimicrobial resistant strains of Acinetobacter species are increasing. Sixty-one strains were isolated from specimens of patients suspected of nosocomial infections during 1991 to 1996. At present, phenotypic identification of Acinetobacter using biochemical test may not be reliable and resulted in the difficulty to clarify the source of infections and epidemiological study of hospital-acquired infections. Aware of the importance of rational taxonomic proposal for these isolates, correct species identification of these organisms by molecular typing method was carried out. A total of fifty-four strains of A. calcoaceticus-A. baumannii complex species which were identified to genospecies 2 and 13 by biochemical characteristics was subjected to identify by ribotyping using restriction endonuclease EcoRI, ClaI, and SalI. Of fifty-four strains, twenty-five strains were identified as A. baumannii (genospecies 2) and twenty-one strains as genospecies 13, and six strains changed to genospecies 3, and the rest two strains were confirmed as A. haemolyticus (genospecies 4). This result suggests that the ribotyping may be of value for identification of genospecies and epidemiological information of Acinetobacter strains.
Acinetobacter baumannii* ; Acinetobacter calcoaceticus* ; Acinetobacter* ; Cross Infection ; DNA Restriction Enzymes ; Humans ; Korea ; Molecular Typing ; Ribotyping*

The purpose of this study was to investigate learners' opinion about the experience of online continuing medical education, and the effectiveness of it. The study was conducted on online continuing medical education courses conducted as a model case by Konggi-do Medical Association and VirtualMD Co., Ltd with the approval of Korean Medical Association, from July through December, 2002. Fifteen online multimedia courses, supported by learning management system and e-test(electronic assessment) system, were opened. Learners' internet log data, and answers to a questionnaire were collected. And a pre-test post-test design experiment was implemented to measure the effectiveness of learning. The results showed that doctors are already technically and environmentally ready to take online continuing medical education and have correct understanding about the necessity and benefits of online continuing medical education. The difference between the pre-test score and the post-test score was statistically significant(t=3.24, p<.01), and practically significant(Effect Size=.89).
Education, Medical, Continuing* ; Internet ; Learning ; Multimedia ; Surveys and Questionnaires

Malignant bone tumors would be classified as primary malignant bone tumors, secondary malignant bone tumors, and metastatic bone tumors. Primary malignant bone tumors are rare diseases occupying 1% of adult cancers, and 6% of pediatric cancers. The chief complaint of malignant bone tumor patients is pain different from that of malignant soft tissue tumor patients. Diagnostic procedures start with clinical evaluation including current illness, past medical history, family history, and physical examination. Then we take a radiograph first and obtain important and diagnostic clues from it. However pathological diagnosis and information about the extent of tumor are required to obtain a more definite diagnosis and staging. Examinations for detection of local and systemic tumor extent are scintigraphy, computed tomography (CT), magnetic resonance imaging, and positron emission tomography-CT. If the clinical and radiographic information suggests aggressive or malignant bone tumor, the patient should be referred to a bone tumor specialist without further evaluations.
Adult ; Biopsy ; Bone Neoplasms ; Diagnosis ; Electrons ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Radionuclide Imaging ; Rare Diseases ; Specialization

Duane's retraction syndrome is a deficiency in abduction and a defect in abduction movements, with retraction and narrowing of the palpebral fissure of the affected eye. In addition, there are often an upshoot or downshoot of the affected eye on attempted abduction, widening of the palpebral fissure with abduction and mild to marked defect in convergence. But, the clinical picture in Duane's retraction syndrome is extremely variable. Two cases of Duane's retraction syndrome are presented, each of them is Duane's type I and type III, which are affected on left eye. The literatures relating to this syndrome are briefly reviewed.
Duane Retraction Syndrome*

A new rodenticide, RH-787, made in Rhom and Hass co. was introduced in this country because it was known relatively harmless to human and beasts. But many internists found that RH-787 induces diabetes in human after accidental ingestions. The effects of RH-787 on various organ are still controversial but the associaton of RH-787 with diabetes is now recognized through the clinical and experimental studies. The cataract is not infrequently seen in juvenile diabetics of several years' duration. In the case to be reported, the cataract was appeared more rapidly within about 2 years after known diabetes due to RH-787 intoxication than usual diabetic cataracts, and the visual results were good after bilateral extracapsular lens extractions with peripheral iridectomy, without any complication.
Cataract* ; Humans ; Iridectomy

OBJECTIVES: To demonstrate the structural pathogenesis of schizophrenia, this study measures cerebral and cerebellar volumes of antipsychotics-navie and first episode schizophrenic patients. Also this study analyzes morphological character of patients with early schizophrenia. METHODS: Volume segmentation incorporating MRI scanning was performed on 25 patients with schizophrenia(mean age: 31.2+/-7.85yr, ranging: 14-18yr) and a control group of 29 healthy dindividuals(mean age: 29.03+/-7.02yr, ranging: 18-42yr). To carry out segmentation, the cerebrum and cerebellum were partitioned by gray matter, white matter and cerebrospinal fluid using a probabilistic histologic algorithm. These images of the segments were defined as the frontal, parietal, temporal and occipital lobes and cerebellum by using the semi-automated technique based on the atlas developed by Talairach. The area of dimension for each fraction was measured and its symmetry was compared. A statistical analysis was performed using the analysis of covariance by compensating the total brain volume with the level of covariance. RESULTS: The total brain volume of the schizophrenic patient group was significantly smaller than that of the control group(t=-1.986, d.f.=38.97, p=0.05). Female patients with schizophrenia showed a smaller right cerebellar volume than the female controls(F=4.20, d.f.=(1,51), p=0.046). Female with schizophrenia showed a larger left frontal white matter volume than their female controls and male with schizophrenia showed a smaller right frontal white matter volume than their male controls(F=6.89, d.f.=(1,51), p=0.012). Male patients with schizophrenia showed a larger right occipital white matter volume than the male controls. Females with schizophrenia showed a larger left occipital white matter volume than their female controls and male with schizophrenia showed a smaller left occipital white matter volume than their male controls(F=3.97, d.f.=(1,51), p=0.050). Female patients with schizophrenia showed a larger parietal white matter volume than the female controls(F=6.14, d.f.=(1,51), p=0.017). Female patients with schizophrenia also showed a smaller right and left cerebellar gray matter volume than the female controls(F=3.90, d.f.=(1,51), p=0.050). Female patients with schizophrenia also showed a smaller temporal gray matter volume than the female controls(F=4.74, d.f.=(1,51), p=0.034). CONCLUSION: These results demonstrate that the cerebellum and frontal lobe are involved in pathogenesis of schizophrenia, difference of white matter between schizophrenic patient and control is an important finding that suggest the importance of cortical dysconnection syndrome as pathophysiology on schizophrenia, and these findings suggest that pathogenesis of schizophrenia include many areas of brain.
Brain* ; Cerebellum ; Cerebrospinal Fluid ; Cerebrum ; Female ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Male ; Occipital Lobe ; Rabeprazole ; Schizophrenia*

OBJECTIVES: This study was designed to verify neuro-developmental hypothesis of schizophrenia and mood disorder. METHOD: We performed Brain Magnetic Resonance Imaging study in 34 schizophrenic patients, 18 mood disorder patients and 22 controls and compared the incidence and the size of carum septi pellucidi (CSP). RESULTS: The incidences of CSP in schizophrenia, mood disorder and controls were 61%, 61%, and 41%, respectively. The incidences of large CSP, defined as largest diameter larger than 3mm in T1-weighted image, were 24% in schizophrenic patients, 11% in mood disorder patients, and 5% in controls. But they didn't show statistically significant differences. CONCLUSION: We could find the tendency that the incidence of CSP was high as following order; schizophrenia, mood disorder, controls. But it was not statistically significant difference. To verify neuro-developmental hypothesis, we need larger pool of patients and better study design.
Brain ; Carum ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Mood Disorders* ; Schizophrenia*