Small and large airways functions were studied in patients with hypertensive heart disease in slightly ro moderately compromised state functionally. In this study, the forced vital capacity and various flow paramaeters reflecting expiratory flow rate were determined from simultaneously recorded forced expiratory volume and maximal expiretory flow volume curves in 86 cases. The closing volume was measured by a single breath nitrogen mrthod in 57 cases and airway resistance with its related parameters by a body plethysmograph in 11 cases. These results were compared with those obtained from the same numbers of healthy controls matched for sex, age and height. In the patient group, the forced vital capadity and all the observed values of flow parameters, execpt for the ratio of the first second vital capacity to the forced vital capacity, were significantly reduced than those in the controls. When the remainder of flow parameters was volume-adjusted to the forced vital capacity, however, the mean of the peak expiratory flow rate and the maximal expiratory flow rate at the 75 percent of the vital capacity were not significantly different from that of controls. In contrast, the volume-adjusted values of maximal expiratory flow were remained significantly smaller than those in the controls. The closing volume and its ratio to the vital capacity were significantly larger in the patient group. Airway resistance and its related parameters revealed no significant differences between two groups. These findings suggest that the patients with hypertensive heart disease in a mild to moderate failure are associated with restrictive ventilatory impairment and a small airways obstruction, but with little or no large airway dysfunction.
Airway Resistance ; Closing Volume ; Forced Expiratory Volume ; Heart Diseases* ; Heart* ; Humans ; Maximal Expiratory Flow Rate ; Nitrogen ; Peak Expiratory Flow Rate ; Vital Capacity

BACKGROUND: Coronary arteriovenous(AV) fistula is a rare congenital disease, and seldom produce symptoms during childhood. However late complications can occur including congestive heart failure, myocardial ischemia, and bacterial endocarditis. Therefore surgical repair is recommended even if the patients are asymptomatic. In these days many investigators are interested in transcatheter embolization because of high procedural success rate without risks and morbidity associated with cardiac surgery. METHODS: Five patients(4 females and 1 male) of coronary AV fistula were treated with transcatheter coil embolization. All had symptom of chest pain. In coronary angiograms fistulous tracts were originated from left anterior descending artery(LAD) and drained to main pulmonary artery(MPA) in 4 cases. The other case had abnormal vessel from left circumflex artery(LCX) to bronchial artery. Transcatherter coil embolization were done with Judkins left guiding catheter, 018 inch Tracker or 3F Microferret catheter, and 018 inch coils. RESULTS: The fistula tracts were completely occluded in 3 cases after coil emboilzation. In 2 cases with multiple fistular vessels, major fistula were occluded, but minor vessels remained. There were no procedure related complications. CONCLUSION: Transcatheter coil embolization may be an effective treatment modality in coronary AV fistula with excellent result and minimal complications.
Arteriovenous Fistula* ; Bronchial Arteries ; Catheters ; Chest Pain ; Embolization, Therapeutic* ; Endocarditis, Bacterial ; Female ; Fistula ; Heart Failure ; Humans ; Myocardial Ischemia ; Research Personnel ; Thoracic Surgery

Antianginal and untoward effects of fenalcomine hydrochloride were studied in 24 cases of angina pectoris. Following discontinuation of all medications for 2 weeks except for liberal use of sublingual nitroglycerin for the relief of anginal attack, fenalcomine, 150mg a day in 3 divided doses, was given for 8 to 16 weeks. In 20 cases, routine blood counts including platelets, serum electrolytes and cholesterol as well as blood sugar level were checked before and at the completion of the medication. hepatic and renal functions were also studied. The effect of fenalcomine on severity, frequency and duration of anginal attack was excellent to good in 17 cases(70.9%), and was fair in 5 cases(20.8%). In the remaining 2 cases(8.3%), who responded poorly had angina pectoris for more than 3 years. It appeared that fenalcomine was similarly effective in those with or without associated hypertension or diabetes mellitus, or history of previous myocardial infarction. The comparison of the results of post-treatment laboratory tests with pre-treatment data revealed no significant changes. Furthermore, no untoward clinical reactions attributable to the drug was noted in all cases. These facts suggest that fenalcomine is a reliable and well tolerated antianginal agent which can be used singly or in combination with other agents.
Angina Pectoris ; Blood Glucose ; Cholesterol ; Diabetes Mellitus ; Electrolytes ; Hypertension ; Myocardial Infarction ; Nitroglycerin

To investigate the effects of prostaglandin E1(PGX1) in prevention of proliferative scar formation, we cultured fibroblasts of normal skin (NS), hypertrophic scar (HS) and keloid (KL) tissues obtained from patients. We have compared type I collagenase production of cultured fibroblasts from normal skin, hypertrophic scar, and keloid tissues under various concentrations of PGE1. Our results demonstrate that type I collagenase production was significantly increased after addition of PGE1 in HS and KL, but not NS. Type I collagenase production of HS and KL fibroblasts were increased similarly in 10M and 10M of PGE1 and maximally increased in the concentration of 10M. This promotive effects of PGE1 on the production of type I collagenase was larger in KL than in HS. These results also suggest that PGE1 may play the promotive effects on type I collagenase production in dose-dependent manner. PGE1 may have a role in the prevention of hypertrophic scar and keloid by enhancing the production of type I collagenase of HS and KL fibroblasts. The promotive effects of PGE1 on type I collagenase production was variable depending on its concentration, and its effects was maximum in certain optimal condition. The maximally effective concentration of PGE1 in the prevention of proliferative scar formation should be searched in further investigations for clinical use.
Alprostadil ; Cicatrix ; Cicatrix, Hypertrophic* ; Collagenases* ; Fibroblasts* ; Humans ; Keloid* ; RNA, Messenger* ; Skin

No abstract available.
Fournier Gangrene* ; Scrotum* ; Sparganosis*

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.
Basal Ganglia* ; Brain ; Brain Edema ; Brain Ischemia* ; Cerebral Infarction ; Cerebrum ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Prognosis* ; Stroke, Lacunar ; Thalamus* ; Thromboembolism ; Tomography, X-Ray Computed

Non-specific periventricular white matter lucencies on computed tomography(leukoaraiosis) were found in 130(40%) of 324 patients with ischemic or hemorrhagic strokes. Patients with leukoaraiosis were significantly older than those without it and correlated with hypertension and lacunar infarction but not with cortical infarction. In patients with hemorrhage, leukoaraiosis occurred sinigificantly more often when aneurysm or arteriovenous malformation were not demonstrated. Our fiindings suggest that leukoaraiosis in cerebrovascular disease is associated with small vessel disease.
Aneurysm ; Arteriovenous Malformations ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Leukoaraiosis* ; Stroke ; Stroke, Lacunar

This study was done to identify the association between serum copper and zinc levels and the cirrhosis and hepatocellular carcinoma(HCC), and to evaluate its diagnostic value on liver diseases. Sixty-three healthy persons, 60 patients with cirrhosis and 33 patients with hepatocellular carcinoma were rendomly selected and investigated for their general characteristics from October 1990 to August 1991. For analysis of the biochemical markers in liver function test and the serum copper and zinc levels, their fasting venous blood were sampled at 9:00 to 11:00 in the morning and centrifuged to separate the serum within one hour. All the samples were immediately analysed for biochemical markers and stored at -20 C in polypropylene tubes further copper and zinc analysis. Mean of serum copper levels was 91.97+/-4.76 microgram/dl in control, 106.21+/-2.73 microgram/dl in cirrhosis and 127.05+/-0.77 microgram/dl in HCC. The value of HCC was statistically significantly higher than that of the control and cirrhosis(p<0.05). Serum zinc levels were 110.82+/-7.24 microgram/dl in control, 68.10+/-5.43 microgram/dl in cirrhosis and 63.78+/-2.20 microgram/dl in HCC. The values of cirrhosis and HCC were statistically significantly different among three groups(p<0.05). Test total protein, albumin, ALP and total bilirubin of biochemical markers of liver function were statistically significantly different among three groups(p<0.05). Differences between cirrhosis and HCC for ALT and AST, and between the control and HCC for direct bilirubin were not statistically significant. Biochemical markers statistically significantly correlated with serum copper and zinc levels and Cu/Zn ratio(p<0.05), were variable in three groups. In multiple logistic regression, odds ratio of serum copper level and Cu/Zn ratio had no statistically significance on the cirrhosis and the HCC, but that of serum zinc was statistically significant as 0.951 and 0.952 (p<0.05). Serum copper and zinc levels and Cu/Zn ratio were not statistically significantly different between the cirrhosis and HCC. Albumin, ALP, zinc, total bilirubin and age among all variables were selected as main variables for three-group discriminant analysis. Percentage of "grouped" cases correctly classified by these five variables was 98.4 for control, 73.4 for cirrhosis, 75.7 for HCC and 84.0 for all subjects. This study suggests that zinc may has an independently inhibitory effect on the liver disease and serum zinc level is considered to play a role as diagnostic marker on the hepatic disorders and be more useful than serum copper level and Cu/Zn ratio in diagnosis of the liver diseases.
Bilirubin ; Biomarkers ; Carcinoma, Hepatocellular* ; Copper* ; Diagnosis ; Fasting ; Fibrosis ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver Function Tests ; Liver* ; Logistic Models ; Odds Ratio ; Polypropylenes ; Zinc*

Priapism is a relatively rare condition of prolonged painful penile erection, unrelated to sexual activity. It is caused by idiopathic, leukemia, sickle cell disease, oral medication, intracavernosal injection therapy, spinal cord injury and malignant cell infiltration. Malignant lymphoma involving the genitourinary system is uncommon and when it occurs the testes is the most common site. However malignant lymphoma involving the penis is even more rare, with only 20 cases reported in literature. To our knowledge, priapism caused by penile lymphoma has not been reported previously in literature. We report a case with a brief review of literature.
Anemia, Sickle Cell ; Leukemia ; Lymphoma* ; Male ; Penile Erection ; Penis ; Priapism* ; Sexual Behavior ; Spinal Cord Injuries ; Testis ; Urogenital System

PURPOSE: Cases of ureteroscopic lithotripsy (URS) were retrospectively reviewed to define the efficacy of an ureteroscopic lithotripsy in the treatment of upper ureteral stones. The success rates, reasons for failure and complications of URS were compared with extracoporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: URS for upper ureteral stones was performed in 48 cases, between January, 2000 and December, 2002. A 7.5Fr, or 9.5Fr, rigid ureteroscopy and stone basket were used with, or without, electrohydraulic lithotripsy. There were 29 males and 19 females, with a mean age of 43.3 years. RESULTS: The overall success rate of the URS was 91.6%. According to the stone size, the success rates were 92.1 and 90% in stones smaller than 10mm and larger than 10mm, respectively. With the ESWL treatments, the overall stone free rate was 71.7% with only one session. The stone free rate was significantly affected by the size, was and were 77.9 and 46.3% in stones smaller than 10mm and larger than 10mm, respectively. The stone free rate after the second and third ESWL sessions were 81.3 and 91.3%, respectively. The associated complication rate for URS was 18.1%, with the complications consisting of ureteral mucosal injuries in 3 patient, flank pain (>48 hours) in 2, a ureteral perforation in 1, fever in 1 and a gross hematuria (>48 hours) in 1, which were all treated successfully with conservative treatment. CONCLUSIONS: URS can be a successful and safe treatment modality for upper ureteral stones, even if larger than 10mm.
Female ; Fever ; Flank Pain ; Hematuria ; Humans ; Lithotripsy* ; Male ; Retrospective Studies ; Shock* ; Ureter* ; Ureteroscopy