No abstract available.
Prospective Studies*

The excitatory influence on heart rate is generally considered by beta-adrenergic neuroreceptors of Ahlquist's classificantion. Blockade of the beta adrenergic system would therefore be expected to alter heart rate and consequently to have an effect of patients with a variety of cardiac arrhythmias. In 1964 a clinically useable agent was produced by the name of propranolol which would effectively block beta action of adrenergic system and safe from side effects. The purpose of this study is to determine and estimate the immediate therapeutic effects of propranolol on 29 cases with various cardiac arrhythmias, administered intravenously. The following results were obtained: 1. It is apparent that propranolol by the intravenous route offers a rapid means of inducing A-V block and hence a reduction of the ventricular response in atrial fibrillation and atrial flutter. 2. Propranolol may be of value in improving digitalis-resistant atrial tachyarrhythmias with the therapeutic supplement. 3. Propranolol diminishes the automaticity of ectopic pacemakers because this is evident in the slowing of atrial rate or conversion of paroxysmal atrial tachycardia to sinus rhythm and the abolition or diminution of ventricular extrasystoles. 4. Digitalis-induced ventricular arrhythmias respond to propranolol well, and propranolol may well be the drug of choice in treating digitalis-induced ventricular arrhythmias. 5. Ventricular arrhythmias not related to digitalis were not satisfactorily treated with propranolol in our series. 6. Side effects associated with propranolol treatment were not remarkable except for development of transient hypertension in 2 cases.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Flutter ; Digitalis ; Heart Rate ; Humans ; Hypertension ; Propranolol* ; Sensory Receptor Cells ; Tachycardia ; Ventricular Premature Complexes

No abstract available.
Anaphylaxis* ; Histamine Release* ; Histamine* ; Mast Cells*

Papillary eccrine adenoma, first described by Rulon and Helwig in 1977, is a rare benign adnexal neoplastn. It is usually present as a solitary dermal nodule on the distal extremities. It has characteristic histopathological findings, consisting of dilated ducts that contain eosinophilic secretions and are associated with intralummal papillations. On the basis of histological and histochemical studies it is believed to be an adnexal neoplasm of possible eccrine differentiation. We report two recent cases of papillary eccrine adenomas occuring in two young male patients without subjective symptoms who had firm dermal nodules on the extremities.
Adenoma* ; Eosinophils ; Extremities ; Humans ; Male

A silver staining technique was used in the study of nucleolar organizer regions(AgNORs) from the paraffin sections of 26 meningiomas. The specimens were divided into four groups as follows:benign(n=16), atypical(n=5), anaplastic or malignant(n=5) and recurrent without atypical histological findings(n=2) groups, and the mean number of AgNORs in each group was 1.47+/-0.27, 1.93+/-0.4, 2.00+/-0.27 and 1.49+/-0.53 respectively. We noted that the mean number of AgNORs reflected the cellular kinetics of a tumor and was related to histological grade. There was no significant difference between non-recurrent & recurrent benign meningiomas and it was thought that the main cause of recurrence in benign meningiomas was not perhaps cell proliferation but incomplete surgical removal.
Cell Proliferation ; Kinetics ; Meningioma* ; Nucleolus Organizer Region* ; Paraffin ; Prognosis* ; Recurrence ; Silver Staining

The authors have studied 37 Korean embryos of Carnegie stage 11~23 and 18 fetuses to demonstrate the development of the shoulder joint. The external feature of the upperlimb bud is observed by stereoscope and camera, and the internal structures are studied by microscopic observation. The results obtained were as follows: In stage 12 upperlimb buds were appeared. In stage 17 mesenchymal condensations for humerus and scapula, and glenoid labrum were observed. In stage 19 one-layered interzone between the humerus and scapula was visible. In stage 22 three-layered interzone between the humerus and glenoid labrum was formed. In stage 23 three-layered interzone between the humerus and glenoid fossa of scapula was visible. In the 9th and 10th weeks distinct joint cavity was formed between humerus and glenoid labrum, and tendon of long head of Biceps brachii was attached to supraglenoid tuberosity and glenoid labrum. In the 11th week the joint cavity was formed between the midportion of humerus and glenoid fossa, and tendon of long head of Biceps brachii was more dense. In the 16th week the glenoid labrum was visible as fibrous cartilage, and joint cavity was more widened. In the 20th to 32nd week the shoulder joint was matured with the distinct joint cavity and glenoid labrum time after time.
Cartilage ; Embryonic Structures* ; Fetus* ; Head ; Humans* ; Humerus ; Joints ; Scapula ; Shoulder Joint* ; Shoulder* ; Tendons

BACKGROUND: The renin-angiotensin-aldosterone system is closely associated with volume status and vascular tone in septic shock. The present study aimed to assess whether plasma renin activity (PRA) and plasma aldosterone concentration (PAC) measurements compared with conventional severity indicators are associated with mortality in patients with septic shock. METHODS: We evaluated 105 patients who were admitted for septic shock. Plasma levels of the biomarkers PRA and PAC, the PAC/PRA ratio, C-reactive protein (CRP) level, and cortisol level on days 1, 3, and 7 were serially measured. During the intensive care unit stay, relevant clinical information and laboratory results were recorded. RESULTS: Patients were divided into two groups according to 28-day mortality: survivors (n = 59) and non-survivors (n = 46). The survivor group showed lower PRA, PAC, Acute Physiologic and Chronic Health Evaluation (APACHE) II score, and Sequential Organ Failure Assessment (SOFA) score than did the non-survivor group (all P < 0.05). The SOFA score was positively correlated with PRA (r = 0.373, P < 0.001) and PAC (r = 0.316, P = 0.001). According to receiver operating characteristic analysis, the areas under the curve of PRA and PAC to predict 28-day mortality were 0.69 (95% confidence interval [CI], 0.58 to 0.79; P = 0.001) and 0.67 (95% CI, 0.56 to 0.77; P = 0.003), respectively, similar to the APACHE II scores and SOFA scores. In particular, the group with PRA value ≥3.5 ng ml⁻¹ h⁻¹ on day 1 showed significantly greater mortality than did the group with PRA value <3.5 ng ml⁻¹ h⁻¹ (log-rank test, P < 0.001). According to multivariate analysis, SOFA score (hazard ratio, 1.11; 95% CI, 1.01 to 1.22), PRA value ≥3.5 ng ml⁻¹ h⁻¹ (hazard ratio, 3.25; 95% CI, 1.60 to 6.60), previous history of cancer (hazard ratio, 3.44; 95% CI, 1.72 to 6.90), and coronary arterial occlusive disease (hazard ratio, 2.99; 95% CI, 1.26 to 7.08) were predictors of 28-day mortality. CONCLUSIONS: Elevated PRA is a useful biomarker to stratify the risk of critically ill patients with septic shock and is a prognostic predictor of 28-day mortality.
Aldosterone* ; APACHE ; Arterial Occlusive Diseases ; Biomarkers ; C-Reactive Protein ; Critical Illness* ; Humans ; Hydrocortisone ; Intensive Care Units ; Mortality ; Multivariate Analysis ; Plasma* ; Renin* ; Renin-Angiotensin System ; ROC Curve ; Shock, Septic* ; Survivors

Malignant fibrous histiocytoma(MFH) is a high grade soft tissue sarcoma, commonly occur in the retroperitoneum, extremities, head and neck in the patient with old ages. But it is very uncommon that MFH primarily occurs in the lung, and uncommon in young ages. We experienced a young male patient with primary MFH of the lung. The patient had huge masses on both lungs which were diagnosed as MFH by thoracoscopy-guided wedge resection of mass, so we could not perform operative management. And we tried 6 cycles of chemotherapy using ifosfamide, doxorubicin, dacarbazine. After chemotherapy, masses still remained in spite of decreasing sizes.
Dacarbazine ; Doxorubicin ; Drug Therapy ; Extremities ; Head ; Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Ifosfamide ; Lung* ; Male ; Neck ; Sarcoma ; Thoracoscopy

Bacillus Calmette-Guerin (BCG) is an attenuated strain of Mycobacterium bovis (M. bovis) that has been used to treat transitional cell carcinoma. Since the initial report by Morales and associates on the use of intravesical BCG for the treatment of recurrent superficial bladder tumors, intravesical therapy with BCG has proved to be more effective for prophylaxis and the treatment of superficial bladder tumors and carcinoma in situ than most of the standard chemotherapeutic agents. While the majority of patients tolerate BCG treatments well, a number of adverse reaction (e.g., fever, hematuria, dysuria, nausea and malaise) have been reported. More serious complications occur on rare occasions and they include pneumonitis/hepatitis, ureteral obstruction, renal abscess and sepsis. We report here on a case of ureteral obstruction that was caused by periureteral tuberculous granuloma after intravesical BCG therapy for superficial bladder tumors, and the condition required distal ureterectomy & ureteroneocystostomy.
Abscess ; Bacillus ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Dysuria ; Fever ; Granuloma* ; Hematuria ; Humans ; Morale ; Mycobacterium bovis* ; Nausea ; Sepsis ; Ureter* ; Ureteral Obstruction* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The purpose of this study was to evaluate cervical lymph node metastasis of oral squamous cell carcinoma patients by MRI film and neural network system. MATERIALS AND METHODS: The oral squamous cell carcinoma patients(21 patients, 59 lymph nodes) who have visited SNU hospital and been taken by MRI, were included in this study. Neck dissection operations were done and all of the cervical lymph nodes were confirmed with biopsy. In MR images, each lymph node were evaluated by using 6 MR imaging criteria(size, roundness, heterogeneity, rim enhancement, central necrosis, grouping) respectively. Positive predictive value, negative predictive value, and accuracy of each single MR imaging criteria were calculated. At neural network system, the layers of neural network system consisted of 10 input layer units, 10 hidden layer units and 1 output layer unit. 6 MR imaging criteria previously described and 4 MR imaging criteria (site I-node level 2, site II-other node level, shape I-oval, shape II-bean) were included for input layer units. The training files were made of 39 lymph nodes(24 metastatic lymph nodes, 10 non-metastatic lymph nodes) and the testing files were made of other 20 lymph nodes(10 metastatic lymph nodes, 10 non-metastatic lymph nodes). The neural network system was trained with training files and the output level (metastatic index) of testing files were acquired. Diagnosis from neural network was decided according to 4 different standard metastatic index-68, 78, 88, 98 respectively and positive predictive values, negative predictive values and accuracy of each standard metastatic index were calculated. RESULTS: In the diagnosis of using single MR imaging criteria, the rim enhancement criteria had the highest positive predictive value, 0.95 and the size criteria showed the highest at negative predictive value, 0.77. The highest accurate criteria was heterogeneity with the accuracy of 0.81 and the lowest one was central necrosis with accuracy of 0.59. In the diagnosis of using neural network systems, the highest accurate standard metastatic index was 78, and that time, the accuracy was 0.90. Neural network system was more accurate than any other single MR imaging criteria in evaluating cervical lymph node metastasis. CONCLUSION: Neural network system has been shown to be more useful than any other single MR imaging criteria. In future, Neural network system will be powerful aiding tool in evaluating cervical node metastasis.
Biopsy ; Carcinoma, Squamous Cell* ; Diagnosis ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging ; Neck Dissection ; Necrosis ; Neoplasm Metastasis* ; Population Characteristics