To stydy the parameters of preload, afterload, and contractility of the heart, we evaluated 10 mitral stenosis, 5 mitral stenoinsufficiency, and 5 mitral stenosis with aortic insufficiency by measuring the external energy potential, external mechaical work, and external energy potential to PVa(Pressure-volume Area) ratio with non-invasive method, echocardiography and carotid pulse tracting. The results are summarized as follows; 1) External energy potential of mitral stenosis was significantly higher than that of MSI or MS with AI. 2) External mechanical work of MSI or MS with AI was significantly higher than that of Ms. 3) External energy potential to PVA ratio was signifiantly higher in the MS, but there was no significantly difference between the MSI and MS with AI. According to the above results, external energy potential to PVA ratio with echocardiogram and carotid pulse tracting was good parameters of preload, afterload, and contractility. And this method may used bed-side monitoring in the clinical area.
Echocardiography ; Heart ; Heart Valve Diseases* ; Mitral Valve Stenosis

Twenty-five patients presenting with severe hemorrhage from benign peptic ulcers were randomized to either endoscopic injection sclerosis using a combination of hypertonic saline- epinephrine solution and 5% ethanolamine or to hypertonic-saline epinephrine solution only. Only high risk patients with active bleeding or endoscopic stigmata of recent hemorrhage of ulcers were considered. A median duration of hospital admission and median transfusion requirements between the two types of treated groups were not significant difference. The initial hemestatic effects of HS-E solution injection group(n=l5) or combination of HS- E solution and 5% ethanolamine injection group(n=l0) were 93%, 90% respectively. The rebleeding rate of HS-E solution injection group(n =15) or combination of HS-E solution and 5% ethanolamine injection group(n=10) were 33%, 30%, respectively. So, both HS-E solution therapy group and comination of HS-E solution & 5% ethanolamine injection group were effective in initial hemostasis for bleeding peptic ulcer patients. However, for the further evaluation of therapeutic effect and comparison of rebleeding rate between the two types of therapy, we think that it will be indispensable to collect more cases and to compare with control group.
Christianity ; Epinephrine ; Ethanolamine ; Hemorrhage* ; Hemostasis ; Humans ; Peptic Ulcer* ; Sclerosis* ; Ulcer

Isovolumic phase indices of right ventricular(RV) systolic function were evaluated in 9 normal control cases(Group I) and 9 patients with mitral stenosis(Group IIa) and 8 patients with mitral stenosis and aortic regurgitation(Group IIb). RV systolic pressures of all patients in Group II(n=17) were over 40mmHg RV dp/dt max, Vmax and Vpm were measured by digitizing method and V(CE10) were measured by manual tangent method. RV isovolumic contractile functional indices were greater in Group II(n=17) compared with those in Group I(n=9) : RV dp/dt max(mmHg. Sec(-1)) 347.8+/-104.4(mean+/-SD) VS 230.5+/-65.5(p<0.05), Vmax(Sec(-1)) 30.9+/-10 VS 20.1+/-5.18(p<0.05), Vpm(Sec(-1)) 22.96+/-9.63 VS 14.8+/-4.04(p<0.05) and V(CE10)(Sec(-1)) 20.4+/-7.11 VS 12.5+/-5.31(p<0.05). But no significant differences were noted between Group IIa(n=9) and Group IIb(n=8) in these indices. In all cases(n=26), significant correlations were noted between V(CE10) and Vmax(r=0.90), V(CE10) and Vpm(r=0.85). We summurized that RV contractile function is preserved in many cases with mitral stenosis and V(CE10) may be used as an convenient index for RV contractile function.
Humans ; Mitral Valve Stenosis*

PURPOSE: Although adjuvant chemotherapy after resection of gastric cancer is a popular practice in Korea, there are still controversies about the effectiveness of the treatment. The fact that the relatively less effective drugs have been used and the rarity of large-scaled controlled studies may be partially responsible for the controversies. FP(5-FU, Cisplatin) combination is one of the most active regimen against advanced gastric cancer, consistently showing a response rate of 50~60%. We tried the FP chemotherapy as an adjuvant treatment for high-risk patients after curative resection of gastric cancer. MATERIALS AND METHODS: Between February 1992 and June 1996, 35 patients with completely resected high-risk gastric cancer(postoperative stage III or IV except thase with M1) received six courses of FP chemotherapy. Endpoints were toxicities of treatment, relapse free survival, and overall survival. RESULTS: With a median follow-up time of 17.1 months, Kaplan-Meier estimates of 2-year overall survival was 63.3% and relapse free survival estimates was 49%. There were no differences between stage III and IV patients in terms of overall survival or relapse free survival. Hematologic and non-hematologic toxicities were tolerable for most of the patients. CONCLUSION: Postoperative FP combination chemotherapy was tolerable for patients with high-risk(stage III and IV) gastric cancer. It is too early to determine the long term survival rates for this patients, but 2-year overall and relapse free survival were comparable to that of historical non-cisplatin containing regimens. Randomized phase III studies are warranted.
Chemotherapy, Adjuvant ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil* ; Follow-Up Studies ; Humans ; Korea ; Recurrence ; Stomach Neoplasms* ; Survival Rate

BACKGROUND/AIMS: Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. MATERIALS AND METHODS: Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = 5 log10 copies/ml. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. RESULTS: Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < 5 log(10) copies/ml or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log(10) copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. CONCLUSIONS: Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.
Alanine Transaminase ; DNA ; Drug Resistance ; Guanine ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Korea ; Medical Records ; Polymerase Chain Reaction ; Retrospective Studies

No abstract available.
Humans* ; Tooth*

No abstract available.
Humans* ; Tooth*

Chronic obstructive pulmonary disease (COPD) is associated with multiple comorbidities, including depression, which carries a higher risk of exacerbation and hospitalization in patients with stable COPD. A newly developed questionnaire, the COPD Assessment Test (CAT), was developed as an alternative to other complex, time-consuming tools for quantifying the symptom burden of COPD in routine practice. It is possible that the correlation between the CAT and depression scales could be useful for early evaluation and management of depression in COPD patients. Thus, we investigated the relationship between the CAT and depression as measured by the Patient Health Questionnaires-9 (PHQ- 9). We performed a retrospective observational COPD cohort study. A total of 97 patients were enrolled. The Korean versions of the CAT and PHQ-9 were completed for stable patients. A correlation analysis was performed between the PHQ-9 and CAT scores. Significant depression among the groups based on the 2011 GOLD guidelines occurred only in class Gold B and D patients (40% and 60%, respectively). The frequency of depression was significantly higher in the group with higher CAT scores (20~29 versus > or =30; odds ratio: 5.67 versus 22.66). Significant association was observed between the PHQ-9 and CAT scores (r=0.545 and P<0.001). As a result, the PHQ-9 score was significantly higher in COPD patients with a higher CAT score. The CAT is a simple and valuable predictor of depression in COPD patients, and it should be frequently used to detect COPD patients with depression in clinical practice.
Animals ; Cats ; Cohort Studies ; Comorbidity ; Depression* ; Hospitalization ; Humans ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive* ; Retrospective Studies ; Weights and Measures

Endoscopy for acute nonvariceal upper gastrointestinal bleeding plays an important role in primary diagnosis and management, particularly with respect to identification of high-risk stigmata lesions and to providing endoscopic hemostasis to reduce the risk of rebleeding and mortality. Early endoscopy, defined as endoscopy within the first 24 hours after presentation, improves patient outcome and reduces the length of hospitalization when compared with delayed endoscopy. Various endoscopic hemostatic methods are available, including injection therapy, mechanical therapy, and thermal coagulation. Either single treatment with mechanical or thermal therapy or a treatment that combines more than one type of therapy are effective and safe for peptic ulcer bleeding. Newly developed methods, such as Hemospray powder and over-the-scope clips, may provide additional options. Appropriate decisions and specific treatment are needed depending upon the conditions.
Christianity ; Diagnosis ; Endoscopy* ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Hospitalization ; Humans ; Mortality ; Peptic Ulcer

BACKGROUND/AIMS: The standard regimen of SBP is cefotaxime 2 g IV, every 8 hours for 10 days, and the success rate is approximately 90%. It was reported that 5-day therapy was as effective as 10-day therapy, but, generally, the 5-day therapy has not been accepted in practice. This study was done to confirm whether the short-term therapy is as effective as long-term therapy, and additionally whether the opsonin capacity influences the final output of antibiotic therapy. METHODS: Of the 27 patients who met strict criteria for SBP or culture negative neutrocytic ascites, 14 were randomized to a group receiving 5 days and 13 to a group receiving 10 days of single agent cefotaxime 2g IV every 8 hours. Many variables (clinical data, standard liver and kidney function results, ascitic fluid data, complement proteins) were obtained at admission, the 2nd day, and the last day(the 5th or 10th day) of the study. RESULTS: Hospitalization mortality(7% vs 15%), recurrence rate(21% vs 0%), infection related mortality(7% vs 0%) and therapeutic response(86% vs 92%) were not significantly different between the 5- and 10-day treatment groups. The opsonic activity was not significantly different between the recurrence(n=3) group and non-recurrence group(n=26), but the indices of opsonic activity in recurrence group showed lower tendency than those in non-recurrence group. Early response rate was significantly different between the high and low protein concentration in ascitic fluid. CONCLUSIONS: Short course treatment of SBP is as effective as long-course therapy and significantly less expensive.
Ascites ; Ascitic Fluid ; Cefotaxime ; Complement System Proteins ; Hospitalization ; Humans ; Kidney ; Liver ; Peritonitis* ; Recurrence