Intracranial tuberculomas have been reported occasionally, especially in Asia, though much decreased in recentyears. Those lesions can be diagnosed more easily and acurately using CT than conventional method, including angiography. Authors analysed CT findings of 21 cases, confirmed as tuberculoma, at Hanyang University Hospital from May 1979 to June 1983. The resuslts were as follows; 1. Of all 21 cases, multiple lesions were seen in 14 cases (67%) and single in 7(33%). 2. Of all 21 cases, lesions located only at supratentorial were in 19 cases(90%) and remained 2(10%) had lesions at both supra and infratentorial area. And temporal and parietal lobes were common location (65%) of all lesions. 3. In precontrast scan, density of tuberculoma showed largely isodense (68%)and others were slight high (29%) and low(3%). 4. All lesions were enhanced showed as homogeneous nodular (68%),ring-shaped(29%) and target shaped(3%). 5. All rings were continuous and thickness was largely uniform(67%), anddensity of center of the ring was mainly low(67%). 6. Edema was seen in 58% of all lesions: comparing with thesize of tuberculoma, edema size was smaller in 50%, lager in 33% and almost the same in 17%.
Angiography ; Asia ; Edema ; Methods ; Parietal Lobe ; Tuberculoma ; Tuberculoma, Intracranial

Disulfiram (DSF) is an aldehyde dehydrogenase inhibitor. DSF has potent anti-cancer activity for solid and hematological malignancies. Although the effects on cancer cells have been proven, there have been few studies on DSF toxicity in bone marrow cells (BMs). DSF reduces the metabolic activity and the mitochondrial membrane potential of BMs. In subset analyses, we confirmed that DSF does not affect the proportion of BMs. In addition, DSF significantly impaired the metabolic activity and differentiation of BMs treated with granulocyte macrophage-colony stimulating factor, an essential growth and differentiation factor for BMs. To measure DSF toxicity in BMs in vivo, mice were injected with 50 mg/kg, a dose used for anti-cancer effects. DSF did not significantly induce BM toxicity in mice and may be tolerated by antioxidant defense mechanisms. This is the first study on the effects of DSF on BMs in vitro and in vivo. DSF has been widely studied as an anti-cancer drug candidate, and many anti-cancer drugs lead to myelosuppression. In this regard, this study can provide useful information to basic science and clinical researchers.

BACKGROUND: The two most commonly used drugs as a stressor during wtress echocardiography are dipyridamole and dobutamine. The purpose of this study was to compare diagnostic accuracies of dipyridamole and dobutamine stress echocardiography for fixed coronary artery disease and evaluate complications related to the two agents in the same patients. METHODS: 30(M : 5=19 : 11, age=56+/-8.8yr) consecutive patients without history of previous myocardial infarction underwent coronary angiography, dipyridamole and dobutamine stress echocardiography in random order. Dipyridamole was infused up to 0.84mg/Kg for 10 minutes during clinical, ECG and echocardiographic montioring. Dobutamine was infused in dose increments from 5 to 40microg/Kg/min under the same condition. Positive criteria for myocardial ischemia by echocardiography was now regional wall mation abnormatity or worsening of regional wall motion after stress. Significant coronary disease was defined as more than 70% stenosis by coronary angiography. RESULTS: The sensitivity and specificity of both stress echocardiography were same, 82% and 92% respectively. In a single vessel disease the sensitivity of dipyridamole echocardiography was 75% and dobutamine echocardiography was 83% without statistical difference. The correlation of ischemic free time during both stress test was 0.375. During dipyridamole infusion no test was prematurely terminated because of side effects, but 3 patients(10%) developed severe hypertension and ventricular arrytricular arrythmia during dobutamine infusion and test was terminated. CONCLUSION: Thus, by this prospective direct comparison of both stress test, dipyridamole and dobutamine stress echocardiography have similar diagnostic accuracies for the detection of coronary artery disease. But during dobutamine infusion, careful monitoring for hemodynamic changes arrythmia is required for possible serious complications.
Arrhythmias, Cardiac ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Exercise Test ; Hemodynamics ; Humans ; Hypertension ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Sensitivity and Specificity

The fibrovascular tissues surrounding a glaucoma implant have been found to play a major role for the orbital absorption of aqueous humor following a glaucoma implant surgery. An ultrasonographic study was performed to investigate the ultrasonographic, characteristics of the tissues and its relationship with the postoperative intraocular pressure(IOP) control. Twenty-three eyes of 23 patients had undergone the e-PTFE membrane-silicone tube implantation and had been followed up for at least 6-month(mean +/- SD, 17 +/- 8.8 months). An ultrasonographic study for these eyes included such paramneters as presence of an aqueous reservoir surrounding the implant, size(height) of the aqueous reservoir and echoreHectivity from the reservoir wall tissues. The aqueous reservoir was identified in 22(96%) of 23 eyes and had a height varying from 1.0 mm to 5.5 mm. In eyes with an aqueons reservoir. 3 mm high or more, the IOPs were all 21 mmHg or less without further glaucoma medications(p=0.040, chi-square). In one eye with an obliterated reservoir on ultrasonography, the opening of the silicone tube was found to be occluded toward the extrascleral portion of the implant when reoperation was performed. The echo reflections from reservoir wall tissues were denser and higher comparing with those from the sclera of the respective eye in 7 eyes with a complete failure of postoperative lOP control(>or=30 mmHg on maximum medical theraph). These eyes also had and irregular echoreflections within the aqueous reservoir, which reflect an invasion of proliferating tissues into the reservoir.
Absorption ; Aqueous Humor ; Glaucoma* ; Humans ; Orbit ; Reoperation ; Sclera ; Silicones ; Ultrasonography

Fenbendazole (FBZ) is a commonly used anthelmintic in veterinary medicine that has recently been found to have anticancer effects in humans. On the other hand, few studies have examined the anti-inflammatory effects of FBZ, and its mechanism is unknown. In this study, mouse bone marrow cells (BMs) were treated with lipopolysaccharide (LPS), a representative inflammation-inducing substance, to generate a situation similar to osteomyelitis in vitro. The effect of FBZ on inflammatory BMs was examined by measuring the metabolic activity, surface marker expression, cell nuclear morphology, and mitochondrial membrane potential (MMP) of BMs. FBZ decreased the metabolic activity and MMP of LPS-treated BMs. Annexin Ⅴ-fluorescein isothiocyanate/propidium iodide staining and Hoechst 33342 staining showed that FBZ reduced the number of viable cells and induced the cell death of inflammatory BMs. In addition, FBZ reduced the proportion of granulocytes more than B lymphocytes in LPS-treated BMs. Overall, FBZ induces cell death by destabilizing the MMP of LPS-induced inflammatory BMs. FBZ can play a role as an anthelmintic and anticancer agent and an anti-inflammatory agent.

BACKGROUND: QT dispersion(QTD : QTmax-QTmin) or JT dispersion(JTD:JTmax-JT-min)in 12 leads ECG has been known to reflect regional variations in ventricular repolarization and has been reported to bel one of the marker of regional myocardial ischemia. To evaluate the significance of QTD or JTD of exercise ECG in diagnosis of coronary artery disease, we studied 106 patients(mean age, 56.9 years old, male 63) who were referred for the evaluation of chest pain on exertion. METHOD: Treadmill exercise stress test with modified Bruce protocol and coronary angiography were performed in 106 patients with chest pain on exertion. ST-segment depression by >1.0 mm 0.08 second after J-point during or after exercise in exercise test and >50% stanosis of epicardial artery in coronary angiogram were defined as positive. Of 106 patients, 41 had positive exercise ECG and positive coronary angiogram(true positive, TP), 20 had positive exercise ECG and negative coronary angiogram(false positive, FT), 20 had negative exercise ECG and positive coronary angiogram(faalse negative, FN), and 23 had negative exercise ECG and negative coronary angiogram(true negative, Tn). QT and JT interval in 12 leads were measured at baseline and peakexercise and were corrected for heart rate using Bazett's formula. QTD and JTD were measured by calculation the difference between the maximum QT and mininum QT and that between maximum JT and minumum JT. RESULTS: QTD at baseline for TP(72.8ms)was prolonged compared to Tn(52.2ms,P<0.01), but was not different from that for FT(70.2 ms). At peak exercise, QTD for TP(81.3 msec) was significantly prolonged(p<0.01), while QTD for FP(71.2 msec) was not different from that for TN(56.8 msec). JTD at baseline(78.4 msec) and at peak exercise(88.2 msec) for TP were significantly prolonged compared to those for TN(55.2msec and 55.1msec p<0.01,p<0.01, respectively), but those for FP were not porlonged(77.0msec and 79.0msec, respectively). QTD and JTD at peak exercise were more markedly prolonged in patients with sever stenosis of coronary artery(p=0.053 and p<0.05, repectively) and multivessels diseases(p<0.01, 0<0.05) than those with less severe disease and single vessel disease. Patients with left anterior descending artery lesion had greater QTD and JTD at peak exercise than those with other vessels lesion(p<0.01). In addition to standard criteria with ST segment displacement in exercise EGC, inclusion of exercise induced QTD of more than 60msec increased the sensitivity of exercise ECG from 66.7% to 83.3%, and JTD of more than 70msec increased the specificity from 52% to 76.0%. CONCLUSION: Measurement of QT dispersion and JT dispersion of exercise ECG may be useful method to identify the severity of coronary artery disease and to improve diagnostic accuracy of exercise ECG in coronary artery disease.
Arteries ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Depression ; Diagnosis ; Electrocardiography* ; Exercise Test ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Sensitivity and Specificity

BACKGROUND: Celiprolol is a new generation beta-adrenoreceptor blocking agent with intrinsic sympathomimetic activity characterized by selective blockade of beta1 receptors and partial agonist activity at beta2 receptors. This study was designed to investigate the antihypertensive efficacy and safety of celiprolol in patients with essential hypertension. METHODS: The study subjects consisted of 36 patients(mean age : 55 years, 11 males, 25 females). Celiprolol was administered orally in a aily dose of 200-800mg once or two divided dose for 10 weeks after the admimstration of placebo for 2 weeks. RESULTS: Blood pressure was significantly reduced from 171+/-19/106.8mmHg to 153+/-20/92+/-12mmHg(p<0.01) after 2 week of therapy and this effect was maintained throughout the study periods. The efficacy rates were total 94%(marked improve : 53%, moderate improve : 22%, mild improve : 19%). The cumulative efficacy rate was 72% at 200mg/day, 91% at 400mg/day, and 94% at 800mg/day. Heart rate did not change throughout 10 weeks. There were no significant change in hematologic and blood chemistry variables. During the period of medication, headache developed in 3 cases(8%) and each of dry cough, dyspnea, epigastric pain and diarrhea and facial flushing developed in 1 case(2.8%) but they were tolerable. CONCLUSIONS: This results suggest that celiprolol is effective and safe drug in the treament of patients with essential hypertension.
Blood Pressure ; Celiprolol* ; Chemistry ; Cough ; Diarrhea ; Dyspnea ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Male

BACKGROUND: The restoration of anterograde flow in the infarct-related artery(IRA) may improve electrophysiological consequences and survival. Patients with occluded IRA are more likely than those with patent IRA to have late potentials on signal-averaged electrocardiogram(SAEKG). The natural history of late potentials in the acute phase after AMI was reported to vary in recent studies and requires further investigation. Therefore, we investigated 1) whether parameters of SAEKG and incidence of late potentials are changed in 2 weeks after AMI, and 2) whether the status of IRA, ejection fraction, ventricular premature beats(VPB) on Holter and the use of thrombolytic agent can influence the developement of late potentials. METHOD: SAEKGs were performed in 40 patients with acute myocardial infarction(AMI, mean age : 56.6yr) and 20 normal controls(mean age : 53.0yr). SAEKGs were recorded first in 48 hours and then 2 weeks after AMI. Late potential were considered to be positive if two of the three following criteria were identified : 1) duration of filtered QRS complex>118ms, 2) duration of HFLA signal>40 ms, and 3) RMS voltage<20microV. RESULT: 1) The duration of filtered QRS complex and HFLA signal in patients with AMI in 48 hours and 2 weeks were longer than in the controls(p<0.01, p<0.05. respectively), and the RMS voltage in only 2 weeks was lower than in the controls(p<0.05). 2) There was no significant difference in the 3 parameters of SAEKG between 48 hours and 2 weeks after AMI, but the incidence of late potentials increased from 35%(14/40) to 42.5%(17/40). Of the 26 patients with a normal initial SAEKG, 3(11.5%) had late potentials in 2 weeks, whereas none of the patients with positive late potentials on initial SAEKG was normalized in 2 weeks. 3) The ejection fraction, the degree of VPB on the Holter EKG and the history of thrombolyic therapy in patients whose late potentials were positive were not different from those in patients with normal SAEKG. 4) In the 3 parameters of SAEKG, RMS voltage in patients with occluded IRA was significantly lower than in those with open IRA(p<0.05), and the incidence of late potentials were higher in the patients with occluded IRA(75%) than in those with open IRA(28.6%)(p<0.05). CONCLUSION: The incidence of late potentials on SAEKG after AMI was modestly increased in 2 weeks, but the development of late potentials was not influenced by the degree of frequently in patients with occluded IRA. These findings may indicate that the development of late potential after AMI tends to increase even in 2 weeks, and that the occlusion in IRA may unfavorably alter the electrophysiological state identified by SAEKG.
Arteries* ; Electrocardiography ; Humans ; Incidence ; Myocardial Infarction* ; Natural History ; Stroke Volume

Renal oncocytoma is a uncommon benign tumor originating from the intercalated cells of the collecting duct, which occurs with an overall incidence of 3% to 7% among all renal tumors. Bilateral, multicentric renal oncocytoma is rare, especially in chronic renal failure. We report a case of 59-year-old woman with bilateral oncocytoma with renal failure. She presented nausea and vomiting for one month, and had no previous past medical history. Abdominal sonography and computed tomography revealed variable sized homogenous mass on both kidneys. Microscopic examination showed large polygonal cells with abundant eosinophilic and granular cytoplasm. Surrounding renal parenchyma revealed marked atrophy and sclerosis with a few intact glomeruli and tubules. We could exclude renal cell carcinoma because tumor cells were negative for CK7, CK20, vimentin, and Hale's colloidal iron staining, and did not show perinuclear halo and mitosis.
Adenoma, Oxyphilic ; Atrophy ; Carcinoma, Renal Cell ; Colloids ; Cytoplasm ; Eosinophils ; Female ; Humans ; Incidence ; Iron ; Kidney ; Kidney Failure, Chronic* ; Middle Aged ; Mitosis ; Nausea ; Renal Insufficiency ; Sclerosis ; Vimentin ; Vomiting

BACKGROUND: Delapril, a recently developed nonsulfhydry(SH) angiotensin converting enzyme inhibitor, was known to have more prolonged duration of action. In order to investigate the efficacy and safety of delapril, patients with essential hypertension were studied. METHODS: The study subject consisted of 37 patients(mean age : 50.4 years, 15 male, 22 female). Because 4 of 37 patients dropped out due to side effects of delapril, the antihypertensive efficacy was evaluated in the remaining 33 patients. Delapril was administered orally in a daily dose of 30-120mg in two divided doses for 10 weeks after the administration of a placebo for 2 weeks. RESULTS: Delapril decreased systolic blood pressure significantly from a baseline value of 162.4+/-18.8mmHg to 142.9+/-20.9mmHg(p<0.01) and diastolic blood pressure from 103.2+/-5.0mmHg to 92.8+/-10.4mmHg(p<0.01) after 2 weeks of therapy, and maintained this effect throughout the study period. The efficacy rates were 72% for systolic pressure, 75% for diastolic pressure. The cumulative efficacy rate was 48% at 30mg/day, 66% at 60mg/day, and 73% at 120mg/day. Heart rate did not change until after 8 weeks, when they modestly decreased(p<0.05), through the 10th week(NS). Side effects were noticed in 12 out of 37 cases(32.4%). The main symptoms included dry cough(7 cases, 18.9%), headache(2 cases, 5.4%), dizziness(1 case, 2.7%), dry mouth(1 case, 2.7%) and angioedema(1 case, 2.7%). Six of the 7cases of dry cough were in women, and 3 caes discontinued the drug due to intractable cough. Angioedema in the oropharynx occurred in 1 patient and caused severe dyspnea which was relieved by the discontinuation of the medication. There was no significant change in CBC and biochemical variables. CONCLUSIONS: A daily dose of delapril in two divided doses is effective in decreasing blood pressure in patients with essential hypertension, and safe when an awareness of possible side effects is taken into account.
Angioedema ; Blood Pressure ; Cough ; Dyspnea ; Female ; Heart Rate ; Humans ; Hypertension* ; Male ; Oropharynx ; Peptidyl-Dipeptidase A