OBJECTIVES: Bee venom contains a potent antiinflammatory peptide 401 as well as mellitin. The purpose of this study was to see the efficacy and safety of purified bee venom injection therapy for knee or spinal osteoarthritis patients. METHODS: One hundred and one osteoarthritis patients were randomly assigned to bee venom injection therapy or oral nabumetone medication group. Bee venom injection group was subdivided into 3 groups according to different dosing schedule(group A: gradual increase up to 0.7mg, group B: up to 1.5mg and group C: up to 2.0mg). Control group patients(group D) were given 1000mg nabumetone daily for 6 weeks. There were 25, 26, 25, and 26 patients assigned to A, B, C, or D group. The efficacy of treatment was evaluated by measuring instruments developed by authors, and the safety of bee venom injection was evaluated by hematology and chemistry laboratory examination. RESULTS: Among 101 patients, eighty-one patients completed the study, but twenty patients were dropped out and two of these patients were dropped out due to adverse drug reaction. The efficacy in bee venom group showed better improvement than nabumetone group(p<0.01). Within bee venom group, group B and C showed better improvement than group A(p<0.01). Itching around injection site occurred in most patients, and bodyache occurred in 49 patients (81.7%). Hemoglobin was decreased(0.3g/dl) in group C, but no significant changes were observed in other laboratory values. CONCLUSION: The efficacy of bee venom injection in the control of knee or back pain in osteoarthritis patients was better than nabumetone medication. No severe allergic or adverse reaction was observed in bee venom treatment patients, but problems related with bee venom injection, such as pruritis, bodyache, and the possibility of anaphylaxis, should be considered for the use of bee venom injection.
Anaphylaxis ; Back Pain ; Bee Venoms* ; Bees* ; Chemistry ; Drug-Related Side Effects and Adverse Reactions ; Hematology ; Humans ; Knee ; Melitten ; Osteoarthritis* ; Osteoarthritis, Spine ; Pruritus

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the residual diameter stenosis after PTCA with fractional flow reserve (FFR) and coronary flow reserve (CFR), and investigate the correlation between FFR and CFR in patients with acute myocardial infarction (AMI). MATERIALS AND METHOD: The study population consisted of twenty seven patients with myocardial infarction. Baseline and hyperemic average peak velocity (APV) were measured using Doppler wire 15 minutes after restoration of infarct-related artery (IRA). CFR was obtained by the ratio of distal hyperemic APV to baseline APV. Distal coronary arterial pressure (Pd) was measured with advancing the wire distal to the lesion of IRA. Simultaneous proximal aortic pressure (Pa) was measured using guiding catheter. Myocardial FFR was obtained by the ratio of hyperemic Pd to hyperemic Pa. RESULTS: Post-interventional CFR and FFR were 0.85+/-0.44, 0.91+/-0.09. CFR did not show significant correlation with luminal diameter stenosis (%ST). There was no significant correlation between FFR and CFR with a correlation coefficient of 0.29 (p=.25). But, significant correlation was found between %ST and FFR, %ST and hyperemic PG (hPG) with correlation coefficient of -0.70 (p=.0012) and 0.68 (p=.0018). CONCLUSION: In AMI patients, %ST has a significant correlation with FFR and hPG after PTCA. But, there was no significant correlation between FFR and CFR.
Arterial Pressure ; Arteries ; Catheters ; Constriction, Pathologic ; Humans ; Myocardial Infarction* ; Phenobarbital

Mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland is a very rare malignant tumor characterized by rapidly progressive clinical course and radioresistance. A 63-year-oid woman had mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland diagnosed by fine needle aspiration cytology (FNA), and the diagnosis was confirmed by histological examination. She had complained of a fixed, egg-sized mass of the anterior neck with hoarseness for 1 year. The findings of FNA consisted of sheets and clusters of polygonal epithelial cells with hyperchromatic, pleomorphic nuclei and eosinophilic, abundant, laminated cytoplasm. These findings were consistent with squamous cell carcinoma. Also, foci of papillary carcinoma were noted, and the cells exhibited nuclear groovings and intranuclear cytoplasmic inclusions. Total thyroidectomy specimen showed a diffusely infiltrating tumor in the left thyroid which was composed of mixed papillary carcinoma and well-differentiated squamous cell carcinoma. In junction between two components, squamous metaplasia of papillary carcinoma was noted.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Child* ; Cytoplasm ; Diagnosis ; Eosinophils ; Epithelial Cells ; Female ; Giant Cell Tumors ; Giant Cells ; Glomerulosclerosis, Focal Segmental* ; Hoarseness ; Humans ; Inclusion Bodies ; Metaplasia ; Neck ; Ribs ; Thyroid Gland ; Thyroidectomy

No abstract available.
Carcinoma, Transitional Cell* ; Tuberculosis, Renal* ; Ureter*

No abstract available.
Angioplasty* ; Budd-Chiari Syndrome* ; Heart Ventricles* ; Stents*

BACKGROUND AND OBJECTIVES: The pathological findings of Non-Q wave myocardial infarction(NQMI) on ECG did not always correspond to subendocardial infarction(SEMI). The purpose of this study was to evaluate the diagnostic validity of ECG for SEMI by myocardial contrast echocardiography (MCE) in the patients with acute myocardial infarction(AMI). MATERIALS AND METHODS: The study population was 84 patients who underwent MCE under the diagnosis of AMI. MCE was performed by intracoronary injection of sonicated Hexabrix into the infarct related artery and SEMI was diagnosed by inspecting endocardial defect with epicardial enhancement on MCE. RESULTS: (1) Among 19 NQMI cases, 7 cases showed SEMI with MCE score 0.5, 11 cases with score 1, and 1 case with score 0. Among 65 Q-wave MI(QMI) cases, only 5 cases showed SEMI. (2) 7 cases who had NQMI with SEMI showed LV wall motion recovery at follow-up echocardiography except 1 case. Whereas, of 5 QMI cases who had SEMI, only 1 case improve LV wall motion. CONCLUSION: NQMI on ECG does not always imply SEMI on MCE, but the absence of pathologic Q wave in the patients with SEMI is thought to be a predictive factor of the recovery of LV wall motion.
Arteries ; Diagnosis ; Echocardiography* ; Electrocardiography* ; Follow-Up Studies ; Humans ; Infarction* ; Ioxaglic Acid

BACKGROUND AND OBJECTIVES: The pathological findings of Non-Q wave myocardial infarction(NQMI) on ECG did not always correspond to subendocardial infarction(SEMI). The purpose of this study was to evaluate the diagnostic validity of ECG for SEMI by myocardial contrast echocardiography (MCE) in the patients with acute myocardial infarction(AMI). MATERIALS AND METHODS: The study population was 84 patients who underwent MCE under the diagnosis of AMI. MCE was performed by intracoronary injection of sonicated Hexabrix into the infarct related artery and SEMI was diagnosed by inspecting endocardial defect with epicardial enhancement on MCE. RESULTS: (1) Among 19 NQMI cases, 7 cases showed SEMI with MCE score 0.5, 11 cases with score 1, and 1 case with score 0. Among 65 Q-wave MI(QMI) cases, only 5 cases showed SEMI. (2) 7 cases who had NQMI with SEMI showed LV wall motion recovery at follow-up echocardiography except 1 case. Whereas, of 5 QMI cases who had SEMI, only 1 case improve LV wall motion. CONCLUSION: NQMI on ECG does not always imply SEMI on MCE, but the absence of pathologic Q wave in the patients with SEMI is thought to be a predictive factor of the recovery of LV wall motion.
Arteries ; Diagnosis ; Echocardiography* ; Electrocardiography* ; Follow-Up Studies ; Humans ; Infarction* ; Ioxaglic Acid

PURPOSE: In recent years, the authors experienced a distinctive clinical entity of multiple intestinal ulcerations and perforations in infants. The purpose of this study was to describe the clinical characteristics of this entity, examine th possible pathogenesis and the effective treatment. METHODS: Seven infants underwent abdominal exploration under suspicion of surgical abdomen and were noted to have multiple intestinal ulcerations and perforations without evidence of necrotizing enterocolitis by the members of the Korean Association of Pediatric Surgeons. The clinical courses, operative findings, bacterial cultures, pathologic findings, treatment and prognosis of these seven cases were evaluated retrospectively. RESULTS: The characteristics of this entity are as follows : The initial presenting symptoms were all different. Despite conservative treatment with a broad spectrum of antibiotics, diarrhea and abdominal distention developed and progressively grew worse. At laparotomy, all patients exhibited numerous typical transverse linear ulcerative lesions with pin-point perforations scattered mainly in the small bowel. Histologic evaluations of the resected specimens revealed mucosal ulcerations with neutrophil infiltration, submucosal microabscesses and colonies of gram-positive cocci. Methicillin-resistant Staphylococcus aureus(MRSA) was the predominant organism cultured from the body fluid. Only two cases, the completely-resected one and the one immediately treated with vancomycin after operation, survived. CONCLUSION: We think this distinct clinical entity exhibiting multiple intestinal ulcerations and perforations is caused by MRSA occurring in infants. It has a high mortality because it is verydifficult to diagnosis in young infants before laparotomy. Vancomycin is highly effective in treating MRSA, so we think the early diagnosis of this entity can make the treatment successful.
Abdomen ; Anti-Bacterial Agents ; Body Fluids ; Diagnosis ; Diarrhea ; Early Diagnosis ; Enterocolitis, Necrotizing ; Gram-Positive Cocci ; Humans ; Infant* ; Intestinal Perforation ; Laparotomy ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mortality ; Neutrophil Infiltration ; Prognosis ; Retrospective Studies ; Staphylococcus ; Ulcer* ; Vancomycin

PURPOSE: In recent years, the authors experienced a distinctive clinical entity of multiple intestinal ulcerations and perforations in infants. The purpose of this study was to describe the clinical characteristics of this entity, examine th possible pathogenesis and the effective treatment. METHODS: Seven infants underwent abdominal exploration under suspicion of surgical abdomen and were noted to have multiple intestinal ulcerations and perforations without evidence of necrotizing enterocolitis by the members of the Korean Association of Pediatric Surgeons. The clinical courses, operative findings, bacterial cultures, pathologic findings, treatment and prognosis of these seven cases were evaluated retrospectively. RESULTS: The characteristics of this entity are as follows : The initial presenting symptoms were all different. Despite conservative treatment with a broad spectrum of antibiotics, diarrhea and abdominal distention developed and progressively grew worse. At laparotomy, all patients exhibited numerous typical transverse linear ulcerative lesions with pin-point perforations scattered mainly in the small bowel. Histologic evaluations of the resected specimens revealed mucosal ulcerations with neutrophil infiltration, submucosal microabscesses and colonies of gram-positive cocci. Methicillin-resistant Staphylococcus aureus(MRSA) was the predominant organism cultured from the body fluid. Only two cases, the completely-resected one and the one immediately treated with vancomycin after operation, survived. CONCLUSION: We think this distinct clinical entity exhibiting multiple intestinal ulcerations and perforations is caused by MRSA occurring in infants. It has a high mortality because it is verydifficult to diagnosis in young infants before laparotomy. Vancomycin is highly effective in treating MRSA, so we think the early diagnosis of this entity can make the treatment successful.
Abdomen ; Anti-Bacterial Agents ; Body Fluids ; Diagnosis ; Diarrhea ; Early Diagnosis ; Enterocolitis, Necrotizing ; Gram-Positive Cocci ; Humans ; Infant* ; Intestinal Perforation ; Laparotomy ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mortality ; Neutrophil Infiltration ; Prognosis ; Retrospective Studies ; Staphylococcus ; Ulcer* ; Vancomycin

BACKGROUND AND OBJECTIVES: As lack of myocardial perfusion was demonstrated Microvascular function after reperfusion of infarct related artery (IRA) can be changed in convalescent stage for several possible mechanisms such as hyperemia and microvascular stunning. Therefore, myocardial contrast echocardiography (MCE) performed early stage after reperfusion of IRA may cause over or underestimation of the extent of myocardial necrosis. The aims of the study were to demonstrate the temporal changes of myocardial perfusion after revascularization of IRA and to explore the association of late changes of myocardial capillary flow with contractile recovery. METHODS: MCE was performed 5-7days after the attack of acute myocardial infarction (AMI) in 21 patients (M:F=17:4, age: 58+/-12yrs) who underwent successful reperfusion of IRA. MCE was graded by semiquantitative score (0: no opacification, 0.5: partial opacification, 1: homogenous opacification) by 16 segment model. Every patient underwent 1-2months follow up 2D echocardiography and MCE. Improvement of wall motion score more than 1 at follow up was considered to have contractile recovery. RESULTS: Thirty-one of 71 initially akinetic segments were scored as 1, 30 segments as 0.5 and 10 segments as 0 after attempted reperfusion. Twelve of 30 segments with score of 0.5 and 5 of 10 segments with score of 0 showed late improvement of MCE score to 1 and 0.5. Only 1 of 30 segments with score of 0.5 got worse to score of 0. Every segment with late improvement from 0.5 to 1 showed contractile recovery, whereas none of 5 segments with late improvement from 0 to 0.5 showed contractile recovery. There was no significant difference of predictive value between early and late MCE (p=ns). CONCLUSION: Temporal changes of myocardial perfusion from 1week to 2 months in AMI were mainly progressive improvement caused by recovery of microvascular function from stunning rather than progressive microvascular damage or reactive hyperemia. However, it may not significantly affect the validity of MCE in predicting contractile recovery.
Arteries ; Capillaries* ; Echocardiography ; Follow-Up Studies ; Humans ; Hyperemia ; Myocardial Infarction* ; Necrosis ; Perfusion ; Reperfusion*