No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Restriction Fragment Length*

Pheochromocytoma is originated from chromaffin cell of sympathetic nervous system and associated with other disease, such as neurofibromatosis, duodenal carcinoid, medullary thyroid cancer and parathyroid adenoma. Especially, pheochromocytoma is developed more than 50% in neurofibromatosis associated with hypertension. In such cases, several clinical features documented as more frequent bilateral phochromocytoma, more associated with other neuroendocrine tumors and thus more poor prognosis. We can observe the sustained hypertension despite of surgical resection of tumors in pheochromocytoma cases. One of the possible reason of post operative sustained hypertension is the pheochromocytoma originated from minor organ of Zukerkandl that was not resected during operation. Untreated or delayed treated cases with pheochromocytoma were often expired by complication of hypertension such as cerebrovascular hemorrhage, myocardial infarction, etc. Thus, in neurofibromatosis with hypertension, screening of pheochromocytorna is very important for the early detection of tumor and more favorable prognosis. Recently, We experienced a case of neurofibromatosis associated with bilateral pheochromocy-toma expired by cerebral hemorrhage during operation, so we report the case with literature review.
Carcinoid Tumor ; Cerebral Hemorrhage ; Chromaffin Cells ; Hemorrhage ; Hypertension ; Mass Screening ; Myocardial Infarction ; Neuroendocrine Tumors ; Neurofibromatoses* ; Parathyroid Neoplasms ; Pheochromocytoma* ; Prognosis ; Sympathetic Nervous System ; Thyroid Neoplasms

BACKGROUND: Confluent and reticulate papillomatosis(CRP) of Gougerot and Carteaud is an uncommon disorder of unknown cause for which a variety of treatments have been proposed. OBJECTIVE: We attempted to evaluate the therapeutic effect of oral minocycline for CRP. METHOD: Nine patients(age range, 14 to 38; mean age, 21years) with CRP were included in this study. They took minocycline 100mg daily. The therapeutic effect was evaluated weekly by 5 scoring systems according to the percentage clearing of the skin lesion: poor (score 1), <25% clearing; fair (score 2), 26-50%; good (score 3), 51-75%; excellent (score 4), 76-95%, clear(score 5), >95%. RESULTS: Two out of 9 patients showed complete clearing(score 5) of the skin lesions within 2 weeks. Seven patients revealed incomplete clearing(score 4) within 3 to 8 weeks. The mean scoring for 9 CRP patients was 4.2. Recurrences were noted in two patients at 24 and 26 months, respectively, but they responded to re-treatment with minocycline. The patients did not show any adverse reactions apart from two patients who developed mild pruritus. CONCLUSION: We recommend minocycline as the first choice of treatment for CRP because minocycline is safe, economic and effective.
Humans ; Minocycline* ; Papilloma* ; Pruritus ; Recurrence ; Skin

The empty sella syndrome is characterized by obesity, frequent pregnancy, headache and high blood pressure, but its exact cause remains unknown. Usually the incomplete diaphragmatic sella has been considered as the cause of the empty sella syndrome, but some authors recently have suggested that the antipituitary antibody way be related to development of pituitary atrophy and the pituitary empty sella syndrome, and thus it may be clinically useful as screening test for the empty sella syndrome. We experienced two empty sella syndromes associated Graves disease and applied the antipituitary antibody as the diagnostic tool of the empty sella syndrome. But none of this two patients had antipituitary antibody and we report these cases with reviews of literatures.
Atrophy ; Empty Sella Syndrome ; Graves Disease ; Headache ; Humans ; Hypertension ; Mass Screening ; Obesity ; Pregnancy

No abstract available.
Echocardiography, Transesophageal*

Carcinoma ex pleomorphic adenoma is one of the rare malignant tumors arising in the salivary glands. Parotid gland is the most frequently affected site, while the other minor salivary glands have much lower incidence rates. There has been no clinical report of the carcinoma ex pleomorphic adenoma developed in the maxillary sinus. Carcinoma ex pleomorphic adenoma is very malignant and its prognosis is rarest among those of parotid gland tumors. We experienced a 24-year-old male patient who had a bulging mass on his left infraorbital area for 18 months. A carcinoma ex pleomorphic adenoma arising in the left maxillary sinus was diagnosed and medial maxillectomy, postoperative chemotherapy and concurrent radiotherapy were done. So far we have followed up the patient for 15 months and there is no sign or symptom of recurrence or metastasis.
Adenoma, Pleomorphic* ; Drug Therapy ; Humans ; Incidence ; Male ; Maxillary Sinus* ; Neoplasm Metastasis ; Parotid Gland ; Prognosis ; Radiotherapy ; Recurrence ; Salivary Glands ; Salivary Glands, Minor ; Young Adult

BACKGROUND: The pattern of left ventricular filling as depicted by Doppler echocardiographic transmitrial flow velocities has been used to left ventricular diastolic properties. Especially, altered transmitral flow by abnormal myocardial wall motion and left ventricular function in ischemic heart disease, was predicted during exercise test. METHODS: To determine the effects of exercise on Doppler echocardiographic measures of left ventricular diastolic filling, we studied 15 angina pectoris patients and 20 normal control subjects. Transmitral flow measurements comprised peak and integrated early passive(E) and late atrial(A) filling velocities and diastolic filling period. RESULTS: Heart rate in negative exercise treadmill test group was 70/min at rest, 111/min just after exercise, and 86/min at 5 minutes after exercise. Positive exercise treadmill test group was 69/min, 109/min and 82/min, respectively. DFP and E duration were also significantly decreased after exercise in group with negative treadmill exercise test. In positive treadmill exercise group, peak A was significantly increased from 0.57+/-0.15m/sec to 0.75+/-0.20m/sec at just after exercise(p<0.01), 0.67+/-0.12m/sec at 5 minuties after exercise. DFP and E duration were also significantly decreased after exercise. CONCLUSION: Doppler echocardiographic transmitral flow was altered by abnormal regional wall motion and left ventricular dysfunction in ischemic heart disease during exercise test. The use of Doppler echocardiography for this purpose is limited, however, because a number of variables may influence transmitral flow patterns, including age, preload, afterload and systolic function.
Angina Pectoris ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Echocardiography ; Echocardiography, Doppler* ; Exercise Test ; Heart Rate ; Humans ; Isoflurophate ; Myocardial Ischemia ; Ventricular Dysfunction, Left ; Ventricular Function, Left

It is well known that hypertension is associated with left ventricular diastolic dysfunction which frequently precede systolic dysfunction. To determine whether nifedipine could improve left ventricular diastolic function in hypertensive patients, we studied 15 hypertensive patients and 15 normotensive subjects matched for sex, age with Doppler echocardiography. After oral administration of 10mg of nifedipine, there were no significant changes in Doppler-derived transmitral diastolic filling indexes of normotensive subjects. On the other hand, although peak flow velocity in atrial systole(PFVA), time velocity integral in atrial systole(TVIA) did not change significantly after nifedipine, nifedipine significantly increased peak flow velocity in early diastole(PFVE) from 40.2+/-6.4cm/sec to 46.5+/-10.9cm/sec(p<0.005), time velocity integral in early diastole(TVIE) from 5.24+/-1.2cm to 5.97+/-1.43cm(p<0.001), the ratio of PFVE/PFVA from 0.69+/-0.11 to 0.76+/-0.12(p<0.05), the ratio of TVIE/TVIA from 1.18+/-0.21 to 1.29+/-0.24(p<0.05), deceleration slope(DS) from 244.9+/-51.9cm/sec2 to 289.9+/-49.1cm/sec2 (p<0.001) and decreased isovolumic relaxation time(IVRT) from 132.3+/-10.3msec to 117.2+/-13.5msec(p<0.001), deceleration time(DT) from 168.8+/-30.3msec to 154.9+/-29.8msec(p<0.05) in hypertensive patients. These fimdings indicated that nifedipine improves Doppler-derived early diastolic filling indexes in hypertensive patients and may be related to improvement of active relaxation of left ventricle in early diastole.
Administration, Oral ; Deceleration ; Diastole ; Echocardiography, Doppler* ; Hand ; Heart Ventricles ; Humans ; Hypertension ; Nifedipine* ; Relaxation

OBJECTIVE: To evaluate the relationship between parathyroid hormone (PTH) gene BstBI polymorphism, bone mineral density (BMD) and bone responsiveness to hormone replacement therapy (HRT). METHODS: PTH BstBI polymorphism was determined by restriction fragment length polymorphism (RFLP) in 444 postmenopausal Korean women. Among these women, 309 women received sequential HRT for 1 year. Serum bone alkaline phosphatase, CrossLaps, osteocalcin, calcitonin, and parathyroid hormone levels were measured by immunoassay and serum calcium and phosphorus levels by atomic absorptiometry. BMD at the lumbar spine and proximal femur was determined by dual energy X-ray absorptiometry before and after HRT of 1 year. RESULTS: PTH genotype frequencies were 81.1% for BB, 18.0% for Bb, and 1.2% for bb (uppercase letters signifying the absence and lowercase letters the presence of the restriction site). BMD at the femoral neck in women with the bb genotype was higher than that in women with the Bb or BB genotype respectively. Similar trend was found in BMD of lumbar spine and Ward's triangle. The PTH genotypes were not distributed differently between HRT-responders and HRT-nonresponders (women who lose more than 3% of bone mass per year) and were not related with annual percent change of BMD after HRT. There were no significant differences in levels of PTH, calcitonin, calcium, phophorus and bone turnover markers or their 6 month percentage changes after HRT among PTH genotypes. CONCLUSION: PTH BstBI polymorphism is not associated with bone responsiveness to HRT but BMD in Korean women.
Absorptiometry, Photon ; Alkaline Phosphatase ; Bone Density* ; Calcitonin ; Calcium ; Female ; Femur ; Femur Neck ; Genotype ; Hormone Replacement Therapy* ; Humans ; Immunoassay ; Osteocalcin ; Parathyroid Hormone* ; Phosphorus ; Polymorphism, Restriction Fragment Length ; Spine

No abstract available.
Animals ; Female ; In Situ Hybridization ; Mice* ; Ovary*