No abstract available.
Adult* ; Esophageal Atresia* ; Fistula* ; Humans

Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

Cryptococcal meningoencephalitis is one of the most cornInon fungal infections of the central nervous system, which mainly affects immunocompromised hosts, especially AIDS patients and patients with long-term steroid therapy. In advanced cases, it causes various complications such as encephailitis, hydrocephalus, and even death if not treated or inadequately treated. Authors have treated a case of cryptococcal meningoencephalitis with focal cerebellar lesion, whose primary infection sources were thought to be right frontal sinus and the ethmoidal sinus, with combination chemotherapy of amphotericine B and flucytosine.
Amphotericin B ; Central Nervous System ; Drug Therapy, Combination ; Flucytosine ; Frontal Sinus ; Humans ; Hydrocephalus ; Immunocompromised Host ; Meningoencephalitis*

The neuroleptic malignant syndrome (NMS), a serious and potentially fatal complication, has been reported to occur in some patients with administration od neuroleptic medications. Its major manifestations are muscular rigidity, autonomic instability, altered consciousness, and hyperthermia, often accompanied by raised creatine kinase (CK) and leukocytosis. Manifestations of NMS are attributed to dopamine receptor blockade in the striatum, increasing thermogenesis, and in the hypothalamus, impaired heat dissipation. Owing to the potential lethality of NMS, the early diagnosis is important. The authors report two survived patients with the NMS who were treated by generalized supportive care and drug therapy.
Consciousness ; Creatine Kinase ; Drug Therapy ; Early Diagnosis ; Fever ; Hot Temperature ; Humans ; Hypothalamus ; Leukocytosis ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Receptors, Dopamine ; Thermogenesis

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

BACKGROUND & METHODS: Approximately 10% of the essential hypertensive patient have overt proteinuria due to renal target organ damage, which indicates poor prognosis. Recently microalbuminuria has been prove to be a good early predictor for renal damage in patients with diabetes or hypertension. Some authors reported that near 40% of the essential hypertensives have microalbuminuria. To determinate prevalence of microalbuminuria in Korea essential hypertensives, 24-hr ambulatory blood pressure monitoring and radioimmunoassay to detect BP and UAER were performed after 4 weeks wash-out period in 137(78 hypertensive and 54 normotensive) consecutive cases. RESULTS: Among 78 hypertensives, overt proteinuria was seen in 8.97%(7/78). And prevalence of microalbuminuria were 29.4%(23/78) in hypertensives and 16.7%(9/54) in normotensives. Urine microalbumin excretion rate(UAER) was significantly correlated with mean arterial pressure(MAP) in total subjects(r=0.286, p=0.0012), but not in total hypertensives(r=0.135, p=NS) or in hypertensives with UAER(r=-0.098, p=NS).UAER of female hypertensives was increase than that of male hypertensives(13.17+/-16.28microg/min vs 22.87microg/min, p=0.027). CONCLUSION: Prevalence of microalbuminuria in Korean hypertensives was relatively lower then other reports. Overt proteinuria was noted in 8.97% of the hypertensives which is same prevalence as other countries. Moreover MAP was well correlated with UAER in total subjects. Further evaluation should be done to detect exact role of UAER in hypertensives as an early predictor for renal target organ damage.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Korea ; Male ; Prevalence* ; Prognosis ; Proteinuria ; Radioimmunoassay

Polyarteritis nodosa(PAN) has been depicted as a necrotizing arteritis of small and medium-sized muscular arteries, affecting multiple organ systems throughout the body. The etiology of PAN remains unknown, but the histopathologic resemblance to chronic serim sickness has suggested an immune complex pathogenesis. The peripheral nervous system(PNS) is more frequently affected (in about 20-50% of patients) than the central nervous system(in about 10-20% of patients). Although multiple mononeuritis multiplex is generally considered to be the typical PNS manifestation of PAN, distal symmetrical polyneuropathy may occur more frequently than previous recognized. We report a case of polyarteritis nodosa with mononeuritis multiplex and distal symmetrical polyneuropathy, which was diagnosed by electrophysiological study and biopsies of muscle and sural nerve.
Antigen-Antibody Complex ; Arteries ; Biopsy ; Mononeuropathies* ; Polyarteritis Nodosa* ; Polyneuropathies ; Sural Nerve

BACKGROUND: Although radiofrequency catheter ablation (RFCA) is useful in the treatment of idiopathic ventricular tachycardia, especially right ventricular outflow tract tachycardia (RVOTT), some tachycardias remain resistant despite several attempts. This study was focused to search of electrocardiographic characteristics suggestive of successful radiofrequency ablation of idiopathic ventricular tahycardia showing LBBB and inferior axis. MATERIALS AND METHODS: The study subjects were 19 patients (mean age 4415, male 5, female 14) those we tried RFCA under the diagnosis of RVOTVT. The study subjects were grouped into success group (N=14) and failed group (N=5). We analyzed the morphologic characteristics of QRS complex during ventricular tachycardias or ventricular premature beats in both groups. RESULTS: Acute success was obtained in 14 of 19 patients. For RFCA of RVOTT, pace mapping and/or activation mapping were used to select an ablation site as described previously(1). Activation mapping was possible only for 5 patients. All patients except one patient of success group showed inferior axis of QRS during VT. We didn't find significant difference in QRS axis, QRS morphologies in lead 1 and aVL, and QRS width in lead II and V2 between success (N=14) and failed group (N=5). However, in analysis of morphologic comparison of precordial leads, 12 out of 14 patients in success group showed initial r wave in V1 (p=0.017) and 11 patients had precordial transition >V3 (p=0.038). Whereas, in failed group, 4 patients had precordial transition V3 and only one patient showed precordial transition >V3. Initial r of V1 was seen in one patient and remaining 4 patients showed QS pattern in V1. CONCLUSION: Analysis of QRS morphology in V1 and precordial transition site may identify patients with high and low success rate during RFCA of idiopathic RVOTT
Axis, Cervical Vertebra* ; Bundle-Branch Block* ; Cardiac Complexes, Premature ; Catheter Ablation* ; Diagnosis ; Electrocardiography* ; Female ; Humans ; Male ; Tachycardia ; Tachycardia, Ventricular*

BACKGROUND: Low dose dobutamine echocardiography has recently been introduced for use in identification of viable myocardium in patients with acute myocardial infarction and prediction of the response of dysfunctioning myocardial segments to coronary angioplasty. The aim of this study was to evaluate wheter tihs test could be used to predict the early response of dysfunctioning myocardial segements to coronary artery bypass grafting(CABG). METHODS: We studied in 23 patients with multi-vessel disease during CABG. Myocardial segments were monitored by intraoperative transesophageal echocardiography(TEE) in the transgastric short-axis view at papillary muscle level. The left ventricle was divided into five segments and sixty eight myocardial segments in 23 patients were analyzed. Percentage of systolic wall thickening(PSWT) was calculated in each segment for three times: at basline(early after pericardiectomy);before bypass during dobutamine infusion(3-5ug/kg/min);and after seperation from cardiopulmonary bypass. Segments showing baseline PSWT >_30% were considered normal and those < 30% were dysfunctional. Segments showing an increase in PSWT >_10% during dobutamine infusion were considered responders and those < 10% nonresponders. RESULTS: AT baseline, 24%(36%) of 68 segments had PSWT > 30%(normal) and 44(68%) had PSWT < 30%(dysfuctioning segments). During dobutamine infusion, 21(47.7%) among 44 dysfunctional segments showed increase in PSWT >_10%(from 12.3+/-7.2% to 33.5+/-11.8%, p<0.01 ; responder segments), and 23(52.3%) showed increase in PSWT < 10%(from 14.7+/-6.5% to 17.4+/-7.4%, p=NS ; nonresponder segments). After CABG, responder segments showed a significant increase in PSWT in comparison with baseline values(from 12.3+/-7.2% to 32.1 +/-11.0%,p<0.01). Segments not responded to dobutamine showed no significant changes in PSWT after CABG(from 14.7+/-6.5% to 16.0+/-8.2%, p=NS). Twenty-four normal segments (PSWT 41.9+/-6.2%) showed a slight but significant reduction in PSWT both during dobutamine infusion(38.7+/-6.9%;p<0.05) and after CABG(38.9+/-6.3%, p<0.05), suggesting that compensatory hyperfunction was present at baseline. Estimation of clinical accruacy of low dose dobutamine TEE yieded to 69% sensitivity, 93.9% specificity, 95.2% positive predictive value, 60.9% negavive predictive value, and 77.3% overall accuracy. In both responders and nonresponders of dysfunctioning segments, there was a correlation between PSWT during dobutamine infusion and that after CABG(r=0.61, r=0.63, respectively). CONCLUSION: Low dose dobutamine TEE test well predicts the early response of dysfunctioning myocardial segments to CABG.
Angioplasty ; Cardiopulmonary Bypass ; Coronary Artery Bypass* ; Coronary Vessels* ; Dobutamine* ; Echocardiography* ; Heart Ventricles ; Humans ; Myocardial Infarction ; Myocardium ; Papillary Muscles ; Sensitivity and Specificity

The name "Sung Min Kim" should be "Seong Min Kim" and "Yoon Mi Kim" should be "Yun Mi Kim".