BACKGROUND: Intracellular calcium overload is a common final feature of the ischemic-reperfused heart and mediates the genesis of irreversible cell damage. Reactive oxygen medabolites have been known to play and important role as toxic mediators in myocardial injuries resulting from ischemia and reperfusion. In order to investigate the mechanism of intracellular calcium accumulation in the ischemic-reperfused myocardium, the present study observed the possible contribution of the reactive oxygen metabolite to the calcium transport of cardiac mitochondria. METHODS: Mitochondrial were isolated from rabbit hearts. The effects of a reactive oxygen metabolite, H2O2 on calcium uptake and release, redox states of endogenous pyridine nucleotides and glutathiones of mitochondria respiring with succinate were observed. Calcium uptake and release were monitored by dual-wave length spectrophotometer using a calcium indicator, arsenaze III. Contents and redox states of pyridine nucleotides and glutathiones were measured by enzymatic methods using spectrofluorometer and HPLC. RESULTS: Hydrogen peroxide(10-500microM) promoted calcium release dose-dependently from CA++-preloaded mitochondria, but did not affect the mitochondrial calcium uptake. The H2O2-induced calcium release was accompanied by simultaneous oxidation of the pyridine nucleotides and decrease in the content of the reduced form of glutathione(GSH). When mitochondria were treated with BCNU(N,N=bis(2-chloroethyl)-N-nitrosourea) to inhibit glutathione reductase and so as to reduce the GSH content, there were no increase in calcium release from the mitochondria. These results may indicate that H2O2 increases the permeability of cardiac mitochondrial membrane to calcium in association with the changes in redox state of endogenous pyridine nucleotides, but not with that of glutathiones. CONCLUSION: It is suggested that the reactive oxygen metabolites induce the release of calcium from mitochondria by altering the redox state of pyridine nucleotides, and it may partly be involved in the elevation of cytosolic calcium concentration in the ischemic-reperfused myocardial cells.
Calcium* ; Chromatography, High Pressure Liquid ; Cytosol ; Glutathione Reductase ; Heart ; Hydrogen ; Ischemia ; Mitochondria* ; Mitochondrial Membranes ; Myocardium ; Nucleotides ; Oxidation-Reduction ; Oxygen* ; Permeability ; Reperfusion ; Succinic Acid

Three children with osteogenesis imperfecta who were treated with fragmentation, realignment and intramedullary rod fixation (Sofield and Millar, 1959) have been followed up for considerable period. Repeated fractures in other sites as well as deformities occurred in overgrown part as the children grew up necessitated further operations of same kind. However, level of activity afterwards was found very much enhanced by the operations in general.
Child ; Congenital Abnormalities ; Humans ; Osteogenesis Imperfecta ; Osteogenesis

No abstract available.
Female ; Fibronectins* ; Hypertension, Pregnancy-Induced* ; Plasma* ; Pregnancy*

Recent immunological investigations have demonstrated that the patients with psoriasis have various humoral and cellular immune abnormalities, such as increased serum IgG, IgE and secretory IgA, anti-IgC factor in psoriatic lesions, in peripheral blood lymphocytes and in serum, rhumatoid-like factors in IgA and IgG classes of immunoglobulins, antinuclear antibodies (ANA; reacting with the basal cell nuclei of uninvolved skin., anti-stratum corneum antibody and complements in psoriatic scales, immuoglobulin and complement bearing polymorphonuclear leucocytes in the Muro microabscess. These abnormal findings are enough to suggest an autoimmune mechanism in the pathogenesis of psoriasis. Several investigators have also reported the results of T cell enumeration in the peripheral blood in psoriatic patients. However, the results are not in general agreement,. Thee present study was undertaken to clarify any abnormality in the proportion of T cells in the peripheral blood in psoriatic patients. Forty-one patients with active psoriasis registered at the Department of Dermatology, Seoul National University Hospital entered this study from May, 1979 through April, 1980. Twelve healthy medical and paramedical personel the comprised the control group. Active and total T cells were enumerated by the method of E-rosetting technique, and the results were as follows. 1, in normal controls, the active and total T celIs identified as E rosetteforming cells accounted for 61.6+7.4% and 68.1+8.9% of the total lymphocyte population, respectively. 2. In patients with psoriasis, significant decrease of active T cells (54. 2,+11.0%,p<0.005) and total T cells (62.2+11.2%, p<0.05) was observed. More profound reduction of T cells was noted in patients with wide spread psoriasis than those with limited extent.
Antibodies, Antinuclear ; Cell Nucleus ; Complement System Proteins ; Dermatology ; Humans ; Immunoglobulin A ; Immunoglobulin A, Secretory ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins ; Lymphocytes ; Psoriasis* ; Research Personnel ; Seoul ; Skin ; T-Lymphocytes* ; Weights and Measures

The Schatzki ring, a submucosal fibrotic thickening of the lower esophagus, occurs at the squamocolumnar junction and is invariably associated with an esophageal histal hernia The ring is discrete narrowing covered with squamous epithelium on its superior aspect and columnar epithelium on its inferior aspect, with various degrees of submucosal fibrosis supporting the annulair ring. Symptoms, when present, are generally those of distal esophageal obstruction to the passage of solids and highly associated with ring diameter. The pathogenesis and etlology are obscure. But one theory suggests that they are caused by gastroesophageal reflux. The vast maiority of symptomatic Schatzki rings sre ameneble to dilation, a few patients will require surgical antireflux measures after dilatation. We have experienced a case of Schatzki ring associated with reflux esophagitis and esophageal hiatal hernia by the esophagogram after barium swallowing and endoscopy. So we report this case with brief review of the previous literatures.
Barium ; Carcinosarcoma ; Deglutition ; Dilatation ; Endoscopy ; Epithelium ; Esophageal Neoplasms ; Esophagitis, Peptic* ; Esophagus* ; Fibrosis ; Gastroesophageal Reflux ; Hernia ; Hernia, Hiatal* ; Humans

BACKGROUND: Pain on injection is one of the major disadvantages of propofol. To solve this problem, many investigations have been done. We postulated that the duration of pre-treatment of local anesthetics might affect the incidence and nature of injection pain. METHODS: Seventy seven patients were involved in our study. They were divided into control group (group C, n = 25); pre-treatment with normal saline and study group (n = 52); pre-treatment with 0.1% lidocaine 1 ml/kg/h for 30 min before propofol injection. The study group was subdivided into 2 groups, one receiving maintenance fluid (group LF, n = 28) and one not (group LS, n = 24). A vein on the dorsum of the hand was used for the intravenous line in all patients. Pain assessment was made twice, immediately after injection of first half dose of propofol and after injection of the remaining half dose. The speed of propofol injection was 0.5 ml/sec. After measuring pain with the visual analogue scale (VAS) and pain scoring (PS) during propofol injection, the highest score in each case was used for comparison. RESULTS: The values of VAS and PS of group LF were not different from group C. However the corresponding values of group LS were lower than those of group C (P<0.05). CONCLUSIONS: From our results, it can be suggested that the duration of 30 min pre-treatment of lidocaine without maintenance fluid is one method for reducing the incidence and nature of pain induced by propofol.
Anesthetics, Local ; Hand ; Humans ; Incidence ; Lidocaine* ; Pain Measurement ; Propofol ; Veins

No abstract available.
Child* ; Humans ; Korea* ; Myocarditis* ; Rheumatic Fever*

OBJECTIVES: Mirtazapine is a newly introduced antidepressant in Korea. The purpose of this study is to evaluate effectiveness and safety of mirtazapine as an antidepressant for the first time in Korean patients with major depression. METHODS: This study is an open, non-comparative, multicenter study treated with mirtazapine for 6 weeks in patients with DSM-IV diagnosis of major depression who have 17-item HAMD score> or = 18 and who are between 18 and 65 years of age. Mirtazapine was administered 30 mg orally as an initial dose and could be increased to 45 mg from the 14th day of treatment, depending on the therapeutic responses of subjects. The clinical efficacy of mirtazapine was assessed at the baseline and at the 1st, 2nd, 4th, and 6th week of treatment. To assess the clinical efficacy of the drug, well-trained psychiatrists have evaluated subjects using 17-item HAMD and CGI on each evaluation periods. Also, for the evaluation of subjective symptoms of patients, BDI was used. Adverse experiences associated with mirtazapine were evaluated on each visit, with recordings of blood pressure, heart rate and weight. The responders were defined as patients with > or = 50% decrease from baseline in total 17-item HAMD scores and remitted patients with a total 17-item HAMD score of < or = 7. RESULTS: Out of 79 subjects enrolled, 45 were completed this study. After 6 weeks, the score of 17-item HAMD, CGI and BDI demonstrated statistically significant decrease compared with at the baseline. This decrease was observed as early as the 1st week of mirtazapine treatment. Moreover, the meaningful reduction in each total scores of these different parameters on each evaluation period could be detected, except in case of 2-4 week and 4-6 week of BDI. The responder rate was 15.6% at the first week of mirtazapine treatment, 88.9% at the 6th week. The rate of remission was 2.2% at the first week and 60.0% at the 6th week. The most frequent adverse events during 6 weeks were somnolence(31.6%), drowsiness(19%) and weight gain(17.7%). Aside from sedation and weight gain, anticholinergic, cardiovascular and stimulating side effects are less than 10%, and no one complained about sexual dysfunction. The dropouts(34 subjects, 43%) were caused by adverse events(38.2%), insufficient compliance(35.3%) and uncooperation with the study(20.6%). CONCLUSION: Mirtazapine has shown to have superior antidepressant effect in this study. Especially, this effect appeared from the early treatment phase, the 1st week of treatment. The most frequent adverse events reported were somnolence, drowsiness and weight gain. Anticholinergic, cardiovascular, stimulating adverse events as well as sexual dysfunction were rarely reported, and there was no clinical significant change on physical examinations. Therefore this study showed that mirtazapine is a superior and safe antidepressant in patients with major depression.
Blood Pressure ; Depression* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart Rate ; Humans ; Korea ; Physical Examination ; Psychiatry ; Sleep Stages ; Weight Gain

OBJECTIVES: Mirtazapine is a newly introduced antidepressant in Korea. The purpose of this study is to evaluate effectiveness and safety of mirtazapine as an antidepressant for the first time in Korean patients with major depression. METHODS: This study is an open, non-comparative, multicenter study treated with mirtazapine for 6 weeks in patients with DSM-IV diagnosis of major depression who have 17-item HAMD score> or = 18 and who are between 18 and 65 years of age. Mirtazapine was administered 30 mg orally as an initial dose and could be increased to 45 mg from the 14th day of treatment, depending on the therapeutic responses of subjects. The clinical efficacy of mirtazapine was assessed at the baseline and at the 1st, 2nd, 4th, and 6th week of treatment. To assess the clinical efficacy of the drug, well-trained psychiatrists have evaluated subjects using 17-item HAMD and CGI on each evaluation periods. Also, for the evaluation of subjective symptoms of patients, BDI was used. Adverse experiences associated with mirtazapine were evaluated on each visit, with recordings of blood pressure, heart rate and weight. The responders were defined as patients with > or = 50% decrease from baseline in total 17-item HAMD scores and remitted patients with a total 17-item HAMD score of < or = 7. RESULTS: Out of 79 subjects enrolled, 45 were completed this study. After 6 weeks, the score of 17-item HAMD, CGI and BDI demonstrated statistically significant decrease compared with at the baseline. This decrease was observed as early as the 1st week of mirtazapine treatment. Moreover, the meaningful reduction in each total scores of these different parameters on each evaluation period could be detected, except in case of 2-4 week and 4-6 week of BDI. The responder rate was 15.6% at the first week of mirtazapine treatment, 88.9% at the 6th week. The rate of remission was 2.2% at the first week and 60.0% at the 6th week. The most frequent adverse events during 6 weeks were somnolence(31.6%), drowsiness(19%) and weight gain(17.7%). Aside from sedation and weight gain, anticholinergic, cardiovascular and stimulating side effects are less than 10%, and no one complained about sexual dysfunction. The dropouts(34 subjects, 43%) were caused by adverse events(38.2%), insufficient compliance(35.3%) and uncooperation with the study(20.6%). CONCLUSION: Mirtazapine has shown to have superior antidepressant effect in this study. Especially, this effect appeared from the early treatment phase, the 1st week of treatment. The most frequent adverse events reported were somnolence, drowsiness and weight gain. Anticholinergic, cardiovascular, stimulating adverse events as well as sexual dysfunction were rarely reported, and there was no clinical significant change on physical examinations. Therefore this study showed that mirtazapine is a superior and safe antidepressant in patients with major depression.
Blood Pressure ; Depression* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart Rate ; Humans ; Korea ; Physical Examination ; Psychiatry ; Sleep Stages ; Weight Gain

PURPOSE: The purpose of this study was to identify the correlation between communication skills for emotional empathy and academic achievement on the Clinical Performance Examination (CPX). METHODS: One hundred twelve medical school students were observed to determine the extent to which they applied communication skills for emotional empathy (preparation stage: interview attitude, respect; rapport stage: encouragement, active listening, will for support; empathy stage: verbal expression empathy, nonverbal expression empathy, acceptance) to the CPX, as well as their level of understanding of these skills to calculate the Pearson r, which can be used to determine the correlation between communication skills and academic achievement (hematochezia, fatigue, abnormal menstruation, chest pain, alcohol problems). RESULTS: Male students had higher scores than females for all communicational skills except verbal expression empathy. Fourth-year students had statistically more significant correlations than third-year students with regard to the rapport stage 'active listening' and empathy stage 'nonverbal expression' and abnormal menstruation and chest pain. Correlations were also more significant for hematochezia in the preparation stage 'interview attitude,' rapport stage 'encouragement,' and empathy stages 'verbal and nonverbal expression' and 'acceptance.' The empathy stage 'nonverbal expressions' was more significant for fourth-year students with alcohol problems. Third-year students largely had negative correlations between emotional empathy communication skills and CPX academic achievement, especially between the preparation stage 'respect' and abnormal menstruation, and between the rapport stage 'encouragement' and hematochezia. CONCLUSION: There was a significant correlation between hematochezia, wherein MS students deliver bad news to patients, and communication skills for emotional empathy.
Achievement ; Chest Pain ; Clinical Competence ; Empathy ; Fatigue ; Female ; Gastrointestinal Hemorrhage ; Humans ; Male ; Menstruation ; Schools, Medical