Systemic lupus erythematosus is a systemic disorder which has frequent involvement of gastrointestinal tract. Non specific symptoms such as anorexia, nausea, diarrhea and abdominal pain are well known symptoms when the gastrointestinal tract is involved. The most feared gastrointestinal complication of systemic lupus erythematosus is lupus enteritis. The pathological change in lupus enteritis is usually a result of mesenteric vasculitis. Major complications such as intestinal bleeding and perforation may occur and sometimes result in sugery. Because of high mortality rate in case of major complications, early diagnosis and appropriate treatment is very important. We experienced three patients with lupus enteritis who presented with severe abdominal pain and dirrhea. They were diagnosed by characteristic radiographical findings of small bowel series and barium study. All radiographical findings has been resolved completely with the steroid therapy. Conclusively we can induce complete remission by steroid therapy alone, if we diagnose lupus enteritis in the early period of disease course.
Abdominal Pain ; Anorexia ; Barium ; Diarrhea ; Early Diagnosis ; Enteritis* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Lupus Erythematosus, Systemic ; Mortality ; Nausea ; Vasculitis

No abstract available.
Humans ; Hysterectomy*

Heorrhage and infarct-like necrosis of anterior lobe of the pituitary gland is one of the characteristic pathologic findings of the autopsied cases of Korean Hemorrhagic Fever (KHF) patients, but there has been rare reports of hypopituitarism in patients with KHF. Recently we have experienced a patient with hyponatremia who had recovered from KHF. He was admitted to our hospital due to nausea, vomiting, and epigastric discornfort. To determine the function of the anterior pituitary gland, hormonal levels of target galnds and pituitary gland were measured, and combined pituitary stimulation test was performed. ACTH, GH, and prolactin deficiency were confirmed by combined pituitary stimulation test in this patient. There was no evidence of hypothalamic or other pituitary diseases by brain MRI. Our experience shows that KHF can be a cause of hypopituitarism and these findings should alert physicians the possibility of hypopituitarisrn in patients who had recovered from KHF.
Adrenocorticotropic Hormone ; Brain ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hyponatremia ; Hypopituitarism* ; Magnetic Resonance Imaging ; Nausea ; Necrosis ; Pituitary Diseases ; Pituitary Gland ; Pituitary Gland, Anterior ; Prolactin ; Vomiting

One family with asymmetric septal hypertrophy was reported. The propositus of this family was 31 years old man who was admitted because of transient syncope. His father and one brother were affected but asymptomatic. His sister was suddenly died at age 21 years. The interventricular septal thickness to left ventricular posterior wall thickness ratios were measured using M-mode echocard ogram. In the affected family, echocardiogram revealed asymmetric septal hypertrophy (1.5:1, 2:1, 1.9:1 respectively). In the propositus, cardiac catheterization and simultaneous biventricular cineangiography were performed. Pressure study revealed mild peak systolic pressure gradient within left ventricular apex and left ventricular outflow tract (4mm Hg respectively). Biventricular cineangiogram showed the septal width increased inferiorly, and left ventricular endocardial surface of the septum was straight, while the right ventricular border convex toward the right ventricle.
Adult ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Cineangiography ; Fathers ; Heart Ventricles ; Humans ; Siblings ; Syncope

BACKGROUND: To evaluate the efficacy of transesophageal echocardiography(TEE) to detect left atrial thrombi(LAT) and to investigate the clinical and echocardiography parameters which related with LAT. METHOD: We performed TEE and TTE simultaneously to 98 consecutive patients who had native mital valve disease or mital prosthesis as usual method. We examined the presence and location of LAT and spontaneous contrast(SC) in TEE and measured left atrial dimension(LAD), ejection fraction(EF), mital valve area(MVA) in TTE. Cardiac rhythm, history of anticoagulation and systemic embolization were also reviewed. We compared such parameters in LAT positive/negative groups and SC positive/negative groups. RESULTS: 1) In TEE, we detected 26 cases of LAT, among them seventeen cases : left atrial appendage(LAA) thrombi, 3 cases : combined LA and LAA thrombi, 6 cases : LA thrombi. In TTE, six cases showed LAT but we couldn't detect LAA thrombi. The difference between two methods was statistically significant(p<0.05). 2) LAT positive group showed larger LAD, lower EF, and higher prevalence of AF, systemic embolization, and LAT than negative groups(p<0.01). 3) SC positive group showed larger LAD, lower EF, higher prevalence of AF, systemic embolization LAT than SC negative groups(p<0.05). 4) In multiple discriminant analysis, the history of systemic embolization was most important factor which can suspect LAT(Wilk's Lambda:0.77152. p<0.0001). SC, EF, presence of AF, LAD, anticoagulation therapy. MVR were also statistically valuable factors in order. The hit ratio of this analysis was 86.84%. CONCLUSION: We can suggest that TEE is very useful method to detect LAT than TTE, and the spontaneous contrast was very important factor which can suggest LAT and systemic embolization in mitral valve disease.
Echocardiography ; Echocardiography, Transesophageal* ; Humans ; Mitral Valve ; Prevalence ; Prostheses and Implants

OBJECTIVE: Mammalian follicle cells are the most important somatic cells which help oocytes grow, mature and ovulate and thus are believed to provide oocytes with various functional and structural components. In the present study we have examined whether cumulus or granulosa cells might play a role in establishing the plasma membrane structure of mouse oocytes during meiotic maturation. DESIGN: In particular the differential resistances of mouse oocytes against chymotrypsin treatment were examined following culture with or without cumulus or granulosa cells, or in these cell-conditioned media. RESULTS: When mouse denuded oocytes, freed from their surrounding cumulus cells, were cultured in vitro for 17~18 hr and then treated with 1% chymotrypsin, half of the oocytes underwent degeneration within 37.5 min (t50=37.5+/-7.5 min) after the treatment. In contrast cumulus-enclosed oocytes showed t50=207.0. Similarly, when oocytes were co-cultured with cumulus cells which were not associated with the oocytes but present in the same medium, the t50 of co-cultured oocytes was 177.5+/-13.1 min. Furthermore, when oocytes were cultured in the cumulus cell-conditioned medium, t50 of these oocytes was 190.0+/-10.8 min whereas t50 of the oocytes cultured in M16 alone was 25.5+/-2.9 min. Granulosa cell-conditioned medium also increased the resistance of oocytes against chymotrypsin treatment such that t50 of oocytes cultured in granulosa cell-conditioned medium was 152.5+/-19.0 min while that of oocytes cultured in M16 alone was 70.0+/-8.2 min. To see what molecular components of follicle cell-conditioned medium are involved in the above effects, the granulosa cell-conditioned medium was separated into two factions by using Microcon-10 membrane filter having a 10 kDa cut-off range. When denuded oocytes were cultured in medium containing the retentate, t50 of the oocytes was 70.0+/-10.5 min. In contrast, t50 of the denuded oocytes cultured in medium containing the filtrate was 142.0+/-26.5 min. T50 of denuded oocytes cultured in medium containing both retentate and filtrate was 188.0+/- 13.6 min. However, t50 of denuded oocytes cultured in M16 alone was 70.0 +/-11.0 min and that of oocytes cultured in whole granulosa cell-conditioned medium was 156.0+/-27.9 min. When surface membrane proteins of oocytes were electrophoretically analyzed, no difference was found between the protein profiles of oocytes cultured in M16 alone and of those cultured in the filtrate. CONCLUSIONS: Based upon these results, it is concluded that mouse follicle cells secrete a factor(s) which enhance the resistance of mouse oocytes against a proteolytic enzyme treatment. The factor appears to be a small molecules having a molecular weight less than 10 kDa.
Animals ; Cell Membrane ; Chymotrypsin* ; Cumulus Cells ; Female ; Granulosa Cells ; Membrane Proteins ; Membranes ; Mice* ; Molecular Weight ; Oocytes*

We report a case of nonsyphilitic isolated coronary ostial stenosis of the left main coronary artery observed by transesophageal echocardiography(TEE) in a 52-year-old woman with angina. The lesion was suspected during coronary angiography and it was not visualized by transthoracic echocradiography. Coronary ostial stenosis, which is potentially lethal as left main coronary artery disease, occurs rarely in the absence of other coronary artery disease. The diagnosis of ostial stenosis has been usually made by the use of coronary angiography, however, it may be difficult to diagnose at angiography if angiographic catheter is positioned across the stenotic lesion, and the unexpected serious complication during coronary angiography in such a patient may happen. The new ultrasonic imaging technique of TEE provides more detailed images of proximal coronary anatomy and coronary blood flow.
Angiography ; Catheters ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Female ; Humans ; Middle Aged ; Ultrasonography

No abstract available.
Amyloidosis*

The soleal line in 115 (left; 61, right; 54) cases of tibiae was studied morphometrically by the method of Mysorekar and Nandedkar. 1. The soleal line showed a uniform character throughout in 26 cases and a mixed characters in 89 cases. The bones showing uniform character were seen generally as a lineal line or wide line. 2. The soleal line having mixed characters divided into three parts. In the upper and middle thirds, the major type of line was wide line. In the lower third, the line was commonly seen as a lineal line. In about 12% of the bones examined the line was seen as a groove, particularly in the middle and lower thirds. 3. The soleal line commenced 1-2cm below the fibular facet In about 61% of cases. 4. The length of the soleal line was 10.5cm, and the ratio to that of the tibia was about 30%. The results of this study provide the characters of the soleal tne of the tibia in Korean. The soleal line, unlike the textbook description, generally shows mixed characters of a line.
Methods ; Tibia*

BACKGROUND: Although a number of indices of diastolic function based on transmitral flow have been proposed, no single factor seems to be adequate for seperating patients with normal from with abnormal diastolic functions. Pulsed Doppler echocardiography of pulmonary venous flow(PVF) is another non-invasive method to evaluate left ventricular diastolic performance. The purpose of this study is to evaluate the normal PVF pattern by TEE. METHOD: We performed pulsed-wave Doppler studies of the PVF and of the mitral flow by transesophageal-(TEE) and transthoracic echocardiography(TTE) in a healthy young adults. RESULTS: In TEE, all sublects showed four phases of the PVE pattern ; two antewgrade systolic phase(early and late : SE and SL), one antewgrade diastolic phase(D) and one retrograde diastolic phase(A). In TTE, there were three phases of the PVF pattern ; two antewgrade phase(systolic, diastolic) and one retrograde diastolic phase but we couldn't find out early systolic phase flow. Peak velocity of each phase of PVF was as follows:SE was 48.9+/-14.1cm/sec, SL was 56.3+/-16.1cm/sec, D was 52.6+/-14.9cm/sec. The timing of SL flow was correlated significantly with that of peak aortic flow(r=0.42, p=<0.01), while the timing of D flow and that of A flow were correlated significntly with timing of mitral E peak and A peak, respectively(r=0.84, p<0.01 ; r=0.80, p<0.01). CONCLUSIONS: In the young normal subject, PVF showed four phase of flow pattern and could be easily obtained by TEE. Furthermore it may be used for evaluation of left ventricular function.
Echocardiography, Doppler, Pulsed ; Echocardiography, Transesophageal* ; Humans ; Ventricular Function, Left ; Young Adult*