PURPOSE: To assess the signal enhancement by gadolinium-DTPA-polylysine (Gd-polylysine) as compared to gadopentetate (Gd-DTPA) in MR imaging of heart that have undergone ischemia-reperfusion, and to estimate the extent of myocardial damage covered bythe MR signal enhancement. MATERIALS AND METHODS: A series of contrast enhanced cardiac MR images were obtained from 17 cats subjected to a 90 minutes of occlusion of the left anterior descending coronary artery (LAD) followed by a 90 minutes of raperfusion. Time courses of changes in the signal intensity (Sl) of the ischemic area were measu red in Gd-polylysine group (8 cats) and Gd- DTPA group (9 cats). The size of U R signal enhanced area was then compared to the sizes of infarction and the area at risk revealed byTTC histochemical staining. RESULTS: Maximum Sis were obtained at 60 minutes and 30 minutes after injection of the contrast material, respectively for Gd-polylysine group and Gd-DTPA group. Signal enhancement was stronger and persistent for a longer period in Gd-polylysine group than in GD-DTPA group. Sizes of the enhanced area, the infarction, and the area at risk were about 30%, 15%, and 50% of the total left ventricle (LV) area; the difference between the groups was statistically insignificant. CONCLUSION: Gd-polylysine can be used better for a blood pool marker than Gd-DTPA in MR imaging of myocardial ischemia, due to its strong and persistent signal enhancement. The MR signal enhanced area includes both the infarcted area and a portion of the area at risk.
Animals ; Cats* ; Coronary Vessels ; Gadolinium DTPA ; Gadolinium* ; Heart ; Heart Ventricles ; Infarction ; Magnetic Resonance Imaging* ; Myocardial Ischemia ; Pentetic Acid ; Polylysine*

The early ultrastructural changes of basement membrane thickening and degeneration of the pericyte were noted in retinal capillaries in diabetic patients. However no early ultrastructural changes were reported in diabetic iris capillary. The authors studied the ultrastructural features of basement membrane of iris capillaries which were obtained during cataract surgery in five diabetic patients and compared with those obtained in five nondiabetic patients. The endothelium basal lamina, pericyte basal lamina and membrane-like pericyte matrix in didabetic iris capillaries were thicker than those in nondiabetic Iris capillaries. The thickening of pericyte basal lamina is more prominant than the endothelium basal lamina in diabetes. The duration of diabetes had no relationship to endothelium basal lamina but, showed statistically significant relationship to thickness of pericyte bascal lamina and pericyte matrix.
Basement Membrane* ; Capillaries* ; Cataract ; Endothelium ; Humans ; Iris* ; Pericytes ; Retinaldehyde

BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires

BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires

Holt-Oram Syndrome is an autosomal dominant disorder characterized by the association of upper-limb abnormalities and congenital heart disease. A woman with no family history of genetic disease underwent antenatal sonography at 27 weeks' menstrual age to screen for fetal anomalies. Ultrasonography revealed abnormalities in the upper limbs. The limb abnormalities included abscence of bilateral thumbs and radius: the left humus was short. Pregnancy termination was performed. The postnatal chromosomal analysis revealed a normal 46XX karyotype and the autopsy finding confirmed the Holt-Oram syndrome. We report a case of Holt-Oram Syndrome in fetus with unaffected parents with brief of the literatures.
Autopsy ; Extremities ; Female ; Fetus ; Heart Defects, Congenital ; Humans ; Karyotype ; Parents* ; Pregnancy ; Radius ; Soil ; Thumb ; Ultrasonography* ; Upper Extremity

We present a case of sarcoidosis, which was associated with anterior granulomatous uveitis in both eyes and involvement of the right lacrimal gland in a 46-year-old korean female. The patient has nodules (various in size) on the nose, on the dorsum of right hand and on the back. Serum gamma globulin was elevated and in the nodules infiltration of giant cells, lymphocytes and epithelioid cells was presented, but no caseous necrosis.
Epithelioid Cells ; Female ; gamma-Globulins ; Giant Cells ; Hand ; Humans ; Lacrimal Apparatus ; Lymphocytes ; Middle Aged ; Necrosis ; Nose ; Sarcoidosis* ; Uveitis*

Intestinal obstruction is not uncommon in infants. The common causes of intestinal obstruction in the neonatal period are Hirschsprung disease, intestinal atresia, meconium ileus, and intussusception. However, small bowel obstruction caused by a congenital band is very rare. We report a 27-day-old baby who was admitted with abdominal distension and fever. The abdominal X-ray revealed massive bowel dilatation and the contrast gastrografin enema suggested a distal small bowel obstruction. The explolaparotomy showed small bowel entrapment due to an unusual anomalous congenital band.
Diatrizoate Meglumine ; Dilatation ; Enema ; Fever ; Hirschsprung Disease ; Humans ; Ileus ; Infant ; Intestinal Atresia ; Intestinal Obstruction ; Intussusception ; Meconium

BACKGROUND: The present study was aimed (1) to assess the effects of nitric oxide (NO) synthesis inhibitor on regional myocardial function and systemic and pulmonary hemodynamics; (2) to determine whether the blockade of the cyclo-oxygenase (COX) pathway modifies these effects on the variables, and (3) to investigate the mechanism of cardiac depression following NO synthesis inhibition in an open-chest canine model. METHODS: Twenty-five dogs of either sex were acutely instrumented under 1.6% ethrane anesthesia to measure aortic, pulmonary arterial and left ventricular pressure, pulmonary (cardiac output) and left circumflex coronary flow, and subendocardial segment length. NG-nitro-L-arginine methyl ester (L- NAME) at doses of 0.3, 1.0, 3.0, or 10.0 mg/kg i.v. was administered alone (control dogs, n = 10) or in the presence of COX inhibitor, indomethacin (10 mg/kg i.v., n = 10). Seven dogs (n = 7) received phenylephrine at doses of 0.1, 0.3, 1.0, or 3.0 microgram/kg/min i.v. to compare its hemodynamic effects with those of L-NAME. The preload recruitable stroke work slope (Mw) and percent systolic shortening (%SS) as an index of regional myocardial contractility, and the maximum segment lengthening rate (dL/dt max) and percent post-systolic shortening (%PSS) as an index of regional diastolic function, were evaluated. RESULTS: L-NAME dose-dependantly attenuated both regional systolic (Mw and %SS) and diastolic functions (dL/dt max and %PSS), whereas it caused an increase of coronary flow. L-NAME dose- dependently increased systemic blood pressure and vascular resistance as well as pulmonary arterial pressure and vascular resistance. L-NAME also reduced cardiac and stroke volume indices. Pretreatment with indomethacin did not affect the regional myocardial and systemic hemodynamic responses to L-NAME, but did blunt the coronary flow and pulmonary pressure responses. The magnitude of decreases in cardiac and stroke volume indices and Mw was greater with L-NAME than with phenylephrine (P <0.05), despite the comparable blood pressure increases. CONCLUSIONS:These results suggest (1) that NO plays a significant role in cardiac function as well as in systemic and pulmonary but not coronary, vasomotor activities, and (2) that COX products are involved in pulmonary hemodynamic responses to NO synthesis inhibition. It is also suggested that the decline in cardiac output following the NO synthesis inhibition results from a direct myocardial depressant effect of the drug.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Depression ; Dogs* ; Enflurane ; Hemodynamics* ; Indomethacin ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Phenylephrine ; Prostaglandin-Endoperoxide Synthases ; Stroke ; Stroke Volume ; Vascular Resistance ; Ventricular Pressure

PURPOSE: The purpose of the present study is to determine the relation between in vitro resistance to 9 drugs, measured with colorimetric methylthiazol tetrazolium(MTT) assay and prognostic factors. METHODS: Thirty children with leukemia were evaluated at the pediatric department of Dongsan Medical Center. All samples tested with the MTT assay contained 80% or more leukemic cells, which were isolated by Ficoll density gradient centrifugation, and were incubated with 9 drugs for 4 days. The optical density(OD) of the wells was measured with microplate spectrophotometer. Leukemic cell survival(LCS) was calculated by OD treated well/OD control wellsx100(%). LD50 was calculated from the dose-response curve and used as a measure of resistance. RESULTS: Among the 30 children with leukemia, 16 were ALL, 14 were AML. Seventeen boys and thirteen girls ranged in age from 9 months to 16 years. Comparing LD50 values according to leukemic type, AML revealed relatively high LD50 values for all drugs, except VCR. But there were no significant differences between ALL and AML(P>0.05). Male showed high LD50 values for ASP, DET, ARA-C, VP16, ADR and 6TG. Age<2 and >10 years children showed high LD50 values for all drugs, except 6TG. Patients with a leukocyte count>100,000/mm3 at diagnosis showed high LD50 values for VCR, ASP, DET, MTX, ARA-C, ADR, and 6TG. Patients with normal chromosome showed higher LD50 values. CONCLUSION: Our study showed higher LD50 values at AML, male, age<2 and 10>years old, leukocyte count>100,000/mm3, and normal karyotype. The MTT test may contribute to the selection of effective chemotherapeutic agent for children with acute leukemia.
Centrifugation, Density Gradient ; Child ; Cytarabine ; DEET ; Diagnosis ; Etoposide ; Female ; Ficoll ; Humans ; Karyotype ; Lethal Dose 50 ; Leukemia ; Leukocytes ; Male ; Viperidae

Spontaneous coronary artery dissection (SCAD) is a very rare cause of peripheral artery thromboembolism. It is especially rare to show symptoms of acute limb ischemia without chest symptoms during a hospital visit. In this case, a rare case of SCAD led to left heart failure and caused left ventricle thrombi, which in turn caused peripheral thromboembolism.
Arteries* ; Coronary Vessels* ; Extremities ; Heart Failure ; Heart Ventricles* ; Ischemia ; Thorax ; Thromboembolism*