No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Nuchal Cord* ; Ultrasonography*

Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Myasthenia Gravis* ; Neck ; Thymectomy* ; Thymus Hyperplasia ; Thyroid Gland ; Thyroidectomy*

BACKGROUND AND OBJECTIVES: In acute myocardial ischemia, the conduction velocity of action potential is decreased by several electrophysiological and physical factors. The ventricular activation time(VAT) is a time duration of electrical impulse propagating from endocardium to epicardium. The goal of this study is to determine whether the reduction in conduction velocity in acute myocardial ischemia can lead a change in VAT. MATERIALS AND METHOD: Thirty patient, 18 males and 12 females, who had received percutaneous balloon coronary angioplasty(PTCA) were enrolled. The mean age was 59 years old. A twelve lead surface electrocardiogram(ECG) were obtained before, during, 1 minute, 5 minutes, and 10 minutes after the PTCA as digitized data by using Cardiolab EP 4.1 program. The magnitude of the QRS wave was amplified 3 to 4 folds and the speed was increased to 200mm/sec in order to get the VAT easily and accurately. The data was the mean of three consecutive VATs. The number of vessel treated with PTCA included left anterior descending artery(12), left circumflex artery(9), and right coronary artery(9). Among twelve chronic stable angina, sixteen unstable angina, and two acute myocardial infarction patients, twenty six had single and four had two vessel diseases. RESULTS: The significant increase in VAT during PTCA compared to that before PTCA was observed in eight of 12 leads. In addition, the significant decrease in VAT of 1, 5, and 10 minutes after PTCA compared to that during PTCA were noted. Furthermore, 10 minutes after PTCA, VAT decreased significantly compared to that before PTCA. The leads did not show a significant change of VAT depending on target vessels. The ECG of 16 patients showed changes of the ST segment during PTCA. The changes of VAT were not related to the ST segment change. CONCLUSION: The conduction delay from endocardium to epicardium in acute myocardial ischemia was presented as a prolongation of VAT in surface ECG. In addition, the conduction delay was recovered within 5 minutes after relief of ischemia. Therefore, the changes of VAT can possibly be used as one of the noninvasive parameters of myocardial ischemia.
Action Potentials ; Angina, Stable ; Angina, Unstable ; Electrocardiography ; Endocardium ; Female ; Humans ; Ischemia ; Male ; Middle Aged ; Myocardial Infarction ; Myocardial Ischemia* ; Pericardium ; Thoracic Surgery, Video-Assisted

BACKGROUND: The real incidence of atherosclerotic lesions in carotid and peripheral arteries in coronary artery disease patients is not well known in Korea. The aim of this study was to prospectively evaluate the prevalence of atherosclerotic involvement of the coronary, carotid, and peripheral arteries in each arterial disease patients. This study was also designed to evaluate the risk factors, the clinical characteristics of associated carotid artery stenosis in patients with coronary artery disease, and associated peripheral vascular disease in patients with coronary artery disease. METHODS: Between June 1996 and March 1998, 475 patients (369 males, 106 females, mean age 60+/-10 years) were studied. Three hundred and seventy-three patients who presented with ischemic symptoms were enrolled in the coronary artery disease group, 81 patients were enrolled in the peripheral vascular disease group due to presenting claudications, and 21 patients were enrolled in the carotid stenosis group due to presenting cerebrovascular symptoms. Coronary angiography was done by the routine method. Carotid angiography was performed at the aortic arch by the digital subtraction angiography method. Peripheral vascular angiography was taken from the suprarenal abdominal aorta to both femoral arteries. RESULTS: 1) Risk factors for coronary stenosis, peripheral vascular disease, and carotid stenosis: The risk factors were not different between coronary stenosis, peripheral vascular disease, and carotid stenosis groups, but smoking was more frequent among patients with peripheral vascular disease than in patients with coronary stenosis (p-value=0.001). 2) Coronary artery stenosis and carotid artery stenosis: The mean age of coronary artery patients with carotid stenosis was significantly older (p-value=0.006) than for patients without carotid stenosis. The prevalence of peripheral vascular disease was more common in patients with carotid stenosis than in patients without carotid stenosis. 3) Coronary artery stenosis and peripheral vascular disease: Carotid stenosis was more common inpatients with peripheral vascular disease than in patients without peripheral vascular disease in the coronary stenosis group. 4) Prevalence of coronary, carotid, and peripheral artery disease: In patients with coronary stenosis, the prevalence of carotid stenosis was 13.9% and that of peripheral vascular disease was 29.2%. In patients with peripheral artery stenosis, the prevalence of coronary stenosis was 45.7% and that of carotid artery disease was 33.3%. In patients with carotid stenosis, the prevalence of coronary stenosis was 81.0% and that of peripheral vascular disease was 52.4%. CONCLUSION: Carotid artery disease and peripheral vascular disease developed concurrently with coronary artery disease in a significant proportion of patients. Therefore, routine angiography of peripheral and carotid arteries in patients with coronary artery disease is considered, especially in old age.
Angiography* ; Angiography, Digital Subtraction ; Aorta, Abdominal ; Aorta, Thoracic ; Arteries ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Stenosis ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Incidence ; Inpatients ; Korea ; Male ; Peripheral Arterial Disease ; Peripheral Vascular Diseases ; Prevalence ; Prospective Studies ; Risk Factors ; Smoke ; Smoking

PURPOSE: The purpose of this study was to evaluate the effects of theophylline in preterm infants with apnea on glucose homeostasis and insulin values. METHOD: In this prospective study, level of glucose and insulin were measured from peripheral blood of 8 neonates(1,450+/-114gm, 31+/-2.1week), who were admitted from April 1, 1997 to July 30, 1997 in Neonatal Intensive Care Unit of Wonkwang University Hospital, for apnea of prematurity(> 20 sec with bradycardia and/or cyanosis) were given aminophylline intravenously. Blood samples were collected at pretreatment, posttreatment 2hours, 1-2days, 3-4days, 5-7days and posttreatment 48hours, and compare to those of the 8 control neonates(1,711+/-232gm, 32+/-1.7week). RESULTS: The results were as follows: 1) Plasma glucose values were significantly higher in the treatment group than those of the control group at 1-2days(104.67+/-20.39mg/dL vs 83.43+/-15.86mg/dL) and 3-4days(111.0+/-32.39mg/dL vs 79.25+/-14.03mg/dL)(p<0.05). 2) Plasma glucose values which were increased at 1-2days(104.67+/-20.39mg/dL)and 3-4days(111.0+-32.39mg/dL), were significantly higher than pretreatment values(66.33+/-31.19mg/ dL)(p<0.02), but were not increased to the level of hyperglycemia(> 125mg/dL). 3) The mean posttreatment glucose levels drawn at 48hours after discontinuation of theophylline was significantly decreased to the values of pretreatment values compared to those of the 1-2days and 3-4days(p<0.01). 4) Insulin concentrations were also increased insignificantly when blood glucose were increased in the treatment group compared with control group. CONCLUSION: In conclusion, intravenous administration of theophylline produces hyperglycemia significantly, including an increase in a serum insulin. But, clinically significant hyperglycemia(> 125mg/dL) was not noted. So, plasma glucose may not need to be monitored in preterm apneic infants receiving theophylline. But, further studies are need to elucidate the effect of theophylline considering the serum toxic level of theophylline.
Administration, Intravenous ; Aminophylline ; Apnea* ; Blood Glucose* ; Bradycardia ; Glucose ; Homeostasis ; Humans ; Hyperglycemia ; Infant ; Infant, Newborn ; Infant, Premature* ; Insulin* ; Intensive Care, Neonatal ; Plasma* ; Prospective Studies ; Theophylline

BACKGROUND : The recent studies shows that Helicobacter pylori (H. pylori) related chronic gastritis leads to dysplasia, intestinal metaplasia and gastric cancer. The aim of this study was to determine the association between precancerous lesion of stomach (dysplasia, intestinal metaplasia) and H.pylori infection in the elderly. METHODS : 469 patients were enrolled this study, Patients with intestinal metaplasia or dysplasia (case, n=148) were compared with controls (without intestinal metaplasia and dysplasia, n=321) about H. pylori positive rates H. pylori positivity was confirmed by histologic determination of endoscopic biopsy specimens. Results : 1) Among study populations H. pylori positive rates were 51.8% (55.8% in male, 40.7% in female). It was significantly higher in male (p=0.001). 2) There were no significant differences in sex distribution between cases and controls, but in old age, the cases were more frequent than in young age (p<0.001). 3) Age distribution of H. pylori positive rates were not significant between cases and controls. 47.5% in intestinal metaplasia, 43.4% in dysplasia, 21.3% in dysplasia+intestinal metaplasia were H. pylori positive. H. pylori positive rates were more higher in controls than cases, followed by in decreasing order by the intestinal metaplasia group, the dysplasia group, and those having both (p=0.003). 4) Age and sex adjusted H. pylori positive rates were more higher in controls (42.7%) than in cases (25.0%)(p<0.009). CONCLUSION : The prevalence of intestinal metaplasia and dysplasia was age dependent. But we couldn't explain the carcinogenic effect of H. pylori, because H. pylori positive rates were lower in cases than in controls
Age Distribution ; Aged ; Aging* ; Biopsy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Metaplasia* ; Prevalence* ; Sex Distribution ; Stomach ; Stomach Neoplasms

BACKGROUND: Cord blood transplantation has generated much enthusiasm because of the low incidence of GVHD(graft-versus-host disease), even in HLA(Human Leukocyte Antigen) mismatched situations, owing to intrinsic defects in mature T cell functions, and human cord blood is a constantly and easily obtainable source for hematopoietic stem cell. This study was undertaken to elucidate the possible mechanisms of low GVHD incidence observed when cord blood is used for stem cell transplantation. Based on current knowledge of the phenotypic correlates with functional subtypes of peripheral blood lymphocytes, we evaluated lymphocyte subpopulation in cord blood. METHODS: The 25 cord blood and 20 peripheral blood of adult control were included in this study. Monoclonal antibodies(MAb) conjugated with fluorescein-isothiocynate(FITC), phycoerythrin(PE) were used in this study. Heparinized whole blood was stained with mAbs using the whole blood lysis method. We used FACScan flow cytometer with argon laser tuned at 488 nm. Analysis was done by either Simulset or lysis II research software. RESULT: 1) The means of WBC and lymphocyte content were higher in cord blood than in adult blood(p<0.05). 2) The overall percentages of cord blood T(CD3+) cells, B(CD19+) cells, NK(natural killer)(CD16+/CD56+) cells were not different from adult controls. 3) The CD4+ : CD8+ ratio of cord blood was higher than thar of adult controls(2.7 in cord bloods versus 1.8 in adults). 4) The majority of the cord blood cells, both CD4+ and CD8+, co-expressed the CD45RA+ (naive) molecule. 5) The CD57, an antigen present on a subpopulation of NK cells, is absent in cord blood. CONCLUSION: We determined that cord blood contained mainly naive T lymphocytes to be predominantly suppressor cells. We found reduced alloproliferative, allostimulatory and allocytotoxic capacity of cord blood lymphocytes. Therefore, the GVHD may be less readily induced in cord blood transplantation, even in the face of HLA difference.
Adult ; Argon ; Fetal Blood* ; Hematopoietic Stem Cells ; Heparin ; Humans ; Incidence ; Killer Cells, Natural ; Leukocytes ; Lymphocyte Subsets* ; Lymphocytes* ; Phenotype ; Stem Cell Transplantation ; T-Lymphocytes

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis