Small and large airways functions were studied in patients with hypertensive heart disease in slightly ro moderately compromised state functionally. In this study, the forced vital capacity and various flow paramaeters reflecting expiratory flow rate were determined from simultaneously recorded forced expiratory volume and maximal expiretory flow volume curves in 86 cases. The closing volume was measured by a single breath nitrogen mrthod in 57 cases and airway resistance with its related parameters by a body plethysmograph in 11 cases. These results were compared with those obtained from the same numbers of healthy controls matched for sex, age and height. In the patient group, the forced vital capadity and all the observed values of flow parameters, execpt for the ratio of the first second vital capacity to the forced vital capacity, were significantly reduced than those in the controls. When the remainder of flow parameters was volume-adjusted to the forced vital capacity, however, the mean of the peak expiratory flow rate and the maximal expiratory flow rate at the 75 percent of the vital capacity were not significantly different from that of controls. In contrast, the volume-adjusted values of maximal expiratory flow were remained significantly smaller than those in the controls. The closing volume and its ratio to the vital capacity were significantly larger in the patient group. Airway resistance and its related parameters revealed no significant differences between two groups. These findings suggest that the patients with hypertensive heart disease in a mild to moderate failure are associated with restrictive ventilatory impairment and a small airways obstruction, but with little or no large airway dysfunction.
Airway Resistance ; Closing Volume ; Forced Expiratory Volume ; Heart Diseases* ; Heart* ; Humans ; Maximal Expiratory Flow Rate ; Nitrogen ; Peak Expiratory Flow Rate ; Vital Capacity

A 53-year-old man had skin-colored linear serpiginous plaque within brownish patch on his left thigh for one year. He habitually drank natural spring water for 3 years. We diagnosed this case as sparganosis infiltrated within dermis by histologic and parasitologic diagnosis. The skin lesion mimicked the cutaneous larva migrans by showing dermal migration of sparganum to pro-duce itchy linear serpiginous plaque. We report an interesting case of sparganosis mimicking cutaneous larva migrans.
Dermis ; Diagnosis ; Humans ; Larva Migrans* ; Middle Aged ; Natural Springs ; Skin ; Sparganosis* ; Sparganum ; Thigh ; Water

Background: Fluvastatin is the first entirely synthetic 3-hydroxy-3-methylglutaryl-coenzyme A(HMG-CoA) reductase inhibitor. Clinical data indicate that this agent exhibits the proven efficacy of its class and also has some theoretical advantages in safety for long-term use because of its unique pharmacololgic property consistent with hepatoselectivity(i.e., low systemic exposure). This study is to evaluate efficacy and safety of fluvastatin in hypercholesterolemic patients in Korea. Methods: An open clinical trial with fluvastatin was conducted in 31 subjects who continued to have high blood cholesterol levels of 6.21 mmol/L(240 mg/dl) or greater after 1 month of lipid-lowering diet plus single blind placebo period. Fluvastatin was administered for 8 weeks with the initial dose of 20 mg per day and if serum cholesterol levels did not fall below 5.20 mmol/L(200 mg/dl) after 4 weeks the dose was increased to 40 mg per day for the second 4 weeks. On each visit every 4 weeks they underwent interview and laboratory tests about side effects and tolerability. Results: The mean % changes in plasma total cholesterol and LDL-cholesterol from baseline were
Cholesterol ; Creatine Kinase ; Diet ; Humans ; Hypercholesterolemia ; Korea ; Oxidoreductases ; Plasma ; Sleep Stages ; Triglycerides

BACKGROUND/AIMS: As the relationship between gastrointestinal stromal tumors (GIST) and interstitial cells of Cajal had become clear, GIST is defined as CD117 positive mesenchymal tumors, and recognized as a new distinct entity among mesenchymal tumors presenting as gastrointestinal submucosal tumors (SMT). To evaluate GISTs in the category of SMTs, we analyzed mesenchymal SMTs immunohistochemically and clinicopathologically. METHODS: Forty-five patients with mesenchymal SMTs, who received surgical or endoscopic resection were retrospectively analyzed for clinical parameters. Immunohistochemical staining for CD117, CD34, NSE, SMA, and S-100 was also performed. RESULTS: Among 45 tumors, 41 (91.1%) expressed CD117 and were diagnosed as GIST. The most frequent location was the gastric body. Except esophageal location (73.3%), GISTs accounted for 100% of SMTs in the gastrointestinal tract. The mixed myoid-neural differentiated type and the spindle cell shape were most common. Metastasis was observed in 5 patients (11%). All of them had tumors larger than 5 cm and died. Their mean survival was 4.6 months. CONCLUSIONS: GIST accounted for majority (91.1%) of SMTs. The presence of metastasis and tumor size at the time of diagnosis indicate poor prognostic factors. Immunohistochemical study is necessary for exact diagnosis of GIST.
Adult ; Aged ; Female ; Gastrointestinal Neoplasms/*chemistry/diagnosis/pathology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Prognosis ; Proto-Oncogene Proteins c-kit/analysis

BACKGROUND: Spontaneous hemopneumothorax is a rare disease and can be life threatening; it occurs in 1~12% of patients with spontaneous pneumothorax. We analyzed clinical reviews and treatments, as well as complications of spontaneous hemopneumothorax patients that were treated to aid in the optimal management. MATERIAL AND METHOD: We studied retrospectively 30 cases with spontaneous hemopneumothorax for 11 years, from 1995 to 2006, at our hospital. RESULT: All the patients were male and most of the patients were under 30 years. The sides with the disorder were as follows: right in 15 cases and left in 15 cases. Patients showed mostly initial symptoms of chest pain, dyspnea and hypovolemic shock. All patients underwent a closed thoracostomy and 27 patients underwent surgery. Chemical pleurodesis was performed because of postoperative persistent air leakage and one case was treated in the ICU due to re-expansion pulmonary edema. There were no other complications such as fibrothorax seen during the follow-up periods. CONCLUSION: The most important finding is proper initial management, as the spontaneous hemopneumothorax can potentially lead to a life-threatening condition. Recently, video assisted thoracoscopic surgery (VATS) is common procedure for general thoracic surgery and overcomes the weak points of performing a thoracotomy. The results of VATS are encouraging.
Chest Pain ; Dyspnea ; Follow-Up Studies ; Hemopneumothorax* ; Hemothorax ; Humans ; Male ; Pleurodesis ; Pneumothorax ; Pulmonary Edema ; Rare Diseases ; Retrospective Studies ; Shock ; Thoracic Surgery ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracostomy ; Thoracotomy

The MHC class II transactivator (CIITA) is the master transcriptional regulator of genes involved in MHC class II restricted antigen presentation. Previously we suggested another role of CIITA in Th1/Th2 balance by demonstrating that forced expression of CIITA in murine T cells repressed Th1 immunity both in vitro and in vivo. However, the results were contradictory to the report that CIITA functioned to suppress the production of Th2 cytokine by CD4+T cells in CIITA deficient mice. In this study, we investigated the influence of constitutive expression of CIITA in T cells on Th2 immune response in vivo using murine experimental colitis model. In the dextran sodium sulfate-induced acute colitis, a disease involving innate immunity, CIITA transgenic mice and wild type control mice showed similar progression of the disease. However, the development of oxazolone-induced colitis, a colitis mediated by predominantly Th2 immune response, was aggravated in CIITA-transgenic mice. And, CD4+T cells from the mesenteric lymph node of CIITA-transgenic mice treated with oxazolone exhibited a high level of IL-4 secretion. Together, these data demonstrate that constitutive expression of CIITA in T cells skews immune response to Th2, resulting in aggravation of Th2-mediated colitis in vivo.
Trans-Activators/*physiology ; Th2 Cells/*immunology ; T-Lymphocytes/*metabolism ; Oxazolone/pharmacology ; Nuclear Proteins/*physiology ; Mice, Transgenic ; Mice, Inbred C57BL ; Mice ; Interleukin-4/biosynthesis ; Colitis/*etiology ; Animals

We report a case of pneumonia in 36 year-old male patient who presented acute respiratory failure and associated radiologic findings of bilateral ground-glass opacity with focal cystic changes, showing rapidly aggravating course and was diagnosed as concomitant Pneumocystis carinii and Cytomegalovirus pneumonia accompanied by acquired immunodeficiency syndrome through antemortem open lung biopsy.
Acquired Immunodeficiency Syndrome ; Biopsy ; Cytomegalovirus ; Humans ; Lung ; Male ; Pneumocystis carinii ; Pneumonia ; Respiratory Insufficiency*

BACKGROUND: The cardiovascular effects of muscle relaxants may be produced by a muscarinic receptor block, ganglion block, increased noradrenaline release and blockage of it's reuptake or histamine liberation. However certain analogues of steroidal muscle relaxants directly cause relaxation of isolated vascular smooth muscles. Rocuronium is the 2-morpholino, 3-desacetyl, 16-N-allyl-pyrrolidino derivative of vecuronium, known to have a relative lack of ganglion blocking, sympathomimetic effects or histamine release. The aim of this study was to investigate the effect and action mechanism of rocuronium on isolated aortic smooth muscle in rats. METHODS: The ability of rocuronium to elicit a direct relaxant effect on vascular smooth muscle has been studied using isolated rat thoracic aortic rings contracted with phenylephrine (PE). Each ring of aortic arteries was suspended on wire supports in a 20 ml tissue bath under 2 g of resting tension. All tissues were bathed in Tris Tyrode solution at 37degrees C and 100% oxygen was supplied. RESULTS: Rocuronium 10(-4) M and 10(-2) M shifted the cumulative concentration-effect curves of PE to the right significantly (P<0.05). This relaxation effect of the aortic rings was not reversed with L-NAME or methylene blue pretreatment. However indomethacine shifted this curve to the right, and intracellular calcium release and extracellular calcium influx decreased significantly (P<0.05). CONCLUSIONS: From the results obtained with this experiment, it is concluded that the relaxation effects of rocuronium is not endothelium dependent and in part, is related with cyclooxygenase inhibition. Rocuronium inhibited intracelluar calcium release and extracelluar calcium influx.
Animals ; Aorta, Thoracic* ; Arteries ; Baths ; Calcium ; Endothelium ; Ganglion Cysts ; Histamine Release ; Indomethacin ; Methylene Blue ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; NG-Nitroarginine Methyl Ester ; Norepinephrine ; Oxygen ; Phenylephrine ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Receptors, Muscarinic ; Relaxation ; Sympathomimetics ; Vecuronium Bromide

A case of quadriplegia resulted from cervical penetrating wound was admitted to chosun university hospital intensive care unit, and undergone steroid therapy and antibiotics therapy. On the 6th hospital day, the septic complication was developed and it proved to be bacterial meningitis by CSF examination. Broad spectrum antibiotics was administered immediately after the diagnosis and the patient was monitored carefully. The bacterial meningitis was improved and no other serious complication was developed. The patient was discharged with permanent neurologic deficit, quadriplegia.
Anti-Bacterial Agents ; Diagnosis ; Humans ; Intensive Care Units ; Meningitis, Bacterial ; Neurologic Manifestations ; Quadriplegia* ; Wounds and Injuries* ; Wounds, Penetrating

Human cases of echinostomiasis have been sporadically diagnosed by extracting worms in the endoscopy in Korea and Japan. Most of these were caused by Echinostoma hortense infection. However, in the present study, we detected 2 live worms of Echinostoma cinetorchis in the ascending colon of a Korean man (68-year old) admitted to the Gyeongsang National University Hospital with complaint of intermittent right lower quadrant abdominal pain for 5 days. Under colonoscopy, 1 worm was found attached on the edematous and hyperemic mucosal surface of the proximal ascending colon and the other was detected on the mid-ascending colon. Both worms were removed from the mucosal surface with a grasping forceps, and morphologically identified as E. cinetorchis by the characteristic head crown with total 37 collar spines including 5 end-group ones on both sides, disappearance of testes, and eggs of 108x60 microm with abopercular wrinkles. The infection source of this case seems to be the raw frogs eaten 2 months ago. This is the first case of endoscopy-diagnosed E. cinetorchis infection in Korea.
Aged ; Animals ; Colon/*parasitology ; Colonoscopy ; Echinostoma/anatomy & histology/classification/*isolation & purification ; Echinostomiasis/*diagnosis/parasitology ; Humans ; Korea ; Male