The effect of oral mexiletin was evaluated by a 10-day double-blind cross-over protocol on 10 subjects with chronic stable high-frequency ventricular premature beats referred to our cardiology clinic from February through July, 1982. Total daily doses were either 450mg or 600mg in three divided portions depending on body weight. The frequency of the premature ventricular beats was measured by 3 separate 24-hour ambulatory EKG recordings by dual-channel Holter monitor on each patient. Mexiletine was judged to be effective in suppressing the ventricular arrhythmias when the 24-hour PVC-counts during the study-drug period showed a decrease by 80% and the hourly average PVC-counts by 70% compared with those of the equivalent intervals of both the baseline and the placebo periods. Mexiletine was effective in 5 of the 10 subjects. Mild tremor and anorexia were noted in 2 patients, but they were able to comply with the study protocol in spite of these minor side effects. Blood level measurements were not done in this study for lack of such facility, the utilization of which would undoubtedly enhance the therapeutic effectiveness of the antiarrhythmic agent in the individualization of treatment.
Anorexia ; Arrhythmias, Cardiac ; Body Weight ; Cardiac Complexes, Premature* ; Cardiology ; Electrocardiography ; Humans ; Mexiletine* ; Tremor ; Ventricular Premature Complexes

No abstract available.
Apoptosis* ; Prostate* ; Prostatic Hyperplasia* ; Prostatic Neoplasms* ; Proto-Oncogene Proteins c-myc*

This study was conducted to determine the level of inflammatory cytokines in the cerebrospinal fluid (CSF) of patients with meningitis. All the CSF of the patients were examined by Gram and acid-fast stain, culture, and PCR for Mycobacterium tuberculosis and Mycoplasrma spp..The levels of sugar, protein and leukocytes count were also evaluated in the CSFs. Concentrations of Interleukin (IL)-1B, IL-6, IL-8, tumor necrosis factor (TNF)-a in the CSF were evaluated by the ELISA kit (Genzyme, USA). General bacteria, tubercle bacilli, and Mycoplasma spp. were not detected with stain and culture methods, but, Mycoplasma spp. was detected by PCR method from four (6.3%) patients with meningitis. The mean CSF concentration of IL-1B, IL-6, IL-8, and TNF-cx in the control group were 0.6+/-0.2, 896.8+/-107.6, 50.1+/-5.1, and 4.8+/-1.4 pg/ml, respectively. The mean CSF concentration of IL-1B, IL-6, IL-8, and TNF-a in the patients with aseptic meningitis were 3.8+/-0.6, 1261.6+/-144.3, 466.7+/-42.3, and 10.8+/-2.0 pg/ml, respectively. The mean CSF concentration of IL-1B, IL-6, IL-8, and TNF-a in the patients with mycoplasmal meningitis were 10.2+/-8.1, 1979.5+/-133.8, 459.7+/-96.4, and 17.5+/-5.1 pg/ml, respectively. There were significantly differences in the levels of IL-1B, IL-6, IL-8, and TNF-a between control and patients with aseptic meningitis or Mycoplasmal meningitis (each p<0.001). These results suggest that increased levels of IL-1B, IL-8, and TNF-a could be higly suggestive of meningitis.
Bacteria ; Cerebrospinal Fluid* ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6* ; Interleukin-8* ; Interleukins ; Leukocytes ; Meningitis* ; Meningitis, Aseptic ; Mycobacterium tuberculosis ; Mycoplasma ; Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha

OBJECTIVES: Risperidone, an atypical antipsychitics which blocks both dopaminergic and serotonergic receptors, have a good response to the negative symptoms as well as positive symptoms, and improve cognitive dysfunction of schizophrenic patients. Furthermore, it has few extrapyramidal side effects and tardive dyskinesia. Although it had been reported that the atypical antipsychotics have less effect on prolactin(PRL) than the classical antipsychotics, we could experience PRL-associated symptoms such as amenorrhea, galactorrhea and hyperprolactinemia in practice. Therefore we tried to identify the sex differences of risperidone-induced hyperprolactinemia, to evaluate factors affecting PRL levels, and to know the association between cognitive disorders and PRL. METHODS: The baseline levels of PRL and TSH prior th risperidone administration were measured by enzyme immunoassay method for 50 patients (25 males and 25 females) admitted with schizophrenia, schizoaffective disorder or schizophreniform disorder according to the DSM-IV classification, and the measurements of PRL were repeated on the 2nd and the 4th wks of risperidone administration. Concomitantly, the severity of psychotic symptoms using CGI, BPRS and PANSS, and the cognitive dysfunction using PANSS-CF were assessed prior to, on the 2nd and the 4th wks of risperidone administration. The PRL and TSH levels of 54 healthy controls(29 males and 25 females) who had no medical, neurological and psychiatric illnesses were also evaluated. Furthermore, the correlation with the psychiatric diagnosis, education, age, sex, duration of illnesses, risperidone dosage, duration of risperdone administration, TSH concentration, cognitive function, severity of psychotic symptoms were also identified. RESULTS: 1) The baseline PRL levels of female schizophrenics(74.3+/-49.6ng/ml) were significantly(p<0.005) higher than those of males(36.3+/-24.6ng/ml), which wee significantly(p<0.0001 respectively) higher than those of controls(females 16.9+/-6.1ng/ml, males 13.3+/-4.9ng/ml). The PRL levels measured on the 2nd wks(females 133.7+/-47.8ng/ml, males 56.9+/-23.6ng/ml) and on the 4th wks(females 146.1+/-45.9ng/ml, males 70.0+/-31.5ng/ml) after risperidone administration were significantly(p<0.0001 respectively) higher in females. The mean dosages of risperidone on the 2nd wks were 3.8+/-1.7mg(2-6mg) for the females and 4.0+/-1.6mg(2-6mg) fore the males, and on the 4th wks were 4.5+/-2.1mg(2-8mg) fore the females and 5.4+/-2.2mg(2-8mg) for the males. 2) The rise of PRL levels were positively correlated with increased risperidone dosage in males(y=0.307 on the 2nd wks and y=0.280 on the 4th wks), while they were not correlated with dosages in females. For the females, the PRL levels were negatively correlated(y=-0.320) with decrease of TSH concentration. The baseline PRL levels were not correlated with age, education, duration of illnesses, psychopathology, cognitive disorders in both males and females, while it was negatively correlated with TSH levels only in females(y=-0.320). 3) The cognitive dysfunction was correlated with PRL levels in males, while PANSS-CF scores were negatively correlated with PRL levels(y=-0.220 on the 2nd wks and y=-0.366 on the 4th wks) in females. The psychopathology was positively correlated with cognitive dysfunction in both males and females. Therefore, the risperdone-induced cognitive improvement seemed to be correlated with improvement of psychopathology in both males and females, and with increase in PRL levels only in females. CONCLUSIONS: The fact that the serum PRL levels of schizophrenics were higher than those of controls, especially in females suggested that it could be related with risperidone dosage in males and with primary pathological process in females. The risperidone-associated cognitive improvement seemed to be related with general improvement of psychopathology as well as the rise of PRL levels especially in females. The facts that the effect of risperidone-induced hyperprolactinemia and the cognitive function were more in females suggested that somewhat different mechanisms could be exerted on them.
Amenorrhea ; Antipsychotic Agents ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Female ; Galactorrhea ; Humans ; Hyperprolactinemia ; Immunoenzyme Techniques ; Male ; Mental Disorders ; Movement Disorders ; Pregnancy ; Prolactin* ; Psychopathology ; Psychotic Disorders ; Risperidone* ; Schizophrenia ; Sex Characteristics

No abstract available.
Antigens, CD4*

While a number of diagnostic methods have been developed, endoscopic ultrasound (EUS) still takes the most important role in the preoperative evaluation of esophageal cancer. EUS can detect lesions of all esophageal cancer and can accurately perform T staging. In a recent meta-analysis of EUS in esophageal cancer, the sensitivity and specificity of EUS on esophageal cancer were 81.6% and 99.4% in T1, 81.4% and 96.3% in T2, 91.4% and 94.4% in T3, and 92.4% and 97.4% in T4, respectively. The use of EUS can reduce unnecessary surgeries and lead to apply proper treatments to patients. The advance of endoscopic submucosal dissection have necessitated the presurgical detection of early cancer lesions without lymph node metastasis. Understanding the practical meanings of images shown by EUS is important to decide patients for whom endoscopic treatments can be effective. In early gastric cancer, EUS can accurately predict mucosal and SM1 (invasion into the submucosal layer of less than 500 microm from muscularis mucosa) lesions, which are considered as good indications for endoscopic treatments.
Endosonography ; Esophageal Neoplasms ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Sensitivity and Specificity ; Stomach Neoplasms

STATEMENT OF PROBLEM: Many studies have been conducted to improve the primary stability of implants by providing bioactive surfaces via surface treatments. Increase of surface roughness may increase osteoblast activity and promote stronger bonding between bone and implant surface and it has been reported that bioactive surface or titanium can be obtained through alkali and heat treatment. PURPOSE: The purpose of this study was to evaluate the stability of alkali and heat treated implants via histomorphometric analysis. MATERIAL AND METHODS: Specimens were divided into three groups; group 1 was the control group with machined surface, the other groups were treated for 24 hours in 5 M NaOH solution and heat treated for 1 hour at 600degrees C in the atmosphere (group 2) and vacuum (group 3) conditions respectively. Surface characteristics were analyzed and fixtures were implanted into rabbits. The specimens were histologically and histomorphometrically compared according to healing periods and change in bone composition were analyzed with EPMA (Electron Probe Micro Analyzer). RESULTS: 1. Groups treated with alkali and heat showed increase of oxidization layer and Na ions. Groups 2 which was heat treated in atmosphere showed significant increase of surface roughness (P<.05). 2. Histomorphometric analysis showed significant increase in BIC (bone to implant contact) according to increase in healing period and there was significant increases in groups 2 and 3 (P<.05). 3. BA(bone area) ratio showed similar results as contact ratio, but according to statistical analysis there was significant increase according to increase in healing period in group 2 only (P<.05). 4. EPMA analysis revealed no difference in gradation of bone composition of K, P, Ca, Ti in surrounding bone of implants according to healing periods but groups 2 and 3 showed increase of Ca and P in the initial stages. CONCLUSION: From the results above, it can be considered that alkali and heat treated implants in the atmosphere have advantages in osseointegration in early stages and may decrease the time interval between implantation and functional adaptation.
Alkalies ; Atmosphere ; Hot Temperature ; Ions ; Nitrogen Mustard Compounds ; Osseointegration ; Osteoblasts ; Rabbits ; Titanium ; Vacuum

High output heart failure due to congenital arteriovenous fistula is a rare disease and is difficult to treat. A 27 year old man, suffering from dyspnea, palpitation, lower extremity edema, and abdominal distension admitted May, 1987. At admission there were continuous thrill and bruit at left supraclavicular and infraclavicular area. The heart sound was irregular and rapid, and grade IV/VI pansystolic murmur was audible at the apex. Chest PA showed marked cardiomegaly with pleural effusion and notching at superior aspect of left 2nd rib. Selective left subclavian artery angiogram showed extensive congenital arteriovenous fistula at the area of left subclavian artery and its branches. After setrial feeding artery embolization and palliative operation, the fistula size decreased much with clinical improvement.
Adult ; Arteries ; Arteriovenous Fistula* ; Cardiomegaly ; Dyspnea ; Edema ; Fistula ; Heart Failure ; Heart Sounds ; Humans ; Lower Extremity ; Pleural Effusion ; Rare Diseases ; Ribs* ; Subclavian Artery* ; Thorax

BACKGROUND: We studied the antibiotic sensitivities to the causative microorganisms of acute simple urinary tract infection for recent 3 years. METHODS: We analyzed 112 microorganisms and their antibiotic sensitivities of the 104 patients who were admitted to or visited the Department of Urology, Catholic University St. Marys Hospital and had more than 10cfu/mL on urine culture from June 1996 to January 1999 retrospectively. RESULTS: The chance of gram negative and positive as causative microorganisms was 72.3% and 27.7% respectively. The most common pathogenic microorganisms were Escherichia coli (67.0%) followed by a-hemolytic streptococci, Entercoccus. In gram negative acute UTI, imipenem, sulperanzone showed relatively higher sensitivity, while cotrimoxazole, ampicillin showed relatively lower sensitivity. In gram positive, vancomycin, penicillin showed relatively higher sensitivity, while ampicillin, imipenem showed relatively lower sensitivity. CONCLUSIONS: We consider that gram negative microorganisms, especially E. coli, is the main cause of acute simple UTI. But, we should be concerned about the increase of gram positive organisms and other gram negative organisms besides E. coli. Regarding to the choice of adequate drug in the treatment of UTI, it is necessary to consider the change of pathologic microorganisms.
Ampicillin ; Escherichia coli ; Humans ; Imipenem ; Penicillins ; Retrospective Studies ; Trimethoprim, Sulfamethoxazole Drug Combination ; Urinary Tract Infections* ; Urinary Tract* ; Urology ; Vancomycin

Successful percutaneous transluminal angioplasty (PTA) of an internal mammary artery graft was performed in a 40 year old male patient who had recurrent angina soon after bypass surgery. Coronary angiography showed total occlusion of proximal portion of the left anterior descending artery and normal right coronary artery. Angiography of the left internal mammary artery graft revealed a tight stenosis (90% diameter narrowing) in the mammary artery at its insection into the left anterior descending artery.Angiography after the angioplasty demonstrated a widely patent graft (residual stenosis 10%) and translesional pressure gradient was 10 mmHg.
Adult ; Angiography ; Angioplasty* ; Arteries ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Vessels ; Humans ; Insects ; Male ; Mammary Arteries* ; Transplants*