No abstract available.
Hemoptysis*

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origins of the coronary arteries. It may be localized or diffuse, and includes a wide spectrum of pathologic changes. A 16 years old school boy was admitted because of exertional dyspnea for 6 years. Clinical diagnosis of supravalvular and valvular aortic stenosis with bicuspid aortic valves and myocardial hypertrophy was made by echocardiography and angiocardiography. Surgical correction was performed successfully. We presented a case of supravalvular and valvular aortic stenosis with a review of literatures.
Adolescent ; Angiocardiography ; Aorta ; Aortic Stenosis, Supravalvular ; Aortic Valve ; Aortic Valve Stenosis* ; Bicuspid ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Hypertrophy ; Male

Deliberately induced hypotension reduces bleeding in operative fields, therby facilitating the surgical manipulation of a highly vascularized lesion and enabling a better dissection to be made. Hypocapnia is a technique by which the regional cerebral blood flow is reduced, effecting a decrease in the intracranial volume. The monitoring of end-tidal CO2 tension(PECO2) is widely done since the amount of end-tidal CO2 tension reflects indirectly the value of the degree of arterial CO2 tension(PaCO2). During hypotension, increased physiologic dead space my produce the widened PaCO2-PECO2 gradient and this large gradient makes PECO2 an unreliable indication of PaCO2. There are many reports on hypotensive agents and techniques. Induced hypotension with halothane has been reported to be a relatively safe and useful method by Murtagh(1960) and Schettini, et al (1967). We reported 100 cases of halothane induce hypotensive anesthesia for intracranial aneurysm surgery in 1979. The present study reports concerning the hypotensive anesthesia for 259 cases of intracranial aneurysm surgery, which were performed at Severance Hospital of the Yonsei University College of Medicine from 1972 to 1985. We evaluated prospectively the PaCO2-PECO2 gradient with modern infrared capnographs during the induced hypotension of 25 cases, which was performed for intracranial aneurysm surgery at this hospital. The result of the retrospective and prostpective studies were as follows. A. Retrospective study 1) Halothane and enflurane were used as the primary anesthetics in 246 and 13 cases, respectively. Hydralasine, nitroprusside, and trimetaphan were supplementarily used for inducing hypotension in 29, 19 and 15 cases, respectively. 2) The mean arterial blood pressure of the lowest blood pressure in the induced hypotension group was 57.2+/-9.3 mmHg, and the mean arterial blood pressure of the highest blood pressures during the induction fo anesthesia was 111.3+/-20.8mmHg. 3) There was no significant difference in the perioperative hemoglobins, hematocrits, and serum electrolytes. 4) In the introperative period gas analysis revealed respiratory alkalosis(arterial CO2 tension and pH were 29.7+/-6.7mmHg and 7.485+/-0.078, respectively). In other values there was no significant change. 5) The mortality rate in 259 cases of intracranial aneurysm surgery was 6.2%. B. Prospective study There was no significant difference in the PaCO2-PECO2 gradients between in the hypotensive period (5.5+/-3.8 mmHg) and in the normotensiveperiod(4.3+/-3.4mmHg). In conclusion, the technique of using induced hypotension with the inhalation anesthetics, halothane or enflurane, is a safe and useful one to use in performing surgery for intracranial aneurysm, and end-tidal carbon dioxide tension can be used as an indirect measure of arterial carbon dioxide during the induced hypotension.
Anesthesia* ; Anesthetics ; Anesthetics, Inhalation ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide ; Electrolytes ; Enflurane ; Halothane ; Hematocrit ; Hemorrhage ; Hydrogen-Ion Concentration ; Hypocapnia ; Hypotension ; Intracranial Aneurysm* ; Mortality ; Nitroprusside ; Prospective Studies ; Retrospective Studies ; Trimethaphan

No abstract available.
Malignant Atrophic Papulosis*

PURPOSE: The prevalence and severity of childhood obesity are increasing rapidly worldwide. Spontaneous and stimulated growth hormone (GH) secretion are impaired in obesity. However, despite the low GH levels, normal or increased insulin-like growth factor-I (IGF-I) levels have been observed in obese subjects. Growth velocity is commonly normal or increased in obese children. As for the possible mechanisms underlying these observations, overnutrition, chronic hyperinsulinemia and increased free IGF-I have been suggested. To explain the possible mechanisms by which obese children are taller than normal weight children, we have compared height, leptin, insulin, IGF-I and IGF binding protein-3 (IGFBP-3) with body mass index and studied the relationship among these parameters in obese and control group. METHODS: Auxological and endocrine evaluation were performed in 33 obese children (18 boys and 15 girls) and 47 non-obese children (24 boys and 23 girls) at Hanyang University Hospital from Jan. 1999 to Dec. 2000. Obesity was defined as a body mass index (BMI) greater than the 95th percentile for age and sex. Fasing blood samples were taken for the measurement of serum leptin, insulin, IGF-I and IGFBP-3 by radioimmunoassay. RESULTS: The serum concentrations of leptin, insulin, IGF-I and IGFBP-3 were significantly higher in obese children than those in non-obese children. The serum concentrations of leptin (r=0.751, P=0.000), insulin (r=0.746, P=0.000) and IGF-I (SDS) (r=0.747, P=0.000) showed positive correlation to BMI. And the serum concentrations of IGFBP-3 showed positive correlation to BMI with low correlation coefficient respectively (r=0.275, P=0.015). The serum concentration of insulin correlated to that of IGF-I (SDS) positively (r=0.585, P=0.000). CONCLUSION: This study suggest that increased sensitivity of GHR modulated by chronic hyperinsulinemia and increased circulating IGF-I produced by accumulated adipose tissue may enhance the growth in obese children.
Adipose Tissue ; Body Mass Index ; Child* ; Growth Hormone ; Humans ; Hyperinsulinism ; Insulin* ; Insulin-Like Growth Factor Binding Protein 3* ; Insulin-Like Growth Factor I* ; Leptin* ; Obesity ; Overnutrition ; Pediatric Obesity ; Prevalence ; Radioimmunoassay

The determination of proliferative activity in the colorectal mucosa has been used for different purposes as the estimation of cancer risk and the assessment of disease activity in ulcerative colitis. But the prognostic significance of proliferative activity in colorectal carcinomas remains controversial. To investigate the prognostic significance of proliferative activity in colorectal carcinomas, the author estimated the proliferative activity immunohisto chemically using the monoclonal antibody PCNA and compared with clinicopathological data in 62 colorectal carcinomas. The results were as follows: 1) The reactivity of PCNA was more pronounced at the infiltrative margins of the tumors and tumor cells within the vascular or lymphatic channels. 2) The mean PCNA index of colorectal carcinomas was 40.5?0.4%. PCNA indices had positive correlations with lymph node invasion(p<0.05), liver, metastasis(p<0.05), Dukes' stage(p<0.01) and TNM classification(p<0.01), and didn't correlated with location of tumor, size of tumor, histological type and lymphtic or vascular invasion. 3) The patients with high PCNA index(more than 45%) represented higher recurrence or metastasis rate(37.5%) than those with low PCNA index (less than 45%)(19.3%) in Dukes B or C colorectal carcinomas during the follow-up periods, but not significant statistically. These results suggested that the reactivity of PCNA may be a useful prognostic factors in colorectal carcinomas.
Neoplasm Metastasis

PURPOSE: We analyzed disease free survival and the prognostic factors of liposarcoma in the extremity. MATERIALS AND METHODS: Between 1994 and 2005, of 44 patients who were diagnosed and treated for liposarcoma of the extremity, 40 patients were restrospectively analysed. 13 out of 40 patients got postoperative radiotherapy. We examined local recurrence, distant metastasis and disease free 5-year survival rate. We also analyzed clinical prognostic factors, such as age, gender, size of tumor, prior unplanned excision, histologic type, surgical excision margin and postoperative radiotherapy respectively. RESULTS: There were 3 cases of local recurrence and 4 cases of distant metastasis. The disease free 5-year survival rate was 85.0%. 26 patients presented with myxoid, 8 well differentiated, 4 round cell, 1 pleomorphic and 1 dedifferentiated histology. The disease free 5-year survival rate of mixoid, well differentiated and round cell liposarcoma were 100.0%, 84.6% and 75.0% (p=0.419). The 5-year disease free survival rate was 90.6% in negative surgical margin (n=25) and 62.5% in positive surgical margin (n=15) (p=0.003). CONCLUSION: Our study suggests that surgical excision margin is significant prognostic factor for 5-year disease free survival rate.
Disease-Free Survival ; Extremities ; Humans ; Liposarcoma ; Neoplasm Metastasis ; Recurrence ; Survival Rate

Responses of mouse lymphocytes to the soybean paste fermented by Korean traditional fashion was examined to clarify its effects in cytokine production in vitro. A fraction of the soybean paste (KFSP-100) was prepared by precipitation with ammonium sulfate and by filtration through ultrafiltration membrane. KFSP-100 were added into cultures of fresh mouse splenic cells in vitro. KFSP-100 significantly enhanced the amount of IL-6 and TNF-a produced by macrophages and IL-6 and IFN-r produced by lymphocytes. Production of IL-12 by macrophages was not much affected by KFSP-100 treatments. The most noticeable finding was the fact that lymphocytes treated with KFSP-100 proliferated to an exceeding numbers (more than 10 times to the control) in 72 hours. The KFSP-100-induced proliferative response was specific to B cells since almost all of the KFSP-100-induced cells in the cultures of splenic cells were B cells. Furthermore, such a proliferative responses were equally observed only in cultures of purified B cells but not in cultures of T cells. In thermostability test, the biologically active components of the KFSP-100 is assumed to be either linear protein or glycoprotein. KFSP-100 did not induce agglutination of lymphocytes demonstrated by lectins in the same cells. These observations suggest that KFSP-100 may be a novel mitogen for B lymphocytes. The component (s) responsible for the B cell proliferation in KFSP-100 might be a factor gained by natural fermentation. None of the fractions of not fermented soybean paste prepared by the same methods demonstrate the same effect.
Agglutination ; Ammonium Sulfate ; Animals ; B-Lymphocytes ; Cell Proliferation ; Fermentation ; Filtration ; Glycoproteins ; Immunologic Factors* ; Interleukin-12 ; Interleukin-6 ; Lectins ; Lymphocytes ; Macrophages ; Membranes ; Mice ; Soybeans* ; T-Lymphocytes ; Ultrafiltration

BACKGROUND: The "timing principle" utilises a single bolus of nondepolarizing neuromuscular blocking drug followed by an induction drug at the onset of clinical weakness. The purpose of this study was to compare the intubating conditions after succinylcholine or rocuronium and after rocuronium using the timing principle. METHODS: Forty patients were randomly allocated into four groups. Patients in group I received rocuronium 0.6 mg/kg using the timing principle. At the onset of clinical weakness, anesthesia was induced with the thiopental 4-5 mg/kg. Patients in group II, III, and IV received rocuronium 0.6, 0.9 mg/kg, and succinylcholine 1.5 mg/kg respectively using the usual technique. The trachea were intubated 60 s after thiopental induction. Accelerographic response to train-of-four (TOF) stimulation of the ulnar nerve was used for neuromuscular monitoring. Intubating conditions were assessed according to a grading scale. RESULTS: The twitch depression immediately before tracheal intubation in group I, II, III, and IV were 14.5, 28.2, 11.1, and 6.8%, respectively. The TOF count showed no significant differences between groups. The duration of action in group III (45.3 +/- 12.1 min) was significantly prolonged compared to that in group I (31.2 +/- 6.4 min). Intubation conditions were either good or exellent in all patients except one in group II. In group I, three patients recalled shortness of breath or general weakness. CONCLUSIONS: It is concluded that the use of rocuronium 2 X ED95 using the timing principle did not provide additional benefits compared to rocuronium 3 X ED95 using the usual technique except in duration.
Anesthesia ; Depression ; Dyspnea ; Humans ; Intubation* ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Succinylcholine ; Thiopental ; Trachea ; Ulnar Nerve

PURPOSE: The purpose of this study was to identify the frequency of urinary incontinence and lower urinary symptoms, to identify lifestyle and sexual matters for UI of adult women in an urban area. METHOD: The sample consisted of 364 educated women from a women's health education program in a public health center. For data collection, the Bristol Female Lower Urinary Tract Symptoms Questionnaire developed by Jackson, et. al.(1996) and the demographic questionnaire were used. For data analysis, SAS 8.2 program was used. RESULT: The results were as follows: 1. the prevalence rate of UI was 73.63%. 45.88% of them were stress incontinence and 27.75% of them were urge incontinence. 2. Remarkable differences were found between the type of UI and LUTS in the case of urgency(x2=42.0585, P<0.001), unexplained incontinence(x2=59.0585, P<0.001), noctural incontinence(x2=18.8080, P<0.001) and catetherization(x2=10.7207, P= 0.004), burning sense(x2=27.7400, P<0.001). 3. Remarkable differences were found between the type of UI and lifestyle matters in the cases as follows fluid intake restriction(x2=31.0532, P=0.008), interference in physical activity(x2= 36.7481, P=0.001), interference in relation with others(x2=22.2729, P=0.034). 4. Remarkable differences were found between the type of UI and sexual matters with difficulty of sexual intercourse(x2=16.1898, P=0.002), and urine leakage during sexual intercourse(x2=17.9752, P=0.001). CONCLUSION: Based on the results, developing and carrying out an adequate UI care and education program is needed.
Adult ; Burns ; Data Collection ; Education ; Female ; Humans ; Life Style* ; Lower Urinary Tract Symptoms* ; Prevalence ; Public Health ; Statistics as Topic ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Women's Health ; Surveys and Questionnaires