Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

Diagnosing pseudoaneurysms of the popliteal artery is usually straightforward in physical examinations and imaging findings. However, when a pseudoaneurysm shows a soft tissue mass with adjacent osseous change, it can mimic a bone tumor or a soft tissue sarcoma. We present a case of a 65-year-old man who had a pseudoaneurysm of the popliteal artery showing soft tissue mass and insinuating into the intramedullary cavity of the tibia. This presented case emphasizes the importance of considering pseudoaneurysms in the differential diagnosis of an apparent soft tissue mass with pressure erosion in adjacent bone.
Aged ; Aneurysm, False ; Diagnosis, Differential ; Humans ; Hydrazines ; Physical Examination ; Popliteal Artery ; Sarcoma ; Tibia

BACKGROUND: Endoscopic Ultrasonography(EUS), a combination of endoscopy and ultrasonography is one of the most useful tools for diagnosis of digestive system diseases. EUS is useful in staging the primary tumor invasion and regional lymph node metastasis because of its ability to image the gut wall and adjacent structures in unique detail. We performed a study preoperatively for assessing the accuracy and limitation of EUS in gastric carcinoma. METHODS: In 75 patients(Male 54, Female 21, Mean age 62.3 years) with a gastric carcinoma confirmed by endoscopic biopsy, we performed EUS preoperatively. The results were compared with the postoperative histopathologic staging. RESULTS: 1) In assessing the depth of tumor invasion, EUS accuracy on depth of invasion was 76.0% and overstaging and understaging were 14.7% and 9.3%, respectively. 2) In assessing the lymph node metastasis, the accuracy rate of EUS was 65.3%. A rate of false-positive diagnosis was 27.3%, and a rate of false-negative diagnosis was 24.5%.3) In assessing the incidence of lymph node metastasis for each T stage, the involve rate was 10.5% in pT1, 36.4% in pT2, 95.7% in pT3, 100% in pT4. CONCLUSIONS: EUS is the most accurate diagnostic methods presently available to determine tumor infiltration depth and lymph node metastasis.
Biopsy ; Diagnosis ; Digestive System Diseases ; Endoscopy ; Endosonography* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Lymph Nodes ; Neoplasm Metastasis ; Stomach* ; Ultrasonography

PURPOSE: The aim of this study is to evaluate the incidence of hyperkalemia and the contributing factors of nonoliguric hyperkalemia in low birth weight infants within 48 hours after birth. METHODS: The incidence of nonoliguric hyperkalemia and difference of clinical features between hyperkalemia (>6.7 mEq/L) and normokalemia (< or =6.7 mEq/L) groups were determined by reviewing medical records of 196 low birth weight infants who were born in Hanyang university hospital between Oct. 2001. and Jul. 2004. We analized the serum level of sodium, potassium, fluid intake, urine output, pH of blood gas and others. RESULTS: Among 196 infants, 17 infants was hyperkalemia developed in 48 hours after birth. In that cases, 10 infants were showed EKG abnormalities, such as ventricular tachycardia. In all cases, birth weight, gestational age, Apgar score, usage of surfactant, urine output, BUN and creatinine were significant. In A group gestational age, urine output, BUN, creatinin were significant, in B group BUN, creatinine were significant, in C group BUN were significant between hyperkalemia and normokalemia. Six infants with hyperkalemia died as a result of hyperkalemia induced cardiac arrhythmia. CONCLUSION: Hyperkalemia frequently occurred extremely premature infants. But hyperkalemia also be developed in low birth weight infants who were not suffered from asphyxia or tissue damage. Serum potassium level should be monitored to avoid life threatening cardiac arrhythmia in low birth weight infant.
Apgar Score ; Arrhythmias, Cardiac ; Asphyxia ; Birth Weight ; Creatinine ; Electrocardiography ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Hyperkalemia* ; Incidence ; Infant* ; Infant, Extremely Premature ; Infant, Low Birth Weight* ; Infant, Newborn ; Medical Records ; Parturition ; Potassium ; Sodium ; Tachycardia, Ventricular

PURPOSE: This study was done to investigate the relationship of family function, self-esteem, life satisfaction, and general characteristics to loneliness in community dwelling Korean elders and identify factors affecting loneliness. METHOD: With a cross-sectional causal-relationship design and a convenience sample, 205 elders residing in three districts of the city of Seoul, S. Korea were recruited. Participants were assessed using the Family APGAR Score, Self-Esteem Scale, Life-Satisfaction Scale, and Revised UCLA Loneliness Scale. RESULTS: The mean score for degree of loneliness (Mean=39.61, SD=10.09) was just below the mean for the scale (Possible range 20-80). Loneliness had significant negative correlations with family function (r= -.400, p<.001), self-esteem (r= -.399, p<.001), and life satisfaction (r= -.644, p<.001). Other general characteristics that had significant or nearly significant relationships with loneliness were perceived current financial and health status, whether doing any exercise or physical activities, degree of close relationship with family members, and length of living in current residence. Among variables, life satisfaction (Standardized beta = -.589, p<.001) and length of living in current residence (Standardized beta = -.136, p<.05) significantly predicted degree of loneliness. CONCLUSION: Findings of this study allow a comprehensive understanding of loneliness and related factors among community dwelling elders in Korea. However, further studies with a larger random sample from various living environments are necessary.
Apgar Score ; Humans ; Korea ; Loneliness* ; Motor Activity ; Seoul

Lysophosphatidic acid (LPA) is a phospholipid growth factor that acts through G-protein-coupled receptors. Previously, we demonstrated an altered profile of LPA-dependent cAMP content during the aging process of human diploid fibroblasts (HDFs). In attempts to define the molecular events associated with the age-dependent changes in cAMP profiles, we determined the protein kinase A (PKA) activity, phosphorylation of cAMP-response element binding protein (CREB), and the protein expression of CRE-regulatory genes, c-fos and COX-2 in young and senescent HDFs. We observed in senescent cells, an increase in mRNA levels of the catalytic subunit a of PKA and of the major regulatory subunit Ia. Senescence-associated increase of cAMP after LPA treatment correlated well with increased CREB phosphorylation accompanying activation of PKA in senescent cells. In senescent cells, after LPA treatment, the expression of c-fos and COX-2 decreased initially, followed by an increase. In young HDFs, CREB phosphorylation decreased following LPA treatment, and both c-fos and COX-2 protein levels increased rapidly. CRE-luciferase assay revealed higher basal CRE-dependent gene expression in young HDFs compared to senescent HDFs. However, LPA-dependent slope of luciferase increased more rapidly in senescent cells than in young cells, presumably due to an increase of LPA-induced CREB phosphorylation. CRE-dependent luciferase activation was abrogated in the presence of inhibitors of PKC, MEK1, p38MAPK, and PKA, in both young and senescent HDFs. We conclude that these kinase are coactivators of the expression of CRE-responsive genes in LPA-induced HDFs and that their changed activities during the aging process contribute to the final expression level of CRE-responsive genes.
Time Factors ; Protein Kinase Inhibitors/pharmacology ; Phosphorylation ; Male ; Lysophospholipids/*pharmacology ; Luciferases/genetics/metabolism ; Humans ; Gene Expression/drug effects ; Fibroblasts/cytology/*drug effects/metabolism ; Diploidy ; Cyclic AMP-Dependent Protein Kinases/genetics/metabolism ; Cyclic AMP Response Element-Binding Protein/metabolism ; Cyclic AMP/*metabolism ; Cells, Cultured ; Cell Aging/physiology ; Catalytic Domain/genetics

BACKGROUND/AIMS: Electrohydraulic lithotrypsy(EHL) under cholangioscopic control has been performed for difficult bile duct stones. The percutaneous transhepatic approach is technically easy and useful in diagnosis and treatment of bile duct obstruction and stones. Biliary stenting with self expanding metal stent is gaining increasingly wider acceptance as a palliative treatment of bile duct obstruction. METHODS: Between Sep. 1994 and Sep. 1996, EHL under choledochoscopy by percutaneous transhepatic approach was performed in 30 cases(Male: 13, Female: 17). After PTBD with 7F pig tail catheter, the percutaneous transhepatic passage was dilated over guide wire with dilaters of increasing size up to 16Fr in 3-Sdays. In one week, after fistula had been estabilished, choledochoscopy was performed. RESULTS: (1) Mean age was 61.3 years. Mean stone number was 2.5. And mean stone size was 1.6 X 2.3 cm. (2) Com.plete removal of the stone was achieved in all patients(100%). (3) There were no serious complications. (4) In six cases, Endocoils were implanted with successful decompression of obstructions and simultaneous removal of biliary stones located at both side of stricutre. CONCLUSIONS: Percutaneous transhepatic choledochoscopy is easy and safe and assists in the diagnosis and treatment of biliary stricture and the management of difficult CBD stone.
Bile Ducts ; Catheters ; Cholestasis ; Common Bile Duct* ; Constriction, Pathologic ; Decompression ; Diagnosis ; Female ; Fistula ; Humans ; Palliative Care ; Stents

BACKGROUND/AIMS: Dyslipidemia is one of the major causes of cardiovascular disease in end-stage renal disease (ESRD) patients. Most of them are dyslipidemic despite the use of lipid-lowering agents. Ezetimibe is a novel chemical entity that inhibits the intestinal absorption of dietary and biliary cholesterol. This study evaluated the effects of ezetimibe on the lipid profile, inflammation markers, endothelial injury, and thrombogenesis in ESRD patients. METHODS: Sixty-five patients with serum low-density lipoprotein (LDL)-cholesterol levels > or =100 mg/d were recruited: 33 patients were on hemodialysis and 32 patients were on peritoneal dialysis. They were assigned randomly to the ezetimibe (10 mg) monotherapy group and the ezetimibe (10 mg) plus simvastatin (10 mg) combination therapy group. Both drugs were administered for 8 weeks. RESULTS: There were no significant differences in the baseline demographic and laboratory characteristics between the two groups. In the monotherapy group, the total and LDL-cholesterol levels were reduced by 14.7 and 21.9%, respectively. There were no changes in the high-density lipoprotein (HDL)-cholesterol or triglyceride levels. Fibrinogen increased significantly (p=0.04). In the combination therapy group, the total and LDL-cholesterol levels were reduced by 29.8 and 42.4%, respectively. There was an additional 15.1% reduction in total cholesterol and an additional 20.5% reduction in LDL cholesterol compared with monotherapy. Several patients complained of minor adverse effects and only one patient in the ezetimibe monotherapy group discontinued medication, because of diarrhea. CONCLUSIONS: In ESRD patients, ezetimibe used as combination therapy with a statin is more effective than ezetimibe monotherapy in ESRD patients.
Azetidines ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, LDL ; Dyslipidemias ; Fibrinogen ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Inflammation ; Intestinal Absorption ; Kidney Failure, Chronic ; Lipoproteins ; Peritoneal Dialysis ; Renal Dialysis ; Simvastatin ; Ezetimibe

Canine atopic dermatitis (CAD) is an allergic skin disease with characteristic clinical features associated with immunoglobulin E (IgE) antibodies. Identification of the causative allergens is the diagnostic goal, which is essential to treat and manage CAD patients. CAD is commonly associated with environmental allergens surrounding the patients. For this reason, it is important for diagnostic tests to select allergens that are related to the environment of each country and each province. There are two main allergen-specific tests, serological IgE test (SAT) and intradermal skin test (IDT). SAT did not show direct cutaneous reaction but did show serological reaction against allergens. However, SAT is simpler and more convenient than IDT in small animal practice. In this study, we selected domestically prevalent allergens for SAT, including 60 food allergens and 60 inhalant allergens, and tested eight dogs tentatively diagnosed with CAD based on Favrot's criteria. Furthermore, IDT was performed on four dogs from the SAT group for comparison of SAT and IDT, and the results were very similar. In SAT, four types of mites (Bloomia tropicalis, Glycophagus domesticus, Euroglyphus maynei, and mite mixture 1 Korea; house dust mites), four types of molds (Botrytis cinerea, Alternaria alternata, mold fungi mixture 11, mold fungi mixture), and one type of pollen (tree pollen mix 3 Korea) induced a reaction in more than half of dogs tested. In IDT, all four dogs reacted positively to Dermatophagoides farinae, and three reacted positively to Dermatophagoides pteronyssinus and house dust. The mean agreement rate between SAT and IDT in this study was 76.3%. This is the first trial to apply local allergens for SAT in Korean veterinary medicine, and it might play an important role for diagnoses and management of animal allergic diseases.
Allergens ; Alternaria ; Animals ; Antibodies ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Diagnosis ; Diagnostic Tests, Routine ; Dogs ; Dust ; Fungi ; Humans ; Immunoglobulin E* ; Immunoglobulins* ; Korea ; Mites ; Pollen ; Prevalence* ; Pyroglyphidae ; Serologic Tests ; Skin Diseases ; Skin Tests ; Veterinary Medicine

In addition to its well-known glycolytic activity, GAPDH displays multiple functions, such as nuclear RNA export, DNA replication and repair, and apoptotic cell death. This functional diversity depends on its intracellular localization. In this study, we explored the signal transduction pathways involved in the nuclear translocation of GAPDH using confocal laser scanning microscopy of immunostained human diploid fibroblasts (HDFs). GAPDH was present mainly in the cytoplasm when cultured with 10% FBS. Serum depletion by culturing cells in a serum-free medium (SFM) led to a gradual accumulation of GAPDH in the nucleus, and this nuclear accumulation was reversed by the re-addition of serum or growth factors, such as PDGF and lysophosphatidic acid. The nuclear export induced by the re-addition of serum or growth factors was prevented by LY 294002 and SH-5, inhibitors of phosphoinositide 3-kinase (PI3K) and Akt/protein kinase B, respectively, suggesting an involvement of the PI3K signaling pathway in the nuclear export of GAPDH. In addition, 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside (AICAR), an activator of AMP-activated protein kinase (AMPK), stimulated the nuclear translocation of GAPDH and prevented serum- and growth factor-induced GAPDH export. AMPK inhibition by compound C or AMPK depletion by siRNA treatment partially prevented SFM- and AICAR-induced nuclear translocation of GAPDH. Our data suggest that the nuclear translocation of GAPDH might be regulated by the PI3K signaling pathway acting mainly as a nuclear export signal and the AMPK signaling pathway acting as a nuclear import signal.