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

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

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: 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

OBJECTIVES: Accurate assessment of the retained or recurrent bile duct stone is important in postcholecystectomy patients who have signs of cholangitis or other pancreatobiliary disease. This study was performed to evaluate the diagnostic and therapeutic reliability of endoscopic retrograde cholangiography in postcholecystectomy patients. METHODS: From October 1975 through August 1995, we reviewed 311 patients retrospectively who had undergone on cholecystectomy. Our study was based on assessment of their age, sex, symptoms and physical findings, comparison between sonographic and endoscopic retrograde cholangiographic findings, and stone removal rate using endoscopic sphincterotomy, basket, electro-hydraulic lithotripsy. RESULTS: The ratio of male to female was 1:1.67, and the mean age was 56+/-14.3 years. After cholecystectomy, they visited our clinic within 2 years in 25 patients(8.4%), beyond 2 years in 286 patients(91.6%). Most common symptoms and physical findings were epigastric pain or tenderness(63.6%). We detected bile duct stone using endoscopic retrograde cholangiography 219 patients. In case of the bile duct stone, we successfully removed it using endoscopic sphincterotomy, basket, electrohydraulic lithotripsy in 194 patients(88.6%). CONCLUSION: From the above results, we concluded that endoscopic retrograde cholangiography was the most effective diagnostic and therapeutic method in postch- olecystetomy patients who have signs of cholangitis.
Bile Ducts ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Female ; Humans ; Lithotripsy ; Male ; Retrospective Studies ; Sphincterotomy, Endoscopic ; Ultrasonography

BACKGROUND: Keratinocyte-derived interleukin-1(IL-1)alpha is one of the key cytokines in initiation of cutaneous inflammation. Release of IL-1alpha from human keratinocytes may be induced by proinflammatory stimuli including ultraviolet B(UVB) irradiation, and subsequently, keratinocyte-derived IL-1alpha may exert numerous paracrine and autocrine effects. 1,25-dihydroxyvitamin D3(1,25(OH)2D3) is involved in the regulation of keratinocyte proliferation and differentiation and is also recognized to have immunoregulatory properties such as an antiinflammatory effect. OBJECTIVE: The purpose of this study was to investigate the in vitro effects of 1,25-(OH)2D3 on the production of IL-1alpha by UVB irradiation in cultured human keratinocyte cell line HaCaT cells. RESULTS: are summerized as follows; 1. The vialility of cultured HaCaT cells measured by MTS assay at 24 hours after UVB irradiation was significantly reduced at the doses of above 100 mJ/cm2 of UVB(p<0.05). 2. The secretion of IL-1alpha by HaCaT cells was significantly increased at the doses of above 30 mJ/cm2 of UVB(p<0.05). UVB irradiation could not influence on the secretion of IL-1beta by HaCaT cells. 3. At the concentrations of 10-8M and 10-6M of 1,25(OH)2D3, the production of IL-1alpha by HaCaT cells(48 hours after 100 mJ/cm2 UVB irradiation) was significantly inhibited in both culture supernatants and cell lysates(p<0.05). CONCLUSION: UVB irradiation increased the production of IL-1alpha by HaCaT cells and this stimulatory effect on the production of IL-1alpha induced by UVB irradiation was suppressed by 1,25-(OH)2D3. Calcipotriol(MC-903) had similar suppressive effect on the production of IL-1alpha induced by UVB irradiation in HaCaT cells to that of 1,25(OH)2D3.
Calcitriol* ; Cell Line* ; Cytokines ; Humans* ; Inflammation ; Interleukin-1alpha* ; Keratinocytes*

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

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.

BACKGROUND/AIMS: Obstructive jaundice is developed from the cholangiocarcinoma, biiliary tract stone, biliary benign stricture and pancreatic head cancer and is rapidly progress to cholangitis or sepsis. So early decompression, accurate diagnosis and treatment are very important. Percutaneous transhepatic choledocoscopy (PTCS) and endoscopic retrograde choledocoscopy (ERCS) have been used for evaluation of the obstructive jaundice. We performed, through the PTCS, electrohydraulic lithotripsy (EHL) for biliary tract stone rernoval, biopsy for diagnosis of biliary stric and self expandible metalic coil stent (EndocoilTM stent, Instent Co.) insertion on biliary stricture to evaluate the usefullness of PTCS in patients with obstructive jaundice. METHODS: Between Auguest 1994 and September 1995, PTCS was performed in 37 patients with obstructive jaundice. First, percutaneous transhepatic biliary drainage (PTBD) with 7Fr. drainage tube was done. Three days later, we exchainged the 7Fr. drainage tube with 16Fr.. Seven days later, through the PTCS, we performed EHL, biopsy and EndocoilTM stent insertion.
Biliary Tract ; Biopsy ; Cholangiocarcinoma ; Cholangitis ; Constriction, Pathologic ; Decompression ; Diagnosis ; Drainage ; Head and Neck Neoplasms ; Humans ; Jaundice, Obstructive ; Lithotripsy ; Sepsis ; Stents