The antiarrhythmic effect of oral amiodarone was evaluated by 24-hr Holter monitoring in 12 patients with frequent and/or complex ventricular ectopy. Amiodarone was administered as following schedule; 600mg a day for the 1st week, 400mg a day for the 2nd week and 200mg a day, 5 days a week from the 3rd week. In 9 patients, the frequency of VPC decreased significantly or the grade of VPC changed to the more benign grade, so we considered them as "Effective Group" (75%). In 7 patients, both the frequency and the grade of VPC improved, so we considered them as "Excellent Group" (58%). No significant side effect was observed during investigation. We concluded that amiodarone is very effective antiarrhythmic drug and has no serious side effect during a short-term observation.
Amiodarone* ; Appointments and Schedules ; Arrhythmias, Cardiac* ; Electrocardiography, Ambulatory ; Humans

We report a rare case of adreno-hepatic fusion in a 63-year-old man with a traumatic hepatic rupture. The adrenal tissue was located beneath the Glisson's capsule of the liver, and measured 3.5x2x0.3 cm. On histologic examination, the ectopic tissue was composed of both adrenal cortex and medulla surrounded by a delicate capsule of connective tissue.
Adrenal Cortex ; Choristoma ; Connective Tissue ; Humans ; Liver ; Middle Aged ; Rupture

In the present study, immunohistochemical detection of p53 oncoprotein was performed to determine whether the grade of differentiation and the histologic type of gastric adenocarcinoma, and the degree of atypia accompanied with adenoma can be related to p53 mutation. Paraffin sections of 22 gastric adenomas and 56 gastric adenocarcinomas were examined for the overexpression of p53 oncoprotein with the avidin-biotin peroxidase complex staining procedure. The obtained results were as follows; 1. All the 22 cases of adenomas and 16 cases of well differentated adenocarcinomas showed uniformly negative staining. 2.Seven of 18 cases of moderately differentiated adenocarcinomas(39%), and five of 30 cases of poorly differentiated adenocarcinomas(17%) exhibited p53 protein expression. 3. Three of 29 cases of diffuse type (10%) and 9 of 19 cases of intestinal type(47%) exhibited p53 protein expression. These results suggest that p53 mutation is important in carcinogenesis of the intestinal type of gastric adenocarcinoma, and there is no correlation between the differentiation of gastric adenocarcinoma and the degree of p53 oncoprotein overexpression.
Adenocarcinoma ; Adenoma

No abstract available.
Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma*

To assess the prognostic value of the 14 ECG variables obtained from the pre-discharge ECG, 35 patients were followed up for at least one year among the 80 patients of the acute myocardial infarction admitted at Seoul Paik Hospital from Sep. 1983 to Aug. 1986. The following results were obtained. 1) The overall in-hospital mortality rate was 20% and the mortality rate tended to decline year by year. 2) The one-year mortality and morbidity rate of the followed patients was 31.4%. 3) Among the 14 variables obtained from the pre-discharge ECG, T-negativity was the only statistically significant (p<0.05) one to predict the one-year prognosis in the patients after the first myocardial infarction, and we could not derive any meaningful datd from the analysis of the combined effects of the three ECG variables (PTF, ST depression and ST elevation).
Depression ; Electrocardiography* ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Prognosis ; Seoul

BACKGROUND: Propofol is useful agents for anesthesia induction and maintenance, but pain on injection and possible hypotension are a commonly encountered problems during induction. Meanwhile, ketamine has potent analgesic and sympathomimetic effect. Therefore, we evaluated the effect of ketamine pretreatment on injection pain and hemodynamic changes during induction with propofol. METHODS: Premedicated one hundred and twenty ASA physical status I or II patients scheduled for elective surgery were randomly allocated into one of four groups (group 1; propofol only, group 2, 3, 4; pretreatment with 25%, 50%, 75% dose of hypnotic ED50 of ketamine, respectively) groups. Intensity and frequency of injection pain, mean arterial pressure and pulse rate were checked for evaluation of ketamine pretreatment on injection pain and hemodynamic changes during induction with propofol. RESULTS: Incidence of pain on injection was significantly reduced in group 2,3 and 4 compared with group 1. Group 2 and 3 showed more stable hemodynamic changes than Group 1 and 4. CONCLUSIONS: 25-50% of hypnotic ED50 of ketamine (0.17-0.33 mg/kg) pretreatment reduced pain on injection and hemodynamic changes during propofol induction significantly.
Anesthesia* ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Ketamine* ; Propofol* ; Sympathomimetics

BACKGROUND: Both propofol and ketamine are useful hypnotics for induction of anesthesia, and the combination of propofol and ketamine has been used for total intravenous anesthesia. The aim of this study was to evaluate the dose response of propofol, ketamine and combination of these drug, and determine possible interaction between two drugs in patients. METHODS: The effect of ketamine on the dose response curve for propofol was studied in unpremedicated 165 ASA physical status I or II patients who were scheduled for elective operation. As an endpoint of hypnosis, ability to open eyes on verbal command was checked. Dose response curves for propofol and ketamine were determined with a probit procedure and their type of pharmacologic interaction was determined by fractional and isobolographic analysis. RESULTS: At the hypnotic endpoint, the ED50s were 1.13 mg/kg propofol, 0.66 mg/kg ketamine, and the ED95s were 1.67 mg/kg propofol, 1.09 mg/kg ketamine. The type of interaction between two drugs for hypnosis was found to be additive and ketamine was 1.7 times potent than propofol as an equieffective dose of hypnosis. CONCLUSIONS: The type of interaction between propofol and ketamine for hypnosis was additive.
Anesthesia* ; Anesthesia, Intravenous ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Ketamine* ; Propofol*

The anesthetic management of patients with pheochromocytoma presents many difficult problems, such as hypertension, cardiac arrhythmias, and hypotension. A 21 year-old male underwent resection of pheochromocytoma under general anesthesia with isoflurane and fentanyl. Hypertensive crisis during induction of anesthesia and surgical manipulation of the tumor were managed with phentolamine and sodium nitroprusside drips. Anesthesia was maintained wtih nitrous oxide : oxygen, 50% : 50%, isoflurane, 0.5-2% and supplemented with fractional doses of fentanyl and vecuronium for muscular relaxation. We also used propranolol for the cardiac arrhythmia. An endotracheal semi-closed circle absorption technique with controlled ventilation was employed. Fentanyl does not release histamine, and has stable hemodynamics. Isoflurane has also advocated on the grounds that arrhythmias are less esaily provocated by circulating catecholamines than with other volatile agents, and has been shown to be a satisfactory agent. Vecuronium does not provoke catecholamine release, does not release histamine, has no autonomic effects at clinical plasma concentrations, and is clearly the neuromuscular blocking agent of choice in this case. Optimal pre-operative preparation, smooth induction of anesthesia, adequate alveolar ventilation, proper cardiovascular control, and good communication between surgeon and anesthesiologist are most important for the anesthetic management of pheochromocytoma.
Absorption ; Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Autonomic Agents ; Catecholamines ; Fentanyl ; Hemodynamics ; Histamine ; Humans ; Hypertension ; Hypotension ; Isoflurane ; Male ; Neuromuscular Blockade ; Nitroprusside ; Nitrous Oxide ; Oxygen ; Phentolamine ; Pheochromocytoma* ; Plasma ; Propranolol ; Relaxation ; Vecuronium Bromide ; Ventilation ; Young Adult

PURPOSE: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. METHODS: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. RESULTS: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6+/-2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18+/-2.10 vs 4.79+/-1.49 days, P=.17) and total fever duration (5.32+/-2.07 vs 6.41+/-3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. CONCLUSION: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
Bacterial Infections ; Bronchiolitis ; Bronchitis ; Child* ; Croup ; Fever ; Hospitalization ; Hospitals, University* ; Humans ; Influenza B virus* ; Influenza, Human ; Inpatients ; Medical Records ; Oseltamivir* ; Outpatients ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Thorax

PURPOSE: Recently many studies show early exposure during childhood growth to endotoxin (lipopolysaccharides, LPS) and/or early exposure to allergens exhibit important role in development of allergy including bronchial asthma. The aim of this study was to evaluate the role of endotoxin and allergen exposure in early life via the airways in the pathogenesis of allergic airways inflammation and airway hyperresposiveness (AHR) in mouse model of asthma. METHODS: Less than one week-old Balb/c mice was used. Groups of mice were received either a single intranasal instillation of sterile physiologic saline, 1% ovalbumin (OVA), LPS or 1.0 microgram LPS in 1% OVA. On 35th day, these animals were sensitized with 1% OVA for 10 consecutive days via the airways. Animals were challenged with ovalbumin for 3 days on 55th days, and airway inflammation, hyperresponsiveness, and cytokine expression were assessed. Measurements of airway function were obtained in unrestrained animals, using whole-body plethysmography. Airway responsiveness was expressed in terms of % enhanced pause (Penh) increase from baseline to aerosolized methacholine. Lung eosinophilia, serum OVA-IgE and bronchoalveolar lavage (BAL) fluid cytokine levels were also assessed. ANOVA was used to determine the levels of difference between all groups. Comparisons for all pairs were performed by Tukey-Kramer honest significant difference test; P values for significance were set to 0.05. RESULTS: Sensitized and challenged mice with OVA showed significant airway eosinophilia and heightened responsiveness to methacholine. Early life exposure of OVA and/or LPS via the airway prevented both development of AHR as well as bronchoalveolar lavage fluid eosinophilia. Exposure with OVA or LPS also resulted in suppression of interleukin (IL)-4, 5 production in BAL fluid and OVA specific IgE in blood. CONCLUSION: These results indicate that antigen and/or LPS exposure in the early life results in inhibition of allergic responses to OVA in this mouse model of astham. Our data show that early life exposure with OVA and/or LPS may have a protective role in the development of allergic airway inflammation and development of allergen-induced airway responses in mouse model of asthma.
Allergens ; Animals ; Asthma ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Interleukins ; Lung ; Methacholine Chloride ; Mice ; Ovalbumin ; Ovum ; Plethysmography