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: Asthma is a complex disease that is characterized by airway hyperresponsiveness (AHR), reversible airway obstruction, and inflammation, marked mainly by eosinophilic infiltration. The bulk of the evidence identifies alphaCD4(+) TH2 cells as having a pivotal role in mediating the inflammation that is central to asthma but The role of CD8(+) T cells in the development of allergic airway disease is still controversial. The purpose of this study was to investigate the role of CD8(+) T cells in the development of AHR and airway inflammation in mouse model of chronic asthma. METHODS: Mice were sensitized to OVA by i.p. injection on day 1, 14 and then challenged by OVA intranasal instillation on days 27, 28, 29 47, 61, 73, 74 and then 75 days. Anti-CD8 antibody was administered to sensitized mice by i.v. injection 2h before second sensitization, day 27 and 73. In vivo airway responsiveness was measured by whole body plethysmography (Penh) to inhaled methacholine (MCh) on day 77. Lung eosinophilia, bronchoalveolar lavage fluid (BALF) cytokine levels were also assessed. RESULTS: Sensitized and challenged mice showed significant airway eosinophilia and heightened AHR to methacholine when compared with non-sensitized animals. Administration of anti-CD8 antibody prevented both development of AHR as well as BALF eosinophilia. Treatment with anti-CD8 antibody also resulted in supression of IL-5 production in BALF. CONCLUSION: These results indicate that CD8 (+) T cell may have a potential role in the development of chronic allergic airway inflammation and development of allergen-induced airway responses in mouse model.
Airway Obstruction ; Animals ; Asthma ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Eosinophils ; Inflammation ; Interleukin-5 ; Lung ; Methacholine Chloride ; Mice ; Negotiating ; Ovum ; Plethysmography, Whole Body ; T-Lymphocytes ; Th2 Cells

PURPOSE: The insulin-like growth factor-I receptor (IGF-IR) is a member of the transmembrane tyrosine kinase family that regulates various biological processes. These processes include maintaining optimal cell growth, establishing and maintaining the transformed phenotype, tumorigenesis for several types of cells, and antiapoptosis. This study investigated the immunohistochemical expression of IGF-IR in relation with the expression of the estrogen receptor (ER), the progesteron receptor (PR), proliferative activity (Ki-67) as well as with the other conventional clinicopathlogical parameters in breast cancer. METHODS: This study was performed on paraffin sections from 64 invasive ductal breast carcinoma specimens by immunohistochemistry using rabbit polyclonal antibodies to the IGF-I receptor. RESULTS: IGF-IR expression was detected in 56 (87.5%) cases. The immunohistochemical stains for the IGF-IR were scored according to a semi quantitative scoring system. IGF-IR staining was positively correlated with the ER status, but not significantly with the PR, lymph node status, tumor size, histological grade, and proliferative activity. The Ki-67 labeling index showed a significant correlation with the tumor grade and ER status. CONCLUSION: The IGF-IR may play a role in estrogen-mediated growth and the pathogenesis of breast cancer.
Antibodies ; Biological Processes ; Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Coloring Agents ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Paraffin ; Phenotype ; Protein-Tyrosine Kinases ; Receptor, IGF Type 1