This study was performed to investigate the effect of kimchi intake on free radical and oxidative substance production in young adults and the elderly. Daily kimchi intake by people in their twenties (n = 93, 20 to 29 years old) and over sixty-five (n = 143, over 65 years old) in M city were surveyed and blood was drawn to analyze the free radicals in their plasma. The average amount of kimchi intake by the subjects was 115.8 +/- 91.7 g. The amount of kimchi intake of those in their twenties (106.1 +/- 80.6 g) was significantly lower than that of those over sixty-five (125.5 +/- 102.9 g, p<0.05). Concentrations of total free radicals and OH radicals were 27 and 33% greater respectively, in those over sixty-five than in those in their twenties, indicating that more free radicals were produced by the older group. The concentration of GSH was not signiacantly different in the two groups, but that of GSSG in the over sixty-five age group was 53% greater than in the twenties group, which resulted in a 35% reduction in GSH/GSSG in the elderly group. TBARS concentration in the over sixty-five group was 26% greater than that of the twenties group. In order to see the effect of kimchi intake on free radical production, subjects in same age group were divided into two sub groups-the mean over and the mean under groups-according to the average amount of kimchi intake, which was 115.8 g. The total free radicals, the OH radicals, the GSH, the GSSG, and the GSH/GSSG in the twenties group were not significantly different in the two kimchi intake groups. However, those in the over sixty-five group were significantly different. The concentration of total free radicals and OH radicals of the mean over group were 21 and 26% lower respectively, than those of the mean ova. group (p<0.05). The GSH and GSH/GSSG of the mean ova. groups were higher by 8 and 12%, respectively. The correlation coefficient between the kimchi intake and the total free radicals was -0.1862 (p<0.05) and that for GSH/GSSG was 0.1861 (p<0.05). In conclusion, the production of free radicals and oxidative substances increased with age, and kimchi seemed to retard this phenomena.
Aged* ; Free Radicals ; Glutathione ; Glutathione Disulfide ; Humans ; Ovum ; Plasma ; Thiobarbituric Acid Reactive Substances ; Young Adult*

Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

PURPOSE: It is well known that use of intranenous methylprednisolone(IVMP)for the patients with idiopathic thrombocytopenic purpura(ITP) is not only as effective as use of intravenous gammaglobulin to mincrease platelets quickly, but also the former is less expensive than the latter. As the adequate dosage of IVMP has not been fully elucidated, we have tried to determine it. METHODS: The subjects were 35 childhood patients below 15 years of age, who were diagnosed with ITP for the first time and whose platelet count was less than 20,000/mm(3) at diagnosis. We divided them into three groups : Group A included 8 cases with IVMP dosage of 5mg/kg/day, Group B included 9 patients with IVMP dosage of 10mg/kg/day, and group C included 18 patients with IVMP dosage of 20mg/kg/day. We checked the platelet count every day after IVMP administration daily for 5 days and also observed for side effects if any. RESULTS: After IVMP administration, we obseved increasing tendency of platelets in all three groups, of which group C was more rapid and higher in increasing platelets than the other groups(p<0.05). After IVMP therapy for 5 days, cases with platelets>20,000/mm(3) were 6(75%) in group A, 7(78%) in group B, and 18(100%) in group C. Cases with platelets >50,000/mm(3) were 5(63%), 6(67%), 17(94%) in groups A, B, C, respectively, and cases with platelets> 100,000/mm(3) were 3(38%), 5(56%), 14(78%), in group A, B, C, respectively. And there were no remarkable side effects except a case of transient hypertensive headache in group C. CONCLUSIONS: We concluded that the effectiveness of IVMP therapy for increasing platelets was more rapid and higher in group C than in group A or B, and side effect was minimal.
Child* ; Diagnosis ; Headache ; Humans ; Methylprednisolone* ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*

Many researchers and clinicians have been concerned about the potential impact of anesthetic agents on human immune system. There have been expanding evidences associating an- esthesia and surgery with down-regulation of immune functions. Immune alterations associated with anesthesia and surgery are manifested by lymphapenia and granulocytosis, decreased T cell and B cell counts, decreased delayed hypersensitivity responses, increased metastatic rates of tumors, depressed basal natural killer cell activity and enhanced antibody responses. All of the above effects have been described as short lived, returning to normal levels within 3 -7 days following surgery. But the clinical significance of suppressed immunity in the perioperative period is important, it has been suggested that such suppression contributes to postoperative dissemination of carcinoma and to postoperative infections. The present study was designed to examine the effects of general and epidural anesthesia on the lymphocyte subpopulations in patients undergoing hysterectomy. Halothane was used as a main anesthetic agent in general anesthesia group(10 patients) while bupivacaine was used in epidural anesthesia group(10 patients). Lymphocyte, granulocytes and T-lymphocyte subpopulations were counted before, during and after anesthesia. A significant reduction in peripheral total T-lymphocyte to total lymphocyte ratio(CD3+ percentage), Helper/Inducer T-lymphocyte to total T-lymphocyte ratio(CD4+ percentage), Suppressor/Cytotoxic T-lymphocyte to total T- lymphocyte ratio(CD8+ percentage) and Suppressor/Inducer T-1ymphocyte to total T-lympho- cyte ratio(CD4+ and CD45R+ percentage) was seen in patients under general anesthesia but minimal changes were found in the patients who had an epidural anesthesia. The results suggest that the immunosuppressive alterations in lymphocyte subsets induced by surgery and general anesthesia can be prevented to certain degree by epidural anesthesia.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General ; Anesthetics ; Antibody Formation ; Bupivacaine ; Cell Count ; Down-Regulation ; Granulocytes ; Halothane ; Humans ; Hypersensitivity, Delayed ; Hysterectomy ; Immune System ; Killer Cells, Natural ; Lymphocyte Subsets* ; Lymphocytes* ; Perioperative Period ; T-Lymphocytes

BACKGROUND: Left atrial thrombi(LAT) and spontaneous echo contrast(SEC) are known as major risk factors for thromboembolic complication in patients with mitral valvular heartdisease. Recent clinical introduction of transesophageal echocardiography(TEE) makes it possible to improve the diagnostic accuracy of these risk facors compared to conventional transthoracic echocardiography(TTE). The aims of the present study were to evaluate diagnostic accuracy of TEE for detection of LAT and to determine if clinical and echocardiographic variables can predict the presence of LAT and/or SEC at TEE. METHODS: From July 1991 to April 1993, both TTE and TEE were performed in 84 patients with mitral valvular heart disease before open heart surgery. The incidence and diagnostic accuracy of TTE and TEE for LAT detection were confirmed at surgery for mitral valve replacement in all cases. Biplane with 5.0 MHz transducer was used in TEE. The following clinical and transthoracic echocardiographic variables were analyzed:age, totoal or recent embolism, atrial fibrillation, left atrial dimension, ejection fraction, mitral valve area, and mitral regurgitation. RESULT: 1) THe sensitivity of TEE for detection of LAT was 100%, which was significantly higher than that of TTE(60.8%). There was no statistical difference in specificity of both techniques(98.3% vs 93.4%). In eleven patients (11/24,45.8%), LAT was confined to the left atrial appendage and TEE was far superior to TTE(sensitivity : 100% vs 27.2%) in detection of appendegeal thrombi. 2) SEC was found in 43 patients(51.2%). Patients with SEC had higher rates of LAT(p<0.001) and embolic episodes (p=0.001) than patients without SEC. There was no association between the severity of SEC and the embolic episodes. 3) Patients with SEC or LAT were characterized by more frequently associated with recent embolic episodes, smaller mitral valve orifice, abscence of mitral regurgitation than those without SEC and LAT. CONCLUSION: TEE is superior to TTE in detection of LAT and appendegeal thrombi. SEC is frequently noted in TEE and also strongly associated with left atrial blood stasis and left atrial thrombi in mitral valve disease.
Atrial Appendage ; Atrial Fibrillation ; Echocardiography ; Echocardiography, Transesophageal* ; Embolism ; Heart Valve Diseases* ; Humans ; Incidence ; Mitral Valve ; Mitral Valve Insufficiency ; Risk Factors ; Sensitivity and Specificity ; Thoracic Surgery ; Thrombosis* ; Transducers

BACKGROUND: Some types of ventricular tachycardia(VT), so called verapamil-sensitive ventricular tachycardia, occur in healthy young people without organic heart disease. The mechanism of the above VT is not established yet. The most possible mechanism is a triggered activity but reentry is also possible mechanism. We studied the possible mechanism and the eletrophysiologic properties of the verapamil-sensitive VT in 6 patients. METHODS: The patients included in this study were patients with documented ventricular tachycardia response to intravenous verapamil and complete RBBB morpholgy. As noninvasive tests, treadmill test, echocardiography and MUGA scan were performed and endomyocardial biopsy was perfomed in all patients in all patients and in patients with inducible VT, the electrophysiologic study was repeated on next day. The response to various antiarrhythmic agents was also studied. RESULTS: Total studied patients were 6(M : F=5 : 1, mean age=22). The noninvasive tests were normal in all patients and the VT was not induecd during treadmill test. The average cycle length of VT was 370msec and the 12-lead ECG during VT showed complete RBBB. The endomyocardial biopsy showed a mild focal infiltration of inflammatory cell in one patient and moderate small vessel vasculosclerosis in one patient. The clinical VT was induced in 5 patients by programmed electrical stimulation(PES). VT was induced in 5 by ventricular stimulation and in 1 by atrial stimulation. The induction and termination modes changed in 4 of 5 on next day. The cycle length dependency of PVC could be measured in 3 patients and the relationship was same direction in 2 patients and inverse direction in another patient. Intravenous procainamide was effective in 2 of 4 patients and IV adenosine was effective in 1 of 5 patients and IV propranolol was not effective in all 3 patients. CONCLUSION: The verapamil-sensitive ventricular tachycardia is a unique VT showing characteristics of both reentry and triggered activity but in one patient of our study, the most possible mechanism is triggered activity. A further cellular electrophysiologic study is needed for the genesis of verapamil-sensitive ventricular tachycardia.
Adenosine ; Biopsy ; Echocardiography ; Electrocardiography ; Exercise Test ; Heart Diseases ; Humans ; Procainamide ; Propranolol ; Tachycardia, Ventricular* ; Verapamil

The residual tense false lumen following surgical repair of aortic dissection remains one of the most difficult and challenging postsurgical problems. Percutaneous fenestration of the dissecting membrane under the guidance of intravascular ultrasound has been recently introduced to depressurize the tense false lumen. A 63-year-old woman who underwent repair of acute type I dissection was readmitted because of claudication and numbness of the left lower extremity. Angiography, computed tomography, and magnetic resonance imaging clearly showed a dissection flap starting from the thoracic aorta distal to the left subclavian artery. Compressed true lumen by the markedly enlarged tense false lumen was also noted in the double-channeled descending thoracoabdominal aorta. Under intravascular ultrasound guidance, the intimal flap was punctured with a Brockenbrough needle advanced to the true lumen through a femoral artery, and then, a balloon catheter was introduced over the guidewire which was placed across the dissection flap. Desired fenestration was obtained successfully by inflation of the balloon without complications. After procedure, symptoms resolved promptly and she is currently(clinical follow-up of 12 months postfenestration) ambulating without claudication. In conclusion, percutaneous fenestration of the intimal flap is a technically feasible and an effective alternative procedure to surgical repair for restoration of perfusion to an ischemic extremity in selected patients complicated with aortic dissection.
Angiography ; Aorta ; Aorta, Thoracic ; Catheters ; Extremities* ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Hypesthesia ; Inflation, Economic ; Ischemia* ; Lower Extremity ; Magnetic Resonance Imaging ; Membranes ; Middle Aged ; Needles ; Perfusion ; Subclavian Artery ; Transcutaneous Electric Nerve Stimulation ; Ultrasonography

OBJECTIVE: Amniocentesis is the most commonly used invasive method for prenatal diagnosis of genetic disorders. We performed this study to analyze the indications, distributions of maternal age and cytogenetic results of midtrimester amniocentesis. METHODS: We retrospectively analyzed 785 cases of midtrimester prenatal genetic amniocentesis which were performed in the cytogenetics laboratory using in situ coverslip culture at Dong-A University Hospital from January 1995 to March 2003. RESULTS: Amniocentesis was practiced mostly from 15 weeks to 20 weeks of gestational ages. Requested indications of amniocentesis were abnormal maternal serum screening (421, 53.7%), advanced maternal age (233, 29.7%) and abnormal ultrasonographic finding (61, 7.8%) in the order of decrease. The overall incidence of chromosome abnormalities was 5.1% (40 cases), and it contains 27 cases (3.4%) of numerical abnormalities and 13 cases (1.7%) of structural abnormalities. Among autosomal abnormalities Down syndrome was most common (13 cases) and followed by Edward syndrome (2 cases). Of the sex chromosomal abnormalities, three cases of Turner syndrome and three cases of Kleinefelter syndrome were found. Chromosomal abnormalities were most frequently noted in the maternal age of 30 to 34 years old (14 cases, 35.0%), 25 to 29 years old (12 cases, 30.0%), followed by 35 to 39 years old (7 cases, 17.5%). The frequency of pseudomosaicism were 5 cases (0.6%). CONCLUSION: Maternal serum screening, advanced maternal age and antenatal ultrasonographic finding must be important screening methods for amniocentesis which is considered to the most effective diagnostic procecdure for prenatal cytogenetic studies. I conclude that the karyotyping analysis of midtrimester amniocentesis is efficacious method for detection of chromosomal aberration and genetic counselling for parents.
Adult ; Amniocentesis* ; Chromosome Aberrations ; Cytogenetic Analysis* ; Cytogenetics* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Incidence ; Karyotyping ; Mass Screening ; Maternal Age ; Parents ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Retrospective Studies ; Turner Syndrome

Membranoproliferative glomerulonephritis type II(MPGN II), also called dense deposit disease, was first described by Berger and Galle in 1963. The diagnosis of MPGN II is based on electron-microscopic finding of an intensely electron-dense substance which replaces the lamina densa of the glomerular basement membrane. Although the etiology and pathogenesis of MPGN II are unknown, it frequently progresses to end-stage renal failure. Typically in MPGN II, hypocomplementemia due to activation of the alternative complement pathway is present. In addition, the association of MPGN II with partial lipodystrophy and complement abnormalities is well documented. The relationship between these associated features and the patient's renal functional outcome is not clear. With respect to the therapy for MPGN II, an alternate-day prednisolone regimen was shown to be effective. Various treatment modalities, including immunosuppression with corticosteroids, cytotoxic drugs and cyclosporin A, anticoagulants and antiplatelet therapies are used, either alone or in combination, with varying degrees of success. The purpose of this paper is to present a case of MPGN II from a 7 years old girl with paroxysmal supraventricular tachycardia(PSVT).
Adrenal Cortex Hormones ; Anticoagulants ; Child ; Complement Pathway, Alternative ; Complement System Proteins ; Cyclosporine ; Diagnosis ; Female ; Glomerular Basement Membrane ; Glomerulonephritis, Membranoproliferative* ; Humans ; Immunosuppression ; Kidney Failure, Chronic ; Lipodystrophy ; Prednisolone

Membranoproliferative glomerulonephritis type II(MPGN II), also called dense deposit disease, was first described by Berger and Galle in 1963. The diagnosis of MPGN II is based on electron-microscopic finding of an intensely electron-dense substance which replaces the lamina densa of the glomerular basement membrane. Although the etiology and pathogenesis of MPGN II are unknown, it frequently progresses to end-stage renal failure. Typically in MPGN II, hypocomplementemia due to activation of the alternative complement pathway is present. In addition, the association of MPGN II with partial lipodystrophy and complement abnormalities is well documented. The relationship between these associated features and the patient's renal functional outcome is not clear. With respect to the therapy for MPGN II, an alternate-day prednisolone regimen was shown to be effective. Various treatment modalities, including immunosuppression with corticosteroids, cytotoxic drugs and cyclosporin A, anticoagulants and antiplatelet therapies are used, either alone or in combination, with varying degrees of success. The purpose of this paper is to present a case of MPGN II from a 7 years old girl with paroxysmal supraventricular tachycardia(PSVT).
Adrenal Cortex Hormones ; Anticoagulants ; Child ; Complement Pathway, Alternative ; Complement System Proteins ; Cyclosporine ; Diagnosis ; Female ; Glomerular Basement Membrane ; Glomerulonephritis, Membranoproliferative* ; Humans ; Immunosuppression ; Kidney Failure, Chronic ; Lipodystrophy ; Prednisolone