No abstract available.
Animals ; Colon* ; Colonic Neoplasms* ; Oncogenes* ; Point Mutation* ; Rats*

BACKGROUND: Liver ischemia and reperfusion injury is associated with activation of several inflammatory pathways including cytokines, tumor necrosis factor (TNF) and cell-mediated tissue damage. tacrolimus causes a regulatory effect on some inflammatory pathways, such as cytokines, TNF, adhesion molecule and inflammatory cells. Prostaglandin E1 (PGE1) has shown vasodilatation by relaxing vascular smooth muscles and inhibits the effect of proinflammatory cytokines which could reduce leukocyte- sinusoidal and platelet-sinusoidal interactions. METHODS: Liver ischemia was induced in rats by occluding the vessels, the supplying median segment, and the left lateral segment with an aneurysmal clip for 60 minutes. The rats received tacrolimus (0.5 mg/kg, tacrolimus group) or PGE1 (100 ug/kg, PGE1 group) or normal saline (Control group) 30 and 5 minutes before ischemia and reperfusion of the liver, respectively. The serum ALT, nitric oxide, and TNF were determined at 1, 24, and 48 hours after reperfusion, and hepatic necrosis was determined at the same times by using HE staining and a microscopic grading system. RESULTS: 1) In the control group, the serum ALT and TNF levels had peak values at 1 hour and were gradually decreased, but the serum nitric-oxide level was gradually increased after the time of reperfusion (p<0.05). No necrosis existed at in one hour, but the tissue necrosis at 24 hours was higher than that at 48 hours (p<0.05). 2) At one hour, the tacrolimus group had significantly lower serum ALT and TNF levels and a higher serum nitric-oxide level in the liver compared with the control group, but the serum nitric-oxide level did not change significantly after reperfusion (p<0.05). The extent of hepatic necrosis was significantly inhibited in the tacrolimus group when compared with that in the control group and the PGE1 group (p<0.05). 3) The PGE1 group exhibited improved hepatic necrosis compared with the control group (p<0.05). The improved hepatic necrosis was reflected in reductions of the serum ALT and TNF and an increase in the serum nitric-oxide level. CONCLUSIONS: These result suggest that tacrolimus and PGE1 protect the liver against ischemia- reperfusion injury by reducing the serum TNF level and increasing the serum nitric-oxide level. The protective effect of tacrolimus is more beneficial than that of PGE1.
Alprostadil* ; Aneurysm ; Animals ; Cytokines ; Ischemia ; Liver* ; Muscle, Smooth, Vascular ; Necrosis ; Nitric Oxide ; Rats* ; Reperfusion ; Reperfusion Injury* ; Tacrolimus* ; Tumor Necrosis Factor-alpha ; Vasodilation

Many investigations about the development and progression of atherosclerosis have reported that hypertension, diabetes mellitus, serum lipids levels and somking status are major risk factors to the atherogenesis of peripheral arteries in Western countries. But the intensities of these epidemiological factors on atherogenesis are not supposed to be equal in oriental population owing to the different pattern of food intake or genetic factors. The aim of this study was to determine how the level of serum lipids and smoking status among the risk factors would be related with the presence of the atherosclerotic occlusive disease of lower extremity. 89 male patients with this disease were included in this study and same numbers of male surgical patients without peripheral arterial occlusive symptoms was used as control group. The levels of serum lipids (total-cholesterol and trglyceride) and smoking status were investigated retrospectively. The results were as follows. 1) serum total-cholesterol levels were higher in disease group than that of the control group (163.3+/-4.63 S.E. vs. 153.3+/-6.10 S.E.), but there was no statistical significance(P>0.05). 2) serum triglyceride levels were significantly higher in disease group than that of control group (148.5+/-11.0 S.E vs. 109.9 +/-.59 S.E., P<0.05 ANOVA). 3) the rate of smoking in disease group was 85.4% (76/89) which was significantly higher than that of the control group, 37.1% (33/89) (P<0.05, Chi-square test). These findings suggested that in our disease population studied, smoking has more strong impact on the development of atherosclerosis of lower extremity than serum total-cholesterol level.
Arterial Occlusive Diseases ; Arteries ; Atherosclerosis ; Cholesterol ; Diabetes Mellitus ; Eating ; Humans ; Hypertension ; Lower Extremity ; Male ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Triglycerides

This study was conducted to investigate the repeat test rate for diagnosis at a tertiary hospital for the outpatients who were referred themselves to the hospital by the clinics and other medical facilities. The study population consisted of 498 patients who visited outpatient department of internal medicine, general surgery, orthopedic surgery and neurosurgery in the hospital between March 16 and April 11, 1992. This study was surveyed by the questionnaire about the tests for diagnosis at first level medical facilities, and then, was investigated by the medical record about the tests for diagnosis at a tertiary hospital. The proportion of test among the patients who utilized the first level medical facilities was 20.9% for the X-ray test, 10.6% for the urinalysis, 9.0% for the electrocardiogram, 3.4% for the computer tomogram and 6.4% for the ultrasonogram. At the tertiary hospital, the X-ray test was 45.2%, the liver function test was 24.7%, the urinalysis was 19.1%, and the electrocardiogram was 15.7%. The proportion of patients who possessed results of test for diagnosis at the first level medical facilities was 76.5% for the computer tomogram, and 31.3% for the ultrasonogram. As the repeat test rate between the first level medical facilities and the tertiary hospital, the thyroid function test was the first rank as 71.4%, the second rank was the routine CBC as 67.9%, and the third rank was the X-ray test as 64.4%. But among the patients that brought the result for tests at the first level medical facilities, the repeat test rate was as follow ; the routine CBC was 75.0%, the liver function test was 72.7%, and the computer tomogram was 15.4%.
Daegu* ; Diagnosis* ; Electrocardiography ; Humans ; Internal Medicine ; Liver Function Tests ; Medical Records ; Neurosurgery ; Orthopedics ; Outpatients ; Surveys and Questionnaires ; Tertiary Care Centers* ; Thyroid Function Tests ; Ultrasonography ; Urinalysis

The Measurement of CSF glucose and CSF glucose-to-blood glucose ratio is a very useful laboratory test for the differential diagnosis of meningitis. We have observed the change of blood glucose & CSF glucose-to-blood glucose ratio according to the time of blood sampling in 84 patients with aseptic meningitis who had been admitted to the department of pediatrics, Dong Kang hospital from May 1993 to June 1993. The results obtained were as follows: 1) The blood glucose level examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 98.29+/-16.20mg/dl and 106.49+/-19.47mg/dl, respectively. 2) The blood glucose level examined with blood sample drawn just before lumbar puncture and one 30 min. after lumbar puncture was 96.47+/-21.52mg/dl and 117.00+/-22.12mg/dl, respectively. 3) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 67.70+/-12.40% and 62.83+/-12.62%, respectively. 4) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 70.10+/-21.77% and 56.35+/-13.75%, reskpectively. We concluded that a simultaneous blood glucose level should be taken just before lumbar puncture.
Blood Glucose ; Diagnosis, Differential ; Glucose* ; Humans ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Spinal Puncture

Renal artery aneurysm is a rare disease and a uniommon cause of renovascular hypertension. The estimated incidence of renal artery aneurysm in the normal population varies from 0.09% to 0.3%. Eight renal artery aneurysms that we experienced between February 1986 and January 1998 were reviewed. All were saccular including one iatrogenic pseudoaneurysm after balloon angioplasty for fibromuscular renal artery stenosis. The ages ranged from 20 through 66 years with the mean age of 42 years and there was no difference in sex distribution. Of the 8 patients, 6 were diagnosed on the basis of arteriography, 1 on the basis of computed tomography, and 1 at a urologic surgery. There was no aneurysm ruptured spontaneously. The aneurysm size ranged from 1.5 cm through 12.5 cm with the mean size of 4.1 cm, but 7 aneurysms were not greater than 5 cm in size. In 4 patients (50%) the aneurysm were calcified. Only four had symptoms such as pain or discomfort on trunk. 2 patients had associated renovascular hypertension. 5 patients (63%) underwent operation i.e. 3 arterial reconstruction and 2 nephrectomy that was inevitable due to complicated location or surrounding adhesion enough to unappreciable of vascular reconstruction. One associated hypertension was cured with operation, another renovascular hypertention was not resolved by operation. There was no operative mortality. This study reveals that the saccular type is predominant and spontaneous rupture is uncommon feature in renal artery aneurysm.
Aneurysm ; Aneurysm, False ; Angiography ; Angioplasty, Balloon ; Humans ; Hypertension ; Hypertension, Renovascular ; Incidence ; Mortality ; Nephrectomy ; Rare Diseases ; Renal Artery Obstruction ; Renal Artery ; Rupture, Spontaneous ; Sex Distribution

Iliac vein compression syndrome is a rare clinical condition in which left common iliac vein is anatomically compressed between right common iliac artery and the fifth lumbar vertebrae or pelvic brim. Patients usually have marked edema of the left leg. Although the actual incidence is unknown, this syndrome most affects women in the second to fourth decade of life. We report 4 cases of iliac compression syndrome treated by surgical intervention during the last fifteen-year period. Among them, two women have suffered from chronic intermittent swelling and pain of left leg, and two men had acute or subacute symptoms. The fibrous web in the entrance of left iliac vein into vena cava existed in one case. Including this one, two were treated by transposition of iliac artery or vein with thrombectomy. One was decompressed the arterial compression by mobilization or adhesiolysis of the surrounding vessles with thrombectomy. To the last one in which the distal common iliac vein was compressed by tortous dilated left internal iliac artery, transsection and ligation of the internal iliac artery was performed. All patients have experienced improved left leg condition after operation. except the last one in which suffered from thrombosis of left popliteal vein after the iliac decompression.
Decompression ; Edema ; Female ; Humans ; Iliac Artery ; Iliac Vein ; Incidence ; Leg ; Ligation ; Lumbar Vertebrae ; Male ; May-Thurner Syndrome ; Popliteal Vein ; Thrombectomy ; Thrombosis ; Veins

OBJECTIVES: Generally, it seemed that the therapeutic result in diabetic patients was changed by compliance. This study was conducted on the basis of assumption that the therapeutic result in diabetic patients could control according to compliance. This study was conducted to analyze the related factors in association with compliance to drug, diet and exercise therapy. METHODS: 224 diabetic patients in Kyungpook National University Hospital were selected through the interviews and HbA1c values from 1 Jan. to 28 Feb. 1997. The drug compliance was tested by regularity of drug administration, the diet compliance was tested by restriction of food, exactly allocation, balance of nutrient, measuring food and the exercise compliance was tested by regularity of exercise per day. We assessed compliance by percentage, X2-test and generalized logit regression model(method:enter). RESULTS: The significant variable was the satisfaction to medical personnels in drug, the knowledge to disease in diet, the participation of the diabetic education in exercise therapy and the satisfaction to medical personnels in HbA1c. Using the generalized logit model(method : enter) in compliance change, the significant variables were the satisfaction to medical personnels and the complication in drug; the significant variables were the age at the first diagnosis, the family history, the concern of health, the knowledge of disease, the self-exertion for therapy and the complication in diet; the only significant variable was the gender in exercise therapy. CONCLUSIONS: The degree of glycemic control in diabetic patients was influenced by compliance. In order to improve patient's compliance, we must foster the knowledge on the diseases, lead participation for diabetic education. Because the satisfaction to medical personnels was the important variables, we must build up good relationship between doctors and patients.
Compliance* ; Diabetes Mellitus ; Diagnosis ; Diet ; Education ; Exercise Therapy ; Gyeongsangbuk-do ; Humans

PURPOSE: There are some controversial opinions on the prognostic value of metastasis- associated tumor markers in breast cancer. Out of them, the overexpression of c-erbB-2 proto-oncogene or CD44 gene has been debated on their activities in promoting metastatic potential. MATERIALS AND METHODS: To detennine the relationship between expression of these genes, and, clinicopathological parameters and disease outcomes including relapse and survival, 48 archival paraffin-embeded breast-cancer tissues were stained using monoclonal antibody against each gene product by immunohistochemical staining method, and the result was analyzed. RESULTS: The positive expression rates of c-erbB-2 and CD44 genes were 45.8% and 18.8%, respectively. The expression rates of both genes were 14.6% and 50% of cases showed no expression of either gene. Except the statistically significant positive correlation between CD44 and tumor size (P=0.003), the expression of c-erbB-2 or CD44 expression had no significant relationship with tumor size, stage, lymph node status, and disease recurrence (P>0.05). In the positive expression cases for CD44, disesase-free survival (DFS) and overall survival (OS) in months were shorter than the negative ones (53+/- 8 vs. 64+/-5 and 67+/-8 vs. 77+/-5 S.E.). And, the c-erbB-2 positive cases had longer OS than the negative ones (78+/- 6 vs. 71+/- 6). The OS of positive co-expression cases with the c-erbB-2 and CD44 was shorter than that of one-gene expression ones (66+/- 6 vs. 75+/-7). Thus the OS result observed in the expression of c-erbB-2 alone was reversed in the co-expression study. Though these results had no statistically significant level (P> 0.05). CONCLUSION: We suggest a question if there is any interaction or dependency between c-erbB-2 and CD44 expression in view of disease process including OS. Finally, further randomised controlled studies are advisable for the reproducible and significant results.
Breast Neoplasms* ; Breast* ; Genes, erbB-2 ; Lymph Nodes ; Recurrence ; Biomarkers, Tumor

Superior mesenteric artery syndrome (SMAS) is a rare disease and is seldom seen in patients with abdominal aortic aneurysms. We experienced a SMAS as a result of an enlarged abdominal aortic aneurysm in a 52 year-old female patient who had undergone renal transplant in the right iliac position 8 years previously. The abdominal aortic aneurysm was successfully resected without an extracorporeal bypass during crossclamping, and postoperatively the patient's symptoms were improved and her renal function was well preserved.
Aortic Aneurysm, Abdominal* ; Female ; Humans ; Kidney Transplantation ; Mesenteric Artery, Superior* ; Middle Aged ; Rare Diseases ; Superior Mesenteric Artery Syndrome* ; Transplantation*