Atrial myxomas are uncommon, but surgical treatment offers a potential cure. Early diagnosis is essential so that tumors can be promptly removed in order to reduce morbidity or mortality from atrioventricular valve dysfunction and embolic complications. They are intracavitary tumors occurring within any of the cardiac chambers, but they have a predilection for the atria, particulary the left atrium. The development of noninvasive, echocardiogaphic technique has made it possible to screen large numbers of patients with atrial myxoma with ease and safty. Recently the development of diagnostic procedure and cardiac surgery increased the accuracy of diagnosis and the opportunity of successful ereatment. We report the two cases of left artial myxomas which were removed successfully by surgery.
Diagnosis ; Early Diagnosis ; Echocardiography ; Heart Atria ; Humans ; Mortality ; Myxoma* ; Thoracic Surgery

To assess the pathological basis of the sonographic changes of the gallbladder wall in cholecystitis, thesonographic appearances of the gallbladder wall were analysed in 17 patients with acute cholecystitis and 27patients with chronic cholecystitis, and correlated with pathological specimens removed at surgery. In acutecholecystitis, a thin sonolucent layer within the echogenic gallbladder wall corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration: in chronic cholecystitis it corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration: in chronic cholelcystitis it corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration, in chronic cholelcystitis it corresponds to muscular hypertrophy.Indistinctness and/or a low echogenicity rind along the inner margin reflects mucosal sloughing or obliteration ofthe mucosal folds. Uniformly decreased echogenicity of the wall is caused by severe inflammatory cell infiltrationwith sloughing of the mucosa or obliteration of the mucosal folds. These sonographic singns are considered to bevaluable sings of cholecystitis.
Cholecystitis ; Cholecystitis, Acute ; Gallbladder ; Humans ; Mucous Membrane ; Ultrasonography

There had been total 20 patients with early onset(4 months~2 years) primary nephrotic syndrome in the Department of Pediatrics, Seoul National University Children's Hospital, during the period from March 1987 to February 1993. We analysed clinical courses, response to treatment, pathological findings and prognosis of the patients And the results were as follows; 1) The initial responders to steroid treatment were 10(50%), of whom 3 became late nonresponders. Of the 10 initial nonresponders, 8 revealed continuing nonresponsiveness. 2) Incidence of hypertension was significantly higher in the intial nonresponders than in the initial responders. 3) Renal biopsies were performed in 9 initial nonresponders and 2 late nonresponders. And the results were 6 with minimal change lesion, 4 with focal segmental glomerulosclerosis and 1 with mesangiocapillary glomerulonephritis. 4) Six continuing or late nonresponders received methylprednisolone pulse therapy or cyclophosphamide. And partial remission was induced in 4 of them. 5) The overall 3 year maintenance rate of normal renal function was 81%(100% in the initial responders and 64% in the initial nonresponders). In conclusion, the initial steroid responsiveness and prognosis were poorer in patients with early onset nephrotic syndrome than in patients with usual childhood nephrotic syndrome.
Biopsy ; Cyclophosphamide ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension ; Incidence ; Methylprednisolone ; Nephrotic Syndrome* ; Pediatrics ; Prognosis ; Seoul

The clinical data of 27 patiets with hypophosphatemic rickets treated with phosphate and 1alpha-hydroxyvitamin D were analysed retrospectively. The median age at diagnosis was 4 years, and the main clinical manifestations were bowleg and short stature. Among total 24 families, 5 families (21%) had X-linked dominant mode of inheritance, 1 family (4%) had autosomal dominant mode and 17 families (71%) had no family history, The serum phosphorus concentration rose from initial value of 2.7+/-0.13mg/dl to 3.5+/-0.19mg/dl. The serum alkaline phosphatase was reduced from 871+/-63IU/L to 393+/-41IU/L. Healing of rickets was demonstrated by radiography. Patients treated for at least two years before the onset of puberty had an increase in the mean height SD score from -1.58 to -0.79. Orthopedic surgeries for severe lower extremity deformity were performed in 11 patients, of whom 8(73%) were dignosed over 5 years of age. Complications of therapy were as follows; 12 patients (44%) developed more than one episode of hypercalciuria, 5 patients (19%) developed more than one episode of hypercalcemia, and nephrocalcinosis was noted in 5(33%) out of 15 patients by renal ultrasound. The group with nephrocalcinosis had a higher incidence of hypercalemic episodes than the group without nephrocalcinosis. In conclusion, treatment of hypophosphatemic rickets results in healing of rickets and acceleration of growth, and we must evaluate complications of therapy such as hypercalcemia and nephrocalcinosis.
Acceleration ; Adolescent ; Alkaline Phosphatase ; Congenital Abnormalities ; Diagnosis ; Humans ; Hypercalcemia ; Hypercalciuria ; Incidence ; Lower Extremity ; Nephrocalcinosis ; Orthopedics ; Phosphorus ; Puberty ; Radiography ; Retrospective Studies ; Rickets ; Rickets, Hypophosphatemic* ; Ultrasonography ; Wills

No abstract available.
Aneurysm* ; Heart Septal Defects, Ventricular*

From January to December 1984, 191 patients with associated ventricular septal defect(VSD) were studied in the cardiac cathetherization laboratory. Among theses 191 cases, 58 cases(30.4%) of subpulmonic VSD were identified by angiocardiography. Among the 59 cases of subpulmonic VSD, 12 cases(20.6%) were complicated with aortic infficiency(AI). The relative frequency of subpulmonic VSD increased with the increase of age and the frequency of complication of AI with the subpulmonic VSD also increased with the increase of age. The amount of left to right shunt in the patients with subpulmonic VSD and AI was small and Qp/Qs ratio was less than 2.0 in all of the 12 cases. Among the 12 patients 4 cases had a pressure gradient greater than 20 mmHg across the infundibular region of the right ventricle.
Angiocardiography ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans

BACKGROUND: The effects of a newly synthesized potassium channel opener, KR-30816((-)(nitro-2-hydroxymethyl-2-methy-2H-1-benzopyran-4-y1)pyridine oxide) on the action potential of papillary muscles of guinea pigs and the ATP-sensitive potassium channel current(IKATP) of single ventricular muscle cells of rats were examined to make clear its action mechanism of the KATPchannel. METHODS: We used the conventional microelectrode and the excised inside-out patch configuration. RESULTS: KR-30816 caused a shortening of the action potential duration in dose-dependent manner, which was inhibited by glibenclamide(3microM). Before run-down of the K+channel, KR-30816 activated the cardiac ATP-sensitive K+ channel only in the presence of ATP and shifted the dose-response relation curve between [ATP]i and the channel activity to the right in parallel. After run-down of the KATP channel, KR-30816 did not after the channel opening either in the absence or in the presence of UDP. CONCLUSION: These results suggest that KR-30816 antagonizes the inhibitory effect of ATP on the KATPchannel in a competitive manner, thereby enhancing the channel openings.
Action Potentials ; Adenosine Triphosphate ; Animals ; Guinea Pigs ; Heart ; Microelectrodes ; Muscle Cells ; Papillary Muscles ; Potassium Channels* ; Potassium* ; Rats ; Uridine Diphosphate

BACKGROUND: With the rapid growth of the elderly population, osteoporosis has become a major health problem worldwide. Although health knowledge and self-efficacy are important assets to facilitate healthy behaviors and disease prevention, such information as it relates to individuals and their bone health is limited. The purpose of this study was to assess the levels of knowledge, self-efficacy, and health behaviors on promoting bone health in middle-aged Korean women. METHODS: This is a cross-sectional survey study. A convenience sampling of middle-aged women (> or =40 years) was done at a community health center in Korea. Bone mineral density was measured by dual energy X-ray absorptiometry with the DEXXUM T. The level of knowledge was measured with the Knowledge of Osteoporosis Scale, and self-efficacy with the Osteoporosis Self-efficacy Scale. A questionnaire for bone health behaviors was developed for this study. Collected data were analyzed through descriptive methods, independent t-test, analysis of variance, and Pearson's correlation analysis. RESULTS: A total of 150 middle-aged women whose mean age was 59.8+/-11.5 years participated in the study. Most (74%) were menopausal. Less than one-quarter of participants (22.7%) had osteoporosis and less than half (42%) had osteopenia based on the T-score at the left femur neck site. Level of knowledge (mean score, 10.35) and self-efficacy (mean score, 47.67) ranged from low to moderate. Intake of calcium and vitamin D-rich foods was insufficient in our subjects. Bone health behaviors had significant positive relationships with knowledge (r=0.22, P=0.008) and self-efficacy (r=0.29, P<0.001) on promoting bone health. CONCLUSIONS: These results indicate that educational interventions are needed to enhance knowledge and confidence and to encourage middle-aged women to engage in bone health behaviors.
Absorptiometry, Photon ; Aged ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Community Health Centers ; Cross-Sectional Studies ; Female ; Femur Neck ; Health Behavior ; Humans ; Korea ; Middle Aged ; Osteoporosis ; Self Efficacy ; Vitamins

Human seminal plasrna (HSP) is mixture of secretion derived from various glands associated with male reproductive tract which comprises approximately 80-90% of the volume of normal ejaculate. The present study was undertaken in an effort to explore the effect of HSP pretreatment on the production of IL-1B, TNF-a and IL-12, in mice, and to investigate if HSP may cause to induce active systemic anaphylaxis (ASA) in mice. In addition, effects of HSP pretreatment on contact hypersensitivity to trinitrochlorobenzene (TNCB), antibody response to polyvinylpyrroridone (PVP), a thymus-independent antigen and on ASA induced by egg albumin (OVA) were also studied in this study. For the experiments of contact hypersensitivity, antibody response and cytokine production, mice were pretreated i.p. daily with 0.3ml of HSP or sterile saline alone (control) for 3 consecutive days before antigen sensitization or lipopolysaccharide injection for the cytokine induction. For the experiments of OVA- induced anaphylaxis, mice were pretreated by a single s.c. injection of HSP 0.3ml per mouse before sensitization. For induction of ASA in mice by HSP, a group of mice were sensitized i.p. 2 consecutive days with 0.3ml of HSP and one day with 0.3 ml of HSP plus 2x10(9) B. pertussis and 1.0 mg of alum (schedule A) or another group of mice were sensitized i.p. with a single i.p. injection of 0.3 ml of HSP with 2x10' B. pertussis and 1.0 mg of alum (schedule B). All sensitized and unsensitized control mice were challenged i.v. with 0.2ml of HSP 14 days after HSP sensitization, and mortality were observed. It was found that HSP pretreatment inhibited the production of IL-lB, TNF-a and IL-12, and also inhibited OVA-induced ASA, contact hypersensitivity to TNCB and anti-PVP antibody production. Interestingly, ASA was induced by HSP irrespective of the applied sensitization schedule. Taken together, this study may provide the direct evidences that HSP may inhibit the production of IL-1B, TNF-a and IL-12 and this may be the first to show the induction of ASA by HSP in mice.
Anaphylaxis* ; Animals ; Antibody Formation ; Appointments and Schedules ; Dermatitis, Contact ; Humans* ; Interleukin-12 ; Male ; Mice* ; Mortality ; Ovum ; Picryl Chloride ; Semen* ; Whooping Cough

Fibrohistiocytic tumors are a diverse group of benign and malignant soft tissue lesions, including dermatofibroma, dermatofibrosarcomaprotuberans, and malignant fibrous histiocytoma. On the clinical point of view, the distinction between benign and malignant lesions and malignancy grading is far more important. Therefore, we investigated 23 fibrohistiocytic tumors, using PCNA (PC10) which was a useful marker of proliferating activity, to differentiate the benign lesions from the malignant and correlate with other prognostic factors including tumor necrosis. cellularity, histologic grade, and mitotic counts. The results obtained were as follows 1) Positive tumor cells were clearly identified by the characteristic diffuse or granular nuclear staining. 2) The number of PCNA-positive tumor cells were 2.16+/-2.39% in dermatofibroma, 16.12+/-7.38% in dermatofibrosacoma protuberans, and 28.02+/-17.47% in the malignant fibrous histiocytoma. The numbers of PCNA-positive tumor cells in the malignant lesions higher than in the benign (p<0.001). 3) Deep seated, large size (>5 cm) and recurred or metastatic cases of MFH were more the high PCNA index (more than 20%) than the low index (less than 20%) groups. 4) PCNA index in MFHs had positive correlation with the number of mitotic counts (r=0.7582, p<0.001), cellularity (r=0.5908, p<0.05) and histologic grade (r=0.4164, p<0.05). These results suggested that reactivity on PCNA might assist in the distinction between benign and malignant lesions in fibrohistiocytic tumors, and could be a useful prognostic factor in the patients with malignant fibrous histiocytoma.
Neoplasm Metastasis