Cardiovascular disease is the most important cause of unexpected sudden death. Although ischemic heart disease by coronary atherosclerosis is the most common cause of sudden cardiac death, other diseases such as cardiomyopathy, congenital heart disease, valvular heart disease and rarely myocarditis can produce sudden cardiac death. Myocarditis is an inflammatory process of the myocardium characterized by an interstitial inflammatory infiltrate and an injury to myocytes adjacent to the inflammatory cells. The clinical expression of myocarditis ranges from the asymptomatic state to fulminant fatal congestive heart failure. Because myocardial involvement is subclinical in most acute infectious disease, the majority of patients have no specific complaints referable to the cardiovascular system. It is possible that it causes a medicolegal problems in case of sudden death. Therefore, author reviewed the clinical and pathological findings of 18 myocarditis autopsy cases. The victims 'age was varied 4-month-59-year olds. 5 (28%) were male and 13 (72%) were female. 15 cases received medical treatment due to clinical symptoms(URI symptoms: 2 cases, tonsillitis and tonsillar abcess: 3 cases, GI symptoms: 5 cases, URI & GI symptoms: 3 cases, pneumonia: 1 case, operation due to ovarian tumor: 1 case) and were associated with medicolegal problem. By the results of this study, important gross findings were pericardial effusions, characteristic cardiomegaly, and pulmonary edema.
Asymptomatic Diseases ; Autopsy ; Cardiomegaly ; Cardiomyopathies ; Cardiovascular Diseases ; Cardiovascular System ; Communicable Diseases ; Coronary Artery Disease ; Death, Sudden ; Death, Sudden, Cardiac ; Female ; Heart Defects, Congenital ; Heart Failure ; Heart Valve Diseases ; Humans ; Male ; Muscle Cells ; Myocardial Ischemia ; Myocarditis* ; Myocardium ; Palatine Tonsil ; Pericardial Effusion ; Pneumonia ; Pulmonary Edema ; Tonsillitis

Glutathione S-Transferase (GST) is a conjugation enzyme in the metabolism of exogenous and endogenous lipophilic compounds for their excretion and detoxification. Acidic isozyme of GST, GST-Pi, has been recognized as a preneoplastic marker in the experimental hyperplastic nodules of liver in rats, and GST-Pi is abundant in the squamous cells of the skin, also. This histochemical study was carried out to evaluate the distribution and the relationship between the differentiation status of squamous cells in dysplastic or neoplastic epithelium in various organs. The human placental form of glutathione S-transferase (GST-Pi) were stained immunohistochemically with specific anti GST-Pi rabbit antibody in 23 cases of human squamous cell carcinomas. The patients consisted of 14 cases from the uterine cervix, 3 cases from the esopahgus, 3 cases from the lung and 3 cases from the larynx. The results obtained were as follows; 1. Basal cells in normal mucosa were stained negative for GST-Pi while superficial keratinocytes were stained moderately positive. Basal dysplastic cells were stained negatively or weakly positive. Carcinoma cells especially large cells either keratinizing or nonkeratinizing were stained moderately to strongly. Carcinoma cells surrounding keratin pearl were strongly reacted with GST-Pi than other carcinoma cells. 2. Differentiated cells of squamous cell carcinoma showed moderate to strong positive reaction to GST-Pi staining irrespective of its site of origin. 3. Therefore, Immunohistochemical staining pattern of GST-Pi in various squamous carcinoma cells showed similar immunohistochemical reaction to the GST-pi, which is closely correlated to the degree of differentiation, keratinigation and also suggested that squamous carcinoma cells had abundant GST-Pi related detoxifying system.
Humans ; Rabbits ; Animals

We reviewed 26 patients with staghorn calculi to determine whether extracorporeal shock wave lithotripsy (ESWL) monotherapy with Dornier MPL-9000X lithotriptor is a successful alternative to the classical approaches. Of the staghorn calculi 5 cases were complete and 21 cases were incomplete staghorn. Double-J ureteral stents were placed in 24 of 26 patients before the ESWL. Of 15 patients with stone volume less than 20ml, 12(80%) showed stone-free after 5.7 mean session of ESWL. Of 11 patients with stone volume more than 20 ml, 7 (64%) became stone-free after 7.1 mean session of ESWL. The post-ESWL complications were flank pain in 9 patients (35%), gross hematuria in 24 (92%), high fever in 3 (13%) and steinstrasse in 24 (92%). Frank pain and high fever were managed successfully with analgesics and antibiotics. Gross hematuria disappeared spontaneously within 2 days. For the steinstrasse, the stone fragments passed spontaneously in 15 cases (62.5%) and ESWL to the steinstrasse was needed in other 9 cases (37.5%). Though the treatment of choice for the staghorn stones is combination therapy (PNL and ESWL) at the present, we experienced good results by ESWL monotherapy in staghorn calculi with Dornier MPL-9000X.
Analgesics ; Anti-Bacterial Agents ; Calculi* ; Fever ; Flank Pain ; Hematuria ; Humans ; Lithotripsy* ; Shock* ; Stents ; Ureter

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

PURPOSE:Ghrelin is an endogenous ligand of the growth hormone secretagogue receptor, and stomach is the major site of ghrelin secretion. The purpose of this study is to compare the serum ghrelin concentrations between patients with type 2 diabetes mellitus (DM) and normal adults. We studied also whether serum ghrelin levels in the patients with type 2 DM are correlated with body mass index (BMI), serum insulin, lipid profiles, and creatinine levels. METHODS:Forty patients with type 2 DM and forty normal adults were included in this study. We measured heights and weights of the subjects and calculated their BMIs. Blood samples were obtained to measure the ghrelin concentration and their sera were stored at -20degreeC until used. In all subjects, serum ghrelin levels were measured using the commercially available Ghrelin(human) EIA kit. RESULTS:No differences of mean values were detected between the control group and the type 2 diabetic group for age, body weight, BMI, and the levels of serum total cholesterol, triglyceride, HDL cholesterol, and creatinine. But ghrelin level of the type 2 diabetic group (71.1+/-30.5 ng/L) was significantly lower than the control group (139.7+/-36.9 ng/L). In the control group, the ghrelin level showed positive correlation with HDL cholesterol (Pearson's correlation coefficient=0.37, P<0.05). In the diabetic group, the ghrelin level showed weakly positive correlation with insulin concentration. However, there was no significant relationship between serum ghrelin and various parameters in the diabetic patients group. CONCLUSION: In this study, ghrelin concentration in type 2 diabetic patients was lower than that in the control group. In the control group, serum ghrelin concentrations were positively correlated with HDL cholesterol. In the type 2 diabetic group, there was no significant correlation between insulin and ghrelin concentrations.
Adult ; Body Mass Index ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Ghrelin* ; Humans ; Insulin ; Receptors, Ghrelin ; Stomach ; Triglycerides ; Weights and Measures

PURPOSE: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. MATERIALS AND METHODS: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of 99mTc-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. RESULTS: GBEF was significantly reduced in diabetes with autonomic neuropathy (43+/-12.3%) and without autonomic neuropathy (57.5+/-13.2%) compared with normal controls (68+/-11.6%, p <0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p <0.05). Fasting blood glucose level, age, sex, hemoglobin A1c, body mass index, serum lipid level were not different in these two diabetic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. CONCLUSION: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy.
Blood Glucose ; Body Mass Index ; Diabetic Neuropathies* ; Fasting ; Female ; Gallbladder* ; Humans ; Injections, Intravenous ; Male ; Meals ; ROC Curve ; Sensitivity and Specificity ; Technetium Tc 99m Disofenin*

No abstract available.
Succimer* ; Thymoma*

No abstract available.
Adolescent* ; Humans ; Male* ; Psoriasis*

Eating ; Female ; Hospitals, General ; Humans ; Male ; Mandible ; Mandibular Fractures ; Respiration ; Tooth ; Violence

The standard treatment of adult femoral shaft fractures is the closed intramedullary nailing using a fracture table, but in polytraumatized patients, this method may be difficult due to concomitant adjacent injury. So, we report on the technique of closed intramedullary nailing without a fracture table for adult femoral shaft fracture using "joystick" technique on radiolucent table in supine position. Among 15 cases, two were open fractures, three were proximal 1/3, seven were middle 1/3, two were distal 1/3, and theree were segmental fractures. According to the Winquist Hansen classification, five type I, four type II, three type III, three were type IV. The eleven patients out of the fifteen were operated within 48 hours. The average operation time was 105 minutes, and the amount of bleeding was below 300cc. Forty-seven percent was anatomically reduced, forty percent had below five degree of angular deformity or below five milimeter of shortening, thirteen percent had above five degree of angular deformity of above five milimeter of shortening. The closed intramedullary nailing of femoral shaft fractures without fracture table using radiolucent table and "joy stick" technique is an effective and safe method in multiple injuries. And it reduced the operation time by reducing the preoperation time including preparing of a fracture table.
Adult ; Classification ; Congenital Abnormalities ; Femoral Fractures ; Fracture Fixation, Intramedullary ; Fractures, Open ; Hemorrhage ; Humans ; Methods ; Multiple Trauma ; Supine Position