No abstract available.
Acneiform Eruptions ; Bevacizumab

29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.
Codon ; Diagnosis* ; Digestion ; DNA ; Isoniazid* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Restriction Mapping ; Tuberculosis

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

Nefazodone, a newer antidepressant is a phenylpiperazine derivative that inhibits the reuptake of both norepinephrine and serotonin, and antagonizes 5-HT2A and alpha1 adrenergic receptors. Compared with SSRIs nefazodone caused the fewer activating symptoms, adverse gastrointestinal effects(nausea, diarrhea, anorexia) and adverse effects of sexual function, but is associated with the more dizziness, dry mouth, constipation, visual disturbances and confusion. We report on 4 cases of visual disturbances and hallucinations in patients taking nefazodone. 1) Nefazodone, as a 5-HT2A antagonist, might induce visual disturbances. 2) mCPP, metabolite of nefazodone might contribute to the hallucination through action on 5-HT receptor. 3) Dopaminergic enhancing activity of nefazodone might cause hallucination. The case report raises the possibility that dose-related perceptual disturbances may exist with nefazodone. The fact emphasizes the need to pay close attention to all possible drug interactions, particularly in patients treated with multiple psychoactive agents, older patients, and patients with decreased hepatic function.
Constipation ; Diarrhea ; Dizziness ; Drug Interactions ; Hallucinations ; Humans ; Mouth ; Norepinephrine ; Psychotropic Drugs ; Receptors, Adrenergic ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists

Solid and papillary epithelial neoplasm of the pancreas(SPENP) is an uncommon low grade malignant tumor histologically distinct from the usual ductal adenocarcinoma and amenable to cure by surgical excision. The main features of SPENP are a peculiar morphology, favorable prognosis, and prediction for women 10 and 40 years of age. In men, the occurrence of SPENP seems to be exceedingly rare. The tumor is usually large at the time of presentation, and surgical excision is the treatment of choice. Gross pathologic examination revealed apparent encapsulation, cystic degeneration, and hemorrhagic necrosis. Microscopically, the tumor was characterized by distinctive solid and papillary patterns. This benign or low-grade malignant epithelial tumor is composed of monomorphous cells variably expressing epithelial, mesenchymal, and endocrine markers. The tumor is known to have good prognosis; although local invasion and infiltration of the capsule may occur. Despite growing recognition of this tumor, its histogenesis remains a matter of controversy i.e. pancreatic ductal cell origin, acinar cell origin, pluripotential cell origin. A 44-year-old male presented with an one-year history of postprandial abdominal pain. Following abdominal ultrasonography, computed axial tomography and angiography, a SPENP suspected. The patient underwent exploratory laparotomy. The tumor was located in the head of pancreas. And thus the patient underwent a pylorus-preserving pancreaticoduodenectomy. His postoperative course was uneventful, and he remains well.
Abdominal Pain ; Acinar Cells ; Adenocarcinoma ; Adult* ; Angiography ; Carcinoma ; Female ; Head ; Humans ; Laparotomy ; Male* ; Necrosis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Prognosis ; Ultrasonography

Background: Esmolol as a drug for induced hypotension can, not only avoid many drawbacks of nitroprusside, but reduce the amount of intraoperative bleeding and make better operative field. This study was performed to evalute cardiovascular changes during esmolol-induced controlled hypotension. Methods: Induced hypotension using esmolol was applied to 18 adult patients receiving spinal surgery under the diagnosis of spinal stenosis or scoliosis. After prehydraion of 2,000 ml of crystalloid solution, 0.5 mg/kg esmolol was used as loading dose once, twice or three times until mean blood pressure (MBP) fell below 70 mmHg, followed by continuous infusion (50~300 microg/kg/min) of esmolol. MBP and heart rate (HR) were measured before, 5, 10, 15, 30, 60 and 90 min after esmolol administration, and 5, 10 and 15 minutes after discontinuation of esmolol. In 8 patients, cardiac output (CO) and mixed venous oxygen tension and saturation were measured before, during and after esmolol use. Results: MBP was decreased from 91+/-12 mmHg to 67+/-7 mmHg after 15 min (P<0.05). HR(BPM) was decreased from 76+/-17 to about 60 after 15 min (P<0.05). CO was decreased about 30% during induced hypotension but recoverd to initial level 15 min after esmolol discontinuation. While oxygen transport was reduced significantly during induced hypotension (P<0.05), oxygen consumption was maintained all the time. Conclusion: With the use of esmolol, stable hypotension could be achieved. Although oxygen transport decreased possibly due to reduction of CO, but oxygen consumption was maintained.
Adult ; Blood Pressure ; Cardiac Output ; Diagnosis ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Hypotension, Controlled ; Nitroprusside ; Oxygen ; Oxygen Consumption ; Scoliosis ; Spinal Stenosis

PURPOSE: To compare the clinical outcomes of glistening-free intraocular lens (IOL) and conventional 1-piece aspheric IOL in implanted in-the-bag. METHODS: After phacoemulsification performed by a single surgeon, 2 different IOLs were implanted: enVista MX60 (glistening-free 1-piece aspheric IOL) in 38 eyes (group A) and AcrySof IQ (conventional 1-piece aspheric IOL) in 46 eyes (group B). Glare symptom score (0-5) obtained by questionnaires, best corrected visual acuity (BCVA), Functional Acuity Contrast Test (FACT), posterior capsular opacity (PCO), glistening formation and spherical equivalent error were compared and analyzed preoperatively and 6 months and 12 months postoperatively. RESULTS: A statistically significant improvement of BCVA and contrast sensitivity postoperatively was observed in all groups. There was statistically significant increase of glistening in group B compared with group A. However, there was no significant difference of FACT scores of spatial frequency in A, B, C, D and E columns and glare symptom score (0-10) obtained by questionnaires 12 months after surgery. Spherical equivalent errors were -0.38 +/- 0.27 D and -0.36 +/- 0.28 D for groups A and B, respectively. PCO occurred in 2 eyes in group A and 4 eyes in group B. CONCLUSIONS: EnVista MX60 IOL showed less glistening formation than AcrySof IQ IOL, however, there was no significant difference in terms of vision quality such as BCVA, FACT and glare symptom score at 12 months postoperatively.
Cataract* ; Contrast Sensitivity ; Glare ; Lenses, Intraocular* ; Phacoemulsification ; Visual Acuity

PURPOSE: Humans have been poisoned by carbon monoxide(CO) ever since they first discovered hydrocarbon fuels, incomplete combustion of which is the usual cause of the poisoning. The early symptoms of CO poisoning are usually variable, vague, and nonspecific, which can lead to thewrong diagnosis. METHODS: This study reviewed 42 cases of CO poisoning that occurred from January 1, 1995, to December 31, 2001. The study was conducted retrospectively to discover the patients' age distribution, sex ratio, the time of exposure, the site of exposure, and the cause of exposure. RESULTS: The ratio of males to females was 1:2.9. Age distribution was broad: 8 of below 18 years old, 9 between 19 and 39 years old, 9 between 40 and 59 years old, and 16 over 60 years old. In terms of seasonal difference, 28 cases happened during the heating season whereas 13 cases occurred in non-heating season. Twenty-three (23) cases happened in the early morning, 12 during the day time, 3 in the evening, and 4 during night. Of the exposures, 27 occurred in the home, 8 in the workplace, and 7 in hotels. Faulty heating systems caused 31 exposures, fires 2 exposures, stoves 4 exposures, and generators 5 exposures. Fifteen patients were repoisoned by CO, and of these, 9 patients had been misdiagnosed in the past exposures. CONCLUSION: The sources of CO are variable, so humans are poisoned often. It is common to see that the victim - sometimes even several members of the same family - had already visited a doctor with symptoms of CO toxicity before the severe exposures or death. The doctor strongly needs to pursue the possibility of victim poisoning when patients have recurrent or vague symptoms similar to those associated with CO exposure.
Adolescent ; Adult ; Age Distribution ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Diagnosis ; Female ; Fires ; Heating ; Hot Temperature ; Humans ; Male ; Middle Aged ; Poisoning ; Retrospective Studies ; Seasons ; Sex Ratio

PURPOSE: To evaluate the therapeutic effects of excimer laser phototherapeutic keratectomy (PTK) combined with amniotic membrane transplantation (AMT) in patients with symptomatic bullous keratopathy and poor visual potential. METHODS: Fifteen eyes of 15 patients were included. After mechanical removal of the epithelium, the central 7.0~7.5 mm zone was ablated with the excimer laser (ablation depth of 50 micrometer) and the peripheral cornea was additionally polished with other pulses of diameter 2.0 mm in an annular fashion. After PTK, the preserved amniotic membrane was sutured onto the cornea. Vision and symptom changes, epithelization time, statue of amniotic membrane, cosmesis, recurrence of bulla, and postoperative complication were analyzed. RESULTS: Mean follow-up period was 8.4 months (range, 6~20). Postoperative visual acuity improved or unchanged in 13 eyes (86.7%) and decreased by 1 line in 2 eyes (13.3%). Symptoms improved in all patients. Ten patients (66.7%) had complete resolution of symptoms. Mean epithelization time was 12.4 days, and cosmetic result was excellent or good in 13 eyes (86.7%). At last examination, though some patients showed a loss of amniotic membrane, epithelial bulla had not recurred in 14 eyes (93.3%). No postoperative complication was detected. CONCLUSIONS: Combined PTK and AMT is effective in symptom relief and prevention of recurrence in the treatment of bullous keratopathy.
Amnion* ; Cornea ; Epithelium ; Follow-Up Studies ; Humans ; Lasers, Excimer ; Postoperative Complications ; Recurrence ; Visual Acuity

PURPOSE: We studied the therapeutic effect and safety of transurethral prostatectomy (TURP) performed with improved instruments by a moderately experienced resectionist. PATIENTS AND METHODS: Clinical data of the 95 consecutive patients who underwent TURP by one surgeon from March 1995 to June 1997 were analyzed. During this period, a continuous-irrigation 26F TUR sheath with a 30-degree lens attached to a monitor screen was used in most patients. RESULTS: The average weight of the resected adenoma was 10.8 7.4 gm, and the resection time was 47.2 21.2 minutes. The average weight of tissue resected per minute was 0.23 0.13 gm. Six patients required transfusion, and four suffered operative complications (one bladder perforation, one bladder neck injury, and two urethral injuries that enforced prolonged catheterization). Postoperative complications developed in seven cases. The duration of postoperative urethral catheterization averaged 2.8 days. The maximal flow rate was improved from 11.3 mL/sec to 20.6 mL/sec. Subjective satisfaction was mentioned by 95.6% of patients (91/95). In comparison with data from the first authors former report, all differences in terms of resection speed, safety, and morbidity were statistically significant. The therapeutic efficacy of the operation with the new equipment seems to be superior to that of other less invasive procedures, and even in terms of complications and duration of catheterization, these results are comparable to those of other procedures. CONCLUSIONS: We think that TURP deserves to be the primary treatment modality for the patients with benign prostatic hyperplasia who need surgical therapy if the procedure is performed by a properly trained surgeon equipped with modern TUR instruments.
Adenoma ; Catheterization ; Catheters ; Humans ; Neck Injuries ; Postoperative Complications ; Prostatic Hyperplasia ; Transurethral Resection of Prostate* ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters