The primary hyperparathyroidism is a complex endocrine disease caused by neoplasm or diffuse hyperplasia of parathyroid gland in which excessive paratyroid hormon is secreted. This results in chemical abnormalities of serum, and exerts major influences on the bone, kidney and gastrointestinal tract. The authors report 2 cases of primary hyperparathyroidism with review of the literature.
Adenoma ; Endocrine System Diseases ; Gastrointestinal Tract ; Hyperparathyroidism, Primary ; Hyperplasia ; Kidney ; Parathyroid Glands

No abstract available.
Diagnosis* ; Myocardial Infarction* ; Radionuclide Imaging* ; Technetium Tc 99m Pyrophosphate*

Various methods of taking of optic foramen view and avalubilities have been studied by many foreigninvistigators, but those in Korea have not been reported yet. The authors have measured and examined the size andshapes of optic foramina of optic foramen views in 111 Korean checked at Inje Medical College Hospital duringabout 3 years form June 1979 to March 1982. The cases were divided into gwo groups, A and B, for the convenienceof study. Group A consisted of 50 normal Korean 5 to 55 years of age with no visual symptoms and signs. Group Bincluded 69 patients 3 to 75 yrs of age with visual symptoms and signs. The results were as follows; 1. Mean valueof actual diameter of optic foramen meassured by Goalwin's method in Group A; Right; A diameter; 4.21mm, Bdiameter; 4.32mm, Left; A diameter; 4.29mm, B diameter; 4.30mm. 2. Absolute symmetry of the greatest diameters ofboth optic foramina in Group A; 36%, difference of 0.5 or lessl 28%, from 0.5 to 1.0mm; 18%, from 1.0 to 1.5mm;8%, uncomparable cases; 10%. The greatest difference was 1.4mm. 3. The shapes of optic foramen in Group A; ovalshape; 65%, circular ; 29%, keyhole or double foramen; 6%. 4. In Goup B, the peak age group was second decade(31%), the most comon clinical cause of examiniation of optic foramen view was optic nerve atrophy(30%), and thepathologic findings were only 4 cases(7%). 5. The technique of optic foramen view by modified Pfeiffer's methoddelineated the outline of optic foramen more clearly than ordinary Rhese's method in our experience.
Humans ; Korea ; Methods ; Optic Nerve

This study was conducted to evaluate the effect of a teaching program on patients with myocardial infarction. Forty-five patients were randomly selected 22 were assigned to a teaching group and 23 to a control group. An individualized teaching program was delivered to the teaching group during the hospitalization period. It covered aspects such as: the characteristics of heart disease, the anatomy and physiology of the heart, risk factors of atherosclerosis, medication and diet and exercise therapy. When these subjects were discharged to their homes, they received regular supportive care via telephone or mail for 12 weeks. Atherosclerotic risk factors, including, smoking, exercise, blood lipid profile and BMI were measured before and after the teaching program. Post-testing revealed that the numbers of those who exercised and the number of non-smokers were significantly higher in the teaching group than in the control group. Increased HDL cholesterol (High-Density Lipoprotein cholesterol) was significantly greater in the teaching group than in the control group. The above findings suggest that this individualized teaching program might be helpful at reducing the risk factors of atherosclerosis in myocardial infarction patients.
Adult ; Aged ; Arteriosclerosis/etiology/*prevention & control ; Comparative Study ; Exercise ; Female ; Human ; Lipids/blood ; Male ; Middle Age ; Myocardial Infarction/*prevention & control ; *Patient Education ; Risk Factors ; Smoking

BACKGROUND: The inhibitory effects of nitric oxide(NO) on platelet adhesion and vascular smooth muscle cell(VSMC) proliferation may have a possible role inhibiting development of neointima following balloon catheter induced injury. We tested the hypothesis that L-arginine, the precursor of NO, would attenuate neointima formation following balloon catheter induced injury via regulation of antagonistic balance between proliferation and apoptosis of VSMC. METHODS: Adult, male Sprague-Dawley rats(300 to 400g) were anesthetized with ketamine (100mg/kg intraperitoneally). The left common and external carotid artery were exposed. For endothelial denudation, 2mm angioplasty catheter was introduced through the left external carotid artery into the left common carotid artery. The catheter was inflated at I atm. and withdrawn three times. Animals were randomized to receive 2.25% L-arginine in their drinking water(n=14) or placebo(n=16) from 2 days prior to and 9 days following denudation. VSMC proliferation was quantified by immunohistochemical staining with an antibody to the proliferating cell nuclear antigen(PCNA). The cells undergoing apoptosis were identified by terminal nucleotidyl transferase-mediated nick end labeling(TUNEL) method and morphologic changes by computerized planimetry and transmission electron microscopy. RESULTS: 1) The neointimal area in injured arteries were significantly reduced in L-arginine supplemented animals compared with placebo group(p<0.05). 2) L-arginine administration significantly reduced the number of PCNA positive cells in neointima when compared with placebo at 9 days(p<0.05). 3) Positive TUNEL cells were not influenced by L-arginine supplementation. 4) On transmission electron microscopy, there were no cells showing characteristics of apoptosis in neointima. CONCLUSION: These results suggested that the inhibitory effect of L-arginine on neointima formation is due to reduced VSMC proliferation, but is not due to increased VSMC apoptosis at the early time period after initmal injur .
Adult ; Angioplasty ; Animals ; Apoptosis ; Arginine* ; Arteries ; Blood Platelets ; Carotid Artery, Common ; Carotid Artery, External ; Catheters ; Drinking ; Humans ; In Situ Nick-End Labeling ; Ketamine ; Male ; Microscopy, Electron, Transmission ; Muscle, Smooth, Vascular ; Neointima* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Vascular System Injuries*

Single breath-hold gradient echo images with Small Tip. Angle Gradient Echo(STAGE) were evaluated in the study of liver in 16 patients(4 normal liver, 5 hepatoma, 5 cholangiocarcinoma, 1 hemangioma, 1 cavernous transformation of portal vein). We obtained one slice of gradient echo during single breath-hold at the level of pathology defined on conventional spin echo inage. Single breath-hold gradient echo images were compared with spin echo images for image quality and artifacts. Single breath-hold gradient image showed improved resolution of vascular detail and excellent contrast between lesion and adjacent normal liver in hepatoma. Cholangiocarcinoma showed decreased contrast between lesion and biliary trees but improved contrast between lesion and blood vessel. Cavernous transformation of porta vein was noted as tortuous vessel of high signal intensity. Single breath-hold gradient echo scan increased vascular artifact, but decreased respiratory artifact leading to improved image quality. Single breath-hold technique can reduce can reduce imaging time and improve image quality and may be used as complementary method to the spin echo scan.
Artifacts ; Blood Vessels ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Hemangioma ; Liver* ; Magnetic Resonance Imaging* ; Methods ; Pathology ; Trees ; Veins

Chemotherapy offers palliative treatment to patient with advanced nonresectable hepatoma. The usefulness of systemic chemotherapy is limited becaused of serious side reaction and low concentration of drug at tumor. Butthis problem may be overcome by intraarterial infusion. Nonsurgical percutaneous hepatic arteiral catheterizationwas done in 21 patients with primary hepatoma, and infusion chemotherapy was done in 19 patients who were successful in catherization. The results were as follows; 1. Selective catheterization of hepatic artery proper,common hepatic artery, and celiac artery were seccessful in 4, 9 and 4 patients, respectively. The success rate ofselective catheterization is 80.9% including celiac artery among 21 patients with hepatoma. 2. Simple catherization method was applied in 14 patients, and catheter exchange and Loop methods were applied in 2 and 1patient respectively. 3. Complications related to catheterization, such as infection and bleeding on punctured site, intimal injury and dislodgement of catheter were not serious. 4. Drugs were well tolerated without serioustoxicity or complication. 5. 3 patients showed objective response and median survival time of treated patients is 2.5 months.
Carcinoma, Hepatocellular ; Catheterization ; Catheters ; Celiac Artery ; Drug Therapy ; Hemorrhage ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Methods ; Palliative Care

PURPOSE: The purpose of this study was to evaluate the relationships among critical thinking disposition, general self-efficacy, leadership and clinical competence, and identify the factors influencing clinical competence in nursing students. METHODS: In this descriptive study, 153 nursing students (from 2nd to 4th school year) of a university in South Korea were enrolled in December 2010. The instruments for this study were the Korean versions of the Critical Thinking Disposition Scale, General Self-Efficacy Scale, Leadership Inventory, and Clinical Competence Scale. Data were analyzed by descriptive statistics, t-test, MANOVA, Pearson correlation, and multiple linear regression with PASW 18.0 software. RESULTS: The mean scores (ranging from 1 to 5) in nursing students for critical thinking disposition, general self-efficacy, leadership, and clinical competence were 3.44, 3.51, 3.55, and 3.42, respectively. Positive correlations were found for clinical competence with critical thinking disposition, general self-efficacy, and leadership. The strongest predictor of clinical competence was leadership. In addition, leadership, nursing school year, and subjective academic achievement accounted for 34.5% of variance in clinical competence. CONCLUSION: This study revealed that developing leadership, critical thinking disposition, and self-efficacy in undergraduate nursing education is important to improve clinical competence of nursing students.
Achievement ; Clinical Competence ; Education, Nursing ; Humans ; Leadership ; Linear Models ; Republic of Korea ; Schools, Nursing ; Students, Nursing ; Thinking

BACKGROUND: In patients with myocardial infarction (MI) and chronic stable angina, the coronary flow reserve (CFR) is reduced not only in the region of myocardium perfused by the ischemia-related artery but also in the regions supplied by angiographically normal coronary arteries. The effect of myocardial stunning on the remote CFR is unknown, however. METHODS: In ten open-chest anesthetized dogs, left circumflex coronary artery was occluded for 15 minutes (myocardial stunning group, n=5) or for 30 minutes (MI group, n=5) and was followed by a reperfusion for 60 minutes. Before coronary occlusion and at 30 minutes and at 60 minutes after reperfusion, resting coronary blood flow (CBF) and maximal CBF after IV injection of each of adenosine (ADE) and acetylcholine (Ach) was measured with electromagnetic flow probe located in the proximal left anterior descending coronary artery. CFR was calculated as the ratio of maximal and resting CBF. RESULTS: At 30 minutes and 60 minutes after reperfusion, the remote resting CBF were significantly increased in both groups and the remote CFR was significantly decreased in both groups. The CFR of the MI group was lower than myocardial stunning group. The coronary vasodilator response to Ach was significantly lower than the response to ADE in both groups. CONCLUSION: After MI and myocardial stunning, there was severe coronary vasodilator abnormality in the remote myocardium and that was more marked after MI. The coronary vasodilator response to Ach was significantly lower than the response to ADE in both groups, suggesting endothelial dysfunction in remote myocardium.
Acetylcholine ; Adenosine ; Angina, Stable ; Animals ; Arteries ; Coronary Occlusion ; Coronary Vessels ; Dogs ; Humans ; Magnets ; Myocardial Infarction ; Myocardial Stunning* ; Myocardium ; Reperfusion

BACKGROUNG AND OBJECTIVES: The aim of this study was to analyze the influence of changes in ventricular preload and afterload, atrial and ventricular pacing on the coronary flow reserve (CFR). METHOD: Five open chest anesthetized dogs were studied in five sequential stages:baseline, saline solution volume loading (293.8+/-29.2 ml for 10 min), atrial and ventricular pacing (120, 140, and 160 bpm), and aortic clamp. Coronary blood flow (CBF) was measured with electro-magnetic flowmeter. CFR was defined as the ratio of hyperemic CBF (hCBF) to resting CBF (rCBF). Hyperemia was induced by IV adenosine infusion (1 mg/kg/min). RESULTS: 1)After volume loading wtih saline solution, CFR significantly decreased (p<0.05) because rCBF was increased while hCBF remained unchanged. 2)Atrial pacing produced increase in rCBF but did not change hCBF. Consequently CFR singificantly reduced when heart rate (HR) increased from sinus rhythm to 120, 140, and 160 bpm (p<0.01). 3)Ventricular pacing produced decrease in hCBF but did not change rCBF. Consequently CFR significantly reduced as HR increased from sinus rhythm to 120 (p<0.05) , 140 (p<0.01), and 160 (p<0.01) bpm. 4)After aortic clamp, CFR significantly decreased (p<0.01) because rCBF increased while hCBF remained unchanged. CONCLUSION: We found that CFR is dependent on the changes in volume loading, HR, and ventricular afterload that may commonly occur in clinical situations.
Adenosine ; Animals ; Dogs* ; Flowmeters ; Heart Rate ; Hyperemia ; Sodium Chloride ; Thorax