BACKGROUND: To evaluate the usefulness of exercise echocardiography in diagnosis of coronary artery disease and to compare it with exercise ECG test. METHOD: We performed exercise test in 48 patients who suffered from angina-like chest pain, according to the modified Bruce protocol. During exercise, we observed the ECG changes and recored the images of left ventricular wall motion before and after exercise on the video tape. The echocardiogram were digitally stored and displayed in a format that allowed simultaneous analysis of rest and stress images. Newly developed left ventricular wall motion abnormalities were determined as positive findings. RESULTS: The feasibility of exercise echocardiography was 75%. The sensitivity and specificity fo exercise ECG test was 67% and 89%. The sensitivity and specificity of exercise echocardiography was 85% and 100%. The sensitivity of ECG and echocardiography was 50%(7 of 14) and 78.6%(11 of 14) in those with one-vessle disease and 84.6%(11 of 13) and 92.3%(12 fo 13) in those with multi-vessle disease. CONCLUSION: Exercise stress echocardiography was very usefull method for detecting the coronary artery disease especially in single vessle disease. And it had much higher accuracy than the stress ECG test.
Chest Pain ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Exercise Test ; Humans ; Sensitivity and Specificity

No abstract available.
Breast Neoplasms* ; Breast* ; Eflornithine* ; Estrogens ; Humans* ; MCF-7 Cells ; Phosphorylation* ; Polyamines

BACKGROUND: The precore mutant hepatits B virus (HBV) cannot produce HBeAg due to the formation of transnational stop codon at nucleotide 1896 of the HBV-DNA precore region. This mutant has been detected worldwide in acute fulminant hepatitis, carrier and chronic HBV infections. It has been controversial whether the emergence of precore mutant HBV is related to the severity of the chronic hepatitis B or not. METHODS: To determine the prevalence and clinical implication of precore mutant infection, 137 HBsAg (+) patients including 12 acute hepatitis, 59 carriers, 41 chronic hepatitis, 15 liver cirrhosis, and 10 hepatomas were examined with mutation site specific assay-polymerase chain reaction (MSSA-PCR). The specificity for the detection of mutant by MSSA-PCR method was confirmed by direct sequencing of PCR products. RESULTS: The precore mutant HBV was detected in 67 of 137 (49%) subjects : none of 12 (0%) acute hepatitis patients, 17 of 59 (29%) carriers, 31 of 41 (76%) chronic hepatitis patients, 12 of IS (80%) liver cirrhosis patients, and 6 of 10 (60%) hepatoma patients. According to the status of serum HBeAg, the emergence rate of precore mutant HBV in HBeAg(-) cases was relatively higher than in HBeAg(+) cases with blood donor and chronic hepatitis. In anti-HBe (+) patients with chronic hepatitis, the precore mutant HBV was found regardless of ALT level in all patients. Emergence rate of precore mutant HBV was abruptly increased after 30 years of age. Among HBV-DNA (-) sera by DNA probe method, the core region of HBV was amplified in 94% of sera by MSSA-PCR method. CONCLUSIONS: The presence of precore mutant HBV may be related to the duration of HBV infections and there seems to be no causal relationship between the presence of precore mutant HBV and the severity of chronic hepatitis.
Blood Donors ; Carcinoma, Hepatocellular ; Codon, Terminator ; DNA ; Hepatitis ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Herpesvirus 1, Cercopithecine ; Humans ; Liver Cirrhosis ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity

Fifty five children with endoscopically proven esophageal varices from Jul. 1987 to Dec. 1992 were analyzed for endoscopic and clinical characteristics. The results were as follows: 1) According to etiological classification of portal hypertension in 55 cases, 35 cases showed intrahepatic causes 964%) and 20 cases had extrahepatic causes (36%). The most common clinical manifestation on admission was hematemesis (42%) and abdominal mass (36%). 2) Portal vein thrombosis was the most common cause of portal hypertension. Patients with portal vein thrombosis showed more frequent bleeding than with intrahepatic portal hypertension. Most of them had the first bleeding episode before 7 years old of age. Progression of portal hypertension in portal vein thrombosis was more rapid and bleeding episode was earlier than that in most of intrahepatic causes of the portal hypertension. 3) Twenty patients showed gastritis (10 cases), duodenitis (4 cases), gastric ulcer (4 cases) and esophagitis (2 cases) besides varix on the endoscopic examination. In 4 cases, the cause of upper GI bleeding was found as duodenal ulcer (3 cases) or hemorrhagic errosive gastritis (1 case) with no variceal bleeding. 4) Among 36 cases with variceal bleeding, 20 cases had predisposing factors for bleeding such as medication for URI including Aspirin. 5) More than one episode of bleeding were noted in 36 cases (65%) of the patients with varix. Thirty-one cases were treated conservatively with success. The remaining 5 cases with severe bleeding were managed with IV pitressin, SB-tube insertion and emergency shunt operation. High mortality rate (40%) was found in these patients group. In conclusion, in patients with clinically suspected portal hypertension, regular endoscopic examination might be recommended for the earlier recognition and effective prevention of variceal bleeding. for bleeding varices, in addition to conservative management, active treatment such as pitressin, SB-tube, sclerotherapy, endoscopic variceal ligation and emergency shunt operation should be considered with the emergency endoscopy which can identify bleeding focus and predict the chance of rebleeding.
Aspirin ; Causality ; Child* ; Classification ; Duodenal Ulcer ; Duodenitis ; Emergencies ; Endoscopy ; Esophageal and Gastric Varices* ; Esophagitis ; Gastritis ; Hematemesis ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation ; Mortality ; Sclerotherapy ; Stomach Ulcer ; Varicose Veins ; Vasopressins ; Venous Thrombosis

Nineteen children found to have gallstones at Seoul National University of Children's Hospital from Jun. 1982 to Jun. 1992 were reviewed. The results were as follows: 1) The mean age was 10 years, with 9 boys and 10girls. Most of the cases(63%) were over 10 years of age. 2) Clinical manifestations were abdominal pain(14 cases), nausea and/or vomiting (5 cases), fever (2 cases), jaundice (2 cases) and fatty food intolerance (1 case). Five cases were asymptomatic. Of 14 cases with abdominal pain, only 5 cases showed typical biliary colic which suggests cholelithiasis. 3) Associated conditions in cholelithiasis were Wilson disease (5 cases), congenital hereditary spherocytosis (2 cases), choledochal cyst (2 cases), total parenteral nutrition following ileal resection (1 case). And the other conditions which had association with cholelithiasis are not certain, and they were nephrotic syndrome, histiocytic cytophathic panniculitis, meningococcal meningitis, portal vein thrombosis and cardiac cirrhosis. The remaining 4 cases showed no associated conditions or diseases. 4) Eleven of 19 patients with cholelithiasis (58%) showed cholecystitis. 5) Cholecystectomy was performed in 4 cases with frequently recurred abdominal pain or associated diseases which needed operative correction. Symptoms completely subsided after operation. In conclusion, cholelithiasis in children has a variety of associated conditions and nonspecific abdominal symptoms were nore common than classic biliary colic. Although cholelithiasis in pediatric population are uncommon problems, the possibility of gallstones should be considered in the evaluation of abdominal pain in children with associated conditions.
Abdominal Pain ; Child ; Cholecystectomy ; Cholecystitis ; Choledochal Cyst ; Cholelithiasis* ; Colic ; Fever ; Fibrosis ; Gallstones ; Hepatolenticular Degeneration ; Humans ; Jaundice ; Meningitis, Meningococcal ; Nausea ; Nephrotic Syndrome ; Panniculitis ; Parenteral Nutrition, Total ; Seoul ; Venous Thrombosis ; Vomiting

A relatively rare and puzzling tumor of the testicular tunic is reported. The tumor, so called a fibrous pseudotumor of testicular tunics, in presented because of the clinical dilemma this rare entity causes urologists and pathologists. This report demonstrates the necessity for familiarity with testicular pseudotumors in order to avoid an unnecessary orchiectomy.
Orchiectomy ; Recognition (Psychology)

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

No abstract available.
Creatinine*

No abstract available.
Blood Donors* ; Humans

No abstract available.
Blood Donors* ; Humans