No abstract available.
Breast* ; Osteosarcoma*

Ischemic stroke is a serious neurological complication of infective endocarditis. Intravenous tissue plasminogen activator (t-PA), which has only been approved for treatment of hyperacute stroke, has been excluded as an ischemic stroke treatment due to infective endocarditis according to current expert consensus guidelines. Here, we describe a case of a hyperacute stroke patient treated with intravenous t-PA, who was later diagnosed with infective endocarditis.

A global increase in the incidence of tuberculosis has prompted the need for earlier diagnosis, treatment, and isolation of the disease. In tuberculosis, concomitant tuberculous meningitis and vascular complications such as intracranial aneurysms and subarachnoid hemorrhage are very rare. Because of the poor prognosis of tuberculous meningitis as well as intracranial aneurysm and subarachnoid hemorrhage, early diagnosis and management are crucial. We present the case of a 76-year-old woman who had two intracranial aneurysms complicated by subarachnoid hemorrhage, who had concomitant tuberculous meningitis. She remained well with medical management.

No abstract available.
Cystitis, Interstitial* ; Dimethyl Sulfoxide*

BACKGROUND: Cyclosporine, an immune suppressive agent has been reported to potentiate the neuromuscular blockade induced by vecuronium and atracurium. And the potentiation degree was more prominent in the vecuronium. Rocuronium and mivacurium have been introduced into clinical practice recently and there is no report whether the cyclosporine potentiates the neuromuscular blocking effects of these agents. We, therefore studied the effect of Sandimun (cyclosporine in cremophor-ethanol) on the neuromuscular blockade action of rocuronium and mivacurium in rabbits. METHOD: The effect of Sandimun on the rocuronium and mivacurium were investigated in anesthetized 30 rabbits. The rabbits were divided into five groups; rocuronium group (rocuronium bromide 1 mg/kg iv), rocuronium - Sandimun group (rocuronium bromide 0.1 mg/kg iv after Sandimun 5 mg/kg iv), mivacurium group (mivacurium chloride 0.064 mg/kg iv), mivacurium - Sandimun group (mivacurium chloride 0.064 mg/kg iv after Sandimun 5 mg/kg iv) and Sandimun group (Sandimun 5 mg/kg iv). Neuromuscular block was assessed by measuring the response of anterior tibial muscle to 0.1Hz single twitch stimulation of the common peroneal nerve. Onset time, duration of muscle relaxation and recovery index were compared among the groups. RESULTS: There were no significant differences in onset time and recovery indices among the groups. Significant difference was found in duration between the rocuronium group and the rocuronium-Sandimun group (p<0.05). CONCLUSION: Sandimun potentiates the rocuronium - induced neuromuscular blockade but not the neuromuscular blocking action of mivacurium.
Atracurium ; Cyclosporine* ; Muscle Relaxation ; Muscle, Skeletal ; Neuromuscular Blockade* ; Peroneal Nerve ; Rabbits ; Vecuronium Bromide

BACKGROUND: Angina with normal coronary angiogram has been called syndrome X or microvasclar angina. Pathophysiologic mechanisms for chest pain in this group of patients are not known exactly. This study was performed to compare the insulin level of the patients with syndrome X with that of the healthy asymptomatic volunteers. METHODS: The syndrome X group was consisted of 18 patients(11 men and 7 women). All patients had typical chest pain and positive exercise test with a completely normal coronary andgiogram. Patients with hypertension, diabetes mellitus, and there taking any drug known to affect the insulin secretion were excluded. The control group was consisted of 38 healthy subjects(25 men and 11 women) who were not taking any medications. We measured the plasma glucose insulin and C-peptide concentration during oral glucose tolerance test in both groups. RESULTS: Fasting plasma glucose was normal in all patients in both groups. There were no significant differences in plasma glucose level, during the oral grucose tolerance test. There were no significant differences between control and wyndrome X group in the fasting plasma insulin concentration(5.1+/-2.4 vs 5.9+/-2.7 microg/ml, p>0.05). However, the insulin levels at 60min(47.6+/-20.0 vs 84.0+/-68.0 microg/ml) and 120 min(31.4+/-18.2 vs 92.9+/-83.8 microg/ml)were significantly higher in the syndrome X group(p<0.05). THere were no significant differences in the C-peptide concentrations at fasting, 60 min and 120 min after oral glucose tolerance test between control and syndrome X group(p>0.05). CONCLUSION: As shown in above results, there were significant differences in insulin concentrations, but nor in C-peptide concentrations between control and syndrome X group. Thus it can be suggested that the increased dinsulin level in these patients is resulted from the altered insulin action to the target tissues, not from the pancreatic overproduction of insulin. We suggest that this hyperinsulinemia resulted from the insulin resistance play a possible role in the abnormality of microvascular circulation as a mechanism of Syndrome X.
Blood Glucose ; C-Peptide ; Chest Pain* ; Diabetes Mellitus ; Exercise Test ; Fasting ; Glucose Tolerance Test ; Humans ; Hyperinsulinism* ; Hypertension ; Insulin ; Insulin Resistance ; Male ; Plasma ; Thorax* ; Volunteers

Patients with chronic renal failure, generally, sufferred from normocytic normochromic anemia caused by decreased level of erythropoietin. But, secondary erythrocytosis has been reported in patients with several renal diseases; renal artery stenosis or throm- bosis, polycystic kidney disease, bilateral hydronephrosis, etc. We report one case of chronic renal failure combined with polycythemia vera. The case was 32 year-old man whose chief complaints were dyspnea, back pain, itching sensation, headache. 6 month ago, the laboratory examination showed only proteinuria and hematuria without deterioration of renal function. The renal function was aggravated with an accelerated course, and bone marrow examination revealed hypercellularity (erythroid predominance), and renal biopsy showed the finding of the end stage of renal disease which may be originated from IgA nephropathy.
Adult ; Anemia ; Back Pain ; Biopsy ; Bone Marrow Examination ; Dyspnea ; Erythropoietin ; Glomerulonephritis, IGA* ; Headache ; Hematuria ; Humans ; Hydronephrosis ; Immunoglobulin A* ; Kidney Failure, Chronic* ; Polycystic Kidney Diseases ; Polycythemia Vera* ; Polycythemia* ; Proteinuria ; Pruritus ; Renal Artery Obstruction ; Sensation

No abstract available.
Blood Platelets* ; Hypertension, Pulmonary* ; Lung Diseases, Obstructive* ; Platelet Activation*

Little has been reported concerning post-operative hypoglycemia in previously asymptomatic individuals. Post-operative hypoglycemic coma is one of the most perplexing problems and must be differentiated from other conditions accompaning coma. We experienced a case of hypoglycemia following emergency cesarean section in primigravida with cephalopelvic disproportion on the fourth post operative day. The comatous state appeared abruptly and developed repeatedly. The causes of post-hypoglycemic coma are discussed and the prolonged starvation before and after operation was suspected to be the cause of coma.
Cephalopelvic Disproportion ; Cesarean Section* ; Coma ; Emergencies ; Female ; Hypoglycemia* ; Pregnancy ; Starvation

BACKGROUND: The angiotensin-converting enzyme(ACE) plays an important role in cardiovascular disease by production of angiotensin and degradation of bradykinin. Cloning of ACE gene revealed an insertion/deletion(I/D) polymorphism according to the presence/absence of a 287 base pair fragment in the 16th intron of ACE gene, and the ACE polymophism was associated with ACE activity. The genotype DD was identified as a risk factor for myocardial infarction in several studies. We analyzed the ACE I/D polymorphism in 62 patients with myocardial infarction and 67 normal subjects. METHODS: Genomic DNA from peripheral blood was amplified by polymerase chain reaction and characterized by three ACE genotypes; two insertion alleles(genotype II), two deletion alleles(genotype DD) and heterogenous alleles(genotype ID). ACE activity was determined by spectrophotometric method utilizing the synthetic substrate. RESULTS: There was no significant difference in ACE polymorphism between patients and normal subjects. But, the frequency of genotype DD was significantly increased in the low-risk group of patients compared with the high-risk group. The multi-vessel disease was more strongly associated with genotype DD, but there was no statistical significance. The ACE activity was strongly associated with ACE polymorphism with the activity being highest in genotype DD. There was no significant difference between patients and control subjects of the same genotype. CONCLUSION: There was no significant difference in ACE polymorphism between patients and normal subjects. The frequencies for genotype II, ID, DD were 0.328, 0.537, 0.134, respectively in normal subjects. There was high frequency of genotype II compared with Caucasians. A deletion polymorphism(genotype DD) may increase the risk for myocardial infarction in lowrisk group, and the serum ACE activity was correlated with three genotypes.
Angiotensins ; Base Pairing ; Bradykinin ; Cardiovascular Diseases ; Clone Cells ; Cloning, Organism ; DNA ; Genotype ; Humans ; Introns ; Myocardial Infarction* ; Polymerase Chain Reaction ; Risk Factors