No abstract available.
Aortic Stenosis, Supravalvular*

Intensive insulin therapy effectively delays the onset and slows the progression of nephropathy in patients with IDDM. TGF- 0 has recently been implicated in the pathogenesis of diabetic nephropathy. We evaluated the effects of different level of glucose control with insulin therapy on the progression of diabetic nephropathy in age-matched control rats(C) and 3 groups of streptozotocininduced diabetic rats', high blood glucose diabetic rats without insulin therapy(HG), rnoderate glucose diabetic rats with insulin therapy(MG), and normal glucose diabetic rats with intensive insulin treatment (NG). Glomerular volume(VG) was measured using Image-Pro morphometric software, glomerular TGF- Bl mRNA expression by in situ hybridization, and glomerular expression of TGF-8 and type IV collagen proteins by immunohistochemical staining. VG was significantly higher in HG than in other groups in 12 weeks. Kidney weight(KW) was the highest while the body weight the lowest in HG of all groups in 12 weeks. Daily urine albumin excretion (UAE) increased with time in all groups but was significantly larger in HG than in all other groups in 12 weeks. MG also had significantly larger UAE than C in 12 weeks. There was no difference in VG, KW, and UAE between NG and C. Glomerular TGF-Bl mRNA expression was significantly higher in HG than in all the rest of the groups in 4 and 12 weeks. Glomerular expression of TGF-B and type IV collagen proteins was proportional to the levels of blood glucose, being the highest in HG in 12 weeks. There was little or no expression of TGF-0 1 mRNA and protein or type IV collagen protein in NG. Thus these results support the view that high blood glucose is the prerequisite for glomerular injury in diabetes mellitus and that the glomerular injury in diabetes mellitus is mediated, in part, by TGF-01 and suppressed by glucose control.
Animals ; Blood Glucose* ; Body Weight ; Collagen Type IV ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies* ; Glucose ; Humans ; In Situ Hybridization ; Insulin* ; Kidney ; Rats ; RNA, Messenger

The determination of the degree and ability of recovery of obstructive hydronephrosis is important in treatment and prediction of prognosis. Among the various methods in determination of the status of kidney, intravenous pyelography is the most important tool to evaluate the morphological and functional changes of kidney in vivo. The purpose of this experiment was the determination of process and recoverability of hydronephrosis depend on duration of unilateral uretreal obstruction. For the experiment, 32 rats were divided into 2 groups; the first group of 12 rats were used to determine the process of hydronephrosis during 1 to 4 weeks of unilateralureteral ligation and the second group of 20 rats were used to determine the recoverability of hydronephrotic kidney depend on same duration of ureteral ligation following relief of ligation. Intravenous pyelography as undertaken and renal angiography, gross and microscopic examination were added. The results obtained are summarized as follows; 1. Kidney enlargement and pelvic dilatation were progressively increased with a relation to duration of ureteral obstruction until 4 weeks. 2. Renal excretory function is not impaired until 3 weeks obstruction, but rapidly impaired to nonfunctioning in 4 weeks obstruction. 3. Renal recovery was possible following relief of ureteral ligation within 3 weeks of ureteral obstruction, but histopathological and functional recovery were impossible in 4 weeks of ureteral ligation. 4. There is no direct correlation between duration of obstruction and recoverability following relief within 3 weeks of uretral obstruction. 5. Intravenous pyelographyis a simple and accurate method to determine the degree of obstructive hydronephrosis and to evaluate morphological and functional recovery of kidney following relief of obstruction.
Angiography ; Animals ; Dilatation ; Hydronephrosis ; Kidney ; Ligation ; Methods ; Prognosis ; Rats ; Ureter ; Ureteral Obstruction ; Urography

Corneal and conjunctival squamous epithelial cells have been known to express the mucin MUC1. We attempted to reveal the expression and localizational characteristics of the membrane-spanning mucin MUC1 as a component of the mucous layer in the human corneal epithelium. An antibody to the MUC1 was used to detect the MUC1 on the corneal epithelium by immunohistochemistry and immunofluorescent staining. In situ hybridization was performed to determine the distribution of MUC1 mRNA in the ocular surface. Immunohistochemically, the MUC1 mucin was observed along the apical membranes of the corneal epithelium. According to immunofluorescent staining, cells varied in the amount of mucin MUC1. Expression of MUC1 mRNA was observed in all layers of the corneal epithelium. The MUC1 mucin synthesized by the corneal epithelia exists on the apical membrane of the superficial cells. The amount of MUC1 may vary with the vertical migration and the activity of the cells.
Epithelial Cells ; Epithelium, Corneal* ; Humans* ; Immunohistochemistry ; In Situ Hybridization ; Membranes ; Mucin-1 ; Mucins ; RNA, Messenger

PURPOSE: This paper is to evaluate radiological features of hypersensitivity pneumonitis, correlated with clinical and pathologic findings. MATERIALS AND METHODS: Patients consisted of 2 men and 3 women, aged 23-51 years old (average 41). Diagnosis was based on the presence of suggestive clinical and radiological findings (chest radiography, high resolutional CT, gallium scintigraphy), and lung biopsy showing characteristic histological features. RESULTS: All patients complained of exertional dyspnea and three patients experienced coughing. On the pulmonary function test, four patients revealed restrictive pattern and one patient was normal. Results of bronchoalveolar lavage, available in four patients, revealed lymphocytosis in three patients and normal finding in one patient. Chest radiographs showed ground glass opacity or diffuse nodular densities. On the HRCT, diffuse nodular opacity and ground glass opacity were seen in variable features. All 4 patients had diffuse increased uptake on the gallium scan. On lung biopsy, a combination of histologic findings showed cellular bronchiolitis, diffuse interstitial infiltrates and non-necrotizing granulomas, consistent with diagnosis of hypersensitivity pneumonitis. CONCLUSION: Hypersensitivity pneumonitis could be diagnosed with these radiological, clinical and pathological findings.
Alveolitis, Extrinsic Allergic* ; Biopsy ; Bronchiolitis ; Bronchoalveolar Lavage ; Cough ; Diagnosis ; Dyspnea ; Female ; Gallium ; Glass ; Granuloma ; Humans ; Hypersensitivity* ; Lung ; Lymphocytosis ; Male ; Radiography ; Radiography, Thoracic ; Respiratory Function Tests

PURPOSE: We studied 278 men who are over 40 years of age to educate BPH and to evaluate the prevalence of BPH in Busan city of Korea. MATERIALS AND METHODS: Between December 1997 and February 1998, 278 men in Busan city were investigated. The screening tests included urinary symptom questionnaire (IPSS), digital rectal examination (DRE), prostate specific antigen (PSA) and uroflometry. RESULTS: Based on the IPSS, 36.3%, 49.7% and 14.0% of the men were mild (1-7), moderately (8-19) and severely (20-35) symptomatic. The mean maximal flow rate and PSA for men 40 to 49, 50 to 59, 50 to 69 and over 70 years old were 18.4 ml/sec, 14.2 ml/sec, 12.9 ml/sec, 10.6 ml/sec and 1.081 ng/ml, 1.195 ng/ml, 1.527 ng/ml, 2.352 ng/ml respectively. CONCLUSIONS: The prevalence rate of clinical BPH(IPSS>7 and peak urinary flow rate<10 ml/sec) in community-based study of 278 men was 25.5%.
Aged ; Busan* ; Digital Rectal Examination ; Humans ; Korea ; Male ; Mass Screening ; Prevalence* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Surveys and Questionnaires

BACKGROUND: Recent interest in the use of normothermic blood cardioplegia is based on theoretical advantages over the traditional method of hypothermic myocardial protection. These reported advantages are a decrease in intraaortic balloon pump use, greater incidence of return to normal sinus rhythm, greater immediate cardiac outputs, and less time weaned from bypass after removal of the aortic cross-clamp. In addition to these advantages, normothermic blood cardioplegia offers the promise to resuscitate the ischemic myocardium and reduce the morbidity and mortality for patients with high-risk disease. This study was designed to compare the effects of cold crystalloid and normothermic blood cardioplegia on the postoperative recovery. METHODS: To evaluate the efficacy of cold versus normothermic cardioplegia, forty-four patients scheduled to undergoing valvular replacement surgery were selected to receive intermittent cold(4degrees C) crystalloid cardioplegia(n=22), group I or continuous normothermic(37degrees C) blood cardioplegia(n=22), group II. Cardiopulmonary bypass(CPB) and aortic cross-clamp(ACC) times were measured during the operation and patients were evaluated postoperatively for serum electrolytes, arterial blood gas analysis, blood pressure, heart rate, complications, ventilator periods and ICU stay. RESULTS: The ACC and CPB times were significantly longer in group II(165.9+/-44.8 min, 210.9+/-60.2 min) compared with group I(121.2+/-38.7 min, 149.7+/-38.1 min)(p<0.01). Group II patients had significantly higher serum potassium level(5.2+/-0.8 mEq/L) than group I(4.3+/-0.4 mEq/L) on the first postoperative day(p<0.01). ICU stay and ventilator period were not significantly different in two groups. There was no significant difference in postoperative complications and mortality rates between two groups. CONCLUSIONS: These results suggest that the continuous normothermic blood cardioplegia may be useful in myocardial protection during cardiac operation.
Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Electrolytes ; Heart Arrest, Induced* ; Heart Rate ; Heart* ; Humans ; Incidence ; Mortality ; Myocardium ; Postoperative Complications ; Potassium ; Thoracic Surgery* ; Ventilators, Mechanical

Acute disseminated encephalomyelitis (ADEM) is a monophasic autoimmune demyelinating disease of the central nervous system, which typically follows acute viral or bacterial infection or vaccination. We report a case of ADEM associated with hepatitis C virus (HCV) infection with positive serum and cerebrospinal fluid (CSF) anti-HCV antibody. After steroid treatment, neurologic symptoms were improved. Virus triggers autoimmunity or direct viral invasion plays a part in the genesis of ADEM. This is the first reported case of ADEM with anti-HCV antibody in the CSF.
Encephalomyelitis, Acute Disseminated/*diagnosis/drug therapy/etiology/virology ; Female ; Hepacivirus/pathogenicity ; Hepatitis C/*complications ; Humans ; Methylprednisolone/therapeutic use ; Middle Aged

OBJECTIVES: The prognosis of spontaneous intracerebral hemorrhage often depends on initial neurologic condition, size and location of hemorrhage and associated intraventricular hemorrhage. However, age of patient, coagulation state and other associated vascular diseases may also play a role when present. In recent years, the geriatric population has been increasing. The age distribution of the patients with intracerebral hemorrhages also has been increased, accordingly. However, such patients, especially when associated with poor initial conditions often tend to be managed rather conservatively. The authors analyzed retrospectively on forty-five patients with spontaneous intracerebral hemorrhage over the seventies with poor initial condition to find out whether there exists a difference of outcome between surgery and non-surgery group. MATERIAL AND METHOD: A total of 45 patients over seventies with spontaneous intracerebral hemorrhage with Glasgow Coma Scale(GCS) 4-8 treated over last six years were included. The validity of surgical management for these patients as well as clinical variables which might have been operated on the outcome of these patients were evaluated. The Glasgow Outcome Scale(GOS) after three months was used for comparison of outcome. RESULTS: In surgical group(19 cases), mean age was 74.5 years old, mean hematoma volume 67.2ml and mean GCS score 5.7 points. In nonsurgical group(26 cases), mean age was 79.3 years old, mean hematoma volume 32.1ml, and mean GCS score 6.8 points. Mortality rate in surgical group was 47.4%(9 patients), including 2 cases of post-operative rebleeding, while that in nonsurgical group was 46.2%. However, when patients with initial GCS 4-6 points and over 30ml in hematoma volume were regrouped, mortality rate in surgical group was 46.2%, whereas mortality rate in nonsurgical group was 66.7%. CONCLUSION: It is concluded that the mortality rate is much low in surgery group with initial GCS less than 6 points and hematoma volume over 30cc. There was no significant difference of outcome in patients with basal ganglia and thalamic hemorrhage. However, surgical treatment lowered the mortality and morbidity rate in patients with subcortical and cerebellar hemorrhage.
Age Distribution ; Basal Ganglia ; Cerebral Hemorrhage* ; Coma ; Geriatrics ; Hematoma ; Hemorrhage ; Humans ; Mortality ; Prognosis* ; Retrospective Studies ; Vascular Diseases

BACKGROUND: Doxapram hydrochloride is a respiratory stimulant that produces arousal effects in patients under anesthesia. We investigated the effects of doxapram on the recovery time and BIS index of patients administered desflurane inhalational anesthesia. METHODS: 40 patients who underwent general anesthesia using desflurane that had an ASA physical status of I or II received either 1 mg/kg of doxapram hydrochloride (doxapram group, n = 20) or normal saline (control group, n = 20) IV at end of surgery. Anesthetic recovery after the injection of doxapram was then determined based on the time to eye opening in response to verbal command, hand squeezing on command, time to extubation, and Aldrete recovery score. BIS index, systolic blood pressure, tidal volume and heart rate were recorded every minute for up to thirteen minutes. RESULTS: The doxapram group showed significantly shorter times to emergence based on eye opening in response verbal command (sec) (409 +/- 114 vs 320 +/- 116), hand squeezing on command (sec) (458 +/- 119 vs 351 +/- 114) and extubation (sec) (491 +/- 103 vs 418 +/- 79) compared to control group. The BIS score was not significantly different between the two groups. CONCLUSIONS: The Bis index was not significant higher in the doxapram group, with the exception of the measurement recorded at 2 minutes, however the recovery time from desflurane inhalational anesthesia was faster in the doxapram group than the control group.
Anesthesia ; Anesthesia, General ; Arousal ; Blood Pressure ; Doxapram ; Eye ; Hand ; Heart Rate ; Humans ; Isoflurane ; Tidal Volume