Acute graft-versus-host disease (GVHD) is one of the most severe complications following allogeneic stem cell transplantation (SCT), and involvement of the gut has been associated with increased mortality and a poorer response to high-dose systemic corticosteroids. For over a decade, oral beclomethasone dipropionate (BDP) has been studied in the treatment of acute gastrointestinal GVHD, as a monotherapy, or in combination with systemic corticosteroids. Here we report, for the first time in Korea, the efficacy of oral BDP (8 mg/day for 25 days) in 3 adults with acute lymphoblastic leukemia who developed steroid-refractory gastrointestinal GVHD (grade III) after myeloablative conditioning SCT (1 matched sibling transplant, 2 matched unrelated transplants). All patients responded completely to oral BDP treatment. Oral BDP is safe and effective for the control of steroid-refractory acute gastrointestinal GVHD.
Adrenal Cortex Hormones ; Adult ; Beclomethasone ; Graft vs Host Disease ; Humans ; Korea ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Siblings ; Stem Cell Transplantation ; Transplants

BACKGROUND: The number of elderly patients undergoing coronary artery bypass grafting (CABG) is increasing. Elderly patients are at increased risk for a variety of perioperative complications and mortality. We identified determinants of operative complications and mortality in elderly patients undergoing CABG. MATERIAL AND METHOD: Between January 1995 and July 2003, 91 patients older than 75 years underwent isolated CABG at Asan Medical Center. There were 67 men and 24 women with mean age of 77.0+/-2.4 years. Thirty clinical or hemodynamic variables hypothesized as predictors of operative mortality were evaluated. RESULT: CABG was performed under emergency conditions in 5 patients. The internal thoracic artery was used in 85 patients and 10 patients received both internal thoracic arteries. The mean number of distal anastomosis was 3.7 per patient. Operative mortality was 3.3%. Twenty-two patients had at least one major postoperative complication. Low cardiac output syndrome was the most common complication, followed by reoperation for bleeding, pulmonary dysfunction, perioperative myocardial infarction, stroke, acute renal failure, ventricular arrhythmia, upper gastrointestinal bleeding, infection, and delayed sternal closure. None were the predictors of mortality. Renal failure, peripheral vascular disease, emergency operation, recent myocardial infarction, congestive heart failure, New York Heart Association (HYHA) class III or IV, Canadian Cardiovascular Society (CCS) angina scale III or IV, and low left ventricle ejection fraction below 40% were univariate predictors of overall complications. Actuarial probability of survival was 94.9%, 89.8%, and 83.5% at postoperative 1, 3 and 5 years respectively. During the follow-up period 93.3% of patients were in NYHA class I, or II and 91.1% were free from angina. CONCLUSION: Although operative complication is increased, CABG can be performed with an acceptable operative mortality and excellent late results in patients older than 75 years.
Aged ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Chungcheongnam-do ; Coronary Artery Bypass* ; Coronary Vessels* ; Emergencies ; Female ; Follow-Up Studies ; Heart ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Hemorrhage ; Humans ; Male ; Mammary Arteries ; Mortality ; Myocardial Infarction ; Peripheral Vascular Diseases ; Postoperative Complications ; Renal Insufficiency ; Reoperation ; Stroke

Tricuspid annuloplasty with the flexible Duran ring may result in a physiologic repair while maintaining the dynamic morphology of the tricuspid annulus. A method for a durable three-dimensional tricuspid annular reconstruction, which retains the plasticity and orifice area of the tricuspid annulus, is described.
Plastics ; Tricuspid Valve

The gross tissue specimens are a valuable aid to the teaching of pathology and anatomy. However, traditional methods for storage and handling of them are discouragingly difficult and, recently, minimal surgical resections as well as preoperative interventions make it more difficult to have instructive gross specimens. Plastination is a process of tissue preservation by impregnation with silicone polymers or epoxy resins. The process in our study involves dehydration by cryosubstitution in aceton, defatting, forced impregnation of silicon polymer in a vacuum, curing and finishing. We submitted 40 surgically resected specimens to plastination. The resulting specimens are odorless, relatively dry, durable, life-like, non-hazardous, maintenance-free, and do not deteriorate with time. Plastinated specimens are a useful adjunct to the teaching of pathology, particularly suited for use in small groups, and appropriate method of tissue preservation. They are much preferred to wet preparation and conventional pots by both students and teachers owing to their accessibility, superior illustrative powers, and comparative ease of interpretation.
Dehydration ; Epoxy Resins ; Humans ; Pathology* ; Polymers ; Silicones ; Tissue Preservation ; Vacuum

OBJECTIVES: APL, which characteristically shows t(15:17), accompanies fatal coagulopathy during remission induction with systemic chemotherapy alone. ATRA, a derivative of vitamin A, can differentiate APL cells as well as HL-60 cells in vitro and induce higher rate of complete remission(CR). Hence, we assessed the effect of ATRA on remission induction and coagulopathy in APL patients. METHODS: (1) 42 patients diagnosed histologically in St. mary's hospital from June 1991 to June 1994 were included. (2) We compared the CR rate, the time required for restoration of derranged coagulation profiles, and the amount of coagulation factors including platelets among the chemotherapy group (control) and ATRA group. RESULTS: 1) There was no difference in CR rate between the control group and ATRA group [84.2%(16 out of 19) vs 87.0%(20 out of 23), p>0.05)] and also no difference between two subgroups of ATRA [ATRA with chemotherapy; 83.3%(10 out of 12) vs ATRA without chemotherapy; 90.9%(10 out of 11), p>0.05] 2) In the ATRA group, the CR rate of newly diagnosed patients was 82.4%(14 out of 17). The first relapsed patients (4) and the second (2) were all achieved CR. 3) The mean duration of coagulopathy, time to normalization of PT, aPTT, FDP, fibrinogen level, was 12.0+/-10.4, 11.1+/-10.2, 16.5+/-9.3, 15.4+/-10.2 days after chemotherapy alone and 4.5+/-4.4, 3.7+/-3.7, 8.9+/-6.1, 8.1+/-6.5 days in the ATRA group(p<0.05). The amount of fresh frozen plasma used in the ATRA group for the purpose of correction of coagulopathy were significantly lower than the control group(p<0.05). The incidence of profound coagulopathy during the remission induction treatment in the ATRA group was significantly lower than the control group[40% (8 out of 20) vs 96.7%(13 out of 15), p
Blood Coagulation Factors ; Drug Therapy ; Fibrinogen ; HL-60 Cells ; Humans ; Incidence ; Leukemia, Promyelocytic, Acute* ; Plasma ; Remission Induction* ; Tretinoin* ; Vitamin A

We report five cases of cytomegalovirus infection in immunocompromised patients which were detected by either cytomegalovirus antigenemia assay or in situ hybridization. Four cases had leukemia and the other had chronic renal failure. All the three BMT recipients suffered from GvHD. Interestingly, there was an unique case of CMV disease without a history of BMT, which reminded us that CMV could attack immunocompromised patients who had not undergone transplantation, too. Four out of five cases died. We think that cytomegalovirus infection or disease should not be regarded as a minor problem in post-transplantation infection in Korea.
Adolescent ; Adult ; Antigens, Viral/*blood ; *Bone Marrow Transplantation ; Case Report ; Cytomegalovirus/*immunology ; Cytomegalovirus Infections/complications/*diagnosis ; Fatal Outcome ; Graft vs Host Disease/complications ; Human ; Immunocompromised Host ; In Situ Hybridization ; Kidney Failure, Chronic/complications ; Kidney Transplantation ; Leukemia/*complications/therapy ; Leukemia, Lymphocytic, Acute, L2/complications/therapy ; Leukemia, Myelocytic, Acute/complications/therapy ; Leukemia, Myeloid, Chronic/complications/therapy ; Male ; Viremia/*diagnosis

The influence of thyroxine upon n the cardiac uptake of catecholamines was investigated in rabbits. A single injection of thyroxine(1.0m/kg) into rabbits did not affect the concentration of myocardial catecholamines. However, this dose of thyroxine greatly increased the cardiac uptake of catecholamine following injection of 2.0mg of norepinephrine as compared to that of untreated normal animals and it remained elevated for several hours. Similarly thyroxine also enhanced the accumulation of myocardial catecholamines following administration of dopa(60-80mg/kg) and epinephrine(1.0-1.5mg/kg).
Animal ; Catecholamines/metabolism* ; Epinephrine/metabolism ; Heart/drug effects* ; Male ; Myocardium/metabolism* ; Norepinephrine/metabolism ; Rabbits ; Thyroxine/pharmacology* ; Tritium

In view of ever rising water pollution problems of river in the vicinity of large urban communities, the author has made an investigation on the pollution of water sampled from Han River (Seoul area) and Nakdong River (Daegu city area) during the period from july to December, 1970. The water samples were taken twice a month during the study period of 6 months from 7 points (locations) along the main stream of Han River at Seoul city and 5 points of Nakdong River at Daegu city. The samples ware measured and analyzed in accordance with the recognized methods in the "Standard Methods or Examination of Water and waste" by American Public Health Association. The obtained results are as follows: I.Han River. 1. Average turbidity was 5.1 units ranging from 1 to 10 units and the turbidity of down stream was higher than that of the upper stream. 2. pH value showed slight alkalinity (mean ; 7.2) except Yunchang-Dong (6.9). 3. The mean value of Dissolved Oxygen contents (D.O) was 7.2 ppm (range of 3.4-10.5ppm). D.O of the upper stream (8.2 ppm. at Walker Hill boating place, 8.0 ppm. at the Gwangzang Bridge and Ddookdo) was higher than that of he downstream (5.6ppm. at Yunchang-Dong. 6.4ppm. at the 2nd Han River Bridge), and D.O in the winter season was higher than that in the summer season, respectively. 4. The mean value of the Biochemical Oxygen Demand (B.O.D.) was 28.3 ppm. (range of 6.2-64.8ppm). The mean value of B.O.D. was 48.7 ppm. at Yunchang-Dong. 42.3ppm. at the 2nd Han River Bridge, 34.0 ppm. at the 1st Han River bridge, 28.5 ppm. at the 3rd Han River Bridge, 19.2 ppm. at Dookdo, 13.2 ppm. at the Gwangzang Bridge, and 10.2 ppm. at the Walker Hill boating place in order of value. B.O.D. in July and August (35.6 and 34.5 ppm.) were the highest and that in November and December (18.6 and 21.2 ppm.) were the lowest. 5. Suspended Solids (SS) were from 15.0 to 667.0 ppm. with the mean of 222.1 ppm "Suspended Solids" of the water samples at Yunchang-Dong and the 2nd Han River Bridge were found to be 378.1 ppm. and 283.9 ppm. respectively which were higher than at the Gwangzang Bridge (134.1ppm.) and at Walker Hill boating place (79.3ppm). 6. Coliform colonies counting of the water samples ranged from 0-2, 500x10/100ml. with the mean value of 205.6x10/100ml. The most contaminated water sample by coliform were from the point of the 2nd Han River Bridge with 640.8x10/100ml while the lowest ones were from Walker Hill boating place with 17.2x10/100ml. There was also a seasonal variation in coliform contamination that is the higher in summer and the lower in winter. II. Nakdong River. 1. The mean value of turbidity was 2.3 units with range of 0 to 9.0 units. The highest point was at Geumho River (7.2 units). and the lowest point was at Gangzung and Moonsan (0.45 and 0.41 units). 2. The mean value of pH was 7.5 (range of 7.1-8.5) and highest point was Geunho River with 8.5. 3. The mean value of D.O was 8.1ppm. (range of 3.4-11.2 ppm.). D.O. of the upper stream showed higher value than that of the down stream, and the winter season than the summer season. 4. B.O.D. ranged from 2.6 to 57.0 ppm. (mean; 20.4 ppm.). The water sample at Geumho River showed the highest value (41.5ppm) while at Moonsan and Gangzung showed the lowest (4.6 and 4.7 ppm.). 5. The mean value of suspended solids was 48.7 ppm. (range of 4.0-182.0 ppm.). The highest month was July (63.7 ppm.) and August (62.1 ppm.) and the lowest month was October (37.0 ppm.) and December (24.4 ppm.). 6. The mean value of the coliform colonies was 22.7x10/100ml. (range of 0-243x10/100ml.). The highest number of the colonies was found in the sample water at the Whawon recreation area (50.5x10/100ml.) followed by the Geumho River (33.9x10/100ml;), the Goryung Bridge (28.3x10/100ml.), Gangzung(0.7x10/100ml), and Moonsan (0.6x10/100ml.).
American Public Health Association ; Daegu ; Hydrogen-Ion Concentration ; Oxygen ; Recreation ; Rivers* ; Seasons ; Seoul ; Ships ; Water Pollution* ; Water*

During the period from July 1st to the end of November 1970, a survey on air pollution and noise level was made in Seoul, Pusan and Taegu, the three largest cities in Korea. Each city was divided into 4-6 areas : the industrial area, the semi-industrial area, the commercial area, the residential area, the park area and the downtown area. Thirty eight sites were selected from each area. A. Method of Measurement : Dustfall was measured by the Deposit Gauge Method, sulfur oxides by PbO2 cylinder method, suspended particles by the Digital Dust Indicator, Sulfur dioxide (SO2) and Carbon Monoxide (CO) by the MSA & Kitakawa Detector and the noise levels by Rion Sound Survey meter. B. Results: 1. The mean value of dustfall in 3 cities was 30.42 ton/km2/month, ranging from 8.69 to 95.44. 2. The mean values of dustfall by city were 33.17 ton/km2/month in Seoul, 32.11 in Pusan and 25.97 in Taegu. 3. The mean values of dustfall showed a trend of decreasing order of semi-industrial area, downtown area, industrial area, commercial area, residential area, and park area. 4. The mean value of dustfall in Seoul by area were 52.32 ton/km2/month in downtown, 50.54 in semi-industrial area, 40.37 in industrial area, 24,19 in commercial area, 16.25 in park area and 15.39 in residential area in order of concentration. 5. The mean values of dustfall in Pusan by area were 48.27 ton/km2/month in semi-industrial area, 36.68 in industrial area 25.31 in commercial area, and 18.19 in residential area. 6. The mean values of dustfall in Taegu by area were 36.46 ton/km2/month in downtown area, 33.52 in industrial area, 20.37 in commercial area and 13.55 in residential area. 7. The mean values of sulfur oxides in 3 cities were 1.52mg SO3/day/100cm2 PbO2, ranging from 0.32 to 4.72. 8. The mean values of sulfur oxides by city were 1.89mg SO3/day/100cm2 PbO2, in Pusan, 1.64 in Seoul and 1.21 in Taegu. 9. The mean values of sulfur oxides by area in 3 cities were 2.16mg SO3/day/100cm2 PbO2 in industrial area, 1.69 in semi-industrial area, 1.50 in commercial area, 1.48 in downtown area, 1.32 in residential area and 0.94 in the park area, respectively. 10. The monthly mean values of sulfur oxides contents showed a steady increase from July reaching a park in November. 11. The mean values of suspended particles was 2.89mg/m3, ranging from 1.15 to 5.27. 12. The mean values of suspended particles by sity were 3.14mg/m3 in Seoul, 2.79 in Taegu and 2.25 in Pusan. 13. The mean values of noise level in 3 cities was 71.3 phon, ranging from 49 to 99 phon. 14. The mean values of noise level by city were 73 phon in Seoul, 72 in Pusan and 69 in Taegu in that order. 15. The mean values of noise level by area in 3 cities showed a decrease in the order of the downtown area, commercial area, industrial area and semi-industrial area, park area and residental area. 16. The mean values of noise level by area in 3 cities indicated that the highest level was detected in the downtown area in Seoul and Taegu and in the industrial area in Pusan. 17. The daily average concentration o sulfur dioxides (SO2) in 3 cities was 0.081 ppm, ranging from 0.004 to 0.196. 18. The daily average concentration of sulfur dioxides by city were 0.092 ppm in Seoul, 0.089 in Pusan and 0.062 in Taegu in that order. 19. the weekly average concentration of carbon monoxides (CO) was 27.59 ppm. 20. The daily average concentration of carbon monoxides by city were 33.37 ppm. in Seoul, 25.76 in Pusan and 23.65 in Taegu in that order. 21. The concentration of SO2 and CO reaches a peak from 6 p.m. to 8 p.m. 22. About 3 times probably the daily average concentration of CO could be detected in the downtown area probably due to heavy traffic emission in comparison with that in the industrial area. 23. As for daily variation of the concentration of SO2 and CO it was found that the concentration maintains relatively higher value during weekdays in the industrial area and on the first part of the week in the downtown area.
Air Pollution* ; Busan* ; Carbon ; Carbon Monoxide ; Daegu* ; Dust ; Korea ; Noise* ; Seoul* ; Sulfur ; Sulfur Dioxide ; Sulfur Oxides

Treatment of rabbits with thyroxine 1 mg/kg daily for three to six days produced a hyperthyroid state as evidenced by increase in the heart rate and PBI. The hyperthyroid animals exhibited a significant shortening of the atrial refractory period. Beta adrenergic receptor blocking agents, propranolol (l0(-6)M pronethalol (5 X 10(-5)M) or MJ-1999 (5 X 10(-4)M), completely blocked the shortening of the atrial refractory period produced by the treatment with thyroxin, and with norepinephrine. Consequently, the shortening of the atrial refractory period of rabbits treated with thyroxin appears to bs mediated through stimulation of the beta adrenergic receptor in the heart. From these results, it may be concluded that the stimulation of the beta adrenergic receptor plays an important role in the alteration of cardiac function found in hyperthyroidism, and that the beta adrenergic blocking agents may be useful in treatment of the cardiac complications of hyperthyroidism.
Adrenergic beta-Antagonists/pharmacology ; Animals ; Female ; Heart Atria/*drug effects/physiopathology ; Hyperthyroidism/chemically induced/*physiopathology ; Male ; Rabbits ; Sympatholytics/*pharmacology ; Thyroxine