BACKGROUND: The purpose of this study was to determine the prognostic significance of chest computed tomographic (CT) parameters in acute submassive pulmonary embolism (PE). METHODS: Between January 2006 and December 2009, 268 consecutive patients with acute submassive PE that was confirmed by chest CT with pulmonary angiography in emergency room were studied. One experienced radiologist measured CT parameters and judged the presence of right ventricular dysfunction. CT parameters were analyzed to determine their ability to predict a major adverse event (MAE). RESULTS: There were 220 patients included and 61 (27.7%) had MAE. Left ventricular and right ventricular maximum minor axis (36.4+/-8.0 vs. 41.7+/-7.4, p<0.01; 45.7+/-9.4 vs. 41.5+/-7.6, p<0.01), superior vena cava diameter (19.2+/-3.4 vs. 18.0+/-3.4, p=0.02), azygos vein diameter (10.0+/-2.2 vs. 9.2+/-2.3, p=0.02), septal displacement (19 vs. 18, p<0.01) were significantly higher in MAE group than in no MAE group. Patients with MAE had high right ventricular/left ventricular dimension ratio (RV/LV ratio) compared to patients without MAE (1.34+/-0.48 vs. 1.03+/-0.28, p<0.01). The most useful cut-off value of RV/LV ratio for MAE was 1.3 and the area under the curve was 0.71 (0.62~0.79). CONCLUSION: RV/LV ratio on chest CT was a significant predictor of submassive PE related shock, intubation, in-hospital mortality, thrombolysis, thrombectomy within 30 days.
Angiography ; Axis, Cervical Vertebra ; Azygos Vein ; Displacement (Psychology) ; Emergencies ; Hospital Mortality ; Humans ; Intubation ; Prognosis ; Pulmonary Embolism ; Shock ; Thorax ; Thrombectomy ; Vena Cava, Superior ; Ventricular Dysfunction, Right

BACKGROUND: The purpose of this study was to determine the prognostic significance of chest computed tomographic (CT) parameters in acute submassive pulmonary embolism (PE). METHODS: Between January 2006 and December 2009, 268 consecutive patients with acute submassive PE that was confirmed by chest CT with pulmonary angiography in emergency room were studied. One experienced radiologist measured CT parameters and judged the presence of right ventricular dysfunction. CT parameters were analyzed to determine their ability to predict a major adverse event (MAE). RESULTS: There were 220 patients included and 61 (27.7%) had MAE. Left ventricular and right ventricular maximum minor axis (36.4+/-8.0 vs. 41.7+/-7.4, p<0.01; 45.7+/-9.4 vs. 41.5+/-7.6, p<0.01), superior vena cava diameter (19.2+/-3.4 vs. 18.0+/-3.4, p=0.02), azygos vein diameter (10.0+/-2.2 vs. 9.2+/-2.3, p=0.02), septal displacement (19 vs. 18, p<0.01) were significantly higher in MAE group than in no MAE group. Patients with MAE had high right ventricular/left ventricular dimension ratio (RV/LV ratio) compared to patients without MAE (1.34+/-0.48 vs. 1.03+/-0.28, p<0.01). The most useful cut-off value of RV/LV ratio for MAE was 1.3 and the area under the curve was 0.71 (0.62~0.79). CONCLUSION: RV/LV ratio on chest CT was a significant predictor of submassive PE related shock, intubation, in-hospital mortality, thrombolysis, thrombectomy within 30 days.
Angiography ; Axis, Cervical Vertebra ; Azygos Vein ; Displacement (Psychology) ; Emergencies ; Hospital Mortality ; Humans ; Intubation ; Prognosis ; Pulmonary Embolism ; Shock ; Thorax ; Thrombectomy ; Vena Cava, Superior ; Ventricular Dysfunction, Right

PURPOSE: Coiling or infusion of embolic materials into a wide necked aneurysm can be performed with stenting. The purpose of our study is to assess the technical feasibility of aneurysm treatment with glue embolization after stenting. MATERIALS AND METHODS: We used four Wallstents for surgically repairing eight canine carotid aneurysms. After confirmation of the aneurysms on the angiogram, we introduced a 6-7 F guiding catheter in order to deploy the stents. After stenting, we passed a microcatheter into the aneurysm lumen through the stent mesh. 28% glue was slowly injected until the glue cast completely filled the lumen. We evaluated the passage of a microcatheter through the stent meshwork, formation of the glue cast and the stents' ability to protection for any leakage of glue. The follow-up angiogram was obtained for two dogs, one to three times until 8 weeks, and then we sacrificed the dogs and performed pathologic examinations. RESULTS: Stenting was successful in all cases except one in which the vessel was occluded because the stent was not completely expanded within the lumen. The microcatheter could not pass through the stent mesh in one aneurysm. The two week follow-up angiogram showed complete occlusion of the aneurysm and a patent carotid lumen in a case after successful stenting and glue embolization without distal migration of glue. Tungsten in the glue was noted to migrate out of aneurysm into the soft tissue of the neck. Histopathologic examination showed successful obliteration and stable organization of the aneurysmal lumen with ingrowth of fibroblasts and a foreign body reaction. In contrast, the aneurysms without the glue embolization being performed showed partially thrombosed aneurysmal lumens that became smaller and indistinct on the 8 week follow-up angiograms. Histopathologic examination showed a disorganized thrombus with numerous recanalizations. CONCLUSION: Glue embolization after stenting could be performed for aneurysm without distal migration of the glue or gluing of the catheter. This concept appears to be useful for applications to the further research and the treatment of aneurysm.
Adhesives* ; Aneurysm* ; Animals ; Carotid Arteries* ; Catheters ; Dogs ; Fibroblasts ; Follow-Up Studies ; Foreign-Body Reaction ; Intracranial Aneurysm ; Neck ; Stents* ; Thrombosis ; Tungsten

The throat swabs obtained from 1,098 adults and 432 children patients with respiratory diseases were examined for Mycoplasma pneumoniae infection detected by culture and polymerase chain reaction (PCR). Antimicrobial susceptibilities of the resulting 60 M. pneumoniae isolates were evaluated by testing minimum inhibitory concentrations (MICs) of erythromycin, minocycline, tetracycline, josamycin, sparfloxacin, ofloxacin, and ciprofloxacin by a broth micro-dilution method. In a preliminary screening, the detection rate of M. pneumoniae by PCR was 29.2% (277/948) for the adults and 28.3% (90/318) for the children. In the second survey, the isolation rate of M. pneumoniae by culture was 29.3% (44/150) for the adults, and 14.0% (16/114) for the children. The PCR detection rate was 36.7% (55/150) for the adults and 23.7% (27/114) for the children. The MIC90s of the M. pneumoniae isolates were 0.015 mg/ml for erythromycin, lower than 0.03 mg/ml for josamycin, 0.06 mg/ml for sparfloxacin and minocycline, 0.12 mg/ml for tetracycline, 0.5 mg/ml for ofloxacin and CFC-222, and 1.0 mg/ml for ciprofloxacin. The isolates were susceptible to erythromycin, josamycin, sparfloxacin, minocycline, tetracycline, and ofloxacin, but the 63.3% of them was resistant to ciprofloxacin. These results indicate that the PCR method has a significant potential as a rapid and sensitive method for early detection of M. pneumoniae infection in clinical specimens as compared with the culture method, but the PCR method could not provide any information concerning the biological chracteristics of M. pneumoniae strains. Erythromycin, josamycin, sparfloxacin, minocycline, and tetracycline could be recommended as the antimicrobial agents of choice in Korea.
Adult ; Anti-Infective Agents ; Child ; Ciprofloxacin ; Erythromycin ; Humans ; Josamycin ; Korea ; Mass Screening ; Microbial Sensitivity Tests ; Minocycline ; Mycoplasma pneumoniae* ; Mycoplasma* ; Ofloxacin ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction ; Tetracycline

OBJECTIVES: Craving is the subjectively experienced motivational states inducing ongoing drug use in addicts. It also proceeds or precipitates relapse episode in drug addicts. Alcohol craving may be triggered by exposure to an object, environment, or emotion that a person has come to associate with alcohol consumption. Such stimuli are called alcohol-related cues. Among alcohol-related cues, alcohol-related visual stimuli are simple and reliable methods in inducing alcohol craving. The object of this study is to develop alcohol-related visual stimuli which induce alcohol craving reliably and to investigate the characteristics of alcohol-related visual stimuli in alcoholics. METHODS: First, the authors developed 27 alcohol and drinking color photos as candidate stimuli. Then, 3 photos which induce alcohol craving most were chosen as alcohol-related visual stimuli respectively by alcoholics, alcoholism high risk group and normal control group. The authors compared characteristics, situation and complexity of selected alcohol-related visual stimuli among three groups. RESULTS: 1) 'A glass of Soju', 'Drinking together' and 'A glass of beer, a bottle of beer and a sidedish' were chosen as alcohol-related visual stimuli which induce most craving in alcoholics, alcoholism high risk group and normal control group respectively. 2) Alcohol photo(stationary object) induced craving most in alcoholics in contrast with drinking photo(situation) in social drinkers. Alcoholics clung to alcohol per se, not to atmosphere or situation of drinking, and alcoholism high risk group felt craving by the expectation of drinking situation. Normal control group showed no consistent finding in choosing alcohol-related visual stimuli. CONCLUSION: With these results, the author suggests classical conditioning as psychopathological model of alcohol craving with alcoholics. In contrast with alcoholics, alcohol craving of alcoholism high risk group may be related to alcohol specific memory or positive expectancies about alcohol use. These finding may support different neurobiological mechanisms of alcohol craving between alcoholics and social drinkers.
Alcohol Drinking ; Alcoholics ; Alcoholism ; Atmosphere ; Beer ; Conditioning, Classical ; Cues ; Drinking ; Drug Users ; Glass ; Humans ; Memory ; Recurrence

The effects of ethylene glycol monoethyl ether (EGEE) on testicular cell populations in pubertal (5 weeks old) and adult (9 weeks old) male rats were investigated by a flow cytometric method. A total of 50 rats (in number, 25 pubertal and 25 adult rats) was divided into 5 experimental groups including 0 (control), 50, 100, 200, and 400 mg EGEE/kg of body weight. The animals were administered by gavage for 4 weeks. In adult rats, the treatment of EGEE at the dose of 400 mg/kg of body weight decreased significantly the populations of haploid, while it increased those of diploid and tetraploid cells. In pubertal rats, the treatment of EGEE at the dose of 400 mg/kg of body weight caused only minimal changes in the relative percent of testicular cell types. These results suggest that the effects of EGEE on testicular function in pubertal rats appear to be less pronounced than in adult rats.
Animals ; Dose-Response Relationship, Drug ; Ethylene Glycols/*toxicity ; Male ; Organ Size/drug effects ; Rats ; Sexual Maturation/*drug effects ; Solvents/*toxicity ; Spermatogenesis/*drug effects ; Testis/drug effects/*pathology ; Time Factors

An age-dependent cellular change of DNA contents in the testis of Sprague-Dawley rats was investigated by flow-cytometric method. Testicular cell suspensions at the age of 4, 5, 6, 7, 8, 10, 12, 16 and 26 weeks were prepared and stained with propidium iodide. The relative proportions in the number of mature and immature haploid (1n), diploid (2n), S-phase and tetraploid (4n) cells were calculated. The proportion in the number of mature haploid cells was sharply increased to the age of 10 weeks (about 38%), thereafter increased slightly to the level of 42% at the age of 26 weeks. The proportion of immature haploid cells was dramatically increased to the age of 6 weeks, then maintained at the level of 20 to 30% thereafter. The proportion of diploid cells was 64% at the age of 4 weeks, then decreased gradually through the age of 26 weeks. The proportion of S-phase cells was increased to the age of 4 weeks, then maintained at a plateau level to the age of 26 weeks. The proportion of tetraploid cells were about 26% at the age of 4 weeks, then decreased gradually to the age of 26 weeks. These results suggest that the proportions of testicular cells may depend on the age of the rat and that the flow cytometric method may be useful in the evaluation of the spermatogenic status with regard to accuracy and sensitivity.
Animals ; DNA/*analysis/genetics ; Diploidy ; Flow Cytometry/methods/veterinary ; Haploidy ; Male ; Rats ; Spermatogenesis ; Testis/chemistry/*growth & development

The root bark of mulberry (Morus alba L. Cortex Mori and other plant of the genus Morus) has been used as an antiphlogistic, diuretic, and expectorant in herbal medicine, and the crude drug is known as "Sangbaikpi" in Korea. Capsaicin, a neurotoxin extracted from a red peppers, has selective effects on peptide-containing C-fiber and induces the release of neuropeptides from sensory nerve ending. But, any reports about the influences of Cortex mori (CM) on the capsaicin-induced neurogenic inflammation were not found, and the precise mechanism of capsaicin-induced neurogenic inflammation remains incompletely understood. The purpose of this study was to determine whether CM could inhibit the capsaicin-induced cutaneous reaction, and to find out its action mechanism. For this purpose, influences of CM on the capsaicin-induced cutaneous reaction (vascular permeability) in back skin of Sprague-Dawley rat, capsaicin-induced histamine release, calcium influx and the change of intracellular cAMP level in rat peritoneal mast cell were estimated. Results obtained were as follows; 1. Pretreatment of CM inhibited remarkably the capsaicin-induced cutaneous reaction. 2. The capsaicin-induced histamine release was inhibited by pretreatment with CM. 3. Capsaicin-induced calcium influx into mast cell was also inhibited by pretreatment with CM. 4. Capsaicin-induced decrease of cAMP level in the mast cell was inhibited significantly by pretreatment with CM. These results suggest that CM contains some substances with an anti-neurogenic inflammatory activity which inhibit the capsaicin-induced cutaneous reaction through the mechanism of mast cell stabilization.
Animals ; Calcium ; Capsaicin ; Capsicum ; Herbal Medicine ; Histamine Release ; Korea ; Mast Cells ; Morus ; Neurogenic Inflammation* ; Neuropeptides ; Plants ; Rats ; Rats, Sprague-Dawley ; Sensory Receptor Cells ; Skin

Klinefelter syndrome is one of the most common forms of primary hypogonadism and infertility in males. It is a clinical syndrome consisting of gynecomastia, azoospermia, and increased urinary excretion of follicle-stimulating hormone. Fequency of diabetes mellitus, emphysema, asthma, breast cancer increase in Klinefelter syndrome. We report a 16-year-old male patient with impaired glucose tolerance in association with Klinefelter syndrome, which was confirmed by chromosome analysis. The mechanism of impaired glucose tolerance in this patient was peripheral insulin resistance which clarified by euglycemic hyperinsulinemic clamp test.
Adolescent ; Asthma ; Azoospermia ; Breast Neoplasms ; Diabetes Mellitus ; Emphysema ; Follicle Stimulating Hormone ; Glucose* ; Gynecomastia ; Humans ; Hypogonadism ; Infertility ; Insulin Resistance ; Klinefelter Syndrome ; Male

PURPOSE: To determine the efficacy of metalic stents in the treatment of experimentally createdcarotid-jugular fistulas. MATERIALS AND METHODS: Carotid-jugular fistulas were constructed surgically in fourmongrel swines. Three Wallstents (Schneider, Bulbanch, Switzerland), 6mm in diameter and 23mm in length, and oneNir stent (Boston Scientific Corporation, Boston, U.S.A.), 3-5mm in diameter and 16mm in length, were placedendovascularly across the fistula holes within the carotid artery. Carotid angiography was performed before,immediately after, and 1-3 months after stent placement. Fistula specimens were ohtained after final angiographyand gross and microscopic examination was performed. RESULTS: Angiography demonstrated decreased flow through thefistula immediately after stent placement. During follow-up, flow through the fistula decreased progressively butcomplete closure did not occur. Carotid arteries p in which Wallstents were placed were patent throughout thefollow-up period. A carotid artery in which a Nir stent was used showed no decreased flow during follow-upangiography lasting two months. Pathologically, a thin layer of endothelium covered the stent wires;there was atransitional zone between the fibrous connective tissue of organizing thrombus, and endothelial proliferationoccurred in the overlying fistula hole. CONCLUSIONS: Stent placement effectively reduced flow through thefistulas but during the ensuing three months closure did not occur. Occlusion was then progressive.Pathologically, intimal proliferntion arose from the oranizing thrombus on the surface of the stent mesh.
Angiography ; Arteriovenous Fistula* ; Carotid Arteries ; Connective Tissue ; Endothelium ; Fistula ; Follow-Up Studies ; Stents* ; Swine ; Thrombosis