, Joon Sim, Yang-Hee Lim, Jin-Hwa Lee, Gil-Ja Shin Most pulmonary thromboemboli arise from the deep vein thrombosis, which have complete clinical and at least near complete roentgenographic and angiographic resolution within four to six week of the acute event.
But chronic pulmonary hypertension and cor pulmonale from unresolved pulmonary embolism complicate acute embolic episode with a frequency of less than 1 percent. Rarely pulmonary thromboemboli can result from right atrial thrombi.
We experienced a case of chronic thromoboembolic pulmonary hypertension, which wrose from right atrial thrombi in the patient with rheumatic valvaular heart disease and thoracic aorta atherosclerotics stenosis.
, Il Hwan Moon CLO test™ is simple, rapid and a commonly used rapid urease test for the diagnosis of
From January 1996 to January 1998, 1,370 cases of CLO test were performed. A gastric biopsy specimen from the greater curvature of antrum within 2cm from pylorus was used for CLO test.
The proportion of performed CLO tests among total endoscopic examinations was 14.1%(1,370/9,709). The most common indication of CLO test was duodenal ulcer, followed by chronic gastritis and gastric ulcer in order. In male, duodenal ulcer was the most common indication of CLO test, while in female, chronic gastritis was the most common. The positive rate of CLO test of total 1,370 cases was 62.0%. The positive rate of CLO test in male was significantly higher than that in female and the 4th decade of age showed the highest prevalence. According to the endoscopic diagnosis, the positive rate of CLO test was the highest in active stage of duodenal ulcer(84.3%), 56.5% in gastric ulcer, 54.6% in chronic gastritis, and 52.8% in gastric cancer. Comparing between 1996 and 1997, the number of CLO test increased, but its positive rate decreased significantly.
Although the most common indication of CLO test was duodenal ulcer in this study, the result that CLO test was also commonly used in chronic gastiritis implies an increasing interest about the role of
The postoperative peritoneal adhesions are associated with numerous complications, including small bowel obstruction, difficult and dangerous reoperations, and infertility. However the adhesion formation is inevitable phenomenon after abdominal surgery. In this study, a reproducible, quantitative rat model was developed that used uniform ischemic injury on the parietal peritoneum of the area over the right lateral thoracoepigastric vessles. The resulting adhesions and the inflammatory reaction of the insulted area were subsequently scored. And then two potential antiadhesive agents, allopurinol and verapamil, were tested and compared.
The result suggest that verapamil appeared to be very effective in reducing adhesion formation but not with allopurinol. However, there was not significant relation to the severity of peritoneal adhesion and inflammatory reaction.
, Choon Won Park This study was performed to find out obstetricians-gynecologists' view on taking hormone replacement therapy HRT to perimenopausal women in Korea.
Questionnaires were mailed to 300 Korean obstetricians-gynecologists in order to obtain their views on the use of hormone replacement therapy. A total of 136 gynecologists responded.
Most of obstetricians-gynecologists(88.2%) were prescrinbing HRT to the perimenopausal or postmenopausal women. The most common indication of HRT was the treatment of vasomotor symptoms(56.6%) in symptomatic postmenopausal women and the prevention of osteoporosis(46.6%) in asymptomatic postmenopausal women. The most common routes of HRT were the oral(66.3%) administration. About two third of respondents prescribed HRT by cyclic estrogen-progestogen combined therapy(47.4%), and 46.8% of respondents thought that HRT must be started within 5 years after menopause. The duration of HRT was variable and 23.5-36.9% of respondents thought that HRT should be continued through the life.
This survey suggests that the most of Korean obstetricians-gynecologists favors the use of HRT in postmenopausal women but the results may become generalisable to the wider population as information on the potential benefits of hormone replacement therapy is disseminated.
Citations
, Jun-Heok Song, Myung-Hyun Kim, Sung-Hak Kim Surgical closure of patent ductus arterious(PDA) by lateral thoracotomy is considered as a standard therapy. But large incision, muscle cutting and chest pain are problematic. So I used two less invasive techniques : minithoracotomy and video-assisted thoracoscopic surgery. I tried to compare the results of them.
I reviewed the clinical records and operative reports of 22 children patients who were treated surgically between Jan. 19996 and Dec. 1996. Ten patients underwent Minithoracotomy(MT) and twelve patients Video-assisted thoracoscopic surgery(VATS). All of them were used tithanium clipping for closure of PDA.
Both groups were similar in age, body weight, Echocardiographically estimated size of PDA and Qp/Qs. All procedures were performed uneventfully. Operative time averaged 104±26 minutes for MT versus 96±31 minutes for VATS. Mean hospital stay was 7.2±1.7 days for MT and 4.6±1.2 days for VATS(p<0.05}. Postoperative hoarseness was occured in one patient(MT group) but was transient. There was no case with residual shunt confirmed by echocardiography.
Minithoracotomy and Video-assisted thoracoscopic surgery were as effective as lateral thoracotomy for closure of patent ductus arteriosus. Operative times were similar in two techniques but hospital stays were shorter in VATS group. Both MT and VATS techniques are effective and less invasive but I advocate VATS technique is more beneficial in terms of hospital stay and cosmetic aspect.
Pulmonary hypertension is characterized by an increase in vascular tone of an abnormal proliferation of muscle cells in the wall of small pulmonary arteries. Endothelin-1(ET-1) is a potent endothelium-derived vasoconstrictor peptide with important mitogenic properties. It has been recognized that endothelin-1 may contribute to increase in pulmonary arterial tone or smooth muscle proliferation in congenital heart disease patients with pulmonary hypertension. To explore the role of endothelin-1 in patent ductus arterious, we measured endothelin-1 before and after closure of ductus in artery and vein plasma.
Seven patients of patent ductus arteriosus underwent thoracoscopic clipping of dustus in 1997 June-August. Their age was 1-24 months and male 4, female 3. Blood samples were drawn from radial artery and inferior vena cava before, 30 minutes and 90 minutes after closure of ductus. Endiothelin-1 was measured by radioimmunoassay method.
Arterial endothelin-1 was 17.96±8.09pg/ml at before closure of ductus, 13.47±3.14pg/ml at 30 minutes after closure of ductus and 11.43±2.9pg/ml at 90 minutes after closure of ductus. Venous endothelin-1 was 9.34±3.55pg/ml at before closure, 8.9±3.74pg/ml at 30 minutes after closure and 8.4±3.71pg/ml at 90minutes after closure of ductus. Arterial endo-thelin-1 was significantly higher than venous one at before and 30 minutes after ductus closure(p<0.05). Arterial endothelin-1 at 90 minutes after ductus closure was significantly lower than that at before the closure(p<0.05).
Patients pf patent ductus arteriosus have substantial alterations in plasma endo-thelin-1 which is decreased after closure of ductus. Comparing with venous plasma, the higher levels of ET-1 in arterial plasma suggest pulmonary production of endothelin-1, which may contribute to induce pulmonary hypertension.
, Seung Cheol Kim, Sunhee C. Lee, Young Sook Pae Experience in development of home pages for Ewha Womans University College of Medicine were documented to present references for future development of informatics media.
Development principles were established for the optimal allocation of human and hardware resources, and for the effective construction of contents and structures of the home pages.
Home pages were implemented on a web server(
The author's experiences will be helpful for the enhancement and maintenance of the home page of each department and for the future development of similar informatics media.
, So Yun Cho, Mi Ae Lee, Kyu Kwang Whang, Jeong Hee Hahm Angiolymphoid hyperplasia with eosinophilia(ALHE) is a benign, uncommon disorder of unknown etiology and usually appears as intradermal or subcutaneous, red to brown papules and/or nodules, usually located on the head and neck region, and occurring in young adults.
Histopathologically ALHE is an angiolymphoproliferative lesion which shows characteristically plump epitheloid or histioid endothelial cells, accompanied by an inflammatory infiltrate that mainly consists of lymphocytes and eosinophils.
We reported a case of angiolymphoid hypreplasia with eosinophilia occurring on the scalp in a 52-year-old female and review the literature.
, So Yun Cho, Jeong Hee Hahm Prurigo pigmentosa is an inflammatory dermatosis characterized by severe pruritic red papules and coarse reticulated hyperpigmentation. More than 300 cases have been reported in Japan and several cases have also been described in Caucasians. It is more common in young adult females, particularly in adolescence, but may sometimes occur in males and older persons. The lesions occur mainly on the trunk and neck with severe itching. The histopathologic findings are not specific but occasionally show lichenoid tissue reaction. The etiology of this disease still remains unknown.
We reported a case of prurigo pigmentosa in a 26-year-old-male, which clinically and histopathologically fulfilled the characteristics of prurigo pigmentosa and was treated with dapsone resulting in significant clinical improvement.
, Myung Shin Kim, Ju Young Lee, Jin Won Whang, Tae Sik Yoon The Arnold-Chiari Malformation is a cognenital disorder with symptoms such as ataxia, dissociated sensory loss, extremity pain, and frequently associated with other malformations of the same kind, including syringomyelia, basilar impression, atlantoaxial instability. The options for managements of the Chiari malformation have been under considerable debate, especially for case with syringomyelia. Presence of syrinx with evidence of motor weakness, sensory loss and ataxia has been reported as poor prognostic factor and may results in functional disability and dependency in activities of daily living and transfer. We report a case of Arnold-Chiari Malformation type I associated with syringomyelia and atlantoaxial instavility.
A 46 year-old man admitted to neurosurgery department with complaints of ataxic gait and decreased sensation in left extremities which were developed when he was 34 years old and aggravated slowly. 25 years ago he developed progressive weakness of intrinsic muscles of right hand. He was diagnosed as Arnold-Chiari Malformation type I. Under the diagnosis of atlantoaxial instability, the patient was treated with operation of craniocervical fusion and laminectomy at C2-C3 level. Despite these treatment, ataxic gait, motor weakness and sensory dissociation was not improved. After the patient was transferred to rehabilitation department, he received comprehensive rehabilitation program. The patient's functional independence measurement(FIM) score at admission was 72 and improved to 104 discharge. The patient was discharged with the state of the monocane ambulation. Like this case, Arnold-Chiari malformation associated with syringomyelia with the evidence of muscle atrophy, ataxia have poor prognosis, therefore early diagnosis and proper managements along with comprehensive rehabilitation is critical in obtaining the best outcome.
Acetaminophen is a mild analgesic and antipyretic agent that is safe and effective when taken in therapeutic doses. Ingestion of overdoses, however, may lead to acute liver failure accompanied by centrilobular degeneration and necrosis. The toxicity of acetaminophen is generally thought to be caused by direct interaction of its reactive metabolites with cellular macromolecules. Cell death, defined as an irreversible loss of vital cellular function and structure, can occur by either necrosis or apoptosis. Until recently, investigation into liver cell death has focused on cell necrosis although it is now appreciated that both apoptosis and necrosis may contribute to liver cell death. The present study examined cultured NCTC-1469 cells for LDH release and DNA laddering and their association with cell death. NCTC-1469 cells were cultured in NCTC-135 medium containing 10% horse serum for 72hr, and changed medium to fresh medium containing acetaminophen(from 0,5mM to 5mM). Cell viability was examined by MTT method and cell necrosis was assessed lactate dehydrogenase leakage. Genomic DNA fragmentation was assessed qualitatively by 1.5% agarose gel electrophoresis. Acetaminophen decreased MTT levels(p<0.05) and increased release of LDH(p<0.05) in dose-dependendent manner. Agarose gel electrophoresis revealed a "ladder" of DNA fragments in all acetaminophen concentration. Cell viability strongly correlated with cell necrosis(r2=0.946). These results show that acetaminophen induced both necrosis and apoptosis in NCTC-1469 cells and cell death mainly attributed to apoptosis.
, Young Hyun Go, Ji Hee Lee Insulin stimulation of glucose transport in adipocytes results from the translocation of vesicles containing the GLUT4 glucose transporter from an intracellular pool to the plasma membrane. In mammalian cells a family of GTP-binding proteins has been implicated in the control of cellular trffic. Thus this study was planned to see whether G-proteins such as Rab, a small molecular mass G-protein and Gαh, a large molecular mass G-protein are involved in insulin induced GLUT4 translocation process.
Diabetic rats(Spraque-Dauley, 200-250g) were prepared by injection of streptozotocin(60mg/kg,IP) and treated with or without insulin(20U/rat) for 4 weeks. The purpose of the study is to elucidate a possible functional relationship between G-protein and the insulin-responsive GLUT4 translocation by immunoblotting method from the subcellular fractions of adipocytes of epididymal tissues.
As results Rab4 protein was coexisted in the membrane of GLUT4 immunoprecipitates of adipocyte total homogenates in normal rats, however Gαh, could not be detected. The amount of GLUT4 at plasma membrane(PM) obtained from insulin treated rats were increased by 21. 35% compared to that of streptozotocin diabetic rats. The increase of Rab4 at the same plasma membrane was negligible. On the other hand, the amounts of GLUT4 and Rab4 at low density microsome(LDM) were decreased by 7.82% and 9.25%, respectively.
These results show that Rab4 is co-localized with GLUT4 in an insulin-responsive intracellular compartment and Rab4 protein plays role in the action of insulin on the GLUT4 translocation but a large molecular G-protein, Gαh is not involved in the GLUT4 translocation process.
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