Management of Right Colon Diverticulitis

PURPOSE: There are still many controversial aspects in the management of right colon diverticulitis. The aim of this study is to find an appropriate treatment for right colon diverticulitis. METHODS: We retrospectively reviewed the medical records of 88 patients who were admitted with right colon diverticulitis to Wallace Memorial Baptist Hospital from January 2001 to December 2007. RESULTS: The patients enrolled in this study included 52 men and 36 women. The mean age was 39.6 yr, ranging from 13 to 84 yr. Fifty-four of 88 patients underwent conservative treatment for right colon diverticulitis, and 34 of 88 patients underwent operative treatment. There were 5 cases of recurrence in the conservative treatment group, but there were no cases of recurrence in the operative treatment group. We experienced 43 cases with right colon diverticulitis at the operational fields, including 9 cases that underwent conservative treatment after an appendectomy: eleven cases that underwent conservative treatment after an appendectomy or an appendectomy with diverticulectomy, 19 cases that underwent an ileocecectomy, and 13 cases that underwent a right hemicolectomy. There were no statistically significant difference in complications among 3 groups (P=0.148). However, there were statistical differences among the 3 groups in the length of hospital stay (P=0.016), and the use of intravenous antibiotics (P<0.001), and the use of oral antibiotics (P=0.019). CONCLUSION: When the preoperative diagnosis is exact, uncomplicated right colon diverticulitis can be managed by conservative treatment. On the other hand, an ileocecectomy or a right hemicolectomy is the proper treatment for complicated right colon diverticulitis. However, if uncomplicated right colon diverticulitis is diagnosed intraoperatively, conservative treatment or a diverticulectomy should be considered.

Endonasal Trans-sphenoidal Approach through One Nostril / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Transseptal TSA (transsphenoidal approach) has advantages of wide exposure, good operative view, and use of two hands, but has disadvantages of external nasal scar, possibility of external nasal deformity and severe nasal pain. And endoscopic TSA can reduce nasal morbidity, but operator can't use two hands with the endoscope and it also has disadvantages of narrow operative field. Endonasal TSA is a new approach technique taking the advantages of transseptal and endoscopic TSA. SUBJECTS AND METHOD: We reviewed 112 patients who had been operated with this method from Mar, 2001 to Sep, 2003. Details of surgical technique of this approach are presented. We investigated the operative time, hospital periods, and complications. RESULTS: The mean operative time was 95 minutes. Nasal packings were removed on the first postoperative day in 106 cases, and on second postoperative days in 6 cases. The mean postoperative hospital stay was 3.2 days. During the follow-up periods (6-24 months, mean 13.5 months), there were complications of olfactory disturbance (4 cases), nasal septal deviation (2 cases), epistaxis (1 case), nasal septal perforation (1 case), CSF leakage (1 case), hypopituitarism (3 cases), and diabetes insipidus (4 cases). Meningitis, external nasal deformity, external scar, paresthesia or sinusitis were not noticed. CONCLUSION: Using endonasal TSA, we could operate easily with two hands, obtaining a good operative view and short operation time. The technique presented minimal nasal morbidity, a short hospital stay and low incidence of complications.

A Case of Huge Benign Tumor of the Ovary / 대한산부인과학회지

Recently a huge benign tumor of the ovary (greater than 25 pounds) is rare because of early detection and operation. Although infrequently seen, many serious problems associated with the removal of such tumors have been described, including cardiovascular and respiratory complications. For successful management and good prognosis, it certainly requires slow decompression. We have experienced one case of huge benign tumor of the ovary, and report this case with brief review of literatures.

A Case of Primary Cutaneous Endometriosis at the Unbilicus / 대한산부인과학회지

Cutaneous endometriosis seems to be more common in women who have had a pelvic or abdominal operation and primary cutaneous endometriosis is very rare. In our hospital we experienced a 41-year-old woman who complained of the appearance at the umbilicus of a nodule and had not had operation. This nodule was responsible for recurrent pain and increasing in size and it was excised. Pathology findings revealed cutaneous endometriosis. So we present a case of primary cutaneous endometriosis with a brief review of literature.

Clinocopathologic analysis of survival of 98 patients with uterine endometrial cancer / 대한산부인과학회지

OBJECTIVE: This study was performed to evaluate the clinicopathologic prognostic factors and overall survival in patients with uterine endometrial cancer. METHODS: From Jan, 1995 to Dec. 2000, medical records of 98 patients with endometrial cancer treated in Kosin University Gospel Hospital were reviewed and the overall survival of patients was determined by support of the death statistics of Korea National Statistical Office. Survival rate was analyzed by Kaplan-Meier method and log-rank test was used for curve comparison, Cox proportional hazards model was used for multivariate analysis. RESULTS: The median age of all patients was 53 years. The most common presenting symptom was abnormal vaginal bleeding (65.3%). The most common histological type was endometrioid adenocarcinoma. (85.1%) The overall 5 years survival rate (5YSR) for all 98 patients was 66.8%. The overall 5YSR for premenopause and postmenopause were 80% and 50%, respectively (p=0.08). The overall 5YSR for preop CA-125 level above 35 U/mL, below 35 U/mL were 40%, 80% (p=0.001). The overall 5YSR of stage I, stage II, stage III, stage IV were 86.8%, 76.9%, 39.4%, 14.4% (p=0.001). The overall 5YSR of grade 1, grade 2, grade 3 were 75%, 70%, 45% (p=0.002). The overall 5YSR of myometrium invasion of none, or=1/2, were 84.3%, 80.3%, 57.2% (p=0.004). The overall 5YSR of peritoneal cytology of negative, posivite were 73.4%, 23.8% (p=0.001). The overall 5YSR of lymphnode metastasis negative, positive were 80.1%, 15% (p=0.001). CONCLUSION: The age (>50), preop CA-125 level, FIGO surgical stage, grade, myometrial invasion, lymph node metastasis and peritoneal cytology were significant prognostic factors of uterine endometrial cancer affecting 5YSR by univariate analysis. The myometrium invasion and grade were significant prognostic factors affecting 5YSR by multivariate analysis.

Prognostic Significance of Peritumoral Vascular Invasion in Patients with Invasive Breast Cancer / 한국유방암학회지

PURPOSE: Multiple clinical, biological, and pathologic factors correlate with the outcomes in patients with invasive breast cancer. The utility of a peritumoral vascular invasion (PVI) as an additional prognostic indicator has been poorly defined. The aim of this study was to determine if the presence or absence of PVI can be used to help assess the survival and recurrence. METHODS: An invasion of the vascular space (lymphatic and/or blood vessel) by a tumor, as assessed on routine hematoxylin and eosin sections, was investigated in a 146 women with primary operable invasive breast carcinoma. The presence of PVI was compared with the established prognostic factors such as age, tumor size, axillary lymph node involvement, histological grade, hormonal receptor status, and expression of c-erb B2, Ki-67 and p53. Survival analysis was performed using Kaplan-Meier method and log-rank test. RESULTS: PVI was found in 35.6% of cases and was significantly associated with an increasing tumor size (P=0.033) and metastatic axillary lymph nodes (P=0.012). The 5 year disease free survival (DFS) and overall survival (OS) were significantly lower in the patients with PVI than without PVI (P=0.0431 and 0.0445, respectively). In multivariate analysis, the axillary lymph node status (P=0.001), the tumor size (P=0.044) and PVI (P=0.050) were significant independent prognostic factors for the DFS. In the node- negative breast cancer group and in the node-positive breast cancer group, the 5 year DFS and OS were lower in the patients with PVI than in those without, but this did not show significant difference. CONCLUSION: Cox multivariate analysis showed that PVI is a strong prognostic factor for patients with operable invasive breast cancer and an independent prognostic factor for a recurrence. A histological assessment of PVI can provide prognostic information on primary operable invasive breast carcinoma and might be helpful in making a clinical decision.

Clinical, Pathologic and Immunohistochemical Features of Phyllodes Tumor of the Breast / 한국유방암학회지

The histological distinction between benign and malignant phyllodes tumors (PT) is often difficult and arbitrary. We analyzed clinical, histological features and expressions of Ki-67 and p53 using immunohistochemistry and estimate its significance in assessing the grade of malignancy and in predicting the clinical behavior of these tumors on 20 cases of PT of the breast (11 benign, 3 low-grade malignancy and 6 high-grade malignancy). Statistically significant differences between benign, low-grade malignant, and high-grade malignant PT by size of tumor, cellular atypism, stromal cellularity, margin of tumor, and number of mitotic figures. The mean labeling index (LI) of Ki-67 in high-grade malignant PT (9.6+/-9.6) was three-fold higher than that in benign PT (2.7+/-2.2), but this difference was not statistically significant (P=0.074). None of the benign PT were positive for p53, whereas 2 of 3 low-grade malignant and 3 of 6 high-grade malignant PT were positive for p53. Statistically significant differences in the pattern of p53 expression existed among the benign, low-grade malignant, and high-grade malignant lesions (P=0.018). Ki-67 LI and p53 expression were associated with numbers of mitotic figure, but were not associated with metastasis (P=0.546 and 0.216). Increased p53 immunoreactivity is present in high-grade and low-grade malignant PTs in contrast to benign PTs, and malignant PT had a higher Ki-67 LI than benign PT. Thus, p53 and Ki-67 expression may assist in distinguishing benign from malignant PT in diagnostically difficult cases.

The Accuracy of the Physical Examination, Mammography, and Ultrasonography in the Assessment of Tumor Size and Axillary Lymph Node Metastasis in Breast Cancer Patient / 한국유방암학회지

PURPOSE: With the increasing use of neoadjuvant chemotherapy and minimally invasive therapy, the accuracy of preoperative determination of breast tumor size and axillary lymph node status become more important. The purpose of this study was to correlate physical examination, mammographic, and ultrasonographic measurements of tumor size and regional lymph node status with pathologic findings and to evaluate the accuracy of various preoperative examination methods. METHODS: Ninety patients presenting with palpable primary breast cancer treated with mastectomy or breast conserving surgery with axillary dissection were measured breast tumor size and axillary lymph node status by physical examination, mammography, and high resolution duplex ultrasonography, and correlated with the values obtained at pathologic examinations. RESULTS: The sensitivity of mammography and sonography for breast tumor were 82.5% and 90.8%, respectively. The average diameter of tumors was 3.39+/-1.77 cm on pathologic examination. Physical examination demonstrated the highest correlation coefficient (r=0.759) in measurement of the tumor size. The sensitivity of physical examination mammography, and sonography for axillary node involvement were 37.5%, 57.7%, and 73.9%, respectively, and with specificity of 98.1%, 86.5%, and 92.9%, respectively, and with positive predictive value of 93.8%, 75.0%, and 85.0%, respectively. CONCLUSION: Physical examination is the best non-invasive predictor of the real size of palpable primary breast cancer, whereas high resolution duplex ultrasonography is most sensitive assessment method of axillary lymph node status. The specificity of axillary nodal status can be increased by fine-needle biopsy under sonographic guidance and it can be serve as useful adjuncts to sentinel node biopsy.

Organizing Hematoma of the Maxillary Sinus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Organizing hematoma of the maxillary sinus can be developed by organizing procedure of hematoma in the unaerated maxillary sinus. To our knowledge, this is the second article describing organizing hematoma in the maxillary sinus. We experienced 7 cases recently, and aimed to describe clinical features, radiologic characteristics, and pathological findings. MATERIALS AND METHODS: Seven patients were diagnosed as organizing hematoma pathologically. We reviewed computed tomography (CT) and medical records to find out clinical features of organizing hematoma of the maxillary sinus. Of seven patients, five were male and two were female. Their mean age was 49 years. RESULTS: All patients had a history of frequent epistaxis without bleeding tendency. They also complained of nasal obstruction, hyposmia, headache, and cheek swelling. Rhinoscopy revealed obliterated nasal cavity due to bulging lateral wall. CT scans showed soft-tissue densities expanding the maxillary sinus with the minimal contrast enhancement. Destruction of the bony wall was observed in two patients. Endoscopic sinus surgery, Caldwell-Luc's operation, and Denker's operation were applied for the treatment singly or in combination, and resulted in successful outcome. CONCLUSION: Organizing hematoma should be included in the differential diagnosis when patients have frequent epistaxis and expansile lesion in the maxillary sinus.

The Change of Hearing Threshold by the Lactate Delivered to Round Window in Guinea Pigs / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is well known that hearing loss can occur by the decreased cochlear blood flow. Because lactate is known to accumulate when there is ischemia in the tissue, we designed this study to analyze the effect of lactate delivered to the inner ear on the hearing threshold measured by the auditory brainstem response (ABR). MATERIALS AND METHOD: We used 22 guinea pigs (GPs) with normal Preyer's reflex, and used 6 GPs (12 ears) to investigate the effect of lactate concentration on the change of hearing threshold and used 6 GPs (12 ears) to investigate the effect of osmolarity on the change of hearing threshold. We determined the concentration of lactate to exclude the effect of osmolarity on the change of hearing threshold. Ten GPs were divided into a control group (n=5, 10 ears) and a study group (n=5, 10 ears). The mastoid cavity was opened to expose the round, and then HBSS buffer (300 mOsm) was applied on the round window. Hearing threshold was measured by ABR after application of 10mM lactate and buffer solution as control. RESULTS: In the control group, the initial hearing threshold was 29.5 dB+/-3.6 dB (mean+/-SD) and changed to 33.5 dB+/-4.7 dB when buffer was applied to the round window. It changed to 33.0 dB+/-4.2 dB 1 hour after applying the buffer, and 37.5 dB+/-3.5 dB 4 hour later. In the study group, the initial hearing threshold was 27.0 dB+/-5.8 dB. The thresholds right after the buffer was applied to the round window, one hour and four hour later were 32.5 dB+/-4.8 dB, 48.0 dB+/-4.2 dB, and 54.5 dB+/-5.9 dB, respectively. There were significant statistical differences between the two groups with regard to the threshold after 1 hour and 4 hours (p<0.05). CONCLUSION: We could observe the elevation of hearing threshold after applying lactate on the round window of guinea pigs. Through these findings, we can draw the conclusion that lactate may be one of the factors raising the hearing threshold by tissue ischemia.

Comparative Analysis of Sleepstrip Versus Laboratory Polysomnography in the Diagnosis of Sleep Disordered Breathing / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Polysomnography is regarded as the gold standard in the diagnosis of sleep disordered breathing, although it is too expensive and uncomfortable to use. There has been a need for more simple and cost-effective techniques to screen large populations for suspected sleep disordered breathing. The aim of this study was to compare sleep parameters between Sleepstrip and laboratory polysomnography in the diagnosis of sleep disordered breathing. MATERIALS AND METHOD: A prospective study was undertaken in 20 patients in whom polysomnography and Sleepstrip were performed simultaneously before surgery from January 2001 to March 2001. Sleepstrip monitored the patients' respiration during sleep, analyzed respiration patterns in real time, and displayed the computed apnea hypopnea index (AHI) on its built-in display the following morning. RESULTS: The correlation between respiratory disturbance index (RDI) of polysomnography and AHI of Sleepstrip was 0.661 (p<.01). When the polysomnography threshold for a positive diagnosis for sleep disordered breathing was set at RDI=20 and the threshold for Sleepstrip 5, sensitivity and specificity of the device were found to be 0.875 and 0.833, respectively. CONCLUSION: Availability of Sleepstrip at a fraction of the cost of a whole night polysomnographic recordings may greatly facilitate the clinical diagnosis of large majorities of yet undiagnosed sleep disordered breathing. Sleepstrip may also prove useful for large scale epidemiological studies and for long term follow-up's of patients after surgery.

Clinical Analysis on the Cystic Lesions in the Maxilla

BACKGROUND AND OBJECTIVES: Jaw cysts are frequently diagnosed by dentists, however they are also presented with symptoms specific to otolaryngology which are different from common symptoms found in dentistry. Thus, those diagnosed by otolaryngologists are likely to show different clinical manifestations. The purpose of this study was to investigate the clinical characteristics of jaw cysts found in otolaryngology. MATERIALS AND METHODS: A retrospective study was carried out. Frequency, sex, age, symptoms, site of occurrence, histopathology, treatment and results of 30 jaw cysts, were analyzed. These were diagnosed and surgically treated between May, 1990 and August, 1998 at our otolaryngology department. RESULTS: Among 30 jaw cysts, there were 15 cases (50%) of nasolabial cysts, 8 cases (27%) of dentigerous cysts, 5 cases (17%) of nasopalatine cysts and 2 cases (6%) of radicular cysts. Nasolabial cysts (NLC) were the most common among middle-aged females, and they showed a common complaint of cheek swelling. They were all removed surgically by gingivobuccal incision. One case of cellulitis was reported postoperatively and it was treated with antibiotics. Dentigerous cysts (DC) were mostly found among young males. The most common chief complaint was cheek swelling. 4 cases (50%) of DC were associated with chronic paranasal sinusitis. In 5 cases (63%) the cysts were surgically removed after opening the maxillary sinus by gingivobuccal incision. 3 cases (37%) were removed by the Caldwell-Luc approach. Nasopalatine cysts (NPC) were prevalent during the third and fourth decade. Common symptoms were palatal swelling, pain and tenderness. All were treated with surgery by the transpalatal approach. One case of postoperative palatal fistula was reported and was successfully repaired. There were 2 cases of radicular cyst (RC). 1 case was removed by sublabial incision, and the other case was removed by the Caldwell-Luc approach. CONCLUSION: The most common jaw cysts in the maxilla were nasolabial cyst. Most jaw cysts were treated by surgery without recurrence.

Clinical Analysis on the Cystic Lesions in the Maxilla

BACKGROUND AND OBJECTIVES: Jaw cysts are frequently diagnosed by dentists, however they are also presented with symptoms specific to otolaryngology which are different from common symptoms found in dentistry. Thus, those diagnosed by otolaryngologists are likely to show different clinical manifestations. The purpose of this study was to investigate the clinical characteristics of jaw cysts found in otolaryngology. MATERIALS AND METHODS: A retrospective study was carried out. Frequency, sex, age, symptoms, site of occurrence, histopathology, treatment and results of 30 jaw cysts, were analyzed. These were diagnosed and surgically treated between May, 1990 and August, 1998 at our otolaryngology department. RESULTS: Among 30 jaw cysts, there were 15 cases (50%) of nasolabial cysts, 8 cases (27%) of dentigerous cysts, 5 cases (17%) of nasopalatine cysts and 2 cases (6%) of radicular cysts. Nasolabial cysts (NLC) were the most common among middle-aged females, and they showed a common complaint of cheek swelling. They were all removed surgically by gingivobuccal incision. One case of cellulitis was reported postoperatively and it was treated with antibiotics. Dentigerous cysts (DC) were mostly found among young males. The most common chief complaint was cheek swelling. 4 cases (50%) of DC were associated with chronic paranasal sinusitis. In 5 cases (63%) the cysts were surgically removed after opening the maxillary sinus by gingivobuccal incision. 3 cases (37%) were removed by the Caldwell-Luc approach. Nasopalatine cysts (NPC) were prevalent during the third and fourth decade. Common symptoms were palatal swelling, pain and tenderness. All were treated with surgery by the transpalatal approach. One case of postoperative palatal fistula was reported and was successfully repaired. There were 2 cases of radicular cyst (RC). 1 case was removed by sublabial incision, and the other case was removed by the Caldwell-Luc approach. CONCLUSION: The most common jaw cysts in the maxilla were nasolabial cyst. Most jaw cysts were treated by surgery without recurrence.

Risk Factors and Prognostic Influences of Burn Wound Infection

PURPOSE: Among persons sustaining severe burns, burn wound infection may develop into devastating sepsis. The purpose of this study is to validate the risk factors for burn wound infection in order to increase the effectiveness of the early treament of those patients at high risk for burn wound infection. METHODS: We retrospectively evaluated 155 hospitalized burn patients with an affected burn area greater than 20% extent and who underwent wound culture because of clinically suspected wound infection from March 1997 to December 2000. RESULTS: When patient age, cause of burn, total burn surface area (TBSA), full thickness burn area (FTBA), anatomical distribution of burn, dehydration at admission treated as independent variables, TBSA and FTBA were seen to significantly influence the burn wound infection rate (p<0.05). When the length of hospital stay, interval from burn to skin graft, outcome of burn were taken as independent variables, the length of hospital stay and outcome of burn were significantly influenced by burn wound infection (p<0.05). CONCLUSION: The high risk group for wound infection comprises patients with extensive TBSA or FTBA and should be selected early to undergo intensive treatment as follows ; meticulous wound monitoring and aseptic maneuver, early eschar excision and early skin graft, adequate nutritional support, isolation against hospital-acquired infection, judicious antibiotic management based on antimicrobial susceptibility testing and control of emergent antibiotic-resistant bacteria.

Laser-assisted uvulopalatoplasty and laser uvulopalatopharyngoplasty for snoring and obsrtuctive sleep apnea: Long-term postoperative patient's satisfaction / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Laser-assisted uvulopalatoplasty (LAUP) and laser uvulopalatopharyngoplasty (Laser-UPPP) are well established and highly successful operation in the treatment of snoring and obstructive sleep apnea (OSA). But, most reports are based on short-term follow-up results. This study was performed to evaluate the patient's satisfaction rate after long-term postoperative follow-up, and to investigate prognostic factors of good surgical outcome, time of recurrence, and sequelae. MATERIALS AND METHOD: 102 patients were operated by LAUP (n=77) and Laser-UPPP (n=25) between Jul,1993 and Dec,1996. These patients were followed up more than 2 years (mean 3.1 years). The degree of snoring and apnea related symptoms were evaluated using questionnaires preoperatively and postoperatively. RESULTS: In 95 (93%) of 102 patients, symptoms were satisfationally reduced in 6 months of surgery. After 2 years the success rate dropped to 68% (70 of 102 patients. In the dissatisfied group 32 patients, most failures occurred between 6 and 12 months after surgery. Prognostic factors of good surgical outcomes were lower preoperative body mass index value, absence of postoperative weight gain, and combined nasal surgery. There was no major postoperative complication, but temporary sequalae ocurred as nasal regurgitation (8.8%), hypernasality (5.9%), pharyngeal foreign body sensation (13.7%), postoperative bleeding (6.9%), and long-lasting pain over 3 weeks (12.7%). CONCLUSION: Long-term follow-up more than 18 months is mandatory to evaluate postoperative results of LAUP and Laser-UPPP. To achieve good postoperative outcomes in the treatment of snoring or OSA, perioperative weight reduction should be recommended, and nasal surgery should be considered in patients with nasal obstruction.

Isolates of Bacteria and Their Sensitivity to Antibiotics in Fungal Maxillary Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In patients with fungal sinusitis, purulent discharge from the maxillary sinus is frequently observed and it responds to antibiotic treatment. Even though fungal sinusitis is resolved after surgery, the purulent discharge continues in some cases. We aimed to identify the pathogens of the purulent discharge in fungal sinusitis and to obtain information for appropriate antibiotics through a sensitivity test. MATERIALS AND METHOD: Among 71 patients with fungal sinusitis of the maxillary sinus, purulent secretions were found in 44 patients (62%) during an endoscopic sinus surgery. Endoscope-guided collection of the maxillary sinus secretions were performed and specimens were sent to the laboratory for bacterial cultures and antibiotic sensitivity tests. RESULTS: Among 44 cases with fungal lesions and purulent secretion in the maxillary sinus, bacteria were isolated in 27 cases (61.4%). Gram (+) aerobes were recovered in 19 cases, and Gram (-) aerobes were recovered in 16 cases. Mixed infection by Gram (+) and Gram (-) bacteria were observed in 8 patients. Anaerobic bacteria were not isolated. Among the Gram (+) aerobes, S. aureus was the most common organism (8 cases), while Enterobacter aerogenes was the most common organism (7 cases) of the Gram (-) aerobes. In an antibiotic sensitivity test for Gram (+) bacteria, ciprofloxacin, vancomycin, and teicoplanin showed sensitivity over 85 %. For Gram (-) bacteria, ceftazidime, ciprofloxacin, ticarcillin, tobramycin, and imipenem showed sensitivity over 90%. CONCLUSION: In patients with fungal sinusitis, concomitant bacterial infections are identified in more than half of the cases. Thus, postoperative administration of appropriate antibiotics can be justified in the treatment of fungal sinusitis.

Effect of beta-amyloid Peptide on Fine Structure of Cardiac Myocytes in Culture / 대한해부학회지

Several predetermined concentrations of beta-amyloid peptide, (betaA) were administered to the rat cardiac myocyte cultures for three days to determine the effects of betaA. Stainings with congo red and crystal violet were used to evaluate the deposition of betaA in the cardiac myocytes and MTT assay was used to elucidate the cytotoxic effects of betaA by anlaysis of cell viability. Beating rates and morphological changes were investigated with inverted microscope and TEM was used to study the fine structures. Administration of 0.5 microgram/ml of betaA to cardiac myocytes induced the reduction of beating rate, however, it did neither affect the viability nor fine structures. No significant differences in cell viability or fine structures were noted in the experimental groups which were exposed to 5 microgram/ml or higher concentration of betaA. Deposition of betaA was confirmed in the cytoplasm of betaA treated cardiac myocytes with congo red and crystal violet amyloid stains. The viability of cardiac myocytes exposed to betaA was found to be reduced significantly (19%) compared to control cultures with the MTT assay. Cardiac myocytes treated with betaA presented a reduced cytoplasmic area that appeared very condensed under inverted microscope. Mitochondrial abnormalities in betaA treated cardiac myocytes included their significant enlargement, vacuolization, disorganization or paucity of cristae, paracrystalline inclusion, and accumulation of amorphous material in mitochondrial space. Mitochondrial abnormalities were present sometimes in betaA treated cardiac myocytes without disorganization of myofibils or degeneration of other cell organelles. To understand the mechanism involved in amyloid deposit and its role in pathogenesis of the diseases such as Alzheimer and inclusion body myositis (IBM), a need for in vitro model is imperative. This model of betaA treated cultured cardiac myocytes represent a amyloidosis model, and it offers several advantages for future studies of betaA to help elucidate the pathogenesis of amyloid diseases. For example, cardiac myocytes can be easily accessible, and since cardiac myocytes can be cultured for quite a long time, it is possible to study morphological and physiological changes consequent to amyloid deposits.

Efficacy of Audiologic Tests in the Differential Diagnosis of Cochlear and Retrocochlear Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are many audiological tests to distinguish between the hearing loss patients of cochlear lesion and the retrocochlear lesion. We started this research to compare the efficacy of the audiological tests and to make helpful selections of the auditory hearing tests in diagnosis of the sensorineural hearing loss patients. MATERIALS AND METHOD: Our study was conducted on 198 patients with hearing loss. They received otologic physical examination, neurological examination, and MRI. We evaluated SISI, STAT, ARDT, DPOAE, and ABR data values and analysed their sensitivity and specificity. RESULTS: Sensitivity of SISI was 55% and specificity was 74%. Sensitivity of STAT was 58% and specificity was 67%. Sensitivity of ARDT was 44% and specificity was 71%. Sensitivity of DPOAE was 50% and specificity was 64%. Sensitivity of ABR was 90% and specificity was 74%. CONCLUSION: Among the tests performed above, ABR showed the highest sensitivity and specificity value, which implies it to be the most meaningful screening test in the sensorineural hearing loss patients. But for the patients with severe hearing loss, such that the auditory hearing test results are suspicious in its accuracy, or for the patients who are suspicious of retrocochlear lesions based upon multiple tests, MRI should be performed to make the final diagnosis.

The Application of Total nutrient Admixture System in Acute Pancreatitis

Total parenteral nutrition (TPN) can improve nutritional status and place the exocrine pancreas at rest in patients with acute pancreatitis. Based on this rationale, nutritional support for a patient with severe acute pancreatitis is currently a widely accepted practice. However, the use of a total nutrient admixture (TNA) system for patients with acute pancreatitis has been controversial because of the etiological association of hyperlipidemia with this disease. In order to evaluate the safety and efficacy of such lipid emulsion-based parenteral nutrition (a TNA system) for acute pancreatitis patients, we prospectively analyzed 37 cases (Ranson's criteria > 3) in which a TNA system had been administered for more than 2 weeks at Wallace Memorial Baptist Hospital from January 1994 to December 1995. We classified the 37 patients into 3 groups by the amount of lipids administered daily (Group I: 75 gm lipid/day) and compared the nutritional indices (weight, albumin, transferrin, total lymphocyte count, and nitrogen balance) and the triglyceride, the amylase, and the lipase levels in each group at the onset of the TNA system and after 2 weeks. The results are summarized as follows: 1) The TNA system had positive effect on maintaining and improving the nutritional indices in 28 (75.7%) of the 37 cases. 2) We could relate the causative effect of the lipids on the aggravation of pancreatitis to the administered amount of lipids by checking the triglyceride, the amylase, and the lipase 2-3 times a week. A simultaneous increase in the amylase, the lipase, and the triglyceride (> 300 mg/dl) was seen in 3 of the 8 cases in Group III. Hence, we think that the TNA system can be a safe and effective method for parenteral nutrition, even in acute pancreatitis, and that the lipid content of the TNA system should be less than 75 gm per day to prevent of disease aggravation.

The cell cycle of the cardiac endothelial cell in short-term culture / 대한해부학회지

No abstract available.