ABSTRACT
Purpose: The morphological study and dynamic stability of the ulnar nerve around the elbow joint was investigated in asymptomatic normal population using ultrasonography. The purpose of this study is to provide fundamental data for ultrasonographic diagnosis of ulnar neuropathy in cubital tunnel syndrome. Materials and Methods: Fifty cases of 25 healthy male volunteers, aged between 20 to 30 years, included in this study. High resolution 7.5 MHz linear probe was used to examine the ulnar nerve in axial and longitudinal views. In a longitudinal view, the course, position and the thickness of nerve were monitored, the diameter of ulnar nerve and dynamic stability at elbow flexion and extension were measured in an axial view at four different points; 1cm proximal to medial epicondyle, behind the medial epicondyle, entrance to Osborne ligament, and 1cm distal to Osborne ligament. Results: The short diameters of ulnar nerve at elbow extension at four anatomic points were 2.66 mm, 2.97 mm, 2.64 mm, and 2.69 mm and the long diameters were 4.61 mm, 4.56 mm, 4.36 mm, and 4.37 mm, which showed no significant change at each point. However, at elbow flexion, the short diameters were changed to 2.72 mm, 2.34 mm, 2.65 mm, and 2.41 mm and the long diameters into 4.49 mm, 5.40 mm, 4.16 mm, and 4.66 mm. At elbow flexion, significant morphologic change was observed in the medial epicondyle area, and the diameter of the ulnar nerve was shortest at the entrance of Osborne ligament both at flexion and extension. In terms of dynamic stability, nine subluxations and seven dislocations were observed. Conclusion: This study shows dynamic instability and a morphological change of long and short diameters of ulnar nerve at flexion and extension in a normal person, which should be considered in the ultrasonographic diagnosis of ulnar neuropathy.
Subject(s)
Humans , Male , Cubital Tunnel Syndrome , Diagnosis , Joint Dislocations , Elbow Joint , Elbow , Ligaments , Ulnar Nerve , Ulnar Neuropathies , Ultrasonography , VolunteersABSTRACT
BACKGROUND: TNF may play an important role (central mediator) in the development of an acute respiratory distress syndrome. Since TNF induced lung injury in the actute respiratory distress syndrome and abnormalities in surfactant function have been dexcribed in acute respiratory distress syndrome, the authors investigated the effects of TNF on the regulation of surfactant protein A, B, and C mRNA accumulation. METHODS: The effects of TNF on gene expression of surfactant protein A, B, and C were analyzed using filter hybridiztion, 12 and 24 hours after intravenous injection of TNF in rats. RESULTS: 1. The accumulation of SP-A mRNA in the TNF treated group (12 and 24 hours after TNF injection) was significantly decreased by 22.9% and 27.4%, respectively, compared to the control group (P < .025, P < .025). 2. The accumulation of SP-B mRNA in 24 hours after TNF treated group was significantly decreased by 20.5% compared to that of the control group (P<.01). 3. The accumulation of SP-C mRNA in 12 hours after treated group was significantly decreased by 31% the compared to that of the control group(P<.01). CONCLUSION: These findings indicate the marked inhibitory effects of tumor necrosis factor on surfactant proteins expression in vivo. This finding, in turn, supports the idea of inhibitory effects of tumor necrosis factor on surfactant proteins expression as it relates to pathogenesis of acute respiratory distress syndrome.
Subject(s)
Animals , Rats , Gene Expression , Injections, Intravenous , Lung Injury , Pulmonary Surfactant-Associated Protein A , Respiratory Distress Syndrome , RNA, Messenger , Tumor Necrosis Factor-alphaABSTRACT
Multiple symmetric lipomatosis ( Madelung's disease ) seems to represent a relatively common disease in Europe but has not been described in the Korean literature. It is characterized by highly typical symmetric deposits of subcutaneous fat on the neck, arms, and upper part of the trunk. The localized increase of adipose tissue is hyperplastic in nature and probably results from a local defect in adrenergic stimulated lipolysis. Multiple symmetric lipomatosis is frequently, but inconstantly, associated with alcoholism, liver disease, glucose intolerance, and hyperuricemia, but their etiologic role remains to be established. Clinical importance is the apparent high incidence of malignant tumors of the upper airways requiring through ear, nose, and throat and internal examination of all patients. Another importance is possibility of airway obstruction due to mass effect. Dietary treatment and weight loss are of limited value. Surgical treatment gives only temporary relief and should be restricted to patients with functional impairment. We report a case of a 63-year-old man with multiple symetric lipomatosis and alcoholism.
Subject(s)
Humans , Middle Aged , Adipose Tissue , Airway Obstruction , Alcoholism , Arm , Ear , Europe , Glucose Intolerance , Hyperuricemia , Incidence , Lipolysis , Lipomatosis , Lipomatosis, Multiple Symmetrical , Liver Diseases , Neck , Nose , Pharynx , Subcutaneous Fat , Weight LossABSTRACT
BACKGROUND: Bronchioloalveolar cell carcinoma today needs further studies as an early diagnosis will drastically improve the chances of cure. METHODS: Twenty-four cases of bronchioloalveolar cell carcinoma for the period of 5 years were studied in terms of incidence, age, sex, underlying diseases, symptoms, radiographic findings, Methods of diagnosis, clinical and pathologic staging, Methods of treatment, and survival retrospectively. RESULTS: No correlation was found between patients' age, sex, and underlying diseases. Most common symptoms were cough(62.5%), chest pain(29.2%), and sputum(29.2%). Of the 24 cases, 13 patients(54.2%) had solitary nodule, 6 patients(25%) had multiple nodules. At the time of diagnosis, 3 patients(12.5%) had the stage I diseases, 3 patients(12.5%) had the stage II diseases, 4 patients(16.7%) had the stage III diseases, 3 patients(12.5%) had the stage IIIb diseases, and 11 patients(45.8%) had the stage IV diseases. 14 cases(58.3%) were found inoperable at the time of admission; they all died within 17 months. In 7 cases with stage I, II, IIIa diseases curative resection were attempted, in 1 case with stage IV disease wedge resection for palliative management was performed, and in 4 cases patients were still alive at the time of Conclusion of this study. CONCLUSION: We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.
Subject(s)
Humans , Diagnosis , Early Diagnosis , Incidence , Retrospective Studies , ThoraxABSTRACT
A 49-year-old man with liver cirrhosis and hypertension was found to have hyperkalemia out of a degree of renal insufficiency and metabolic acidosis with low to normal anion gap, aggravated by volume contraction with diarrhea and medications (captopril, spironolactone and atenolol) interfering with potassium homeostasis. Plasma renin activity and serum aldosterone levels of this patient on a regular diet after discontinuation of medications were very low compared to those of five other cirrhotic patients with normokalemia as controls. Also, the renin-aldosterone stimulation testing on this patient performed by sodium restricted diet and furosemide, upright position and by angiotensin converting enzyme inhibition (captopril, 50 mg) showed the blunted renin and aldosterone responses to each of these stimuli, almost no changes from baseline renin and aldosterone levels, it was concluded that the underlying defect responsible for hyperkalemia in this case was hyporeninemic hypoaldosteronism and this was aggravated by other factors or drugs affecting potassium homeostasis.
Subject(s)
Humans , Male , Middle Aged , Aldosterone/blood , Captopril/pharmacology , Furosemide/pharmacology , Hyperkalemia/etiology , Hypertension/complications , Hypoaldosteronism/complications , Liver Cirrhosis/complications , Renin/bloodABSTRACT
BACKGROUND: The hypotensive effect of the lisinopril, a long acting angiotensin converting enzyme inhibitor, was studied. METHOD: 10mg of lisinopril was administered in 30 hypertensive Korean adults during twelve week after a weeks observation for washout with stepwise increments of the dose according to the patients blood pressure in every two weeks. RESULTS: The supine blood pressures were decreased from 173.3+/-27.9/105.7+/-19.4mmHg to 131.8+/-23.1mmHg/81.4+/-18.7mmHg at the end of twelve weeks durg therapy(P<0.05). The standing blood pressures were also decreased conferrably and to the some lower levels. Hematologic examination and blood chemistry revealed no discernible abnormal findings before and after the treatment. During the period of the study a few probably drug-related symptom such as dry cough and dry mouth developed but not troublesome enough to stop administering. CONCLUSION: Lisinopril 10mg once daily regimen is well tolerated and effective in the treatment of hypertensive patients.