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Yonsei medical journal 8건

  1. [국내논문]   The changes in muscle strength and relaxation time after a comprehensive rehabilitation program for patients with myotonic dystrophy.  

    Moon, J H , Na, Y M , Kang, S W , Lee, H S
    Yonsei medical journal v.37 no.4 ,pp. 237 - 242 , 1996 , 0513-5796 ,

    초록

    Myotonic dystrophy is a muscular disorder characterized by muscle weakness and myotonia. Myotonia manifests with abnormally slow relaxation after strong voluntary contraction of the muscles. In our previous study we reported that quinine sulfate provided therapeutic benefit to myotonia and a home exercise program based on muscle strengthening exercises improved muscle strength. The purpose of this study was to determine the effect of a multi-therapeutic program in patients with myotonic dystrophy. For six months, seven patients with myotonic dystrophy received heat therapy, were given psychologic intervention using relaxation techniques, were trained at home, and were given quinine sulfate. The changes in muscle strength and relaxation time between the post-six-months home exercise program combined with quinine sulfate therapy, and the post-six months multi-therapeutic program, were assessed from the first dorsal interossei, the elbow flexors, and the knee extensors. The results were as follows: 1) The mean muscle strength of the each of the three muscles after the six months multi-therapeutic program was improved but was not significant compared with the post-six-months home exercise program combined with quinine sulfate therapy. 2) The mean relaxation time of each of the three muscles after the six months multi-therapeutic program was significantly reduced compared with the home exercise program combined with quinine sulfate therapy. In conclusion, the multi-therapeutic program undertaken in this study was the better program for the patients with myotonic dystrophy.

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  2. [국내논문]   Nodal metastasis in the distal mesorectum: need for total mesorectal excision of rectal cancer.  

    Choi, J S , Kim, S J , Kim, Y I , Min, J S
    Yonsei medical journal v.37 no.4 ,pp. 243 - 250 , 1996 , 0513-5796 ,

    초록

    Locoregional failure of rectal cancer is a troublesome problem and a major cause of morbidity and mortality following curative surgery. The mesorectum has been regarded as an important site in local failure after surgery of rectal cancer. Total mesorectal excision (TME) has been raised by some colorectal surgeons to prevent early local recurrence. This study was performed to ascertain the incidence of metastatic lymph nodes in the distal mesorectum (DMR) of the colorectal cancer patient. We also examined the clinicopathologic risk factors of distal mesorectal metastasis. Eight of 53 patients had positive metastatic lymph nodes in DMR. Twenty-seven patients were Dukes B and 26 patients were Dukes C stage. Out of 26 Dukes C patients, 8 patients (30.8%) had metastatic lymph nodes in the DMR. However, there was no significant difference in risk factors between DMR positive and DMR negative patients with Dukes C stage. In conclusion, the incidence of metastatic lymph nodes in DMR was about 30.8%, therefore the mesorectum especially the DMR should be removed completely by total mesorectal excision to eradicate the metastatic lymph nodes which may cause local recurrence.

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  3. [국내논문]   Changes in intracellular Ca2+ concentration of rabbit coronary artery smooth muscle cell during ischemic cardioplegic period.  

    Lee, Y H , Choi, G B , Ahn, D S , Kang, B S
    Yonsei medical journal v.37 no.4 ,pp. 251 - 261 , 1996 , 0513-5796 ,

    초록

    To elucidate the possibility whether an elevation of intracellular Ca2+ concentration ([Ca2+]i) in rabbit coronary artery myocytes during ischemic cardioplegic period may serve as one of the mechanisms of the "no-reflow' phenomenon or not, the changes in [Ca2+]i were measured under ischemic cardioplegia conditions using a fluorescent Ca2+ indicator, fura 2/AM. When single cells were perfused with cardioplegic or ischemic cardioplegic solutions, [Ca2+]i was significantly increased and the degree of [Ca2+]i elevation was further augmented by the ischemic cardioplegic solution. Pretreatment of a sarcoplasmic reticulum emptying agent, 20 mM caffeine, had no effect on ischemic cardioplegia-induced [Ca2+]i changes, but application of a Ca2+ channel blocker, 5 x 10 (-1)M nifedipine, or an antagonist of Na+/Ca2+ exchange, 5 mM Ni2+, significantly inhibited the [Ca2+]i elevation, respectively. The magnitude of ischemic cardioplegia-induced [Ca2+]i elevation was dependent on the Ca2+ concentration of perfusate in the range of 0 and 25 mM. When Ni2+ was added to the reperfusion solution, recovery of ischemic cardioplegia-induced [Ca2+]i elevation was very rapid compared with the controls. It is concluded that ischemic cardioplegia-induced [Ca2+]i elevation may serve as one of the mechanisms of the "no-reflow' phenomenon in rabbit coronary artery smooth muscle cells. We propose that Na+/Ca2+ exchange may serve as a key function in ischemic cardioplegia-induced [Ca2+]i elevation.

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  4. [국내논문]   Hemodynamic characteristics of extracellular UTP in the perfused rat liver.  

    Kong, I D , Chung, H S , Park, K S , Han, J K , Lee, J W
    Yonsei medical journal v.37 no.4 ,pp. 262 - 269 , 1996 , 0513-5796 ,

    초록

    Uridine 5'-triphosphate (UTP) is stored in the granules of cells such as platelets and is released into the extracellular space upon cell stimulation. Extracellular UTP is known to influence many biological processes. We investigated the hemodynamic effects of UTP on the perfused rat liver and characterized its receptors. Liver perfusions were performed in a recirculation system under constant pressure (28 cmH2O). The perfusion flow and oxygen consumption rate were measured at 30 second intervals. UTP decreased the perfusion flow and the oxygen consumption rate, dose-dependently. UTP-induced changes were transient and disappeared in about 10 minutes. Suramin (P2-purinergic antagonist, 100 uM) and indomethacin (cyclooxygenase inhibitor, 20 uM) blocked UTP-induced hemodynamic changes significantly. The effects of UTP were also inhibited when Kupffer cells were damaged with treatment of gadolinium chloride (10 mg/kg iv). L-NAME (1 mM), a potent inhibitor of nitric oxide synthase, markedly enhanced and prolonged the contractile response of UTP in the hepatic vessel. These results suggest that UTP acts mainly on suramin-sensitive UTP receptors on the Kupffer cell through prostanoid synthesis. The nitric oxide systems in the endothelium seem to counteract the vasoconstrictile action of UTP in the hepatic circulation.

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  5. [국내논문]   Evaluation of therapeutic regimens for the treatment of Helicobacter pylori infection.  

    Lee, D H , Park, H J , Song, S Y , Lee, S J , Choi, W , Lee, Y C , Chung, J B , Kang, J K , Park, I S , Lee, Y H , Kim, H K
    Yonsei medical journal v.37 no.4 ,pp. 270 - 277 , 1996 , 0513-5796 ,

    초록

    Helicobacter pylori (H. pylori) is currently considered the most important exogenous factor in the genesis of gastritis and peptic ulcer disease. However, the optimum regimen for the eradication of H. pylori remains unclear. The purpose of this study was to evaluate the eradication rate of H. pylori, the side effects, and the patients' compliance with regard to various drug regimens. We also analyzed factors influencing the eradication of H. pylori. One hundred and eighty patients were included and divided into four groups: 42 patients (Group I) received tripotassium dicitrato bismuthate (240 mg b.i.d.), metronidazole (250 mg t.i.d.) and amoxicillin (500 mg t.i.d.) for 14 days; 55 patients (Group 2) received omeprazole (20 mg b.i.d.) and amoxicillin (1000 mg b.i.d.) for 14 days; 36 patients (Group 3) were treated with omeprazole (20 mg b.i.d.), metronidazole (250 mg t.i.d.) and amoxicillin (500 mg t.i.d.) for 14 days; and 47 patients (Group 4) received omeprazole (20 mg q.d.) and amoxicillin (500 mg t.i.d.) for 14 days and then tripotassium dicitrato bismuthate (240 mg b.i.d.) and nizatidine (150 mg q.d.) for 14 days. The diagnosis of H. pylori was made by histology. The eradication of H. pylori was defined both by histology (H&E and Giemsa stain) and by rapid urease test (CLOR) showing negative for H. pylori 4 weeks after the completion of therapy. Of the 180 patients, 95 patients had non-ulcer dyspepsia, 40 patients had gastric ulcer and 45 patients had duodenal ulcer. The eradication rate of H. pylori was highest (89.3%) in Group 3, as compared with Group 1 (68.9%), Group 2 (65.4%), and Group 4 (48.9%). The eradication rate was significantly higher in Group 3 than in Groups 2 and 4 (p

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  6. [국내논문]   The functional relationships between hiatal hernia and reflux esophagitis.  

    Park, H J , Lee, J D , Jung, J K , Moon, B S , Collins, P J , Park, I S
    Yonsei medical journal v.37 no.4 ,pp. 278 - 283 , 1996 , 0513-5796 ,

    초록

    The purpose of this research was to investigate functional studies by which the hiatal hernia (HH) may be relevant to a reflux esophagitis (RE). Group I consisted of healthy controls who were endoscopically normal (n = 21). Group II consisted of patients with hiatal hernia but no reflux esophagitis (n = 8). Group III had patients with hiatal hernia with reflux esophagitis (n = 9). Group IV had patients with reflux esophagitis but no hiatal hernia (n = 16). Esophageal manometry, ambulatory 24 hour intraesophageal pH monitoring, acid clearance test, and gastric emptying scan were performed in each of the patients. The contraction amplitude at 3 cm above the lower esophageal sphincter did not differ significantly among the four groups, but the mean lower esophageal sphincter pressure was significantly decreased in group II. The DeMeester score in ambulatory 24 hour intraesophageal pH monitoring was significantly higher in group III compared with the controls. No significant difference among the groups was found with respect to acid clearance. Total and proximal gastric emptying times (T1/2) were significantly delayed in group III. We found that hiatal hernia combined with delayed gastric emptying may bear a relationship to the multifactorial origins of reflux esophagitis, and we suggest a rationale for using prokinetic agents as the therapeutic regimen in patients with HH complicated by RE.

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  7. [국내논문]   Adenomyoepithelioma of the breast--its diagnostic problems and histogenesis.  

    Choi, J S , Bae, J Y , Jung, W H
    Yonsei medical journal v.37 no.4 ,pp. 284 - 289 , 1996 , 0513-5796 ,

    초록

    We report three cases of adenomyoepithelioma of the breast that occurred in middle aged women. The tumor is characterized by a balanced proliferation of epithelial tubules and surrounding myoepithelial cells that are spindle shaped or have clear cytoplasms. The first case mimicked tubular adenoma in the initial biopsy. However, on excision it turned out to be an adenomyoepithelioma of the tubular. The other two cases were lobulated types and had fibroadenomatous areas. The morphologic appearance of this tumor varies, making it misleading to other benign or even malignant lesions. The tumor has a potential for local recurrence, therefore, wide excision is recommended for proper diagnosis and treatment.

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  8. [국내논문]   Linear and whorled nevoid hypermelanosis with delayed psychomotor development.  

    Yim, S Y , Lee, I Y , Rah, U W , Moon, H W , Hahn, S H , Lee, E S , Yim, H L
    Yonsei medical journal v.37 no.4 ,pp. 290 - 294 , 1996 , 0513-5796 ,

    초록

    We report a case of a 25-month-old girl presented to us for the evaluation of a severe delayed psychomotor development who also has pigmentary abnormalities. Linear and whorled hyperpigmentations following Blaschko's lines were noticed on her entire body except on her face, palms, soles, eyes and mucous membranes, which closely resembled those found in hypomelanosis of Ito, but inversely pigmented. Histologic examination revealed basal layer hyperpigmentation without incontinence of pigment or dermal melanophages. Chromosomal analysis of cultured peripheral leukocytes and fibroblasts from the hyperpigmented and the hypopigmented skin revealed normal female karyotype with no evidence of mosaicism or chimerism. This entity represents a kind of neurocutaneous syndrome-referred to by some authors as linear and whorled nevoid hypermelanosis.

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