No abstract available.
Hearing* ; Humans ; Tinnitus*

No abstract available.
Otoacoustic Emissions, Spontaneous*

'I'he adult form of myasthenia gravis (MG) is an autoimmune disorder characterized by the presence of anti-acetylcholine receptor immunoglobulin G antibodies (anti-ACHRIgG) which blocks the formation of acetylcholine at the motor end plate and causes anatomic deterioration of this structure. 'I'he end result is defective neuromuscular transmission manifested by progressive skeletal muscle weakness. We have experienced a full term pregnancy complicated with the myasthenia gravis. We experienced a case of myathenia gravis associated with pregnancy who underwent cesarean section. The case is presented here with a brief review of literatures concerned.
Acetylcholine ; Adult ; Antibodies ; Cesarean Section ; Female ; Humans ; Immunoglobulin G ; Motor Endplate ; Muscle, Skeletal ; Myasthenia Gravis ; Pregnancy*

Background & Objective: Although the clinical manifestations and outcomes of neuralgic amyotrophy have been previously described, some controversies remain. Thus, we evaluated clinical manifestations and outcomes of patients with neuralgic amyotrophy. Methods: We evaluated the clinical and electrodiagnostic data, and the outcomes, of 32 patients with neuralgic amyotrophy.Of the 32 patients, 26 were followed-up for one year after onset of the disease.Results:The initial symptoms were pain (50.0%), pain with weakness (21.9%), other sensory symptoms without weakness (6.3%), and painless weakness or atrophy (21.9%). The commonly involved nerves were the median (75.0%), radial (68.8%), suprascapular (50.0%), ulnar (50.0%), axillary (46.9%), and musculocutaneous (40.6%) nerves. The initial symptoms were not associated with nerve involvement. Of all patients, 59% recovered fully, 16% had residual mild weakness without functional disability, and 6% experienced persistent severe weakness and were unable to return to work. Some patients were not evaluated because they were lost to follow-up. Conclusions: Painless weakness as an initial symptom of neuralgic amyotrophy may be more common than previously noted. Of all patients, 75% enjoyed favorable outcomes by one year after disease onset. These results will be useful when planning treatment strategies and will deepen our understanding of prognosis of neuralgic amyotrophy.
Brachial Plexus Neuritis

BACKGROUND: Coronary artery spasm is an important mechanism in producing myocardial ischemia. But the exact mechanism of the spasm is not well known. We investigated the mutation of endothelial nitric oxide synthase (eNOS) that produce nitric oxide and relationship between eNOS mutation and coronary artery spasm. MATERIALS AND METHODS: Blood were drawn from the patients with angiographically proven coronary artery spasm and normal controls. DNA were extracted and polymerase chain reaction and restriction analysis with Nae I were performed to find T-786-- Cholesterol ; Chungcheongnam-do ; Coronary Vessels* ; DNA ; Female ; Humans ; Incidence* ; Korea ; Male ; Myocardial Ischemia ; Nitric Oxide ; Nitric Oxide Synthase Type III ; Polymerase Chain Reaction ; Prevalence ; Smoke ; Smoking ; Spasm* ; Triglycerides

BACKGROUND: Coronary artery spasm is an important mechanism in producing myocardial ischemia. But the exact mechanism of the spasm is not well known. We investigated the mutation of endothelial nitric oxide synthase (eNOS) that produce nitric oxide and relationship between eNOS mutation and coronary artery spasm. MATERIALS AND METHODS: Blood were drawn from the patients with angiographically proven coronary artery spasm and normal controls. DNA were extracted and polymerase chain reaction and restriction analysis with Nae I were performed to find T-786-- Cholesterol ; Chungcheongnam-do ; Coronary Vessels* ; DNA ; Female ; Humans ; Incidence* ; Korea ; Male ; Myocardial Ischemia ; Nitric Oxide ; Nitric Oxide Synthase Type III ; Polymerase Chain Reaction ; Prevalence ; Smoke ; Smoking ; Spasm* ; Triglycerides

Infective endocarditis is the infectious disease that produces vegetation on endocardium. Acute bacterial endocarditis is most frequently caused by Staphylococcus aureus, occurs on a normal heart valve, and subacute endocarditis usually caused by Streptococcus viridans occurs on damaged valves. Gemella haemolysans are gram-positive cocci that is placed in the family Streptococcaceae. As opportunistic pathogen, Gemella haemolysans are able to cause severe localized and generalized infections and it is known that this organism very rarely causes infective endocarditis. The paucity of reports concerning Gemella haemolysans is probably related to the difficulties associated with their identification. Several laboratory tests to prevent misinterpretation of this organism are now suggested. We have experienced a case of infective endocarditis that is caused by Gemella haemolysans in 37 year old male patient with ventricular septal defect. Gemella haemolysans were detected by blood culture and he was treated with intravenous vancomycin with gentamicin and ceftriaxone, and also underwent cardiac surgery. This is the first case of Gemella haemolysans endocarditis of ventricular septal defect in Korea.
Adult ; Ceftriaxone ; Communicable Diseases ; Endocarditis* ; Endocarditis, Bacterial ; Endocardium ; Gemella* ; Gentamicins ; Gram-Positive Cocci ; Heart Septal Defects, Ventricular* ; Heart Valves ; Humans ; Korea ; Male ; Staphylococcus aureus ; Streptococcaceae ; Thoracic Surgery ; Vancomycin ; Viridans Streptococci

We have determined and analyzed the full-length cDNA sequence of a coxsackievirus B3 (CVB3) Korean isolate (CVB3-Korea/97) which has been known as a general human pathogen. The whole genome contains 7,400 nucleotides and has a single large open reading frame with 6,555 nucleotides that encodes a potential polyprotein precursor of 2,185 amino acids. The genome also contains a 5' non-coding region (NCR) of 741 bases and a 3' NCR of 104 bases followed by poly(A) tail. Sequence homologies of nucleotides and deduced amino acids between the CVB3-Korea/97 strain and the prototype (Nancy strain) were 81.7% and 91.5%, respectively. The genes encoding the functional proteins including viral protease and RNA dependent RNA polymerase showed higher homology than those encoding the structural proteins. We have further analyzed the sequences of 5' NCR, VP1 and VP2 of CVB3-Korea/97, which are known as cardiovirulent determining factors at the nucleotide and amino acid levels. Although the CVB 3-Korea/97 strain was isolated from an aseptic meningitis patient without cardiomyopathy, its 234th nucleotide and 165th amino acid were uracil and Asn as same as those of other cardiovirulent strains one. However, the 155th amino acid of VR1, which closely associated with cardiovirulence, was replaced with Arg155 by single nucleoptide substitution from A2916 to T2916. Moreover, additional amino acid substitutions were observed in the flanking region of Asp155. Taken together, aminoacid(s) substitution in VP1 may play a critical role in determining cardiovirulence of the CVB3-Korea/97 strain rather than individual nucleotide replacements in the 5' NCR and/or an amino acid substitution in VP2.
Amino Acid Substitution ; Amino Acids ; Cardiomyopathies ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary* ; Genome ; Humans ; Korea* ; Meningitis, Aseptic ; Nucleotides ; Open Reading Frames ; RNA Replicase ; RNA, Messenger ; Sequence Analysis* ; Sequence Homology ; Uracil

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

PURPOSE: This study was performed to investigate the effects of intravesical instillation of cyclooxygenase-2 (COX-2) inhibitors on the cyclophosphamide-induced overactive bladder. MATERIALS AND METHODS: The 40 Sprague-Dawley rats were divided into 3 groups; the control group, the overactive group, and the COX-2 inhibitor treated group. Cystometrograms (CMG) were performed and the contraction interval, inter-contraction interval, contraction time and contraction pressure were measured. After CMG, the bladders of each group were dissected out, and weighed. RESULTS: On CMG, the contraction interval and inter-contraction interval for the overactive group were significantly decreased compared with the control group. After treatment with COX-2 inhibitor, the contraction interval and inter-contraction interval were significantly increased compared with the overactive group (p<0.05). The contraction time in the overactive group was significantly increased compared with the control group, and it was also decreased in the COX-2 inhibitor treated group compared with the overactive group (p<0.05). The contraction pressure in the overactive group and the COX-2 inhibitor treated group were significantly increased compared with the control group. There were no significant differences between the overactive and COX-2 inhibitor treated groups. The bladder weights of the overactive and COX-2 inhibitor treated groups were significantly increased compared with the control group (p<0.05). CONCLUSIONS: Intravesical instillation of COX-2 inhibitor can suppress cyclophosphamide-induced detrusor overactivity. Therefore, intravesical instillation of COX-2 inhibitor may be considered as a possible treatment for the overactive bladder.
Administration, Intravesical* ; Cyclooxygenase 2 Inhibitors ; Cyclooxygenase 2* ; Cyclophosphamide ; Rats, Sprague-Dawley ; Urinary Bladder ; Urinary Bladder, Overactive* ; Weights and Measures