One hundred patients with hyperventilation syndrome presenting to emergency department(ED) were studied. Those were diagnosed on clinical basis by emergency medical physician. The male to female ratio was 15 : 85. In monthly distribution, the numbers of patients were increased during the two months, June and July. The 41% of patients visited the emergency center from 9:00 p.m. to 3:00 a.m.. The most common predisposing factors were the domestic problems, especially those between husband and wife(37%). Presenting complaints were dyspnea(34), paresthesia(30), muscle spasm(24), dizziness(6) and palpitation(6 patients). The initial examination of the patients in the ED were as follows, systolic blood pressure(134+/-7.15mmHg), heart rate(87.67+/-14.34/minute), respiratory rate(22.21+/-3.34/minute) and body temperature(36.61+/-0.31 degrees C, n=98). Arterial blood gas analysis showed alkalemia(pH 7.51+/-0.09) and hypocapnia(PCO2 26.67+/-8.30mmHg). After emergency cares, including carbone dioxide re-breathing and antianxietics, most of the symptoms were disappeared. The mean duration of stay in ED was 3.27+/-0.23 hours. The most important considerations in diagnosis of hyperventilation syndrome was the patients's history and the effective management was carbon dioxide rebreathing for a few minutes and antianxietics.
Blood Gas Analysis ; Carbon ; Carbon Dioxide ; Causality ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Heart ; Humans ; Hyperventilation* ; Male ; Spouses

The Kallmanns syndrome is the most common form of isolated hypogonadotropic hypogonadism in which anosmia or hyposmia resulting from agenesis of hypoplasia of the olfactory lobes is associated with LHRH deficiency, This syndrome is genetically heterogeneous and can be trans-mitted as an X-linked, autosomal dominant or autosomal recessive trait. The hypogonadotropic hypogonadism results in absent or incomplete pubertal development and may be associated with anosmia or hyposmia, mid-line defect(color blindness, cleft-lip or
Blindness ; Cryptorchidism ; Epiphyses ; Femur Neck ; Gonadotropin-Releasing Hormone ; Growth Plate ; Head ; Humans ; Hypogonadism ; Kallmann Syndrome ; Male ; Olfaction Disorders ; Olfactory Cortex ; Slipped Capital Femoral Epiphyses

Purpose: The purpose of this pilot study was to assess the feasibility of a proposed study “To investigate the effects of applying a vibration stimulation to the paretic and non-paretic sides on balance and gait in stroke patients” before proceeding with the main study. Methods: A total of 30 patients who had suffered a stroke and who met the selection criteria participated in this study. However, only 14 patients completed the study. The study subjects were randomly assigned to vibration stimulation on either both sides (B group) or the paralyzed side (P group). The interventions were applied for six weeks. The patients were assessed using the Berg balance scale (BBS), Timed up and go (TUG), 10-meter walk (10 MW), and 6-minute walk (6 MW) tests. Results: There was a significant difference before and after the application of vibration stimulation in the BBS, TUG, 10MW, and 6 MW tests in the B group (p < 0.05). Similarly, there was also a significant difference observed in the 10 MW and 6 MW tests in the P group (p < 0.05). The difference between the two groups was not significant in the BBS, TUG, 10 MW, and 6 MW tests (p > 0.05). Conclusion This pilot study suggests that it would be feasible to conduct a large-scale randomized controlled trial (RCT) to examine the effects of applying a vibration stimulation to the paretic and non-paretic sides, on the balance and gait in stroke patients.

PURPOSE: To identify the inter-fractional shift pattern and to assess an adequate treatment margin in the radiotherapy of a liver tumor using mega-voltage computed tomography (MVCT) of a tomotherapy unit. MATERIALS AND METHODS: Twenty-six patients were treated for liver tumors by tomotherapy from April 2006 to August 2007. The MVCT images of each patient were analyzed from the 1st to the 10th fraction for the assessment of the daily liver shift by four groups based on Couinard's proposal. Daily setup errors were corrected by bony landmarks as a prerequisite. Subsequently, the anterior-, posterior-, right-, and left shifts of the liver edges were measured by maximum linear discrepancies between the kilo-voltage computed tomography (KVCT) image and MVCT image. All data were set in the 2-dimensional right angle coordinate system of the transverse section of each patient's body. RESULTS: The liver boundary shift had different patterns for each group. In group II (segment 2, 3, and 4), the anterior mean shift was 2.80+/-1.73 mm outwards, while the left mean shift was 2.23+/-1.37 mm inwards. In group IV (segment 7 and 8), the anterior-, posterior-, right-, and left mean shifts were 0.15+/-3.93 mm inwards, 3.15+/-6.58 mm inwards, 0.60+/-3.58 mm inwards, and 4.50+/-5.35 mm inwards, respectively. The reduced volume in group II after MVCT reassessment might be a consequence of stomach toxicity. CONCLUSION: Inter-fractional liver shifts of each group based on Couinard's proposal were somewhat systematic despite certain variations observed in each patient. The geometrical deformation of the liver by respiratory movement can cause shrinkage in the left margins of liver. We recommend a more sophisticated approach in free-breathing mode when irradiating the left lobe of liver in order to avoid stomach toxicity.

The survival rate and motility recovered after cryopreservation of testicular spermatozoa in testicular sperm extraction (TESE)-ICSl program is low. The purpose of this study was to assess the availability and efficiency of mouse empty zona pellucida in cryopreserving human TESE spermatozoa. Mouse empty zonae pellucidae were obtained by extraction of cytoplasm with or without cytochalasin B treatment. Motile sperm from proven-fertile donor and two azoospermic patients after TESE were individually inserted into empty zona pellucida and cryopreserved. Two to five days after cyropreservation, the frozen sperm were thawed and the rates of recovery and motility were observed. The ooplasmic extraction rates of control (N=80) and cytochalasin B treated oocytes (N=80) were 94.0% and 96.2%, respectively (p>0.05). The post-thaw recovery rates of spermatozoa and rates of motility recovery of ejaculate (N=70) and testicular (N=70) sperm were 97.1%, 97.1% and 95.7%, 94.3%, respectively (p>0.05). The results of this study showed that the mouse zone pellucida is useful for cryostorage of single testicular spermatozoa.
Animals ; Cryopreservation* ; Cytochalasin B ; Cytoplasm ; Herpes Zoster* ; Humans ; Mice* ; Oocytes ; Sperm Injections, Intracytoplasmic* ; Spermatozoa* ; Survival Rate ; Tissue Donors ; Zona Pellucida*

Purpose: To assess the effectiveness of the prostate health index (PHI) in patients with no index lesions on multiparametric magnetic resonance imaging (mpMRI) or with negative findings on past prostate biopsy if there was an index lesion on mpMRI. Materials and Methods: Patients without an index lesion on MRI or with a negative result on combined biopsy for index lesions were assessed. Patients who underwent transperineal mapping biopsy among those suspected of having prostate cancer (PCa) due to persistently elevated prostate-specific antigen (PSA) levels were analyzed. Results: Of the 291 patients, 82 (28.2%) were diagnosed with PCa. Sixty-five of 291 patients had negative finding in previous combined biopsy. In total, 226 patients did not have any index lesions. The mean age of the PCa group was 64.33±8.88 years and that of the non-cancer group was 59.88±10.26 years (p<0.001). The PHI was 46.75±28.22 in the PCa group and 37.74±17.37 in the noncancer group (p=0.001), and the prostate volume was 41.52±15.77 mL in the PCa group and 50.78±23.97 mL in the non-cancer group (p=0.001). In multivariate analysis, age (odds ratio [OR] 1.096, p<0.001), PHI (OR 1.021, p=0.005), and prostate volume (OR 0.954, p<0.001) were identified as significant factors for PCa detection. The optimal cutoff value of the PHI for PCa detection was 44.6 and the PHI density (PHID) was 0.88. Conclusions In patients with elevated PSA levels but no index lesions on mpMRI or negative biopsy findings, PHI and PHID demonstrated significant potential for improving PCa detection.

OBJECTIVES: In the third trimester hypertensive pregnancies, we would like to evaluate effects of white coat hypertension, severity of hypertension and diurnal variation of blood pressure on the fetal outcome by using 24- hour ambulatory blood pressure monitoring. METHODS: Hypertensives(n=50) and normotensives (n=14) in the third trimester of the pregnancy underwent 24-hour ambulatory blood pressure monitoring. We excluded hypertensives(n=5) who became pre-eclampsia patients. Hypertensives(n=45) were classified as white coat hypertensives(n=14, mean ambulatory blood pressure <139/87mmHg) and sustained hypertensives(n=31). Sustained hypertensives(n=31) were divided as moderate to severe hypertensives(n=5, systolic blood pressure >160 mmHg or diastolic blood pressure >100mmHg) and mild hypertensives(n=26). Sustained hypertensives were also divided into two groups which had diurnal variation of blood pressure or not. To exclude effects of hypertension severity, effects of diurnal variation were evaluated in hypertensives with similar mean arterial blood pressure. Gestational age, body weight, body weight for gestational age were used as parameters of the fetal outcome. RESULTS: 1) The prevalence of white coat hypertension was 28%(14/50). 2) There were no significant differences in the fetal outcome between normotensives(n=14) and white coat hypertensives(n=14). 3) Body weight of fetus and body weight for gestational age in moderate to severe hypertensives(n=5) were less than those of mild hypertensives(n=26), but gestational age was not significantly different between two groups. 4) Body weight of fetus and body weight for gestational age in sustained hypertensives without diurnal variation(n=10) were less than those with diurnal variation(n=8), but gestational age was not significantly different between two groups. 5) All hypertensives who became pre-eclampsia (n=5) were severe hypertensives and had no diurnal variation of blood pressure. CONCLUSION: White coat hypertension in the third trimester was quite often and did not affect on the fetal outcome. The more severe hypertension and/or absence of diurnal variation of blood pressure caused poor fetal outcome. Patients who became pre-eclampsia were severe hypertensives and had no diurnal variation of blood pressure. Ambulatory blood pressure monitoring may have several roles in the antenatal management of hypertenison.
Arterial Pressure ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Body Weight ; Female ; Fetus ; Gestational Age ; Humans ; Hypertension ; Pre-Eclampsia ; Pregnancy Trimester, Third ; Pregnancy* ; Prevalence ; White Coat Hypertension

PURPOSE: To assess the diagnostic value of dynamic perfusion MR imaging for differentiation between benign and malignant musculoskeletal lesions. MATERIALS AND METHODS: Dynamic perfusion MR imaging was performed using a 3.0 T system in 32 female and 30 male patients (aged 10-90 years, mean age, 43 years). Following the assessment of the precontrast imaging, a dynamic study was performed. This dynamic technique allowed for 638 images to be obtained at 11 levels throughout the lesion. Twenty-eight lesions originated within bone (8 benign, 20 malignant), whereas 34 lesions were of soft tissue origin (22 benign, 12 malignant). The final diagnosis was histopathologically confirmed in all patients. To differentiate between benign and malignant lesions, we analyzed the four parameters: (maximal relative enhancement (MRE), time to peak (TTP), wash in rate (WI), steepest slope (SS) and the distribution of time intensity curve (TIC) patterns. RESULTS: The TTP, WI, and SS values of malignant lesions were statistically significant from those of benign lesions (p < 0.05). However, the difference for the MRE values was not statistically significant. The distribution of TIC patterns was a helpful indicator of benign or malignant state, however the difference between the two states was not significant. CONCLUSION: Dynamic perfusion MR imaging is a helpful tool in differentiating benign and malignant musculoskeletal lesions.
Bone Neoplasms ; Female ; Humans ; Male ; Musculoskeletal Diseases ; Perfusion ; Soft Tissue Neoplasms ; Thymine Nucleotides ; Tics

This paper describes the epidemiological characteristics of bovine brucellosis in Korea during January 2000~September 2004, which encompasses the period when the incidence of bovine brucellosis increased abruptly. Data from the National Animal Infectious Disease Data Management System were used for this study. A range of epidemiological measures was calculated including annual herd and animal incidence. During the study period, there were 1,183 outbreaks on 638 farms. In beef cattle, annual herd incidence increased from 0.2 (2000) to 11.5 (2004, to September) outbreaks per 10,000 and annual animal incidence varied between 3.4 (2000) and 105.8 (2004, to September) per 100,000, respectively. On 401 (62.9%) infected farms during this period, infection was eradicated without recurrence. Recurrence of infection was significantly higher on farms where abortion was reported (53.3%), compared to farms where it was not (30.0%). On beef cattle farms, infection was introduced most frequently through purchased cattle (46.2%). Based on the results of this study, the establishment and spread of brucellosis in the Korean beef cattle population were mainly due to incomplete or inappropriate treatment of aborted materials and the movement of infected cattle.
Animals ; Brucellosis ; Brucellosis, Bovine ; Cattle ; Communicable Diseases ; Disease Outbreaks ; Incidence ; Korea ; Recurrence

OBJECTIVES: Delirium is a common postoperative complication in old adults associated with adverse events including functional decline, longer lengths of stay, and risk of institutionalization. The purpose of this study is to evaluate the incidence, preoperative, intraoperative, and postoperative risk factors of postoperative delirium in spine surgery. METHODS: Seventy-nine patients who underwent spine surgery were included. Preoperative assessments included current medical illness, number of comorbid problems, and the number of medications by past medical history, medical record, and interview with patients and caregivers. Intraoperative risk factors were evaluated. Laboratory data were checked preoperatively and postoperatively. The presence of delirium was determined by the Korean version of Delirium Rating Scale (K-DRS). RESULTS: Postoperative delirium was found in patients (7.6%). There was an association suggested between older age and postoperative delirium in spine surgery (p<0.05). An association was suggested between increasing numbers of medical conditions and postoperative delirium (p<0.05). Preoperative hemoglobin, hematocrit, sodium, potassium, calcium, albumin levels and postoperative hemoglobin and total protein levels were in the delirium group was significantly lower than those in control group (p<0.05). CONCLSION: This study showed that the postoperative delirium in spine surgery is not rare and several preoperative and postoperative factors are involved in the development of delirium. This pilot study is the first prospective trial in the area of postoperative delirium in spine surgery with a small sample size and short-term period, so further research with large sample size will be necessary.
Adult ; Aged ; Calcium ; Caregivers ; Delirium* ; Hematocrit ; Humans ; Incidence ; Institutionalization ; Medical Records ; Pilot Projects* ; Postoperative Complications ; Potassium ; Prospective Studies ; Risk Factors ; Sample Size ; Sodium ; Spine*