No abstract available.
Rectal Prolapse* ; Surgical Procedures, Operative*

The paraproteinemia is a disorder in which a single clone of plasma cells (monoclonal gammopathy) is responsible for the proliferation of monoclonal proteins (M-proteins). Approximately 10% of patients with idiopathic peripheral neuropathy have monoclonal gammopathy. Some M-proteins have the properties of an antibody to the components of peripheral nerve myelin, but the pathophysiological relationship between the neuropathy and the M-protein is often obscure. The relationship between peripheral neuropathy and monoclonal gammopathy requires the appropriate neurological and hematological investigations for precise diagnosis and treatment. In this review, we provide an update on the causal associations between peripheral neuropathy and monoclonal gammopathy as well as characteristics of clinical and electrophysiologic features.
Clone Cells ; Diagnosis ; Humans ; Myelin Sheath ; Paraproteinemias ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Plasma Cells ; Polyneuropathies

Free radicals, formed by ionization of water molecules, cause significant increase of morbidity and mortality in irradiated humans. The skeletal muscle is relatively radio-resistant because of its few content of proliferating cells. But the incidence and severity of muscular damage depends on the dose of radiation and time lapse. This study is aimed to investigate the ultrastructural changes and the effect of radiation and DMTU on two muscles, the tibialis anterior and the soleus muscle; the former is dominantly composed of white muscles while the latter is mainly composed of red muscles. Each muscle also show differences in energy production and distribution of capillaries. The male Sprague-Dawley rats weighing from 200 g to 250 g were used as experimental animals. Under urethane(1.15 g/kg, i.p.) anesthesia, 30Gy irradiation to lower extremities with PICKER-C9 cobalt 60 teletherapy unit was done. DMTU(500 mg/kg, i.p.) was administered 1 hour prior to irradiation. The animals were sacrificed 1 day, 3 days, 7 days, 2 weeks, and 4 weeks after irradiation. The muscular tissues in midbelly of tibialis anterior and the soleus muscles were obtained and sliced into 2 mm in length, 1 mm in width and thickness. The specimens were prepared by routine method for electron microscopy. The results obtained were as follows: 1. Widening of interfibrillar space, mitochondrial changes of eletron-lucent matrix and dilated cristae, and cisternal dilatation of sarcoplasmic reticulum were observed in both muscles after irradiation. More severe ultrastructural changes with time course were observed by 2 weeks. But those were recovered to normal at 4 weeks after irradiation. 2. More severe ultrastructural changes in soleus were observed 1 and 3 days after irradiation, and in tibialis anterior at 7 days and 2 weeks. Those findings were associated with reduction of glycogen contents in the myofibers of both muscles. 3. Widening of intermyofibrillar space, mitochondrial changes of electron-lucent matrix and indistinct cristae, and cisternal dilatation of sarcoplasmic reticulum were observed in both muscles after DMTU treatment. 4. Pretreatment of DMTU attenuated the ultrastructural changes induced by irradiation. Those were recoved normally by 2 weeks. Consequently, DMTU attenuates the ultrastructural changes in tibialis anterior and soleus muscle after irradiation. The more severe morphological changes in soleus muscle at 1 day and 3 days, and in tibialis anterior at 7 days and 2 weeks after irradiation are associated with the reduction of glycogen contents.
Anesthesia ; Animals ; Capillaries ; Cobalt ; Dilatation ; Free Radicals ; Glycogen ; Humans ; Incidence ; Lower Extremity ; Male ; Microscopy, Electron ; Mortality ; Muscle, Skeletal ; Muscles* ; Rats* ; Rats, Sprague-Dawley ; Sarcoplasmic Reticulum

No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

BACKGROUND: The diagnosis of malaria has been usually made using microscopic examination of Wright stained thin blood films in Korean army. This method is labor-intensive, time consuming and requires the microscopic expertise. Therefore, the alternative techniques, rapid diagnostic test, have been sought for use in Korean army. We performed a comparison of the OptiMAL test with GENEDIA Malaria (P. vivax) Ab Rapid I, II to assess its sensitivity and specificity of Plasmodium vivax malaria. METHODS: Blood specimen were collected from 51 patients who were presented and initially diagnosed for P. vivax by the microscopy of blood smears and from 30 control patients without malaria infection at the Capital Armed Forces General Hospital (CAFGH) between October 2000 and February 2001. Among the 51 patients, we also collected 24 samples from 24 patients at 2 or 3 days after therapy. The OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid I, II were performed according to the manufacturer's instructions on all samples respectively. RESULTS: Compared with the blood film, sensitivities and specificities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II were 94.1~100% (29/29), 80.4~83.3%, 96.1~96.7% respectively. One case was interpreted as 'undetermined' by OptiMAL test. In 24 patients during therapy, the sensitivities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II on 8 specimens with mean 120/microliter parasitemia and 16 specimens with negative parasitemia were 75~43.8%, 87.5~81.3%, 100~100% respectively. CONCLUSION: Our data demonstrated that the sensitivity and specificity of the GENEDIA Malaria (P. vivax) Ab Rapid I were not satisfactory, but the sensitivity and specificity of the OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid II were relatively high and useful diagnostic tests for diagnosis of P. vivax in areas like the militaries where laboratory facilities are poor or non-existent.
Arm ; Diagnosis* ; Diagnostic Tests, Routine ; Hospitals, General ; Humans ; Malaria* ; Malaria, Vivax ; Microscopy ; Military Personnel* ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Sensitivity and Specificity

BACKGROUND: Vivax malaria reemerged in the Republic of Korea in 1993. Since 1993, many cases with malaria have been reported. But due to the antimalarial activities including chemoprophylaxis and repellents, the annual incidence of malaria has been decreased. Antimalarial chemoprophylaxis is effective to control disease, but will facilitate the spread of drug-resistance or drug-tolerance. Thus, it is needed to analyze the effect of treatment outcome. METHODS: We analyzed the patients diagnosed as vivax malaria who readmitted in military hospital from 1997 to 2003. All cases were confirmed as malaria by peripheral blood smear in military hospital. RESULTS: Forty-five cases were observed in second attack and three cases were observed in third attack. All cases were vivax malaria with fever, and tertian fever developed in 25 cases (55.5%) in first attack, 22 cases (48.8%) in second attack. Various distribution of the interval between first attack remission and second attack was observed (from 8 days to 37 months). Of the all cases, 41 cases (91.1%) developed malaria between May and October in first attack, 39 cases (86.6%) in second attack. Readmission rate were 0.68%. CONCLUSION: We observed that only 45 of 6,566 (0.68%) cases were readmitted. The treatment of vivax malaria in Korea Army is effective in controlling malaria and should be cotinued. But continued surveillance with veterans and with or without chemoprophylaxis are warranted to eliminate the spread of the disease.
Chemoprevention ; Fever ; Hospitals, Military* ; Humans ; Incidence ; Korea ; Malaria ; Malaria, Vivax* ; Military Personnel* ; Patient Readmission ; Plasmodium vivax ; Republic of Korea ; Treatment Outcome ; Veterans

BACKGROUND: Nasotracheal intubation is one of techniques of airway management that is essential for the emergency physician to master. It is very important to determine the optimal initial depth of tube in nasotracheal intubation, prior to obtaining a chest radiograph. The average distance from the external naris to the carina is 32cm in the adult male and 27 to 28cm in the adult female in American. We thought that this distance would be inappropriate to Korean adults because of the difference of body habitus. So we studied the proper depth of nasotracheal tube in korean adults and evaluated the factors influencing to that distance. METHODS: A prospective study was performed to determine the distance from the external naris to the carina in 127 Korean adults examined by flexible fiberoptic bronchoscopy from October 1998 to August 1999. In addition, the influence of age, height and weight to that distance was evaluated in korean adults. RESULT:S: The distance from the external naris to the carina in Korean adults was 31.0 +/-1.3 cm in male and 27.6 +/-1.6 cm in female. That distance was positive related to height and weight, but not to age. CONCLUSION: If the tip of the nasotracheal tube be placed at 2cm above the carina, proper depth of nasotracheal tube should be 29cm in male and 26cm in female in Korean adults. And the distance from the external naris to the carina was related to height and weight.
Adult* ; Airway Management ; Bronchoscopy ; Emergencies ; Female ; Humans ; Intubation ; Male ; Prospective Studies ; Radiography, Thoracic

Nephrocalcinosis is described as the deposition of calcium crystals in the renal parenchyma that result from prolonged states of hypercalcemia. Recently recognized is the deposition of calcium phosphate in the renal tubular injury by using sodium phosphate cathartics commonly used for the colonic cleansing. This phenomenon was termed phosphate nephropathy. Acute renal failure secondary to phosphate nephropathy has been increasingly recognized as a complication after the administration of sodium phosphate solution for colonoscopy. We report a case of acute phosphate nephropathy following oral sodium phosphate solution to cleanse the bowel for colonoscopy. A renal biopsy showed diffuse tubular calcium deposition.
Acute Kidney Injury ; Biopsy ; Calcium ; Calcium Phosphates ; Cathartics ; Colon ; Colonoscopy ; Hypercalcemia ; Nephrocalcinosis ; Phosphates ; Renal Insufficiency ; Sodium

BACKGROUND AND OBJECTIVES: Acoustic pharyngometry is a relatively new noninvasive method that quantifies the geometrically complex oropharyngeal dimensions. We aimed this study to investigate the predictability and usefulness of acoustic pharyngometry in the diagnosis of obstructive sleep apnea (OSA). SUBJECTS AND METHOD: We conducted a prospective clinical trial in consecutive 49 patients with snoring or sleep apnea. Polysomnography was used to determine whether the patient had OSA. All subjects were examined by acoustic pharyngometry in sitting, supine, and both lateral recumbent positions while awake with tidal breathing. Morphometric oral cavity measurements were obtained and the Kushida index was calculated for each patient. RESULTS: Upper-airway cross-sectional areas measured by acoustic pharyngometry were significantly smaller in patients with OSA than in subjects without OSA. Especially, the oropharyngeal junction area (OPJ) in supine position was the most prominent parameter to discriminate between them. CONCLUSION: Acoustic pharyngometry can be a clinically useful tool for localizing the upper-airway obstruction and for predicting obstructive sleep apnea.
Acoustics* ; Diagnosis ; Humans ; Mouth ; Polysomnography ; Prospective Studies ; Respiration ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Supine Position

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Anti-Bacterial Agents ; Delayed Diagnosis ; Mediastinitis ; Mediastinum ; Sepsis